The Genetic and Molecular Bases for Hypertrophic Cardiomyopathy: The role for calcium sensitization

Abstract Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders. In patients, it leads to cardiac ischemia, heart failure, dysfunction of other organ systems, and increased risk for sudden unexpected cardiac deaths. HCM can be...

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Published in:Journal of cardiothoracic and vascular anesthesia Vol. 32; no. 1; pp. 478 - 487
Main Authors: Ren, Xianfeng, MD, PhD, Hensley, Nadia, MD, Brady, Mary Beth, MD, Gao, Wei Dong, MD, PhD
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-02-2018
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Abstract Abstract Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders. In patients, it leads to cardiac ischemia, heart failure, dysfunction of other organ systems, and increased risk for sudden unexpected cardiac deaths. HCM can be caused by single point mutations, insertion or deletion mutations, or truncation of cardiac myofilament proteins. The molecular mechanism that leads to disease progression and presentation is still poorly understood, despite decades of investigations. However, recent research has made dramatic advances in our understanding of HCM disease development. Studies have shown that increased Ca2+ sensitivity is a universal feature in HCM. At the molecular level, increased cross-bridge force (or power) generation resulting in hypercontractility is the prominent feature. Thus, Ca2+ sensitization/hypercontractility is emerging as the primary stimulus for HCM disease development and phenotypic expression. Cross-bridge inhibition has been shown to halt HCM presentation, and myofilament desensitization appears to reduce lethal arrhythmias in animal models of HCM. These advances in basic research will continue to deepen our knowledge of HCM pathogenesis and are beginning to revolutionize the management of HCM.
AbstractList Abstract Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders. In patients, it leads to cardiac ischemia, heart failure, dysfunction of other organ systems, and increased risk for sudden unexpected cardiac deaths. HCM can be caused by single point mutations, insertion or deletion mutations, or truncation of cardiac myofilament proteins. The molecular mechanism that leads to disease progression and presentation is still poorly understood, despite decades of investigations. However, recent research has made dramatic advances in our understanding of HCM disease development. Studies have shown that increased Ca2+ sensitivity is a universal feature in HCM. At the molecular level, increased cross-bridge force (or power) generation resulting in hypercontractility is the prominent feature. Thus, Ca2+ sensitization/hypercontractility is emerging as the primary stimulus for HCM disease development and phenotypic expression. Cross-bridge inhibition has been shown to halt HCM presentation, and myofilament desensitization appears to reduce lethal arrhythmias in animal models of HCM. These advances in basic research will continue to deepen our knowledge of HCM pathogenesis and are beginning to revolutionize the management of HCM.
Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders and leads to cardiac ischemia, heart failure, dysfunction of other organ systems, and increased risk for sudden unexpected cardiac deaths. HCM can be caused by single-point mutations, insertion or deletion mutations, or truncation of cardiac myofilament proteins. The molecular mechanism that leads to disease progression and presentation is still poorly understood, despite decades of investigations. However, recent research has made dramatic advances in the understanding of HCM disease development. Studies have shown that increased calcium sensitivity is a universal feature in HCM. At the molecular level, increased crossbridge force (or power) generation resulting in hypercontractility is the prominent feature. Thus, calcium sensitization/hypercontractility is emerging as the primary stimulus for HCM disease development and phenotypic expression. Cross-bridge inhibition has been shown to halt HCM presentation, and myofilament desensitization appears to reduce lethal arrhythmias in animal models of HCM. These advances in basic research will continue to deepen the knowledge of HCM pathogenesis and are beginning to revolutionize the management of HCM.
Author Ren, Xianfeng, MD, PhD
Gao, Wei Dong, MD, PhD
Hensley, Nadia, MD
Brady, Mary Beth, MD
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/29203298$$D View this record in MEDLINE/PubMed
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Keywords myofilaments
molecular bases
hypertrophic cardiomyopathy
genetics
calcium sensitization
Language English
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Snippet Abstract Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders. In patients, it leads...
Hypertrophic cardiomyopathy (HCM) affects millions of people around the world as one of the most common genetic heart disorders and leads to cardiac ischemia,...
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SubjectTerms Anesthesia & Perioperative Care
calcium sensitization
Critical Care
genetics
hypertrophic cardiomyopathy
molecular bases
myofilaments
Title The Genetic and Molecular Bases for Hypertrophic Cardiomyopathy: The role for calcium sensitization
URI https://www.clinicalkey.es/playcontent/1-s2.0-S105307701730513X
https://dx.doi.org/10.1053/j.jvca.2017.05.035
https://www.ncbi.nlm.nih.gov/pubmed/29203298
https://search.proquest.com/docview/1973024944
Volume 32
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