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Abstract   Aims  The biological mechanisms conveying the salutary effects of cardiac resynchronization therapy in heart failure remain elusive. We have recently developed a mouse model of heart failure with dyssynchrony/resynchronization. The aim of this study was to characterize regional left ventricular heterogeneity in protein expression comparing early (septum) and late (lateral) activated left ventricular wall segments in synchronous (SHF), dyssynchronous (DHF), and resynchronized heart failure (RHF).    Methods and results  Mice subjected to ischaemia/reperfusion were divided into three groups: sinus rhythm for 4 weeks (SHF), right ventricular pacing for 4 weeks (DHF), and right ventricular pacing for 2 weeks and 2 weeks of sinus rhythm (RHF). Relative concentrations of 92 proteins from septal and lateral left ventricular wall segments ( n  = 10 per group) were compared  within  each group. We also analysed the effect of DHF vs. SHF and RHF vs. DHF on protein expression pattern comparing the same left ventricular segments between the groups. Proteins with significantly differential expression between left ventricular segments were analysed for protein–protein correlations, protein–protein interactions, and biological and signalling pathways. Eight proteins were significantly down‐regulated in the late activated (compared with early activated) lateral wall uniquely in RHF ( P  &lt; 0.05 adjusted for a 5% false discovery rate): Erbb4, Ntf3, Pdgfb, Tnf, Notch3, Qdpr, Tpp1, and Itgb6. Protein correlation matrix showed that six of these were strongly and positively correlated and five had known protein–protein interactions. Biological pathways mainly down‐regulated in late activated myocardium in RHF were MAPK signalling and hypertrophic cardiomyopathy. There were no significantly differentially expressed proteins comparing the same left ventricular segments between the DHF and SHF (range of  P ‐values: 0.05–1.00) and RHF and DHF (range of  P ‐values: 0.32–1.00).    Conclusions  In a mouse model of heart failure with dyssynchrony and resynchronization, we observed down‐regulation of several proteins in the late activated lateral wall, compared with the septum, in resynchronized mice. These proteins display significant protein–protein correlation and share biological signalling pathways, including MAPK activation and hypertrophy signalling.

Regional protein expression changes within the left ventricle in a mouse model of dyssynchronous and resynchronized heart failure