Acute postischemic treatment with estrogen receptor-alpha agonist or estrogen receptor-beta agonist improves myocardial recovery

Surgery. 2009 Aug;146(2):145-54. doi: 10.1016/j.surg.2009.04.026.

Abstract

Background: After ischemia/reperfusion (I/R) injury, female hearts demonstrate improved functional recovery compared with male, which suggests a protective role for estrogen. Acute postischemic treatment with 17-beta-estradiol (E2) attenuates myocardial dysfunction. However, it is unknown by which estrogen receptor (ER) E2 mediates this acute cardioprotection during I/R. Therefore, we hypothesize that postischemic infusion of the selective ER-alpha agonist (4,4',4''-[4-propyl-(1H)-pyrazole-1,3,5-triyl]tris-phenol [PPT]) or the selective ER-beta agonist (2,3-bis(4-hydroxyphenyl)-propionitrile [DPN]) will improve myocardial function after I/R injury.

Methods: Isolated, perfused hearts (Langendorff) from adult male rats were subjected to 25 minutes of ischemia followed by 40 minutes of reperfusion. Hearts (n = 4-6 per group) were randomly infused with either perfusate, PPT or DPN at 1, 10, or 100 nmol/L throughout reperfusion. After I/R, heart tissue was analyzed for tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, vascular endothelial growth factor (VEGF), and lactate dehydrogenase (LDH).

Results: Postischemic treatment with 10 nmol/L of PPT significantly improved myocardial function. Additionally, 10 or 100 nmol/L of DPN significantly increased myocardial functional recovery after I/R injury, with maximum benefit at the 10 nmol/L dose. A trend toward lower levels of LDH was noted in DPN- and PPT-treated groups after I/R injury. Neither PPT nor DPN affected myocardial production of TNF-alpha or IL-1beta. However, higher levels of myocardial VEGF were noted in the PPT-treated group compared with controls.

Conclusion: Both ER-alpha and ER-beta are involved in mediating E2-induced rapid cardioprotection after I/R injury. Advancing our understanding of both ER subtypes may be useful for the development of novel strategies that may benefit both males and females in response to myocardial ischemia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Coronary Circulation
  • Estrogen Receptor alpha / agonists*
  • Estrogen Receptor alpha / physiology
  • Estrogen Receptor beta / agonists*
  • Estrogen Receptor beta / physiology
  • Female
  • In Vitro Techniques
  • Interleukin-1beta / metabolism
  • L-Lactate Dehydrogenase / metabolism
  • Male
  • Myocardial Contraction
  • Myocardial Reperfusion Injury / metabolism
  • Myocardial Reperfusion Injury / physiopathology*
  • Myocardium / metabolism
  • Nitriles / pharmacology*
  • Phenols / pharmacology
  • Pyrazoles / pharmacology
  • Rats
  • Rats, Sprague-Dawley
  • Sex Characteristics
  • Tumor Necrosis Factor-alpha / metabolism
  • Vascular Endothelial Growth Factor A / metabolism
  • Ventricular Function, Left

Substances

  • 2,3-bis(4-hydroxyphenyl)-propionitrile
  • Estrogen Receptor alpha
  • Estrogen Receptor beta
  • Interleukin-1beta
  • Nitriles
  • Phenols
  • Pyrazoles
  • Tumor Necrosis Factor-alpha
  • Vascular Endothelial Growth Factor A
  • 4,4',4''-(4-propyl-((1)H)-pyrazole-1,3,5-triyl) tris-phenol
  • L-Lactate Dehydrogenase