Chronic β-adrenergic stress contributes to cardiomyopathy in rodents with collagen-induced arthritis

Patients with rheumatoid arthritis (RA) have a much higher incidence of cardiac dysfunction, which contributes to the high mortality rate of RA despite anti-arthritic drug therapy. In this study, we investigated dynamic changes in cardiac function in classic animal models of RA and examined the potential effectors of RA-induced heart failure (HF). Collagen-induced arthritis (CIA) models were established in rats and mice. The cardiac function of CIA animals was dynamically monitored using echocardiography and haemodynamics. We showed that cardiac diastolic and systolic dysfunction occurred in CIA animals and persisted after joint inflammation and that serum proinflammatory cytokine (IL-1 beta, TNF-alpha) levels were decreased. We did not find evidence of atherosclerosis (AS) in arthritic animals even though cardiomyopathy was significant. We observed that an impaired cardiac beta(1)AR-excitation contraction coupling signal was accompanied by sustained increases in blood epinephrine levels in CIA rats. Furthermore, serum epinephrine concentrations were positively correlated with the heart failure biomarker NT-proBNP in RA patients (r(2)=+0.53, P < 0.0001). In CIA mice, treatment with the nonselective beta AR blocker carvedilol (2.5 mg.kg(-1).d(-1), for 4 weeks) or the specific GRK2 inhibitor paroxetine (2.5 mg.kg(-1).d(-1), for 4 weeks) effectively rescued heart function. We conclude that chronic and persistent beta-adrenergic stress in CIA animals is a significant contributor to cardiomyopathy, which may be a potential target for protecting RA patients against HF.