Abstract

Hypertrophic cardiomyopathy (HCM) is a genetic disorder caused by mutations in genes coding for proteins involved in sarcomere function. The disease is associated with mitochondrial dysfunction. Evolutionarily developed variation in mitochondrial DNA (mtDNA), defining mtDNA haplogroups and haplogroup clusters, is associated with functional differences in mitochondrial function and susceptibility to various diseases, including ischemic cardiomyopathy. We hypothesized that mtDNA haplogroups, in particular H, J and K, might modify disease susceptibility to HCM. Mitochondrial DNA, isolated from blood, was sequenced and haplogroups identified in 91 probands with HCM. The association with HCM was ascertained using two Danish control populations. Haplogroup H was more prevalent in HCM patients, 60% versus 46% (p = 0.006) and 41% (p = 0.003), in the two control populations. Haplogroup J was less prevalent, 3% vs. 12.4% (p = 0.017) and 9.1%, (p = 0.06). Likewise, the UK haplogroup cluster was less prevalent in HCM, 11% vs. 22.1% (p = 0.02) and 22.8% (p = 0.04). These results indicate that haplogroup H constitutes a susceptibility factor and that haplogroup J and haplogroup cluster UK are protective factors in the development of HCM. Thus, constitutive differences in mitochondrial function may influence the occurrence and clinical presentation of HCM. This could explain some of the phenotypic variability in HCM. The fact that haplogroup H and J are also modifying factors in ischemic cardiomyopathy suggests that mtDNA haplotypes may be of significance in determining whether a physiological hypertrophy develops into myopathy. mtDNA haplotypes may have the potential of becoming significant biomarkers in cardiomyopathy.

Highlights

  • Mitochondria are responsible for a diversity of essential functions in cardiomyocytes including the production of ATP by oxidative phosphorylation (OXPHOS), several signaling pathways, control of apoptosis, as well as control of the cytosolic calcium concentration [1]

  • MtDNA haplotyping performed by Mikkelsen et al were based on variants in the hyper-variable regions 1 and 2 according to [26] and the mitochondrial DNA (mtDNA) haplotying performed by Benn et al were based on haplogroup specific markers in the coding region of the mtDNA (Table 2)

  • All major haplogroups were identified in this study and compared with the haplogroup frequencies obtained from two studies by Benn et al and Mikkelsen et al Haplogroup H was found to have a higher frequency in Hypertrophic cardiomyopathy (HCM) probands, 60% versus 41%(p = 0.006), and 46%, (p = 0.003) as compared to controls (Table 4)

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Summary

Introduction

Mitochondria are responsible for a diversity of essential functions in cardiomyocytes including the production of ATP by oxidative phosphorylation (OXPHOS), several signaling pathways, control of apoptosis, as well as control of the cytosolic calcium concentration [1]. Mitochondria contain 3-10 16,570 bp circular DNA molecules, mitochondrial DNA (mtDNA), comprising a non-coding control region and a coding region containing 37 genes. The genes encode 13 polypeptide components, constituting a small fraction of the many proteins involved in the OXPHOS system, consisting of complex I-IV and complex V (ATP synthase). The haplogroup defining variants encompass transitions and transversions in both protein- and RNA-coding genes (Tables 1 and 2), mtDNA haplogroups are likely to confer different functional characteristics.

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