Cardioprotective effects of 70-kDa heat shock protein in transgenic mice.

Heat shock proteins are proposed to limit injury resulting from diverse environmental stresses, but direct metabolic evidence for such a cytoprotective function in vertebrates has been largely limited to studies of cultured cells. We generated lines of transgenic mice to express human 70-kDa heat shock protein constitutively in the myocardium. Hearts isolated from these animals demonstrated enhanced recovery of high energy phosphate stores and correction of metabolic acidosis following brief periods of global ischemia sufficient to induce sustained abnormalities of these variables in hearts from nontransgenic littermates. These data demonstrate a direct cardioprotective effect of 70-kDa heat shock protein to enhance postischemic recovery of the intact heart.

Targeted disruption of gp130, a common signal transducer for the interleukin 6 family of cytokines, leads to myocardial and hematological disorders.

gp130 is a ubiquitously expressed signal-transducing receptor component shared by interleukin 6, interleukin 11, leukemia inhibitory factor, oncostatin M, ciliary neurotrophic factor, and cardiotrophin 1. To investigate physiological roles of gp130 and to examine pathological consequences of a lack of gp130, mice deficient for gp130 have been prepared. Embryos homozygous for the gp130 mutation progressively die between 12.5 days postcoitum and term. On 16.5 days postcoitum and later, they show hypoplastic ventricular myocardium without septal and trabecular defect. The subcellular ultrastructures in gp130-/- cardiomyocytes appear normal. The mutant embryos have greatly reduced numbers of pluripotential and committed hematopoietic progenitors in the liver and differentiated lineages such as T cells in the thymus. Some gp130-/- embryos show anemia due to impaired development of erythroid lineage cells. These results indicate that gp130 plays a crucial role in myocardial development and hematopoiesis during embryogenesis.

Cardioprotective effect of insulin-like growth factor I in myocardial ischemia followed by reperfusion.

In the present study, the cardioprotective effects of insulin-like growth factor I (IGF-I) were examined in a murine model of myocardial ischemia reperfusion (i.e., 20 min + 24 hr). IGF-I (1-10 micrograms per rat) administered 1 hr prior to ischemia significantly attenuated myocardial injury (i.e., creatine kinase loss) compared to vehicle (P < 0.001). In addition, cardiac myeloperoxidase activity, an index of neutrophil accumulation, in the ischemic area was significantly attenuated by IGF-I (P < 0.001). This protective effect of IGF-I was not observed with des-(1-3)-IGF-I. Immunohistochemical analysis of ischemic-reperfused myocardial tissue demonstrated markedly increased DNA fragmentation due to programmed cell death (i.e., apoptosis) compared to nonischemic myocardium. Furthermore, IGF-I significantly attenuated the incidence of myocyte apoptosis after myocardial ischemia and reperfusion. Therefore, IGF-I appears to be an effective agent for preserving ischemic myocardium from reperfusion injury and protects via two different mechanisms--inhibition of polymorphonuclear leukocyte-induced cardiac necrosis and inhibition of reperfusion-induced apoptosis of cardiac myocytes.

Bioenergetic scaling: metabolic design and body-size constraints in mammals.

The cytosolic phosphorylation ratio ([ATP]/[ADP][P(i)]) in the mammalian heart was found to be inversely related to body mass with an exponent of -0.30 (r = 0.999). This exponent is similar to -0.25 calculated for the mass-specific O2 consumption. The inverse of cytosolic free [ADP], the Gibbs energy of ATP hydrolysis (delta G'ATP), and the efficiency of ATP production (energy captured in forming 3 mol of ATP per cycle along the mitochondrial respiratory chain from NADH to 1/2 O2) were all found to scale with body mass with a negative exponent. On the basis of scaling of the phosphorylation ratio and free cytosolic [ADP], we propose that the myocardium and other tissues of small mammals represent a metabolic system with a higher driving potential (a higher delta G'ATP from the higher [ATP]/[ADP][P(i)]) and a higher kinetic gain [(delta V/Vmax)/delta [ADP]] where small changes in free [ADP] produce large changes in steady-state rates of O2 consumption. From the inverse relationship between mitochondrial efficiency and body size we calculate that tissues of small mammals are more efficient than those of large mammals in converting energy from the oxidation of foodstuffs to the bond energy of ATP. A higher efficiency also indicates that mitochondrial electron transport is not the major site for higher heat production in small mammals. We further propose that the lower limit of about 2 g for adult endotherm body size (bumblebee-bat, Estrucan shrew, and hummingbird) may be set by the thermodynamics of the electron transport chain. The upper limit for body size (100,000-kg adult blue whale) may relate to a minimum delta G'ATP of approximately 55 kJ/mol for a cytoplasmic phosphorylation ratio of 12,000 M-1.

Continuous activation of gp130, a signal-transducing receptor component for interleukin 6-related cytokines, causes myocardial hypertrophy in mice.

To investigate the physiological roles of gp130 in detail and to determine the pathological consequence of abnormal activation of gp130, transgenic mice having continuously activated gp130 were created. This was carried out by mating mice from interleukin 6 (IL-6) and IL-6 receptor (IL-6R) transgenic lines. Offspring overexpressing both IL-6 and IL-6R showed constitutive tyrosine phosphorylation of gp130 and a downstream signaling molecule, acute phase response factor/signal transducer and activator of transcription 3. Surprisingly, the distinguishing feature of such offspring was hypertrophy of ventricular myocardium and consequent thickened ventricular walls of the heart, where gp130 is also expressed, in adulthood. Transgenic mice overexpressing either IL-6 or IL-6R alone did not show detectable myocardial abnormalities. Neonatal heart muscle cells from normal mice, when cultured in vitro, enlarged in response to a combination of IL-6 and a soluble form of IL-6R. The results suggest that activation of the gp130 signaling pathways leads to cardiac hypertrophy and that these signals might be involved in physiological regulation of myocardium.

Iontophoresis for modulation of cardiac drug delivery in dogs.

Cardiac arrhythmias are a frequent cause of death and morbidity. Conventional antiarrhythmia therapy involving oral or intravenous medication is often ineffective and complicated by drug-associated side effects. Previous studies from our laboratory have demonstrated the advantages of cardiac drug-polymer implants for enhanced efficacy for cardiac arrhythmia therapy compared with conventional administration. However, these studies were based on systems that deliver drugs at a fixed release rate. Modulation of the drug delivery rate has the advantage of regulating the amount of the drug delivered depending upon the disease state of the patient. We hypothesized that iontophoresis could be used to modulate cardiac drug delivery. In this study, we report our investigations of a cardiac drug implant in dogs that is capable of iontophoretic modulation of the administration of the antiarrhythmic agent sotalol. We used a heterogeneous cation-exchange membrane (HCM) as an electrically sensitive and highly efficient rate-limiting barrier on the cardiac-contacting surface of the implant. Thus, electric current is passed only through the HCM and not the myocardium. The iontophoretic cardiac implant demonstrated in vitro drug release rates that were responsive to current modulation. In vivo results in dogs have confirmed that iontophoresis resulted in regional coronary enhancement of sotalol levels with current-responsive increases in drug concentrations. We also observed acute current-dependent changes in ventricular effective refractory periods reflecting sotalol-induced refractoriness due to regional drug administration. In 30-day dog experiments, iontophoretic cardiac implants demonstrated robust sustained function and reproducible modulation of drug delivery kinetics.

Electro-mechanical coupling in the aging heart: role of the Late Na+ current

The aging myopathy manifests itself with diastolic dysfunction and preserved ejection fraction. However, the difficulty in defining myocardial aging and the mechanisms involved complicates the recognition of the cellular processes underlying impaired diastolic relaxation. We raised the possibility that, in a mouse model of physiological aging, defects in the electromechanical properties of cardiomyocytes are important determinants of the diastolic properties of the myocardium, independently from changes in the structural composition of the muscle and collagen framework. Here we show that an increase in the late Na+ current (INaL) in aging cardiomyocytes prolongs the action potential (AP) and influences the temporal kinetics of Ca2+ cycling and cell shortening. These alterations increase force development and passive tension. Inhibition of INaL shortens the AP and corrects the dynamics of Ca2+ transient, cell contraction and relaxation. Similarly, repolarization and diastolic tension of the senescent myocardium are partly restored. INaL offers inotropic support, but negatively interferes with cellular and ventricular compliance, providing a new perspective of the biology of myocardial aging and the etiology of the defective cardiac performance in the elderly.

Propriedades físico-químicas e mecânicas de membranas porosas de carboximetilquitosana e hidrogéis de quitosana para aplicação em engenharia de tecidos

Este trabalho teve como principal objetivo produzir membranas porosas de carboximetilquitosana e hidrogéis de quitosana com propriedades físico-químicas e mecânicas adequadas para aplicações em Engenharia de Tecidos. Para isso, quitosanas com diferentes graus de acetilação (4,0%<GA<40%) e de elevada massa molar média viscosimétrica (Mv>750.000 g.mol-1) foram produzidas através da aplicação de processos consecutivos de desacetilação assistida por irradiação de ultrassom de alta intensidade (DAIUS) à beta-quitina extraída de gládios de lulas Doryteuthis spp. A carboximetilação de quitosana extensivamente desacetilada (Qs-3; GA=4%) foi realizada pela reação com ácido monocloroacético em meio isopropanol/solução aquosa de NaOH, gerando a amostra CMQs-0 (GS≈0,98; Mv≈190.000 g.mol-1). A irradiação de ultrassom de alta intensidade foi empregada para tratar solução aquosa de CMQs-0 durante 1 h e 3 h, resultando nas amostras CMQs-1 (Mv≈94.000 g.mol-1) e CMQs-3 (Mv≈43.000 g.mol-1), respectivamente. Para a produção de membranas reticuladas, genipina foi adicionada em diferentes concentrações (1,0x10-4 mol.L-1, 3,0x10-4 mol.L-1 ou 5,0x10-4 mol.L-1) às soluções aquosas das CMQs, que foram vertidas em placas de Petri e a reação de reticulação procedeu por 24 h. Em seguida, as membranas reticuladas (M-CMQs) foram liofilizadas, neutralizadas, lavadas e liofilizadas novamente, resultando em nove amostras, que foram caracterizadas quanto ao grau médio de reticulação (GR), grau médio de hidratação (GH), morfologia, propriedades mecânicas e quanto à susceptibilidade à degradação por lisozima. O grau médio de reticulação (GR) foi tanto maior quanto maior a concentração de genipina empregada na reação, variando de GR≈3,3% (M-CMQs-01) a GR≈17,8% (M-CMQs-35). As análises de MEV revelaram que as membranas reticuladas M-CMQs são estruturas porosas que apresentam maior densidade de poros aparentes quanto maiores os valores de Mve GR. Entretanto, as membranas preparadas a partir de CMQs de elevada massa molar (Mv>94.000 g.mol-1) e pouco reticuladas (GR<10%), apresentaram propriedades mecânicas superiores em termos de resistência máxima à tração (>170 kPa) e elongação máxima à ruptura (>40%). Por outro lado, as membranas mais susceptíveis à degradação enzimática foram aquelas preparadas a partir de CMQs de baixa massa molar (Mv≈43.000 g.mol-1) e que exibiram baixos graus de reticulação (GR<11%). Hidrogéis estáveis de quitosana sem o uso de qualquer agente de reticulação externo foram produzidos a partir da gelificação de soluções aquosas de quitosana com solução de NaOH ou vapor de NH3. Os hidrogéis produzidos a partir de soluções de quitosana de elevada massa molar média ponderal (Mw≈640.000 g.mol-1) e extensivamente desacetilada (DA≈2,8%) em concentrações poliméricas acima 2,0%, exibiram melhores propriedades mecânicas com o aumento da concentração polimérica, devido à formação de numerosos emaranhamentos físicos das cadeias poliméricas em solução. Os resultados mostram que as propriedades físico-químicas e mecânicas dos hidrogéis de quitosana podem ser controladas variando a concentração do polímero e o processo de gelificação. A avaliação biológica de tais hidrogéis para a regeneração de miocárdio infartado de ratos revelou que os hidrogéis de quitosana preparados a partir de soluções de polímero a 1,5% foram perfeitamente incorporados sobre a superfície do epicárdio do coração e apresentaram degradação parcial acompanhada por infiltração de células mononucleares.

Apical hypertrophic cardiomyopathy : a review

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Effet des acides gras polyinsaturés EPA et DHA dans un modèle d’infarctus du myocarde

Plusieurs études montrent que les acides gras (AG) oméga-3 sont bénéfiques pour la santé cardiovasculaire. Une étude antérieure dans notre laboratoire a montré que l’administration des acides gras oméga-3 réduit la taille de l'infarctus du myocarde (IM). Cependant, la question demeure de savoir si les deux principaux acides gras oméga-3 à longue chaîne, l'acide eicosapentaénoïque (EPA) et l'acide docosahexaénoïque (DHA) possèdent la même efficacité à réduire la taille de l'infarctus. Le but de ce projet sera de déterminer l’efficacité relative de chacun de ces acides gras oméga-3 à protéger le cœur dans un modèle d’ischémie/reperfusion et d’étudier certaines voies de cardioprotection. Des rats mâles adultes Sprague-Dawley ont été nourris pendant 14 jours avec une diète comprenant l'un: 1- aucun AG oméga-3; 2- 5 g d'EPA / kg de nourriture; 3- 5 g de DHA / kg de nourriture; 4- 2,5 g de chaque oméga-3 AG / kg de nourriture; 5- 5 g chaque AG oméga-3 / kg de nourriture. Par la suite, les animaux ont été soumis à une ischémie pendant 40 minutes, causée par l'occlusion de l'artère coronaire gauche descendante. Au bout de 24 heures de reperfusion, la taille de l'infarctus est déterminée. Dans un sous-groupe d'animaux, l'activité d’Akt et des caspase-3 sont mesurées dans la région ischémique après 30 minutes de reperfusion. Finalement, à 15 minutes de reperfusion, l'ouverture du pore de transition de perméabilité mitochondriale mPTP est déterminée dans un autre sous-groupe. Les résultats indiquent que les diètes EPA ou DHA réduisent de manière significative la taille de l'infarctus par rapport à la diète sans AG oméga-3, tandis que la combinaison de deux acides gras oméga-3 n'a pas montré de diminution de la taille de l'infarctus. L'activité de la caspase-3 est réduite pour le groupe DHA puis, l'activité d'Akt est augmentée avec les diètes EPA et DHA seules. Finalement, en présence d’une diète enrichie uniquement de DHA, l'ouverture des mPTP est retardée comparativement aux autres diètes.

Prognostic Value of Secretoneurin in Critically Ill Patients With Infections.

OBJECTIVES Secretoneurin is produced in neuroendocrine cells, and the myocardium and circulating secretoneurin levels provide incremental prognostic information to established risk indices in cardiovascular disease. As myocardial dysfunction contributes to poor outcome in critically ill patients, we wanted to assess the prognostic value of secretoneurin in two cohorts of critically ill patients with infections. DESIGN Two prospective, observational studies. SETTING Twenty-four and twenty-five ICUs in Finland. PATIENTS A total of 232 patients with severe sepsis (cohort #1) and 94 patients with infections and respiratory failure (cohort #2). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We measured secretoneurin levels by radioimmunoassay in samples obtained early after ICU admission and compared secretoneurin with other risk indices. In patients with severe sepsis, admission secretoneurin levels (logarithmically transformed) were associated with hospital mortality (odds ratio, 3.17 [95% CI, 1.12-9.00]; p = 0.030) and shock during the hospitalization (odds ratio, 2.17 [1.06-4.46]; p = 0.034) in analyses that adjusted for other risk factors available on ICU admission. Adding secretoneurin levels to age, which was also associated with hospital mortality in the multivariate model, improved the risk prediction as assessed by the category-free net reclassification index: 0.35 (95% CI, 0.06-0.64) (p = 0.02). In contrast, N-terminal pro-B-type natriuretic peptide levels were not associated with mortality in the multivariate model that included secretoneurin measurements, and N-terminal pro-B-type natriuretic peptide did not improve patient classification on top of age. Secretoneurin levels were also associated with hospital mortality after adjusting for other risk factors and improved patient classification in cohort #2. In both cohorts, the optimal cutoff for secretoneurin levels at ICU admission to predict hospital mortality was ≈ 175 pmol/L, and higher levels were associated with mortality also when adjusting for Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores. CONCLUSIONS Secretoneurin levels provide incremental information to established risk indices for the prediction of mortality and shock in critically ill patients with severe infections.

Understanding hypertrophic cardiomyopathy /

Mode of access: Internet.

Effects of A1 adenosine receptor overexpression on normoxic and post-ischemic gene expression

Objectives: To identify potential molecular genetic determinants of cardiovascular ischemic tolerance in wild-type and transgenic hearts overexpressing A(1) adenosine receptors (A(1)ARs). Methods: cDNA microarrays were used to explore expression of 1824 genes ill wild-type hearts and ischemia-tolerant mouse hearts overexpressing A(1)ARs. Results: Overexpression of A(1)ARs reduced post-ischemic contractile dysfunction, limited arrhythmogenesis, and reduced necrosis by similar to80% in hearts subjected to 30 min global ischemia 60 mill reperfusion. Cardioprotection was abrogated by acute A(1)AR antagonism, and only a small number (19) of genes were modified by A(1)AR overexpression in normoxic hearts. Ischemia-reperfusion significantly altered expression of 75 genes in wild-type hearts (14 induced, 61 down-regulated), including genes for metabolic enzymes, structural/motility proteins, cell signaling proteins, defense/growth proteins, and regulators of transcription and translation. A(1)AR overexpression reversed the majority of gene down-regulation whereas gene induction was generally unaltered. Additionally, genes involved in cell defence, signaling and gene expression were selectively modified by ischemia in transgenic hearts (33 induced, 10 down-regulated), possibly contributing to the protected phenotype. Real-time PCR verified changes in nine selected genes, revealing concordance with array data. Transcription of the A(1)AR gene was also modestly reduced post-ischemia, consistent with impaired functional sensitivity to A(1)AR stimulation Conclusions: Data are presented regarding the early post-ischemic gene profile of intact heart. Reduced A(1)AR transcription is observed which may contribute to poor outcome from ischemia. A(1)AR overexpression selectively modifies post-ischemic gene expression, potentially contributing to ischemic-tolerance. (C) 2003 European Society of Cardiology. Published by Elsevier Science B.V. All rights reserved.

Neurally-mediated increase in calcineurin activity regulates cardiac contractile function in absence of hypertrophy

Objective: The calcineurin pathway has been involved in the development of cardiac hypertrophy, yet it remains unknown whether calcineurin activity can be regulated in myocardium independently from hypertrophy and cardiac load. Methods: To test that hypothesis, we measured calcineurin activity in a rat model of infrarenal aortic constriction (IR), which affects neurohormonal pathways without increasing cardiac afterload. Results: In this model, there was no change in arterial pressure over the 4-week experimental period, and the left ventricle/body weight ratio did not increase. At 2 weeks after IR, calcineurin activity was increased 1.8-fold (P

Effects of revascularisation and contractile reserve on left ventricular remodelling in patients with impaired left ventricular function

Objective: We sought to define the influence of revascularisation and contractile reserve on left ventricular (LV) remodelling in patients with LV dysfunction after myocardial infarction. Revascularisation of viable myocardium is associated with improved regional function, but the effect on remodelling is undefined. Methods: We studied 70 patients with coronary artery disease and LV dysfunction, 31 of whom underwent revascularisation. A standard dobutamine stress echocardiogram (DbE) was carried out. All patients underwent standard medical treatment; the decision to revascularise was made clinically, independent of this study. LV volumes and ejection fraction were measured by 3D echocardiography at baseline and after an average of 40 weeks. Results: There was no significant difference in baseline ejection fraction or volumes between patients who underwent revascularisation and the remainder. Compared to medically treated patients, revascularised patients had significant improvements in ejection fraction and end-systolic volume in follow-up. The impact of baseline variables on remodelling was assessed by dividing patients into tertiles of LV ejection fraction and volumes. Revascularised patients in the lowest tertile of ejection fraction at baseline (<38%) had a significant improvement in end-systolic volume and ejection fraction, larger than obtained in medically treated patients with low ejection fraction. Revascularised patients with an ejection fraction >38% did not show significant improvement in volumes compared to baseline. Revascularised patients in the largest tertiles of end-systolic (>88 ml) or end-diastolic volume (>149 ml) at baseline had a significant improvement in end-systolic volume. Conclusion: Remodeling appears to occur independent of the presence of regional contractile reserve but does correlate with the volume response to low-dose dobutamine. (C) 2003 Elsevier Ireland Ltd. All rights reserved.