Chronic urotensin-II infusion induces diastolic dysfunction and enhances collagen production in rats.

The vasoactive peptide urotensin-II (U-II) is likely to play a key causal role in cardiac remodeling that ultimately leads to heart failure. Its contribution, specifically to the development of diastolic dysfunction and the downstream intracellular signaling, however, remains unresolved. This study interrogates the effect of chronic U-II infusion in normal rats on cardiac structure and function. The contribution of Rho kinase (ROCK) signaling to these pathophysiological changes is evaluated in cell culture studies. Chronic high-dose U-II infusion over 4 wk significantly impaired diastolic function in rats on echocardiography-derived Doppler indexes, including E-wave deceleration time (vehicle 56.7 +/- 3.3 ms, U-II 118.0 +/- 21.5 ms; P < 0.01) and mitral valve annulus peak early/late diastolic tissue velocity (vehicle 2.01 +/- 0.19 ms, U-II 1.04 +/- 0.25 ms; P < 0.01). A lower dose of U-II infusion (1 nmol.kg(-1).h(-1)) yielded comparable changes. Diastolic dysfunction was accompanied by molecular [significant increases in procollagen-alpha(1)(I) gene expression on real-time PCR] and morphological (increases in total collagen, P < 0.05, and collagen type-I protein deposition, P < 0.001) evidence of left ventricular (LV) fibrosis following high-dose U-II infusion. The ROCK inhibitor GSK-576371 (10(-7) to 10(-5) M) elicited concentration-dependent inhibition of U-II (10(-7) M)-stimulated cardiac fibroblast collagen synthesis and cardiac myocyte protein synthesis. Chronic U-II infusion causes diastolic dysfunction, caused by fibrosis of the LV. The in vitro data suggest that this may be in part occurring via a ROCK-dependent pathway.

Therapeutic potential of blockade of the urotensin II system in systemic hypertension.

Urotensin II, an 11-amino acid peptide, has been found to be the most potent vasoconstrictor yet described, in certain vascular beds. Discovery of its endogenous receptor (UII-R) has ignited considerable interest in this system's role in disease states associated with increased vascular tone (eg, systemic hypertension). Urotensin II was shown to have direct effects on the heart in addition to effects on vascular tone. In human systemic hypertension, increased plasma levels of urotensin II were noted, with a weak but significant correlation to absolute blood pressure levels. Furthermore, hypertensive patients demonstrate net vasoconstrictor responsiveness in skin microcirculation compared to normal controls. Highly selective UII-R antagonists have been developed based on the known structure of UII-R. Early preclinical and clinical studies report potential beneficial effects in renal disease, heart failure, and diabetes, although effects on blood pressure have been equivocal.