Role of plakophilin-2 expression on exercise-related progression of arrhythmogenic right ventricular cardiomyopathy: a translational study. (19th November 2021)

• Record Type: Journal Article
• Authors: Cerrone, Marina; Marrón-Liñares, Grecia M; van Opbergen, Chantal J M; Costa, Sarah; Bourfiss, Mimount; Pérez-Hernández, Marta; Schlamp, Florencia; Sanchis-Gomar, Fabian; Malkani, Kabir; Drenkova, Kamelia; Zhang, Mingliang; Lin, Xianming; Heguy, Adriana; Velthuis, Birgitta K; Prakken, Niek H J; LaGerche, Andre; Calkins, Hugh; James, Cynthia A; Te Riele, Anneline S J M; Delmar, Mario
• Is Part Of: European heart journal. Volume 43:Number 12(2022)
• Page Start: 1251
• Page End: 1264
• Publication Date: 2021-11-19
• Subjects: Arrhythmogenic right ventricular cardiomyopathy -- ARVC -- Plakophilin-2 -- Desmosomes -- Exercise; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab772
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Aims: Exercise increases arrhythmia risk and cardiomyopathy progression in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients, but the mechanisms remain unknown. We investigated transcriptomic changes caused by endurance training in mice deficient in plakophilin-2 (PKP2cKO), a desmosomal protein important for intercalated disc formation, commonly mutated in ARVC and controls. Methods and results: Exercise alone caused transcriptional downregulation of genes coding intercalated disk proteins. The changes converged with those in sedentary and in exercised PKP2cKO mice. PKP2 loss caused cardiac contractile deficit, decreased muscle mass and increased functional/transcriptomic signatures of apoptosis, despite increased fractional shortening and calcium transient amplitude in single myocytes. Exercise accelerated cardiac dysfunction, an effect dampened by pre-training animals prior to PKP2-KO. Consistent with PKP2-dependent muscle mass deficit, cardiac dimensions in human athletes carrying PKP2 mutations were reduced, compared to matched controls. Conclusions: We speculate that exercise challenges a cardiomyocyte "desmosomal reserve" which, if impaired genetically (e.g., PKP2 loss), accelerates progression of cardiomyopathy. Graphical Abstract: