Abstract 606: Soluble Guanylate Cyclase (sGC) Stimulator Reduces The Cardiac And Renal Damage In Angiotensin II (Ang II)-induced Diastolic Heart Failure

Abstract

Diastolic heart failure (DHF) is estimated to account for approximately 40% of heart failure cases. Due to the high prevalence and high mortality rates, diastolic heart failure represents a major challenge in cardiovascular medicine. The novel therapeutic alternative with NO-independent direct stimulators of sGC has recently been approved for the treatment of pulmonary hypertension. We analyzed the role of the sGC stimulator BAY 41-8543 in a transgenic rat model of hypertension-induced diastolic heart failure. We used 4 week-old male double transgenic rats harboring both human renin and angiotensinogen genes (dTGRs). At age 7 weeks, dTGR show striking cardiac hypertrophy with fibrosis, severe diastolic dysfunction but preserved systolic function, albuminuria, and renal failure. We compared vehicle-treated dTGR receiving 10% transcutol, 20% cremophor, 70% water, dTGR receiving 3 mg/kg/d BAY 41-8543, and vehicle-treated SD control rats (single oral dose per day for 3 weeks). Systolic blood pressure increased progressively in vehicle-treated dTGRs compared with SD rats. BAY 41-8543 significantly reduced the blood pressure (197 ± 11 mmHg vehicle vs 133 ± 4 mmHg BAY 41-8543). Treatment with sGC stimulator ameliorated albuminuria (0.3 ± 0.06 mg/8h at week 7) compared with vehicle-treated dTGRs (12.4 ± 2.6 mg/8h at week 7). In addition BAY 41-8543 prevented fibrosis and inflammation in kidney and heart. Cardiac hypertrophy or myocyte size were not reduced by BAY 41-8543 treatment. Cardiac echocardiography and hemodynamic investigations showed that BAY 41-8543 increased ejection fraction and improved diastolic function including speckle tracking and tissue doppler imaging. Programmed electrical stimulation showed a high non-sustained and sustained ventricular tachycardia induction rate in vehicle-treated dTGRs (46%), which was significantly reduced in BAY 41-8543-treated dTGR (11%). Finally, BAY 41-8543 treatment resulted in 100% survival at week 7, whereas 76% of vehicle-treated dTGRs died. Our data demonstrate that sGC stimulators ameliorate cardiac and renal end-organ damage including electrical remodeling in a transgenic rat model of hypertension-induced DHF. Treatment of DHF with sGC stimulators offers a novel therapeutic potential.