Compensatory and decompensatory alterations in cardiomyocyte Ca2+ dynamics in hearts with diastolic dysfunction

Sara Gattoni1, Åsmund Treu Røe2,3, Jan Magnus Aronsen4

  • 1King's College London, Department of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, 4th floor North Wing, The Rayne Institute, London, SE1 7EH, UK.

Insights

Cardiac hypertrophy remodels cellular function, impacting calcium dynamics. Biophysical models show L-type Ca2+ channels and SERCA regulate Ca2+ but hypertrophy diminishes dynamic systolic function while maintaining diastolic Ca2+ homeostasis.

Area of Science:

  • Cardiovascular Physiology
  • Computational Biology
  • Cellular Electrophysiology

Background:

  • Cardiac hypertrophy, caused by elevated left ventricular afterload, leads to cellular remodeling, affecting ionic channels, pumps, and exchangers.
  • This remodeling alters calcium (Ca2+) dynamics and the Ca2+ transient within myocytes, but the precise roles of subcellular processes are not fully understood.

Purpose of the Study:

  • To create and validate biophysical cardiac cell models to simulate electrophysiology and Ca2+ dynamics in healthy and hypertrophied rat myocytes.
  • To quantitatively link cellular-scale remodeling of ionic pathways to emergent cellular functionality and Ca2+ homeostasis.

Main Methods:

  • Developed and validated two biophysical cardiac cell models for control (SHAM) and aortic-banded (hypertrophy) rats.
  • Simulated electrophysiology and Ca2+ dynamics, calculating the contribution of each ionic pathway to Ca2+ kinetics.

Main Results:

  • Identified L-type Ca2+ channel (LCC) and sarco/endoplasmic reticulum Ca2+-ATPase (SERCA) as principal regulators of systolic and diastolic Ca2+, respectively.
  • In the hypertrophy model, systolic Ca2+ sensitivity to LCC density decreased 16-fold, while diastolic Ca2+ sensitivity to SERCA density increased 23%.
  • The ability to dynamically alter systolic function was significantly diminished, but diastolic Ca2+ maintenance capacity increased.

Conclusions:

  • Biophysical models effectively simulate Ca2+ dynamics in cardiac hypertrophy, quantitatively linking ionic pathway remodeling to cellular function.
  • Despite reduced dynamic systolic Ca2+ regulation, hypertrophied cells efficiently compensate to maintain Ca2+ homeostasis and minimize systolic dysfunction.
  • Ionic pathway remodeling in compensated hypertrophy maintains Ca2+ function and efficiency, with diminished systolic adaptability but enhanced diastolic control.

Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.1K
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
675
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
940
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
551
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.2K
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
3.3K