Abstract
In the early 1990s, researchers identified a genetic basis for hypertrophic cardiomyopathy (HCM) (Geisterfer-Lowrance et al., Cell, 62(5):999–1006, 1990). They proposed that mutations in sarcomeric genes are causal for the hypertrophic phenotype. This opened the door to a new understanding of the disease pathology (Seidman and Seidman, Cell, 104(4):557–67, 2001). Experimentation into the molecular mechanisms of these mutations, along with increased genetic testing, revealed that sarcomeric gene mutations are also causal for dilated cardiomyopathy (DCM) and restrictive cardiomyopathy (RCM). This led to the redefining of these familial diseases as sarcomeric cardiomyopathies (Tardiff et al., Cardiovasc Res, 105(4):457–70, 2015; van der Velden et al., Cardiovasc Res, 105(4):449–56, 2015). This chapter provides an overview of the molecular mechanisms of sarcomeric cardiomyopathies and experimental therapies that target these mechanisms.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Geisterfer-Lowrance AA, Kass S, Tanigawa G, Vosberg HP, McKenna W, Seidman CE, Seidman JG. A molecular basis for familial hypertrophic cardiomyopathy: a beta cardiac myosin heavy chain gene missense mutation. Cell. 1990;62(5):999–1006.
Seidman JG, Seidman C. The genetic basis for cardiomyopathy: from mutation identification to mechanistic paradigms. Cell. 2001;104(4):557–67.
Tardiff JC, Carrier L, Bers DM, Poggesi C, Ferrantini C, Coppini R, Maier LS, Ashrafian H, Huke S, van der Velden J. Targets for therapy in sarcomeric cardiomyopathies. Cardiovasc Res. 2015;105(4):457–70.
van der Velden J, Ho CY, Tardiff JC, Olivotto I, Knollmann BC, Carrier L. Research priorities in sarcomeric cardiomyopathies. Cardiovasc Res. 2015;105(4):449–56.
Gordon AM, Homsher E, Regnier M. Regulation of contraction in striated muscle. Physiol Rev. 2000;80(2):853–924.
Bers DM. Cardiac excitation-contraction coupling. Nature. 2002;415(6868):198–205.
Li MX, Spyracopoulos L, Sykes BD. Binding of cardiac troponin-I147-163 induces a structural opening in human cardiac troponin-C. Biochemistry. 1999;38(26):8289–98.
Willott RH, Gomes AV, Chang AN, Parvatiyar MS, Pinto JR, Potter JD. Mutations in Troponin that cause HCM, DCM AND RCM: what can we learn about thin filament function? J Mol Cell Cardiol. 2010;48(5):882–92.
Farah CS, Reinach FC. The troponin complex and regulation of muscle contraction. FASEB J. 1995;9(9):755–67.
Tobacman LS. Thin filament-mediated regulation of cardiac contraction. Annu Rev Physiol. 1996;58:447–81.
Huke S, Knollmann BC. Increased myofilament Ca2+-sensitivity and arrhythmia susceptibility. J Mol Cell Cardiol. 2010;48(5):824–33.
Yasuda S, Coutu P, Sadayappan S, Robbins J, Metzger JM. Cardiac transgenic and gene transfer strategies converge to support an important role for troponin I in regulating relaxation in cardiac myocytes. Circ Res. 2007;101(4):377–86.
Day SM, Westfall MV, Metzger JM. Tuning cardiac performance in ischemic heart disease and failure by modulating myofilament function. J Mol Med (Berl). 2007;85(9):911–21.
Wolff MR, Buck SH, Stoker SW, Greaser ML, Mentzer RM. Myofibrillar calcium sensitivity of isometric tension is increased in human dilated cardiomyopathies: role of altered beta-adrenergically mediated protein phosphorylation. J Clin Invest. 1996;98(1):167–76.
Nonaka M, Morimoto S. Experimental models of inherited cardiomyopathy and its therapeutics. World J Cardiol. 2014;6(12):1245–51.
Maron BJ, Maron MS, Semsarian C. Genetics of hypertrophic cardiomyopathy after 20 years: clinical perspectives. J Am Coll Cardiol. 2012;60(8):705–15.
Lu QW, Wu XY, Morimoto S. Inherited cardiomyopathies caused by troponin mutations. J Geriatr Cardiol. 2013;10(1):91–101.
Spudich JA. Hypertrophic and dilated cardiomyopathy: four decades of basic research on muscle lead to potential therapeutic approaches to these devastating genetic diseases. Biophys J. 2014;106(6):1236–49.
Ho CY. Genetic considerations in hypertrophic cardiomyopathy. Prog Cardiovasc Dis. 2012;54(6):456–60.
Coppini R, Ho CY, Ashley E, Day S, Ferrantini C, Girolami F, Tomberli B, Bardi S, Torricelli F, Cecchi F, Mugelli A, Poggesi C, Tardiff J, Olivotto I. Clinical phenotype and outcome of hypertrophic cardiomyopathy associated with thin-filament gene mutations. J Am Coll Cardiol. 2014;64(24):2589–600.
Alfares AA, Kelly MA, McDermott G, Funke BH, Lebo MS, Baxter SB, Shen J, McLaughlin HM, Clark EH, Babb LJ, Cox SW, DePalma SR, Ho CY, Seidman JG, Seidman CE, Rehm HL. Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity. Genet Med. 2015;17:880.
Mestroni L, Brun F, Spezzacatene A, Sinagra G, Taylor MR. Genetic causes of dilated cardiomyopathy. Prog Pediatr Cardiol. 2014;37(1-2):13–8.
McNally EM, Puckelwartz MJ. Genetic variation in cardiomyopathy and cardiovascular disorders. Circ J. 2015;79(7):1409–15.
Blankenburg R, Hackert K, Wurster S, Deenen R, Seidman JG, Seidman CE, Lohse MJ, Schmitt JP. beta-Myosin heavy chain variant Val606Met causes very mild hypertrophic cardiomyopathy in mice, but exacerbates HCM phenotypes in mice carrying other HCM mutations. Circ Res. 2014;115(2):227–37.
Maron BJ, Ho CY. Hypertrophic cardiomyopathy without hypertrophy: an emerging preclinical subgroup composed of genetically affected family members. JACC Cardiovasc Imaging. 2009;2(1):65–8.
Maron BJ, Yeates L, Semsarian C. Clinical challenges of genotype positive (+)-phenotype negative (-) family members in hypertrophic cardiomyopathy. Am J Cardiol. 2011;107(4):604–8.
Gollapudi SK, Tardiff JC, Chandra M. The functional effect of dilated cardiomyopathy mutation (R144W) in mouse cardiac troponin T is differently affected by alpha- and beta-myosin heavy chain isoforms. Am J Physiol Heart Circ Physiol. 2015;308(8):H884–93.
Tardiff JC. It’s never too early to look: subclinical disease in sarcomeric dilated cardiomyopathy. Circ Cardiovasc Genet. 2012;5(5):483–6.
McNally EM, Golbus JR, Puckelwartz MJ. Genetic mutations and mechanisms in dilated cardiomyopathy. J Clin Invest. 2013;123(1):19–26.
McNally EM. Genetics: broken giant linked to heart failure. Nature. 2012;483(7389):281–2.
Leinwand LA, Tardiff JC, Gregorio CC. Mutations in the sensitive giant titin result in a broken heart. Circ Res. 2012;111(2):158–61.
Wang D, McCully ME, Luo Z, McMichael J, Tu AY, Daggett V, Regnier M. Structural and functional consequences of cardiac troponin C L57Q and I61Q Ca(2+)-desensitizing variants. Arch Biochem Biophys. 2013;535(1):68–75.
Liu B, Tikunova SB, Kline KP, Siddiqui JK, Davis JP. Disease-related cardiac troponins alter thin filament Ca2+ association and dissociation rates. PLoS One. 2012;7(6):e38259.
Parvatiyar MS, Pinto JR, Liang J, Potter JD. Predicting cardiomyopathic phenotypes by altering Ca2+ affinity of cardiac troponin C. J Biol Chem. 2010;285(36):27785–97.
Lim CC, Yang H, Yang M, Wang CK, Shi J, Berg EA, Pimentel DR, Gwathmey JK, Hajjar RJ, Helmes M, Costello CE, Huo S, Liao R. A novel mutant cardiac troponin C disrupts molecular motions critical for calcium binding affinity and cardiomyocyte contractility. Biophys J. 2008;94(9):3577–89.
Davis J, Metzger JM. Combinatorial effects of double cardiomyopathy mutant alleles in rodent myocytes: a predictive cellular model of myofilament dysregulation in disease. PLoS One. 2010;5(2):e9140.
Du CK, Zhan DY, Morimoto S. In vivo effects of propyl gallate, a novel Ca(2+) sensitizer, in a mouse model of dilated cardiomyopathy caused by cardiac troponin T mutation. Life Sci. 2014;109(1):15–9.
Du CK, Morimoto S, Nishii K, Minakami R, Ohta M, Tadano N, Lu QW, Wang YY, Zhan DY, Mochizuki M, Kita S, Miwa Y, Takahashi-Yanaga F, Iwamoto T, Ohtsuki I, Sasaguri T. Knock-in mouse model of dilated cardiomyopathy caused by troponin mutation. Circ Res. 2007;101(2):185–94.
Duncker DJ, Bakkers J, Brundel BJ, Robbins J, Tardiff JC, Carrier L. Animal and in silico models for the study of sarcomeric cardiomyopathies. Cardiovasc Res. 2015;105(4):439–48.
Tardiff JC. Tropomyosin and dilated cardiomyopathy: revenge of the actinomyosin “gatekeeper”. J Am Coll Cardiol. 2010;55(4):330–2.
Bos JM, Towbin JA, Ackerman MJ. Diagnostic, prognostic, and therapeutic implications of genetic testing for hypertrophic cardiomyopathy. J Am Coll Cardiol. 2009;54(3):201–11.
Hernandez OM, Szczesna-Cordary D, Knollmann BC, Miller T, Bell M, Zhao J, Sirenko SG, Diaz Z, Guzman G, Xu Y, Wang Y, Kerrick WG, Potter JD. F110I and R278C troponin T mutations that cause familial hypertrophic cardiomyopathy affect muscle contraction in transgenic mice and reconstituted human cardiac fibers. J Biol Chem. 2005;280(44):37183–94.
Chandra M, Rundell VL, Tardiff JC, Leinwand LA, De Tombe PP, Solaro RJ. Ca(2+) activation of myofilaments from transgenic mouse hearts expressing R92Q mutant cardiac troponin T. Am J Physiol Heart Circ Physiol. 2001;280(2):H705–13.
Michele DE, Albayya FP, Metzger JM. Direct, convergent hypersensitivity of calcium-activated force generation produced by hypertrophic cardiomyopathy mutant alpha-tropomyosins in adult cardiac myocytes. Nat Med. 1999;5(12):1413–7.
Davis J, Wen H, Edwards T, Metzger JM. Allele and species dependent contractile defects by restrictive and hypertrophic cardiomyopathy-linked troponin I mutants. J Mol Cell Cardiol. 2008;44(5):891–904.
Tardiff JC, Hewett TE, Palmer BM, Olsson C, Factor SM, Moore RL, Robbins J, Leinwand LA. Cardiac troponin T mutations result in allele-specific phenotypes in a mouse model for hypertrophic cardiomyopathy. J Clin Invest. 1999;104(4):469–81.
Montgomery DE, Tardiff JC, Chandra M. Cardiac troponin T mutations: correlation between the type of mutation and the nature of myofilament dysfunction in transgenic mice. J Physiol. 2001;536(Pt 2):583–92.
Javadpour MM, Tardiff JC, Pinz I, Ingwall JS. Decreased energetics in murine hearts bearing the R92Q mutation in cardiac troponin T. J Clin Invest. 2003;112(5):768–75.
He H, Javadpour MM, Latif F, Tardiff JC, Ingwall JS. R-92L and R-92W mutations in cardiac troponin T lead to distinct energetic phenotypes in intact mouse hearts. Biophys J. 2007;93(5):1834–44.
Haim TE, Dowell C, Diamanti T, Scheuer J, Tardiff JC. Independent FHC-related cardiac troponin T mutations exhibit specific alterations in myocellular contractility and calcium kinetics. J Mol Cell Cardiol. 2007;42(6):1098–110.
Moore RK, Grinspan LT, Jimenez J, Guinto PJ, Ertz-Berger B, Tardiff JC. HCM-linked 160E cardiac troponin T mutation causes unique progressive structural and molecular ventricular remodeling in transgenic mice. J Mol Cell Cardiol. 2013;58:188–98.
Schlossarek S, Mearini G, Carrier L. Cardiac myosin-binding protein C in hypertrophic cardiomyopathy: mechanisms and therapeutic opportunities. J Mol Cell Cardiol. 2011;50(4):613–20.
Mearini G, Stimpel D, Geertz B, Weinberger F, Krämer E, Schlossarek S, Mourot-Filiatre J, Stoehr A, Dutsch A, Wijnker PJ, Braren I, Katus HA, Müller OJ, Voit T, Eschenhagen T, Carrier L. Mybpc3 gene therapy for neonatal cardiomyopathy enables long-term disease prevention in mice. Nat Commun. 2014;5:5515.
Tyska MJ, Hayes E, Giewat M, Seidman CE, Seidman JG, Warshaw DM. Single-molecule mechanics of R403Q cardiac myosin isolated from the mouse model of familial hypertrophic cardiomyopathy. Circ Res. 2000;86(7):737–44.
Palmer BM, Fishbaugher DE, Schmitt JP, Wang Y, Alpert NR, Seidman CE, Seidman JG, VanBuren P, Maughan DW. Differential cross-bridge kinetics of FHC myosin mutations R403Q and R453C in heterozygous mouse myocardium. Am J Physiol Heart Circ Physiol. 2004;287(1):H91–9.
Knollmann BC, Kirchhof P, Sirenko SG, Degen H, Greene AE, Schober T, Mackow JC, Fabritz L, Potter JD, Morad M. Familial hypertrophic cardiomyopathy-linked mutant troponin T causes stress-induced ventricular tachycardia and Ca2+-dependent action potential remodeling. Circ Res. 2003;92(4):428–36.
Baudenbacher F, Schober T, Pinto JR, Sidorov VY, Hilliard F, Solaro RJ, Potter JD, Knollmann BC. Myofilament Ca2+ sensitization causes susceptibility to cardiac arrhythmia in mice. J Clin Invest. 2008;118(12):3893–903.
Huke S, Venkataraman R, Faggioni M, Bennuri S, Hwang HS, Baudenbacher F, Knollmann BC. Focal energy deprivation underlies arrhythmia susceptibility in mice with calcium-sensitized myofilaments. Circ Res. 2013;112(10):1334–44.
Schober T, Huke S, Venkataraman R, Gryshchenko O, Kryshtal D, Hwang HS, Baudenbacher FJ, Knollmann BC. Myofilament Ca sensitization increases cytosolic Ca binding affinity, alters intracellular Ca homeostasis, and causes pause-dependent Ca-triggered arrhythmia. Circ Res. 2012;111(2):170–9.
Parvatiyar MS, et al. Cardiac troponin mutations and restrictive cardiomyopathy. J Biomed Biotechnol. 2010;2010:350706.
Jean-Charles PY, Li YJ, Nan CL, Huang XP. Insights into restrictive cardiomyopathy from clinical and animal studies. J Geriatr Cardiol. 2011;8(3):168–83.
Mogensen J, Kubo T, Duque M, Uribe W, Shaw A, Murphy R, Gimeno JR, Elliott P, McKenna WJ. Idiopathic restrictive cardiomyopathy is part of the clinical expression of cardiac troponin I mutations. J Clin Invest. 2003;111(2):209–16.
van den Wijngaard A, Volders P, Van Tintelen JP, Jongbloed JD, van den Berg MP, Lekanne Deprez RH, Mannens MM, Hofmann N, Slegtenhorst M, Dooijes D, Michels M, Arens Y, Jongbloed R, Smeets BJ. Recurrent and founder mutations in the Netherlands: cardiac Troponin I (TNNI3) gene mutations as a cause of severe forms of hypertrophic and restrictive cardiomyopathy. Neth Heart J. 2011;19(7-8):344–51.
Gomes AV, Liang J, Potter JD. Mutations in human cardiac troponin I that are associated with restrictive cardiomyopathy affect basal ATPase activity and the calcium sensitivity of force development. J Biol Chem. 2005;280(35):30909–15.
Kobayashi T, Solaro RJ. Increased Ca2+ affinity of cardiac thin filaments reconstituted with cardiomyopathy-related mutant cardiac troponin I. J Biol Chem. 2006;281(19):13471–7.
Wen Y, Xu Y, Wang Y, Pinto JR, Potter JD, Kerrick WG. Functional effects of a restrictive-cardiomyopathy-linked cardiac troponin I mutation (R145W) in transgenic mice. J Mol Biol. 2009;392(5):1158–67.
Wen Y, Pinto JR, Gomes AV, Xu Y, Wang Y, Wang Y, Potter JD, Kerrick WG. Functional consequences of the human cardiac troponin I hypertrophic cardiomyopathy mutation R145G in transgenic mice. J Biol Chem. 2008;283(29):20484–94.
Davis J, Wen H, Edwards T, Metzger JM. Thin filament disinhibition by restrictive cardiomyopathy mutant R193H troponin I induces Ca2+-independent mechanical tone and acute myocyte remodeling. Circ Res. 2007;100(10):1494–502.
Davis J, Yasuda S, Palpant NJ, Martindale J, Stevenson T, Converso K, Metzger JM. Diastolic dysfunction and thin filament dysregulation resulting from excitation-contraction uncoupling in a mouse model of restrictive cardiomyopathy. J Mol Cell Cardiol. 2012;53(3):446–57.
Du J, Liu J, Feng HZ, Hossain MM, Gobara N, Zhang C, Li Y, Jean-Charles PY, Jin JP, Huang XP. Impaired relaxation is the main manifestation in transgenic mice expressing a restrictive cardiomyopathy mutation, R193H, in cardiac TnI. Am J Physiol Heart Circ Physiol. 2008;294(6):H2604–13.
Ho CY, Charron P, Richard P, Girolami F, Van Spaendonck-Zwarts KY, Pinto Y. Genetic advances in sarcomeric cardiomyopathies: state of the art. Cardiovasc Res. 2015;105(4):397–408.
Hwang PM, Sykes BD. Targeting the sarcomere to correct muscle function. Nat Rev Drug Discov. 2015;14(5):313–28.
Cleland JG, Teerlink JR, Senior R, Nifontov EM, Mc Murray JJ, Lang CC, Tsyrlin VA, Greenberg BH, Mayet J, Francis DP, Shaburishvili T, Monaghan M, Saltzberg M, Neyses L, Wasserman SM, Lee JH, Saikali KG, Clarke CP, Goldman JH, Wolff AA, Malik FI. The effects of the cardiac myosin activator, omecamtiv mecarbil, on cardiac function in systolic heart failure: a double-blind, placebo-controlled, crossover, dose-ranging phase 2 trial. Lancet. 2011;378(9792):676–83.
Utter MS, Ryba DM, Li BH, Wolska BM, Solaro RJ. Omecamtiv mecarbil, a cardiac myosin activator, increases Ca2+-sensitivity in myofilaments with a dilated cardiomyopathy mutant tropomyosin E54K. J Cardiovasc Pharmacol. 2015;66:347.
Tadano N, Morimoto S, Takahashi-Yanaga F, Miwa Y, Ohtsuki I, Sasaguri T. Propyl gallate, a strong antioxidant, increases the Ca2+ sensitivity of cardiac myofilament. J Pharmacol Sci. 2009;109(3):456–8.
Semsarian C, Ahmad I, Giewat M, Georgakopoulos D, Schmitt JP, McConnell BK, Reiken S, Mende U, Marks AR, Kass DA, Seidman CE, Seidman JG. The L-type calcium channel inhibitor diltiazem prevents cardiomyopathy in a mouse model. J Clin Invest. 2002;109(8):1013–20.
Ho CY, Lakdawala NK, Cirino AL, Lipshultz SE, Sparks E, Abbasi SA, Kwong RY, Antman EM, Semsarian C, González A, López B, Diez J, Orav EJ, Colan SD, Seidman CE. Diltiazem treatment for preclinical hypertrophic cardiomyopathy sarcomere mutation carriers: a pilot randomized trial to modify disease expression. JACC Heart Fail. 2015;3(2):180–8.
Ashrafian H, Horowitz JD, Frenneaux MP. Perhexiline. Cardiovasc Drug Rev. 2007;25(1):76–97.
Abozguia K, Elliott P, McKenna W, Phan TT, Nallur-Shivu G, Ahmed I, Maher AR, Kaur K, Taylor J, Henning A, Ashrafian H, Watkins H, Frenneaux M. Metabolic modulator perhexiline corrects energy deficiency and improves exercise capacity in symptomatic hypertrophic cardiomyopathy. Circulation. 2010;122(16):1562–9.
Mearini G, Stimpel D, Krämer E, Geertz B, Braren I, Gedicke-Hornung C, Précigout G, Müller OJ, Katus HA, Eschenhagen T, Voit T, Garcia L, Lorain S, Carrier L. Repair of Mybpc3 mRNA by 5′-trans-splicing in a mouse model of hypertrophic cardiomyopathy. Mol Ther Nucleic Acids. 2013;2:e102.
Gedicke-Hornung C, Behrens-Gawlik V, Reischmann S, Geertz B, Stimpel D, Weinberger F, Schlossarek S, Précigout G, Braren I, Eschenhagen T, Mearini G, Lorain S, Voit T, Dreyfus PA, Garcia L, Carrier L. Rescue of cardiomyopathy through U7snRNA-mediated exon skipping in Mybpc3-targeted knock-in mice. EMBO Mol Med. 2013;5(7):1060–77.
Jiang J, Wakimoto H, Seidman JG, Seidman CE. Allele-specific silencing of mutant Myh6 transcripts in mice suppresses hypertrophic cardiomyopathy. Science. 2013;342(6154):111–4.
Katz MG, Fargnoli AS, Williams RD, Bridges CR. Gene therapy delivery systems for enhancing viral and nonviral vectors for cardiac diseases: current concepts and future applications. Hum Gene Ther. 2013;24(11):914–27.
Zsebo K, Yaroshinsky A, Rudy JJ, Wagner K, Greenberg B, Jessup M, Hajjar RJ. Long-term effects of AAV1/SERCA2a gene transfer in patients with severe heart failure: analysis of recurrent cardiovascular events and mortality. Circ Res. 2014;114(1):101–8.
Boutin S, Monteilhet V, Veron P, Leborgne C, Benveniste O, Montus MF, Masurier C. Prevalence of serum IgG and neutralizing factors against adeno-associated virus (AAV) types 1, 2, 5, 6, 8, and 9 in the healthy population: implications for gene therapy using AAV vectors. Hum Gene Ther. 2010;21(6):704–12.
Jinek M, Chylinski K, Fonfara I, Hauer M, Doudna JA, Charpentier E. A programmable dual-RNA-guided DNA endonuclease in adaptive bacterial immunity. Science. 2012;337(6096):816–21.
Long C, McAnally JR, Shelton JM, Mireault AA, Bassel-Duby R, Olson EN. Prevention of muscular dystrophy in mice by CRISPR/Cas9-mediated editing of germline DNA. Science. 2014;345(6201):1184–8.
Davis J, Westfall MV, Townsend D, Blankinship M, Herron TJ, Guerrero-Serna G, Wang W, Devaney E, Metzger JM. Designing heart performance by gene transfer. Physiol Rev. 2008;88(4):1567–651.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Thompson, B.R., Asp, M.L., Metzger, J.M. (2017). Molecular Mechanism of Sarcomeric Cardiomyopathies. In: Garry, D., Wilson, R., Vlodaver, Z. (eds) Congestive Heart Failure and Cardiac Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-44577-9_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-44577-9_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-44575-5
Online ISBN: 978-3-319-44577-9
eBook Packages: MedicineMedicine (R0)