RESUMEN
PURPOSE: This study examines if ischemic postconditioning is preserved in hypertrophied myocardium of spontaneously hypertensive rats (SHR). METHODS: Infarct sizes, hemodynamic, morphometric, and biochemical parameters were obtained from normotensive controls [Wistar-Kyoto (WKY) rats] and compared with SHRs. In open-chest rats, the infarct size was determined after 30 minutes of regional ischemia. Postconditioning was performed by 3 cycles of ischemia/reperfusion with 30 seconds each or 6 cycles of ischemia/reperfusion with 10 seconds each immediately after the infarction. RESULTS: Infarct size was comparable between control rats and SHRs. In WKY rats, postconditioning reduced the infarct size significantly. However, in SHRs, the postconditioning effect was completely lost for both postconditioning protocols. Even shortening of the ischemic period to 20 minutes did not restore the infarct sparing effect in SHRs. The phosphorylation of glycogen synthase kinase 3ß increased 2.1-fold by ischemic postconditioning in WKY rats; however, this increase was completely absent in SHRs with both postconditioning protocols. CONCLUSIONS: Myocardial hypertrophy inhibits the protection by postconditioning in an experimental animal model. Future studies have to clarify whether this result can be extrapolated to patients with arterial hypertension and myocardial hypertrophy.
Asunto(s)
Cardiomegalia/etiología , Hipertensión/complicaciones , Poscondicionamiento Isquémico , Infarto del Miocardio/prevención & control , Miocardio/patología , Daño por Reperfusión/prevención & control , Animales , Cardiomegalia/metabolismo , Cardiomegalia/patología , Cardiomegalia/fisiopatología , Modelos Animales de Enfermedad , Glucógeno Sintasa Quinasa 3/metabolismo , Glucógeno Sintasa Quinasa 3 beta , Hemodinámica , Hipertensión/metabolismo , Hipertensión/patología , Hipertensión/fisiopatología , Masculino , Infarto del Miocardio/metabolismo , Infarto del Miocardio/patología , Infarto del Miocardio/fisiopatología , Miocardio/metabolismo , Fosforilación , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Daño por Reperfusión/fisiopatología , Factores de TiempoRESUMEN
Post-conditioning by repetitive cycles of reperfusion/ischemia after prolonged ischemia protects the heart from infarction. The objectives of this study were: Are kinases (PI3-kinase, mTOR, and GSK-3beta) involved in the signaling pathway of post-conditioning? Does post-conditioning result in a diminished necrosis or apoptosis? In open chest rats the infarct size was determined after 30 min of regional ischemia and 30 min of reperfusion using propidium iodide and microspheres. Post-conditioning was performed by three cycles of 30 s reperfusion and reocclusion each, immediately upon reperfusion. PI3-kinase and mTOR were blocked using wortmannin (0.6 mg/kg) or rapamycin (0.25 mg/kg), respectively. The phosphorylation of GSK-3beta and p70S6K was determined with phospho-specific antibodies. TUNEL staining and detection of apoptosis-inducing factor (AIF) were used for the determination of apoptosis. Control hearts had an infarct size of 49 +/- 3%, while post-conditioning significantly reduced it to 29 +/- 3% (P < 0.01). Wortmannin as well as rapamycin completely blocked the infarct size reduction of post-conditioning (51 +/- 2% and 54 +/- 5%, respectively). Western blot analysis revealed that post-conditioning increased the phosphorylation of GSK-3beta by 2.3 times (P < 0.01), and this increase could be blocked by wortmannin, a PI3-kinase inhibitor. Although rapamycin blocked the infarct size reduction, phosphorylation of p70S6K was not increased in post-conditioned hearts. After 2 h of reperfusion, the post-conditioned hearts had significantly fewer TUNEL-positive nuclei (35 %) compared to control hearts (53%; P < 0.001). AIF was equally reduced in post-conditioned rat hearts (P < 0.05 vs. control). Infarct size reduction by ischemic post-conditioning of the in vivo rat heart is PI3-kinase dependent and involves mTOR. Furthermore, GSK-3beta, which is thought to be a regulator of the mPTP, is part of the signaling pathway of post-conditioning. Finally, apoptosis was inhibited by post-conditioning, which was shown by two independent methods. The role of apoptosis and/or autophagy in post-conditioning has to be further elucidated to find therapeutic targets to protect the heart from the consequences of acute myocardial infarction.