Increased Postnatal Cardiac Hyperplasia Precedes Cardiomyocyte Hypertrophy in a Model of Hypertrophic Cardiomyopathy

Emily T Farrell1, Adrian C Grimes2, Willem J de Lange1

  • 1Department of Pediatrics, University of Wisconsin School of Medicine and Public HealthMadison, WI, United States.

Insights

In hypertrophic cardiomyopathy (HCM), increased cell division, not just cell growth, precedes heart enlargement in a mouse model. This early proliferation may determine disease severity in this common genetic heart condition.

Area of Science:

  • Cardiovascular Biology
  • Developmental Biology
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) affects ~0.5% of the population and is a major cause of sudden cardiac death in young adults.
  • While cardiomyocyte hypertrophy is the accepted mechanism for cardiac enlargement in HCM, the early signaling pathways initiating this process remain poorly understood.
  • Mutations in cardiac myosin binding protein C (MYBPC3) are a common cause of HCM.

Purpose of the Study:

  • To investigate the early cellular and molecular events preceding overt cardiac enlargement in a mouse model of MYBPC3-associated HCM.
  • To characterize the perinatal phenotype of cMyBP-C knockout (cMyBP-C-/-) mice, which rapidly develop cardiomegaly.
  • To determine whether cardiomyocyte proliferation or hypertrophy is the primary driver of early cardiac growth in this model.

Main Methods:

  • Utilized a cMyBP-C-/- mouse model of HCM, comparing knockout mice to wild-type littermates.
  • Employed a multi-omics approach including microarray analysis, quantitative PCR (qPCR), and immunohistochemistry (IHC).
  • Conducted echocardiography and isolated cardiomyocyte measurements to assess cardiac function and cell size/number over a time course from birth to postnatal day 9.

Main Results:

  • cMyBP-C-/- hearts exhibited elevated cardiomyocyte cell cycling at postnatal day 1, preceding the onset of overt hypertrophy by postnatal day 9.
  • Increased heart weight-to-body weight ratios were observed prior to cellular hypertrophy, correlating with increased cardiomyocyte proliferation.
  • Heterozygous cMyBP-C deletion showed a trend towards increased heart size but did not reach statistical significance by postnatal day 9.

Conclusions:

  • Altered cell cycle regulation and elevated cardiomyocyte proliferation precede hypertrophy in the cMyBP-C-/- HCM mouse model.
  • Increased cardiomyocyte number, resulting from proliferation, contributes significantly to early heart enlargement in this HCM model.
  • The pre-hypertrophic period characterized by proliferation represents a critical window for determining HCM commitment and disease severity.

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