. ACE inhibition prevents myocardial infarction-induced skeletal muscle mitochondrial dysfunction. J Appl Physiol 101: [385][386][387][388][389][390][391] 2006. First published April 13, 2006; doi:10.1152/japplphysiol.01486.2005.-Heart failure is associated with alterations in cardiac and skeletal muscle energy metabolism resulting in a generalized myopathy. We investigated the molecular and cellular effects of angiotensin-converting enzyme inhibition (ACEi) on skeletal muscle metabolism in infarcted animals. Myocardial infarction (MI) was obtained by left descending coronary artery ligation. Sham, MI, and MI-treated rats (perindopril, 2 mg ⅐ kg Ϫ1 ⅐ day Ϫ1 given 7 days after MI) were studied 1 and 4 mo after surgery. Oxygen consumption of white gastrocnemius (Gas) muscle was studied in saponin-permeabilized fibers, using the main substrates of mitochondrial respiration. mRNA expression of nuclear factors (PGC-1␣, NRF-2␣, and mtTFA), involved in the transcription of mitochondrial proteins, and of MCIP1, a marker of calcineurin activation, were also determined. Echocardiographic left ventricular fractional shortening was reduced in both MI and perindopril group after 1 and 4 mo, whereas systemic blood pressure was reduced by 16% only in the MI group after 4 mo. The capacity of Gas to oxidize glutamate-malate, glycerol-triphosphate, or pyruvate (Ϫ30%, P Ͻ 0.01; Ϫ32%, P Ͻ 0.05; Ϫ33%, P Ͻ 0.01, respectively), was greatly decreased. Furthermore, PGC-1␣ (Ϫ54%), NRF-2␣ (Ϫ45%), and MCIP1 (Ϫ84%) gene expression were significantly downregulated. ACEi improved survival, left ventricular function, and blood pressure. Perindopril protected also totally the Gas mitochondrial function and preserved the mRNAs concentration of the mitochondrial transcriptional factors. Moreover, PGC-1␣ correlated with Gas oxidative capacity (r ϭ 0.48), mitochondrial cytochrome-c oxidase (r ϭ 0.65), citrate synthase (r ϭ 0.45) activities, and MCIP1 expression (r ϭ 0.44). Thus ACEi totally prevented MI-induced alterations of skeletal muscle mitochondrial function and protein expression, halting the development of this metabolic myopathy. rehabilitation; mitochondria; angiotensin-converting enzyme inhibition CHRONIC HEART FAILURE (CHF) is characterized by impaired cardiac function, muscular fatigue, and reduced exercise tolerance. Reduction of exercise capacities involves not only the cardiovascular system but also the skeletal muscles themselves. Indeed, clinical and animal studies described muscular atrophy associated with fiber-type phenotype shift toward a more fast-twitch glycolytic phenotype during heart failure (14,23,24,26). Furthermore, impairments of mitochondrial function were observed in the heart and fast and slow skeletal muscles (3, 4) and were attributed to the downregulation of transcriptional coactivators and transcription factors implicated in mitochondrial biogenesis (PGC-1␣, NRF-2␣, and Tfam; Ref. 11).The generalized character of this metabolic myopathy suggests that humoral systemic factors could be involved (27). The renin-an...