Restoration of Cardiac Function After Myocardial Infarction by Long-Term Activation of the CNS Leptin-Melanocortin System

JACC Basic Transl Sci. 2021 Jan 25;6(1):55-70. doi: 10.1016/j.jacbts.2020.11.007. eCollection 2021 Jan.

Abstract

Heart failure has a high mortality rate, and current therapies offer limited benefits. The authors demonstrate that activation of the central nervous system leptin-melanocortin pathway confers remarkable protection against progressive heart failure following severe myocardial infarction. The beneficial cardiac-protective actions of leptin require activation of brain melanocortin-4 receptors and elicit improvements in cardiac substrate oxidation, cardiomyocyte contractility, Ca2+ coupling, and mitochondrial efficiency. These findings highlight a potentially novel therapeutic approach for myocardial infarction and heart failure.

Keywords: AMPK, adenosine monophosphate–activated protein kinase; BP, blood pressure; CNS, central nervous system; HF, heart failure; HR, heart rate; ICV, intracerebroventricular; LV, left ventricular; MC4R; MC4R, melanocortin-4 receptor; MI, myocardial infarction; MTII, melanotan II; appetite; blood pressure; cardiac metabolism; heart failure; mTOR, mechanistic target of rapamycin.