Cholestatic liver disease modulates susceptibility to ischemia/reperfusion-induced arrhythmia, but not necrosis and hemodynamic instability: the role of endogenous opioid peptides

J Hepatol. 2005 Sep;43(3):491-8. doi: 10.1016/j.jhep.2005.02.043.

Abstract

Background/aims: Acute cholestasis is associated with cardiovascular complications, which mainly manifest during stressful conditions. The goal of this study is to evaluate susceptibility of 7-day bile duct-ligated rats to ischemia/reperfusion-induced injury.

Methods: Sham-operated and cholestatic rats, treated with daily normal saline, L-NAME (a non-selective NO synthase inhibitor) naltrexone, or both L-NAME and naltrexone were subjected to 30 min of ischemia followed by 2 h of reperfusion.

Results: Cholestatic rats demonstrated significant bradycardia, hypotension (P < 0.01), and QT prolongation (P < 0.001). The incidence of premature ventricular contractions (P < 0.01), incidence and duration of ventricular tachycardia (P < 0.05), but not ventricular fibrillation, were significantly lower in cholestatic rats. There was no significant difference in hemodynamic instability and infarct size between the groups. L-NAME corrected QT prolongation in cholestatic rats (P < 0.05), with no effect on heart rate, blood pressure and arrhythmia. Naltrexone restored normal heart rate (P < 0.05), blood pressure (P < 0.05) and susceptibility to arrhythmia (P < 0.05) in cholestatic animals, with no significant effect on QT interval. L-NAME and naltrexone co-administration corrected bradycardia (P < 0.05), hypotension (P < 0.05), QT prolongation (P < 0.05) and abolished resistance of cholestatic rats against arrhythmia (P < 0.05).

Conclusions: This study suggests that short-term cholestasis is associated with resistance against ischemia/reperfusion-induced arrhythmia, which depends on availability of endogenous opioids.

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / physiopathology*
  • Blood Pressure
  • Cholestasis, Intrahepatic / pathology
  • Cholestasis, Intrahepatic / physiopathology*
  • Electrocardiography
  • Heart Rate
  • Hemodynamics
  • Male
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • NG-Nitroarginine Methyl Ester / pharmacology*
  • Naltrexone / pharmacology
  • Necrosis
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury / physiopathology*

Substances

  • Naltrexone
  • NG-Nitroarginine Methyl Ester