Abstract

Acute myocardial infarction (AMI) is a common cause of death for which effective treatments are available provided that diagnosis is rapid. The current diagnostic gold standards are circulating cardiac troponins I and T. However, their slow release delays diagnosis, and their persistence limits their utility in the identification of reinfarction. The aim was to identify candidate biomarkers of AMI. Isolated mouse hearts were perfused with oxygenated protein-free buffer, and coronary effluent was collected after ischemia or during matched normoxic perfusion. Effluents were analyzed using proteomics approaches based on one- or two-dimensional initial separation. Of the 459 proteins identified after ischemia with one-dimensional separation, 320 were not detected in the control coronary effluent. Among these were all classic existing biomarkers of AMI. We also identified the cardiac isoform of myosin-binding protein C in its full-length form and as a 40-kDa degradation product. This protein was not detected in the other murine organs examined, increased markedly with even trivial myocardial infarction, and could be detected in the plasma after myocardial infarction in vivo, a profile compatible with a biomarker of AMI. Two-dimensional fluorescence DIGE of ischemic and control coronary effluents identified more than 200 asymmetric spots verified by swapping dyes. Once again existing biomarkers of injury were confirmed as well as posttranslational modifications of antioxidant proteins such as peroxiredoxins. Perfusing hearts with protein-free buffers provides a platform of graded ischemic injury that allows detailed analysis of protein release and identification of candidate cardiac biomarkers like myosin-binding protein C.

Highlights

  • Acute myocardial infarction (AMI) is a common cause of death for which effective treatments are available provided that diagnosis is rapid

  • The aim of this study was to identify candidate biomarkers by comprehensively analyzing the proteins released into the coronary effluent after a duration of myocardial ischemia chosen to cause mild injury

  • Our extensive proteomics analysis confirmed the presence of all existing biomarkers of AMI and revealed posttranslational modifications of antioxidant proteins and identified the cardiac isoform of cardiac myosin-binding protein C (cMyBP-C) as a candidate biomarker

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Summary

Introduction

Acute myocardial infarction (AMI) is a common cause of death for which effective treatments are available provided that diagnosis is rapid. Of the 459 proteins identified after ischemia with one-dimensional separation, 320 were not detected in the control coronary effluent. Among these were all classic existing biomarkers of AMI. Perfusing hearts with protein-free buffers provides a platform of graded ischemic injury that allows detailed analysis of protein release and identification of candidate cardiac biomarkers like myosin-binding protein C. Its use is limited by its presence in skeletal muscle and normal serum and by sensitivity of the assay to interference, causing some to question its utility [3] Myoglobin is another cytoplasmic protein found in cardiac and skeletal, but not smooth, muscle. The abbreviations used are: AMI, acute myocardial infarction; CK, creatine kinase; FABP, fatty acid-binding protein; H-FABP, heartspecific FABP; TTC, triphenyl tetrazolium chloride; 1D, one-dimensional; 2D, two-dimensional; LTQ, linear trap quadrupole; LDH, lactate dehydrogenase; Prdx, peroxiredoxin; MyBP-C, myosin-binding protein C; cMyBP-C, cardiac myosin-binding protein C

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