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Circulation Research. 2009
Published online before print January 29, 2009, doi: 10.1161/CIRCRESAHA.108.193326
A more recent version of this article appeared on March 27, 2009
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Right arrow Heart failure - basic studies

Submitted on August 12, 2008
Revised on December 23, 2008
Accepted on January 21, 2009

Hypophosphorylation of the Stiff N2B Titin Isoform Raises Cardiomyocyte Resting Tension in Failing Human Myocardium

Attila Borbély ; Ines Falcao-Pires ; Loek van Heerebeek ; Nazha Hamdani ; István Édes ; Cristina Gavina ; Adelino F. Leite-Moreira ; Jean G.F. Bronzwaer ; Zoltán Papp ; Jolanda van der Velden ; Ger J.M. Stienen ; and Walter J. Paulus *

From the Department of Physiology (A.B., I.F-P, L.v.H., N.H., J.v.d.V, G.J.M.S., W.J.P.) and Cardiology (J.G.F.B.), Institute for Cardiovascular Research, VU University Medical Center Amsterdam, The Netherlands; Institute of Cardiology (A.B., I.É., Z.P.), University of Debrecen Medical and Health Science Center, Debrecen, Hungary; and Department of Physiology (I.F-P., C.G., A.F.L-M.), University of Porto, Portugal.

* To whom correspondence should be addressed. E-mail: wj.paulus{at}vumc.nl.

High diastolic stiffness of failing myocardium results from interstitial fibrosis and elevated resting tension (Fpassive) of cardiomyocytes. A shift in titin isoform expression from N2BA to N2B isoform, lower overall phosphorylation of titin, and a shift in titin phosphorylation from N2B to N2BA isoform can raise Fpassive of cardiomyocytes. In left ventricular biopsies of heart failure (HF) patients, aortic stenosis (AS) patients, and controls (CON), we therefore related Fpassive of isolated cardiomyocytes to expression of titin isoforms and to phosphorylation of titin and titin isoforms. Biopsies were procured by transvascular technique (44 HF, 3 CON), perioperatively (25 AS, 4 CON), or from explanted hearts (4 HF, 8 CON). None had coronary artery disease. Isolated, permeabilized cardiomyocytes were stretched to 2.2-µm sarcomere length to measure Fpassive. Expression and phosphorylation of titin isoforms were analyzed using gel electrophoresis with ProQ Diamond and SYPRO Ruby stains and reported as ratio of titin (N2BA/N2B) or of phosphorylated titin (P-N2BA/P-N2B) isoforms. Fpassive was higher in HF (6.1±0.4 kN/m2) than in CON (2.3±0.3 kN/m2; P<0.01) or in AS (2.2±0.2 kN/m2; P<0.001). Titin isoform expression differed between HF (N2BA/N2B=0.73±0.06) and CON (N2BA/N2B=0.39±0.05; P<0.001) and was comparable in HF and AS (N2BA/N2B=0.59±0.06). Overall titin phosphorylation was also comparable in HF and AS, but relative phosphorylation of the stiff N2B titin isoform was significantly lower in HF (P-N2BA/P-N2B=0.77±0.05) than in AS (P-N2BA/P-N2B=0.54±0.05; P<0.01). Relative hypophosphorylation of the stiff N2B titin isoform is a novel mechanism responsible for raised Fpassive of human HF cardiomyocytes.


Key words: myocardium • heart failure • diastole • titin




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