Obesity improves myocardial ischaemic tolerance and RISK signalling in insulin-insensitive rats

Obesity with associated metabolic disturbances worsens ischaemic heart disease outcomes, and rodent studies confirm that obesity with insulin-resistance impairs myocardial resistance to ischemia-reperfusion (I-R) injury. However, the effects of obesity per se are unclear, with some evidence for paradoxic cardioprotection (particularly in older subjects). We tested the impact of dietary obesity on I-R tolerance and reperfusion injury salvage kinase (RISK) signalling in hearts from middle-aged (10 months old) insulin-insensitive rats. Hearts from Wistar rats on either a 32-week control (CD) or high carbohydrate obesogenic (OB) diet were assessed for I-R resistance in vivo (45 minutes left anterior descending artery occlusion and 120 minutes reperfusion) and ex vivo (25 minutes ischemia and 60 minutes reperfusion). Expression and d-opioid receptor (d-OR) phospho-regulation of pro-survival (Akt/PKB, Erk1/2, eNOS) and pro-injury (GSK3ߩ enzymes were also examined. OB rats were heavier (764Ჵ versus 657Ჲ g for CD; P<0.05), hyperleptinaemic (11.1ᰮ7 versus 5.0ᰮ7 for CD; P<0.01) and comparably insulin-insensitive (HOMA-IR of 63.2ᳮ3 versus 63.2ᱮ6 for CD). In vivo infarction was more than halved in OB (20᳥) versus CD rats (45ᶥ P<0.05), as was post-ischaemic lactate dehydrogenase efflux (0.4ᰮ3 mU/ml versus 5.6ᰮ5 mU/ml; P<0.02) and ex vivo contractile dysfunction (62Ქ versus 44ᶥ recovery of ventricular force; P