s-biased β2-adrenergic receptor signaling from restoring synchronous contraction in the failing heart

Khalid Chakir, Charlene Depry, Veronica L. Dimaano, Wei Zhong Zhu, Marc Vanderheyden, Jozef Bartunek, Theodore P. Abraham, Gordon F. Tomaselli, Shu Bai Liu, Yang K. Xiang, Manling Zhang, Eiki Takimoto, Nickolai Dulin, Rui Ping Xiao, Jin Zhang, David A. Kass

Research output: Contribution to journalArticle

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Abstract

Cardiac resynchronization therapy (CRT), in which both ventricles are paced to recoordinate contraction in hearts that are dyssynchronous from conduction delay, is the only heart failure (HF) therapy to date to clinically improve acute and chronic function while also lowering mortality. CRT acutely enhances chamber mechanical efficiency but chronically alters myocyte signaling, including improving β-adrenergic receptor reserve. We speculated that the latter would identify unique CRT effects that might themselves be effective for HF more generally. HF was induced in dogs by 6 weeks of atrial rapid pacing with (HFdys, left bundle ablated) or without (HFsyn) dyssynchrony. We used dyssynchronous followed by resynchronized tachypacing (each 3 weeks) for CRT. Both HFdys and HFsyn myocytes had similarly depressed rest and β-adrenergic receptor sarcomere and calcium responses, particularly the β2-adrenergic response, whereas cells subjected to CRT behaved similarly to those from healthy controls. CRT myocytes exhibited suppressed Gαi signaling linked to increased regulator of G protein (heterotrimeric guanine nucleotide-binding protein) signaling (RGS2, RGS3), yielding Gαs-biased β2-adrenergic responses. This included increased adenosine cyclic AMP responsiveness and activation of sarcoplasmic reticulum-localized protein kinase A. Human CRT responders also showed up-regulated myocardial RGS2 and RGS3. Inhibition of Gαi (with pertussis toxin, RGS3, or RGS2 transfection), stimulation with a Gαs-biased β2 agonist (fenoterol), or transient (2-week) exposure to dyssynchrony restored β-adrenergic receptor responses in HFsyn to the values obtained after CRT. These results identify a key pathway that is triggered by restoring contractile synchrony and that may represent a new therapeutic approach for a broad population of HF patients.

Original languageEnglish (US)
Article number100ra88
JournalScience Translational Medicine
Volume3
Issue number100
DOIs
StatePublished - Sep 14 2011
Externally publishedYes

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Cardiac Resynchronization Therapy
Adrenergic Receptors
Heart Failure
Muscle Cells
Adrenergic Agents
Fenoterol
Heterotrimeric GTP-Binding Proteins
Sarcomeres
Guanine Nucleotides
Pertussis Toxin
Sarcoplasmic Reticulum
Cyclic AMP-Dependent Protein Kinases
Cyclic AMP
Adenosine
Transfection
Carrier Proteins
Dogs
Calcium
Mortality
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Chakir, K., Depry, C., Dimaano, V. L., Zhu, W. Z., Vanderheyden, M., Bartunek, J., ... Kass, D. A. (2011). s-biased β2-adrenergic receptor signaling from restoring synchronous contraction in the failing heart. Science Translational Medicine, 3(100), [100ra88]. https://doi.org/10.1126/scitranslmed.3001909

s-biased β2-adrenergic receptor signaling from restoring synchronous contraction in the failing heart. / Chakir, Khalid; Depry, Charlene; Dimaano, Veronica L.; Zhu, Wei Zhong; Vanderheyden, Marc; Bartunek, Jozef; Abraham, Theodore P.; Tomaselli, Gordon F.; Liu, Shu Bai; Xiang, Yang K.; Zhang, Manling; Takimoto, Eiki; Dulin, Nickolai; Xiao, Rui Ping; Zhang, Jin; Kass, David A.

In: Science Translational Medicine, Vol. 3, No. 100, 100ra88, 14.09.2011.

Research output: Contribution to journalArticle

Chakir, K, Depry, C, Dimaano, VL, Zhu, WZ, Vanderheyden, M, Bartunek, J, Abraham, TP, Tomaselli, GF, Liu, SB, Xiang, YK, Zhang, M, Takimoto, E, Dulin, N, Xiao, RP, Zhang, J & Kass, DA 2011, 's-biased β2-adrenergic receptor signaling from restoring synchronous contraction in the failing heart', Science Translational Medicine, vol. 3, no. 100, 100ra88. https://doi.org/10.1126/scitranslmed.3001909
Chakir, Khalid ; Depry, Charlene ; Dimaano, Veronica L. ; Zhu, Wei Zhong ; Vanderheyden, Marc ; Bartunek, Jozef ; Abraham, Theodore P. ; Tomaselli, Gordon F. ; Liu, Shu Bai ; Xiang, Yang K. ; Zhang, Manling ; Takimoto, Eiki ; Dulin, Nickolai ; Xiao, Rui Ping ; Zhang, Jin ; Kass, David A. / s-biased β2-adrenergic receptor signaling from restoring synchronous contraction in the failing heart. In: Science Translational Medicine. 2011 ; Vol. 3, No. 100.
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abstract = "Cardiac resynchronization therapy (CRT), in which both ventricles are paced to recoordinate contraction in hearts that are dyssynchronous from conduction delay, is the only heart failure (HF) therapy to date to clinically improve acute and chronic function while also lowering mortality. CRT acutely enhances chamber mechanical efficiency but chronically alters myocyte signaling, including improving β-adrenergic receptor reserve. We speculated that the latter would identify unique CRT effects that might themselves be effective for HF more generally. HF was induced in dogs by 6 weeks of atrial rapid pacing with (HFdys, left bundle ablated) or without (HFsyn) dyssynchrony. We used dyssynchronous followed by resynchronized tachypacing (each 3 weeks) for CRT. Both HFdys and HFsyn myocytes had similarly depressed rest and β-adrenergic receptor sarcomere and calcium responses, particularly the β2-adrenergic response, whereas cells subjected to CRT behaved similarly to those from healthy controls. CRT myocytes exhibited suppressed Gαi signaling linked to increased regulator of G protein (heterotrimeric guanine nucleotide-binding protein) signaling (RGS2, RGS3), yielding Gαs-biased β2-adrenergic responses. This included increased adenosine cyclic AMP responsiveness and activation of sarcoplasmic reticulum-localized protein kinase A. Human CRT responders also showed up-regulated myocardial RGS2 and RGS3. Inhibition of Gαi (with pertussis toxin, RGS3, or RGS2 transfection), stimulation with a Gαs-biased β2 agonist (fenoterol), or transient (2-week) exposure to dyssynchrony restored β-adrenergic receptor responses in HFsyn to the values obtained after CRT. These results identify a key pathway that is triggered by restoring contractile synchrony and that may represent a new therapeutic approach for a broad population of HF patients.",
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