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A preclinical rat model of heart failure with preserved ejection fraction with multiple comorbidities

ABSTRACT: As patients with heart failure with preserved ejection fraction (HFpEF) present with multiple comorbidities, we hypothesized, that metabolic syndrome in aging animals could lead to the development of diastolic dysfunction and HFpEF. HFpEF is a common complex morbid syndrome for which there are currently little evidence-based therapies. Obesity-prone rats were exposed to high-fat diet and compared to obesity-resistant rats fed with standard chow. Phenotyping of metabolic syndrome, associated with echocardiographic and cardiac hemodynamic measurements, was performed after 4 and 12 months. Blood and myocardial tissue sampling were performed for pathobiological evaluation. High-fat diet in obesity-prone rats elicited metabolic syndrome, characterized by increased body and abdominal fat weights, glucose intolerance and hyperlipidemia, as well as increased left ventricular (LV) systolic pressure (after 12 months). This was associated with LV diastolic dysfunction (assessed by increased LV end-diastolic pressure) and pulmonary hypertension (assessed by increased right ventricular systolic pressure). Echocardiography revealed significant concentric LV hypertrophy, while LV ejection fraction was preserved. LV remodeling was associated with cardiomyocyte hypertrophy, as well as myocardial and perivascular fibrosis. Circulating levels of soluble ST2 markedly increased in rats with HFpEF, while plasma NT-proBNP levels decreased. RNA-sequencing analysis identified clusters of genes implicated in fatty acid metabolism and calcium-dependent contraction as upregulated pathways in the myocardium of rats with HFpEF. High-fat diet during 12 months in obesity-prone rats led to the development of a relevant preclinical model of HFpEF with multiple comorbidities, suitable for investigating novel therapeutic interventions.

ORGANISM(S): Rattus norvegicus

PROVIDER: GSE189190 | GEO | 2022/02/02

REPOSITORIES: GEO

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Project description:The ongoing pandemics of obesity and hypertension have increasingly impacted an aging population with heart disease creating a prevalent cardiometabolic syndrome (CMS). This affects many post-menopausal women and men and manifests by multi-organ adiposity, insulin desensitization and diabetes, impaired fat metabolism, and heart failure symptoms. Effective therapy countering these multiple defects remains lacking. Natriuretic peptides (NP) synthesized by the heart both protect against cardiac disease and reduce obesity by stimulating lipolysis, improving insulin signaling, and lowering appetite. However, their clinical translation remains stymied by blood pressure reduction and complex in vivo peptide pharmacology. Phosphodiesterase type 9 is expressed in myocardium and fat of mammals including humans and controls NP-coupled cyclic GMP hydrolysis. Its inhibition (PDE9-I) protects hearts against pressure-induced stress without changing blood pressure, though its impact on fat remains unknown. Here we show PDE9-I potently improves high-fat diet-induced severe obesity in mice with cardiometabolic syndrome without altering food intake or activity, but this only occurs in males and ovariectomized females. PDE9 localizes with mitochondria and its inhibition stimulates mitochondrial respiration, uncoupling, and fat oxidation in heart and adipose tissue to reduce abdominal and liver fat by activating peroxisome proliferator-activator receptor a (PPARa) signaling. ChIP-seq reveals that the sexual dimorphism relates to reduced PPARa DNA binding in genes regulating fatty acid metabolism due to estrogen-receptor activation. Human translation is revealed in obese patients with heart failure and preserved ejection fraction (HFpEF), in whom PDE9A and PPARA gene expression inversely correlate, and PPARA and fat metabolism regulated genes are reduced. This potent PDE9-PPARa regulated pathway has implications for treating obese post-menopausal females and males with cardiometabolic syndrome. HFpEF accounts for half of all heart failure and is now commonly associated with class II (BMI>35 kg/m2) or greater obesity and CMS. The obesity is particularly hard to treat in these patients given that exercise capacity is quite limited, diet is rarely impactful at such weight, and surgical therapy poses greater risks. Despite having heart disease, NP levels are often low as hearts are less dilated and there is greater peripheral clearance with obesity. Loss of estrogen after menopause increases female risks for cardiovascular disease and stimulates visceral adiposity. Ovariectomy (OVX) mimics these changes, and when combined with a high-fat diet, exacerbates adiposity and adverse consequences of ischemic and hypertensive stress. These are reversed by exogenous estrogen but not therapies that require intact nitric oxide signaling, revealing an important role of estrogen-NO pathways. Estrogen treatment is largely abandoned due to adverse effects in humans. However, PDE9-I elevates cGMP-signaling by the NP pathway independent of NO-stimulation. We hypothesized that PDE9-I retains cardiac benefits in OVX female hearts subjected to pressure-induced stress and may also stimulate fat loss to improve CMS in concomitant diet induced obesity.

Project description:Impaired myocardial contractile function is a hallmark of heart failure (HF) which may present under resting conditions and/or during physiological stress. Previous studies reported that high fat feeding in HF is associated with improved myocardial contractile function at baseline. Our goal was to determine whether myocardial function is compromised in response to physiological stress and to evaluate the global gene expression profile of rats fed high dietary fat following infarction. Male Wistar rats underwent ligation or sham surgery and were fed normal (10% kcal fat) (SHAM+NC, HF+NC) or high fat (60% kcal saturated fat) (SHAM+SAT, HF+SAT) for 8 weeks. Myocardial contractile function was assessed using a Millar pressure-volume (PV) conductance catheter at baseline, during inferior vena caval occlusions and dobutamine (DOB) stress. Steady state indices of systolic function, left ventricular (LV)+dP/dtmax, stroke work and maximal power were increased in HF+SAT vs HF+NC; HF+NC were reduced vs SHAM+NC. Preload-recruitable measures of contractility [end systolic PV relationship, maximal elastance, preload recruitable SW and peak+dP/dtmax to end diastolic volume] were decreased in HF+NC but not HF+SAT. β-adrenergic responsiveness (delta-LV+dP/dtmax and delta-cardiac output DOB 0-10 µg•kg-1•min-1) was reduced in HF, but high fat feeding did not further impact contractile reserve in HF. Contractile reserve was reduced by high fat in SHAM+SAT. Microarray gene expression analysis reveals the majority of significantly altered pathways identified to contain multiple gene targets correspond to cell signaling pathways and energy metabolism. These findings suggest that high saturated fat improves myocardial function at rest and during physiological stress in infarcted hearts, but may negatively impact contractile reserve under non-pathological conditions. Furthermore, high fat feeding-induced alterations in gene expression related to energy metabolism and specific signaling pathways reveal promising targets through which high saturated fat potentially mediates cardioprotection in heart failure/LV dysfunction. Comparison of gene expression in heart failure or sham surgery hearts exposed to saturated or normal diets. Male Wistar rats (300-350g) were maintained on a reverse light-dark cycle and all procedures were done 3-6 hours into the dark phase cycle to synchronize with the normal active state of the rodents. Rats were randomly assigned to receive either a sham-operation (SH) or coronary ligation to induce cardiac dysfunction (HF). Heart failure was induced by ligating the left main coronary artery. Following surgery, rats were immediately fed either a normal rodent chow (NC) or a high saturated fat chow (SAT) with 60% caloric content derived from fat (25% palmitic, 33% stearic, 33% oleic acid, Research Diets).

Project description:Background: Post-menopausal obesity is an established risk factor for breast cancer. Consumption of diets high in fat is known to be highly correlated with obesity. In this, we sought to evaluate the interaction(s) between high fat diet, weight gain and mammary carcinogenesis using an obese-resistant and obese-prone rat model with direct correlates to human disease. Methods: Female obese-prone (OP) and obese-resistant (OR) weanling rats were placed on either a low fat (10% kcal) or a high fat (39% kcal) n-6 polyunsaturated (PUFA) safflower diet for 30 days. At post natal day (PND) 50, global gene expression profiling was performed on microdissected mammary epithlelium from one cohort of rats and another cohort of rats were given a single oral gavage of either 7,12-dimethylbenz[a]anthracene (DMBA at 14 mg/kg) or vehicle. Rats were then maintained on the diets and body weights, food consumption and development of mammary lesions were monitored weekly. Results: The DMBA-treated OR rats on the 39% safflower diet had significantly greater incidence of ductal carcinoma-in-situ (DCIS) lesions and significantly greater DCIS multiplicity than DMBA-treated OR rats on the 10% safflower diet. These differences were not seen in the OP strain. Gene expression analysis of mammary ductal epithelium from OR rats on the high fat diet showed significant upregulation of proliferation-related genes compared to those consuming the low fat safflower diet. Again, these differences were not seen in the OP strain. Conclusion: Our findings indicate that consumption of high fat safflower diet enhances mammary carcinogenesis in an OR rat strain through increased proliferation of mammary epithelium at the time of exposure, but not in the OP rat strain. Thus, the diet-induced increase in sensitivity was strain-specific and independent of weight gain or obesity level. Female obese-prone (OP) and obese-resistant (OR) weanling rats were placed on either a low fat (10% kcal) or a high fat (39% kcal) n-6 polyunsaturated (PUFA) safflower diet for 30 days. At post natal day (PND) 50, global gene expression profiling was performed on microdissected mammary epithlelium from one cohort of rats and another cohort of rats were given a single oral gavage of either 7,12-dimethylbenz[a]anthracene (DMBA at 14 mg/kg) or vehicle. Rats were then maintained on the diets and body weights, food consumption and development of mammary lesions were monitored weekly.

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A preclinical rat model of heart failure with preserved ejection fraction with multiple comorbidities

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