Leucine Supplementation Improves Diastolic Function in HFpEF by HDAC4 Inhibition.

Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome associated with a high morbidity and mortality rate. Leucine supplementation has been demonstrated to attenuate cardiac dysfunction in animal models of cachexia and heart failure with reduced ejection fraction (HFrEF). So far, no data exist on leucine supplementation on cardiac function in HFpEF. Thus, the current study aimed to investigate the effect of leucine supplementation on myocardial function and key signaling pathways in an established HFpEF rat model. Female ZSF1 rats were randomized into three groups: Control (untreated lean rats), HFpEF (untreated obese rats), and HFpEF_Leu (obese rats receiving standard chow enriched with 3% leucine). Leucine supplementation started at 20 weeks of age after an established HFpEF was confirmed in obese rats. In all animals, cardiac function was assessed by echocardiography at baseline and throughout the experiment. At the age of 32 weeks, hemodynamics were measured invasively, and myocardial tissue was collected for assessment of mitochondrial function and for histological and molecular analyses. Leucine had already improved diastolic function after 4 weeks of treatment. This was accompanied by improved hemodynamics and reduced stiffness, as well as by reduced left ventricular fibrosis and hypertrophy. Cardiac mitochondrial respiratory function was improved by leucine without alteration of the cardiac mitochondrial content. Lastly, leucine supplementation suppressed the expression and nuclear localization of HDAC4 and was associated with Protein kinase A activation. Our data show that leucine supplementation improves diastolic function and decreases remodeling processes in a rat model of HFpEF. Beneficial effects were associated with HDAC4/TGF-ß1/Collagenase downregulation and indicate a potential use in the treatment of HFpEF.

Loss of Sox9 in cardiomyocytes delays the onset of cardiac hypertrophy and fibrosis.

BACKGROUND: The transcription factor Sox9 has been associated with cardiac injury and remodeling. Studies of mammalian hearts confirm Sox9 upregulation in fibroblasts following ischemic insults associated with enhanced fibrosis. The role of cardiomyocyte-specific Sox9 remains unclear. This study aimed to evaluate the role of cardiomyocyte-specific Sox9 in development and progression of left ventricular (LV) hypertrophy and fibrosis. METHODS: In male conditional Sox9 knockout mice (Sox9-KO) or floxed littermates (control group) transverse aortic constriction (TAC) was performed to induce LV hypertrophy. LV function and wall thickness were assessed weekly using echocardiography. LV mRNA- and protein expression levels of hypertrophy-, fibrosis-, and remodeling-associated genes were analyzed for each time point. Histological sections were stained for fibrosis and Sox9 expression. RESULTS: Only one week after TAC, the control group showed significantly enhanced heart weights and thickened LV posterior walls accompanied by elevated Anp- and Lox-mRNA levels. Simultaneously, Col1a1- and Col3a1-levels as well as Sox9 expression were strongly upregulated, Contrary, Sox9-KO mice did not develop cardiac hypertrophy until 4 weeks after TAC. Collagen and Sox9 expression also peaked at that later time point. Ejection fraction declined similarly in both groups after TAC. However, the control group showed a slightly better cardiac performance at 2 weeks after TAC. CONCLUSIONS: Cardiomyocyte-specific Sox9 mediates hypertrophy and early fibrosis, following cardiac pressure-overload. Loss of Sox9 delays cardiac growth and remodeling processes, however, does not preserve the cardiac function. We suggest that cardiomyocyte-driven Sox9 initiates a pro-hypertrophic cascade, possibly involving a cross-talk between myocytes and fibroblasts.

Lung ventilation- and perfusion-weighted Fourier decomposition magnetic resonance imaging: in vivo validation with hyperpolarized 3He and dynamic contrast-enhanced MRI.

The purpose of this work was to validate ventilation-weighted (VW) and perfusion-weighted (QW) Fourier decomposition (FD) magnetic resonance imaging (MRI) with hyperpolarized (3)He MRI and dynamic contrast-enhanced perfusion (DCE) MRI in a controlled animal experiment. Three healthy pigs were studied on 1.5-T MR scanner. For FD MRI, the VW and QW images were obtained by postprocessing of time-resolved lung image sets. DCE acquisitions were performed immediately after contrast agent injection. (3)He MRI data were acquired following the administration of hyperpolarized helium and nitrogen mixture. After baseline MR scans, pulmonary embolism was artificially produced. FD MRI and DCE MRI perfusion measurements were repeated. Subsequently, atelectasis and air trapping were induced, which followed with FD MRI and (3)He MRI ventilation measurements. Distributions of signal intensities in healthy and pathologic lung tissue were compared by statistical analysis. Images acquired using FD, (3)He, and DCE MRI in all animals before the interventional procedure showed homogeneous ventilation and perfusion. Functional defects were detected by all MRI techniques at identical anatomical locations. Signal intensity in VW and QW images was significantly lower in pathological than in healthy lung parenchyma. The study has shown usefulness of FD MRI as an alternative, noninvasive, and easily implementable technique for the assessment of acute changes in lung function.