The roles of the microtubule cytoskeletal network in cardiac mechanobiology.

The intracellular cytoskeletal network is a central mediator of mechanobiology, transmitting extracellular cues from the cell membrane to elicit downstream changes in cell behaviour and morphology. In cardiomyocytes, mechanotransduction via the intracellular cytoskeleton plays a pivotal role in regulating cardiac output, development and pathological remodelling. Various structural components contribute to this process, including tension-mediated ion channels, contractile sarcomere units, transmembrane cell junction proteins, intermediate filaments and the microtubule network. Among these components, microtubules are the largest and most rigid cytoskeletal elements. This Review highlights the essential, but often understated, role of microtubules in cardiomyocyte mechanobiology, particularly in their coordination with other cytoskeletal elements. Furthermore, this Review highlights how the microtubule cytoskeletal network is connected to cardiac disease phenotypes.