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European Journal of Heart Failure Advance Access published online on June 5, 2009

European Journal of Heart Failure, doi:10.1093/eurjhf/hfp070
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Blockage of receptor for advanced glycation end products prevents development of cardiac dysfunction in db/db type 2 diabetic mice

Jan M. Nielsen1,*, Steen B. Kristiansen1, Rikke Nørregaard2, Claus L. Andersen3, Larry Denner4, Torsten T. Nielsen1, Allan Flyvbjerg5 and Hans E. Bøtker1

1 Department of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus N, Denmark
2 The Water and Salt Research Center, Aarhus University Hospital, Skejby, Denmark
3 Molecular Diagnostic Laboratory, Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Denmark
4 Stark Diabetes Center, Division of Endocrinology, University of Texas Medical Branch, Galveston, TX, USA
5 The Medical Research Laboratories, Clinical Institute, Medical Department M (Diabetes and Endocrinology), Aarhus University Hospital, Skejby, Denmark

* Corresponding author. Tel: +45 89496241, Fax: +45 89496009, Email: janmn{at}dadlnet.dk


   Abstract

Aims: Activation of the receptor for advanced glycation end products (RAGE) is associated with long-term complications in diabetes mellitus. In this study, we tested whether RAGE activation in the diabetic myocardium is implicated in the development of cardiac dysfunction.

Methods and results: Using MRI and conductance catheter techniques, we evaluated cardiac function in a type 2 diabetic mouse model (db/db), and assessed the effect of blocking RAGE with a RAGE antibody. Gene expressions were evaluated in samples of myocardial tissue. Diabetic db/db mice demonstrated an accelerated age-dependent deterioration in cardiac function associated with altered expression of genes related to cardiac structure and function. Blockage of RAGE signalling prevented the reduction in systolic function (preload recruitable stroke work: 109.8 ± 13.8 vs. 94.5 ± 14.9 mmHg/µL, P = 0.04) and development of increased LV diastolic chamber stiffness (0.18 ± 0.05 vs. 0.27 ± 0.07 mmHg, P = 0.01). The cardiac expression of collagen (col1a1) was reduced by approximately 45% and the expression of myosin was switched from the foetal isoform (MHCβ) to the adult isoform (MHC{alpha}).

Conclusion: Activation of RAGE is a significant pathogenetic mechanism for the development of cardiac dysfunction in type 2 diabetes. The underlying mechanisms involve not only the passive biophysical properties of the myocardium but also myocyte function.

Key Words: RAGE • Diabetic cardiomyopathy • Advanced Glycation end products • db/db mice • Heart failure • Conductance catheter

Received November 27, 2008; Revised March 9, 2009; Accepted April 2, 2009


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