The expression patterns of both α- and βMYH have been described previously in the developing chick. αMYH is predominately expressed in the atrium and atrial septum and is expressed at lower levels in the developing ventricular chambers (
Rutland et al., 2009;
Somi et al., 2006). Though initially expressed throughout the heart tube, βMYH becomes predominate in the ventricular myocardium as development proceeds (
Somi et al., 2006). By comparison, expression of eMYH was demonstrated in the early looping heart, and subsequently throughout the myocardium of the OFT, atrium and atrial septum, and at lower levels to the ventricular chamber. Knockdown of eMYH in the chick resulted in abnormal atrial septal development, similar to that seen upon αMYH knockdown (
Ching et al., 2005;
Rutland et al., 2009). The atrial septum either failed to form with only a small outgrowth of the dorsocranial wall observed or a small septum formed in comparison with controls. Knockdown at different stages of septal development (HH12-HH16) showed no temporal effect with the phenotypes present at high penetrance (98% of eMYH knockdown embryos affected). In addition, there was an absent atrial septum in the HH14/17 knockdown hearts (only about 8 hours between knockdown and harvesting). Together, these data suggest that eMYH plays a specific and crucial role in atrial septa initiation and maintenance. Although the role eMYH plays in atrial septal formation is not fully understood, the 18% increase in apoptosis in the eMYH knockdown hearts suggests that eMYH might aid cell survival. Knockdown of eMYH also resulted in an enlarged heart and reduced trabeculation; however, no effect was observed upon myofibril assembly or maintenance. The enlarged external ventricular phenotype was observed in 82% and reduced trabeculae in 98% of eMYH knockdown hearts, with stereology indicating that the ventricular wall and trabeculae together were just 69% of the expected value. As the ventricle was enlarged but the wall was thinner, it was deemed appropriate to define the HH19 enlarged heart as dilated cardiomyopathy (
Maron et al., 2006). This phenotype is also consistent with the increased tissue disintegration seen in subcellular analysis of embryonic heart structure and by an increase in apoptosis in eMYH knockdowns compared with controls. Apoptosis has previously been associated with dilated cardiomyopathy in humans and animal models during development and in the adult (
Das et al., 2010;
Guerra et al., 1999;
Tintu et al., 2009;
Wencker et al., 2003) and is potentially a mechanism in this disease (
Wencker et al., 2003). Therefore, it was not unexpected that apoptosis was observed in these eMYH knockdown enlarged hearts. Data presented in suggests that eMYH knockdown does not affect myofibrillogenesis or myofibril maintenance per se but results in focal impaired tissue integrity in the heart. These data might be explained by the expression of eMYH in a subset of the cardiomyocytes and its expression at the plasma membrane, suggesting a stabilising role in the cytoskeleton ().
Many different mutations in
MYH7 (human analogue of β
MYH) are known to cause cardiomyopathy (
Walsh et al., 2010), with different mutations also associated with skeletal muscle myopathies (
Meredith et al., 2004;
Tajsharghi et al., 2003). In addition, some families with mutations in
MYH7 have both cardiomyopathy and myopathy (
Tajsharghi et al., 2007), and mutations have been associated with cardiomyopathy in infants and children (
Towbin et al., 2006). Both
MYH7 and
MYH6 (human homologue of α
MYH) are known to be involved in normal atrial septal development, with families with mutations in these genes afflicted with ASDs (
Budde et al., 2007;
Ching et al., 2005). Furthermore, mutations in
MYH6 have also been found in individuals with cardiomyopathy (
Carniel et al., 2005). Interestingly, mutations in the structural protein cardiac α-actin have been associated with atrial septal defects (
Matsson et al., 2008) or cardiomyopathy (
Mogensen et al., 1999;
Olson et al., 2000;
Olson et al., 1998), with some individuals with mutations having both defects (
Monserrat et al., 2007). To our knowledge,
MYH3 or
eMYH have not previously been associated with heart abnormalities in humans or animal models. The data presented here demonstrates that
MYH3 is the only skeletal MYH gene family member expressed in the human foetal heart, expressed in both the atrial and ventricular regions. Mutations in
MYH3 have been associated with distal arthrogryposis type I, 2A (Freeman-Sheldon syndrome) and 2B (Sheldon-Hall syndrome) (
Alvarado et al., 2011;
Toydemir et al., 2006). Mutations are largely missense, and are primarily to the head domain, potentially affecting the catalytic activity of
MYH3. However, in many cases the consequence of a gene mutation is poorly understood. Therefore, different types of mutations might lead to different defects, such as ASDs with certain mutations and cardiomyopathy or skeletal myopathies with other mutations. Knockdown of chick eMYH leads to haploinsufficiency and, hence, a loss of function.
The excitation-contraction coupling process is fundamental to heart physiology: the electrical stimulus is usually an AP and the mechanical response is a contraction. The vast majority of papers on cardiac excitation-contraction coupling deal only with the ventricle (
Fabiato and Fabiato, 1979;
Langer, 1973;
Orchard and Brette, 2008). In this study, we have shown the differing effects following the manipulation of e-, α- or βMYH in both the atria and ventricle at early stages of heart development, which might result in alterations between the generation of the electrical activity of the cells and their Ca
2+ transients. These Ca
2+ transient changes are fundamental to proper activation of the machinery of contraction, in which MYH plays a key role (
Chandra et al., 2007;
Dillmann, 2009;
Khait and Birla, 2009), but also to the regulation of gene expression (
Webb and Miller, 2003). Evidence is presented suggesting that eMYH has a major impact on the AP properties of the atrial and ventricular cells, with AP characteristics that are normally found during very early heart development (
Arguello et al., 1986). These data suggest that eMYH might play a key role in the normal development of the AP in these regions. Some of the AP changes in eMYH-treated cells (such as the prolongation of the AP duration) resemble phenotypes described in NKX2.5-(
Briggs et al., 2008;
Pashmforoush et al., 2004) and TBX5-(
Bruneau et al., 2001) deficient mice (which also exhibit atrial septal and conduction defects) or humans with heart failure (
Kaab et al., 1998). Thus, it could be possible that eMYH knockdown alters these and/or other common proteins/pathways (such as the reducing potassium channel proteins Kv1.2, Kv1.5 and Kv2.1) resulting in similar phenotypes. Alternatively, changes in the mechanical forces in these altered hearts might result in a different microenvironment for the cardiomyocytes inducing a re-differentiation or de-differentiation process in these cells (
Porter and Turner, 2009;
Schenke-Layland et al., 2008). Furthermore, neither αMYH nor βMYH knockdown had a major impact in the AP morphology from the atria or ventricles. We found that a decrease in eMYH expression induces a disruption not only in the contraction of these cells but also in their ability to generate an AP, decreased I
+K and Ca
2+ transient spikes (in ~80% of the ventricular myocytes). One possible explanation is that these electrically inactive cells represent ventricular cells that will undergo apoptosis, which is supported by the increase in apoptotic cells in the eMYH knockdown ventricles in comparison with controls. If this is the case, it raises new questions: Why are ventricular cells more sensitive than atrial cells? Is this a sign that early in development the excitation-contraction mechanism is tightly interrelated? If so, at what point in development does this interrelation become looser? Our current understanding of these issues is limited and further insights are required. Changes in the flow or load to the embryonic heart results in alterations in the composition and function of the cardiac microenvironment, modifying size, structure and function (
Porter and Turner, 2009). Thus, the effects observed by eMYH reduction could be attributed to some of these factors.
It is recognised that intracellular Ca
2+ plays a key role in the proper contraction of cardiomyocytes (
Rigoard et al., 2009). In this study, we show that manipulation of e-, α- and βMYH have an impact on the profile of the spontaneous Ca
2+ transients in atrial and ventricular cells. To what extent these changes in intracellular Ca
2+ might affect the ability of cardiomyocytes to generate the proper force remains to be analysed. It is also well established that intracellular Ca
2+ plays an important role not only in the contraction process but also in the modulation of many Ca
2+ dependent intracellular functions. It remains to be elucidated whether the changes induced by manipulation of different MYHs are sufficient to temporarily or permanently alter any of these processes.
The data presented here demonstrates that eMYH is present in the early developing heart, and that it plays crucial roles during cardiogenesis, specifically in atrial septation and in normal heart function. Novel insights into the role that the MYH family plays in the electrical activity and calcium signalling within the developing heart are presented. These data suggest that the human functional homologue to eMYH, which we postulate to be MYH3, could provide novel insights into the molecular genetics of cardiovascular disorders and, hence, would be a candidate gene worthy of further investigation.