BACKGROUND
Familial restrictive cardiomyopathy (FRCM) has a poor prognosis due to diastolic dysfunction and restrictive physiology (RP). Myocardial stiffness, with or without fibrosis, underlie the RP, but the mechanism(s) of restrictive remodeling is unclear. Myopalladin (MYPN) is a messenger molecule that links structural and gene regulatory molecules via translocation from the Z-disk and I-bands to the nucleus in cardiomyocytes. Expression of N-terminal MYPN peptide results in a severe disruption of sarcomere.
OBJECTIVES
A nonsense MYPN-Q529X mutation previously identified in the FRCM family was studied here in an animal model to explore the molecular and pathogenic mechanisms of FRCM.
METHODS
Functional (echocardiography, cardiac magnetic resonance [CMR] imaging, electrocardiography), morphohistological, gene expression, and molecular studies were performed in knock-in heterozygote (MypnWT/Q526X) and homozygote mice harboring the human MYPN-Q529X mutation.
RESULTS
At 12 weeks of age, echocardiographic and CMR imaging signs of diastolic dysfunction with preserved systolic function were identified in MypnWT/Q526X mice. Histology revealed interstitial and perivascular fibrosis without overt hypertrophic remodeling. Truncated MypnQ526X protein was found to translocate to the nucleus. Levels of total and nuclear cardiac ankyrin repeat protein (Carp/Ankrd1) and phosphorylation of Mek1/2, Erk1/2, Smad2, and Akt were reduced. Up-regulation was evident for muscle LIM protein (Mlp), desmin, and heart failure (Nppa, Nppb, and Myh6) and fibrosis (TgfÎČ1, αSma, Opn, and Postn) markers.
CONCLUSIONS
Heterozygote MypnWT/Q526X knock-in mice develop RCM due to persistence of mutant Mypn-Q526X protein in the nucleus. Down-regulation of Carp and up-regulation of Mlp and desmin appear to augment fibrotic restrictive remodeling, and reduced Erk1/2 blunts a hypertrophic response in MypnWT/Q526X hearts.