Electroacupuncture Pretreatment Reduces Myocardial Ischemia–Reperfusion Injury in Rats by Suppressing Cardiomyocyte Ferroptosis

Background Myocardial ischemia–reperfusion injury (MIRI) poses a significant obstacle in the management of ischemic heart disease. This research investigated the preventive effects and possible mechanisms of electroacupuncture pretreatment on MIRI in rats. Methods Forty-eight rats were randomly assigned to four groups (sham, model, electroacupuncture, and erastin). Electroacupuncture was administered 5 days before inducing MIRI. Serum parameters including cardiac troponin I (cTnI), creatine kinase MB (CK-MB), and lactic dehydrogenase (LDH); myocardial contents of Fe 2+ , malondialdehyde (MDA), and glutathione (GSH); myocardial infarct size; pathological morphology; mitochondrial ultrastructure; and expression of ferroportin 1 (FPN1), glutathione peroxidase 4 (GPX4), and acyl coenzyme A synthetase long-chain family member 4 (ACSL4) were assessed. Results The model group showed significantly higher levels of cTnI, CK-MB, and LDH, larger infarction areas, and more severe pathological damage compared with the sham group. Additionally, the contents of Fe 2+ and MDA were increased, the contents of GSH were decreased, the mitochondria were damaged, the cristae structure was disordered, the expression of FPN1 and GPX4 was downregulated, and the expression of ACSL4 was upregulated. In the electroacupuncture group, myocardial injury serological indicators; infarction area; pathological damage; contents of Fe 2+ , MDA, and GSH; mitochondrial ultrastructural abnormalities; and the expression of FPN1, GPX4, and ACSL4 were significantly ameliorated. However, the administration of erastin, a ferroptosis inducer, attenuated the protective effect of electroacupuncture pretreatment on MIRI. Conclusion Electroacupuncture pretreatment exerts a protective effect against MIRI, which may be related to the inhibition of cardiomyocyte ferroptosis.