1. Iron-deficiency anemia reduces cardiac contraction by downregulating RyR2 channels and suppressing SERCA pump activity
- Author
-
Pawel Swietach, Kyung Chan Park, Samira Lakhal-Littleton, Aminah A. Loonat, Yu Jin Chung, Peter A. Robbins, and Antao Luo
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,SERCA ,Anemia ,Iron ,Primary Cell Culture ,Cardiology ,Down-Regulation ,Heart failure ,Ryanodine receptor 2 ,Ferric Compounds ,Sarcoplasmic Reticulum Calcium-Transporting ATPases ,03 medical and health sciences ,Mice ,0302 clinical medicine ,Internal medicine ,medicine ,Animals ,Humans ,Myocytes, Cardiac ,Maltose ,Cells, Cultured ,Ejection fraction ,Anemia, Iron-Deficiency ,Chemistry ,Myocardium ,Calcium-Binding Proteins ,Calcium signaling ,Ryanodine Receptor Calcium Release Channel ,Stroke Volume ,General Medicine ,Iron deficiency ,medicine.disease ,Magnetic Resonance Imaging ,Myocardial Contraction ,Phospholamban ,Disease Models, Animal ,Sarcoplasmic Reticulum ,030104 developmental biology ,Endocrinology ,Iron-deficiency anemia ,030220 oncology & carcinogenesis ,Administration, Intravenous ,Calcium ,Excitation contraction coupling ,Research Article - Abstract
Iron deficiency is present in ~50% of heart failure (HF) patients. Large multicenter trials have shown that treatment of iron deficiency with i.v. iron benefits HF patients, but the underlying mechanisms are not known. To investigate the actions of iron deficiency on the heart, mice were fed an iron-depleted diet, and some received i.v. ferric carboxymaltose (FCM), an iron supplementation used clinically. Iron-deficient animals became anemic and had reduced ventricular ejection fraction measured by magnetic resonance imaging. Ca2+ signaling, a pathway linked to the contractile deficit in failing hearts, was also significantly affected. Ventricular myocytes isolated from iron-deficient animals produced smaller Ca2+ transients from an elevated diastolic baseline but had unchanged sarcoplasmic reticulum (SR) Ca2+ load, trigger L-type Ca2+ current, or cytoplasmic Ca2+ buffering. Reduced fractional release from the SR was due to downregulated RyR2 channels, detected at protein and message levels. The constancy of diastolic SR Ca2+ load is explained by reduced RyR2 permeability in combination with right-shifted SERCA activity due to dephosphorylation of its regulator phospholamban. Supplementing iron levels with FCM restored normal Ca2+ signaling and ejection fraction. Thus, 2 Ca2+-handling proteins previously implicated in HF become functionally impaired in iron-deficiency anemia, but their activity is rescued by i.v. iron supplementation., Iron deficiency, a common comorbidity in heart failure, reduces the strength of cardiac contraction through effects on Ca2+-handling proteins crucial for normal cardiac function but typically deranged failing hearts.
- Published
- 2019
- Full Text
- View/download PDF