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J Thorac Cardiovasc Surg 2009;137:853-861
© 2009 The American Association for Thoracic Surgery


Acquired Cardiovascular Disease

Reduction of four-and-a-half LIM-protein 2 expression occurs in human left ventricular failure and leads to altered localization and reduced activity of metabolic enzymes

Esta Bovill, MRCSa,*, Steven Westaby, FRCS, PhDb, Alastair Crisp, MAc, Shiney Jacobs, PhDa, Tony Shaw, PhDa

a Department of Medicine, University College London, London, United Kingdom
b Oxford Heart Center, John Radcliffe Hospital, Oxford, United Kingdom
c Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom

Received for publication April 14, 2008; revisions received August 13, 2008; accepted for publication September 1, 2008.

* Address for reprints: Esta Bovill, MRCS, c/o Oxford Heart Centre, John Radcliffe Hospital Headley Way, Headington, Oxford OX3 9DU, United Kingdom. (Email: ebovill{at}doctors.net.uk).

Objective: We sought to identify changes in four-and-a-half LIM-protein 2 levels and location in human cardiomyocytes during the transition from compensated aortic stenosis to left ventricular failure. We also sought to characterize four-and-a-half LIM-protein 2 binding with the metabolic enzymes phosphofructokinase 2, adenylate kinase, and creatine kinase M isoform during this transition and their consequential subcellular localization in failing human ventricles.

Methods: Left ventricular biopsy specimens from selected patients undergoing aortic valve replacement for aortic stenosis were allocated to one of 2 groups: (1) nondilated with preserved left ventricular function (nonfailing group, n = 16) and (2) grossly dilated with poor left ventricular function (failing group, n = 15). These were compared with a control group of unused donor hearts (n = 6). Protein levels and subcellular localization were determined by means of Western blotting and immunofluorescence. Four-and-a-half LIM-protein 2 binding to adenylate kinase, creatine kinase M isoform, or phosphofructokinase 2 was studied by means of coimmunoprecipitation. Phosphofructokinase 2, adenylate kinase, and creatine kinase M isoform activities were assayed in protein extractions.

Results: Four-and-a-half LIM-protein 2 levels were preserved in nonfailing hypertrophied hearts but reduced by 53% in failing hearts. The pattern of four-and-a-half LIM-protein 2 staining was disrupted in failing hearts: four-and-a-half LIM-protein 2 was lost from the sarcomere but present in the perinuclear Golgi apparatus complex. Phosphofructokinase 2, adenylate kinase, and creatine kinase M isoform coimmunoprecipitated in vitro and colocalized with four-and-a-half LIM-protein 2 in both hypertrophied and failing hearts. Phosphofructokinase 2 and adenylate kinase activities were reduced to 77% and 58% of normal values in compensated aortic stenosis, with phosphofructokinase 2 activity decreased further to 56% of normal value in failing hearts, but creatine kinase activity remained unchanged.

Conclusions: Altered four-and-a-half LIM-protein 2 expression in heart failure is associated with disruption of the normal subcellular localization of phosphofructokinase 2, adenylate kinase, and creatine kinase M isoform and reduced activity of phosphofructokinase 2 and adenylate kinase, which might have important consequences for myocardial energy metabolism in heart failure.



Abbreviations and Acronyms ADP = adenosine diphosphate; AK = adenylate kinase; ATP = adenosine triphosphate; ATPase = adenosine triphosphatase; CK-M = creatine kinase isoform M; DAPI = 4'-6-Diamidino—2-phenylindole, dihydrochloride; ERK = extracellular signal-regulated kinase; FHL2 = four-and-a-half LIM-protein 2; LV = left ventricular; PBS = phosphate-buffered saline; PFK2 = phosphofructokinase 2; SDS = sodium dodecylsulfate








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