Journal
EUROPEAN HEART JOURNAL
Volume 32, Issue 15, Pages 1935-1945Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehq436
Keywords
Chronic kidney disease; Cardiovascular protection; Calcineurin inhibition; Cyclosporine; Tacrolimus; Vascularization
Categories
Funding
- Stifterverband fur die Deutsche Wissenschaft and Simon-Claussen-Stiftung [H1405409999915626]
- Else Kroner-Fresenius Stiftung [P38/09//A55/09]
- Novartis
- Astellas Pharma GmbH
- IZKF Core facility Echo
- Deutsche Forschungsgemeinschaft (DFG) [SFB 656-C3/C7]
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Aims Chronic kidney disease is directly associated with cardiovascular complications. Heart remodelling, including fibrosis, hypertrophy, and decreased vascularization, is frequently present in renal diseases. Our objective was to investigate the impact of calcineurin inhibitors (CNI) on cardiac remodelling and function in a rat model of renal disease. Methods and results Male Sprague Dawley rats were divided into six groups: sham-operated rats, 5/6 nephrectomized rats (Nx) treated with vehicle, CNI (cyclosporine A 5.0 or 7.5, or tacrolimus 0.5 mg/kg/day) or hydralazine (20 mg/kg twice a day) for 14 days, starting on the day of surgery. Creatinine clearance was significantly lower and blood pressure significantly higher in Nx rats when compared with controls. Morphological and echocardiographic analyses revealed increased left ventricular hypertrophy and decreased number of capillaries in Nx rats. Treatment with CNI affected neither the renal function nor the blood pressure, but prevented the development of cardiac hypertrophy and improved vascularization. In addition, regional blood volume improved as confirmed by contrast agent-based echocardiography. Hydralazine treatment did not avoid heart remodelling in this model. Gene expression analysis verified a decrease in hypertrophic genes in the heart of CNI-treated rats, while pro-angiogenic and stem cell-related genes were upregulated. Moreover, mobilization of stem/progenitor cells was increased through manipulation of the CD26/SDF-1 system. Conclusion We conclude from our studies that CNI-treatment significantly prevented cardiac remodelling and improved heart function in Nx rats without affecting renal function and blood pressure. This sheds new light on possible therapeutic strategies for renal patients at high cardiovascular risk.
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