应激性高血糖对大鼠心肌缺血再灌注损伤的观察

目的观察应激性高血糖（SHG）对大鼠心肌缺血/再灌注损伤（MIRI）时缺血期和再灌注期的不同影响,分析不同时期的SHG与心肌损伤之间的关系。方法成年SD大鼠50只随机分为5组：假手术组（SHAM）、高糖组（HG）、生理盐水对照组（CON）、缺血期高糖组（HGI）和再灌注期高糖组（HGR）,每组各10只;制备大鼠MIRI模型（缺血30min,再灌注3h）,静脉输注高浓度的葡萄糖液,造成应激性高血糖动物模型;术中监测血糖水平,再灌注结束后检测血清乳酸脱氢酶（LDH）水平,伊文斯兰染色测心肌梗死面积（Infarct size,IS）,分析不同时期高血糖对心肌损伤的影响。结果与SHAM组相比,静脉输注高糖LDH表达并未明显改变;与CON组相比,机体发生MIMI时,LDH水平升高,HGI组LDH水平明显升高,IS显著扩大,差异有统计学意义（P〈0.01）;而HGR组心肌酶谱水平和IS与CON组比较差异无统计学意义。结论缺血期应激性高血糖加重大鼠心肌缺血/再灌注损伤。     

缺血期急性高血糖对大鼠心肌缺血/再灌注损伤的影响

目的 探讨缺血期急性高血糖对大鼠心肌缺血/再灌注(MI/R)后心肌损伤的影响,并分析血糖水平与心肌损伤之间的关系.方法 在制备急性大鼠MI/R(缺血30min,再灌注6h)模型的基础上,静脉输注高浓度的葡萄糖溶液,造成2个不同浓度的缺血期急性高血糖动物模型.将32只SD大鼠随机平均分配为4组:(1)假手术组(SHAM),(2)生理盐水对照组(CON),(3)高糖1组(HG1)和(4)高糖2组(HG2).术中监测血糖水平,再灌注结束后检测心肌酶谱水平和心肌梗死面积(IS).结果 (1)与CON组相比较,HG1组和HG2组缺血期血糖水平均显著升高,分别为(10.5±1.0)、(18.0±1.2)mmol/L vs(4.7±0.7)mmol/L(P<0.05).(2)HG1组和HG2组的血肌酸激酶和乳酸脱氢酶水平明显升高,且心肌酶谱与血糖水平存在正相关(r分别为0.80和0.73,P<0.01).(3)HG1组的IS较CON组有扩大趋势,但差异无统计学意义[(40.8±5.2)%vs(37.6±5.8)%,P>0.05),HG2组的IS明显扩大[(45.6±8.5)%v8(37.6±5.8)%,P<0.05],且IS与血糖水平存在正相关(r=0.57,P<0.01).结论 缺血期急性高血糖加重大鼠MI/R损伤,且血糖水平与心肌酶谱和IS之间存在正相关.     

高血糖促进氧化应激加重大鼠心肌缺血/再灌注损伤

目的:研究高血糖是否可通过增加大鼠急性缺血/再灌注（I/R）心肌氧化应激而加重心肌损伤,并探讨其机制。方法: 将SD大鼠随机分为3组:假手术组(Sham)、生理盐水对照组(Vehicle)和高糖组(HG)。通过缺血30 min再灌注6 h,建立大鼠急性心肌I/R模型。通过静脉输注高浓度葡萄糖溶液,建立大鼠急性心肌I/R并发高血糖动物模型。术中监测血糖水平。再灌注结束后,检测血浆心肌酶谱水平,心肌梗死面积（IS）、心肌细胞凋亡指数（AI）和caspase 3的活性,检测心肌组织中氧化应激指标超氧阴离子、gp91phox、MDA、SOD,以及硫氧还蛋白结合蛋白（Txnip）的水平和硫氧还蛋白（Trx）的活性。结果: 与Vehicle组比较,HG组大鼠血糖水平显著升高,肌酸激酶（CK）、乳酸脱氢酶（LDH）的水平和IS增加,AI和caspase 3的活性升高(P<0.05)。HG组I/R心肌组织氧化应激程度显著升高,超氧阴离子、gp91phox和MDA水平增加(P<0.05)。同时,HG组I/R心肌组织的Txnip表达增加而Trx活性降低(P<0.05)。结论: 高血糖可增加大鼠I/R心肌中Txnip的表达,抑制Trx的活性促进氧化应激,这可能是其加重I/R心肌损伤的机制。     

三甲氧苄嗪对心肌缺血/再灌注损伤的保护作用

目的 :探讨三甲氧苄嗪增补于停搏液中对缺血 /再灌注离体鼠心的保护作用。方法 :将 2 4只 Wistar大鼠随机分为三甲氧苄嗪组 （A）和对照组 （B）。离体鼠心在改良的 L angendorff- Neely灌注模型上预灌注 30 min,停搏 12 0min、再灌注 30 min。缺血前及再灌注期间测定血流动力学指标、心肌酶 （CPK,L DH ）、心肌超氧化物歧化酶 （SOD）、过氧化脂质 （L PO）含量、心肌 ATP水平。电镜观察心肌超微结构。结果 :再灌注后 ,A组心功能、心肌超微结构的改善 ,明显优于 B组 ;心肌酶 （CPK ,L DH）、L PO含量显著低于 B组 （P<0 .0 1） ;SOD含量和 ATP水平显著高于 B组（P<0 .0 1）。结论 :三甲氧苄嗪增补于停搏液中可显著减轻心肌缺血 /再灌注损伤 ,具有良好的心肌保护作用     

芪丹通脉片对大鼠缺血/再灌注损伤心肌细胞GLUT4的影响

目的探讨中药复方芪丹通脉片对大鼠缺血/再灌注损伤（RMMI）心肌细胞葡萄糖转运蛋白（GLUT4）的影响。方法选用雄性SD大鼠36只,随机分为6组（n=6）,即正常组、假手术组、单纯模型组、芪丹通脉片高剂量组和低剂量组、恬尔心组,各组均用生理盐水配制成等体积药液灌胃7d,每日1次,采用冠脉结扎的方法建立大鼠心肌缺血/再灌注模型,将大鼠冠状动脉左前降支完全闭塞40min,再灌注4h后,速取再灌注区心肌组织,用免疫荧光、Western blot方法检测心肌细胞GLUT4的表达。结果单纯模型组心肌细胞膜GLUT4蛋白明显表达,细胞中总的GLUT4含量较正常组增加;芪丹通脉片高剂量组和恬尔心组心肌细胞膜GLUT4蛋白表达明显增强,细胞中总的GLUT4含量较单纯模型组增加。结论芪丹通脉片能明显增强RMMI大鼠心肌细胞总GLUT4的表达,并促进其向细胞膜转位,从而起到保护RMMI心肌的作用。     

缺血后适应对老龄大鼠心肌缺血再灌注损伤的保护作用

目的：研究缺血后适应能否减轻老龄大鼠急性心肌缺血再灌注损伤,比较缺血后适应的心脏保护作用在成年和老龄大鼠之间有无差别。方法32只雄性F344大鼠分为成年（6～8月龄）和老龄（20～22月龄）组,每组再分为缺血再灌注（I/R）组（缺血30min,再灌注2h,8只）和缺血后适应（IPost）组（缺血30min,给予4轮10s再通/10s缺血后再灌注2h,8只）,监测平均动脉压（MAP）、心率收缩压乘积（RPP）等血流动力学参数和心电图,测定心肌梗死面积,再灌注2h后检测血清肌酸激酶（CK）和乳酸脱氢酶（LDH）浓度。结果再灌注2h时,成年IPost组MAP和RPP均高于I/R组（P＜0.05）,而老龄IPost组与I/R组间差异无统计学意义（P＞0.05）。再灌注初30min内,成年IPost组和I/R组心律失常评分分别为1分和3.5分,两者间差异有统计学意义（P＜0.05）;老龄IPost组和I/R组心律失常评分分别为2分和3分,两者间差异无统计学意义（P＞0.05）。成年和老龄IPost组心肌梗死面积较I/R组分别减少52%和44%（均P＜0.05）。成年和老龄IPost组CK和LDH浓度较I/R组均有明显降低（P＜0.05）。结论缺血后适应能缩小老龄大鼠心肌梗死面积、减少心肌酶释放,且其程度与成年大鼠相似;同时缺血后适应能改善成年大鼠心肌顿抑、减少再灌注心律失常,但此作用在老龄大鼠未观察到。     

梓醇减轻心肌缺血/再灌注损伤及机制

目的:观察梓醇是否可减轻急性心肌缺血/再灌注（MI/R）损伤。方法:建立大鼠MI/R模型,随机给予生理盐水和梓醇预处理,全程检测大鼠的心脏功能。再灌注末检测大鼠心肌梗死(MI)面积、心肌细胞凋亡指数、血清肌酸激酶和乳酸脱氢酶的活性、心肌组织过氧亚硝基阴离子（ONOO-）、一氧化氮（NO）、超氧化物及超氧化物歧化酶（SOD）的含量。结果:梓醇预处理可明显改善心脏功能,减少心肌梗死面积和心肌细胞的凋亡与坏死（均P<0.05）。同时,ONOO-和超氧化物的产生也显著减少（P<0.05）;NO和SOD的含量显著增加（均P<0.05）。缺血前给予ONOO-清除剂尿酸（UA）显著减少ONOO-生成及MI范围（P<0.05）,但不能额外增强梓醇降低ONOO-及减小MI范围的效应（MI/R+梓醇+UA组 vs. MI/R+梓醇组）。结论:梓醇可抑制ONOO-形成,从而减轻MI/R损伤,其机制可能与增加NO水平及减少超氧化物生成有关。     

芪丹通脉片对大鼠心肌缺血/再灌注乳酸脱氢酶及氧自由基的影响

目的探讨芪丹通脉片对大鼠心肌缺血/再灌注损伤（RMMI）的防治及其作用机制。方法选用SD大鼠36只,随机分为6组（n=6）,即假手术组、模型组、芪丹通脉片低剂量组、中剂量组和高剂量组、恬尔心组,用生理盐水配制等体积药液灌胃14 d,1次/d。造成大鼠心肌缺血/再灌注模型,检测各组大鼠乳酸脱氢酶（LDH）和超氧化物歧化酶（SOD）活性及丙二醛（MDA）含量。结果与假手术组比较,模型组大鼠LDH活性、MDA含量显著升高,SOD活性显著下降（P<0.05）。与模型组比较芪丹通脉片各剂量组、恬尔心组LDH活性、MDA含量显著下降,SOD活力显著上升（P<0.05）。结论芪丹通脉片对大鼠RMMI有显著的保护作用,可能与其有效地消除或抑制氧自由基的损伤有关。     

褪黑素抗心肌缺血/再灌注损伤的作用及其对Notch1/Hes1信号通路影响

目的 探讨褪黑素（melatonin,Mel）对减轻大鼠心肌缺血/再灌注（MI/R）损伤的作用及其对心肌Notch1/Hes1信号的影响。方法 90只雄性SD大鼠（200~250） g,随机分为3组（每组n=30）:假手术（Sham）组、溶剂对照（MI/R+V）组和Mel处理（MI/R+Mel）组〔10 mg/(kg·d),灌胃4周〕。行结扎大鼠冠状动脉左前降支手术造成MI/R模型,心肌缺血30 min,再灌注4 h后检测心肌Notch1 受体胞内区（Notch1 intracellular domain,NICD）及Hes1、PTEN、p-Akt/Akt比值和凋亡相关蛋白表达,再灌注6 h后检测梗死面积和心肌细胞凋亡率,再灌注72 h后检测心功能。结果 MI/R损伤显著下调左心射血分数（LVEF）与左心室短轴缩短率（LVFS）,增加心肌凋亡率及梗死面积。Mel口服预防性治疗4周可显著改善心功能并减轻心肌凋亡及梗死（P<0.01）。另外口服Mel治疗可显著激活心肌Notch1/Hes1信号通路并调控PTEN/Akt信号,从而下调心肌凋亡信号(P<0.05)。结论 口服Mel预防性治疗可显著减轻MI/R损伤后心肌梗死及凋亡水平,改善心功能。而且,Mel口服可显著上调缺血打击后心肌Notch1/Hes1信号并对PTEN/Akt信号发挥调控作用,下调心肌凋亡信号,从而保护心肌。     

激活乙醛脱氢酶2抑制硝酸甘油耐受大鼠缺血再灌注心肌损伤

目的:探讨乙醛脱氢酶2（ALDH2）激动剂（Alda-1）对硝酸甘油耐受(NT)大鼠心肌缺血/再灌注损伤(MI/RI)的影响。方法: 24只成年雄性SD大鼠随机分为4组:Con组、Alda-1组、NT组和NT+Alda-1治疗组，每组6只(n=6)。经静脉给予硝酸甘油10 mg/(kg·day)处理7 d，建立NT大鼠模型，治疗组在硝酸甘油给药的第5天起，同时输注Alda-110 mg/(kg·day) 3 d。模型建立后，采用冠脉左前降支结扎缺血30 min再灌注4 h建立在体大鼠急性心肌缺血/再灌注(MI/R)模型。术中监测血流动力学指标，再灌结束后检测血清乳酸脱氢酶(LDH)并取心肌组织检测心肌梗死面积、蛋白质羰基化程度和心肌内活性氧簇(ROS)的水平。结果: 离体血管灌流显示，硝酸甘油连续处理7 d，可导致大鼠血管内皮依赖性和内皮非依赖性舒张能力显著降低，提示出现NT。定量检测心肌ALDH2的活性发现Alda-1可显著改善NT导致的心肌ALDH2活性抑制。在NT情况下，MI/RI较对照组显著加重，表现为心肌收缩舒张速率显著降低，血清LDH的水平显著增加，心肌梗死面积扩大（均P<0.05）。与NT组相比，采用Alda-1治疗，可显著改善NT组大鼠的MI/RI（均P<0.05）。并且，Alda-1治疗可显著抑制NT情况下缺血/再灌注心肌中蛋白质羰基化程度和ROS的含量。结论: 激活ALDH2可显著抑制NT导致的MI/RI加重，其机制可能与减轻心肌蛋白质氧化损伤有关。     

褪黑素通过减轻内质网应激抗心肌缺血/再灌注损伤的作用及机制

目的 研究褪黑素（melatonin,Mel）对大鼠心肌缺血/再灌注（MI/R）损伤的预防作用与心肌内质网应激（endoplasmic reticulum stress,ER stress）水平变化情况。方法 90只体质量180~220 g雄性SD大鼠,随机分为3个组:假手术（Sham）组、溶剂对照（MI/R+V）组、Mel预防（MI/R+Mel）组。结扎大鼠左冠状动脉前降支30min后松开结扎线恢复血流灌注,建立MI/R损伤模型,再灌注4 h后Western blot法检测ER stress水平标志分子葡萄糖调节蛋白78（glucose regulated protein78,GRP78）及CCAAT/增强子结合蛋白同源蛋白（CCAAT/enhancer-binding protein homologous protein,CHOP）和凋亡相关蛋白表达情况;再灌6 h后ELISA法检测血清酶学指标,TUNEL法检测心肌细胞凋亡率,Evans blue-TTC双染法测定梗死面积;再灌注24 h后检测各大鼠超声心动图。结果 Mel预防性治疗4周可提高左室射血分数（LVEF）及左室短轴缩短率（LVFS）,降低血清乳酸脱氢酶（LDH）及血清肌酸激酶（CK）水平,下调心肌细胞凋亡率及梗死面积,降低ER stress标志蛋白GGRP78及CHOP,降低凋亡通路蛋白（均P<0.01）。结论 Mel预防性治疗显著减轻心肌缺血再灌注损伤,其机制可能与抑制ER stress相关。     

褪黑素减轻心肌缺血/再灌注损伤的作用及机制

目的:探讨褪黑素（melatonin,Mel）在大鼠心肌缺血/再灌注（MI/R）损伤中的拮抗作用及其机制。方法:80只体质量200~250 g雄性SD大鼠随机分为4组:假手术（Sham）组、溶剂对照（MI/R+V）组、Mel治疗（MI/R+Mel）组、Mel+EX527（MI/R+Mel+EX）组。常规结扎左冠状动脉前降支行心肌缺血/再灌注手术,缺血30 min,再灌72 h后超声心动图法检测各组大鼠心功能,再灌6 h后ELISA法检测血清酶学指标,TUNEL法检测心肌细胞凋亡率,Evans blue-TTC双染法测定梗死面积,Western blot法检测沉默信息转录调控因子1（SIRT1）、乙酰化叉头转录因子1（Ac-Foxo1）及凋亡相关蛋白表达水平。结果:Mel治疗可显著改善MI/R损伤后心功能,降低血清肌酸激酶（CK）及乳酸脱氢酶（LDH）水平,降低凋亡率及梗死面积,上调SIRT1表达,下调Ac-Foxo1水平,降低凋亡相关蛋白表达。而使用EX527阻断SIRT1信号后逆转Mel的上述作用（均P<0.01）。结论:Mel可发挥抗凋亡作用减轻MI/R损伤并改善心功能,其作用机制可能与其激活SIRT1信号通路并降低Ac-Foxo1水平有关。     

Determinants of a protective effect of glucose and insulin on the ischemic myocardium. Effects on contractile function, diastolic compliance, metabolism, and ultrastructure during ischemia and reperfusion

The efficacy of hyperglycemia and insulin therapy for reducing ischemic myocardial injury is controversial and unproven. Accordingly, factors that might influence the effects of hyperglycemia and insulin were studied in isolated perfused rabbit hearts at two degrees of global ischemia, either "severe" or "moderate." During the ischemic period, different groups (n = 15-28/group) received either 100 mg/100 ml glucose-no insulin (control group), 500 mg/100 ml glucose + 100 mU/ml insulin (G + I), or 100 mg/100 ml glucose + 400 mg/100 ml mannitol (osmotic control). During moderate ischemia, effective washout of myocardial lactate was maintained, and hyperglycemia and insulin doubled the glycolytic flux, completely prevented contracture during ischemia, decreased contracture during reperfusion, increased recovery of postischemic contractile function, decreased ultrastructural damage, and increased high energy phosphate levels. Hyperglycemia and insulin increased glycolytic flux only after 30 minutes of ischemia had elapsed, suggesting that endogenous glycogen provided adequate glycolytic substrate prior to this time. The mannitol-glucose substrate had no beneficial effects, indicating that the hyperglycemia and insulin substrate had a metabolic rather than an osmotic mechanism of action. In contrast, during severe ischemia, tissue lactate washout was ineffective; the hyperglycemia and insulin substrate increased glycolytic flux by only 15% and produced no persistent beneficial effects. These results suggest that hyperglycemia and insulin therapy is beneficial to the ischemic myocardium when two conditions are met. First, the degree of myocardial perfusion, although in the ischemic range, must be adequate to prevent the accumulation of high tissue levels of lactate which inhibit glycolysis and prevent any glycolytic stimulation by hyperglycemia and insulin. Second, the ischemic myocardium must be "glucose dependent" for glycolytic substrate; in our studies this occurred after 30-45 minutes of sustained ischemia, probably because myocardial glycogen stores became depleted.     

Effect of blood glucose level in acute cerebral ischemia in spontaneously hypertensive rats--survival and brain pathology

The present study was designed to examine the effect of blood glucose level on survival and pathologic changes of the cortical neuronal cells during and after three-hour incomplete cerebral ischemia, which was induced by bilateral carotid artery ligation in spontaneously hypertensive rats (SHRs). Blood glucose levels were varied by intraperitoneal infusion of 50% glucose (hyperglycemia) or insulin with hypertonic saline (hypoglycemia) or hypertonic saline (normoglycemia). None of the hyperglycemic or normoglycemic animals died during three-hour ischemia, whereas 45% of hypoglycemic animals died (p greater than 0.001). The survival rate for twenty-four hours after recirculation was in the following ascending order: hypoglycemia, normoglycemia, and hyperglycemia. Neither hypoglycemia nor hyperglycemia (38-392 mg/dL) in nonischemic animals developed any morphologic changes in the cerebral cortex. However, both the ischemic and recirculated brains showed various degrees of histologic changes such as shrinkage of the neuronal cells with cytoplasmic vacuoles, perineuronal edema, and swelling of neuropils. Such ischemic damage of the brain was more marked in hypoglycemic animals than in hyperglycemic or normoglycemic ones during ischemia, as well as one hour after recirculation. The results suggest that cerebral ischemia and its outcome become more deleterious in hypoglycemic than in normoglycemic and hyperglycemic states. On the other hand, hyperglycemia is not necessarily a disadvantage in acute cerebral ischemia with or without reperfusion in this model.     

Nitrative inactivation of thioredoxin-1 increases vulnerability of diabetic hearts to ischemia/reperfusion injury

Hyperglycemia (HG) significantly increases mortality after myocardial infarction (MI) in patients with and without established diabetes. The specific underlying mechanism remains unknown. The present study attempted to determine whether nitrative inactivation of thioredoxin-1 (Trx-1) may contribute to the exaggerated myocardial ischemia/reperfusion (I/R) injury observed in the hyperglycemic condition. Diabetes was induced by multiple intraperitoneal injections of low-dose streptozotocin (STZ) in mice. After 30 min ischemia by slip-knot ligature of the left anterior descending coronary artery, the myocardium was reperfused for 3 h after knot release (for apoptosis, Trx-1-activity, and -nitration determination) or 24 h (for cardiac function and infarct size determination). At 10 min before reperfusion, diabetic mice were randomized to receive vehicle, EUK134 (a peroxynitrite scavenger), recombinant human Trx-1 (rhTrx-1), or SIN-1 (a peroxynitrite donor) nitrated Trx-1 (N-Trx-1) administration. Diabetes intensified I/R-induced myocardial injury, evidenced by further enlarged infarct size, increased apoptosis, and decreased cardiac function in diabetic mice. Trx-1 nitrative inactivation was elevated in the diabetic heart before I/R and was further amplified after I/R. Treatment with EUK134 or rhTrx-1, but not N-Trx-1, before reperfusion significantly reduced Trx-1 nitration, preserved Trx-1 activity, attenuated apoptosis, reduced infarct size, and improved cardiac function in diabetic mice. Taken together, our results demonstrated that HG increased cardiac vulnerability to I/R injury by enhancing nitrative inactivation of Trx-1, suggesting that blockade of Trx-1 nitration, or supplementation of exogenous rhTrx-1, might represent novel therapies to attenuate cardiac injury after MI in diabetic patients.     

The study of vasodilative and antiischemic function of nicorandil in regional ischemia and reperfusion of rat heart in vivo

Aim of the work was to study effect of nicorandil [N-(2-nitrooxiethyl) nicotinamide, SG75] on blood pressure (BP), heart rate (HR) and rhythm disturbances during regional ischemia and reperfusion of the heart in rats in vivo and its ability to limit acute myocardial infarction (MI). Nicorandil was obtained by nitrating nicotinamide ethanol using produced by industry ethylnicotinate. MI in Wistar rats was modeled by 40-min occlusion of anterior descending coronary artery (ADCA) and subsequent 60-min reperfusion. Nicorandil (3,2 mmol/kg) was administered intravenously before occlusion. Nitroglycerine was used as preparation of comparison; it was administered in the same dose. MI area and zone at risk (ZR) were measured by computer planimetry after staining of left ventricular sections with 2, 3, 5-triphenyltetrazolium chloride. Lowering of mean BP under influence of nicorandil during ADCA occlusion and subsequent reperfusion were deeper and longer than under influence of nitroglycerine. Contrary to nitroglycerine administration of nicorandil did not cause decrease of HR. Administration of both drugs postponed origination of rhythm disturbances during ischemia but did not affect their duration. MI dimension assessed by MI/ZR ratio after administration of nicorandil and nitroglycerine was significantly lowered down to 22 +/- 4 and 32 +/- 3%, respectively, compared with 47 +/- 3% in control. The results obtained evidence that in this model of ischemic and reperfusion damage of the heart vasodilating properties of nicorandil combined with decrease of postischemic loss of cardiomyocytes in ZR are comparable with effects of nitroglycerine.     

Ghrelin protects the heart against ischemia-induced arrhythmias by preserving connexin-43 protein

Vagal nerve stimulation has been postulated to confer an antifibrillatory effect. We studied whether ghrelin administration would exert an antiarrhythmic effect via modulation of autonomic nerve activity in rats after acute myocardial ischemia (MI). Male Sprague-Dawley rats were exposed to 30 min of ischemia following ligation of the left coronary artery. Animals were then randomized to receive either ghrelin (n = 26) or saline (n = 26) during the period of coronary ligation. Power spectral analysis of heart-rate variability revealed that the administration of ghrelin increased the high-frequency (HF) power and decreased the low-frequency (LF)/HF ratio. Ventricular tachyarrhythmias were less frequent in rats after MI who received ghrelin in comparison with rats that received saline. Immunoblotting and immunohistochemistry revealed that rats given saline alone during MI exhibited a marked reduction in phosphorylated connexin-43 within the left ventricle, whereas those that received ghrelin displayed only minor reductions in comparison with sham-operated rats. These effects of ghrelin were diminished by the coadministration of atropine or the blockade of vagal afferents. These data demonstrate that the beneficial effect of ghrelin might be mediated by modulation of cardiac autonomic nerve activity.