Empagliflozin Attenuates Myocardial Sodium and Calcium Dysregulation and Reverses Cardiac Remodeling in Streptozotocin-Induced Diabetic Rats

oleh: Ting-I Lee, Yao-Chang Chen, Yung-Kuo Lin, Cheng-Chih Chung, Yen-Yu Lu, Yu-Hsun Kao, Yi-Jen Chen

Format: Article
Diterbitkan: MDPI AG 2019-04-01

Deskripsi

Diabetes mellitus (DM) has significant effects on cardiac calcium (Ca<sup>2+</sup>) and sodium (Na<sup>+</sup>) regulation. Clinical studies have shown that empagliflozin (Jardiance&#8482;) has cardiovascular benefits, however the mechanisms have not been fully elucidated. This study aimed to investigate whether empagliflozin modulates cardiac electrical activity as well as Ca<sup>2+</sup>/Na<sup>+</sup> homeostasis in DM cardiomyopathy. Electrocardiography, echocardiography, whole-cell patch-clamp, confocal microscopic examinations, and Western blot, were performed in the ventricular myocytes of control and streptozotocin-induced DM rats, with or without empagliflozin (10 mg/kg for 4 weeks). The results showed that the control and empagliflozin-treated DM rats had smaller left ventricular end-diastolic diameters and shorter QT intervals than the DM rats. In addition, the prolonged action potential duration in the DM rats was attenuated in the empagliflozin-treated DM rats. Moreover, the DM rats had smaller sarcoplasmic reticular Ca<sup>2+</sup> contents, intracellular Ca<sup>2+</sup> transients, L-type Ca<sup>2+</sup>, reverse mode Na<sup>+</sup>-Ca<sup>2+</sup>exchanger currents, lower protein expressions of sarcoplasmic reticulum ATPase, ryanodine receptor 2 (RyR2), but higher protein expressions of phosphorylated RyR2 at serine 2808 than the control and empagliflozin-treated DM rats. The incidence and frequency of Ca<sup>2+</sup> sparks, cytosolic and mitochondrial reactive oxygen species, and late Na<sup>+</sup> current and Na<sup>+</sup>/hydrogen-exchanger currents were greater in the DM rats than in the control and empagliflozin-treated DM rats. Empagliflozin significantly changed Ca<sup>2+</sup> regulation, late Na<sup>+</sup> and Na<sup>+</sup>/hydrogen-exchanger currents and electrophysiological characteristics in DM cardiomyopathy, which may contribute to its cardioprotective benefits in DM patients.