Pyruvate-fortified cardioplegia evokes myocardial erythropoietin signaling in swine undergoing cardiopulmonary bypass

Myoung Gwi Ryou, Devin C. Flaherty, Besim Hoxha, Jie Sun, Hunaid Gurji, Steven Rodriguez, Glenn Bell, Albert H. Olivencia-Yurvati, Robert T. Mallet

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Pyruvate-fortified cardioplegia protects myocardium and hastens postsurgical recovery of patients undergoing cardiopulmonary bypass (CPB). Pyruvate reportedly suppresses degradation of the α-subunit of hypoxia-inducible factor-1 (HIF-1), an activator of the gene encoding the cardioprotective cytokine erythropoietin (EPO). This study tested the hypothesis that pyruvate-enriched cardioplegia evoked EPO expression and mobilized EPO signaling mechanisms in myocardium. Hearts of pigs maintained on CPB were arrested for 60 min with 4:1 blood-crystalloid cardioplegia. The crystalloid component contained 188 mM glucose ± 24 mM pyruvate. After 30-min cardiac reperfusion with cardioplegia-free blood, the pigs were weaned from CPB. Left ventricular myocardium was sampled 4 h after CPB for immunoblot assessment of HIF-1α, EPO and its receptor, the signaling kinases Akt and ERK, and endothelial nitric oxide synthase (eNOS), an effector of EPO signaling. Pyruvate-fortified cardioplegia stabilized arterial pressure post-CPB, induced myocardial EPO mRNA expression, and increased HIF-1α, EPO, and EPO-R protein contents by 60, 58, and 123%, respectively, vs. control cardioplegia (P < 0.05). Pyruvate cardioplegia also increased ERK phosphorylation by 61 and 118%, respectively, vs. control cardioplegia-treated and non-CPB sham myocardium (P < 0.01), but did not alter Akt phosphorylation. Nitric oxide synthase (NOS) activity and eNOS content fell 32% following control CPB vs. sham, but pyruvate cardioplegia prevented these declines, yielding 49 and 80% greater NOS activity and eNOS content vs. respective control values (P < 0.01). Pyruvate-fortified cardioplegia induced myocardial EPO expression and mobilized the EPOERK-eNOS mechanism. By stabilizing HIF-1α, pyruvate-fortified cardioplegia may evoke sustained activation of EPO's cardioprotective signaling cascade in myocardium.

Original languageEnglish
Pages (from-to)H1914-H1922
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume297
Issue number5
DOIs
StatePublished - 1 Nov 2009

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Induced Heart Arrest
Erythropoietin
Cardiopulmonary Bypass
Pyruvic Acid
Swine
Hypoxia-Inducible Factor 1
Nitric Oxide Synthase Type III
Myocardium
Nitric Oxide Synthase
Phosphorylation
Erythropoietin Receptors
Reperfusion
Arterial Pressure
Phosphotransferases
Cytokines

Keywords

  • Endothelial nitric oxide synthase
  • Hypoxia-inducible factor

Cite this

Ryou, Myoung Gwi ; Flaherty, Devin C. ; Hoxha, Besim ; Sun, Jie ; Gurji, Hunaid ; Rodriguez, Steven ; Bell, Glenn ; Olivencia-Yurvati, Albert H. ; Mallet, Robert T. / Pyruvate-fortified cardioplegia evokes myocardial erythropoietin signaling in swine undergoing cardiopulmonary bypass. In: American Journal of Physiology - Heart and Circulatory Physiology. 2009 ; Vol. 297, No. 5. pp. H1914-H1922.
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abstract = "Pyruvate-fortified cardioplegia protects myocardium and hastens postsurgical recovery of patients undergoing cardiopulmonary bypass (CPB). Pyruvate reportedly suppresses degradation of the α-subunit of hypoxia-inducible factor-1 (HIF-1), an activator of the gene encoding the cardioprotective cytokine erythropoietin (EPO). This study tested the hypothesis that pyruvate-enriched cardioplegia evoked EPO expression and mobilized EPO signaling mechanisms in myocardium. Hearts of pigs maintained on CPB were arrested for 60 min with 4:1 blood-crystalloid cardioplegia. The crystalloid component contained 188 mM glucose ± 24 mM pyruvate. After 30-min cardiac reperfusion with cardioplegia-free blood, the pigs were weaned from CPB. Left ventricular myocardium was sampled 4 h after CPB for immunoblot assessment of HIF-1α, EPO and its receptor, the signaling kinases Akt and ERK, and endothelial nitric oxide synthase (eNOS), an effector of EPO signaling. Pyruvate-fortified cardioplegia stabilized arterial pressure post-CPB, induced myocardial EPO mRNA expression, and increased HIF-1α, EPO, and EPO-R protein contents by 60, 58, and 123{\%}, respectively, vs. control cardioplegia (P < 0.05). Pyruvate cardioplegia also increased ERK phosphorylation by 61 and 118{\%}, respectively, vs. control cardioplegia-treated and non-CPB sham myocardium (P < 0.01), but did not alter Akt phosphorylation. Nitric oxide synthase (NOS) activity and eNOS content fell 32{\%} following control CPB vs. sham, but pyruvate cardioplegia prevented these declines, yielding 49 and 80{\%} greater NOS activity and eNOS content vs. respective control values (P < 0.01). Pyruvate-fortified cardioplegia induced myocardial EPO expression and mobilized the EPOERK-eNOS mechanism. By stabilizing HIF-1α, pyruvate-fortified cardioplegia may evoke sustained activation of EPO's cardioprotective signaling cascade in myocardium.",
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Pyruvate-fortified cardioplegia evokes myocardial erythropoietin signaling in swine undergoing cardiopulmonary bypass. / Ryou, Myoung Gwi; Flaherty, Devin C.; Hoxha, Besim; Sun, Jie; Gurji, Hunaid; Rodriguez, Steven; Bell, Glenn; Olivencia-Yurvati, Albert H.; Mallet, Robert T.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 297, No. 5, 01.11.2009, p. H1914-H1922.

Research output: Contribution to journalArticle

TY - JOUR

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AU - Ryou, Myoung Gwi

AU - Flaherty, Devin C.

AU - Hoxha, Besim

AU - Sun, Jie

AU - Gurji, Hunaid

AU - Rodriguez, Steven

AU - Bell, Glenn

AU - Olivencia-Yurvati, Albert H.

AU - Mallet, Robert T.

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