Activating PPARα Prevents Post-Ischemic Contractile Dysfunction in Hypertrophied Neonatal Hearts
Rationale: Post-ischemic contractile dysfunction is a contributor to morbidity and mortality following the surgical correction of congenital heart defects (CHDs) in neonatal patients. Pre-existing hypertrophy in the newborn heart can exacerbate these ischemic injuries, which may partly be due to a decreased energy supply to the heart resulting from low fatty acid β-oxidation rates.
Objective: We determined whether stimulating fatty acid β-oxidation with GW7647, a peroxisome proliferator activated receptor-α (PPARα) activator, would improve cardiac energy production and post-ischemic functional recovery in neonatal rabbit hearts subjected to volume overload-induced cardiac hypertrophy.
Methods and Results: Volume-overload cardiac hypertrophy was produced in 7-day-old rabbits via an aorto-caval shunt, following which, the rabbits were treated with or without GW7647 (3 mg/kg/day) for 14 days. Biventricular working hearts were subjected to 35 min of aerobic perfusion, 25 min of global no-flow ischemia, and 30 min of aerobic reperfusion. GW7647 treatment did not prevent the development of cardiac hypertrophy, but did prevent the decline in left ventricular ejection fraction in vivo. GW7647 treatment increased cardiac fatty acid β-oxidation rates pre- and post-ischemia, which resulted in a significant increase in overall ATP production and an improvement in vitro post-ischemic functional recovery. A decrease in post-ischemic proton production and endoplasmic reticulum (ER) stress, as well as an activation of SERCA2 and citrate synthase, was evident in GW7647-treated hearts.
Conclusions: Stimulating fatty acid ß-oxidation in immature hearts may present a novel cardioprotective intervention to limit post-ischemic contractile dysfunction.
- Received April 16, 2015.
- Revision received May 13, 2015.
- Accepted May 14, 2015.