Heart failure & cardiomyopathies

Inhibition of adenosine kinase alleviates hypertrophic cardiomyopathy by ameliorating coronary microvascular dysfunction

ESC Heart FailPublished Mendelian randomization and colocalization analyses

Authors' conclusion

Our study established ADK as a therapeutic target for HCM treatment. Targeting ADK is a promising strategy for ameliorating microvascular dysfunction in HCM. Drug repurposing findings suggest that dabigatran may confer benefits in HCM via ADK inhibition.

Study context

Population
Hypertrophic cardiomyopathy (HCM) genome-wide association data (FinnGen; IEU OpenGWAS)FinnGen cases 1,376 · FinnGen controls 210,300 · IEU OpenGWAS cases 507 · IEU OpenGWAS controls 489,220
Outcome
ADK as a causal gene for HCM
Methodological detailsdrug repurposing with molecular docking, dynamics simulations, and cellular thermal shift assay, validated in HCM mice and endothelial cells (EC)
  • Drug repurposing with molecular docking, dynamics simulations, and cellular thermal shift assay
  • Validated in HCM mice and endothelial cells (EC)

Main finding

As reported in the abstract

Mendelian randomization OR

1.10, 95%CI 1.02-1.19

P = .015

Validation OR

1.28, 1.01-1.61

P = .039

Colocalization PP.H4

82.0%

Further findings

Adenosine kinase (ADK) inhibition in HCM mice

ADK inhibition attenuated cardiac hypertrophy, fibrosis, and microvascular dysfunction

ADK inhibition in ECs in vitro

ADK inhibition rescued the impaired function of ECs induced by Ang II stimulation

Drug repurposing: dabigatran binding to ADK

Highest binding energy
−9.3 kcal/mol
  • Confirmed using molecular dynamics simulations and cellular thermal shift assay

Dabigatran effects

Dabigatran improved EC function in vitro and, in HCM mice, ameliorated microvascular dysfunction and pathological cardiac remodelling

Original publication

Inhibition of adenosine kinase alleviates hypertrophic cardiomyopathy by ameliorating coronary microvascular dysfunction. ESC Heart Fail. Published 22 April 2026. doi:10.1093/eschf/xvag118

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