Heart disease is the number-one killer in the developed world. The end stage of heart disease is heart failure, in which the heart cannot pump enough blood to satisfy the body's needs, researchers said.
The molecular structure of the heart muscle changes as heart failure progresses, though scientists cannot always agree on what changes are good or bad.
One change that occurs is an increase in "calcium sensitivity".
Calcium ions are pumped in and out of the muscle cell with each heartbeat, turning contractions on and off. When the calcium sensitivity increases, contractility increases, but at a price: the relaxation of the heart becomes slower.
Since 1976 medical researchers have known that the heart regulates its calcium sensitivity by phosphorylating (adding negative phosphate groups) to a key cardiac protein called troponin I.
The troponin complex is made up of three proteins, C, I, and T, which trigger muscle contraction in response to calcium.
In heart failure, the phosphate groups are removed from troponin I, but it wasn't known how this caused an increase in calcium sensitivity.
They observed that unphosphorylated troponin I binds to troponin C to keep it in an optimal orientation for triggering contraction.
The (N-terminal) region of troponin I that interacts with troponin C is very positively charged, while troponin C is very negatively charged, so adding negative phosphate groups to troponin I disrupts the interaction and releases troponin C so that it becomes less efficient at triggering contraction.
"Actually, the change brings it into the optimal alignment to trigger contraction. The heart has other mechanisms of regulating calcium sensitivity that probably also act by stabilising or disrupting this arrangement," Hwang said.
The study was published in the journal PNAS.
