Uncoupling of mitochondrial oxidative phosphorylation alters lipid peroxidation-derived free radical production but not recovery of postischemic rat hearts and post-hypoxic endothelial cells

The contribution of mitochondrial free radical production towards the initiation of lipid peroxidation (LPO) and functional injury in the post-ischemic heart is unclear. Using the isolated rat heart model, the effects of the uncoupler of mitochondrial oxidative phosphorylation dinitrophenol (DNP, 50 M final) on post-ischemic lipid peroxidation-derived free radical production and functional recovery were assessed. Hearts were subjected to 30 min total global ischemia followed by 15 min of reperfusion in the presence of DNP. As expected, DNP enhanced oxygen consumption before (11.3 ± 0.9 mol/min, p < 0.001) and during reperfusion (at 10 min: 7.9 ± 0.7 umol/min), compared to the heart with control treatment (8.2 ± 0.5 and 6.7 ± 0.3, respectively). This effect was only associated with a higher incidence of ventricular tachycardia during reperfusion (80 vs. 50% for control treatment, p < 0.05). Electron spin resonance spectroscopy (ESR) and spin trapping with u.-phenyl-tert-butylnitrone (PBN, 3 mM final) were used to monitor free radical generation during reperfusion. The vascular concentration of PBN-radical adducts (untreated: 6.4 ±1.0 nM, at 10 min) decreased in the presence of DNP (1.7 ± 0.4 nM, p < 0.01). The radical concentration inversely correlated with myocardial oxygen consumption. Total liberation of free radical adducts during the initial 10 min of reperfusion was reduced by DNP (0.59 ± 0.09 nmol, p < 0.01) compared to the respective control treatment (1.26 ± 0.16 nmol). Similar effects, prevention of PBN adduct formation and unchanged viability in the presence of DNP, were obtained with endothelial cells during post-hypoxic reoxygenation. Since inhibition of mitochondrial phosphorylation can inhibit the formation of LPO-derived free radicals after an ischemic/hypoxic interval, mitochondria may represent an important source of free radicals capable of initiating lipid peroxidative injury during reperfusion/reoxygenation. (Mol Cell Biochem 160/161: 167–177, 1996)     

Regulation of the slow Ca++ channels of myocardial cells

Contraction of the heart is regulated by a number of mechanisms, such as neurotransmitters, hormones, autacoids, pH, intracellular ATP, and Ca⁺⁺ ions. These actions are mediated, at least in part, by actions on the sarcolemmal slow (L-type) Ca⁺⁺ channels, exerted directly or indirectly. The major mechanisms for the regulation of the slow Ca⁺⁺ channels of myocardial cells includes the following. cAMP/PK-A phosphorylation stimulates the slow Ca` channel activity, whereas cGMP/PK-G phosphorylation inhibits. DAG/PK-C phosphorylation and tyrosine kinase phosphorylation are suggested to stimulate the slow Ca⁺⁺ channel activity. Intracellular application of G_s protein increases the slow Ca⁺⁺ currents (ICa(L)). Lowering of intracellular ATP inhibits I_Ca(L). Acidosis and increase in [Ca]_i inhibits I_Ca(L). A number of changes in the Ca⁺⁺ channels also occur during development and aging. Thus, it appears that the slow Ca⁺⁺ channel is a complex structure, including perhaps several associated regulatory proteins, which can be regulated by a number of extrinsic and intrinsic factors, and thereby control can be exercised over the force of contraction of the heart.     

Biphasic changes in relaxation following reperfusion after myocardial ischemia

The present study provides evidences of left ventricular diastolic alterations following reperfusion in a model of global ischemia. Isolated perfused rabbit and rat hearts, were subjected to ischemia for 15 and 20 min respectively, followed by 30 min of reperfusion. In rabbit heart at the end of the reperfusion period, isovolumic left ventricular developed pressure (LVDP) and +dP/dt_max stabilized at 55 ± 3% and 60 ± 2% of preischemic values respectively and, in rat heart LVDP = 61 ± 8% and +dP/dt_max = 57 ± 9% of preischemic values. Stunned heart was then obtained from both species. Left ventricular end diastolic pressure (LVEDP) values stabilized at the end of reperfusion period at values higher than preischemic conditions in both species (38.9 ± 4.4 mmHg and 30.3 ± 3.1 mmHg in rabbit and rat respectively). The time constant of relaxation (T) increased early in reperfusion in both species, but then decreased and stabilized at the end of reperfusion period at values lower than preischemic values. The ratio between both maximal velocities (+P/-P), also showed a transitory impairment in relaxation, followed by normalization and stabilization at values lower than preischemic values. This biphasic pattern in relaxation was detected in both species. The changes in relaxation were dissociated from the diastolic compliance and could be the result of a transitory calcium overload and/or sarcoplasmic reticulum dysfunction. The faster myocardial relaxation at the end of reperfusion period is consistent with the decreased myofilament sensitivity, which characterizes the stunned myocardium.     

Partial contribution of the ATP-sensitive K+ current to the effects of mild metabolic depression in rabbit myocardium

The object of the study was to compare the capability of glibenclamide to block the effects of K⁺-ATP channel activators on action potential duration and steady state whole cell current to its efficiency in counteracting the effects of hypoxia or metabolic poisons in the presence of glycolytic substrate. The modulation of action potential duration by 30 M glibenclamide was tested in perfused hearts subjected to hypoxia or to the K⁺-ATP channel opener pinacidil. Similar protocols were used to study the modifications of the steady state whole cell current in isolated ventricular myocytes. It was found that glibenclamide did not prevent early action potential shortening induced by hypoxia but produced a partial recovery after 15 min of exposure. At the steady state the action potential duration had lengthened by 53±6% at plateau level and 42±3% at 95% repolarization. In contrast, action potential shortening induced by 100 M pinacidil was fully reversed by glibenclamide within 2 min. Freshly dispersed ventricular myocytes were characterized in control conditions as for the properties of the steady state current. This current, measured at the end of 450 ms long pulses showed typical inward rectification that was abolished by 50 M Ba²⁺. Cyanide (2 mM), carbonyl-cyanide m-chlorophenylhydrazone (CCCP, 200 nM) and BRL 38227 (30 M) produced characteristic increases in time independent outward currents. Glibenclamide abolished the outward current induced by BRL 38227 and the concomitant action potential shortening. Addition of cyanide in the presence of glibenclamide and BRL 38227 produced a new increase in outward current accompanied by action potential shortening. In the absence of K⁺-ATP channel activators, glibenclamide partly inhibited the CCCP induced current. Our data suggested that the delayed onset of glibenclamide action in hypoxic hearts is not due to diffusion barriers. They rather support the view that mechanisms other than K⁺-ATP channel activation could determine the early action potential shortening in whole hearts. The partial recovery observed under glibenclamide may be due, in part, to channel desensitization but also reflect the contribution of more than one current system to the action potential shortening because the glibenclamide insensitive fraction of the CCCP induced current is partly blocked by low concentrations of Ba²⁺. Differences with other data in the literature are attributed to the degree to metabolic blockade, to species differences, and to the inherent heterogeneities of the whole heart model where non-muscle cells may modulate the response to hypoxia.     

Erythropoietin protects post-ischemic hearts by preventing extracellular matrix degradation: role of Jak2-ERK pathway

Factors predisposing to extracellular matrix degradation associated with myocardial ischemia/reperfusion (IR) usually cause cell death. Recombinant human erythropoietin (EPO) protects the myocardium from IR, but whether it affects extracellular matrix (ECM) degradation is not known. This study examined the effect of the Jak2-ERK pathway, which is triggered by EPO, on the expression of matrix metalloproteinases (MMPs), tissue inhibitor of MMP 4 (TIMP-4), and collagen in post-ischemic hearts. Rat hearts were isolated and perfused in a Langendorff apparatus. IR was induced by 40 min of stopped flow and 120 min of aerobic reperfusion; EPO was added immediately before reperfusion. Compared to untreated controls, poor recovery of the left ventricular developed pressure (LVDP) was seen in IR hearts. IR resulted in myocyte injury measured by creatine kinase MB release and infarction. Western blot analysis showed increased levels of MMP-2 and MMP-9 and reduced levels of TIMP-4 and collagen III. IR rats given 5 IU/ml of EPO showed improved LVDP with reduced injury. EPO increased Jak2 and ERK activity, decreased MMP expression, increased TIMP-4 expression, and prevented collagen degradation in IR hearts. All these effects were blocked by the upstream ERK inhibitor, U0126 (5 microM). These observations show that EPO attenuates extracellular matrix degradation following IR and this may be the basis of the protection from cell death. Jak2-ERK phosphorylation may be an important signal in this process.     

Re-modelling 'hostile' milieu of diseased myocardium via paracrine function of transplanted cells or relaxin

While the approaches of regenerating cardiac muscle remain undetermined, recent evidence indicates that paracrine function of transplanted cells contributes significantly to the beneficial effects of cell therapy. Combination of such paracrine function of grafted cells with extracellular matrix remodelling by relaxin represents a promising complement to cell-based therapy for cardiac repair and muscle regeneration.     

Diverse effects of L-arginine on cardiac function of rats subjected to myocardial ischemia and reperfusion in vivo

In vivo administration of L-arginine at different time points during the course of myocardialischemia and reperfusion(MI/R)has been shown to differentially regulate postischemic apoptosis.Cardiacfunction is one of the most important indexes used to judge the degree of myocardial injury.The presentstudy attempted to determine whether in vivo administration of L-arginine at different stages of MI/R has adiverse influence on cardiac function of ischemic reperfused hearts and,if so,to investigate the mechanismsinvolved.Male adult rats were subjected to 30 min myocardial ischemia followed by 5 h reperfusion.Anintravenous L-arginine bolus was given either 10 min before and 50 min after reperfusion(early treatment)or3 h and 4 h after reperfusion(late treatment).Early treatment with L-arginine markedly increased the leftventricular systolic pressure(LVSP)and dP/dt_(max),and decreased myocardial nitrotyrosine content.In strictcontrast,late treatment with L-arginine resulted in a significant decrease in LVSP and dP/dt_(max)from 4 h to 5h after reperfusion,and increase in toxic peroxynitrite formation as measured by nitrotyrosine.These resultssuggest that the administration of L-arginine at different time points during the course of MI/R leads todiverse effects on cardiac dysfunction.Early supplementation decreased the nitrative stress and improvedleft ventricular function.However,late treatment with L-arginine increased the formation of peroxynitriteand aggravated cardiac functional injury.     

远端保护装置在急性心肌梗死急诊PCI中的应用研究

目的:评价在急性心肌梗死(AMI)的经皮冠脉介入治疗(PCI)过程中,应用远端保护装置Guard Wire Plus TM的安全性及有效性。方法:自2004年9月至2006年5月共72例急性心肌梗死接受急诊PCI治疗的患者随机分为远端保护组(GW组)和非远端保护组(NGW组),其中GW组38例,NGW组34例。比较两组间的基础临床状况、造影情况、ST段回落情况、术后TIMI分级、TIMI记帧、和心肌blush分级以及术后一周内及3个月后左室射血分数(LVEF)。结果:两组全部病例均成功地置入支架,GW组全部成功放置GuardWire PlusTM保护装置,GW组ST段回落□50%的百分比明显高于NGW组(68．4%vs41．2%,p＜0．05)。术后TIMI分级两组没有明显差别,TIMI记帧(p=0．043)和心肌blush分级有明显差别(p=0．000)。GW组的左室射血分数(LVEF)明显高于NGW组。结论:急性心肌梗死急诊PCI中联合应用远端保护装置可以有效的预防远端血栓栓塞,缩小梗死面积,改善LVEF。     

冠心病患者肾上腺髓质素前体N端20肽变化的临床研究

目的:观察不同类型冠心病与肾上腺髓质素前体N端20肽(Proadrenomedullin N Terminal 20 Peptide,PAMP)的关系。方法:选择稳定型心绞痛组(SA)14例,不稳定型心绞痛组(UA)22例,急性心肌梗死组(AMI)12例,正常对照组20例,用放免方法分别测定其外周血中PAMP含量。结果:稳定型心绞痛、不稳定型心绞痛、急性心肌梗死血浆PAMP含量分别为20．34±3．41ng/L、27．46±2．54ng/L、32．12±3．63 ng/L。不稳定型心绞痛及急性心肌梗死患者血浆中PAMP含量与正常对照组相比差别有明显统计学意义(P＜0．01);单支病变组、双支病变组、三支病变组血浆PAMP含量分别为30．54±1．98ng/L、30．54±1．98ng/L、21．80±3．54 ng/L,前两者PAMP水平较正常对照组差别有显著统计学意义(P＜0．01),PAMP水平与病变支数无明显相关性。结论:不稳定型心绞痛和急性心梗患者PAMP浓度明显升高,有助于冠心病的危险分层,对评估冠状动脉严重程度及预后可能有意义。