Single-Cell Splicing Isoform Atlas of the Adult Human Heart and Heart Failure

T Timothy Pan (Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.) L Lina Lu K Keith Youker C Cheng-Kai Shiau (Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.) M Minhua Wang H Hsiao-yun Lin A Anh Nguyen Y Yueying He (Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.) E Eric Tong (Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.) P Pei Zhu (Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine) R Rajul Ranka (Center for RNA Therapeutics, Houston Methodist Research Institute, TX (K.Y., R.R.).) Y Yuanqing Yan A Arjun Sinha (Division of Cardiology, Department of Medicine (A.S., J.W.), Northwestern University, Chicago, IL.) A Ankit Bharat T Todd Eagar (Department of Pathology and Genomic Medicine, Houston Methodist Hospital, TX (T.E.).) J Jane Wilcox (Division of Cardiology, Department of Medicine (A.S., J.W.), Northwestern University, Chicago, IL.) A Arvind Bhimaraj (Department of Cardiology, Houston Methodist Hospital, Houston, TX (A.B.).) R Ruli Gao (Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.)

Abstract

BACKGROUND: Alternative splicing plays crucial roles in normal heart development and cardiac disease by influencing protein-coding sequences, functional domains, and molecular networks. However, a detailed characterization of the human heart isoform landscape remains incomplete. METHODS: Leveraging long-read single-nucleus RNA sequencing and computational analysis, we dissected full-length isoform heterogeneities, expression patterns, and usage shifts across cell types, cell states, and cardiac conditions of the adult left ventricle. We applied in silico approaches to assess the functional relevance of identified isoforms; validated isoform compositions of representative cardiac genes using reverse transcription quantitative polymerase chain reaction and targeted amplicon sequencing; and developed a web server for interactive navigation of our results. RESULTS: The data revealed that isoform heterogeneity is widespread in the cardiac cellular system, serving as a posttranscriptional buffer mechanism that calibrates the molecule reservoirs in human hearts. In healthy left ventricles, ≈30% of cell type–specific genes were polyform, using multiple isoforms tailored to cell type–specific programs. Among ubiquitously expressed genes, >300 showed differential isoform usage with cell type specificity in normal hearts. Comparisons of cardiomyocytes across conditions uncovered 379 genes with marked isoform usage shifts, most of which are predicted to change protein coding outcomes through direct changes in protein coding sequences and switches between intron retention and non–protein-coding biotypes. In contrast, cell state–specific programs tend to operate on monoform genes associated with changes among cell states. In addition, our data revealed heart failure–associated differential isoform usage events in stromal and immune cell types in the cardiac microenvironment. CONCLUSIONS: We present a comprehensive atlas of splicing isoforms in the normal adult heart and heart failure through long-read single-nucleus RNA sequencing and computational analyses. The results suggest crucial roles of isoforms in buffering core cellular programs and contributing to disease-associated cell states. The full-length details of these cell-specific isoforms serve as an important reference for downstream translational and mechanistic studies and are available on our online data portal at https://github.com/gaolabtools/heart-isoform-atlas .

Article Details

Journal Circulation
Volume / Issue Vol. 152, Issue 21
Published November 25, 2025
Pages 1501-1514
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (18)

T

Timothy Pan

Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.

L

Lina Lu

K

Keith Youker

C

Cheng-Kai Shiau

Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.

M

Minhua Wang

H

Hsiao-yun Lin

A

Anh Nguyen

Y

Yueying He

Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.

E

Eric Tong

Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.

P

Pei Zhu

Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine

R

Rajul Ranka

Center for RNA Therapeutics, Houston Methodist Research Institute, TX (K.Y., R.R.).

Y

Yuanqing Yan

A

Arjun Sinha

Division of Cardiology, Department of Medicine (A.S., J.W.), Northwestern University, Chicago, IL.

A

Ankit Bharat

T

Todd Eagar

Department of Pathology and Genomic Medicine, Houston Methodist Hospital, TX (T.E.).

J

Jane Wilcox

Division of Cardiology, Department of Medicine (A.S., J.W.), Northwestern University, Chicago, IL.

A

Arvind Bhimaraj

Department of Cardiology, Houston Methodist Hospital, Houston, TX (A.B.).

R

Ruli Gao

Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine (T.P., L.L., C.-K.S., M.W., H.-Y.L., Y.H., E.T., P.Z., R.G.), Northwestern University, Chicago, IL.