Postischemic apoptosis and functional recovery after angiotensin II type 1 receptor blockade in isolated working rat hearts

OBJECTIVE

To determine whether chronic angiotensin (AngII) type I receptor (AT1R) blockade inhibits cardiomyocyte (CM) apoptosis and attenuates left ventricular (LV) dysfunction after ischemia-reperfusion (IR) in the isolated working rat heart.

METHODS

Postischemic recovery of LV developed pressure, the apoptotic index (terminal deoxynucleotidyl transferase (TdT)-mediated dUTP in situ nick end labeling or TUNEL assay), and changes in expression of apoptotic markers Bcl-2, Bax, p53 and caspase-3 (Western immunoblots) were measured after IR (50 min aerobic perfusion; 25 min global ischemia; 40 min reperfusion) in working rat hearts that were randomized to five groups of six each along 1 week or 3 week pretreatment arms: sham (no drug, no perfusion); no drug, aerobic perfusion; and oral AT1R blockers losartan (30 mg/kg per day) or UP269-6 (3 mg/kg per day), or no drug before IR.

RESULTS

Compared to the no drug group after IR, losartan (not UP269-6) preserved functional recovery in 1 and 3 week groups. However, both losartan and UP269-6 reduced the apoptotic index and normalized the increase in Bax, decrease in Bcl-2 and increase in p53 and caspase-3 after IR. A bell-shaped relation between apoptosis and functional recovery after IR was flattened by AT1R blockade.

CONCLUSION

The results indicate that IR is associated with LV dysfunction and CM apoptosis involving activation of p53, caspase-3, and increased Bax/Bcl-2 ratio in the working rat heart. Importantly, chronic AT1R blockade inhibited the apoptosis and changes in expression of the markers without improving functional recovery, implying that decrease in apoptosis does not necessarily translate into decreased LV dysfunction.

Opposite effects of amlodipine and enalapril on infarct collagen and remodelling during healing after reperfused myocardial infarction

OBJECTIVES

To compare the effects of the calcium channel blocker amlodipine versus the angiotensin-converting enzyme inhibitor enalapril with or without reperfusion on infarct collagen and remodelling during healing after anterior myocardial infarction (MI).

ANIMALS AND METHODS

In vivo left ventricular (LV) remodelling and function (by quantitative echocardiography) and hemodynamics were measured over six weeks in dogs that were randomized 24 h after reperfusion (2 h after anterior MI) or no reperfusion to oral amlodipine (5 mg bid, n=6), enalapril (5 mg bid, n=6), placebo (bid, n=6) or sham surgery (n=6) for six weeks. Ex vivo infarct size, infarct collagen (hydroxyproline), collagen volume fraction and LV topography were measured at six weeks.

RESULTS

Compared with placebo controls without reperfusion over six weeks in vivo, enalapril or amlodipine with or without reperfusion produced LV unloading and preserved volumes, shape and function, but enalapril limited LV hypertrophy more than amlodipine. However, compared with no reperfusion, amlodipine preserved infarct wall thickness and shape while enalapril decreased infarct wall thickness and increased the shape index. Ex vivo at six weeks, scar size as a percentage of risk was similar in the MI groups. Importantly, enalapril decreased infarct collagen already lowered by reperfusion, while amlodipine preserved infarct collagen after reperfusion and increased collagen volume fraction in spared myocardium.

CONCLUSIONS

Preservation of infarct collagen limits infarct remodelling during healing after reperfused MI and preserves LV shape. Amlodipine and enalapril exert opposite effects on infarct collagen and remodelling after reperfused MI.

Inhibition of apoptosis after ischemia-reperfusion in rat myocardium by cycloheximide

Macromolecular synthesis inhibitors protect cells from apoptosis in many systems. To determine whether the protein synthesis inhibitor cycloheximide (CHX) might inhibit apoptosis and protect the myocardium during ischemia-reperfusion, we subjected isovolumic isolated perfused rat hearts to 25 min of normothermic global ischemia followed by reperfusion. We monitored coronary flow, end-diastolic pressure and rate-pressure product (RPP) throughout and assessed apoptosis by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL). Regardless of the treatment regimen (only before ischemia; only during reperfusion; or both before ischemia and during reperfusion), CHX significantly improved functional recovery during reperfusion. These effects were most pronounced when CHX was present during reperfusion. When hearts were treated with CHX only during reperfusion the recovery of sinus rhythm was more frequent in the CHX-treated hearts than control hearts (80% v 53%) and earlier for CHX-treated than control hearts: 6.4 +/- 2 v 19.4 +/- 4.7 min of reperfusion. The maximal RPP recoveries for the CHX-treated hearts were 45 +/- 4.0% (P=0.005) of pre-ischemic values, compared to 26 +/- 3% for controls. In control hearts reperfused for 2 h, TUNEL identified 49.5 +/- 10 intact nuclei and 7.5 +/- 2 fragmented nuclei per 1000 nuclei counted. A significantly lower incidence of labeled nuclei with or without fragmentation was observed in CHX treated hearts: 7.6 +/- 3.4 (P=0.009) intact labeled nuclei and 1.8 +/- 0.7/10(3)fragmented labeled nuclei. Our results suggest that CHX-induced inhibition of apoptosis in reperfused myocardium is cardioprotective and promotes functional recovery in vitro.

Protective effect of vanadate on oxyradical-induced changes in isolated perfused heart

In order to examine the mechanisms of the beneficial effects of vanadate on cardiac dysfunction in chronic diabetes, rat hearts were perfused with xanthine plus xanthine oxidase, an oxyradical generating system in the absence or presence of vanadate. The heart failed to generate contractile force and increased the resting tension markedly within 5 min of perfusion with xanthine plus xanthine oxidase. These changes were prevented by the addition of 4 microM vanadate in the perfusion medium. The protective effects of vanadate on the loss of developed tension and increased resting tension due to xanthine plus xanthine oxidase were dose-dependent (0.1-5 microM). Perfusion of the hearts with glucose-free medium did not abolish the protective actions of vanadate. The sarcolemmal Ca(2+)-pump (ATP-dependent Ca2+ uptake and Ca(2+)-stimulated ATPase) and Na(+)-dependent Ca2+ uptake activities were decreased upon perfusing the hearts with a medium containing xanthine plus xanthine oxidase for 5 min; these effects were prevented by the addition of 2-4 microM vanadate in the perfusion medium. The signals for superoxide radicals produced by xanthine plus xanthine oxidase, as detected by electron paramagnetic resonance spectroscopic technique, were inhibited by 5-100 microM vanadate. These results suggest that vanadate is an oxyradical scavenger and thus may prevent heart dysfunction under some pathological conditions by its antioxidant action.