1. Cardiac resynchronization sensitizes the sarcomere to calcium by reactivating GSK-3?
- Author
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Pieter P. de Tombe, David A. Kass, Giulio Agnetti, Jennifer E. Van Eyk, Namthip Witayavanitkul, Jonathan A. Kirk, Wei Dong Gao, Viola Kooij, Richard S. Tunin, Ronald J. Holewinski, Kirk JA, Holewinski RJ, Kooij V, Agnetti G, Tunin RS, Witayavanitkul N, de Tombe PP, Gao WD, Van Eyk J, and Kass DA
- Subjects
Sarcomeres ,medicine.medical_specialty ,Myofilament ,genetic structures ,medicine.medical_treatment ,Heart Ventricles ,Cardiac resynchronization therapy ,chemistry.chemical_element ,Biology ,Calcium ,Cell Enlargement ,In Vitro Techniques ,Sarcomere ,Glycogen Synthase Kinase 3 ,Dogs ,Myofibrils ,Troponin T ,Internal medicine ,Troponin I ,medicine ,Myocyte ,Animals ,cardiovascular diseases ,Phosphorylation ,Ventricular dyssynchrony ,Heart Failure ,General Medicine ,medicine.disease ,Myocardial Contraction ,Enzyme Activation ,Endocrinology ,chemistry ,Heart failure ,Cardiology ,cardiovascular system ,CARDIAC RESYNCHRONIZATION THERAPY ,Protein Processing, Post-Translational ,Research Article ,circulatory and respiratory physiology - Abstract
Cardiac resynchronization therapy (CRT), the application of biventricular stimulation to correct discoordinate contraction, is the only heart failure treatment that enhances acute and chronic systolic function, increases cardiac work, and reduces mortality. Resting myocyte function also increases after CRT despite only modest improvement in calcium transients, suggesting that CRT may enhance myofilament calcium responsiveness. To test this hypothesis, we examined adult dogs subjected to tachypacing-induced heart failure for 6 weeks, concurrent with ventricular dyssynchrony (HFdys) or CRT. Myofilament force-calcium relationships were measured in skinned trabeculae and/or myocytes. Compared with control, maximal calcium-activated force and calcium sensitivity declined globally in HFdys; however, CRT restored both. Phosphatase PP1 induced calcium desensitization in control and CRT-treated cells, while HFdys cells were unaffected, implying that CRT enhances myofilament phosphorylation. Proteomics revealed phosphorylation sites on Z-disk and M-band proteins, which were predicted to be targets of glycogen synthase kinase-3beta (GSK-3beta). We found that GSK-3beta was deactivated in HFdys and reactivated by CRT. Mass spectrometry of myofilament proteins from HFdys animals incubated with GSK-3beta confirmed GSK-3beta-dependent phosphorylation at many of the same sites observed with CRT. GSK-3beta restored calcium sensitivity in HFdys, but did not affect control or CRT cells. These data indicate that CRT improves calcium responsiveness of myofilaments following HFdys through GSK-3beta reactivation, identifying a therapeutic approach to enhancing contractile function.
- Published
- 2014