van Hees Hieronymus W H, van der Heijden Henricus F M, Ottenheijm Coen A C, Heunks Leo M A, Pigmans Cindy J C, Verheugt Freek W A, Brouwer Rene M H J, Dekhuijzen P N Richard
Department of Pulmonary Diseases - 454, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Am J Physiol Heart Circ Physiol. 2007 Jul;293(1):H819-28. doi: 10.1152/ajpheart.00085.2007. Epub 2007 Apr 20.
Diaphragm weakness commonly occurs in patients with congestive heart failure (CHF) and is an independent predictor of mortality. However, the pathophysiology of diaphragm weakness is poorly understood. We hypothesized that CHF induces diaphragm weakness at the single-fiber level by decreasing myosin content. In addition, we hypothesized that myofibrillar Ca(2+) sensitivity is decreased and cross-bridge kinetics are slower in CHF diaphragm fibers. Finally, we hypothesized that loss of myosin in CHF diaphragm weakness is associated with increased proteolytic activities of caspase-3 and the proteasome. In skinned diaphragm single fibers of rats with CHF, induced by left coronary artery ligation, maximum force generation was reduced by approximately 35% (P < 0.01) compared with sham-operated animals for slow, 2a, and 2x fibers. In these CHF diaphragm fibers, myosin heavy chain content per half-sarcomere was concomitantly decreased (P < 0.01). Ca(2+) sensitivity of force generation and the rate constant of tension redevelopment were significantly reduced in CHF diaphragm fibers compared with sham-operated animals for all fiber types. The cleavage activity of the proteolytic enzyme caspase-3 and the proteasome were approximately 30% (P < 0.05) and approximately 60% (P < 0.05) higher, respectively, in diaphragm homogenates from CHF rats than from sham-operated rats. The present study demonstrates diaphragm weakness at the single-fiber level in a myocardial infarct model of CHF. The reduced maximal force generation can be explained by a loss of myosin content in all fiber types and is associated with activation of caspase-3 and the proteasome. Furthermore, CHF decreases myofibrillar Ca(2+) sensitivity and slows cross-bridge cycling kinetics in diaphragm fibers.
膈肌无力常见于充血性心力衰竭(CHF)患者,并且是死亡率的独立预测因素。然而,膈肌无力的病理生理学仍知之甚少。我们推测CHF通过减少肌球蛋白含量在单纤维水平诱发膈肌无力。此外,我们推测CHF膈肌纤维中肌原纤维对Ca(2+)的敏感性降低且横桥动力学较慢。最后,我们推测CHF膈肌无力中肌球蛋白的丢失与caspase-3和蛋白酶体的蛋白水解活性增加有关。在通过左冠状动脉结扎诱导的CHF大鼠的皮肤膈肌单纤维中,与假手术动物相比,慢肌纤维、2a肌纤维和2x肌纤维的最大力量产生降低了约35%(P < 0.01)。在这些CHF膈肌纤维中,每半个肌节的肌球蛋白重链含量也随之降低(P < 0.01)。与假手术动物相比,CHF膈肌纤维中所有纤维类型的力量产生的Ca(2+)敏感性和张力再发展的速率常数均显著降低。CHF大鼠膈肌匀浆中蛋白水解酶caspase-3和蛋白酶体的裂解活性分别比假手术大鼠高约30%(P < 0.05)和约60%(P < 0.05)。本研究在CHF的心肌梗死模型中证实了单纤维水平的膈肌无力。最大力量产生的降低可以用所有纤维类型中肌球蛋白含量的减少来解释,并且与caspase-3和蛋白酶体的激活有关。此外,CHF降低了膈肌纤维中肌原纤维对Ca(2+)的敏感性并减慢了横桥循环动力学。