Chronic Central Nervous System Leptin Infusion Improves Cardiac Function and Metabolism after Ischemia/Reperfusion Injury

Abstract

Important adverse changes in cardiac energy metabolism occur after ischemia/reperfusion injury (I/R), contributing to the worsening of cardiac function and development of heart failure. We recently showed that leptin, via its actions on the central nervous system (CNS), improves left ventricular (LV) function in a model of heart failure induced by permanent ligation of the left anterior descending coronary artery (LAD). In the present study, we examined whether the CNS‐ effects of leptin protect against myocardial I/R injury, and if chronic intracerebroventricular (ICV) leptin infusion improves cardiac substrate utilization, assessed by markers of myocardial fatty acid (FA) and glucose oxidation, NAD+/NADH redox state and plasma levels of β‐hydroxybutyrate (β‐HOB). Male Wistar rats were instrumented with an ICV cannula in the brain lateral ventricle. After recovery and baseline assessment of cardiac function by echocardiography (ECHO), myocardial I/R was induced by temporary (60 min) ligation of the LAD. Vehicle (saline, 0.5 µL/hr) or leptin (0.62 µg/hr) was infused chronically for 28 days starting 20 min after reperfusion using osmotic minipumps connected to the ICV cannula. ECHO assessment of cardiac function was performed weekly. At the end of week 4, +dP/dtmax was accessed by LV catheterization. Hearts and plasma samples were collected for evaluation of CD36, PPAR‐δ, PDK4 and p‐PDH1/PDH1 by western blot and cardiac NAD+/NADH ratio and plasma levels of β‐OHB were measured by ELISA. Our results showed that ICV leptin treatment improved cardiac function as evidenced by increased ejection fraction 4 weeks after I/R (46±3 vs. 26±3 %) and +dP/dtmax (10387±1686 vs. 5022±442 mmHg/s) when compared with vehicle‐treated rats. ICV leptin infusion also significantly increased cardiac protein expression of CD36 (1.4±0.1 vs. 1.0±0.1 au), PPAR‐δ (1.8±0.1vs. 1.0±0.01 au), PDK4 (1.8±0.1 vs. 1.0±0.1 au) and p‐PDH1/PDH1 (2.2±0.3 vs. 1.0±0.2 au) when compared with vehicle‐treated animals. In addition, ICV leptin infusion increased cardiac NAD+/NADH ratio (6.8±2 vs. 1.02±0.3 pmol/µL) and reduced plasma levels of β‐OHB (18.2±3 vs. 62.8±7.0 nmol/µL). These results demonstrate that chronic ICV leptin infusion improves cardiac function following I/R injury and suggest that leptin’s CNS‐mediated cardioprotective effects may involve improved myocardial FA oxidation and NAD+/NADH redox state, reducing the reliance on ketone bodies (β‐OHB) as an energy source.