Key result
In a pig model of left ventricular volume overloading, Cx43 protein expression was initially up-regulated during the acute hypertrophic response but reduced as hypertrophy progressed up to 3 months.
Up-regulation of Cx43 gap-junction protein may represent an immediate compensatory response in the early stages of ventricular overloading, followed by a reduction during chronic hypertrophy.
Hypothesis-generating in volume-overload hypertrophy; leaves open Cx43 as a therapeutic target pending human studies.
Gap-junctions are specialized regions of intercellular contacts allowing electrical impulse propagation among adjacent cardiomyocytes. Connexin43 (Cx43) is the predominant gap-junction protein in the working ventricular myocardium and its reduced expression has been extensively implicated in the genesis of conduction abnormalities and re-entry arrhythmia of chronically hypertrophied hearts. In contrast, data on the role played by this protein during cardiac remodeling and early phases of developing hypertrophy are lacking. Therefore, in the present study, we investigated this issue using an experimental model of pig left ventricle (LV) volume overloading consisting in the creation of an aorto-cava fistula. At scheduled times (6, 24, 48, 96, 168 h, and 2, 3 months after surgery) echocardiographic and haemodynamic measurements were performed and myocardial biopsies were taken for the morphological and biochemical analyses. When faced with the increased load, pig myocardium underwent an initial period (from 6 up to 48 h) of remarkable tissue remodeling consisting in the occurrence of cardiomyocyte damage and apoptosis. After that time, the tissue developed a hypertrophic response that was associated with early dynamic changes (up-regulation) in Cx43 protein expression, as demonstrated by Western blot and confocal immunofluorescence analyses. However, an initial transient increase of this protein was also found after 6 h from surgery. With the progression of LV hypertrophy (from 168 hr up to 3 months), a reduction in the myocardial Cx43 expression was, instead, observed. The increased expression of Cx43 protein during acute hypertrophic response was associated with a corresponding increase in the levels of its specific mRNA, as detected by RT-PCR. We concluded that up-regulation of Cx43 gap-junction protein could represent an immediate compensatory response to support the new working conditions in the early stages of ventricular overloading.
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Formigli et al. (2003) studied Left ventricle volume overloading and hypertrophy. Aorto-cava fistula (volume overloading) was evaluated on Cx43 protein expression and myocardial remodeling. In a pig model of left ventricular volume overloading, Cx43 protein expression was initially up-regulated during the acute hypertrophic response but reduced as hypertrophy progressed up to 3 months.
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