Abstract 23: Overexpression Of Tbx20 In Adult Cardiomyocytes Promotes Cardiomyocyte Proliferation And Improves Cardiac Function Post Myocardial Infarction

Abstract

Background: Adult mammalian cardiomyocytes (CM) have the potential to proliferate, but this is not sufficient to compensate for the massive loss of functional CMs after myocardial infarction (MI), which remains a leading cause of death in the US. During embryonic heart development, the transcription factor Tbx20 is required for CM proliferation, and Tbx20 overexpression promotes fetal characteristics in adult CMs when initiated before birth in mice. We hypothesize that Tbx20 overexpression (Tbx20OE), when induced in adult CMs after injury, improves cardiac function and repair via dedifferentiation of CMs, thus promoting cell cycle re-entry and repair in mice post-MI. Methods and Results: αMHCMerCreMer (STG) and the inducible cardiomyocyte-specific Tbx20 transgenic (αMHCMerCreMer/CAG-CAT-Tbx20, DTG) mice were subjected to MI or sham surgeries. Tbx20OE was induced 3 days post-surgery via tamoxifen to specifically target cardiac repair post-MI. In sham-operated mice, no difference in cardiac function or morphology was observed between DTG and STG groups. However, more proliferating CMs as labeled by Ki67 were found in DTG sham myocardium compared to STG. Expression of cyclin D1, E1 (cell cycle markers) and IGF1 mRNA was increased, while p21 (cell cycle inhibitor) and Meis1 (negative regulator of proliferation) were decreased, in DTG sham hearts compared to STG controls. In mice subjected to MI, cardiac function, as measured by echocardiography, was significantly improved, and the infarct scar size was smaller (58.1% vs 38.3%) in the DTG group compared to STG controls 2 and 4 weeks post-MI. Myocardial hypertrophy determined by heart to body weight ratio and myocyte diameter was also significantly reduced in DTG heart compared to STG 4 weeks post-MI. Thus, induction of Tbx20OE post-MI injury leads to improved cardiac performance, decreased scar size, and decreased maladaptive cardiac remodeling. Ongoing studies will determine if proliferation indices (Ki67, pHH3, aurora kinase B) and cytokinesis of CM post-MI are increased in myocardium and isolated adult cardiomyocytes with Tbx20OE. Conclusions: Tbx20OE in adult CM activates cell proliferation markers and also improves cardiac function and repair in mice when induced post-MI.