Hypoxia induces dilated cardiomyopathy in the chick embryo: mechanism, intervention, and long-term consequences

Andrei Tintu, Ellen Rouwet, Stefan Verlohren, Joep Brinkmann, Shakil Ahmad, Fatima Crispi, Marc van Bilsen, Peter Carmeliet, Anne Cathrine Staff, Marc Tjwa, Irene Cetin, Eduard Gratacos, Edgar Hernandez-Andrade, Leo Hofstra, Michael Jacobs, Wouter H. Lamers, Ingo Morano, Erdal Safak, Asif Ahmed, Ferdinand le Noble

Research output: Contribution to journalArticle

Abstract

Background - Intrauterine growth restriction is associated with an increased future risk for developing cardiovascular diseases. Hypoxia in utero is a common clinical cause of fetal growth restriction. We have previously shown that chronic hypoxia alters cardiovascular development in chick embryos. The aim of this study was to further characterize cardiac disease in hypoxic chick embryos.

Methods - Chick embryos were exposed to hypoxia and cardiac structure was examined by histological methods one day prior to hatching (E20) and at adulthood. Cardiac function was assessed in vivo by echocardiography and ex vivo by contractility measurements in isolated heart muscle bundles and isolated cardiomyocytes. Chick embryos were exposed to vascular endothelial growth factor (VEGF) and its scavenger soluble VEGF receptor-1 (sFlt-1) to investigate the potential role of this hypoxia-regulated cytokine.

Principal Findings - Growth restricted hypoxic chick embryos showed cardiomyopathy as evidenced by left ventricular (LV) dilatation, reduced ventricular wall mass and increased apoptosis. Hypoxic hearts displayed pump dysfunction with decreased LV ejection fractions, accompanied by signs of diastolic dysfunction. Cardiomyopathy caused by hypoxia persisted into adulthood. Hypoxic embryonic hearts showed increases in VEGF expression. Systemic administration of rhVEGF165 to normoxic chick embryos resulted in LV dilatation and a dose-dependent loss of LV wall mass. Lowering VEGF levels in hypoxic embryonic chick hearts by systemic administration of sFlt-1 yielded an almost complete normalization of the phenotype.

Conclusions/Significance - Our data show that hypoxia causes a decreased cardiac performance and cardiomyopathy in chick embryos, involving a significant VEGF-mediated component. This cardiomyopathy persists into adulthood.
Original languageEnglish
Article numbere5155
Number of pages11
JournalPLoS ONE
Volume4
Issue number4
DOIs
Publication statusPublished - 9 Apr 2009

Bibliographical note

Copyright: © 2009 Tintu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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    Tintu, A., Rouwet, E., Verlohren, S., Brinkmann, J., Ahmad, S., Crispi, F., van Bilsen, M., Carmeliet, P., Staff, A. C., Tjwa, M., Cetin, I., Gratacos, E., Hernandez-Andrade, E., Hofstra, L., Jacobs, M., Lamers, W. H., Morano, I., Safak, E., Ahmed, A., & le Noble, F. (2009). Hypoxia induces dilated cardiomyopathy in the chick embryo: mechanism, intervention, and long-term consequences. PLoS ONE, 4(4), [e5155]. https://doi.org/10.1371/journal.pone.0005155