Rats were injected every alternate day (6 times) with (1) saline, (2) 2.5 mg/kg i.p. DOX, (3) 33 μg/kg i.v. Cl-IB-MECA, (4) DOX + Cl-IB-MECA. Left ventricular functions were assessed by invasive (pressure) and non-invasive (echocardiography) techniques at the end of the injection period and 4 weeks later. Cytosolic and intramitochondrial calcium levels were measured with indo-1 and rhod-2 probes. SR Ca2+ content was determined by exposing cultured rat cardiomyocytes to caffeine.
Echocardiography data demonstrate left ventricular wall thinning (23 % ), an increase in the end systolic dimension (170 % ) and decreased fractional shortening (35 ± 5 % vs. 54 ± 5 % , p < 0.01) in DOX-treated animals, compared to the control group. DOX increased Ca2+ levels in the cytosol and in mitochondria by diminishing the SR Ca2+ uptake. Pretreatment with Cl-IB-MECA attenuated left ventricular dysfunction, improved SR calcium storage capacity and prevented mitochondrial Ca2+ overload.
We conclude that the adenosine A3 receptor agonist is effective in vivo against DOX cardiotoxicity via the restoration of Ca2+ homeostasis and prevention of mitochondrial damage that occurs as a result of Ca2+ overload.