Efficacy of Moxibustion at CV8 on Exercise-Induced Ventricular Arrhythmia: Inhibition of Cardiomyocyte Apoptosis via the SIRT1/p53/Bax Pathway

Abstract

Objective: Clinical studies have shown that moxibustion at CV8 can prevent pathological myocardial injury and improve heart function; however, the underlying mechanisms remain unclear. This study explored how moxibustion at CV8 prevents and treats exercise-induced ventricular arrhythmia by inhibiting cardiomyocyte apoptosis via the SIRT1/p53/Bax pathway. Methods: A 12-week treadmill exercise regimen was implemented to develop a rat model of exercise-induced ventricular arrhythmia. The impact of moxibustion at CV8 on this condition was evaluated by analyzing serum biomarkers, myocardial cell mitochondria, and tissue-related indicators using ELISA, colorimetric assays, Western blotting, immunohistochemistry, and HE and TUNEL staining. Results: Moxibustion at CV8 effectively alleviated myocardial injury, improved pathological electrocardiograms, and lowered the serum levels of BNP, CK-MB, cTnI, and cTnT. It also reduced myocardial tissue levels of p53, acetyl-p53, Cyt-c, Bax, caspase-9, cleaved caspase-9, caspase-3, and cleaved caspase-3 while increasing the activity of myocardial mitochondria I–IV and the expression of SIRT1 and Bcl-2, thereby inhibiting myocardial cell apoptosis. Conclusions: Moxibustion at CV8 inhibits myocardial cell apoptosis and prevents exercise-induced ventricular arrhythmia by regulating the SIRT1/p53/Bax pathway.

Keywords

moxibustion CV8 sports-induced ventricular arrhythmia apoptosis SIRT1 p53

Get full access to this article

View all access options for this article.

References

Abdulla

Nielsen

J. R.

(2009). Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace, 11(9), 1156–1159. https://doi.org/10.1093/europace/eup197

Antoniou

C. K.

Dilaveris

Manolakou

Galanakos

Magkas

Gatzoulis

Tousoulis

(2017). QT Prolongation and malignant arrhythmia: How serious a problem? European Cardiology, 12(2), 112–120. https://doi.org/10.15420/ecr.2017:16:1

Chang

(2015). Current Status and prospects of research on exercise-induced arrhythmias. Chinese Journal of Sports Medicine, 34(1), 59–68. https://doi.org/10.16038/j.1000-6710.2015.01.012

Chang

Yang

H. X.

(2012). The expression of troponin T in cardiac conduction system after exhaustive exercise and their role in exercise-induced arrhythmia. Chin J Clinicians (Electronic Edition), 6(16), 4748–4753. https://doi.org/10.3877/cma.j.issn.1674-0785.2012.16.103

Corrado

Basso

Pavei

Michieli

Schiavon

Thiene

(2006). Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA, 296(13), 1593–1601. https://doi.org/10.1001/jama.296.13.1593

Dröse

Stepanova

Galkin

(2016). Ischemic A/D transition of mitochondrial complex I and its role in ROS generation. Biochim Biophys Acta, 1857(7), 946–957. https://doi.org/10.1016/j.bbabio.2015.12.013

Gomez

A. T.

Prutkin

J. M.

Rao

A. L.

(2016). Evaluation and management of athletes with long QT syndrome. Sports Health, 8(6), 527–535. https://doi.org/10.1177/1941738116660294

Guo

Jiang

Tong

Z. Y.

Zhou

Xiao

X. Z.

(2020). Shikonin ameliorates LPS-induced cardiac dysfunction by SIRT1-dependent inhibition of NLRP3 inflammasome. Frontiers in Physiology, 11(10), 570441. https://doi.org/10.3389/fphys.2020.570441

Ilhan

Asci

Tepebasi

M. Y.

Sevuk

M. A.

Temel

E. N.

Ozmen

(2023). Selenium exerts protective effects on inflammatory cardiovascular damage: Molecular aspects via SIRT1/p53 and Cyt-c/Cas-3 pathways. Molecular Biology Reports, 50(2), 1627–1637. https://doi.org/10.1007/s11033-022-08192-5

10.

James

T. N.

Martin

Willis

P. W.

Lohr

T. O.

(1996). Apoptosis as a possible cause of gradual development of complete heart block and fatal arrhythmias associated with absence of the AV node, sinus node, and internodal pathways. Circulation, 93(7), 1424–1438. https://doi.org/10.1161/01.CIR.93.7.1424

11.

Kim

H. J.

Joe

J. K.

(2015). Carbon monoxide protects against hepatic ischemia/reperfusion injury by modulating the miR-34a/SIRT1 pathway. Biochim Biophys Acta, 1852(7), 1550–1559. https://doi.org/10.1016/j.bbadis.2015.04.017

12.

Kleiven

(2019). Endurance exercise and myocardial injury. Eur J Prev Cardiol, 26(3), 316–317. https://doi.org/10.1177/2047487318815302

13.

Laslett

Eisenbud

Lind

(1996). Evidence of myocardial injury during prolonged strenuous exercise. Am J Cardiol, 78(4), 488–490. https://doi.org/10.1016/0002-9149(97)00003-9

14.

Liang

Cao

B. Z.

(2014). Research progress on mitochondrial regulation of cell apoptosis. Biomedical Engineering and Clinical, 18(5), 501–505. https://doi.org/10.13339/j.cnki.sglc.2014.05.049

15.

Liang

Y. L.

S. L.

X. K.

R. D.

Wang

Zhu

W. L.

Sun

D. Y.

Fang

C. Y.

(2022). Effects of moxibustion at CV8 on prohibitin-1 expression and mitochondrial function in skeletal muscles of rats with long-term exercise-induced fatigue. Acupuncture & Electro-Therapeutics Research, 47(3), 471–429. https://doi.org/10.3727/036012921X16341481788267

16.

Liang

Y. L.

Zhu

Yong

Liao

(2024). China: Press of Chinese Medicine.

17.

Lin

Y. B.

Sheng

M. W.

Ding

Y. J.

Zhang

Song

Y. Y.

H. Y.

W. L.

(2018). Berberine protects renal tubular cells against hypoxia/reoxygenation injury via the Sirt1/p53 pathway. J Nat Med, 72(3), 715–723. https://doi.org/10.1007/s11418-018-1210-1

18.

Liu

Y., Fan

L.H.

C.G.

Yin

S.T.

H.B.

(2020). Functional role of p53 in the regulation of chemical-induced oxidative stress. Oxid Med Cell Longev, 2020(1), 6039769. https://doi.org/10.1155/2020/6039769

19.

Lü

S. L.

R. D.

Zhang

Z. M.

Wang

Liang

Y. L.

W. L.

Sun

D. Y.

(2023). Exploring the mechanism of moxibustion in myocardial protection of rats with long-term fatigue exercise based on the classical pyroptosis pathway. Journal of Acupuncture and Tuina Science, 21(2), 121–128. https://doi.org/10.1007/s11726-023-1362-8

20.

Wang

D. N.

Peng

Qin

Y. S.

R. B.

Liu

B. C.

Y. L.

Liu

Y. R.

(2021). Research progress on mechanisms and monitoring biomarkers of myocardial injury induced by high-load exercise training. Journal of Logistics College of Armed Police Forces (Medical Edition), 30(5), 153–156. https://doi.org/10.16548/j.2095-3720.2021.05.049

21.

Luo

H. M.

Wang

Z. X.

Jiang

X. J.

P. G.

(2019). Clinical study on treatment of coronary heart disease with angina pectoris by shexiang baoxin pill combined with thermal moxibustion. Nanjing University of Traditional Chinese Medicine, 35(4), 391–394. https://doi.org/10.14148/j.issn.1672-0482.2019.0391

22.

Y. Y.

(2023). Effects of Moringa flavonoids on oxidative stress and energy metabolism in exercise-injured rats. Molecular Plant Breeding, 21(16), 5504–5509. https://doi.org/10.13271/j.mpb.021.005504

23.

Oláh

Németh

B. T.

Mátyás

Horváth

E. M.

Hidi

Birtalan

Kellermayer

Ruppert

Merkely

Szabó

(2015). Cardiac effects of acute exhaustive exercise in a rat model. Int J Cardiol, 182(1 March), 258–266. https://doi.org/10.1016/j.ijcard.2014.12.045

24.

Peng

F. L.

Huang

L. L.

Guo

Y. J.

(2016). Preparation of a rat model of exercise-induced myocardial ischemic injury. Chinese Journal of Tissue Engineering Research, 20(40), 6007–6013. https://doi.org/10.3969/j.issn.2095-4344.2016.40.012

25.

Ping

Cao

X. B.

(2018). Research progress on prevention, treatment, and mechanisms of exercise-induced cardiac injury. Journal of PLA Medicine, 30(2), 110–113. https://doi.org/10.3969/j.issn.2095-140X.2018.02.029

26.

Rizwan

Pal

Sabnam

Pal

(2020). High glucose augments ROS generation regulates mitochondrial dysfunction and apoptosis via stress signalling cascades in keratinocytes. Life Sci, 241(15 January), 117148. https://doi.org/10.1016/j.lfs.2019.117148

27.

Shen

Z. X.

Zhu

Liang

Y. L.

Zhang

Z. F.

(2021). Effect of moxibustion on cardiac remodeling and myocardial function in rats with exercise-induced fatigue. World Journal of Traditional Chinese Medicine, 7(02), 254–257. https://doi.org/10.4103/wjtcm.wjtcm_70_20

28.

Sun

X. J.

Feng

W. L.

Hou

(2017). The role of the JAK2/STAT3 signaling pathway in exercise preconditioning against myocardial cell apoptosis. Chinese Journal of Applied Physiology, 33(5), 393–397. https://doi.org/10.12047/j.cjap.5473.2017.095

29.

Zhang

Z. F.

Liang

Y. L.

Lü

T. Y.

Shen

Z. X.

Wang

Zhu

W. L.

Lü

S. L.

Sun

D. Y.

(2021). Effect of moxibustion at Shenque (CV 8) on myocardial remodeling and function in exercise-induced fatigue rats. J Acupunct Tuina Sci, 19(4), 249–257. https://doi.org/10.1007/s11726-021-1255-7

30.

Zhang

Y. H.

Zhou

X. H.

Zhang

Z. F.

Liang

Y. L.

Gao

Sun

D. Y.

Sun

(2019). Effect of moxibustion at Shenque (CV 8) on immune system in rats with different degrees of exhaustive exercise. J Acupunct Tuina Sci, 17(2), 74–79. https://doi.org/10.1007/s11726-019-1096-9

31.

Zhu

Zhang

X. Z.

(2018). Clinical observation of exercise rehabilitation combined with moxibustion at shenque acupoint in the treatment of patients with coronary heart disease and heart failure. Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine, 6(22), 166–167. https://doi.org/10.3969/j.issn.2095-6681.2018.22.127