Abstract

Exposure to chronic hypoxia (CH) induces elevated pulmonary artery pressure/resistance, leading to an eventual maladaptive right ventricular hypertrophy (RVH). Muscle RING finger-1 (MuRF1) is a muscle-specific ubiquitin ligase that mediates myocyte atrophy and has been shown to play a role in left ventricular hypertrophy and altered cardiac bioenergetics in pressure overloaded hearts. However, little is known about the contribution of MuRF1 impacting RVH in the setting of CH. Therefore, we hypothesized that MuRF1 deletion would enhance RVH compared to their wild-type littermates, while cardiac-specific overexpression would reduce hypertrophy following CH-induced pulmonary hypertension. We assessed right ventricular systolic pressure (RVSP), right ventricle to left ventricle plus septal weight ratio (RV/LV+S) and hematocrit (Hct) following a 3-wk isobaric CH exposure. Additionally, we conducted dual-isotope SPECT/CT imaging with cardiac function agent 201Tl-chloride and cell death agent 99mTc-annexin V. Predictably, CH induced pulmonary hypertension, measured by increased RVSP, RV/LV+S and Hct in WT mice compared to normoxic WT mice. Normoxic WT and MuRF1-null mice exhibited no significant differences in RVSP, RV/LV+S or Hct. CH-induced increases in RVSP were also similar between WT and MuRF1-null mice; however, RV/LV+S and Hct were significantly elevated in CH-exposed MuRF1-null mice compared to WT. In cardiac-specific MuRF1 overexpressing mice, RV/LV+S increased significantly due to CH exposure, even greater than in WT mice. This remodeling appeared eccentric, maladaptive and led to reduced systemic perfusion. In conclusion, these results are consistent with an atrophic role for MuRF1 regulating the magnitude of right ventricular hypertrophy following CH-induction of pulmonary hypertension.

Highlights

  • Right ventricular hypertrophy (RVH) occurs in the setting of primary pulmonary arterial hypertension (PAH) and frequently precipitates mortality in this disease [1], with recent estimates of 44% of PAH patients dying from right ventricular failure or sudden cardiac death [2]

  • Right ventricular Muscle RING finger 1 (MuRF1) mRNA expression decreases in response pulmonary hypertension

  • C57BL/6 mice challenged to chronic hypoxia exhibited increased right ventricular hypertrophy

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Summary

Introduction

Right ventricular hypertrophy (RVH) occurs in the setting of primary pulmonary arterial hypertension (PAH) and frequently precipitates mortality in this disease [1], with recent estimates of 44% of PAH patients dying from right ventricular failure or sudden cardiac death [2]. A critical component to the regulation of muscle mass is the turnover over and degradation of sarcomere proteins, which MuRF1 has been reported to ubiquitinate and target for proteasome-mediated degradation, including cardiac troponin I and beta-Myosin heavy chain [11,12]. In ischemia-reperfusion injury, MuRF1 regulates JNK-mediated apoptosis through its interaction, poly-ubiquitination, and degradation of phosphorylated c-Jun activated by reperfusion [15]. In models of cardiac atrophy and left ventricular cardiac hypertrophy reversal, MuRF1 is a critical mediator, as demonstrated in MuRF1-/- mice, resistant to both processes [9]

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