The microtubule cytoskeleton in cardiac mechanics and heart
Microtubule-based transport establishes, maintains and remodels important subcellular compartments in cardiomyocytes, including the intercalated disc, transverse tubule and sarcoplasmic reticulum membrane systems. Microtubules distribute mRNA and the translational machinery throughout cardiomyocytes to control local protein synthesis and cardiomyocyte hypertrophy. The microtubule network remodels in terms of its density, post-translational modifications, tubulin isoform composition, stability and crosslinking in various cardiac pathologies.

A modified, dense and crosslinked microtubule network increases the viscoelastic resistance to cardiomyocyte motion in heart failure, which can contribute to elevated myocardial stiffness. Although gross microtubule disruption improves cardiac outcomes in certain large-animal and small-animal models of heart failure, more targeted therapeutic approaches are needed for clinical application.