Obesity improves myocardial ischaemic tolerance and RISK signalling in insulin-insensitive rats

Dis Model Mech. 2013 Mar;6(2):457-66. doi: 10.1242/dmm.010959. Epub 2012 Nov 16.

Abstract

Obesity with associated metabolic disturbances worsens ischaemic heart disease outcomes, and rodent studies confirm that obesity with insulin-resistance impairs myocardial resistance to ischemia-reperfusion (I-R) injury. However, the effects of obesity per se are unclear, with some evidence for paradoxic cardioprotection (particularly in older subjects). We tested the impact of dietary obesity on I-R tolerance and reperfusion injury salvage kinase (RISK) signalling in hearts from middle-aged (10 months old) insulin-insensitive rats. Hearts from Wistar rats on either a 32-week control (CD) or high carbohydrate obesogenic (OB) diet were assessed for I-R resistance in vivo (45 minutes left anterior descending artery occlusion and 120 minutes reperfusion) and ex vivo (25 minutes ischemia and 60 minutes reperfusion). Expression and δ-opioid receptor (δ-OR) phospho-regulation of pro-survival (Akt/PKB, Erk1/2, eNOS) and pro-injury (GSK3β) enzymes were also examined. OB rats were heavier (764 ± 25 versus 657 ± 22 g for CD; P<0.05), hyperleptinaemic (11.1 ± 0.7 versus 5.0 ± 0.7 for CD; P<0.01) and comparably insulin-insensitive (HOMA-IR of 63.2 ± 3.3 versus 63.2 ± 1.6 for CD). In vivo infarction was more than halved in OB (20 ± 3%) versus CD rats (45 ± 6% P<0.05), as was post-ischaemic lactate dehydrogenase efflux (0.4 ± 0.3 mU/ml versus 5.6 ± 0.5 mU/ml; P<0.02) and ex vivo contractile dysfunction (62 ± 2% versus 44 ± 6% recovery of ventricular force; P<0.05). OB hearts exhibited up to 60% higher Akt expression, with increased phosphorylation of eNOS (+100%), GSK3β (+45%) and Erk1/2 (+15%). Pre-ischaemic δ-OR agonism with BW373U86 improved recoveries in CD hearts in association with phosphorylation of Akt (+40%), eNOS (+75%) and GSK3β (+30%), yet failed to further enhance RISK-NOS activation or I-R outcomes in OB hearts. In summary, dietary obesity in the context of age-related insulin-insensitivity paradoxically improves myocardial I-R tolerance, in association with moderate hyperleptinaemic and enhanced RISK expression and phospho-regulation. However, OB hearts are resistant to further RISK modulation and cardioprotection via acute δ-OR agonism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Benzamides / pharmacology
  • Cardiotonic Agents / pharmacology
  • Cardiotonic Agents / therapeutic use
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / pharmacology
  • Humans
  • In Vitro Techniques
  • Insulin / pharmacology*
  • Myocardial Contraction / drug effects
  • Myocardial Infarction / complications
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / enzymology
  • Myocardial Ischemia / pathology*
  • Myocardial Ischemia / physiopathology
  • Myocardial Reperfusion Injury / complications
  • Myocardial Reperfusion Injury / enzymology
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / physiopathology
  • Nitric Oxide Synthase / metabolism
  • Obesity / complications
  • Obesity / enzymology*
  • Obesity / pathology
  • Obesity / physiopathology
  • Phosphorylation / drug effects
  • Piperazines / pharmacology
  • Protein Kinases / metabolism*
  • Rats
  • Receptors, Opioid, delta / agonists
  • Receptors, Opioid, delta / metabolism
  • Signal Transduction / drug effects*
  • Thinness / complications
  • Thinness / enzymology
  • Thinness / pathology
  • Thinness / physiopathology

Substances

  • Benzamides
  • Cardiotonic Agents
  • Dietary Carbohydrates
  • Insulin
  • Piperazines
  • Receptors, Opioid, delta
  • BW 373U86
  • Nitric Oxide Synthase
  • Protein Kinases