Why the study?
Omecamtiv mecarbil action in situ remains poorly understood because enhanced myofilament Ca2+-sensitivity contrasts with reduced force and rate of force development at saturating Ca2+.
Physiological concentrations of inorganic phosphate reverse the force-depressing effects of omecamtiv mecarbil at the sarcomere level, suggesting an energetically efficient mechanism for its inotropic action during increased heart rate.
Omecamtiv mecarbil (OM) is a putative positive inotropic tool for treatment of systolic heart dysfunction, based on the finding that in vivo it increases the ejection fraction and in vitro it prolongs the actin-bond life time of the cardiac and slow-skeletal muscle isoforms of myosin. OM action in situ, however, is still poorly understood as the enhanced Ca 2+ -sensitivity of the myofilaments is at odds with the reduction of force and rate of force development observed at saturating Ca 2+ . Here we show, by combining fast sarcomere-level mechanics and ATPase measurements in single slow demembranated fibres from rabbit soleus, that the depressant effect of OM on the force per attached motor is reversed, without effect on the ATPase rate, by physiological concentrations of inorganic phosphate (Pi) (1-10 mM). This mechanism could underpin an energetically efficient reduction of systolic tension cost in OM-treated patients, whenever [Pi] increases with heart-beat frequency.
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Governali et al. (2020) studied this question.
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