Chaanine Antoine H, Sreekumaran Nair K, Bergen Robert H, Klaus Katherine, Guenzel Adam J, Hajjar Roger J, Redfield Margaret M
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Division of Endocrinology, Mayo Clinic, Rochester, MN.
J Am Heart Assoc. 2017 Jun 15;6(6):e005869. doi: 10.1161/JAHA.117.005869.
Following pressure overload, compensatory concentric left ventricular remodeling (CR) variably transitions to eccentric remodeling (ER) and systolic dysfunction. Mechanisms responsible for this transition are incompletely understood. Here we leverage phenotypic variability in pressure overload-induced cardiac remodeling to test the hypothesis that altered mitochondrial homeostasis and calcium handling occur early in the transition from CR to ER, before overt systolic dysfunction.
Sprague Dawley rats were subjected to ascending aortic banding, (n=68) or sham procedure (n=5). At 3 weeks post-ascending aortic banding, all rats showed CR (left ventricular volumes < sham). At 8 weeks post-ascending aortic banding, ejection fraction was increased or preserved but 3 geometric phenotypes were evident despite similar pressure overload severity: persistent CR, mild ER, and moderate ER with left ventricular volumes lower than, similar to, and higher than sham, respectively. Relative to sham, CR and mild ER phenotypes displayed increased phospholamban, S16 phosphorylation, reduced sodium-calcium exchanger expression, and increased mitochondrial biogenesis/content and normal oxidative capacity, whereas moderate ER phenotype displayed decreased p-phospholamban, S16, increased sodium-calcium exchanger expression, similar degree of mitochondrial biogenesis/content, and impaired oxidative capacity with unique activation of mitochondrial autophagy and apoptosis markers (BNIP3 and Bax/Bcl-2).
After pressure overload, mitochondrial biogenesis and function and calcium handling are enhanced in compensatory CR. The transition to mild ER is associated with decrease in mitochondrial biogenesis and content; however, the progression to moderate ER is associated with enhanced mitochondrial autophagy/apoptosis and impaired mitochondrial function and calcium handling, which precede the onset of overt systolic dysfunction.
压力超负荷后,代偿性向心性左心室重构(CR)会不同程度地转变为离心性重构(ER)和收缩功能障碍。导致这种转变的机制尚未完全明确。在此,我们利用压力超负荷诱导的心脏重构中的表型变异性,来检验以下假设:在明显的收缩功能障碍出现之前,从CR向ER转变的早期阶段会发生线粒体稳态和钙处理的改变。
将Sprague Dawley大鼠进行升主动脉缩窄手术(n = 68)或假手术(n = 5)。在升主动脉缩窄术后3周,所有大鼠均表现为CR(左心室容积 < 假手术组)。在升主动脉缩窄术后8周,射血分数增加或保持不变,但尽管压力超负荷严重程度相似,仍出现了3种几何表型:持续性CR、轻度ER和中度ER,其左心室容积分别低于、相似于和高于假手术组。相对于假手术组,CR和轻度ER表型显示受磷蛋白、S16磷酸化增加,钠钙交换体表达减少,线粒体生物合成/含量增加且氧化能力正常,而中度ER表型显示p-受磷蛋白、S16减少,钠钙交换体表达增加线粒体生物合成/含量程度相似,氧化能力受损,伴有线粒体自噬和凋亡标志物(BNIP3和Bax/Bcl-2)的独特激活。
压力超负荷后,代偿性CR中线粒体生物合成、功能及钙处理增强。向轻度ER的转变与线粒体生物合成和含量减少有关;然而,向中度ER的进展与线粒体自噬/凋亡增强、线粒体功能和钙处理受损有关,这些变化在明显的收缩功能障碍发生之前就已出现。