Molecular Changes in Children with Heart Failure Undergoing Left Ventricular Assist Device Therapy - 18/04/17
Abstract |
Objective |
To determine whether left ventricular assist device (LVAD) treatment in children with heart failure would result in the modification of molecular pathways involved in heart failure pathophysiology.
Study design |
Forty-seven explanted hearts from children were studied (16 nonfailing control, 20 failing, and 11 failing post-LVAD implantation [F-LVAD]). Protein expression and phosphorylation states were determined by receptor binding assays and Western blots. mRNA expression was measured with real-time quantitative polymerase chain reaction. To evaluate for interactions and identify correlations, 2-way ANOVA and regression analysis were performed.
Results |
Treatment with LVAD resulted in recovery of total β-adrenergic receptor expression and β1-adrenergic receptor (β1-AR) in failing hearts to normal levels (β-adrenergic receptor expression : 67.2 ± 11.5 fmol/mg failing vs 99.5 ± 27.7 fmol/mg nonfailing, 104 ± 38.7 fmol/mg F-LVAD, P ≤ .01; β1-AR: 52.2 ± 10.3 fmol/mg failing vs 83.0 ± 23 fmol/mg non-failing, 76.5 ± 32.1 fmol/mg F-LVAD P ≤ .03). The high levels of G protein-coupled receptor kinase-2 were returned to nonfailing levels after LVAD treatment (5.6 ± 9.0 failing vs 1.0 ± 0.493 nonfailing, 1.0 ± 1.3 F-LVAD). Interestingly, β2-adrenergic receptor expression was significantly greater in F-LVAD (27.5 ± 12; P < .005) hearts compared with nonfailing (16.4 ± 6.1) and failing (15.1 ± 4.2) hearts. Phospholamban phosphorylation at serine 16 was significantly greater in F-LVAD (7.7 ± 11.7) hearts compared with nonfailing (1.0 ± 1.2, P = .02) and failing (0.8 ± 1.0, P = .01) hearts. Also, atrial natriuretic factor (0.6 ± 0.8) and brain natriuretic peptide (0.1 ± 0.1) expression in F-LVAD was significantly lower compared with failing hearts (2.8 ± 3.6, P = .01 and 0.6 ± 0.7, P = .02).
Conclusion |
LVAD treatment in children with heart failure results in reversal of several pathologic myocellular processes, and G protein-coupled receptor kinase-2 may regulate β1-AR but not β2-adrenergic receptor expression in children with heart failure.
Le texte complet de cet article est disponible en PDF.Keywords : β-adrenergic receptor, phospholamban, pathological gene program
Abbreviations : α-MyHC, β-AR, β1-AR, β2-AR, Bmax, GRK2, IDC, F-LVAD, LVAD, SERCA
Plan
| Supported by the Millisor Chair in Pediatric Heart Disease, Boedecker Foundation, Boulder, CO, the Nair Family, the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI; R21HL113846, R01HL126928 [both to S.M.], R01HL107715 [to B.S.], R21HL097123 [to S.M., B.S., C.S.]), and NIH/National Center for Advancing Translational Sciences Colorado (UL1 TR001082). E.M. was supported by NIH NHLBI (R01HL107715-01A1S1 [to B.S.]). Contents are the authors' sole responsibility and do not necessarily represent official NIH views. B.S. has received support from Forest Laboratories, Inc, and Stealth Biotherapeutics. C.S. has received equity in Miragen, Inc. S.M., B.S., and C.S. have received equity in Coramir Biomedical, Inc. P.N. declares no conflicts of interest. |
Vol 182
P. 184 - mars 2017 Retour au numéro
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