Systems biology provides an integrative platform by which to account for the
biological complexity related to cardiac health and disease. In this way, consequences of
ATP-sensitive K(+) (K(
ATP)) channel deficiency for
heart failure prediction, diagnosis, and
therapy were resolved recently at a proteomic level. Under stress-free conditions, knockout of the Kir6.2 K(
ATP) channel pore induced metabolic
proteome remodelling, revealing overrepresentation of markers of
cardiovascular disease. Imposed stress precipitated structural and functional defects in Kir6.2-knockout hearts, decreasing survival and validating prediction of
disease susceptibility. In the setting of
hypertension, a leading risk for
heart failure development, proteomic analysis diagnosed the metabolism-centric impact of K(
ATP) channel deficiency in disease. Bioinformatic interrogation of K(
ATP) channel-dependent
proteome prioritized heart-specific adverse effects, exposing cardiomyopathic traits of aggravated contractility,
fibrosis, and ventricular
hypertrophy. In
dilated cardiomyopathy induced by Kir6.2-knockout pressure overload, proteomic remodelling was exacerbated, underlying a multifaceted molecular pathology that indicates the necessity for a broad-based strategy to achieve repair. Embryonic stem cell intervention in cardiomyopathic K(
ATP) channel knockout hearts elicited a distinct
proteome signature that forecast amelioration of adverse cardiac outcomes. Functional/structural measurements validated improved contractile performance, reduced ventricular size, and decreased cardiac damage in the treated cohort, while systems assessment unmasked cardiovascular development as a prioritized
biological function in stem cell-reconstructed hearts. Thus, proteomic deconvolution of K(
ATP) channel-deficient hearts provides definitive evidence for the channel's homeostatic contribution to the cardiac metaboproteome and establishes the utility of systems-oriented approaches to predict
disease susceptibility, diagnose consequences of
heart failure progression, and monitor
therapy outcome.