Tetrahydrobiopterin improves diastolic dysfunction by reversing changes in myofilament properties

Euy Myoung Jeong, Michelle M. Monasky, Lianzhi Gu, Domenico M. Taglieri, Bindiya G. Patel, Hong Liu, Qiongying Wang, Ian Greener, Samuel C. Dudley, R. John Solaro

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53 Scopus citations


Despite the increasing prevalence of heart failure with preserved left ventricular function, there are no specific treatments, partially because the mechanism of impaired relaxation is incompletely understood. Evidence indicates that cardiac relaxation may depend on nitric oxide (NO), generated by NO synthase (NOS) requiring the co-factor tetrahydrobiopterin (BH4). Recently, we reported that hypertension-induced diastolic dysfunction was accompanied by cardiac BH4 depletion, NOS uncoupling, a depression in myofilament cross-bridge kinetics, and S-glutathionylation of myosin binding protein C (MyBP-C). We hypothesized that the mechanism by which BH4 ameliorates diastolic dysfunction is by preventing glutathionylation of MyBP-C and thus reversing changes of myofilament properties that occur during diastolic dysfunction. We used the deoxycorticosterone acetate (DOCA)-salt mouse model, which demonstrates mild hypertension, myocardial oxidative stress, and diastolic dysfunction. Mice were divided into two groups that received control diet and two groups that received BH4 supplement for 7days after developing diastolic dysfunction at post-operative day 11. Mice were assessed by echocardiography. Left ventricular papillary detergent-extracted fiber bundles were isolated for simultaneous determination of force and ATPase activity. Sarcomeric protein glutathionylation was assessed by immunoblotting. DOCA-salt mice exhibited diastolic dysfunction that was reversed after BH4 treatment. Diastolic sarcomere length (DOCA-salt 1.70±0.01 vs. DOCA-salt+BH4 1.77±0.01μm, P<0.001) and relengthening (relaxation constant, τ, DOCA-salt 0.28±0.02 vs. DOCA-salt+BH4 0.08±0.01, P<0.001) were also restored to control by BH4 treatment. pCa50 for tension increased in DOCA-salt compared to sham but reverted to sham levels after BH4 treatment. Maximum ATPase rate and tension cost (δATPase/δTension) decreased in DOCA-salt compared to sham, but increased after BH4 treatment. Cardiac MyBP-C glutathionylation increased in DOCA-salt compared to sham, but decreased with BH4 treatment. MyBP-C glutathionylation correlated with the presence of diastolic dysfunction. Our results suggest that by depressing S-glutathionylation of MyBP-C, BH4 ameliorates diastolic dysfunction by reversing a decrease in cross-bridge turnover kinetics. These data provide evidence for modulation of cardiac relaxation by post-translational modification of myofilament proteins.

Original languageEnglish (US)
Pages (from-to)44-54
Number of pages11
JournalJournal of Molecular and Cellular Cardiology
Issue number1
StatePublished - Mar 2013
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by NIH/NHLBI grants RO1 HL022231, RO1 HL064035, PO1 HL062426 to RJS, and NIH/NHLBI grants RO1 HL085558, RO1 HL073753, PO1 HL058000, and a Veterans Affairs MERIT grant to SCD. MMM was supported by NIH T32 HL07692-16-20; DMT was supported by a University of Illinois at Chicago Center for Clinical and Translational Science (Award Number UL1RR029879) from the National Center for Research Resources, and by a University of Illinois at Chicago Fellowship.


  • Ca sensitivity
  • Deoxycorticosterone acetate (DOCA)-salt mice
  • Diastolic heart failure
  • MyBP-C
  • Oxidative stress
  • S-glutathionylation

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