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BackgroundCoronary artery disease leading to myocardial ischemia is the most common cause of heart failure. Apelin (APLN), the endogenous peptide ligand of the APJ receptor, has emerged as a novel regulator of the cardiovascular system.Methods and ResultsHere we show a critical role of APLN in myocardial infarction (MI) and ischemia‐reperfusion (IR) injury in patients and animal models. Myocardial APLN levels were reduced in patients with ischemic heart failure. Loss of APLN increased MI‐related mortality, infarct size, and inflammation with drastic reductions in prosurvival pathways resulting in greater systolic dysfunction and heart failure. APLN deficiency decreased vascular sprouting, impaired sprouting of human endothelial progenitor cells, and compromised in vivo myocardial angiogenesis. Lack of APLN enhanced susceptibility to ischemic injury and compromised functional recovery following ex vivo and in vivo IR injury. We designed and synthesized two novel APLN analogues resistant to angiotensin converting enzyme 2 cleavage and identified one analogue, which mimicked the function of APLN, to be markedly protective against ex vivo and in vivo myocardial IR injury linked to greater activation of survival pathways and promotion of angiogenesis.ConclusionsAPLN is a critical regulator of the myocardial response to infarction and ischemia and pharmacologically targeting this pathway is feasible and represents a new class of potential therapeutic agents.

Rationale Diabetic cardiovascular complications are reaching epidemic proportions. Angiotensin-converting enzyme-2 (ACE2) is a negative regulator of the renin-angiotensin system. We hypothesize that loss of ACE2 exacerbates cardiovascular complications induced by diabetes. Objective To define the role of ACE2 in diabetic cardiovascular complications. Methods and Results We used the well-validated Akita mice, a model of human diabetes, and generated double-mutant mice using the ACE2 knockout (KO) mice (Akita/ACE2−/y). Diabetic state was associated with increased ACE2 in Akita mice, whereas additional loss of ACE2 in these mice leads to increased plasma and tissue angiotensin II levels, resulting in systolic dysfunction on a background of impaired diastolic function. Downregulation of SERCA2 and lipotoxicity were equivalent in Akita and Akita/ACE2KO hearts and are likely mediators of the diastolic dysfunction. However, greater activation of protein kinase C and loss of Akt and endothelial nitric oxide synthase phosphorylation occurred in the Akita/ACE2KO hearts. Systolic dysfunction in Akita/ACE2KO mice was linked to enhanced activation of NADPH oxidase and metalloproteinases, resulting in greater oxidative stress and degradation of the extracellular matrix. Impaired flow-mediated dilation in vivo correlated with increased vascular oxidative stress in Akita/ACE2KO mice. Treatment with the AT1 receptor blocker, irbesartan rescued the systolic dysfunction, normalized altered signaling pathways, flow-mediated dilation, and the increased oxidative stress in the cardiovascular system. Conclusions Loss of ACE2 disrupts the balance of the renin-angiotensin system in a diabetic state and leads to an angiotensin II/AT1 receptor-dependent systolic dysfunction and impaired vascular function. Our study demonstrates that ACE2 serves as a protective mechanism against diabetes-induced cardiovascular complications.

An approach preventing contact to ambient air during transfer from liquid environment for electrochemical treatment to UHV environment for surface analysis by X-Ray Photoelectron Spectroscopy and Time-of-Flight Secondary Ion Mass Spectrometry was applied to study the mechanisms of Cr and Mo enrichments in the passive oxide film formed on 316L austenitic stainless steel. Starting from the air-formed native oxide-covered surface, exposures were conducted in aqueous sulfuric acid solution first at open circuit potential and then under anodic polarization in the passive range. At open circuit potential the thickness of the bi-layered oxide film was observed to decrease and the enrichments of both Cr(III) and Mo, mostly Mo(VI), to markedly increase as well as the film hydroxylation. This is due to preferential dissolution of the Fe(III) oxide/hydroxide, not compensated by oxide growth in the absence of an electric field established by anodic polarization. Anodic polarization in the passive domain causes the bi-layered structure of the oxide film to re-grow by oxidation of iron, chromium and molybdenum, without impacting the Cr enrichment and only slightly mitigating the Mo enrichment. De-hydroxylation of the inner layer is also promoted upon anodic polarization. These results show that the treatment of the surface oxide film in acid solution at open circuit potential enhances Cr and Mo enrichments and promotes hydroxylation. Passivation by anodic polarization allows dehydroxylation, yielding more Cr oxide, without markedly affecting the Mo enrichment, also beneficial for the corrosion resistance.