Sorrentino Andrea, Borghetti Giulia, Zhou Yu, Cannata Antonio, Meo Marianna, Signore Sergio, Anversa Piero, Leri Annarosa, Goichberg Polina, Qanud Khaled, Jacobson Jason T, Hintze Thomas H, Rota Marcello
Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Fondazione Cardiocentro Ticino, University of Zurich, Lugano, Switzerland.
Am J Physiol Heart Circ Physiol. 2017 Jan 1;312(1):H150-H161. doi: 10.1152/ajpheart.00737.2016. Epub 2016 Nov 23.
Diabetes and other metabolic conditions characterized by elevated blood glucose constitute important risk factors for cardiovascular disease. Hyperglycemia targets myocardial cells rendering ineffective mechanical properties of the heart, but cellular alterations dictating the progressive deterioration of cardiac function with metabolic disorders remain to be clarified. In the current study, we examined the effects of hyperglycemia on cardiac function and myocyte physiology by employing mice with high blood glucose induced by administration of streptozotocin, a compound toxic to insulin-producing β-cells. We found that hyperglycemia initially delayed the electrical recovery of the heart, whereas cardiac function became defective only after ~2 mo with this condition and gradually worsened with time. Prolonged hyperglycemia was associated with increased chamber dilation, thinning of the left ventricle (LV), and myocyte loss. Cardiomyocytes from hyperglycemic mice exhibited defective Ca transients before the appearance of LV systolic defects. Alterations in Ca transients involved enhanced spontaneous Ca releases from the sarcoplasmic reticulum (SR), reduced cytoplasmic Ca clearance, and declined SR Ca load. These defects have important consequences on myocyte contraction, relaxation, and mechanisms of rate adaptation. Collectively, our data indicate that hyperglycemia alters intracellular Ca homeostasis in cardiomyocytes, hindering contractile activity and contributing to the manifestation of the diabetic cardiomyopathy.
NEW & NOTEWORTHY: We have investigated the effects of hyperglycemia on cardiomyocyte physiology and ventricular function. Our results indicate that defective Ca handling is a critical component of the progressive deterioration of cardiac performance of the diabetic heart.
糖尿病和其他以血糖升高为特征的代谢性疾病是心血管疾病的重要危险因素。高血糖会作用于心肌细胞,使心脏的机械性能失效,但导致心脏功能随代谢紊乱而逐渐恶化的细胞改变仍有待阐明。在本研究中,我们通过使用链脲佐菌素诱导高血糖的小鼠来研究高血糖对心脏功能和心肌细胞生理的影响,链脲佐菌素是一种对产生胰岛素的β细胞有毒的化合物。我们发现,高血糖最初会延迟心脏的电恢复,而在这种情况下约2个月后心脏功能才会出现缺陷,并随时间逐渐恶化。长期高血糖与心室扩张增加、左心室变薄和心肌细胞丢失有关。在左心室收缩缺陷出现之前,高血糖小鼠的心肌细胞就表现出钙瞬变缺陷。钙瞬变的改变包括肌浆网(SR)自发钙释放增强、细胞质钙清除减少和SR钙负荷下降。这些缺陷对心肌细胞的收缩、舒张和心率适应机制有重要影响。总的来说,我们的数据表明高血糖会改变心肌细胞内的钙稳态,阻碍收缩活动并导致糖尿病性心肌病的表现。
我们研究了高血糖对心肌细胞生理和心室功能的影响。我们的结果表明,钙处理缺陷是糖尿病心脏心脏功能逐渐恶化的关键因素。