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European Journal of Heart Failure 2003 5(3):229-239; doi:10.1016/S1388-9842(03)00010-2
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© 2003 European Society of Cardiology

Role of nitric oxide in posthypoxic contractile dysfunction of diabetic cardiomyopathy

Magdi M. El-Omara, Roger Lordb, Nick J. Drapera and Ajay M. Shahc,*

a Department of Cardiology, University of Wales College of Medicine Heath Park, Cardiff CF4 4XN, UK
b Discipline of Surgery, University of Tasmania Hobart, Australia
c Guy's, King's & St. Thomas's School of Medicine, King's College London Bessemer Road, London SE5 9PJ, UK

* Corresponding author. Tel: +44-207-346-3865; fax: +44-207-346-4771. E-mail address: ajay.shah{at}kcl.ac.uk


   Abstract

We investigated the role of nitric oxide synthase (NOS) in the contractile dysfunction of diabetic cardiomyopathy, comparing streptozotocin-treated (60 mg/kg) diabetic Wistar rats with matched non-diabetic controls. Isolated isovolumic heart function was studied during normoxia and in response to brief hypoxia-reoxygenation. Diabetic hearts had significantly lower left-ventricular pressure and slower isovolumic relaxation than controls (relaxation time constant, T 40.2±2.3 vs. 27.7±0.9 ms; P<0.05) and a blunted response to hypoxia. These abnormalities were unaffected by NOS inhibition. Upon reoxygenation after brief hypoxia, diabetic hearts exhibited substantial worsening of LV relaxation compared to normal hearts (T 69.1±3.3 vs. 56.6±7.9 ms; P<0.05). This post-hypoxic diastolic dysfunction was significantly attenuated either by the non-selective NOS inhibitor L-NAME, the iNOS inhibitor L-NIL, or the reactive-oxygen-species (ROS) scavenger thiourea. Only diabetic hearts expressed iNOS protein, whereas eNOS expression was similar in both groups. In conclusion, diabetic hearts exhibit markedly abnormal post-hypoxic relaxation, which is attributable to both ROS and NO derived from iNOS.

Key Words: Diastole • Nitric oxide synthase (NOS) • Hypoxia • Relaxation • Reactive oxygen species

Received August 16, 2002; Revised October 18, 2002; Accepted November 12, 2002


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