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Review
. 2019 May;471(5):683-699.
doi: 10.1007/s00424-019-02257-4. Epub 2019 Jan 31.

Hereditary heart disease: pathophysiology, clinical presentation, and animal models of HCM, RCM, and DCM associated with mutations in cardiac myosin light chains

Sunil Yadav  1 , Yoel H Sitbon  1 , Katarzyna Kazmierczak  1 , Danuta Szczesna-Cordary  2
Affiliations
Review

Hereditary heart disease: pathophysiology, clinical presentation, and animal models of HCM, RCM, and DCM associated with mutations in cardiac myosin light chains

Sunil Yadav et al. Pflugers Arch. 2019 May.

Abstract

Genetic cardiomyopathies, a group of cardiovascular disorders based on ventricular morphology and function, are among the leading causes of morbidity and mortality worldwide. Such genetically driven forms of hypertrophic (HCM), dilated (DCM), and restrictive (RCM) cardiomyopathies are chronic, debilitating diseases that result from biomechanical defects in cardiac muscle contraction and frequently progress to heart failure (HF). Locus and allelic heterogeneity, as well as clinical variability combined with genetic and phenotypic overlap between different cardiomyopathies, have challenged proper clinical prognosis and provided an incentive for identification of pathogenic variants. This review attempts to provide an overview of inherited cardiomyopathies with a focus on their genetic etiology in myosin regulatory (RLC) and essential (ELC) light chains, which are EF-hand protein family members with important structural and regulatory roles. From the clinical discovery of cardiomyopathy-linked light chain mutations in patients to an array of exploratory studies in animals, and reconstituted and recombinant systems, we have summarized the current state of knowledge on light chain mutations and how they induce physiological disease states via biochemical and biomechanical alterations at the molecular, tissue, and organ levels. Cardiac myosin RLC phosphorylation and the N-terminus ELC have been discussed as two important emerging modalities with important implications in the regulation of myosin motor function, and thus cardiac performance. A comprehensive understanding of such triggers is absolutely necessary for the development of target-specific rescue strategies to ameliorate or reverse the effects of myosin light chain-related inherited cardiomyopathies.

Keywords: Cardiomyopathy mutations; Human phenotype; Myosin essential light chain; Myosin regulatory light chain; Transgenic mice.

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Figures

Figure 1.
Figure 1.. Tertiary structure of human beta-cardiac heavy meromyosin interacting-heads motif (PDB: 5TBY) obtained by homology modeling (using Swiss-model) of human sequence from aphonopelma homology model (PDB: 3JBH).
The myosin heavy chain (MHC) is indicated with blue ribbon, myosin regulatory light chain (RLC) with magenta ribbon and myosin essential light chain (ELC) in red ribbon.
Figure 2.
Figure 2.. Schematic representation of MYL2 (genomic and protein) of the human cardiac myosin regulatory light chain (RLC).
The non-coding regions of MYL2 are highlighted in black, and the location of mutations are indicated with stars. EF-hand domains and the MLCK-phosphorylation site are depicted in the amino-acid sequence. The structural domains are denoted with red blocks (±-helix) and blue arrows (β-strand). Modified from Bonne et al. Circ Res 83: 580–593, 1998.
Figure 3.
Figure 3.. Schematic representation of MYL3 (genomic and protein) of the human cardiac myosin essential light chain (ELC).
The non-coding regions of MYL2 are highlighted in black, and the location of mutations are indicated with stars. EF-hand domains and the MLCK-phosphorylation site are depicted in the amino-acid sequence. The structural domains are denoted with red blocks (α-helix) and blue arrows (β-strand). Modified from Bonne et al. Circ Res 83: 580–593. 1998.
Figure 4.
Figure 4.. Mutations in myosin MYL2 (A) and MYL3 (B) in the background of human beta-cardiac heavy meromyosin interacting-heads motif (PDB: 5TBY).
Cardiac MLCK-dependent phosphorylation site at Ser-15 (S15) is emphasized in myosin RLC (A) and the N-ELC region in myosin ELC (B).
See this image and copyright information in PMC

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