Disease modeling of a mutation in α‐actinin 2 guides clinical therapy in hypertrophic cardiomyopathy
2019
Hypertrophic cardiomyopathy (HCM) is a cardiac genetic disease accompanied by structural and contractile alterations. We identified a rare c.740C>T (p.T247M) mutation in ACTN2, encoding alpha-actinin 2 in a HCM patient, who presented with left ventricular hypertrophy, outflow tract obstruction, and atrial fibrillation. We generated patient-derived human-induced pluripotent stem cells (hiPSCs) and show that hiPSC-derived cardiomyocytes and engineered heart tissues recapitulated several hallmarks of HCM, such as hypertrophy, myofibrillar disarray, hypercontractility, impaired relaxation, and higher myofilament Ca(2+) sensitivity, and also prolonged action potential duration and enhanced L-type Ca(2+) current. The L-type Ca(2+) channel blocker diltiazem reduced force amplitude, relaxation, and action potential duration to a greater extent in HCM than in isogenic control. We translated our findings to patient care and showed that diltiazem application ameliorated the prolonged QTc interval in HCM-affected son and sister of the index patient. These data provide evidence for this ACTN2 mutation to be disease-causing in cardiomyocytes, guiding clinical therapy in this HCM family. This study may serve as a proof-of-principle for the use of hiPSC for personalized treatment of cardiomyopathies.
Keywords:
- Long QT syndrome
- Cancer research
- Mutation
- Human Induced Pluripotent Stem Cells
- Disease
- Diabetes mellitus
- Precision medicine
- Hypertrophic cardiomyopathy
- Actinin
- Biology
- Immunology
- Diltiazem
- Induced pluripotent stem cell
- Left ventricular hypertrophy
- Atrial fibrillation
- Internal medicine
- Muscle hypertrophy
- Cardiology
- Myofilament
- Correction
- Source
- Cite
- Save
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