Effects of Adiponectin on Calcium Handling Proteins in Heart Failure with Preserved Ejection Fraction
Background—Despite the increasing prevalence of heart failure (HF) with preserved ejection fraction (HFpEF) in humans, there remains no therapeutic options for HFpEF. Adiponectin (APN), an adipocyte-derived cytokine exerts cardioprotective actions and its deficiency is implicated in the development of hypertension and HF with reduced ejection fraction. Similarly APN deficiency in HFpEF exacerbates left ventricular hypertrophy (LVH), diastolic dysfunction and HF. However, the therapeutic effects of APN in HFpEF remain unknown. We sought to test the hypothesis that chronic APN overexpression protects against the progression of HF in a murine model of HFpEF.
Methods and Results—APN transgenic (APNTG) and wild-type (WT) mice underwent uninephrectomy, a continuous saline or d-aldosterone infusion and given 1.0% sodium chloride drinking water for 4-weeks. Aldosterone-infused WT mice developed HFpEF with hypertension, LVH and diastolic dysfunction. Aldosterone infusion increased myocardial oxidative stress and decreased sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) protein expression in HFpEF. Although total phospholamban (PLN) protein expression was unchanged, there was decreased expression of PKA-dependent PLN phosphorylation at Ser16 and CaMKII-dependent PLN phosphorylation at Thr17. APN overexpression in aldosterone-infused mice ameliorated LVH, diastolic dysfunction, lung congestion and myocardial oxidative stress without affecting blood pressure (BP) and LVEF. This improvement in diastolic function parameters in aldosterone-infused APNTG mice was accompanied by preserved protein expression of PKA-dependent phosphorylation of PLN at Ser16. APN replacement prevented the progression of aldosterone-induced HFpEF, independent of BP, by improving diastolic dysfunction and modulating cardiac hypertrophy.
Conclusions—These findings suggest that APN may have therapeutic effects in patients with HFpEF.
- heart failure with preserved ejection fraction
- oxidative stress
- calcium handling proteins
- diastolic dysfunction
- left ventricular hypertrophy
- Received March 15, 2014.
- Accepted August 14, 2014.