Abstract

Cardiorenal syndrome is defined by primary heart failure conditions influencing or leading to renal injury or dysfunction. Dilated cardiomyopathy (DCM) is a major co-existing form of heart failure (HF) with renal diseases. Myocardin (MYOCD), a cardiac-specific co-activator of serum response factor (SRF), is increased in DCM porcine and patient cardiac tissues and plays a crucial role in the pathophysiology of DCM. Inhibiting the increased MYOCD has shown to be partially rescuing the DCM phenotype in porcine model. However, expression levels of MYOCD in the cardiac tissues of the cardiorenal syndromic patients and the effect of inhibiting MYOCD in a cardiorenal syndrome model remains to be explored. Here, we analyzed the expression levels of MYOCD in the DCM patients with and without renal diseases. We also explored, whether cardiac specific silencing of MYOCD expression could ameliorate the cardiac remodeling and improve cardiac function in a renal artery ligated rat model (RAL). We observed an increase in MYOCD levels in the endomyocardial biopsies of DCM patients associated with renal failure compared to DCM alone. Silencing of MYOCD in RAL rats by a cardiac homing peptide conjugated MYOCD siRNA resulted in attenuation of cardiac hypertrophy, fibrosis and restoration of the left ventricular functions. Our data suggest hyper-activation of MYOCD in the pathogenesis of the cardiorenal failure cases. Also, MYOCD silencing showed beneficial effects by rescuing cardiac hypertrophy, fibrosis, size and function in a cardiorenal rat model.

Highlights

  • Dilated cardiomyopathy (DCM) is a major cause of HF1, accounting for nearly 1/3rd of total cases

  • Cardiac MYOCD expression level is significantly increased in cardiorenal syndrome patients

  • The mRNA and protein expression levels of MYOCD was increased in endomyocardial biopsies obtained from DCM patients compared to healthy controls

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Summary

Introduction

DCM is a major cause of HF1, accounting for nearly 1/3rd of total cases. Many of these patients subsequently display kidney dysfunction or injury leading to cardiorenal syndrome. Transforming growth factor (TGF-β) was shown to induce MYOCD expression in fibroblasts and vice-versa[9]. TGF-β induction of MYOCD expression in the infarcted heart may have a potential function in fibroblast-to-myofibroblast transition, similar to Myocardin related transcription factor MRTF-A and MRTF-B which have been shown to be key regulator in fibroblast to Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. We analyzed the cardiac-specific expression of MYOCD in DCM patients with renal disease and DCM alone cases. The results showed the MYOCD is overexpressed in the DCM patients with renal disease compared to DCM alone cases. The cardiac-specific silencing of MYOCD in rats decreased the expression of upregulated hypertrophic and fibrotic genes leading to restoration of left ventricular function

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