Abstract 14975: SIRT1 Ameliorates Cardiac Dysfunction Caused by Lamin A/C Deficiency Via Mitochondrial Bioenergetics Improvement

Background: The LMNA gene encodes lamin A/C and is the second most frequently mutated gene associated with dilated cardiomyopathy (DCM) but lacks effective therapeutic options. Recent transcriptomic studies have shown that mutation of LMNA leads to abnormal expression of genes related to mitochondrial function, however, the mechanisms have not been investigated further. Hypothesis: LMNA protects against cardiac dysfunction via mitochondrial bioenergetics maintenance. Aims To decipher the mechanism by which LMNA mediates mitochondrial bioenergetics and DCM phenotype. Methods: Proteomics was performed to decipher the pathogenesis of DCM in Lmna -/- mice. Neonatal rat ventricular myocytes (NRVMs) were used to dissect molecular mechanisms. Adenovirus and adeno-associated virus (AAV) were constructed to overexpress SIRT1 in vitro and in vivo , respectively. Results: Lmna -/- mice at 1 month of age showed obvious cardiac dysfunction, while 2-week-old Lmna -/- mice showed no obvious cardiac phenotype. Proteomics revealed downregulated mitochondrial function-related pathways in Lmna -/- hearts. Early injured mitochondria with decreased cristae density were detected and the only reduced mitochondrial biogenesis regulator SIRT1 was found in 2 week-old Lmna -/- hearts. Overexpression of SIRT1 in lamin A/C knockdown NRVMs effectively improved mitochondrial oxidative respiration capacity. AAV-SIRT1 injection significantly alleviated mitochondrial injury, DCM phenotype of Lmna -/- mice, and prolonged lifespan (Figure 1). Mechanistically, LMNA maintains mitochondrial bioenergetics through SIRT1-PARKIN axis. Conclusions: Lamin A/C deficiency leads to mitochondrial damage in cardiomyocytes and promotes the development of DCM through SIRT1 downregulation. Targeting SIRT1 ameliorates mitochondrial injury and DCM phenotype in Lmna -/- mice, which may provide a novel therapeutic strategy for LMNA mutation-associated DCM.