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Huang Y, Lu H, Ren X, Li F, Bu W, Liu W, Dailey WP, Saeki H, Gabrielson K, Abraham R, Eckenhoff R, Gao WD. Fropofol prevents disease progression in mice with hypertrophic cardiomyopathy. Cardiovasc Res 2021; 116:1175-1185. [PMID: 31424496 DOI: 10.1093/cvr/cvz218] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/12/2019] [Accepted: 08/15/2019] [Indexed: 01/12/2023] Open
Abstract
AIMS Increased myofilament contractility is recognized as a crucial factor in the pathogenesis of hypertrophic cardiomyopathy (HCM). Direct myofilament desensitization might be beneficial in preventing HCM disease progression. Here, we tested whether the small molecule fropofol prevents HCM phenotype expression and disease progression by directly depressing myofilament force development. METHODS AND RESULTS Force, intracellular Ca2+, and steady-state activation were determined in isolated trabecular muscles from wild-type (WT) and transgenic HCM mice with heterozygous human α-myosin heavy chain R403Q mutation (αMHC 403/+). αMHC 403/+ HCM mice were treated continuously with fropofol by intraperitoneal infusion for 12 weeks. Heart tissue was analysed with histology and real-time PCR of prohypertrophic and profibrotic genes. Fropofol decreased force in a concentration-dependent manner without significantly altering [Ca2+]i in isolated muscles from both WT and αMHC 403/+ HCM mouse hearts. Fropofol also depressed maximal Ca2+-activated force and increased the [Ca2+]i required for 50% activation during steady-state activation. In whole-animal studies, chronic intra-abdominal administration of fropofol prevented hypertrophy development and diastolic dysfunction. Chronic fropofol treatment also led to attenuation of prohypertrophic and profibrotic gene expression, reductions in cell size, and decreases in tissue fibrosis. CONCLUSIONS Direct inhibition of myofilament contraction by fropofol prevents HCM disease phenotypic expression and progression, suggesting that increased myofilament contractile force is the primary trigger for hypertrophy development and HCM disease progression.
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Affiliation(s)
- Yiyuan Huang
- Department of Cardiology, 2nd Xiangya Hospital Central South University, 139 Renmin Middle Road, Changsha, Hunan 410011, China
| | - Haisong Lu
- Department of Anesthesiology, Peking Union Hospital, Peking Union Medical College and Chinese Academy of Medical Science, 1 Shuaifuyuan, Wangfujin, Dongcheng District, Beijing 100730, China
| | - Xianfeng Ren
- Department of Anesthesiology, China-Japan Friendship Hospital, 2 Yinghuanyuan East Street, Chaoying District, Beijing 100029, China
| | - Fazhao Li
- Department of General Surgery, 2nd Xiangya Hospital, 139 Renmin Middle Road, Central South University, Changsha, Hunan 410011, China
| | - Weiming Bu
- Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Wenjie Liu
- Department of Anesthesiology, South China University School of Medicine, 69 Chuanshan Road, Shigu District, Hengyang, Hunan 421001, China
| | - William P Dailey
- Department of Chemistry, University of Pennsylvania School of Arts and Sciences, 231 S. 34 Street, Philadelphia, PA 19104, USA
| | - Harumi Saeki
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, 733 N. Broadway, MRB 807, Baltimore, MD 21205, USA
| | - Kathleen Gabrielson
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, 733 N. Broadway, MRB 807, Baltimore, MD 21205, USA
| | - Roselle Abraham
- Division of Cardiology, Department of Medicine, University of California San Francisco, 555 Mission Bay Blvd South, Smith Cardiovascular Research Building, 452K, San Francisco, CA 94158, USA
| | - Roderic Eckenhoff
- Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Wei Dong Gao
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed Tower 6208, Baltimore, MD 21287, USA
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Packer M. Uric Acid Is a Biomarker of Oxidative Stress in the Failing Heart: Lessons Learned from Trials With Allopurinol and SGLT2 Inhibitors. J Card Fail 2020; 26:977-984. [PMID: 32890737 DOI: 10.1016/j.cardfail.2020.08.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022]
Abstract
Hyperuricemia increases the risk of heart failure, and higher levels of serum uric acid are seen in patients who have worse ventricular function, functional capacity, and prognosis. Heart failure is also accompanied by an upregulation of xanthine oxidase, the enzyme that catalyzes the formation of uric acid and a purported source of reactive oxygen species. However, the available evidence does not support the premise that either uric acid or the activation of xanthine oxidase has direct injurious effects on the heart in the clinical setting. Xanthine oxidase inhibitors (allopurinol and oxypurinol) have had little benefit and may exert detrimental effects in patients with chronic heart failure in randomized controlled trials, and the more selective and potent inhibitor febuxostat increases the risk of cardiovascular death more than allopurinol. Instead, the available evidence indicates that changes in xanthine oxidase and uric acid are biomarkers of oxidative stress (particularly in heart failure) and that xanthine oxidase may provide an important source of nitric oxide that quenches the injurious effects of reactive oxygen species. A primary determinant of the cellular redox state is nicotinamide adenine dinucleotide, whose levels drive an inverse relationship between xanthine oxidase and sirtuin-1, a nutrient deprivation sensor that exerts important antioxidant and cardioprotective effects. Interestingly, sodium-glucose cotransporter 2 inhibitors induce a state of nutrient deprivation that includes activation of sirtuin-1, suppression of xanthine oxidase, and lowering of serum uric acid. The intermediary role of sirtuin-1 in both uric acid-lowering and cardioprotection may explain why, in mediation analyses of large-scale cardiovascular trials, the effect of sodium-glucose cotransporter 2 inhibitors to decrease serum uric acid is a major predictor of the ability of these drugs to decrease serious heart failure events.
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Affiliation(s)
- Milton Packer
- Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas and Imperial College, London, UK.
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Meng T, Ren X, Chen X, Yu J, Agrimi J, Paolocci N, Gao WD. Anesthetic Agents Isoflurane and Propofol Decrease Maximal Ca 2+-Activated Force and Thus Contractility in the Failing Myocardium. J Pharmacol Exp Ther 2019; 371:615-623. [PMID: 31515443 DOI: 10.1124/jpet.119.259556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/11/2019] [Indexed: 01/16/2023] Open
Abstract
In the normal heart, frequently used anesthetics such as isoflurane and propofol can reduce inotropy. However, the impact of these agents on the failing myocardium is unclear. Here, we examined whether and how isoflurane and propofol influence cardiac contractility in intact cardiac muscles from rats treated with monocrotaline to induce heart failure. We measured force and intracellular Ca2+ ([Ca2 +]i) in trabeculae from the right ventricles of the rats in the absence or presence of propofol or isoflurane. At low to moderate concentrations, both propofol and isoflurane dose-dependently depressed cardiac force generation in failing trabeculae without altering [Ca2+]i At high doses, propofol (but not isoflurane) also decreased amplitude of [Ca2+]i transients. During steady-state activation, both propofol and isoflurane impaired maximal Ca2+-activated force (Fmax) while increasing the amount of [Ca2+]i required for 50% of maximal activation (Ca50). These events occurred without apparent change in the Hill coefficient, suggesting no impairment of cooperativity. Exposing these same muscles to the anesthetics after fiber skinning resulted in a similar decrement in Fmax and rise in Ca50 but no change in the myofibrillar ATPase-Ca2+ relationship. Thus, our study demonstrates that challenging the failing myocardium with commonly used anesthetic agents such as propofol and isoflurane leads to reduced force development as a result of lowered myofilament responsiveness to Ca2+ SIGNIFICANCE STATEMENT: Commonly used anesthetics such as isoflurane and propofol can impair myocardial contractility in subjects with heart failure by lowering myofilament responsiveness to Ca2+. High doses of propofol can also reduce the overall amplitude of the intracellular Ca2+ transient. These findings may have important implications for the safety and quality of intra- and perioperative care of patients with heart failure and other cardiac disorders.
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Affiliation(s)
- Tao Meng
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Xianfeng Ren
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Xinzhong Chen
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Jingui Yu
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Jacopo Agrimi
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Nazareno Paolocci
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
| | - Wei Dong Gao
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China (T.M., J.Y.); Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China (X.R.); Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China (X.C.); Division of Cardiology (J.A., N.P.) and Department of Anesthesiology and Critical Care Medicine (W.D.G.), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Department of Biomedical Sciences, University of Padova, Padova, Italy (N.P.)
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Maurício AF, de Carvalho SC, Santo Neto H, Marques MJ. Effects of dietary omega-3 on dystrophic cardiac and diaphragm muscles as evaluated by 1 H magnetic resonance spectroscopy: Metabolic profile and calcium-related proteins. Clin Nutr ESPEN 2017; 20:60-67. [DOI: 10.1016/j.clnesp.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/08/2017] [Indexed: 12/22/2022]
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Li Z, Singh S, Suryavanshi SV, Ding W, Shen X, Wijaya CS, Gao WD, McConnell BK. Force development and intracellular Ca 2+ in intact cardiac muscles from gravin mutant mice. Eur J Pharmacol 2017; 807:117-126. [PMID: 28428008 DOI: 10.1016/j.ejphar.2017.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 04/13/2017] [Accepted: 04/13/2017] [Indexed: 02/08/2023]
Abstract
Gravin (AKAP12) is an A-kinase-anchoring-protein that scaffolds protein kinase A (PKA), β2-adrenergic receptor (β2-AR), protein phosphatase 2B and protein kinase C. Gravin facilitates β2-AR-dependent signal transduction through PKA to modulate cardiac excitation-contraction coupling and its removal positively affects cardiac contraction. Trabeculae from the right ventricles of gravin mutant (gravin-t/t) mice were employed for force determination. Simultaneously, corresponding intracellular Ca2+ transient ([Ca2+]i) were measured. Twitch force (Tf)-interval relationship, [Ca2+]i-interval relationship, and the rate of decay of post-extrasysolic potentiation (Rf) were also obtained. Western blot analysis were performed to correlate sarcomeric protein expression with alterations in calcium cycling between the WT and gravin-t/t hearts. Gravin-t/t muscles had similar developed force compared to WT muscles despite having lower [Ca2+]i at any given external Ca2+ concentration ([Ca2+]o). The time to peak force and peak [Ca2+]i were slower and the time to 75% relaxation was significantly prolonged in gravin-t/t muscles. Both Tf-interval and [Ca2+]i-interval relations were depressed in gravin-t/t muscles. Rf, however, did not change. Furthermore, Western blot analysis revealed decreased ryanodine receptor (RyR2) phosphorylation in gravin-t/t hearts. Gravin-t/t cardiac muscle exhibits increased force development in responsiveness to Ca2+. The Ca2+ cycling across the SR appears to be unaltered in gravin-t/t muscle. Our study suggests that gravin is an important component of cardiac contraction regulation via increasing myofilament sensitivity to calcium. Further elucidation of the mechanism can provide insights to role of gravin if any in the pathophysiology of impaired contractility.
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Affiliation(s)
- Zhitao Li
- Department of Pathophysiology, Harbin Medical University, Heilongjiang, China
| | - Sonal Singh
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Santosh V Suryavanshi
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Texas Medical Center, Houston, TX, USA
| | - Wengang Ding
- Department of Anesthesiology of 2nd Affiliated Hospital, Harbin Medical University, Heilongjiang, China
| | - Xiaoxu Shen
- Cardiology Department, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Cori S Wijaya
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Texas Medical Center, Houston, TX, USA
| | - Wei Dong Gao
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zaye Tower 6208, Baltimore, MD 21287, USA.
| | - Bradley K McConnell
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Texas Medical Center, Houston, TX, USA.
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Gladden JD, Zelickson BR, Guichard JL, Ahmed MI, Yancey DM, Ballinger S, Shanmugam M, Babu GJ, Johnson MS, Darley-Usmar V, Dell'Italia LJ. Xanthine oxidase inhibition preserves left ventricular systolic but not diastolic function in cardiac volume overload. Am J Physiol Heart Circ Physiol 2013; 305:H1440-50. [PMID: 24014679 DOI: 10.1152/ajpheart.00007.2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Xanthine oxidase (XO) is increased in human and rat left ventricular (LV) myocytes with volume overload (VO) of mitral regurgitation and aortocaval fistula (ACF). In the setting of increased ATP demand, XO-mediated ROS can decrease mitochondrial respiration and contractile function. Thus, we tested the hypothesis that XO inhibition improves cardiomyocyte bioenergetics and LV function in chronic ACF in the rat. Sprague-Dawley rats were randomized to either sham or ACF ± allopurinol (100 mg·kg(-1)·day(-1), n ≥7 rats/group). Echocardiography at 8 wk demonstrated a similar 37% increase in LV end-diastolic dimension (P < 0.001), a twofold increase in LV end-diastolic pressure/wall stress (P < 0.05), and a twofold increase in lung weight (P < 0.05) in treated and untreated ACF groups versus the sham group. LV ejection fraction, velocity of circumferential shortening, maximal systolic elastance, and contractile efficiency were significantly depressed in ACF and significantly improved in ACF + allopurinol rats, all of which occurred in the absence of changes in the maximum O2 consumption rate measured in isolated cardiomyocytes using the extracellular flux analyzer. However, the improvement in contractile function is not paralleled by any attenuation in LV dilatation, LV end-diastolic pressure/wall stress, and lung weight. In conclusion, allopurinol improves LV contractile function and efficiency possibly by diminishing the known XO-mediated ROS effects on myofilament Ca(2+) sensitivity. However, LV remodeling and diastolic properties are not improved, which may explain the failure of XO inhibition to improve symptoms and hospitalizations in patients with severe heart failure.
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Affiliation(s)
- James D Gladden
- University of Alabama at Birmingham (UABComprehensive Cardiovascular Center, UAB Birmingham, Alabama
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Redox activation of Nrf2 & NF-κB: a double end sword? Cell Signal 2013; 25:2548-57. [PMID: 23993959 DOI: 10.1016/j.cellsig.2013.08.007] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 08/23/2013] [Indexed: 12/20/2022]
Abstract
Moderate concentrations of reactive oxygen species (ROS) are produced by diverse sources under physiological conditions. At such low levels, these molecules may act as upstream mediators of relevant signaling pathways; however an increase in their concentration with respect to the antioxidant system activity, changes their redox signaling function into a deleterious role. Thus, cell health depends, at least in part, on redox balance. This review includes global aspects of oxygen chemistry, ROS generation, antioxidant system, and redox signaling. It is also focused on the description of two relevant redox-sensitive transcription factors: nuclear factor erythroid 2-related factor 2 (Nrf2), which may be a potential target to confer cell protection, and nuclear factor κB (NF-κB), which is involved in deleterious effects in the cell. Finally, recent findings on the interplay between both factors for the development of different pathologies are discussed.
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Springer J, Tschirner A, Hartman K, von Haehling S, Anker SD, Doehner W. The xanthine oxidase inhibitor oxypurinol reduces cancer cachexia-induced cardiomyopathy. Int J Cardiol 2013; 168:3527-31. [PMID: 23751350 DOI: 10.1016/j.ijcard.2013.05.063] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 01/30/2013] [Accepted: 05/03/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cachexia is a common complication of cancer and may be responsible for 22% of all cancer-related deaths. The exact cause of death in cancer cachexia patients is unknown. Recently, atrophy of the heart has been described in cancer cachexia animal models, which resulted in impaired cardiac function and is likely to contribute to mortality. In cancer patients hyperuricaemia independent of tumour lysis syndrome is often associated with a worse prognosis. Xanthine oxidase (XO) metabolizes purines to uric acid and its inhibition has been shown to improve clinical outcome in patients with chronic heart failure. METHODS The rat Yoshida AH-130 hepatoma cancer cachexia model was used in this study. Rats were treated with 4 or 40 mg/kg/d oxypurinol or placebo starting one day after tumour-inoculation for maximal 15 days. Cardiac function was analyzed by echocardiography on day 11. RESULTS Here we show that inhibition of XO by oxypurinol significantly reduces wasting of the heart and preserves cardiac function. LVEF was higher in tumour-bearing rats treated with 4 mg/kg/d (61±4%) or 40 mg/kg/d (64±5%) oxypurinol vs placebo (51±3%, both p<0.05). Fractional shortening was improved by 4 mg/kg/d (43±3%) oxypurinol vs placebo (30±2, p<0.05), while 40 mg/kg/d oxypurinol (41±5%) did not reach statistical significance. Cardiac output was increased in the 4 mg/kg/d dose only (71±11 mL/min vs placebo 38±4 mL/min, p<0.01). CONCLUSION Inhibition of XO with oxypurinol has beneficial effects on cardiac mass and function in a rat model of severe cancer cachexia, suggesting that XO might be a viable drug target in cancer cachexia.
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Affiliation(s)
- Jochen Springer
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany; Center for Cardiovascular Research, Charite Medical School, Berlin, Germany; Norwich Medical School, University of East Anglia, Norwich, UK.
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Affiliation(s)
- Gerd Heusch
- Institut für Pathophysiologie, Universitätsklinikum Essen
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