Skip to main content
Log in

Renal Revascularization Attenuates Myocardial Mitochondrial Damage and Improves Diastolic Function in Pigs with Metabolic Syndrome and Renovascular Hypertension

  • Original Article
  • Published:
Journal of Cardiovascular Translational Research Aims and scope Submit manuscript

Abstract

Percutaneous transluminal renal angioplasty (PTRA) may improve cardiac function in renovascular hypertension (RVH), but its effect on the biological mechanisms implicated in cardiac damage remains unknown. We hypothesized that restoration of kidney function by PTRA ameliorates myocardial mitochondrial damage and preserves cardiac function in pigs with metabolic syndrome (MetS) and RVH. Pigs were studied after 16 weeks of MetS+RVH, MetS+RVH treated 4 weeks earlier with PTRA, and Lean and MetS Sham controls (n=6 each). Cardiac function was assessed by multi-detector CT, whereas cardiac mitochondrial morphology and function, microvascular remodeling, and injury pathways were assessed ex vivo. PTRA attenuated myocardial mitochondrial damage, improved capillary and microvascular maturity, and ameliorated oxidative stress and fibrosis, in association with attenuation of left ventricular remodeling and diastolic dysfunction. Myocardial mitochondrial damage correlated with myocardial injury and renal dysfunction. Preservation of myocardial mitochondria with PTRA can enhance cardiac recovery, underscoring its therapeutic potential in experimental MetS+RVH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

RVH:

Renovascular hypertension

MetS:

Metabolic syndrome

PTRA:

Percutaneous transluminal renal angioplasty

ATP:

Adenosine triphosphate

ROS:

Reactive oxygen species

LV:

Left ventricular

PRA:

Plasma renin activity

MCP:

Monocyte chemoattractant protein

IL:

Interleukin

NT-proBNP:

N-terminal pro-brain natriuretic peptide

MDCT:

Multi-detector computed tomography

LVMM:

LV muscle mass

LA:

Left atrium

RBF:

Renal blood flow

GFR:

Glomerular filtration rate

H202 :

Hydrogen peroxide

COX-IV:

Cytochrome-c oxidase

DHE:

Dihydroethidium

WGA:

Wheat germ agglutinin

EDV:

End-diastolic volume

References

  1. Herrmann, S. M., & Textor, S. C. (2019). Renovascular hypertension. Endocrinol Metab Clin N Am, 48(4), 765–778.

    Article  Google Scholar 

  2. Green, D., Kalra, P. A., & The heart in atherosclerotic renovascular disease. (2012). Front Biosci (Elite Ed), 4, 856–864.

    Google Scholar 

  3. Textor, S. C., & Lerman, L. O. (2015). Paradigm shifts in atherosclerotic renovascular disease: Where are we now? J Am Soc Nephrol, 26(9), 2074–2080.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kane, G. C., et al. (2010). Renal artery revascularization improves heart failure control in patients with atherosclerotic renal artery stenosis. Nephrol Dial Transplant, 25(3), 813–820.

    Article  PubMed  Google Scholar 

  5. Holmuhamedov, E. L., et al. (2012). Cardiac subsarcolemmal and interfibrillar mitochondria display distinct responsiveness to protection by diazoxide. PLoS One, 7(9), e44667.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Duchen, M. R. (2004). Mitochondria in health and disease: Perspectives on a new mitochondrial biology. Mol Asp Med, 25(4), 365–451.

    Article  CAS  Google Scholar 

  7. Yuan, F., et al. (2018). Mitochondrial targeted peptides preserve mitochondrial organization and decrease reversible myocardial changes in early swine metabolic syndrome. Cardiovasc Res, 114(3), 431–442.

    Article  CAS  PubMed  Google Scholar 

  8. Yuan, F., et al. (2018). Mitoprotection attenuates myocardial vascular impairment in porcine metabolic syndrome. Am J Physiol Heart Circ Physiol, 314(3), H669–H680.

    PubMed  Google Scholar 

  9. Eirin, A., et al. (2016). Restoration of mitochondrial cardiolipin attenuates cardiac damage in swine renovascular hypertension. J Am Heart Assoc, 5(6).

  10. Aghajani Nargesi, A., et al. (2020). Renovascular hypertension induces myocardial mitochondrial damage, contributing to cardiac injury and dysfunction in pigs with metabolic syndrome. Am J Hypertens.

  11. Eirin, A., et al. (2018). Mesenchymal stem cell-derived extracellular vesicles improve the renal microvasculature in metabolic renovascular disease in swine. Cell Transplant, 27(7), 1080–1095.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Eirin, A., et al. (2017). Mesenchymal stem cell-derived extracellular vesicles attenuate kidney inflammation. Kidney Int, 92(1), 114–124.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Nargesi, A. A., et al. (2019). Coexisting renal artery stenosis and metabolic syndrome magnifies mitochondrial damage, aggravating poststenotic kidney injury in pigs. J Hypertens, 37(10), 2061–2073.

    Article  CAS  PubMed  Google Scholar 

  14. Farahani, R. A., et al. (2020). Percutaneous transluminal renal angioplasty attenuates poststenotic kidney mitochondrial damage in pigs with renal artery stenosis and metabolic syndrome. J Cell Physiol.

  15. Pawar, A. S., et al. (2015). Adipose tissue remodeling in a novel domestic porcine model of diet-induced obesity. Obesity (Silver Spring), 23(2), 399–407.

    Article  CAS  Google Scholar 

  16. Lerman, L. O., et al. (1999). Noninvasive evaluation of a novel swine model of renal artery stenosis. J Am Soc Nephrol, 10(7), 1455–1465.

    Article  CAS  PubMed  Google Scholar 

  17. Eirin, A., et al. (2012). A mitochondrial permeability transition pore inhibitor improves renal outcomes after revascularization in experimental atherosclerotic renal artery stenosis. Hypertension, 60(5), 1242–1249.

    Article  CAS  PubMed  Google Scholar 

  18. Eirin, A., et al. (2011). Persistent kidney dysfunction in swine renal artery stenosis correlates with outer cortical microvascular remodeling. Am J Physiol Ren Physiol, 300(6), F1394–F1401.

    Article  CAS  Google Scholar 

  19. Eirin, A., et al. (2012). Adipose tissue-derived mesenchymal stem cells improve revascularization outcomes to restore renal function in swine atherosclerotic renal artery stenosis. Stem Cells, 30(5), 1030–1041.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Eirin, A., et al. (2012). Changes in glomerular filtration rate after renal revascularization correlate with microvascular hemodynamics and inflammation in Swine renal artery stenosis. Circ Cardiovasc Interv, 5(5), 720–728.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Eirin, A., et al. (2015). Intra-renal delivery of mesenchymal stem cells attenuates myocardial injury after reversal of hypertension in porcine renovascular disease. Stem Cell Res Ther, 6, 7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rodriguez-Porcel, M., et al. (2004). Long-term antioxidant intervention improves myocardial microvascular function in experimental hypertension. Hypertension, 43(2), 493–498.

    Article  CAS  PubMed  Google Scholar 

  23. Zhu, X. Y., et al. (2007). Simvastatin prevents coronary microvascular remodeling in renovascular hypertensive pigs. J Am Soc Nephrol, 18(4), 1209–1217.

    Article  CAS  PubMed  Google Scholar 

  24. Krier, J. D., et al. (2001). Noninvasive measurement of concurrent single-kidney perfusion, glomerular filtration, and tubular function. Am J Physiol Ren Physiol, 281(4), F630–F638.

    Article  CAS  Google Scholar 

  25. Eirin, A., et al. (2016). Urinary mitochondrial DNA copy number identifies chronic renal injury in hypertensive patients. Hypertension, 68(2), 401–410.

    Article  CAS  PubMed  Google Scholar 

  26. Pi, J., et al. (2007). Reactive oxygen species as a signal in glucose-stimulated insulin secretion. Diabetes, 56(7), 1783–1791.

    Article  CAS  PubMed  Google Scholar 

  27. Eirin, A., et al. (2014). Mitochondrial targeted peptides attenuate residual myocardial damage after reversal of experimental renovascular hypertension. J Hypertens, 32(1), 154–165.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Conlon, P. J., et al. (2001). Severity of renal vascular disease predicts mortality in patients undergoing coronary angiography. Kidney Int, 60(4), 1490–1497.

    Article  CAS  PubMed  Google Scholar 

  29. Wright, J. R., et al. (2005). Left ventricular morphology and function in patients with atherosclerotic renovascular disease. J Am Soc Nephrol, 16(9), 2746–2753.

    Article  PubMed  Google Scholar 

  30. Cooper, C. J., et al. (2014). Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med, 370(1), 13–22.

    Article  CAS  PubMed  Google Scholar 

  31. Ritchie, J., et al. (2014). High-risk clinical presentations in atherosclerotic renovascular disease: Prognosis and response to renal artery revascularization. Am J Kidney Dis, 63(2), 186–197.

    Article  PubMed  Google Scholar 

  32. Hollander, J. M., Thapa, D., & Shepherd, D. L. (2014). Physiological and structural differences in spatially distinct subpopulations of cardiac mitochondria: influence of cardiac pathologies. Am J Physiol Heart Circ Physiol, 307(1), H1–H14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Wong, H. S., et al. (2017). Production of superoxide and hydrogen peroxide from specific mitochondrial sites under different bioenergetic conditions. J Biol Chem, 292(41), 16804–16809.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Li, Y., et al. (2006). Cytochrome c oxidase subunit IV is essential for assembly and respiratory function of the enzyme complex. J Bioenerg Biomembr, 38(5-6), 283–291.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Bao, L., et al. (2009). Mitochondria are the source of hydrogen peroxide for dynamic brain-cell signaling. J Neurosci, 29(28), 9002–9010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Kluge, M. A., Fetterman, J. L., & Vita, J. A. (2013). Mitochondria and endothelial function. Circ Res, 112(8), 1171–1188.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Ahmad, A., et al. (2020). Coronary microvascular dysfunction is associated with exertional haemodynamic abnormalities in patients with heart failure with preserved ejection fraction. Eur J Heart Fail.

  38. Zhao, W., et al. (2008). Oxidative stress mediates cardiac fibrosis by enhancing transforming growth factor-beta1 in hypertensive rats. Mol Cell Biochem, 317(1-2), 43–50.

    Article  CAS  PubMed  Google Scholar 

  39. Eirin, A., et al. (2013). Endothelial outgrowth cells shift macrophage phenotype and improve kidney viability in swine renal artery stenosis. Arterioscler Thromb Vasc Biol, 33(5), 1006–1013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Lerman, L. O., et al. (2001). Increased oxidative stress in experimental renovascular hypertension. Hypertension, 37(2 Pt 2), 541–546.

    Article  CAS  PubMed  Google Scholar 

  41. Wilson, S. H., et al. (1999). Enhanced coronary vasoconstriction to oxidative stress product, 8-epi-prostaglandinF2 alpha, in experimental hypercholesterolemia. Cardiovasc Res, 44(3), 601–607.

    Article  CAS  PubMed  Google Scholar 

  42. Zhang, L., et al. (2020). Selective intrarenal delivery of mesenchymal stem cell-derived extracellular vesicles attenuates myocardial injury in experimental metabolic renovascular disease. Basic Res Cardiol, 115(2), 16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Eirin, A., et al. (2013). Inflammatory and injury signals released from the post-stenotic human kidney. Eur Heart J, 34(7), 540–548a.

    Article  CAS  PubMed  Google Scholar 

  44. Urbieta-Caceres, V. H., et al. (2012). Selective improvement in renal function preserved remote myocardial microvascular integrity and architecture in experimental renovascular disease. Atherosclerosis, 221(2), 350–358.

    Article  CAS  PubMed  Google Scholar 

  45. Tapuria, N., et al. (2008). Remote ischemic preconditioning: A novel protective method from ischemia reperfusion injury--a review. J Surg Res, 150(2), 304–330.

    Article  PubMed  Google Scholar 

  46. Mangalat, D., et al. (2009). Value of cardiac CT in patients with heart failure. Curr Cardiovasc Imaging Rep, 2(6), 410–417.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Pipinos, I. I., et al. (1998). Response to angiotensin inhibition in rats with sustained renovascular hypertension correlates with response to removing renal artery stenosis. J Vasc Surg, 28(1), 167–177.

    Article  CAS  PubMed  Google Scholar 

  48. Safian, R. D., & Madder, R. D. (2009). Refining the approach to renal artery revascularization. JACC Cardiovasc Interv, 2(3), 161–174.

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the NIH grants: DK122137, DK104273, DK120292, HL095638, DK118120, and DK102325.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alfonso Eirin.

Ethics declarations

Ethics Approval

This article does not contain any studies with human participants. All animal studies were approved by the Mayo Clinic Animal Care and Use Committee.

Conflict of Interest

The authors declare no competing interests.

Additional information

Associate Editor Nicola Smart oversaw the review of this article

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(PDF 1090 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farahani, R.A., Yu, S., Ferguson, C.M. et al. Renal Revascularization Attenuates Myocardial Mitochondrial Damage and Improves Diastolic Function in Pigs with Metabolic Syndrome and Renovascular Hypertension. J. of Cardiovasc. Trans. Res. 15, 15–26 (2022). https://doi.org/10.1007/s12265-021-10155-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12265-021-10155-3

Keywords

Navigation