Xiaona Zhang - Department of Cardiovascular Diseases, Xi’an International Medical Center Hospital, Xi’an, ۷۱۰۱۰۰, China
Kai Jing - Department of Proctology, The People’s Hospital of Huaiyin Jinan, ۲۵۰۰۲۱, Shandong, China
Wei Ma - Department of Cardiovascular Diseases, Xi’an International Medical Center Hospital, Xi’an, ۷۱۰۱۰۰, China
Jin Wang - Department of Cardiology, The Fifth People’s Hospital of Jinan, ۲۵۰۰۲۲, Shandong, China

Objective(s): Myocardial arrhythmia is a major complication of ischemia-reperfusion (I/R) injury in patients with diabetes. Irisin has significant cardioprotective effects, while its role in the pathophysiology of I/R injury-induced myocardial arrhythmia in the presence of diabetes is not well identified. Here, we aimed to investigate the potential antiarrhythmic impacts and mechanisms (mitochondrial biogenesis, endoplasmic reticulum (ER) stress, and pyroptosis) by which irisin reduces I/R injury-induced myocardial arrhythmia in diabetic rats.Materials and Methods: Thirty high-fat diet-induced diabetic rats were subjected to I/R injury and myocardial arrhythmia. Irisin (۰.۵ μg/kg/day) was injected intraperitoneally before induction of I/R injury. Electrocardiography was used to measure the incidence and severity of ventricular arrhythmias. ELISA and western blotting analyses were employed to quantify the expression of mitochondrial biogenesis, ER stress, and pyroptosis-related proteins in ischemic myocardium.Results: Irisin treatment in diabetic rats significantly decreased the lactate dehydrogenase level and the number and severity of arrhythmia induced by I/R injury. Irisin up-regulated the expression of mitochondrial biogenesis-related proteins while down-regulating the expression of ER stress and pyroptosis-related proteins. Furthermore, the inhibition of mitochondrial quality control by mdivi-۱ significantly abolished the cardioprotective effect of irisin.Conclusion: Our findings suggest that irisin reduced myocardial arrhythmia induced by I/R injury in diabetic rats by modulating the interaction of mitochondrial biogenesis and ER stress proteins and inhibiting the pyroptosis pathway. These findings provide a promising strategy for managing myocardial arrhythmia in diabetic patients, but supplementary studies are needed to confirm the clinical efficacy of irisin in these patients.

Arrhythmia, Cardioprotection, Diabetes, Inflammation, Pyroptosis, Reperfusion