Atrial tachyarrhythmia causes atrial imbalance of the Ace/Ace2 ratio in aged and hypertensive rats

Abstract

Purpose: Arterial hypertension and age are the most predominant factors causing atrial fibrillation (AF). The exact proarrhythmogenic pathways involved are still unknown. The present study was designed to examine changes in the composition of atrial members of the renin-angiotensin system (RAS) in response to tachyarrhythmia in the presence of arterial hypertension at different ages. The local RAS plays a crucial role in remodelling processes in the heart, primarily through the action of angiotensin II (AngII), which is generated by angiotensin converting enzyme (ACE). ACE2 counterbalances the action of ACE by cleaving of AngII into peptides that act protective. Methods: Atrial tissue from spontaneously hypertensive male rats (SHR; n=6) and their normotensive controls, Wistar-Kyoto (n=6), were analysed at the age of 12 weeks and 6-8 months. Atrial slices were rapidly stimulated at 5 Hz up to 20h to resemble AF (n=4 per group and age). The changes in the expression of RAS components (ACE, ACE2, angiotensin receptors) as well as RAS-associated downstream effectors were estimated at the mRNA and protein levels. Moreover, the activation of MAPK and NF-κB signalling were analysed by immunoblotting. Results: Our data revealed that left atrium of SHR expressed constantly high levels of ACE protein (3.8±0.7; p=0.03) and mRNA (1.7±0.7; p=0.04) compared to normotensive controls (1.0) in each age group. ACE2-mRNA levels did not show any changes at 12 weeks between normotensive and hypertensive rats. With age the mRNA levels of ACE2 diminished in SHR (0.79±0.04; p=0.02). These molecular changes were accompanied by activation of MAPK, NF-κB signalling and the presence of the active caspase-3 in SHR. In response to the stimulation in the electrical field, the atrial tissue from hypertensive rats showed 1.6-fold (p=0.01) and of normotensive rats 3.0-fold increase (p=0.01) in the expression of ACE. In normotensive young rats, ACE2 counterbalanced this action at the mRNA (1.5±0.12; p=0.01) and protein level (2.7±0.80; p=0.11). This protective action of ACE2 decreased with age in normotensive rats, and it disappeared completely in SHR (mRNA: 0.94±0.13; protein: 0.98±0.11). Conclusions: Our data show that hypertension in SHR is accompanied by enhanced atrial expression of angiotensin-converting enzyme. This fact strongly implies a sustained exposure of atrial tissue to elevated levels of local AngII. The observed imbalance of the ACE/ACE2 ratio in aged hypertensive rats might facilitate the susceptibility to arrhythmia especially in this clinical scenario.