Abstract 186: The Cardiac Specific Splicing Regulator Rbm20 decreases in Specific Forms of Acquired Heart Disease

Abstract

Introduction: Rbm20 is a RNA-binding protein enriched in heart- and skeletal muscle. Mutations in Rbm20 have been described to cause heart failure. Furthermore, Rbm20 has been shown to regulate alternative splicing of titin (Ttn). This demonstrates that RBM20 has a major role in cardiac biology. However, it is unknown how Rbm20 expression changes in acquired heart disease. Therefore, we investigated expression of Rbm20 on mRNA and protein level and the degree of alternative splicing of Ttn in various forms of heart disease. Methods: We measured mRNA expression and protein levels of Rbm20 by western blotting and qPCR in transverse aorta constrictions (TAC) in mice and pigs, and in human heart disease including hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), aortic stenosis (AoS) and pulmonary artery hypertension (PAH). We measured cardiac function in mice with echocardiography, and measured stress markers with qPCR. Furthermore, we analyzed Ttn splicing using qPCR and RT-PCR. Results: Real-time PCR and western blotting revealed that Rbm20 is selectively downregulated in mice after TAC and in patients with aortic stenosis. In contrast, we did not observe a difference in Rbm20 levels in patients with DCM, HCM and PAH. Furthermore, we measured functional parameters such as ejection fraction (EF), systolic left ventricular internal diameter (LVIDsys), and fractional shortening (FS), as well as ANF level in TAC mice, and correlated these to Rbm20 level. We found that the level of downregulation of Rbm20 is correlated with heart failure severity in mice after TAC. Also, we found that Ttn is differentially spliced after loss of Rbm20. Conclusions: Here we show for the first time that Rbm20 decreases in acquired forms of heart failure such as TAC in mice and pigs, and AoS in men. Furthermore, in experimental HF in mice, Rbm20 levels correlate to HF severity. Moreover, loss of Rbm20 leads to skipping of intron retention in Ttn in the region between exon 50-70. However, the biological effect of this event remains unclear. Given its major role in the heart, loss of Rbm20 may play an important role in the development of heart disease.