Levosimendan reduces myocardial damage and improves cardiodynamics in streptozotocin induced diabetic cardiomyopathy via SERCA2a/NCX1 pathway

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• 作者：Md. Sayeed Akhtar^a ; Krishna Kolappa Pillai^a ; Md. Quamrul Hassan^a ; Neha Dhyani^b ; Md. Vasim Ismail^c ; Abul Kalam Najmi^a ; ^{aknajmi@jamiahamdard.ac.in" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cardiomyopathy ; Diabetes ; Levosimendan ; Mitochondrial damage ; Myocardial contractility ; Streptozotocin
• 刊名：Life Sciences
• 出版年：2016
• 出版时间：15 May 2016
• 年：2016
• 卷：153
• 期：Complete
• 页码：55-65
• 全文大小：1876 K

文摘

Diabetic cardiomyopathy (DCM) is one of the most common causes of mortality. Its pathophysiology is not fully understood and involve number of factors including, cardiovascular and metabolic disorders. The present study was designed to study the pathogenesis of DCM and to explore the effects of levosimendan along with either ramipril or insulin in the long term management of DCM.

Materials and methods

Streptozotocin (STZ) was used to develop DCM in Wistar rats at the dose of 25 mg/kg body weight for three consecutive days. Rats were randomly divided into 9 groups and treatments were started after 2 weeks of STZ administration.

Key findings

Persistent hyperglycemia was observed in STZ treated rats, leading to significant contractile dysfunction as evidenced by decreased left ventricular pressure (LVP), + LV (dp/dt), − LV (dp/dt) as well as elevated Tau and LVEDP. Marked myocardial damage such as fibrosis, increased wall tension, depletion of contractile proteins were observed as evidenced by increased levels of TGF-β, BNP, cTroponin-I, as well as decreased expression of SERCA2a and NCX1 proteins in diabetic rats. The levosimendan alone and also in combination with either ramipril or insulin significantly normalized the myocardial dysfunctions developed during the course of persistent hyperglycemia.

Significance

The study suggests that levosimendan treatment improves cardiac dysfunction significantly. Its combined use with ramipril proves better than with insulin in correcting myocardial performance as well as reduction in myocardial damage.