International Journal of Molecular Sciences Review Genetic Restrictive Cardiomyopathy: Causes and Consequences—An Integrative Approach Diana Cimiotti 1,* , Heidi Budde 2, Roua Hassoun 2 and Kornelia Jaquet 2,* 1 Department of Clinical Pharmacology, Ruhr-University Bochum, 44801 Bochum, Germany 2 Experimental and Molecular Cardiology, St. Josef Hospital and BG Bergmannsheil, Clinics of the Ruhr-University Bochum, 44791 Bochum, Germany;
[email protected] (H.B.);
[email protected] (R.H.) * Correspondence:
[email protected] (D.C.);
[email protected] (K.J.); Tel.: +49-234-32-27639 (D.C.) Abstract: The sarcomere as the smallest contractile unit is prone to alterations in its functional, structural and associated proteins. Sarcomeric dysfunction leads to heart failure or cardiomyopathies like hypertrophic (HCM) or restrictive cardiomyopathy (RCM) etc. Genetic based RCM, a very rare but severe disease with a high mortality rate, might be induced by mutations in genes of non- sarcomeric, sarcomeric and sarcomere associated proteins. In this review, we discuss the functional effects in correlation to the phenotype and present an integrated model for the development of genetic RCM. Keywords: cardiomyopathy; restrictive cardiomyopathy; pediatric; sarcomere; contractile dysfunc- tion; calcium; aggregation; gene expression 1. The Sarcomere The sarcomere as the substructure of myofibrils is the contractile unit of striated muscles i.e. skeletal and cardiac muscle (Figure1). It forms a symmetric unit with the Citation: Cimiotti, D.; Budde, H.; M-disc in the center and is bordered by the Z-discs. M-disc and Z-disc provide the anchors Hassoun, R.; Jaquet, K. Genetic for thin, thick and elastic filaments. The elastic filament is composed of the giant protein Restrictive Cardiomyopathy: Causes and Consequences—An Integrative titin spanning half the sarcomere.