Document Detail


Changes in sarcomeric and non-sarcomeric cytoskeletal proteins and focal adhesion molecules during clinical myocardial recovery after left ventricular assist device support.
MedLine Citation:
PMID:  17346624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Reverse remodeling can occur after left ventricular assist device (LVAD) support, which is sufficient in some cases to allow explantation of the device without cardiac transplantation. The molecular mechanisms involved remain unknown. A specific pattern of expression of sarcomeric and non-sarcomeric proteins in the myocardium is thought to be essential for normal myocardial function. However, a detailed protein analysis of their role in recovery has not been performed previously. METHODS: Myocardial samples were collected at implantation and explantation in 7 patients with dilated cardiomyopathy who had sufficient recovery for device explantation. Western blotting and immunoprobing were used to quantitate changes in the expression of sarcomeric and cytoskeletal proteins. RESULTS: At implantation, all patients (6 men and 1 woman, age [mean +/- SD] 36.1 +/- 10.4 years) were inotrope-dependent; ejection fraction (EF) was 12.6 +/- 4.6%, cardiac index (CI) was 1.66 +/- 0.5 liters/min/m2 and pulmonary capillary wedge pressure (PCWP) was 26 +/- 6 mm Hg. Mean duration of LVAD support was 333 +/- 235 days. Prior to explantation, EF (pump off for 15 minutes) was 62.7 +/- 11.4%, CI was 2.7 +/- 0.7 liters/min/m2 and PCWP was 10.9 +/- 3.5 mm Hg. At explantation, the following statistically significant increases were noted: myosin heavy chain, 1.90-fold (p < 0.05); sarcomeric actin, 1.80-fold (p < 0.05); alphaII spectrin, 1.40-fold (p = 0.05); troponin C, 1.34-fold (p < 0.05); troponin T, 2.10-fold (p < 0.05); cytoskeletal actinin, 5.16-fold (p < 0.05); and smooth muscle alpha-actin, 4.10-fold (p = 0.05). Although not significant (NS), increases were also seen for: troponin I, 1.27-fold; myosin light chain 1, 1.28-fold; tropomyosin, 1.28-fold; and sarcomeric actinin at 3.24-fold. There was a decrease in talin of 2.01-fold (p = NS) between implant and explant. Vimentin was unchanged. CONCLUSIONS: Our data suggest that reverse remodeling of the myocardium parallels improvements in hemodynamic function in LVAD patients showing clinical myocardial recovery.
Authors:
Najma Latif; Magdi H Yacoub; Robert George; Paul J R Barton; Emma J Birks
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  26     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-04-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-5     Citation Subset:  IM    
Affiliation:
Imperial College London, National Heart and Lung Institute, Heart Science Centre, Harefield Hospital, Harefield, Middlesex, UK. n.latif@imperial.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Output, Low / metabolism,  physiopathology*,  therapy*
Cytoskeletal Proteins / metabolism*
Female
Focal Adhesions / metabolism*
Heart / physiopathology*
Heart-Assist Devices*
Humans
Male
Middle Aged
Myocardium / metabolism*
Recovery of Function
Sarcomeres / metabolism*
Ventricular Remodeling
Chemical
Reg. No./Substance:
0/Cytoskeletal Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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