CaMKII inhibition in heart failure, beneficial, harmful, or both

Am J Physiol Heart Circ Physiol. 2012 Apr 1;302(7):H1454-65. doi: 10.1152/ajpheart.00812.2011. Epub 2012 Jan 27.

Abstract

Calmodulin-dependent protein kinase II (CaMKII) has been proposed to be a therapeutic target for heart failure (HF). However, the cardiac effect of chronic CaMKII inhibition in HF has not been well understood. We have tested alterations of Ca(2+) handling, excitation-contraction coupling, and in vivo β-adrenergic regulation in pressure-overload HF mice with CaMKIIδ knockout (KO). HF was produced in wild-type (WT) and KO mice 1 wk after severe thoracic aortic banding (sTAB) with a continuous left ventricle (LV) dilation and reduction of ejection fraction for up to 3 wk postbanding. Cardiac hypertrophy was similar between WT HF and KO HF mice. However, KO HF mice manifested exacerbation of diastolic function and reduction in cardiac reserve to β-adrenergic stimulation. Compared with WT HF, L-type calcium channel current (I(Ca)) density in KO HF LV was decreased without changes in I(Ca) activation and inactivation kinetics, whereas I(Ca) recovery from inactivation was accelerated and Ca(2+)-dependent I(Ca) facilitation, a positive staircase blunted in WT HF, was recovered. However, I(Ca) response to isoproterenol was reduced. KO HF myocytes manifested dramatic decrease in sarcoplasmic reticulum (SR) Ca(2+) leak and slowed cytostolic Ca(2+) concentration decline. Sarcomere shortening was increased, but relaxation was slowed. In addition, an increase in myofilament sensitivity to Ca(2+) and the slow skeletal muscle troponin I-to-cardiac troponin I ratio and interstitial fibrosis and a decrease in Na/Ca exchange function and myocyte apoptosis were observed in KO HF LV. CaMKIIδ KO cannot suppress severe pressure-overload-induced HF. Although cellular contractility is improved, it reduces in vivo cardiac reserve to β-adrenergic regulation and deteriorates diastolic function. Our findings challenge the strategy of CaMKII inhibition in HF.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Agonists / pharmacology
  • Animals
  • Aorta, Thoracic / physiology
  • Apoptosis / drug effects
  • Blotting, Western
  • Calcium Channels / drug effects
  • Calcium Channels / metabolism
  • Calcium Signaling / physiology
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2 / antagonists & inhibitors*
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2 / genetics
  • Cytosol / drug effects
  • Cytosol / metabolism
  • Fibrosis / pathology
  • Heart Failure / diagnostic imaging
  • Heart Failure / drug therapy*
  • Heart Ventricles / drug effects
  • Isoenzymes / metabolism
  • Male
  • Mice
  • Mice, Knockout
  • Myocardial Contraction / physiology
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / physiology
  • Myofibrils / physiology
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use*
  • Protein Kinase Inhibitors / toxicity
  • Receptors, Adrenergic, beta / drug effects
  • Receptors, Adrenergic, beta / physiology
  • Sarcomeres / drug effects
  • Sarcoplasmic Reticulum / metabolism
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / physiology
  • Sodium-Calcium Exchanger / antagonists & inhibitors
  • Sodium-Calcium Exchanger / metabolism
  • Ultrasonography

Substances

  • Adrenergic beta-Agonists
  • Calcium Channels
  • Isoenzymes
  • Protein Kinase Inhibitors
  • Receptors, Adrenergic, beta
  • Sodium-Calcium Exchanger
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases