Metabolic dysfunction in the myocardium three months after exertional heat stroke in mice
Authors: Clanton Thomas , Alzahrani Jamal , Smuder Ashley , Montalvo Ryan , Morse Deborah , Finleigh Fitton 
Published: May 2024

In humans, exposure to heat stroke has proven to be a risk factor for development of cardiovascular disease later in life. We hypothesized that exposure to exertional heat stroke (EHS) would result in the development of similar long-term cardiac disease in mice. In this study we followed mice for three months after EHS, using ultrasound imaging of the heart, metabolomics and histological analysis of ventricular tissue and biomarker analysis after 4 weeks of recovery. Methods: Mice were instrumented with temperature telemetry devices and were trained to run on forced running wheels using an incremental exercise protocol. EHS mice ran in an temperature elevated environmental chamber; females 37.5°C; males 34°C; whereas, matched exercise control mice (EXC) ran in 22-23°C. Running stopped when EHS mice reached symptom limitation (unconsciousness). The mice were followed for 12 wks post EHS, with two ultrasound measures at 2 and 10 wks of recovery. At the end of the study, mice were anesthetized, a blood sample drawn, and ventricular tissue collected for metabolomics. RESULTS: Male but not female EHS mice gained ~10% greater body mass compared to EXC over the course of recovery ( P<0.01). Hearts from male but not female EHS mice exhibited elevations in heart mass per tibia length ( P<0.01). At three months, metabolomics in male EHS hearts revealed significant elevations in glucose and glucose metabolites and significant decreases in acylcarnitines consistent with a metabolic shift toward glucose and away from lipid metabolism. In contrast, female hearts exhibited fewer abnormalities but with significant elevations in lipid and arachidonate metabolites. At two weeks post, there were no differences in male ultrasound measures between EHS and EXC mice but in females there was a reduced posterior wall velocity ( P=0.012) and a trend towards narrower posterior wall thickness ( P= 0.06) . Between 2 and 12 wks post EHS, there were significant elevations in fractional shortening in males ( P<0.05) and elevations in posterior wall velocity ( P<0.01). In contrast, females exhibited significant reductions posterior wall velocity. From blood samples, male EHS mice had increased HDL and females exhibited decreased HDL (p<0.01 in both). LDL increased only in males P<0.05. Vascular adhesion molecules sICAM ( P<0.01) and Pecam1 ( P<0.01) were significantly decreased in EHS males and females and e-Selectin was decreased in EHS males only ( P<0.001). Total serum protein was significantly reduced in both male and females ( P<0.01). Male EHS mice also exhibited significant elevations in white blood cell count and total lymphocytes ( P=0.01) suggesting ongoing activation of the immune system . CONCLUSIONS: In this controlled preclinical model of EHS, both male and female mice exhibited long-lasting cardiovascular and systemic disorders that could account for the lingering incidence of cardiovascular disease and poor overall health in heat stroke victims. Supported by US Army Med. Research and Devel. Command BA180078 and the BK and Betty Stevens Endowment. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.