Soluble guanylyl cyclase activation improves progressive cardiac remodeling and failure after myocardial infarction. Cardioprotection over ACE inhibition

Basic Res Cardiol. 2014 Jul;109(4):421. doi: 10.1007/s00395-014-0421-1. Epub 2014 Jun 8.

Abstract

Impaired nitric oxide (NO)-soluble guanylate cyclase (sGC)-cGMP signaling is involved in the pathogenesis of ischemic heart diseases, yet the impact of long-term sGC activation on progressive cardiac remodeling and heart failure after myocardial infarction (MI) has not been explored. Moreover, it is unknown whether stimulating the NO/heme-independent sGC provides additional benefits to ACE inhibition in chronic ischemic heart failure. Starting 10 days after MI, rats were treated with placebo, the sGC activator ataciguat (10 mg/kg/twice daily), ramipril (1 mg/kg/day), or a combination of both for 9 weeks. Long-term ataciguat therapy reduced left ventricular (LV) diastolic filling pressure and pulmonary edema, improved the rightward shift of the pressure-volume curve, LV contractile function and diastolic stiffness, without lowering blood pressure. NO/heme-independent sGC activation provided protection over ACE inhibition against mitochondrial superoxide production and progressive fibrotic remodeling, ultimately leading to a further improvement of cardiac performance, hypertrophic growth and heart failure. We found that ataciguat stimulating sGC activity was potentiated in (myo)fibroblasts during hypoxia-induced oxidative stress and that NO/heme-independent sGC activation modulated fibroblast-cardiomyocyte crosstalk in the context of heart failure and hypoxia. In addition, ataciguat inhibited human cardiac fibroblast differentiation and extracellular matrix protein production in response to TGF-β1. Overall, long-term sGC activation targeting extracellular matrix homeostasis conferred cardioprotection against progressive cardiac dysfunction, pathological remodeling and heart failure after myocardial infarction. NO/heme-independent sGC activation may prove to be a useful therapeutic target in patients with chronic heart failure and ongoing fibrotic remodeling.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / pharmacology*
  • Animals
  • Cardiotonic Agents / pharmacology*
  • Cell Communication
  • Cells, Cultured
  • Disease Models, Animal
  • Drug Therapy, Combination
  • Enzyme Activation
  • Enzyme Activators / pharmacology*
  • Extracellular Matrix / metabolism
  • Fibrosis
  • Guanylate Cyclase / metabolism*
  • Heart Failure / drug therapy*
  • Heart Failure / enzymology
  • Heart Failure / etiology
  • Heart Failure / pathology
  • Heart Failure / physiopathology
  • Hemodynamics / drug effects
  • Humans
  • Male
  • Mice
  • Mitochondria, Heart / drug effects
  • Mitochondria, Heart / enzymology
  • Myocardial Contraction / drug effects
  • Myocardial Infarction / complications*
  • Myocardial Infarction / enzymology
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / enzymology
  • Myocytes, Cardiac / pathology
  • Myofibroblasts / drug effects
  • Myofibroblasts / enzymology
  • Nitric Oxide / metabolism
  • Nitric Oxide Synthase Type III / metabolism
  • Oxidative Stress / drug effects
  • Ramipril / pharmacology*
  • Rats, Wistar
  • Receptors, Cytoplasmic and Nuclear / metabolism*
  • Soluble Guanylyl Cyclase
  • Sulfonamides / pharmacology*
  • Superoxides / metabolism
  • Time Factors
  • Ventricular Function, Left / drug effects
  • Ventricular Remodeling / drug effects*
  • ortho-Aminobenzoates / pharmacology*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Cardiotonic Agents
  • Enzyme Activators
  • Receptors, Cytoplasmic and Nuclear
  • Sulfonamides
  • ortho-Aminobenzoates
  • Superoxides
  • Nitric Oxide
  • Nitric Oxide Synthase Type III
  • Nos3 protein, rat
  • Guanylate Cyclase
  • Soluble Guanylyl Cyclase
  • Ramipril
  • 5-chloro-2-(5-chlorothiophene-2-sulfonylamino)-N-(4-(morpholine-4-sulfonyl)phenyl)benzamide