@phdthesis{Govindaraj2009,
  author    = {Govindaraj, Vijayakumar},
  title     = {Improved Cardiac Glucose Uptake: A Potential Mechanism for Estrogens to Prevent the Development of Cardiac Hypertrophy},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-35911},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {The incidence of cardiovascular diseases including cardiac hypertrophy and failure in pre-menopausal women is lower compared to age-matched men but the risk of heart disease increases substantially after the onset of menopause. It has been postulated that female sex hormones play an important role in cardiovascular health in pre-menopausal women. In animal studies including spontaneously hypertensive (SHR) rats, the development of cardiac hypertrophy is attenuated by 17\&\#946;-estradiol treatment. Cardiac energy metabolism is crucial for normal function of the heart. In cardiac hypertrophy and heart failure, the myocardium undergoes a metabolic shift from fatty acid as primary cardiac energy source to glucose, which re-introduces the fetal type of metabolism that representing the glucose as a major source of energy. Many studies have reported that the disruption of the balance between glucose and fatty acid metabolism plays an important role in cardiac pathologies including hypertrophy, heart failure, diabetes, dilative cardiomyopathy and myocardial infarction. Glucose enters cardiomyocytes via GLUT1 and GLUT4 glucose transporters and GLUT4 is the major glucose transporter which is insulin-dependent. Cardiac-selective GLUT4 deficiency leads to cardiac hypertrophy. This shows that the decrease in cardiac glucose uptake may play a direct role in the pathogenesis of cardiac hypertrophy. Estrogens modulate glucose homeostasis in the liver and the skeletal muscle. But it is not known whether estrogens affect also cardiac glucose uptake which could provide another mechanism to explain the prevention of cardiac hypertrophy by female sex hormones. In the present study, SHR Rats were ovariectomized (OVX), not ovariectomized (sham) or ovariectomized and treated with subcutaneous 17\&\#946;-estradiol. After 6 weeks of treatment, body weight, the serum levels of estrogen, insulin, intra-peritoneal glucose tolerance test (IP-GTT), myocardial glucose uptake by FDG-PET (2-(18F)-fluoro-deoxyglucose (18FDG) and Positron Emission Tomography), cardiac glucose transporter expression and localization and cardiac hexokinase activity were analyzed. As results of this study, PET analysis of female SHR revealed decreased cardiac glucose uptake in OVX animals compared to intact that was normalized by estrogen supplementation. Interestingly, there was no change in global glucose tolerance among the treatment groups. Serum insulin levels and cardiac hexokinase activity were elevated by E2 substitution. The protein content of cardiac glucose transporters GLUT-4 and GLUT-1, and their translocation as determined by fractionation studies and immuno-staining did not show any significant change by ovariectomy and estrogen replacement. Also levels of insulin receptor substrate-1 (IRS-1) and its tyrosine phosphorylation, which is required for activation and translocation of GLUT4, was un-affected in all groups of SHR. Cardiac gene expression analysis in SHR heart showed that ei4Ebp1 and Frap1 genes which are involved in the mTOR signaling pathway, were differentially expressed upon estrogen treatment. These genes are known to be activated in presence of glucose in the heart. As a conclusion of this study, reduced myocardial FDG uptake in ovariectomized spontaneously hypertensive rat is normalized by 17\&\#946;-estradiol treatment. Increased myocardial hexokinase appears as a potential mechanism to explain increased myocardial glucose uptake by 17\&\#946;-estradiol. Increased cardiac glucose uptake in response to 17\&\#946;-estradiol in ovariectomized SHR may provide a novel mechanism to explain the reduction of cardiac hypertrophy in E2 treated SHR. Therefore, 17\&\#946;-estradiol improves cardiac glucose utilization in ovariectomized SHR which may give rise to possible mechanism for its protective effects against cardiac hypertrophy.},
  subject      = {estrogen},
  language  = {en}
}
@phdthesis{Jager2002,
  author    = {Jager, Tertia ¬de¬},
  title     = {Estrogen action in the myocardium},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-1182573},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2002},
  abstract  = {Cardiovascular disease is the leading cause of mortality in both men and women in the Western world. Earlier observations have pointed out that pre-menopausal women have a lower risk of developing cardiovascular disease than age-matched men, with an increase in risk after the onset of menopause. This observation has directed the attention to estrogen as a potential protective factor in the heart. So far the focus of research and clinical studies has been the vascular system, leaving the current knowledge on the role of estrogen in the myocardium itself rather scarce. Functional estrogen receptor-alpha as well as -beta have recently been identified in the myocardium, making the myocardium an estrogen target organ. The focus of this thesis was 1) to investigate the role of estrogen and estrogen receptors in modulating myocardial gene expression both in vivo in an animal model for cardiac hypertrophy (spontaneously hypertensive rats; SHR), as well as in vitro in isolated neonatal cardiomyocytes, 2) to investigate the mechanisms of the rapid induction of an estrogen target gene, the early growth response gene-1 (Egr-1) and 3) to initiate the search for novel estrogen target genes in the myocardium. 1) The effects of estrogen on the expression of one of the major myocardial specific contractile proteins, the alpha-myosin heavy chain (alpha-MHC) have been investigated. In ovarectomised animals treated either with 17beta-estradiol alone or in combination with a specific estrogen receptor antagonist, ICI 182780, it was shown that both alpha-MHC mRNA and protein were upregulated by estrogen in an estrogen receptor specific manner. The in vivo results were confirmed in vitro in isolated neonatal cardiomyocytes which showed that estrogen has a direct action on the myocardium potent enough to upregulate the expression of alpha-MHC. Furthermore it was shown that the alpha-MHC promoter is induced by estrogen in an estrogen receptor-dependent manner and first investigations into the mechanisms involved in this upregulation identified Egr-1 as a potential transcription factor which, upon induction by estrogen, drives the expression of the alpha-MHC promoter. 2) Previously it was shown that Egr-1 is rapidly induced by estrogen in an estrogen receptor-dependent manner which was mediated via 5 serum response elements (SREs) in the promoter region and surprisingly not via the estrogen response elements (EREs). In this study it was shown that estrogen-treatment of cardiomyocytes resulted in the recruitment of serum response factor (SRF), or an antigenically related protein, to the SREs in the Egr-1 promoter, which was specifically inhibited by the estrogen receptor antagonist ICI 182780. Transfection experiments showed that estrogen induced a heterologous promoter consisting only of 5 tandem repeats of the c-fos SRE in an ER-dependent manner, which identified SREs as promoter elements able to confer an estrogen response to target genes. 3) Potentially new target genes regulated by estrogen in vivo were analysed using hearts of ovarectomised animals as well as ovarectomised animals treated with estrogen. Analyses of cDNA microarray filters containing 1250 known genes identified 24 genes that were modified by estrogen in vivo. Among these genes, some might have potentially important functions in the heart and further analyses of these genes will create a more global picture of the role and function of estrogen in the myocardium. Taken together, the results showed that estrogen does have a direct action on the myocardium both by regulating the expression of myocardial specific genes in vivo, as well as exerting rapid non-nuclear effects in cardiac myocytes. It was shown that SREs in the promoter region of genes can confer an estrogen response to genes identifying SREs as important elements in regulation of genes by estrogen. Furthermore, 24 potentially new estrogen targets were identified in the myocardium, contributing to the general understanding of estrogen action in the myocardium.},
  subject      = {Herzmuskel},
  language  = {en}
}