Homoarginine treatment of rats improves cardiac function and remodeling in response to pressure overload

Low serum concentrations of the amino acid homoarginine (HA) are associated with increased cardiovascular mortality by incompletely understood mechanisms. This study sought to assess the influence of HA on cardiac remodeling in rats undergoing either transaortic banding or inhibition of nitric oxide synthesis by Nω‐Nitro‐L‐arginine methyl ester hydrochloride (L‐NAME). Male Wistar rats ( n = 136) underwent sham operation (SH) or aortic banding (AB). Both groups were equally divided into 14 subgroups, receiving different doses of HA alone or in combination with lisinopril, spironolactone, or L‐NAME for 4 weeks. HA treatment in AB animals resulted in a dose‐dependent improvement of cardiac function up to a concentration of 800 mg·kg −1 ·day −1 . Combining 800 mg·kg −1 ·day −1 HA with spironolactone or lisinopril yielded additional effects, showing a positive correlation with LV ejection fraction (+33%, p = 0.0002) and fractional shortening (+41%, p = 0.0014). An inverse association was observed with collagen area fraction (−41%, p < 0.0001), myocyte cross‐sectional area (−22%, p < 0.0001) and the molecular markers atrial natriuretic factor (−74%, p = 0.0091), brain natriuretic peptide (−42%, p = 0.0298), beta‐myosin heavy chain (−46%, p = 0.0411), and collagen type V alpha 1 chain (−73%, p = 0.0257) compared to placebo‐treated AB animals. Co‐administration of HA and L‐NAME was found to attenuate cardiac remodeling and prevent NO‐deficient hypertension following AB. HA treatment has led to a dose‐dependent improvement of myocardial function and marked histological and molecular changes in cardiac remodeling following AB. Combining HA with standard heart failure medication resulted in additional beneficial effects boosting its direct impact on heart failure pathophysiology.