Background Since their discovery in the early 1960s, doxorubicin (DOX) remains the most effective anticancer drug. However, this drug has confirmed to be a double-edged sword because it causes a cardiomyopathy that leads to congestive heart failure. Ghrelin, a multi-functional peptide, plays an important role in cardiovascular protection. Therefore, we investigated the effects of ghrelin on vascular endothelial growth factor-beta (VEGF-B) and connexin-43 (Cx43) expression in DOX-induced cardiomyopathy. Methods Forty adult male rats were divided randomly into four groups: normal, normal + ghrelin, DOX-induced cardiomyopathy, and DOX-induced cardiomyopathy + ghrelin. Biochemical and histopathological analysis, electrocardiograph (ECG), heart rate, systolic blood pressure (SBP), and immunohistochemical staining of VEGF-B and Cx43 were assessed for all rats in heart tissue specimens. The duration of the study was 2 weeks. Results DOX-induced cardiomyopathy in rats showed significant ECG changes such as prolongation of PR, QT, QTC intervals and ST segment, a decrease in amplitude and an increase in the duration of QRS complex, bradycardia, and a decrease in SBP. Also, rats in the DOX group showed myocardial histopathological damage in the form of severe fibrosis with decreased expression of Cx43 and a non-significant difference in expression of VEGF-B when compared to normal rats. Treatment with ghrelin resulted in a significant improvement in all the studied parameters and was associated with an increase in VEGF-B and Cx43 expression. Conclusions Ghrelin has a beneficial effect against DOX-induced cardiomyopathy which may be mediated through VEGF-B and Cx43 expression in the myocardium. Ghrelin is a promising cardioprotective drug in DOX-induced cardiomyopathy patients, but further studies are needed to evaluate its use.
Keywords: VEGF-B; cardiomyopathy; cardiotoxicity; connexin 43; doxorubicin; ghrelin.