Anett Hellebø Ottesen1, Cathrine R Carlson1, William E Louch1, Mai Britt Dahl1, Ragnhild A Sandbu1, Rune Forstrøm Johansen1, Hilde Jarstadmarken1, Magnar Bjørås1, Arne Didrik Høiseth1, Jon Brynildsen1, Ivar Sjaastad1, Mats Stridsberg1, Torbjørn Omland1, Geir Christensen1, Helge Røsjø2. 1. From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.). 2. From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.). helge.rosjo@medisin.uio.no.
Abstract
BACKGROUND: Chromogranin A (CgA) levels have previously been found to predict mortality in heart failure (HF), but currently no information is available regarding CgA processing in HF and whether the CgA fragment catestatin (CST) may directly influence cardiomyocyte function. METHODS AND RESULTS: CgA processing was characterized in postinfarction HF mice and in patients with acute HF, and the functional role of CST was explored in experimental models. Myocardial biopsies from HF, but not sham-operated mice, demonstrated high molecular weight CgA bands. Deglycosylation treatment attenuated high molecular weight bands, induced a mobility shift, and increased shorter CgA fragments. Adjusting for established risk indices and biomarkers, circulating CgA levels were found to be associated with mortality in patients with acute HF, but not in patients with acute exacerbation of chronic obstructive pulmonary disease. Low CgA-to-CST conversion was also associated with increased mortality in acute HF, thus, supporting functional relevance of impaired CgA processing in cardiovascular disease. CST was identified as a direct inhibitor of CaMKIIδ (Ca2+/calmodulin-dependent protein kinase IIδ) activity, and CST reduced CaMKIIδ-dependent phosphorylation of phospholamban and the ryanodine receptor 2. In line with CaMKIIδ inhibition, CST reduced Ca2+ spark and wave frequency, reduced Ca2+ spark dimensions, increased sarcoplasmic reticulum Ca2+ content, and augmented the magnitude and kinetics of cardiomyocyte Ca2+ transients and contractions. CONCLUSIONS: CgA-to-CST conversion in HF is impaired because of hyperglycosylation, which is associated with clinical outcomes in acute HF. The mechanism for increased mortality may be dysregulated cardiomyocyte Ca2+ handling because of reduced CaMKIIδ inhibition.
BACKGROUND:Chromogranin A (CgA) levels have previously been found to predict mortality in heart failure (HF), but currently no information is available regarding CgA processing in HF and whether the CgA fragment catestatin (CST) may directly influence cardiomyocyte function. METHODS AND RESULTS:CgA processing was characterized in postinfarction HF mice and in patients with acute HF, and the functional role of CST was explored in experimental models. Myocardial biopsies from HF, but not sham-operated mice, demonstrated high molecular weight CgA bands. Deglycosylation treatment attenuated high molecular weight bands, induced a mobility shift, and increased shorter CgA fragments. Adjusting for established risk indices and biomarkers, circulating CgA levels were found to be associated with mortality in patients with acute HF, but not in patients with acute exacerbation of chronic obstructive pulmonary disease. Low CgA-to-CST conversion was also associated with increased mortality in acute HF, thus, supporting functional relevance of impaired CgA processing in cardiovascular disease. CST was identified as a direct inhibitor of CaMKIIδ (Ca2+/calmodulin-dependent protein kinase IIδ) activity, and CST reduced CaMKIIδ-dependent phosphorylation of phospholamban and the ryanodine receptor 2. In line with CaMKIIδ inhibition, CST reduced Ca2+ spark and wave frequency, reduced Ca2+ spark dimensions, increased sarcoplasmic reticulum Ca2+ content, and augmented the magnitude and kinetics of cardiomyocyte Ca2+ transients and contractions. CONCLUSIONS:CgA-to-CST conversion in HF is impaired because of hyperglycosylation, which is associated with clinical outcomes in acute HF. The mechanism for increased mortality may be dysregulated cardiomyocyte Ca2+ handling because of reduced CaMKIIδ inhibition.
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