Pathogenesis of hypertrophic cardiomyopathy is mutation rather than disease specific: A comparison of the cardiac troponin T E163R and R92Q mouse models

Cecilia Ferrantini, Raffaele Coppini, José Manuel Pioner, Francesca Gentile, Benedetta Tosi, Luca Mazzoni, Beatrice Scellini, Nicoletta Piroddi, Annunziatina Laurino, Lorenzo Santini, Valentina Spinelli, Leonardo Sacconi, Pieter De Tombe, Rachel Moore, Jil C Tardiff, Alessandro Mugelli, Iacopo Olivotto, Elisabetta Cerbai, Chiara Tesi, Corrado Poggesi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background-In cardiomyocytes from patients with hypertrophic cardiomyopathy, mechanical dysfunction and arrhythmogenicity are caused by mutation-driven changes in myofilament function combined with excitation-contraction (E-C) coupling abnormalities related to adverse remodeling. Whether myofilament or E-C coupling alterations are more relevant in disease development is unknown. Here, we aim to investigate whether the relative roles of myofilament dysfunction and E-C coupling remodeling in determining the hypertrophic cardiomyopathy phenotype are mutation specific. Methods and Results-Two hypertrophic cardiomyopathy mouse models carrying the R92Q and the E163R TNNT2 mutations were investigated. Echocardiography showed left ventricular hypertrophy, enhanced contractility, and diastolic dysfunction in both models; however, these phenotypes were more pronounced in the R92Q mice. Both E163R and R92Q trabeculae showed prolonged twitch relaxation and increased occurrence of premature beats. In E163R ventricular myofibrils or skinned trabeculae, relaxation following Ca2+ removal was prolonged; resting tension and resting ATPase were higher; and isometric ATPase at maximal Ca2+ activation, the energy cost of tension generation, and myofilament Ca2+ sensitivity were increased compared with that in wildtype mice. No sarcomeric changes were observed in R92Q versus wild-type mice, except for a large increase in myofilament Ca2+ sensitivity. In R92Q myocardium, we found a blunted response to inotropic interventions, slower decay of Ca2+ transients, reduced SERCA function, and increased Ca2+/calmodulin kinase II activity. Contrarily, secondary alterations of E-C coupling and signaling were minimal in E163R myocardium. Conclusions-In E163R models, mutation-driven myofilament abnormalities directly cause myocardial dysfunction. In R92Q, diastolic dysfunction and arrhythmogenicity are mediated by profound cardiomyocyte signaling and E-C coupling changes. Similar hypertrophic cardiomyopathy phenotypes can be generated through different pathways, implying different strategies for a precision medicine approach to treatment.

Original languageEnglish (US)
Article numbere005407
JournalJournal of the American Heart Association
Volume6
Issue number7
DOIs
StatePublished - Jul 1 2017

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Troponin T
Myofibrils
Hypertrophic Cardiomyopathy
Excitation Contraction Coupling
Mutation
Phenotype
Cardiac Myocytes
Adenosine Triphosphatases
Myocardium
Premature Cardiac Complexes
Calcium-Calmodulin-Dependent Protein Kinases
Precision Medicine
Left Ventricular Hypertrophy
Echocardiography
Costs and Cost Analysis

Keywords

  • Excitation-contraction coupling
  • Hypertrophic cardiomyopathy
  • Pathophysiology
  • Sarcomere physiology
  • Troponin T

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Pathogenesis of hypertrophic cardiomyopathy is mutation rather than disease specific : A comparison of the cardiac troponin T E163R and R92Q mouse models. / Ferrantini, Cecilia; Coppini, Raffaele; Pioner, José Manuel; Gentile, Francesca; Tosi, Benedetta; Mazzoni, Luca; Scellini, Beatrice; Piroddi, Nicoletta; Laurino, Annunziatina; Santini, Lorenzo; Spinelli, Valentina; Sacconi, Leonardo; De Tombe, Pieter; Moore, Rachel; Tardiff, Jil C; Mugelli, Alessandro; Olivotto, Iacopo; Cerbai, Elisabetta; Tesi, Chiara; Poggesi, Corrado.

In: Journal of the American Heart Association, Vol. 6, No. 7, e005407, 01.07.2017.

Research output: Contribution to journalArticle

Ferrantini, C, Coppini, R, Pioner, JM, Gentile, F, Tosi, B, Mazzoni, L, Scellini, B, Piroddi, N, Laurino, A, Santini, L, Spinelli, V, Sacconi, L, De Tombe, P, Moore, R, Tardiff, JC, Mugelli, A, Olivotto, I, Cerbai, E, Tesi, C & Poggesi, C 2017, 'Pathogenesis of hypertrophic cardiomyopathy is mutation rather than disease specific: A comparison of the cardiac troponin T E163R and R92Q mouse models', Journal of the American Heart Association, vol. 6, no. 7, e005407. https://doi.org/10.1161/JAHA.116.005407
Ferrantini, Cecilia ; Coppini, Raffaele ; Pioner, José Manuel ; Gentile, Francesca ; Tosi, Benedetta ; Mazzoni, Luca ; Scellini, Beatrice ; Piroddi, Nicoletta ; Laurino, Annunziatina ; Santini, Lorenzo ; Spinelli, Valentina ; Sacconi, Leonardo ; De Tombe, Pieter ; Moore, Rachel ; Tardiff, Jil C ; Mugelli, Alessandro ; Olivotto, Iacopo ; Cerbai, Elisabetta ; Tesi, Chiara ; Poggesi, Corrado. / Pathogenesis of hypertrophic cardiomyopathy is mutation rather than disease specific : A comparison of the cardiac troponin T E163R and R92Q mouse models. In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 7.
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abstract = "Background-In cardiomyocytes from patients with hypertrophic cardiomyopathy, mechanical dysfunction and arrhythmogenicity are caused by mutation-driven changes in myofilament function combined with excitation-contraction (E-C) coupling abnormalities related to adverse remodeling. Whether myofilament or E-C coupling alterations are more relevant in disease development is unknown. Here, we aim to investigate whether the relative roles of myofilament dysfunction and E-C coupling remodeling in determining the hypertrophic cardiomyopathy phenotype are mutation specific. Methods and Results-Two hypertrophic cardiomyopathy mouse models carrying the R92Q and the E163R TNNT2 mutations were investigated. Echocardiography showed left ventricular hypertrophy, enhanced contractility, and diastolic dysfunction in both models; however, these phenotypes were more pronounced in the R92Q mice. Both E163R and R92Q trabeculae showed prolonged twitch relaxation and increased occurrence of premature beats. In E163R ventricular myofibrils or skinned trabeculae, relaxation following Ca2+ removal was prolonged; resting tension and resting ATPase were higher; and isometric ATPase at maximal Ca2+ activation, the energy cost of tension generation, and myofilament Ca2+ sensitivity were increased compared with that in wildtype mice. No sarcomeric changes were observed in R92Q versus wild-type mice, except for a large increase in myofilament Ca2+ sensitivity. In R92Q myocardium, we found a blunted response to inotropic interventions, slower decay of Ca2+ transients, reduced SERCA function, and increased Ca2+/calmodulin kinase II activity. Contrarily, secondary alterations of E-C coupling and signaling were minimal in E163R myocardium. Conclusions-In E163R models, mutation-driven myofilament abnormalities directly cause myocardial dysfunction. In R92Q, diastolic dysfunction and arrhythmogenicity are mediated by profound cardiomyocyte signaling and E-C coupling changes. Similar hypertrophic cardiomyopathy phenotypes can be generated through different pathways, implying different strategies for a precision medicine approach to treatment.",
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T1 - Pathogenesis of hypertrophic cardiomyopathy is mutation rather than disease specific

T2 - A comparison of the cardiac troponin T E163R and R92Q mouse models

AU - Ferrantini, Cecilia

AU - Coppini, Raffaele

AU - Pioner, José Manuel

AU - Gentile, Francesca

AU - Tosi, Benedetta

AU - Mazzoni, Luca

AU - Scellini, Beatrice

AU - Piroddi, Nicoletta

AU - Laurino, Annunziatina

AU - Santini, Lorenzo

AU - Spinelli, Valentina

AU - Sacconi, Leonardo

AU - De Tombe, Pieter

AU - Moore, Rachel

AU - Tardiff, Jil C

AU - Mugelli, Alessandro

AU - Olivotto, Iacopo

AU - Cerbai, Elisabetta

AU - Tesi, Chiara

AU - Poggesi, Corrado

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background-In cardiomyocytes from patients with hypertrophic cardiomyopathy, mechanical dysfunction and arrhythmogenicity are caused by mutation-driven changes in myofilament function combined with excitation-contraction (E-C) coupling abnormalities related to adverse remodeling. Whether myofilament or E-C coupling alterations are more relevant in disease development is unknown. Here, we aim to investigate whether the relative roles of myofilament dysfunction and E-C coupling remodeling in determining the hypertrophic cardiomyopathy phenotype are mutation specific. Methods and Results-Two hypertrophic cardiomyopathy mouse models carrying the R92Q and the E163R TNNT2 mutations were investigated. Echocardiography showed left ventricular hypertrophy, enhanced contractility, and diastolic dysfunction in both models; however, these phenotypes were more pronounced in the R92Q mice. Both E163R and R92Q trabeculae showed prolonged twitch relaxation and increased occurrence of premature beats. In E163R ventricular myofibrils or skinned trabeculae, relaxation following Ca2+ removal was prolonged; resting tension and resting ATPase were higher; and isometric ATPase at maximal Ca2+ activation, the energy cost of tension generation, and myofilament Ca2+ sensitivity were increased compared with that in wildtype mice. No sarcomeric changes were observed in R92Q versus wild-type mice, except for a large increase in myofilament Ca2+ sensitivity. In R92Q myocardium, we found a blunted response to inotropic interventions, slower decay of Ca2+ transients, reduced SERCA function, and increased Ca2+/calmodulin kinase II activity. Contrarily, secondary alterations of E-C coupling and signaling were minimal in E163R myocardium. Conclusions-In E163R models, mutation-driven myofilament abnormalities directly cause myocardial dysfunction. In R92Q, diastolic dysfunction and arrhythmogenicity are mediated by profound cardiomyocyte signaling and E-C coupling changes. Similar hypertrophic cardiomyopathy phenotypes can be generated through different pathways, implying different strategies for a precision medicine approach to treatment.

AB - Background-In cardiomyocytes from patients with hypertrophic cardiomyopathy, mechanical dysfunction and arrhythmogenicity are caused by mutation-driven changes in myofilament function combined with excitation-contraction (E-C) coupling abnormalities related to adverse remodeling. Whether myofilament or E-C coupling alterations are more relevant in disease development is unknown. Here, we aim to investigate whether the relative roles of myofilament dysfunction and E-C coupling remodeling in determining the hypertrophic cardiomyopathy phenotype are mutation specific. Methods and Results-Two hypertrophic cardiomyopathy mouse models carrying the R92Q and the E163R TNNT2 mutations were investigated. Echocardiography showed left ventricular hypertrophy, enhanced contractility, and diastolic dysfunction in both models; however, these phenotypes were more pronounced in the R92Q mice. Both E163R and R92Q trabeculae showed prolonged twitch relaxation and increased occurrence of premature beats. In E163R ventricular myofibrils or skinned trabeculae, relaxation following Ca2+ removal was prolonged; resting tension and resting ATPase were higher; and isometric ATPase at maximal Ca2+ activation, the energy cost of tension generation, and myofilament Ca2+ sensitivity were increased compared with that in wildtype mice. No sarcomeric changes were observed in R92Q versus wild-type mice, except for a large increase in myofilament Ca2+ sensitivity. In R92Q myocardium, we found a blunted response to inotropic interventions, slower decay of Ca2+ transients, reduced SERCA function, and increased Ca2+/calmodulin kinase II activity. Contrarily, secondary alterations of E-C coupling and signaling were minimal in E163R myocardium. Conclusions-In E163R models, mutation-driven myofilament abnormalities directly cause myocardial dysfunction. In R92Q, diastolic dysfunction and arrhythmogenicity are mediated by profound cardiomyocyte signaling and E-C coupling changes. Similar hypertrophic cardiomyopathy phenotypes can be generated through different pathways, implying different strategies for a precision medicine approach to treatment.

KW - Excitation-contraction coupling

KW - Hypertrophic cardiomyopathy

KW - Pathophysiology

KW - Sarcomere physiology

KW - Troponin T

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