Direct measurement of mavacamten and deoxyATP perturbation of the SRX/DRX ratio in porcine cardiac myofibrils using a simple, accessible and multiplexed approach

Cardiac muscle adapts to varying physiological demands by modulating the number of active myosin II motors available for contraction. These motors are organized into thick filaments in the sarcomere and generate force through an ATP-dependent interaction with thin filaments that contain actin. To conserve energy, when demand is low myosin can occupy the super-relaxed (SRX) state, which acts as a reserve. Here, we build upon the earlier studies to quantify the size of this cardiac reserve using fluorescence imaging of Cy3-ATP directly in myofibrils. This approach employs a pulse-chase method and exploits the high permeability of isolated myofibrils to monitor nucleotide release in situ. By preserving sarcomeric architecture while enabling rapid reagent exchange, this method bridges the gap between complex single-molecule imaging and traditional stopped-flow bulk assays using MANT-ATP. Using this approach we have studied biochemical perturbation of the SRX reserve with deoxyATP and mavacamten. DeoxyATP caused large depletion of the cardiac reserve, and mavacamten increased its size, consistent with its clinical application. Our results demonstrate the utility of this technique and the potential for further enhancement using multiplexing (i.e. imaging multiple samples in the same acquisition period), holding promise for future applications in health and disease.