However, ICV injection of leptin or MTII did not confer any cardiac protection if rats subjected to MI were lacking the melanocortin 4 receptor (MC4R). ICV injection of melanotan II (MTII) provided a similar degree of protection as leptin. This centrally applied leptin markedly attenuated the cardiac dysfunction that normally occurs following MI. ( 2) addressed this issue by chronically applying intracerebroventricular (ICV) leptin into the lateral ventricle of the brain of rats subjected to myocardial infarction (MI). In this issue of JACC: Basic to Translational Science, Gava et al. Although leptin can reduce the severity of cardiac dysfunction and remodeling that can occur following chronic ischemic heart failure ( 1), it is not known if this is due to central or peripheral effects of leptin. An example of this is the adipocyte-derived peptide leptin, which not only exerts a direct effect on cardiac energy metabolism and inflammation, but also has prominent actions in the CNS. Part of this confusion relates to the fact that some of the approaches used to treat heart failure may have both peripheral cardiovascular actions and direct CNS effects. Although it is well known how heart failure impacts central nervous system (CNS) function, it is less clear how altering CNS function can affect the progression of heart failure. Heart failure that results from a myocardial infarction is a serious medical condition that is associated with a high mortality and poor heart function.
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