1
|
Ma W, del Rio CL, Qi L, Prodanovic M, Mijailovich S, Zambataro C, Gong H, Shimkunas R, Gollapudi S, Nag S, Irving TC. Myosin in autoinhibited off state(s), stabilized by mavacamten, can be recruited in response to inotropic interventions. Proc Natl Acad Sci U S A 2024; 121:e2314914121. [PMID: 38346202 PMCID: PMC10895252 DOI: 10.1073/pnas.2314914121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Mavacamten is a FDA-approved small-molecule therapeutic designed to regulate cardiac function at the sarcomere level by selectively but reversibly inhibiting the enzymatic activity of myosin. It shifts myosin toward ordered off states close to the thick filament backbone. It remains elusive whether these myosin heads in the off state(s) can be recruited in response to physiological stimuli when required to boost cardiac output. We show that cardiac myosins stabilized in these off state(s) by mavacamten are recruitable by 1) Ca2+, 2) increased chronotropy [heart rate (HR)], 3) stretch, and 4) β-adrenergic (β-AR) stimulation, all known physiological inotropic interventions. At the molecular level, we show that Ca2+ increases myosin ATPase activity by shifting mavacamten-stabilized myosin heads from the inactive super-relaxed state to the active disordered relaxed state. At the myofilament level, both Ca2+ and passive lengthening can shift mavacamten-ordered off myosin heads from positions close to the thick filament backbone to disordered on states closer to the thin filaments. In isolated rat cardiomyocytes, increased stimulation rates enhanced shortening fraction in mavacamten-treated cells. This observation was confirmed in vivo in telemetered rats, where left-ventricular dP/dtmax, an index of inotropy, increased with HR in mavacamten-treated animals. Finally, we show that β-AR stimulation in vivo increases left-ventricular function and stroke volume in the setting of mavacamten. Our data demonstrate that the mavacamten-promoted off states of myosin in the thick filament are at least partially activable, thus preserving cardiac reserve mechanisms.
Collapse
Affiliation(s)
- Weikang Ma
- Biophysics Collaborative Access Team, Department of Biology, Illinois Institute of Technology, Chicago, IL60616
- Center for Synchrotron Radiation Research and Instrumentation, Illinois Institute of Technology, Chicago, IL60616
| | - Carlos L. del Rio
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA94005
- Cardiac Consulting, San Mateo, CA94010
| | - Lin Qi
- Department of Biology, Illinois Institute of Technology, Chicago, IL60616
| | - Momcilo Prodanovic
- Institute for Information Technologies, University of Kragujevac, Kragujevac34000, Serbia
- FilamenTech, Inc., Newtown, MA02458
| | | | | | - Henry Gong
- Department of Biology, Illinois Institute of Technology, Chicago, IL60616
| | - Rafael Shimkunas
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA94005
| | - Sampath Gollapudi
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA94005
| | - Suman Nag
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA94005
| | - Thomas C. Irving
- Biophysics Collaborative Access Team, Department of Biology, Illinois Institute of Technology, Chicago, IL60616
- Center for Synchrotron Radiation Research and Instrumentation, Illinois Institute of Technology, Chicago, IL60616
- Department of Biology, Illinois Institute of Technology, Chicago, IL60616
| |
Collapse
|
2
|
Jani VP, Song T, Gao C, Gong H, Sadayappan S, Kass DA, Irving TC, Ma W. The structural OFF and ON states of myosin can be decoupled from the biochemical super- and disordered-relaxed states. PNAS NEXUS 2024; 3:pgae039. [PMID: 38328779 PMCID: PMC10849796 DOI: 10.1093/pnasnexus/pgae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
There is a growing awareness that both thick-filament and classical thin-filament regulations play central roles in modulating muscle contraction. Myosin ATPase assays have demonstrated that under relaxed conditions, myosin may reside either in a high-energy-consuming disordered-relaxed (DRX) state available for binding actin to generate force or in an energy-sparing super-relaxed (SRX) state unavailable for actin binding. X-ray diffraction studies have shown that the majority of myosin heads are in a quasi-helically ordered OFF state in a resting muscle and that this helical ordering is lost when myosin heads are turned ON for contraction. It has been assumed that myosin heads in SRX and DRX states are equivalent to the OFF and ON states, respectively, and the terms have been used interchangeably. In this study, we use X-ray diffraction and ATP turnover assays to track the structural and biochemical transitions of myosin heads, respectively, induced with either omecamtiv mecarbil (OM) or piperine in relaxed porcine myocardium. We find that while OM and piperine induce dramatic shifts of myosin heads from the OFF to the ON state, there are no appreciable changes in the population of myosin heads in the SRX and DRX states in both unloaded and loaded preparations. Our results show that biochemically defined SRX and DRX can be decoupled from structurally defined OFF and ON states. In summary, while SRX/DRX and OFF/ON transitions can be correlated in some cases, these two phenomena are measured using different approaches, reflect different properties of the thick filament, and should be investigated and interpreted separately.
Collapse
Affiliation(s)
- Vivek P Jani
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Taejeong Song
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Chengqian Gao
- College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning 116044, China
| | - Henry Gong
- Department of Biology, Illinois Institute of Technology, Chicago, IL 60616, USA
| | - Sakthivel Sadayappan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
| | - David A Kass
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Thomas C Irving
- Department of Biology, Illinois Institute of Technology, Chicago, IL 60616, USA
- Center for Synchrotron Radiation Research and Instrumentation, Illinois Institute of Technology, Chicago, IL 60616, USA
| | - Weikang Ma
- Department of Biology, Illinois Institute of Technology, Chicago, IL 60616, USA
- Center for Synchrotron Radiation Research and Instrumentation, Illinois Institute of Technology, Chicago, IL 60616, USA
| |
Collapse
|
3
|
Ma W, Jani VP, Song T, Gao C, Gong H, Sadayappan S, Kass DA, Irving TC. The structural OFF and ON states of myosin can be decoupled from the biochemical super-relaxed and disordered-relaxed states. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.18.562891. [PMID: 37904972 PMCID: PMC10614925 DOI: 10.1101/2023.10.18.562891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
There is a growing awareness that both thick filament and classical thin filament regulation play central roles in modulating muscle contraction. Myosin ATPase assays have demonstrated that under relaxed conditions, myosin may reside in either a high energy-consuming disordered-relaxed (DRX) state available for binding actin to generate force, or in an energy-sparing super-relaxed (SRX) state unavailable for actin binding. X-ray diffraction studies have shown the majority of myosin heads are in a quasi-helically ordered OFF state in a resting muscle and that this helical ordering is lost when myosin heads are turned ON for contraction. It has been assumed that myosin heads in SRX and DRX states are equivalent to the OFF and ON state respectively and the terms have been used interchangeably. Here, we use X-ray diffraction and ATP turnover assays to track the structural and biochemical transitions of myosin heads respectively induced with either omecamtiv mecarbil (OM) or piperine in relaxed porcine myocardium. We find that while OM and piperine induce dramatic shifts of myosin heads from the OFF to ON states, there are no appreciable changes in the population of myosin heads in the SRX and DRX states in both unloaded and loaded preparations. Our results show that biochemically defined SRX and DRX can be decoupled from structurally-defined OFF and ON states. In summary, while SRX/DRX and OFF/ON transitions can be correlated in some cases, these two phenomena are measured using different approaches, do not necessarily reflect the same properties of the thick filament and should be investigated and interpreted separately.
Collapse
Affiliation(s)
- Weikang Ma
- Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Vivek P. Jani
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Taejeong Song
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, OH, USA
| | - Chengqian Gao
- College of Basic Medical Sciences, Dalian Medical University, Dalian, Liaoning, China
| | - Henry Gong
- Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Sakthivel Sadayappan
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati, OH, USA
| | - David A. Kass
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Thomas C. Irving
- Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| |
Collapse
|
4
|
Ma W, Lee KH, Delligatti CE, Davis MT, Zheng Y, Gong H, Kirk JA, Craig R, Irving T. The structural and functional integrities of porcine myocardium are mostly preserved by cryopreservation. J Gen Physiol 2023; 155:e202313345. [PMID: 37398997 PMCID: PMC10318404 DOI: 10.1085/jgp.202313345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/05/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
Structural and functional studies of heart muscle are important to gain insights into the physiological bases of cardiac muscle contraction and the pathological bases of heart disease. While fresh muscle tissue works best for these kinds of studies, this is not always practical to obtain, especially for heart tissue from large animal models and humans. Conversely, tissue banks of frozen human hearts are available and could be a tremendous resource for translational research. It is not well understood, however, how liquid nitrogen freezing and cryostorage may impact the structural integrity of myocardium from large mammals. In this study, we directly compared the structural and functional integrity of never-frozen to previously frozen porcine myocardium to investigate the consequences of freezing and cryostorage. X-ray diffraction measurements from hydrated tissue under near-physiological conditions and electron microscope images from chemically fixed porcine myocardium showed that prior freezing has only minor effects on structural integrity of the muscle. Furthermore, mechanical studies similarly showed no significant differences in contractile capabilities of porcine myocardium with and without freezing and cryostorage. These results demonstrate that liquid nitrogen preservation is a practical approach for structural and functional studies of myocardium.
Collapse
Affiliation(s)
- Weikang Ma
- BioCAT, Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Kyoung Hwan Lee
- Electron Microscopy Facility, UMass Chan Medical School, Worcester, MA, USA
| | | | - M. Therese Davis
- Department of Cell and Molecular Physiology, Loyola University Chicago, Chicago, IL, USA
| | - Yahan Zheng
- College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Henry Gong
- BioCAT, Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Jonathan A. Kirk
- Department of Cell and Molecular Physiology, Loyola University Chicago, Chicago, IL, USA
| | - Roger Craig
- Division of Cell Biology and Imaging, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Thomas Irving
- BioCAT, Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| |
Collapse
|
5
|
Ochala J, Lewis CTA, Beck T, Iwamoto H, Hessel AL, Campbell KS, Pyle WG. Predominant myosin superrelaxed state in canine myocardium with naturally occurring dilated cardiomyopathy. Am J Physiol Heart Circ Physiol 2023; 325:H585-H591. [PMID: 37505469 DOI: 10.1152/ajpheart.00369.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
Dilated cardiomyopathy (DCM) is a naturally occurring heart failure condition in humans and dogs, notably characterized by a reduced contractility and ejection fraction. As the identification of its underlying cellular and molecular mechanisms remain incomplete, the aim of the present study was to assess whether the molecular motor myosin and its known relaxed conformational states are altered in DCM. For that, we dissected and skinned thin cardiac strips from left ventricle obtained from six DCM Doberman Pinschers and six nonfailing (NF) controls. We then used a combination of Mant-ATP chase experiments and X-ray diffraction to assess both energetic and structural changes of myosin. Using the Mant-ATP chase protocol, we observed that in DCM dogs, the amount of myosin molecules in the ATP-conserving conformational state, also known as superrelaxed (SRX), is significantly increased when compared with NF dogs. This alteration can be rescued by applying EMD-57033, a small molecule activating myosin. Conversely, with X-ray diffraction, we found that in DCM dogs, there is a higher proportion of myosin heads in the vicinity of actin when compared with NF dogs (1,0 to 1,1 intensity ratio). Hence, we observed an uncoupling between energetic (Mant-ATP chase) and structural (X-ray diffraction) data. Taken together, these results may indicate that in the heart of Doberman Pinschers with DCM, myosin molecules are potentially stuck in a nonsequestered but ATP-conserving SRX state, that can be counterbalanced by EMD-57033 demonstrating the potential for a myosin-centered pharmacological treatment of DCM.NEW & NOTEWORTHY The key finding of the present study is that, in left ventricles of dogs with a naturally occurring dilated cardiomyopathy, relaxed myosin molecules favor a nonsequestered superrelaxed state potentially impairing sarcomeric contractility. This alteration is rescuable by applying a small molecule activating myosin known as EMD-57033.
Collapse
Affiliation(s)
- Julien Ochala
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Beck
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hiroyuki Iwamoto
- SPring-8, Japan Synchrotron Radiation Research Institute, Hyogo, Japan
| | - Anthony L Hessel
- Institute of Physiology II, University of Muenster, Muenster, Germany
- Accelerated Muscle Biotechnologies, Boston, Massachusetts, United States
| | - Kenneth S Campbell
- Department of Physiology, University of Kentucky, Lexington, Kentucky, United States
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - W Glen Pyle
- IMPART Investigator Team, Dalhousie Medicine, Saint John, New Brunswick, Canada
- Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
6
|
Ma W, del Rio CL, Qi L, Prodanovic M, Mijailovich S, Zambataro C, Gong H, Shimkunas R, Gollapudi S, Nag S, Irving TC. Myosin in autoinhibited off state(s), stabilized by mavacamten, can be recruited via inotropic effectors. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.10.536292. [PMID: 37090664 PMCID: PMC10120679 DOI: 10.1101/2023.04.10.536292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Mavacamten is a novel, FDA-approved, small molecule therapeutic designed to regulate cardiac function by selectively but reversibly inhibiting the enzymatic activity of myosin. It shifts myosin towards ordered off states close to the thick filament backbone. It remains unresolved whether mavacamten permanently sequesters these myosin heads in the off state(s) or whether these heads can be recruited in response to physiological stimuli when required to boost cardiac output. We show that cardiac myosins stabilized in these off state(s) by mavacamten are recruitable by Ca2+, increased heart rate, stretch, and β-adrenergic (β-AR) stimulation, all known physiological inotropic effectors. At the molecular level, we show that, in presence of mavacamten, Ca2+ increases myosin ATPase activity by shifting myosin heads from the reserve super-relaxed (SRX) state to the active disordered relaxed (DRX) state. At the myofilament level, both Ca2+ and passive lengthening can shift ordered off myosin heads from positions close to the thick filament backbone to disordered on states closer to the thin filaments in the presence of mavacamten. In isolated rat cardiomyocytes, increased stimulation rates enhanced shortening fraction in mavacamten-treated cells. This observation was confirmed in vivo in telemetered rats, where left-ventricular dP/dtmax, an index of inotropy, increased with heart rate in mavacamten treated animals. Finally, we show that β-AR stimulation in vivo increases left-ventricular function and stroke volume in the setting of mavacamten. Our data demonstrate that the mavacamten-promoted off states of myosin in the thick filament are activable, at least partially, thus leading to preservation of cardiac reserve mechanisms.
Collapse
Affiliation(s)
- Weikang Ma
- BioCAT, Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Carlos L. del Rio
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA 94005
| | - Lin Qi
- Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Momcilo Prodanovic
- Institute for Information Technologies, University of Kragujevac, Kragujevac, Serbia
- FilamenTech, Inc., Newtown, MA 02458, USA
| | | | | | - Henry Gong
- Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| | - Rafael Shimkunas
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA 94005
| | - Sampath Gollapudi
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA 94005
| | - Suman Nag
- Cardiovascular Drug Discovery, Bristol Myers Squibb, Brisbane, CA 94005
| | - Thomas C. Irving
- BioCAT, Department of Biology, Illinois Institute of Technology, Chicago, IL, USA
| |
Collapse
|
7
|
Jani V, Aslam MI, Fenwick AJ, Ma W, Gong H, Milburn G, Nissen D, Cubero Salazar IM, Hanselman O, Mukherjee M, Halushka MK, Margulies KB, Campbell KS, Irving TC, Kass DA, Hsu S. Right Ventricular Sarcomere Contractile Depression and the Role of Thick Filament Activation in Human Heart Failure With Pulmonary Hypertension. Circulation 2023; 147:1919-1932. [PMID: 37194598 PMCID: PMC10270283 DOI: 10.1161/circulationaha.123.064717] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Right ventricular (RV) contractile dysfunction commonly occurs and worsens outcomes in patients with heart failure with reduced ejection fraction and pulmonary hypertension (HFrEF-PH). However, such dysfunction often goes undetected by standard clinical RV indices, raising concerns that they may not reflect aspects of underlying myocyte dysfunction. We thus sought to characterize RV myocyte contractile depression in HFrEF-PH, identify those components reflected by clinical RV indices, and uncover underlying biophysical mechanisms. METHODS Resting, calcium-, and load-dependent mechanics were prospectively studied in permeabilized RV cardiomyocytes isolated from explanted hearts from 23 patients with HFrEF-PH undergoing cardiac transplantation and 9 organ donor controls. RESULTS Unsupervised machine learning using myocyte mechanical data with the highest variance yielded 2 HFrEF-PH subgroups that in turn mapped to patients with decompensated or compensated clinical RV function. This correspondence was driven by reduced calcium-activated isometric tension in decompensated clinical RV function, whereas surprisingly, many other major myocyte contractile measures including peak power and myocyte active stiffness were similarly depressed in both groups. Similar results were obtained when subgroups were first defined by clinical indices, and then myocyte mechanical properties in each group compared. To test the role of thick filament defects, myofibrillar structure was assessed by x-ray diffraction of muscle fibers. This revealed more myosin heads associated with the thick filament backbone in decompensated clinical RV function, but not compensated clinical RV function, as compared with controls. This corresponded to reduced myosin ATP turnover in decompensated clinical RV function myocytes, indicating less myosin in a crossbridge-ready disordered-relaxed (DRX) state. Altering DRX proportion (%DRX) affected peak calcium-activated tension in the patient groups differently, depending on their basal %DRX, highlighting potential roles for precision-guided therapeutics. Last, increasing myocyte preload (sarcomere length) increased %DRX 1.5-fold in controls but only 1.2-fold in both HFrEF-PH groups, revealing a novel mechanism for reduced myocyte active stiffness and by extension Frank-Starling reserve in human heart failure. CONCLUSIONS Although there are many RV myocyte contractile deficits in HFrEF-PH, commonly used clinical indices only detect reduced isometric calcium-stimulated force, which is related to deficits in basal and recruitable %DRX myosin. Our results support use of therapies to increase %DRX and enhance length-dependent recruitment of DRX myosin heads in such patients.
Collapse
Affiliation(s)
- Vivek Jani
- Department of Biomedical Engineering (V.J., O.H., D.A.K.), Johns Hopkins School of Medicine, Baltimore, MD
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - M. Imran Aslam
- Division of Cardiology, Department of Medicine, University of Texas San Antonio School of Medicine (M.I.A.)
| | - Axel J. Fenwick
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Weikang Ma
- Biophysics Collaborative Access Team (BioCAT), Department of Biology, Illinois Institute of Technology, Chicago (W.M., H.G., D.N., T.C.I.)
| | - Henry Gong
- Biophysics Collaborative Access Team (BioCAT), Department of Biology, Illinois Institute of Technology, Chicago (W.M., H.G., D.N., T.C.I.)
| | - Gregory Milburn
- Division of Cardiovascular Medicine, Department of Medicine, University of Kentucky, Lexington (G.M., K.S.C.)
| | - Devin Nissen
- Biophysics Collaborative Access Team (BioCAT), Department of Biology, Illinois Institute of Technology, Chicago (W.M., H.G., D.N., T.C.I.)
| | - Ilton M. Cubero Salazar
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Olivia Hanselman
- Department of Biomedical Engineering (V.J., O.H., D.A.K.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Monica Mukherjee
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Marc K. Halushka
- Division of Cardiovascular Pathology, Department of Pathology (M.K.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Kenneth B. Margulies
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia (K.B.M.)
| | - Kenneth S. Campbell
- Division of Cardiovascular Medicine, Department of Medicine, University of Kentucky, Lexington (G.M., K.S.C.)
| | - Thomas C. Irving
- Biophysics Collaborative Access Team (BioCAT), Department of Biology, Illinois Institute of Technology, Chicago (W.M., H.G., D.N., T.C.I.)
| | - David A. Kass
- Department of Biomedical Engineering (V.J., O.H., D.A.K.), Johns Hopkins School of Medicine, Baltimore, MD
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Steven Hsu
- Division of Cardiology, Department of Medicine (V.J., A.J.F., I.M.C.S., M.M., D.A.K., S.H.), Johns Hopkins School of Medicine, Baltimore, MD
| |
Collapse
|
8
|
Jani V, Aslam MI, Fenwick AJ, Ma W, Gong H, Milburn G, Nissen D, Salazar IC, Hanselman O, Mukherjee M, Halushka MK, Margulies KB, Campbell K, Irving TC, Kass DA, Hsu S. Right Ventricular Sarcomere Contractile Depression and the Role of Thick Filament Activation in Human Heart Failure with Pulmonary Hypertension. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.09.531988. [PMID: 36945606 PMCID: PMC10029011 DOI: 10.1101/2023.03.09.531988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Rationale Right ventricular (RV) contractile dysfunction commonly occurs and worsens outcomes in heart failure patients with reduced ejection fraction and pulmonary hypertension (HFrEF-PH). However, such dysfunction often goes undetected by standard clinical RV indices, raising concerns that they may not reflect aspects of underlying myocyte dysfunction. Objective To determine components of myocyte contractile depression in HFrEF-PH, identify those reflected by clinical RV indices, and elucidate their underlying biophysical mechanisms. Methods and Results Resting, calcium- and load-dependent mechanics were measured in permeabilized RV cardiomyocytes isolated from explanted hearts from 23 HFrEF-PH patients undergoing cardiac transplantation and 9 organ-donor controls. Unsupervised machine learning using myocyte mechanical data with the highest variance yielded two HFrEF-PH subgroups that in turn mapped to patients with depressed (RVd) or compensated (RVc) clinical RV function. This correspondence was driven by reduced calcium-activated isometric tension in RVd, while surprisingly, many other major myocyte contractile measures including peak power, maximum unloaded shortening velocity, and myocyte active stiffness were similarly depressed in both groups. Similar results were obtained when subgroups were first defined by clinical indices, and then myocyte mechanical properties in each group compared. To test the role of thick-filament defects, myofibrillar structure was assessed by X-ray diffraction of muscle fibers. This revealed more myosin heads associated with the thick filament backbone in RVd but not RVc, as compared to controls. This corresponded to reduced myosin ATP turnover in RVd myocytes, indicating less myosin in a cross-bridge ready disordered-relaxed (DRX) state. Altering DRX proportion (%DRX) affected peak calcium-activated tension in the patient groups differently, depending on their basal %DRX, highlighting potential roles for precision-guided therapeutics. Lastly, increasing myocyte preload (sarcomere length) increased %DRX 1.5-fold in controls but only 1.2-fold in both HFrEF-PH groups, revealing a novel mechanism for reduced myocyte active stiffness and by extension Frank-Starling reserve in human HF. Conclusions While there are multiple RV myocyte contractile deficits In HFrEF-PH, clinical indices primarily detect reduced isometric calcium-stimulated force related to deficits in basal and recruitable %DRX myosin. Our results support use of therapies to increase %DRX and enhance length-dependent recruitment of DRX myosin heads in such patients.
Collapse
|
9
|
Kooiker KB, Mohran S, Turner KL, Ma W, Flint G, Qi L, Gao C, Zheng Y, McMillen TS, Mandrycky C, Martinson A, Mahoney-Schaefer M, Freeman JC, Costales Arenas EG, Tu AY, Irving TC, Geeves MA, Tanner BCW, Regnier M, Davis J, Moussavi-Harami F. Danicamtiv increases myosin recruitment and alters the chemomechanical cross bridge cycle in cardiac muscle. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.31.526380. [PMID: 36778318 PMCID: PMC9915609 DOI: 10.1101/2023.01.31.526380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Modulating myosin function is a novel therapeutic approach in patients with cardiomyopathy. Detailed mechanism of action of these agents can help predict potential unwanted affects and identify patient populations that can benefit most from them. Danicamtiv is a novel myosin activator with promising preclinical data that is currently in clinical trials. While it is known danicamtiv increases force and cardiomyocyte contractility without affecting calcium levels, detailed mechanistic studies regarding its mode of action are lacking. Using porcine cardiac tissue and myofibrils we demonstrate that Danicamtiv increases force and calcium sensitivity via increasing the number of myosin in the "on" state and slowing cross bridge turnover. Our detailed analysis shows that inhibition of ADP release results in decreased cross bridge turnover with cross bridges staying on longer and prolonging myofibril relaxation. Using a mouse model of genetic dilated cardiomyopathy, we demonstrated that Danicamtiv corrected calcium sensitivity in demembranated and abnormal twitch magnitude and kinetics in intact cardiac tissue. Significance Statement Directly augmenting sarcomere function has potential to overcome limitations of currently used inotropic agents to improve cardiac contractility. Myosin modulation is a novel mechanism for increased contraction in cardiomyopathies. Danicamtiv is a myosin activator that is currently under investigation for use in cardiomyopathy patients. Our study is the first detailed mechanism of how Danicamtiv increases force and alters kinetics of cardiac activation and relaxation. This new understanding of the mechanism of action of Danicamtiv can be used to help identify patients that could benefit most from this treatment.
Collapse
|