title: Transmural heterogeneity of cellular level power output is reduced in human heart failure.
abstract: Heart failure is associated with pump dysfunction and remodeling but it is not yet known if the condition affects different transmural regions of the heart in the same way. We tested the hypotheses that the left ventricles of non-failing human hearts exhibit transmural heterogeneity of cellular level contractile properties, and that heart failure produces transmural region-specific changes in contractile function. Permeabilized samples were prepared from the sub-epicardial, mid-myocardial, and sub-endocardial regions of the left ventricular free wall of non-failing (n=6) and failing (n=10) human hearts. Power, an in vitro index of systolic function, was higher in non-failing mid-myocardial samples (0.59±0.06μWmg(-1)) than in samples from the sub-epicardium (p=0.021) and the sub-endocardium (p=0.015). Non-failing mid-myocardial samples also produced more isometric force (14.3±1.33kNm(-2)) than samples from the sub-epicardium (p=0.008) and the sub-endocardium (p=0.026). Heart failure reduced power (p=0.009) and force (p=0.042) but affected the mid-myocardium more than the other transmural regions. Fibrosis increased with heart failure (p=0.021) and mid-myocardial tissue from failing hearts contained more collagen than matched sub-epicardial (p<0.001) and sub-endocardial (p=0.043) samples. Power output was correlated with the relative content of actin and troponin I, and was also statistically linked to the relative content and phosphorylation of desmin and myosin light chain-1. Non-failing human hearts exhibit transmural heterogeneity of contractile properties. In failing organs, region-specific fibrosis produces the greatest contractile deficits in the mid-myocardium. Targeting fibrosis and sarcomeric proteins in the mid-myocardium may be particularly effective therapies for heart failure.
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Premi
authors.initials: P
authors.lastname: Haynes
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Kristofer E
authors.initials: KE
authors.lastname: Nava
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lawson
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Chung
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Mihail I
authors.initials: MI
authors.lastname: Mitov
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Campbell
authors.affiliation: Department of Statistics, University of Kentucky, Lexington, KY, USA.
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Stromberg
authors.affiliation: Department of Cell and Molecular Physiology, Stritch School of Medicine, Loyola University, Chicago, USA.
authors.forename: Sakthivel
authors.initials: S
authors.lastname: Sadayappan
authors.affiliation: Division of Cardiothoracic Surgery, University of Kentucky, Lexington, KY, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Bonnell
authors.affiliation: Division of Cardiothoracic Surgery, University of Kentucky, Lexington, KY, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Hoopes
authors.affiliation: Department of Physiology, University of Kentucky, Lexington, KY, USA; Center for Muscle Biology, University of Kentucky, Lexington, KY, USA. Electronic address: k.s.campbell@uky.edu.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Campbell
mesh_terms: D000199:Actins / Q000235:genetics / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D003893:Desmin / Q000235:genetics / Q000378:metabolism; D004699:Endocardium / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005355:Fibrosis; D015870:Gene Expression; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D018994:Myosin Light Chains / Q000235:genetics / Q000378:metabolism; D009928:Organ Specificity; D010496:Pericardium / Q000378:metabolism / Q000503:physiopathology*; D019210:Troponin I / Q000235:genetics / Q000378:metabolism
chemical_list: D000199:Actins; D003893:Desmin; D018994:Myosin Light Chains; D019210:Troponin I
keywords: Collagen; Left ventricular function; Mechanics; Myofilament protein; Sarcomere