Hypothesis and theory: mechanical instabilities and non-uniformities in hereditary sarcomere myopathies

A novel equation that incorporates the linear and hyperbolic nature of the force-velocity relationship in lower and upper limb exercises

The purpose of this study is to provide a force-velocity (F-V) equation that combines a linear and a hyperbolic region, and to compare its derived results to those obtained from linear equations. A total of 10 cross-training athletes and 14 recreationally resistance-trained young men were assessed in the unilateral leg press (LP) and bilateral bench press (BP) exercises, respectively. F-V data were recorded using a force plate and a linear encoder. Estimated maximum isometric force (F₀), maximum muscle power (P_max), and maximum unloaded velocity (V₀) were calculated using a hybrid (linear and hyperbolic) equation and three different linear equations: one derived from the hybrid equation (linear_hyb), one applied to data from 0 to 100% of F₀ (linear_0-100), and one applied to data from 45 to 100% of F₀ (linear_45-100). The hybrid equation presented the best fit to the recorded data (R² = 0.996 and 0.998). Compared to the results derived from the hybrid equation in the LP, significant differences were observed in F₀ derived from linear_0-100; V₀ derived from linear_hyb, linear_0-100 and linear_45-100; and P_max derived from linear_hyb and linear_45-100 (all p < 0.05). For the BP, compared to the hybrid equation, significant differences were found in F₀ derived from linear_0-100; and V₀ and P_max derived from linear_hyb, linear_0-100 and linear_45-100 (all p < 0.05). An F-V equation combining a linear and a hyperbolic region showed to fit adequately recorded F-V data from ~ 20 to 100% of F₀, and overcame the limitations shown by linear equations while providing relevant results.

Critical Evaluation of Current Hypotheses for the Pathogenesis of Hypertrophic Cardiomyopathy

Hereditary hypertrophic cardiomyopathy (HCM), due to mutations in sarcomere proteins, occurs in more than 1/500 individuals and is the leading cause of sudden cardiac death in young people. The clinical course exhibits appreciable variability. However, typically, heart morphology and function are normal at birth, with pathological remodeling developing over years to decades, leading to a phenotype characterized by asymmetric ventricular hypertrophy, scattered fibrosis and myofibrillar/cellular disarray with ultimate mechanical heart failure and/or severe arrhythmias. The identity of the primary mutation-induced changes in sarcomere function and how they trigger debilitating remodeling are poorly understood. Support for the importance of mutation-induced hypercontractility, e.g., increased calcium sensitivity and/or increased power output, has been strengthened in recent years. However, other ideas that mutation-induced hypocontractility or non-uniformities with contractile instabilities, instead, constitute primary triggers cannot yet be discarded. Here, we review evidence for and criticism against the mentioned hypotheses. In this process, we find support for previous ideas that inefficient energy usage and a blunted Frank–Starling mechanism have central roles in pathogenesis, although presumably representing effects secondary to the primary mutation-induced changes. While first trying to reconcile apparently diverging evidence for the different hypotheses in one unified model, we also identify key remaining questions and suggest how experimental systems that are built around isolated primarily expressed proteins could be useful.

Stochastic allelic expression as trigger for contractile imbalance in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM), the most common inherited cardiac disease, is caused by several mostly heterozygous mutations in sarcomeric genes. Hallmarks of HCM are cardiomyocyte and myofibrillar disarray and hypertrophy and fibrosis of the septum and the left ventricle. To date, a pathomechanism common to all mutations remains elusive. We have proposed that contractile imbalance, an unequal force generation of neighboring cardiomyocytes, may contribute to development of HCM hallmarks. At the same calcium concentration, we found substantial differences in force generation between individual cardiomyocytes from HCM patients with mutations in β-MyHC (β-myosin heavy chain). Variability among cardiomyocytes was significantly larger in HCM patients as compared with donor controls. We assume that this heterogeneity in force generation among cardiomyocytes may lead to myocardial disarray and trigger hypertrophy and fibrosis. We provided evidence that burst-like transcription of the MYH7-gene, encoding for β-MyHC, is associated with unequal fractions of mutant per wild-type mRNA from cell to cell (cell-to-cell allelic imbalance). This will presumably lead to unequal fractions of mutant per wild-type protein from cell to cell which may underlie contractile imbalance. In this review, we discuss molecular mechanisms of burst-like transcription with regard to contractile imbalance and disease development in HCM.

On the Shape of the Force-Velocity Relationship in Skeletal Muscles: The Linear, the Hyperbolic, and the Double-Hyperbolic

The shape of the force-velocity (F-V) relationship has important implications for different aspects of muscle physiology, such as muscle efficiency and fatigue, the understanding of the pathophysiology of several myopathies or the mechanisms of muscle contraction per se, and may be of relevance for other fields, such as the development of robotics and prosthetic applications featuring natural muscle-like properties. However, different opinions regarding the shape of the F-V relationship and the underlying mechanisms exist in the literature. In this review, we summarize relevant evidence on the shape of the F-V relationship obtained over the last century. Studies performed at multiple scales ranging from the sarcomere to the organism level have described the concentric F-V relationship as linear, hyperbolic or double-hyperbolic. While the F-V relationship has most frequently been described as a rectangular hyperbola, a large number of studies have found deviations from the hyperbolic function at both ends of the F-V relation. Indeed, current evidence suggests that the F-V relation in skeletal muscles follows a double-hyperbolic pattern, with a breakpoint located at very high forces/low velocities, which may be a direct consequence of the kinetic properties of myofilament cross-bridge formation. Deviations at low forces/high velocities, by contrast, may be related to a recently discovered, calcium-independent regulatory mechanism of muscle contraction, which may also explain the low metabolic cost of very fast muscle shortening contractions. Controversial results have also been reported regarding the eccentric F-V relationship, with studies in prepared muscle specimens suggesting that maximum eccentric force is substantially greater than isometric force, whereas in vivo studies in humans show only a modest increase, no change, or even a decrease in force in lengthening contractions. This review discusses possible reasons reported in the literature for these discrepant findings, including the testing procedures (familiarization, pre-load condition, and temperature) and a potential neural inhibition at higher lengthening velocities. Finally, some unresolved questions and recommendations for F-V testing in humans are reported at the end of this document.

Do Actomyosin Single-Molecule Mechanics Data Predict Mechanics of Contracting Muscle?

In muscle, but not in single-molecule mechanics studies, actin, myosin and accessory proteins are incorporated into a highly ordered myofilament lattice. In view of this difference we compare results from single-molecule studies and muscle mechanics and analyze to what degree data from the two types of studies agree with each other. There is reasonable correspondence in estimates of the cross-bridge power-stroke distance (7–13 nm), cross-bridge stiffness (~2 pN/nm) and average isometric force per cross-bridge (6–9 pN). Furthermore, models defined on the basis of single-molecule mechanics and solution biochemistry give good fits to experimental data from muscle. This suggests that the ordered myofilament lattice, accessory proteins and emergent effects of the sarcomere organization have only minor modulatory roles. However, such factors may be of greater importance under e.g., disease conditions. We also identify areas where single-molecule and muscle data are conflicting: (1) whether force generation is an Eyring or Kramers process with just one major power-stroke or several sub-strokes; (2) whether the myofilaments and the cross-bridges have Hookean or non-linear elasticity; (3) if individual myosin heads slip between actin sites under certain conditions, e.g., in lengthening; or (4) if the two heads of myosin cooperate.

Actomyosin based contraction: one mechanokinetic model from single molecules to muscle?

Bridging the gaps between experimental systems on different hierarchical scales is needed to overcome remaining challenges in the understanding of muscle contraction. Here, a mathematical model with well-characterized structural and biochemical actomyosin states is developed to that end. We hypothesize that this model accounts for generation of force and motion from single motor molecules to the large ensembles of muscle. In partial support of this idea, a wide range of contractile phenomena are reproduced without the need to invoke cooperative interactions or ad hoc states/transitions. However, remaining limitations exist, associated with ambiguities in available data for model definition e.g.: (1) the affinity of weakly bound cross-bridges, (2) the characteristics of the cross-bridge elasticity and (3) the exact mechanistic relationship between the force-generating transition and phosphate release in the actomyosin ATPase. Further, the simulated number of attached myosin heads in the in vitro motility assay differs several-fold from duty ratios, (fraction of strongly attached ATPase cycle times) derived in standard analysis. After addressing the mentioned issues the model should be useful in fundamental studies, for engineering of myosin motors as well as for studies of muscle disease and drug development.

Contribution of Post-translational Phosphorylation to Sarcomere-Linked Cardiomyopathy Phenotypes

Secondary shifts develop in post-translational phosphorylation of sarcomeric proteins in multiple animal models of inherited cardiomyopathy. These signaling alterations together with the primary mutation are predicted to contribute to the overall cardiac phenotype. As a result, identification and integration of post-translational myofilament signaling responses are identified as priorities for gaining insights into sarcomeric cardiomyopathies. However, significant questions remain about the nature and contribution of post-translational phosphorylation to structural remodeling and cardiac dysfunction in animal models and human patients. This perspective essay discusses specific goals for filling critical gaps about post-translational signaling in response to these inherited mutations, especially within sarcomeric proteins. The discussion focuses primarily on pre-clinical analysis of animal models and defines challenges and future directions in this field.

Poorly understood aspects of striated muscle contraction

Muscle contraction results from cyclic interactions between the contractile proteins myosin and actin, driven by the turnover of adenosine triphosphate (ATP). Despite intense studies, several molecular events in the contraction process are poorly understood, including the relationship between force-generation and phosphate-release in the ATP-turnover. Different aspects of the force-generating transition are reflected in the changes in tension development by muscle cells, myofibrils and single molecules upon changes in temperature, altered phosphate concentration, or length perturbations. It has been notoriously difficult to explain all these events within a given theoretical framework and to unequivocally correlate observed events with the atomic structures of the myosin motor. Other incompletely understood issues include the role of the two heads of myosin II and structural changes in the actin filaments as well as the importance of the three-dimensional order. We here review these issues in relation to controversies regarding basic physiological properties of striated muscle. We also briefly consider actomyosin mutation effects in cardiac and skeletal muscle function and the possibility to treat these defects by drugs.