Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload
Abstract Patients with type 2 diabetes treated with Sodium glucose transporter 2 (SGLT2) inhibitors show reduced mortality and hospitalization for heart failure (HF). SGLT2 inhibitors are considered to activate multiple cardioprotective pathways; however, underlying mechanisms are not fully describe...
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Nature Portfolio
2021
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oai:doaj.org-article:d12309a66d7741a1b29740eef4e5bfd02021-12-02T18:50:03ZEmpagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload10.1038/s41598-021-97787-22045-2322https://doaj.org/article/d12309a66d7741a1b29740eef4e5bfd02021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97787-2https://doaj.org/toc/2045-2322Abstract Patients with type 2 diabetes treated with Sodium glucose transporter 2 (SGLT2) inhibitors show reduced mortality and hospitalization for heart failure (HF). SGLT2 inhibitors are considered to activate multiple cardioprotective pathways; however, underlying mechanisms are not fully described. This study aimed to elucidate the underlying mechanisms of the beneficial effects of SGLT2 inhibitors on the failing heart. We generated a left ventricular (LV) pressure overload model in C57BL/6NCrSlc mice by transverse aortic constriction (TAC) and examined the effects of empagliflozin (EMPA) in this model. We conducted metabolome and transcriptome analyses and histological and physiological examinations. EMPA administration ameliorated pressure overload-induced systolic dysfunction. Metabolomic studies showed that EMPA increased citrulline levels in cardiac tissue and reduced levels of arginine, indicating enhanced metabolism from arginine to citrulline and nitric oxide (NO). Transcriptome suggested possible involvement of the insulin/AKT pathway that could activate NO production through phosphorylation of endothelial NO synthase (eNOS). Histological examination of the mice showed capillary rarefaction and endothelial apoptosis after TAC, both of which were significantly improved by EMPA treatment. This improvement was associated with enhanced expression phospho-eNOS and NO production in cardiac endothelial cells. NOS inhibition attenuated these cardioprotective effects of EMPA. The in vitro studies showed that catecholamine-induced endothelial apoptosis was inhibited by NO, arginine, or AKT activator. EMPA activates the AKT/eNOS/NO pathway, which helps to suppress endothelial apoptosis, maintain capillarization and improve systolic dysfunction during LV pressure overload.Masaaki NakaoIppei ShimizuGoro KatsuumiYohko YoshidaMasayoshi SudaYuka HayashiRyutaro IkegamiYung Ting HsiaoShujiro OkudaTomoyoshi SogaTohru MinaminoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021) |
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Medicine R Science Q Masaaki Nakao Ippei Shimizu Goro Katsuumi Yohko Yoshida Masayoshi Suda Yuka Hayashi Ryutaro Ikegami Yung Ting Hsiao Shujiro Okuda Tomoyoshi Soga Tohru Minamino Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
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Abstract Patients with type 2 diabetes treated with Sodium glucose transporter 2 (SGLT2) inhibitors show reduced mortality and hospitalization for heart failure (HF). SGLT2 inhibitors are considered to activate multiple cardioprotective pathways; however, underlying mechanisms are not fully described. This study aimed to elucidate the underlying mechanisms of the beneficial effects of SGLT2 inhibitors on the failing heart. We generated a left ventricular (LV) pressure overload model in C57BL/6NCrSlc mice by transverse aortic constriction (TAC) and examined the effects of empagliflozin (EMPA) in this model. We conducted metabolome and transcriptome analyses and histological and physiological examinations. EMPA administration ameliorated pressure overload-induced systolic dysfunction. Metabolomic studies showed that EMPA increased citrulline levels in cardiac tissue and reduced levels of arginine, indicating enhanced metabolism from arginine to citrulline and nitric oxide (NO). Transcriptome suggested possible involvement of the insulin/AKT pathway that could activate NO production through phosphorylation of endothelial NO synthase (eNOS). Histological examination of the mice showed capillary rarefaction and endothelial apoptosis after TAC, both of which were significantly improved by EMPA treatment. This improvement was associated with enhanced expression phospho-eNOS and NO production in cardiac endothelial cells. NOS inhibition attenuated these cardioprotective effects of EMPA. The in vitro studies showed that catecholamine-induced endothelial apoptosis was inhibited by NO, arginine, or AKT activator. EMPA activates the AKT/eNOS/NO pathway, which helps to suppress endothelial apoptosis, maintain capillarization and improve systolic dysfunction during LV pressure overload. |
format |
article |
author |
Masaaki Nakao Ippei Shimizu Goro Katsuumi Yohko Yoshida Masayoshi Suda Yuka Hayashi Ryutaro Ikegami Yung Ting Hsiao Shujiro Okuda Tomoyoshi Soga Tohru Minamino |
author_facet |
Masaaki Nakao Ippei Shimizu Goro Katsuumi Yohko Yoshida Masayoshi Suda Yuka Hayashi Ryutaro Ikegami Yung Ting Hsiao Shujiro Okuda Tomoyoshi Soga Tohru Minamino |
author_sort |
Masaaki Nakao |
title |
Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
title_short |
Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
title_full |
Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
title_fullStr |
Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
title_full_unstemmed |
Empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
title_sort |
empagliflozin maintains capillarization and improves cardiac function in a murine model of left ventricular pressure overload |
publisher |
Nature Portfolio |
publishDate |
2021 |
url |
https://doaj.org/article/d12309a66d7741a1b29740eef4e5bfd0 |
work_keys_str_mv |
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