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Impact of Perinatal Chronic Hypoxia on Cardiac Tolerance to Acute Ischemia

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Molecular Defects in Cardiovascular Disease

Abstract

Perinatal period is critical for the normal cardiac development, and different interventions imposed on the heart may significantly influence myocardial structure and function. Perinatal hypoxemia, although transient, may thus have serious early and late consequences on the cardiovascular system. Epidemiological and experimental studies have repeatedly suggested a possible link between perinatal hypoxia and increased sensitivity to ischemia/reperfusion (I/R) injury in adults. The mechanisms of this increased susceptibility are not known at present. It has been found that prenatal chronic hypoxia sensitizes the apoptosis pathway in the adult male heart in response to I/R stimulation. In addition, cardiac heat shock proteins (Hsp) 70 expression was significantly lower in prenatal hypoxic hearts than in controls; this fact may play a role in the increased susceptibility of the adult heart to I/R injury. The decreased eNOS levels in adult prenatal hypoxic hearts may also contribute to their increased sensitivity. These studies suggest that chronic hypoxic exposure during early development may cause in utero or neonatal programming of several genes which can play an important role in the increased susceptibility of the adult male heart to I/R injury. Furthermore, it has been observed in the rat model that late myocardial effects of chronic hypoxia, experienced in early life, may be sex-dependent. Unlike in males, perinatal exposure to chronic hypoxia significantly increased cardiac tolerance to acute I/R injury in adult females, expressed as the lower incidence of ischemic arrhythmias, decreased infarct size, decreased cardiac enzyme release, and increased postischemic recovery of left ventricular function. It was suggested that these sex-dependent changes may be due to differences in fetal programming of PKCε gene expression, which play a pivotal role in cardioprotection; down-regulation of PKCε function was observed in the hearts of adult male offspring only. These results would have important clinical implications, since cardiac sensitivity to oxygen deprivation in adult patients may be significantly influenced by perinatal hypoxia in a sex-dependent manner.

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Acknowledgments

This study was supported by grants MSMT 1 M0510 and AVOZ 50110509.

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Authors and Affiliations

  1. Centre for Cardiovascular Research, Prague, Czech Republic

    Bohuslav Ostadal & I. Netuka

  2. Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic

    Bohuslav Ostadal, I. Ostadalova & F. Kolar

  3. Centre for Cardiovascular Research, Academy of Sciences of the Czech Republic, Prague, Czech Republic

    I. Ostadalova & F. Kolar

  4. Institute for Clinical and Experimental Medicine, Prague, Czech Republic

    I. Netuka

  5. Centre for Cardiovascular Research, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

    O. Szarszoi

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  1. Bohuslav Ostadal
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  2. I. Ostadalova
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  3. F. Kolar
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  4. I. Netuka
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  5. O. Szarszoi
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Correspondence to Bohuslav Ostadal .

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Editors and Affiliations

  1. St. Boniface General Hospital, Research Centre, Institute of Cardiovascular Sciences, Tache Avenue 351, Winnipeg, R2H 2A6, Manitoba, Canada

    Naranjan S. Dhalla

  2. Jikei University School of Medicine, Shibuya-ku, Ebisu 3-31-6, Tokyo, 150-0013, Japan

    Makoto Nagano

  3. Czech Republic, Institute of Physiology, Academy of Sciences of the, Videnska 1083, Prague, 142 20, Czech Republic

    Bohuslav Ostadal

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Ostadal, B., Ostadalova, I., Kolar, F., Netuka, I., Szarszoi, O. (2011). Impact of Perinatal Chronic Hypoxia on Cardiac Tolerance to Acute Ischemia. In: Dhalla, N., Nagano, M., Ostadal, B. (eds) Molecular Defects in Cardiovascular Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7130-2_5

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