RT Journal Article SR Electronic T1 Single-cell dissection of live human hearts in ischemic heart disease and heart failure reveals cell-type-specific driver genes and pathways JF bioRxiv FD Cold Spring Harbor Laboratory SP 2021.06.23.449672 DO 10.1101/2021.06.23.449672 A1 Suvi Linna-Kuosmanen A1 Eloi Schmauch A1 Kyriakitsa Galani A1 Carles A. Boix A1 Lei Hou A1 Tiit Örd A1 Anu Toropainen A1 Lindsey K. Stolze A1 Elamaran Meibalan A1 Julio C. Mantero A1 Ashley Renfro A1 Johannes Ojanen A1 Leandro Z. Agudelo A1 Maija Hollmen A1 Juho Jalkanen A1 Jarmo Gunn A1 Pasi Tavi A1 Casey E. Romanoski A1 Calum A. MacRae A1 Minna U. Kaikkonen A1 Guillermo Garcia-Cardena A1 Tuomas Kiviniemi A1 Manolis Kellis YR 2021 UL http://biorxiv.org/content/early/2021/06/24/2021.06.23.449672.abstract AB Ischemic heart disease is the single most common cause of death worldwide with an annual death rate of over 9 million people. Genome-wide association studies have uncovered over 200 genetic loci underlying the disease, providing a deeper understanding of the causal mechanisms leading to it. However, in order to understand ischemic heart disease at the cellular and molecular level, it is necessary to identify the cell-type-specific circuits enabling dissection of driver variants, genes, and signaling pathways in normal and diseased tissues. Here, we provide the first detailed single-cell dissection of the cell types and disease-associated gene expression changes in the living human heart, using cardiac biopsies collected during open-heart surgery from control, ischemic heart disease, and ischemic and non-ischemic heart failure patients. We identify 84 cell types/states, grouped in 12 major cell types. We define markers for each cell type, providing the first extensive reference set for the live human heart. These major cell types include cardiovascular cells (cardiomyocytes, endothelial cells, fibroblasts), rarer cell types (B lymphocytes, neurons, Schwann cells), and rich populations of previously understudied layer-specific epicardial and endocardial cells. In addition, we reveal substantial differences in disease-associated gene expression at the cell subtype level, revealing t arterial pericytes as having a central role in the pathogenesis of ischemic heart disease and heart failure. Our results demonstrate the importance of high-resolution cellular subtype mapping in gaining mechanistic insight into human cardiovascular disease.Competing Interest StatementThe authors have declared no competing interest.