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Aromatase deficiency confers paradoxical postischemic cardioprotection.
[aromatase deficiency]
The
conventional
view
is
that
estrogen
confers
female
cardioprotection
.
Estrogen
synthesis
depends
on
androgen
availability
,
with
aromatase
regulating
conversion
of
testosterone
to
estradiol
.
Extragonadal
aromatase
expression
mediates
estrogen
production
in
some
tissues
,
but
a
role
for
local
steroid
conversion
has
not
yet
been
demonstrated
in
the
heart
.
This
study
's
goal
was
to
investigate
how
aromatase
deficiency
influences
myocardial
function
and
ischemic
resilience
.
RT-PCR
analysis
of
C
5
7
Bl
/
6
mouse
hearts
confirmed
cardiac
-
specific
aromatase
expression
in
adult
females
.
Functional
performance
of
isolated
hearts
from
female
aromatase
knockout
(
ArKO
)
and
aromatase
wild-
type
mice
were
compared
.
Left
ventricular
developed
pressures
were
similar
in
aerobic
perfusion
,
but
the
maximal
rate
of
rise
of
ventricular
pressure
was
modestly
reduced
in
ArKO
hearts
(
3725
±
144
vs
.
4272
±
154
mm
Hg
/
sec
,
P
<
0
.
05
)
.
After
25
min
of
ischemia
,
the
recovery
of
left
ventricular
developed
pressure
was
substantially
improved
in
ArKO
(
percentage
of
basal
at
60
min
of
reperfusion
,
62
±
8
vs
.
30
±
6
%
;
P
<
0
.
05
)
.
Hypercontracture
was
attenuated
(
end
diastolic
pressure
,
25
±
5
vs
.
51
±
1
mm
Hg
;
P
<
0
.
05
)
,
and
lactate
dehydrogenase
content
of
coronary
effluent
was
reduced
throughout
reperfusion
in
ArKO
hearts
.
This
was
associated
with
a
hyperphosphorylation
of
phospholamban
and
a
reduction
in
phosphorylated
Akt
.
Immediately
after
reperfusion
,
ArKO
hearts
exhibited
increased
incidence
of
ventricular
premature
beats
(
194
±
70
vs
.
46
±
6
,
P
<
0
.
05
)
.
These
observations
indicate
more
robust
functional
recovery
,
reduced
cellular
injury
,
and
modified
cardiomyocyte
Ca
(
2
+
)
handling
in
aromatase-
deficient
hearts
.
Our
findings
indicate
that
androgen-
to
-estrogen
conversion
may
be
of
pathophysiologic
importance
to
the
heart
and
challenge
the
notion
that
estrogen
deficiency
is
deleterious
.
These
studies
suggest
the
possibility
that
aromatase
suppression
may
offer
inotropic
benefit
in
the
acute
ischemia
/
reperfusion
setting
with
appropriate
arrhythmia
management
.
Diseases
Validation
Diseases presenting
"robust functional recovery"
symptom
aromatase deficiency
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