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Circulation. 1999;100:292-298

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Right arrow Heart failure - basic studies
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(Circulation. 1999;100:292-298.)
© 1999 American Heart Association, Inc.


Basic Science Reports

Endothelial Dysfunction in Chronic Myocardial Infarction Despite Increased Vascular Endothelial Nitric Oxide Synthase and Soluble Guanylate Cyclase Expression

Role of Enhanced Vascular Superoxide Production

Johann Bauersachs, MD; Anne Bouloumié, PhD; Daniela Fraccarollo, PhD; Kai Hu, MD; Rudi Busse, MD, PhD; Georg Ertl, MD

From the II. Medizinische Klinik, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, and Institut für Kardiovaskuläre Physiologie, Klinikum der J.W. Goethe-Universität, Frankfurt am Main (A.B., R.B.), Germany.

Correspondence to Dr Johann Bauersachs, II. Medizinische Klinik, Klinikum, Theodor-Kutzer-Ufer, D-68135 Mannheim, Germany. E-mail johann.bauersachs{at}med2.ma.uni-heidelberg.de

Background—Endothelial dysfunction of the peripheral vasculature is a well-known phenomenon in congestive heart failure that contributes to the elevated peripheral resistance; however, the underlying mechanisms have not yet been clarified.

Methods and Results—Dilator responses, the expression of protein and mRNA of the endothelial nitric oxide synthase (eNOS), inducible NOS (iNOS), and soluble guanylate cyclase (sGC), and superoxide anion (O2-) and peroxynitrite production were determined in aortic rings from Wistar rats 8 weeks after myocardial infarction and compared with those in sham-operated animals. In rats with heart failure, the concentration-response curve of the endothelium-dependent vasodilator acetylcholine (after preconstriction with phenylephrine) was significantly shifted to the right, and the maximum relaxation was attenuated. Determination of expression levels of the 2 key enzymes for NO-mediated dilations, eNOS and sGC, revealed a marked upregulation of both enzymes in aortas from rats with heart failure, whereas iNOS expression was not changed. Pretreatment with exogenous superoxide dismutase partially restored the acetylcholine-induced relaxation in aortas from rats with heart failure. Aortic basal and NADH-stimulated O2- production assessed by use of lucigenin-enhanced chemiluminescence was significantly elevated in rats with chronic myocardial infarction. Peroxynitrite-mediated nitration of protein tyrosine residues was not different between the 2 groups of rats.

Conclusions—These results demonstrate that endothelial dysfunction in ischemic heart failure occurs despite an enhanced vascular eNOS and sGC expression and can be attributed to an increase in vascular O2- production by an NADH-dependent oxidase. By inactivation of NO, O2- production appears to be an essential mechanism for the endothelial dysfunction observed in heart failure.


Key Words: endothelium • endothelium-derived factors • myocardial infarction • heart failure • free radicals




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CirculationHome page
K. Fukuo, J. Yang, O. Yasuda, M. Mogi, T. Suhara, N. Sato, T. Suzuki, S. Morimoto, and T. Ogihara
Nifedipine Indirectly Upregulates Superoxide Dismutase Expression in Endothelial Cells via Vascular Smooth Muscle Cell-Dependent Pathways
Circulation, July 16, 2002; 106(3): 356 - 361.
[Abstract] [Full Text] [PDF]


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CirculationHome page
U. Landmesser and H. Drexler
Allopurinol and Endothelial Function in Heart Failure: Future or Fantasy?
Circulation, July 9, 2002; 106(2): 173 - 175.
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Am. J. Physiol. Heart Circ. Physiol.Home page
J. H. Traverse, Y. Chen, M. Hou, and R. J. Bache
Inhibition of NO production increases myocardial blood flow and oxygen consumption in congestive heart failure
Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2278 - H2283.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. Ahmad, Y. Zhang, Y. Zhang, C. Papharalambus, and R. W. Alexander
Role of Isoprenylcysteine Carboxyl Methyltransferase in Tumor Necrosis Factor-{alpha} Stimulation of Expression of Vascular Cell Adhesion Molecule-1 in Endothelial Cells
Arterioscler Thromb Vasc Biol, May 1, 2002; 22(5): 759 - 764.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
L. Sanchez de Miguel, M. a M. Arriero, J. Farre, P. Jimenez, A. Garcia-Mendez, T. de Frutos, A. Jimenez, R. Garcia, F. Cabestrero, J. Gomez, et al.
Nitric oxide production by neutrophils obtained from patients during acute coronary syndromes: expression of the nitric oxide synthase isoforms
J. Am. Coll. Cardiol., March 6, 2002; 39(5): 818 - 825.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
J. Bauersachs, M. Heck, D. Fraccarollo, S. K. Hildemann, G. Ertl, M. Wehling, and M. Christ
Addition of spironolactone to angiotensin-converting enzyme inhibition in heart failure improves endothelial vasomotor dysfunction: Role of vascular superoxide anion formation and endothelial nitric oxide synthase expression
J. Am. Coll. Cardiol., January 16, 2002; 39(2): 351 - 358.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
J. A. Wagner, K. Hu, J. Bauersachs, J. Karcher, M. Wiesler, S. K. Goparaju, G. Kunos, and G. Ertl
Endogenous cannabinoids mediate hypotension after experimental myocardial infarction
J. Am. Coll. Cardiol., December 1, 2001; 38(7): 2048 - 2054.
[Abstract] [Full Text] [PDF]


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Eur J Heart FailHome page
M. de Lorgeril, P. Salen, M. Accominotti, M. Cadau, J.-P. Steghens, F. Boucher, and J. de Leiris
Dietary and blood antioxidants in patients with chronic heart failure. Insights into the potential importance of selenium in heart failure
Eur J Heart Fail, December 1, 2001; 3(6): 661 - 669.
[Abstract] [Full Text] [PDF]


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J. Am. Soc. Nephrol.Home page
M. Marques, I. Millas, A. Jimenez, E. Garcia-Colis, J. A. Rodriguez-Feo, S. Velasco, A. Barrientos, S. Casado, and A. Lopez-Farre
Alteration of the Soluble Guanylate Cyclase System in the Vascular Wall of Lead-Induced Hypertension in Rats
J. Am. Soc. Nephrol., December 1, 2001; 12(12): 2594 - 2600.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
R. Nakamura, K. Egashira, K. Arimura, Y. Machida, T. Ide, H. Tsutsui, H. Shimokawa, and A. Takeshita
Increased inactivation of nitric oxide is involved in impaired coronary flow reserve in heart failure
Am J Physiol Heart Circ Physiol, December 1, 2001; 281(6): H2619 - H2625.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
G. Wiemer, G. Itter, T. Malinski, and W. Linz
Decreased Nitric Oxide Availability in Normotensive and Hypertensive Rats With Failing Hearts After Myocardial Infarction
Hypertension, December 1, 2001; 38(6): 1367 - 1371.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
G. F. Mitchell, J.-C. Tardif, J. M. O. Arnold, G. Marchiori, T. X. O'Brien, M. E. Dunlap, and M. A. Pfeffer
Pulsatile Hemodynamics in Congestive Heart Failure
Hypertension, December 1, 2001; 38(6): 1433 - 1439.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. M. Wildhirt, M. Weis, C. Schulze, N. Conrad, S. Pehlivanli, G. Rieder, G. Enders, W. von Scheidt, and B. Reichart
Expression of Endomyocardial Nitric Oxide Synthase and Coronary Endothelial Function in Human Cardiac Allografts
Circulation, September 18, 2001; 104 (2009): I-336 - I-343.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
J. Bauersachs, I. Fleming, D. Fraccarollo, R. Busse, and G. Ertl
Prevention of endothelial dysfunction in heart failure by vitamin E: Attenuation of vascular superoxide anion formation and increase in soluble guanylyl cyclase expression
Cardiovasc Res, August 1, 2001; 51(2): 344 - 350.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
P. V. Ennezat, S. L. Malendowicz, M. Testa, P. C. Colombo, A. Cohen-Solal, T. Evans, and T. H. LeJemtel
Physical training in patients with chronic heart failure enhances the expression of genes encoding antioxidative enzymes
J. Am. Coll. Cardiol., July 1, 2001; 38(1): 194 - 198.
[Abstract] [Full Text] [PDF]


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Eur. J. Cardiothorac. Surg.Home page
S. M. Wildhirt, M. Weis, C. Schulze, N. Conrad, S. Pehlivanli, G. Rieder, G. Enders, W. von Scheidt, and B. Reichart
Coronary flow reserve and nitric oxide synthases after cardiac transplantation in humans
Eur. J. Cardiothorac. Surg., June 1, 2001; 19(6): 840 - 847.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Mulsch, M. Oelze, S. Kloss, H. Mollnau, A. Topfer, A. Smolenski, U. Walter, J.-P. Stasch, A. Warnholtz, U. Hink, et al.
Effects of In Vivo Nitroglycerin Treatment on Activity and Expression of the Guanylyl Cyclase and cGMP-Dependent Protein Kinase and Their Downstream Target Vasodilator-Stimulated Phosphoprotein in Aorta
Circulation, May 1, 2001; 103(17): 2188 - 2194.
[Abstract] [Full Text] [PDF]


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Journal of Renin-Angiotensin-Aldosterone SystemHome page
L. J Wagenaar, H. Buikema, Y. M Pinto, and W. H van Gilst
Improvement of endothelial dysfunction in experimental heart failure by chronic RAAS-blockade: ACE-inhibition or AT1-receptor blockade?
Journal of Renin-Angiotensin-Aldosterone System, March 1, 2001; 2(1_suppl): S64 - S69.
[Abstract] [PDF]


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Cardiovasc ResHome page
A.C. Mendes Ribeiro, T.M.C. Brunini, J.C. Ellory, and G.E. Mann
Abnormalities in L-arginine transport and nitric oxide biosynthesis in chronic renal and heart failure
Cardiovasc Res, March 1, 2001; 49(4): 697 - 712.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
H. Cai and D. G. Harrison
Endothelial Dysfunction in Cardiovascular Diseases: The Role of Oxidant Stress
Circ. Res., November 10, 2000; 87(10): 840 - 844.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
K. M. Channon, H. Qian, and S. E. George
Nitric Oxide Synthase in Atherosclerosis and Vascular Injury : Insights From Experimental Gene Therapy
Arterioscler Thromb Vasc Biol, August 1, 2000; 20(8): 1873 - 1881.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
J. Bauersachs, D. Fraccarollo, P. Galuppo, J. Widder, and G. Ertl
Endothelin-receptor blockade improves endothelial vasomotor dysfunction in heart failure
Cardiovasc Res, July 1, 2000; 47(1): 142 - 149.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. B. Driss, C. Devaux, D. Henrion, M. Duriez, C. Thuillez, B. I. Levy, and J.-B. Michel
Hemodynamic Stresses Induce Endothelial Dysfunction and Remodeling of Pulmonary Artery in Experimental Compensated Heart Failure
Circulation, June 13, 2000; 101(23): 2764 - 2770.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
T. J. Guzik, N. E. J. West, E. Black, D. McDonald, C. Ratnatunga, R. Pillai, and K. M. Channon
Vascular Superoxide Production by NAD(P)H Oxidase : Association With Endothelial Dysfunction and Clinical Risk Factors
Circ. Res., May 12, 2000; 86 (9): e85 - e90.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
R. P. Brandes, D.-y. Kim, F.-H. Schmitz-Winnenthal, M. Amidi, A. Godecke, A. Mulsch, and R. Busse
Increased Nitrovasodilator Sensitivity in Endothelial Nitric Oxide Synthase Knockout Mice : Role of Soluble Guanylyl Cyclase
Hypertension, January 1, 2000; 35(1): 231 - 236.
[Abstract] [Full Text] [PDF]


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CirculationHome page
T. Munzel and D. G. Harrison
Increased Superoxide in Heart Failure : A Biochemical Baroreflex Gone Awry
Circulation, July 20, 1999; 100(3): 216 - 218.
[Full Text] [PDF]


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J. Biol. Chem.Home page
H.-Y. Sohn, M. Keller, T. Gloe, H. Morawietz, U. Rueckschloss, and U. Pohl
The Small G-protein Rac Mediates Depolarization-induced Superoxide Formation in Human Endothelial Cells
J. Biol. Chem., June 16, 2000; 275(25): 18745 - 18750.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
D. B. Haitsma, D. Merkus, J. Vermeulen, P. D. Verdouw, and D. J. Duncker
Nitric oxide production is maintained in exercising swine with chronic left ventricular dysfunction
Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2198 - H2209.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
G. D. Thomas, W. Zhang, and R. G. Victor
Impaired Modulation of Sympathetic Vasoconstriction in Contracting Skeletal Muscle of Rats With Chronic Myocardial Infarctions : Role of Oxidative Stress
Circ. Res., April 27, 2001; 88(8): 816 - 823.
[Abstract] [Full Text] [PDF]