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1Institut für Herz- und Kreislaufphysiologie, Heinrich-Heine-Universität Düsseldorf, 40001 Düsseldorf, Germany
Submitted 18 September 2002 ; accepted in final form 5 March 2003
| ABSTRACT |
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O2). Stimulation of NO
formation by 10 µM bradykinin (BK) increased coronary venous nitrite
release fivefold to 58 ± 33 nM (n = 17). Vasodilatation by BK,
adenosine (1 µM), or papaverine (10 µM) decreased perfusion pressure,
left ventricular developed pressure (LVDP), and
M
O2. In the presence of
adenosine-induced vasodilatation, stimulation of endothelial NO synthesis by
BK had no effect on LVDP and
M
O2. Also, inhibition of
NO formation by NG-monomethyl-L-arginine
(L-NMMA, 100 µM) did not significantly alter LVDP and
M
O2. Similarly,
intracoronary infusion of authentic NO ≤2 µM did not influence LVDP or
M
O2 (-1 ± 1%).
Only when NO was >2 µM were contractile dysfunction and
M
O2 reduction observed.
Because BK-induced stimulation of endothelial NO formation and basal NO are
not sufficient to impair
M
O2 in the
saline-perfused mouse heart, a tonic control of the respiratory chain by
endothelial NO is difficult to conceive.
nitrite; bradykinin; nitric oxide synthase inhibition
-adrenergic signal transduction (e.g., see Refs.
16,
43,
46) and via cGMP-dependent and
-independent effects on Ca2+ influx and cycling
(3; for review, see Refs.
25,
29).
In the heart, NO is formed predominantly in the coronary endothelium by the
endothelial nitric oxide synthase (eNOS). NO is also formed within
cardiomyocytes (2), where
20% of the eNOS protein resides
(16). The presence of NOS
within or close to cardiac mitochondria was reported in several studies and
attributed to eNOS in rats (4),
inducible NOS (iNOS) in pigs
(14), and neuronal NOS (nNOS)
in mouse heart (24). Its
physiological significance is under debate
(14,
24). Not only the formation of
NO but also its metabolism is characterized by a high degree of
compartmentalization. In the presence of O2, NO is oxidized to
nitrite (
), e.g., in the
intravascular space. The very fast reaction of NO with oxyhemoglobin to
nitrate (
) and methemoglobin is
considered to be a major route of NO catabolism. In addition, nitrosylation of
hemoglobin and other proteins binds NO
(17). We have also recently
shown that myoglobin contributes to intracellular NO degradation to nitrate
(
) and is thus a potent
intracellular scavenger of NO
(13).
The notion of a tonic control of myocardial oxygen consumption
(M
O2) by NO was supported
by studies that demonstrated increased
M
O2 after blockade of NO
synthesis in both isolated hearts and dogs in vivo
(5,
9), whereas enhanced
endothelial NO formation decreased
M
O2, e.g., in myocardial
tissue pieces (30,
44). On the basis of these
findings, it was concluded that endothelium-derived NO regulates cardiac
M
O2
(42). However, increasing NO
in the canine or reducing NO formation in the porcine or human heart had no
effect on M
O2
(8,
11,
41). The recent recognition
that myocardial myoglobin is a potent scavenger of NO
(13) implies a steep
intracellular NO-concentration gradient, which casts further doubt on the
control of mitochondrial oxidative phosphorylation by endothelium-derived NO.
We have therefore tested in well-oxygenated isolated mouse hearts whether
enhancing endothelium-derived NO formation by bradykinin (BK) is
quantitatively sufficient to decrease
M
O2 and contractile
function. Myocardial NO levels were also modulated by application of authentic
NO or inhibition of cardiac NO synthesis.
| MATERIALS AND METHODS |
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A dedicated perfusion system (isolated heart size 1, HSE Harvard Apparatus;
March-Hugstett, Germany) enabled temperature control of both inflow medium and
ambient air. The following parameters were continuously recorded (Powerlab,
ADInstruments; Castle Hill, NSW, Australia): coronary flow as measured by a
transit-time ultrasonic flowmeter (HSE Harvard Apparatus), coronary perfusion
pressure, left intraventricular pressure as assessed by a fluid-filled
balloon, heart rate, and coronary venous PO2. For
reliable PO2 measurements, a fraction of the coronary
venous effluent (0.5 ml/min) was sucked continuously through a small-diameter
tube placed in the opening of the pulmonary artery across a Clark-type
PO2 electrode (model 733, Diamond General; Ann Arbor,
MI) by a peristaltic pump (Minipulse 3, Gilson Medical Electronics;
Villiers-le-Bel, France). For the measurement of
release, coronary venous effluent
was collected as well.
Protocols. After completion of the preparation, hearts were initially perfused at constant pressure (100 mmHg, 13.3 kPa) inside a water-jacketed chamber set to 37°C. Cardiac pacing (500 min-1) was initiated and continued throughout. All hearts were allowed to equilibrate for 20 min before left ventricular end-diastolic pressure was set to 5 mmHg.
Twenty minutes after the onset of cardiac pacing, the coronary perfusion
rate was fixed to the steady-state flow finally attained (in general,
1.52.5 ml/min) and was maintained constant thereafter by a
peristaltic pump. Basal functional parameters were acquired before subjecting
the hearts to the different experimental protocols. In the first set of
experiments, only BK was applied. In the presence of a constant flow,
BK-induced vasodilatation resulted in a decrease in perfusion pressure and
contractility. To verify that the latter effect was due to vasodilatation, the
effects of two other vasodilators (adenosine and papaverine) were evaluated.
In the main set of experiments, maximal vasodilatation was initiated by
application of adenosine (1 µM), which was continued throughout, before the
different interventions under steady-state conditions were started. BK (10
µM), NG-monomethyl-L-arginine
(L-NMMA, 100 µM), or authentic NO (33 nM20 µM) was
applied in the presence of 1 µM adenosine. For infusion of authentic NO,
aqueous NO solutions were prepared as previously described in detail
(26). At the end of the
experiment, hearts were gently blotted and weighed.
Measurement of
M
O2. To enable the
sensitive detection of even small changes in
M
O2, hearts were perfused
at a constant arterial PO2 (
600 mmHg) and flow as
previously described by others
(19,
38). In brief, measurement of
the coronary venous PO2 (see General methods)
allowed the determination of the arteriovenous PO2
difference. Because flow was maintained constant, any change in O2
consumption translated into a considerable change in coronary venous
PO2. Preliminary experiments demonstrated both the
stability of the PO2 electrode signal at a given
PO2 (electrode drift, <0.1 mmHg/min) as well as the
ability of the setup to respond to changes in
M
O2: when the external
Ca2+ concentration was decreased from 2.5 to 2 mM, the coronary
venous PO2 increased by 16 ± 2 mmHg, which
corresponds to a change in
M
O2 of 4% (n =
3).
release measurements. To obtain a
measure of cardiac NO formation, the
release of the saline-perfused
hearts was determined. Measurement of
release was not attempted, because
it is complicated by a low-
content
of the arterial inflow medium due to contamination of the commonly available
medium constituents. The arterial inflow and coronary venous outflow
concentrations were measured by a
NO analyzer (NOA, model 280; Sievers; Boulder, CO) based on the
chemiluminescence method. Comparison with
standards enabled quantification
with the detection limit being 1 pmol. To measure reliably the low coronary
concentrations, an injection volume
of 500 µl was employed. For standards in the range of 1200 nM
, a linear correlation coefficient
(r) of 0.98 was obtained.
Chemicals. BK, L-NMMA, and urethane were obtained from Sigma (Deisenhofen, Germany), and heparin was purchased from Hoffmann-LaRoche (Grenzau, Germany). All other reagents were obtained from Merck (Darmstadt, Germany). NO gas was obtained from AGA gas (Hamburg, Germany).
Data analysis. To compare control or basal values with those obtained during the different interventions, Student's t-test or one-way ANOVA followed by post hoc tests [least-significant difference (LSD) and Bonferroni as indicated] were employed as appropriate. A P value of <0.05 was considered to indicate a significant difference. All results are expressed as means ± SD.
| RESULTS |
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O2 of 10.7 ± 3.1
µmol O2 · min-1 · g-1.
In this model, coronary vasodilatation does not affect coronary flow (which
is held constant) but results in a fall in coronary perfusion pressure. This
is associated with a decrease in LVDP (the garden-hose phenomenon) and a
decline in M
O2 that is
independent of the mechanism of action of the vasodilator: adenosine-induced
maximal vasodilatation (1 µM, n = 17) caused a rapid decrease in
LVDP (-34 ± 9%) and an increase in coronary venous
PO2 by >30 mmHg due to a decrease in
M
O2 by 10.1 ± 3.6%
(see Fig. 1). Similarly,
intracoronary infusion of BK (10 µM, n = 17) caused a drop in
coronary perfusion pressure (-49%) that was associated with significant
decreases in LVDP (-22%) and
M
O2 (-6%). Finally,
papaverine (10 µM, n = 8) also decreased LVDP and
M
O2 to a comparable
extent (-34 ± 18% and -10.6 ± 4.2%, respectively).
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To eliminate this confounding factor, all further experiments were conducted in the presence of maximal vasodilatation (1 µM adenosine). As can be seen in Fig. 1, under these conditions, additional application of BK (n = 12) had no further effect on coronary venous PO2 (-6 ± 6 mmHg compared to adenosine) and thus O2 consumption. Neither did BK induce any additional changes in LVDP and coronary perfusion pressure.
To quantify the increase in NO formation induced by BK (10 µM) in our
experimental model, coronary venous
release was determined. Basal coronary venous
concentration was 22.8 ±
12.6 nM (Fig. 2). After
correction for the arterial
inflow
(13 nM), basal myocardial
release
was calculated to be 192 pmol · min-1 ·
g-1. BK induced a fivefold increase in
release to 960 pmol ·
min-1 · g-1, which translates into a coronary
venous effluent concentration of 66 nM
(Fig. 2).
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To test whether the basal formation of NO contributed to a tonic inhibition
of M
O2, NO synthesis was
blocked by L-NMMA (100 µM) again in the presence of maximal
vasodilatation (1 µM adenosine). Under these conditions, L-NMMA
induced small increases in coronary perfusion pressure (46.3 ± 3.6 vs.
44.6 ± 3.3 mmHg) and pressure development (43.8 ± 5.0 vs. 41.5
± 3.8 mmHg) but had no effect on coronary venous
PO2 and thus O2 consumption values, which
were 10.97 ± 2.15 µmol · min-1 ·
g-1 before and 10.74 ± 2.23
µmol·min-1·g-1 after NOS blockade by
L-NMMA (n = 6).
To finally obtain insight into the NO concentration necessary to
significantly inhibit mitochondrial oxidative phosphorylation and depress
cardiac contractile function and
M
O2, a
concentration-response curve for exogenously applied authentic NO was obtained
again in the presence of adenosine. As shown in
Fig. 3, in the concentration
range <2 µM, NO had no effect on either contractile function or
M
O2 (n = 9).
Only at concentrations >2 µM did NO impair contractile function and
decrease M
O2 in a
concentration-dependent manner (n = 6).
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| DISCUSSION |
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O2. When modulating NO
levels by arterial application of authentic NO, concentrations >2 µM NO
were required to induce a decrease in
M
O2, which is a
concentration three orders of magnitude higher than basal
release. Thus endogenous
endothelial NO formation does not regulate O2 consumption in this
model.
This conclusion is at variance with the postulate that endothelium-derived
NO tonically controls M
O2
(42). This view was initially
based on studies demonstrating (e.g., in dog hearts in vivo) an increase in
M
O2 upon blockade of NOS
(39). It was subsequently
supported by studies in myocardial tissue pieces (wet weight, 40 mg), in which
a reduction in M
O2 on BK
addition was consistently observed
(30,
31,
45). What could be the reason
for this discrepancy?
Insufficient stimulation of NO formation by BK in the present study can be
excluded: the BK concentration employed was 10-fold higher than the maximally
effective vasodilatory concentration in mice
(13) and was similar to that
used in other studies (30).
Moreover, in the present study, the BK-induced increase in
release (+400%), which is a
commonly used index of cardiac NO formation, by far exceeded that seen in
guinea pig hearts (27) or
canine coronary microvessels
(33), the latter being
sufficient to profoundly affect the
M
O2 of neighboring
myocardial tissue pieces (33).
Moreover, the basal release of
was
similar to the
and
release measured in vivo
(5).
An important difference, however, may have been the degree of tissue oxygenation: the saline-perfused mouse heart as established in our laboratory was well oxygenated. This is indicated by a high creatine phosphate concentration and low Pi and adenosine release, as well as its free energy of ATP hydrolysis (-63 kJ/mol; Refs. 12, 15). Its high rate of O2 consumption (10 µmol · min-1 · g-1) is in line with the high murine heart rate (500 min-1 in the present study). Although the coronary venous PO2 in this model was significantly higher than values in vivo, already a moderate decrease in O2 supply results in a substantial decrease in myocardial function and oxygenation (32), which indicates near-physiological conditions. In contrast, when studying O2 consumption in mouse myocardial tissue pieces, values of <0.2 µmol · min-1 · g-1 were reported (30, 33). This was possibly due to insufficient oxygenation at least in the tissue core, which would have rendered the pieces especially vulnerable to an increase in NO, because the inhibitory action of NO at cytochrome c oxidase is competitive with regard to O2 (28).
A BK-induced decrease in O2 consumption due to enhanced eNO
formation has not been seen in the heart in vivo to the best of our knowledge.
The lack of effect of BK in the present study under well-controlled conditions
despite a fivefold increase in endothelial NO formation therefore strongly
suggests that endothelial NO does not regulate
M
O2. One decisive factor
for the observed dissociation of endothelial NO formation and mitochondrial
oxidative phosphorylation is most likely the presence of high concentrations
of the potent NO scavenger myoglobin
(13) in cardiac tissue. This
is a major player in the spatial confinement of NO formed by different
isoforms (3) and constitutes a
safeguard to protect mitochondria from endothelial NO. Myoglobin-mediated NO
inactivation not only diminishes the bio-activity of endothelium-derived NO in
the control of mitochondrial respiration, it is most likely also this
degradation pathway that made the application of very high arterial NO
concentrations necessary to induce contractile dysfunction and a decline in
M
O2 in the present and
previous studies (10,
26). It cannot be excluded
that extracellular degradation of NO, facilitated by the relatively high
capillary PO2, results in a small decrease in the
effectively applied NO concentration (see Ref.
26). The intracellular
myoglobin-mediated NO inactivation may also explain why high levels of
myocardial iNOS overexpression increased
release but had little effect on
contractile function in a recent study
(20). In vivo, the
intravascular degradation of NO by hemoglobin will even further reduce the
myocardial effects of endothelium-derived NO.
In the present study, blockade of myocardial NO formation by
L-NMMA did not increase
M
O2. The concentration of
L-NMMA employed (100 µM) increased perfusion pressure
(13), decreased the
deleterious effects of NO in reperfusion
(12), and increased
O2 consumption in the guinea pig heart
(9) in previous studies of our
group, excluding insufficient enzyme inhibition. In fact, much lower
concentrations were employed by others in the field
(35). The lack of effect of
L-NMMA was in line with previous studies in wild-type murine
myocytes (24) and tissue
pieces (30). Also in humans
and pigs, NOS blockade had no effect on
M
O2
(41). In canine hearts,
contradictory effects were reported
(5,
8,
39,
40), whereas in guinea pigs,
inhibition of NO formation consistently increased
M
O2
(9). The recent observation
that enhanced expression of NOS in mitochondria [from dystrophin-deficient
(mdx) mice] reduces cellular O2 consumption
(24) may shed some light on
these potential species differences. We would like to suggest that the
species-dependent level of mitochondrial NO formation governs the relative
importance of NO in the control of mitochondrial respiration. In fact, the low
activity of NOS in porcine mitochondria recently reported
(14) is fully consistent with
the lack of effect of NOS inhibition in pigs
(11), whereas the functionally
active presence of NOS in guinea pig myocardial mitochondria
(22) complements our previous
observation of enhanced
M
O2 following NOS
blockade in guinea pig hearts
(9).
The study of the role of NO in the regulation of
M
O2 is complicated by the
fact that NO may influence energy demand and O2 consumption not
only on the level of the respiratory chain. NO modulates substrate uptake in
vivo thereby resulting either in decreased glucose uptake and metabolism
(36) or reduced fatty acid
uptake (37). Although this
NO-mediated effect would either increase or decrease O2
consumption, it does not play a role in the present study: glucose and
pyruvate were the only substrates provided, and pyruvate will inhibit the
mitochondrial metabolism of endogenous fatty acids. NO may modulate myocardial
contractile efficiency by unknown mechanisms
(21,
40). Furthermore, NO may
influence
-adrenergic signal transduction
(1,
16,
46; see also
34,
43), the directional effect
being dependent on the extent of the adrenergic stimulation. This results in
modulation of Ca2+ entry via voltage-gated Ca2+ channels
and of Ca2+ release from the sarcoplasmic reticulum. Whether NO
exerts a positive or negative inotropic effect in vivo appears to be
influenced also by the local NO concentration
(29), and the subcellular
localization of NOS isoforms will play a significant role in this regard
(3). However, the physiological
relevance of these effects is still under debate
(6,
43). The lack of a functional
effect of increasing the endothelial production of NO or blocking NO formation
in this study indicates a minor role of these regulatory pathways in the
present model. It is thus well suited for studying the control of
mitochondrial oxidative phosphorylation by endothelium-derived NO in the
intact heart.
In the well-oxygenated saline-perfused murine heart, we found no evidence
for the control of cardiac respiration by endothelium-derived NO. In view of
the subcellular localization of different NOSs in the myocardium (e.g., see
Ref. 3) and the potent
inactivation of NO by myoglobin
(13), a direct endothelial
control of the mitochondrial oxidative phosphorylation of the myocytes appears
to be highly unlikely. We propose that the sometimes contradictory effects of
NOS inhibition on M
O2
reported in the literature do not only reflect a variability of endothelial NO
formation but may be also be due to differences in substrate selection and
local NO formation, e.g., in the vicinity of sarcoplasmic reticula or caveolae
or in mitochondria.
| ACKNOWLEDGMENTS |
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This work was supported by the Deutsche Forschungsgemeinschaft (DFG De 487/4-1) and the Center for Biological and Medical Research (Biomedizinisches Forschungszentrum) of the Heinrich-Heine-University Düsseldorf.
| FOOTNOTES |
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The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Present address of Z. Z. Kojic: Department of Physiology, School of Medicine, University of Belgrade, Visegradska 26/II, 11000 Belgrade, Serbia.
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