Abstract

Inhibition of succinate dehydrogenase (SDH) by Dimethyl Malonate (DiMal) reduces cardiac ischemia–reperfusion (IR) injury. We investigated the cardioprotective effect of DiMal in a rat model during advancing type 2 diabetes. Zucker Diabetic Fatty rats and lean controls were investigated corresponding to prediabetes, onset and mature diabetes. Hearts were mounted in an isolated perfused model, and subjected to IR for investigation of infarct size (IS) and mitochondrial respiratory control ratio (RCR). DiMal was administered for 10 min before ischemia. Compared with age-matched non-diabetic rats, prediabetic rats had larger IS (49 ± 4% vs. 36 ± 2%, p = 0.007), rats with onset diabetes smaller IS (51 ± 3% vs. 62 ± 3%, p = 0.05) and rats with mature diabetes had larger IS (79 ± 3% vs. 69 ± 2%, p = 0.06). At the prediabetic stage DiMal did not alter IS. At onset of diabetes DiMal 0.6 mM increased IS in diabetic but not in non-diabetic control rats (72 ± 4% vs. 51 ± 3%, p = 0.003). At mature diabetes DiMal 0.1 and 0.6 mM reduced IS (68 ± 3% vs. 79 ± 3% and 64 ± 5% vs. 79 ± 3%, p = 0.1 and p = 0.01), respectively. DiMal 0.1 mM alone reduced IS in age-matched non-diabetic animals (55 ± 3% vs. 69 ± 2% p = 0.01). RCR was reduced at mature diabetes but not modulated by DiMal. Modulation of SDH activity results in variable infarct size reduction depending on presence and the stage of diabetes. Modulation of SDH activity may be an unpredictable cardioprotective approach.

Highlights

  • Patients with diabetes have a high prevalence of coronary artery disease [1] and impaired clinical outcome following acute myocardial infarction despite reperfusion therapy compared to patients without diabetes [2,3,4,5,6,7,8]

  • In the present study we extended our investigations to explore the potential cardioprotection by dimethyl malonate (DiMal) to cover three different stages of diabetes: prediabetes, onset diabetes and mature diabetes [26, 27] and study the interactions between diabetes stage, mitochondrial function and effect of DiMal

  • The present study confirms that susceptibility to IR injury depends on stage of type 2 diabetes mellitus (T2DM) with increased injury in hearts with mature diabetes and decreased susceptibility at onset of diabetes [26, 27, 30]

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Summary

Introduction

Patients with diabetes have a high prevalence of coronary artery disease [1] and impaired clinical outcome following acute myocardial infarction despite reperfusion therapy compared to patients without diabetes [2,3,4,5,6,7,8]. The consequences of the coronary obstruction are predominantly determined by cardiac ischemia time and by the reperfusion injury, which influences the extent of myocardial damage following modern reperfusion therapy of acute myocardial infarction [9]. With increasing succinate concentration during ischemia, the augmented SDH activity rapidly oxidizes succinate, reverses electron transport and enhances reactive oxygen species (ROS) production during early reperfusion [16,17,18]. Blocking SDH by dimethyl malonate (DiMal) during ischemia reduces succinate accumulation and IR injury [16]

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