- Rhee, June-Wha;
- Yi, Hyoju;
- Thomas, Dilip;
- Lam, Chi Keung;
- Belbachir, Nadjet;
- Tian, Lei;
- Qin, Xulei;
- Malisa, Jessica;
- Lau, Edward;
- Paik, David T;
- Kim, Youngkyun;
- Choi, Beatrice SeungHye;
- Sayed, Nazish;
- Sallam, Karim;
- Liao, Ronglih;
- Wu, Joseph C
Excessive iron accumulation in the heart causes iron overload cardiomyopathy (IOC), which initially presents as diastolic dysfunction and arrhythmia but progresses to systolic dysfunction and end-stage heart failure when left untreated. However, the mechanisms of iron-related cardiac injury and how iron accumulates in human cardiomyocytes are not well understood. Herein, using human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), we model IOC and screen for drugs to rescue the iron overload phenotypes. Human iPSC-CMs under excess iron exposure recapitulate early-stage IOC, including oxidative stress, arrhythmia, and contractile dysfunction. We find that iron-induced changes in calcium kinetics play a critical role in dysregulation of CM functions. We identify that ebselen, a selective divalent metal transporter 1 (DMT1) inhibitor and antioxidant, could prevent the observed iron overload phenotypes, supporting the role of DMT1 in iron uptake into the human myocardium. These results suggest that ebselen may be a potential preventive and therapeutic agent for treating patients with secondary iron overload.