P-590: Obesity regulates renal endothelin and endothelin ETA receptor expression in vivo. Differential effects of chronic ETA receptor blockade

ETA receptors have been implicated in obesity-associated hypertension (Hypertension 1999; 33: 1169). We characterized the renal endothelin system in diet-induced obesity and determined the effects of chronic treatment with the ETA antagonist darusentan. C57BL/6J mice were fed a standard diet (control) or a high-fat diet (Harlan TD88137) with or without darusentan (50 mg/kg/d, 30 wk). Total RNA was extracted from whole kidneys and mRNA expression of preproendothelin-1 (ppET-1), ETA receptors, and β-actin were determined by RT-PCR using mouse-specific primers. PCR-products were normalized vs. β-actin or 18S rRNA. Renal ET-1 protein was measured by RIA/HPLC. High fat diet increased body weight by 257% compared to 54% (control diet). Darusentan had no effect on body weight in obese mice (263%) and treatments had no effect on systolic blood pressure. Obesity was associated with upregulation of renal ETA receptors (144±5% vs 100±7%, p<0.05 vs. control) and to a lesser extent, preproendothelin-1 (113±5% vs.100±2%, p<0.05 vs. control). In obese mice chronic darusentan treatment in part prevented the ETA receptor upregulation (126% vs. 144±5%, p<0.05) but had no significant effect on ppET-1 mRNA expression (101±9 vs. 100±2%, n.s.). Renal ET-1 protein increased in obese animals (from 190±18 to 267±19 pg/g tissue, p<0.05 vs. control). This increase was not affected by concomitant darusentan treatment (n.s.). These data for the first time demonstrate that obesity in normotensive rats is associated with upregulation of renal ETA receptor expression suggesting that body weight per se affects ET receptor expression in the kidney. Our data further indicate that in this model ETA receptors control expression of the ETA receptor but not the ppET-1 gene, suggesting autocrine regulation in vivo. These mechanisms might contribute to the pathogenesis of obesity-associated diseases affecting the kidney and/or blood pressur

Caffeine Impairs Myocardial Blood Flow Response to Physical Exercise in Patients with Coronary Artery Disease as well as in Age-Matched Controls

BACKGROUND: Caffeine is one of the most widely consumed pharmacologically active substances. Its acute effect on myocardial blood flow is widely unknown. Our aim was to assess the acute effect of caffeine in a dose corresponding to two cups of coffee on myocardial blood flow (MBF) in coronary artery disease (CAD). METHODOLOGY/PRINCIPAL FINDINGS: MBF was measured with (15)O-labelled H2O and Positron Emission Tomography (PET) at rest and after supine bicycle exercise in controls (n = 15, mean age 58+/-13 years) and in CAD patients (n = 15, mean age 61+/-9 years). In the latter, regional MBF was assessed in segments subtended by stenotic and remote coronary arteries. All measurements were repeated fifty minutes after oral caffeine ingestion (200 mg). Myocardial perfusion reserve (MPR) was calculated as ratio of MBF during bicycle stress divided by MBF at rest. Resting MBF was not affected by caffeine in both groups. Exercise-induced MBF response decreased significantly after caffeine in controls (2.26+/-0.56 vs. 2.02+/-0.56, P<0.005), remote (2.40+/-0.70 vs. 1.78+/-0.46, P<0.001) and in stenotic segments (1.90+/-0.41 vs. 1.38+/-0.30, P<0.001). Caffeine decreased MPR significantly by 14% in controls (P<0.05 vs. baseline). In CAD patients MPR decreased by 18% (P<0.05 vs. baseline) in remote and by 25% in stenotic segments (P<0.01 vs. baseline). CONCLUSIONS: We conclude that caffeine impairs exercise-induced hyperaemic MBF response in patients with CAD to a greater degree than age-matched controls

Hemodynamics.

<p>DBP = diastolic blood pressure (BP); HR = heart rate; MAP = mean BP; RPP = rate pressure product; SBP = systolic BP.</p><p>P-values are given for the comparison of baseline vs. caffeine.</p

Exercise-induced hyperemia: effects of caffeine.

<p>Caffeine decreases exercise-induced hyperaemic MBF. This effect was most prominent in stenotic segments of CAD patients. *<i>P</i><0.005 for the comparison versus baseline.</p

Myocardial Blood Flow, Coronary Resistance and Flow Reserve.

<p>MBF, myocardial blood flow (ml/min/g). Cor Res, coronary resistance (mmHg/ml/min/g). MPR, myocardial perfusion reserve (relative values). Ex, exercise.</p>*<p>P<0.05 for the comparison with remote segments.</p>†<p>P<0.05 for the comparison with age-matched controls.</p

Coronary resistance during physical exercise.

<p>Coronary resistance at exercise increased in all groups. A massive increase in resistance was found in stenotic segments. ‡<i>P</i><0.05 for the comparison versus remote. *<i>P</i><0.05 for the comparison versus remote segments and age-matched controls.</p

Myocardial perfusion reserve: effects of caffeine.

<p>Caffeine decreases myocardial perfusion reserve. This effect was most pronounced in stenotic segments of CAD patients. *<i>P</i><0.05 for the comparison versus baseline.</p