Alteration of myocardial sarcoplasmic reticulum Ca2+‐ATPase and Na+–Ca2+ exchanger expression in human left ventricular volume overload

Background: Reduced myocardial contractility is often attributed to altered Ca 2+ transients and expression of Ca 2+ -ATPase of the SR (SERCA) and Na+/Ca 2+ exchanger (NCX) genes. Aims: To assess myocardial expression of SERCA and NCX protein levels in left ventricular (LV) remodelling due to chronic severe mitral regurgitation (MR). Methods: Myocardial expression of SERCA/NCX in biopsy specimens obtained during mitral surgery was assessed in 36 MR patients with LV remodelling and plasma neurohumoral/cytokine activation and in four non-failing hearts (NFH). Results: Myocardial protein levels of SERCAwere significantly (20%) lower in the MR group than in NFH group (p=0.016). No significant changes in NCX were observed. However, a lack of homogeneity with regard to SERCA/NCX proteins was observed. Moreover, SERCA was negatively correlated with BNP (r=�0.49, p=0.02), TNFα (r=�0.68, p=0.0005) and IL-6 (r=�0.52, p=0.02), whereas NCX was only negatively correlated with TNFα (r=�0.62, p=0.002). Conclusions: MRpatientsshowedwidevariationsinSERCA/NCXproteinexpression.MyocardialproteinlevelsofSERCAweresignificantlylower in the MR population. Moreover, a correlation between BNP, cytokines (IL-6, TNFα) and the expression of SERCA/NCX proteins was observed.