Volume 30, Issue 2 pp. 218-223
Original Article

Atorvastatin Regulates Apoptosis in Chronically Ischemic Myocardium

Ashraf A. Sabe M.D.

Ashraf A. Sabe M.D.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Nassrene Y. Elmadhun M.D.

Nassrene Y. Elmadhun M.D.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Ahmed A. Sadek B.S.

Ahmed A. Sadek B.S.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Rahul S. Dalal B.S.

Rahul S. Dalal B.S.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Louis M. Chu M.D.

Louis M. Chu M.D.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Cesario Bianchi M.D., Ph.D.

Cesario Bianchi M.D., Ph.D.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

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Frank W. Sellke M.D.

Corresponding Author

Frank W. Sellke M.D.

Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island

Address for correspondence: Frank W. Sellke, MD, Division of Cardiothoracic Surgery, Cardiovascular Research Center, Warren Alpert Medical School of Brown University, 2 Dudley Street, MOC 360, Providence, RI 02905. Fax: (401) 444-2380; e-mail: [email protected]

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First published: 16 December 2014
Citations: 4
All authors listed have contributed to the conception and design, analysis and interpretation, data collection, and writing/critical revision of this manuscript.
Disclosures: Dr. Sellke is a consultant for CSL Behring

Abstract

Background

We previously demonstrated that atorvastatin upregulates proangiogenic proteins and increases arteriolar density in ischemic myocardium. Despite this, there was a lack of collateral-dependent perfusion, possibly related to apoptosis. We utilized a swine model of metabolic syndrome and chronic myocardial ischemia to investigate the effects of atorvastatin on apoptosis.

Materials and methods

Sixteen Ossabaw miniswine were fed a high-cholesterol diet for 14 weeks then underwent surgical placement of an ameroid constrictor to their circumflex artery inducing chronic ischemia. Eight pigs additionally received supplemental atorvastatin (1.5 mg/kg daily). Myocardium was harvested six months later for western blotting and TUNEL staining.

Results

Animals supplemented with atorvastatin had significant increases in markers associated with apoptosis including p-38, BAX, and caspase 3 (p < 0.05). Atorvastatin supplementation also resulted in significant increases in expression of cell survival proteins Bcl-2 and P-ERK and an overall decrease in apoptosis demonstrated by TUNEL staining (p < 0.05).

Conclusions

Atorvastatin acts on multiple pathways and its effects on angiogenesis remain unclear. Although there is increased expression in several markers of apoptosis, key anti-apoptotic proteins were also upregulated with an overall decrease in apoptosis. Further investigation of these pathways may provide insight into the role of statins on myocardial protection after ischemia. doi: 10.1111/jocs.12488 (J Card Surg 2015;30:218–223)

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