Inflammation may play an important role in the pathogenesis of cardiac
fibrosis in
heart failure (HF) after
myocardial infarction (MI). N-
acetyl-seryl-aspartyl-lysyl-proline (
Ac-SDKP) is a naturally occurring antifibrotic
peptide whose plasma concentration is increased 4- to 5-fold by
angiotensin-converting enzyme inhibitors. We tested the hypothesis that in rats with HF after MI,
Ac-SDKP acts as an anti-inflammatory
cytokine, preventing and also reversing cardiac
fibrosis in the noninfarcted area (reactive
fibrosis), and thus affording functional improvement. We found that
Ac-SDKP significantly decreased total
collagen content in the prevention group from 23.7+/-0.9 to 15.0+/-0.7 microg/mg and in the reversal group from 22.6+/-2.2 to 14.4+/-1.6 (P<0.01). Interstitial
collagen volume fraction and perivascular
collagen were likewise significantly reduced. We also found that infiltrating macrophages were reduced from 264.7+/-8.1 to 170.2+/-9.2/mm2, P<0.001 (prevention), and from 257.5+/-9.1 to 153.1+/-8.5 mm2, P<0.001 (reversal), while
transforming growth factor (
TGF)-beta-positive cells were decreased from 195.6+/-8.4 to 129.6+/-5.7/mm2, P<0.01 (prevention), and from 195.6+/-8.4 to 130.7+/-10.8/mm2, P<0.01 (reversal).
Ac-SDKP did not alter either blood pressure or
left ventricular hypertrophy (LVH); however, it depressed systolic cardiac function in the prevention study while having no significant effect in the reversal group. We concluded that
Ac-SDKP has an anti-inflammatory effect in HF that may contribute to its antifibrotic effect; however, this decrease in
fibrosis without changes in LVH was not accompanied by an improvement in cardiac function.