Familial hypertrophic cardiomyopathy (FHC) is associated with mutations in 11 genes encoding sarcomeric
proteins. Most families present mutations in MYBPC3 and MYH7 encoding
cardiac myosin-
binding protein C and
beta-myosin heavy chain. The consequences of MYH7 mutations have been extensively studied at the molecular level, but controversial results have been obtained with either reduced or augmented
myosin motor function depending on the type or homogeneity of
myosin studied. In the present study, we took advantage of the accessibility to an explanted heart to analyze for the first time the properties of human homozygous mutant
myosin. The patient exhibited eccentric
hypertrophy with severely impaired ejection fraction leading to
heart transplantation, and carries a homozygous mutation in MYH7 (R403W) and a heterozygous variant in MYBPC3 (V896M). In situ analysis of the left ventricular tissue showed myocyte disarray and
hypertrophy plus interstitial
fibrosis. In vitro motility assays showed a small, but significant increase in sliding velocity of fluorescent-labeled actin filaments over human mutant
cardiac myosin-coated surface compared to control (+18%; P<0.001). Mutant
myosin exhibited a large increase in maximal
actin-activated ATPase activity (+114%; P<0.05) and Km for actin (+87%; P<0.05) when compared to control. These data show disproportionate enhancement of mechanical and enzymatic properties of human mutant
myosin. This suggests inefficient
ATP utilization and reduced mechanical efficiency in the myocardial tissue of the patient, which could play an important role in the development of FHC phenotype.