Highlight article: Telmisartan improves myocardial remodeling by inhibiting leptin autocrine activity and activating PPARγ

The mechanism responsible for myocardial remodeling in hypertensive left ventricular hypertrophy (LVH) is complex. This study was designed to investigate the role of telmisartan in improving myocardial remodeling in hypertensive LVH and to explore the molecular mechanisms underlying the effects of telmisartan on hypertensive LVH. Hypertensive LVH was established in eight-week-old male Sprague–Dawley (SD) rats by abdominal aortic constriction. Telmisartan was intragastrically administered six weeks after surgery. Telmisartan improved cardiac dysfunction and myocardial fibrosis and reduced myocardial renin-angiotensin-aldosterone system (RAAS) activity and leptin levels in hypertensive LVH rats. To assess the mechanism underlying hypertensive LVH, cardiac fibroblasts were treated in vitro with angiotensin II (Ang II) or leptin, plus various inhibitors. Ang II stimulated leptin synthesis and secretion in cardiac fibroblasts by promoting AP-1 nuclear translocation via the AT1R-ROS-ERK1/2 pathway. Leptin induced collagen metabolism disorder in cardiac fibroblasts via the JAK2/STAT3 pathway. Telmisartan improved collagen metabolism disorder by inhibiting leptin induced by local Ang II in an autocrine manner. Telmisartan also improved Ang II-induced collagen metabolism disorder by inhibiting STAT3 phosphorylation, a leptin downstream signal, by activating PPAR-γ. Telmisartan therefore improved myocardial remodeling in hypertensive LVH rats by acting as an AT1R antagonist, inhibiting leptin autocrine activity induced by local Ang II and by acting as a PPAR-γ agonist, inhibiting downstream leptin activation of STAT3 phosphorylation. These findings indicate the crosstalk between local myocardial RAAS and leptin and suggest a molecular mechanism by which telmisartan improves myocardial remodeling in hypertensive LVH. Impact statement: This study shows the crosstalk between local myocardial RAAS and leptin in hypertensive LVH rats; that Ang II induces myocardial remodeling by stimulating leptin autocrine activity by promoting AP-1 nuclear translocation via the AT1R-ROS-ERK1/2 pathway; and that telmisartan improves myocardial remodeling by inhibiting local Ang II-induced leptin autocrine activity and by inhibiting the leptin downstream signal STAT3 phosphorylation by activating PPAR-γ. These findings reveal novel molecular mechanisms by which telmisartan improves myocardial remodeling and could help to identify therapeutic targets for hypertensive LVH.