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Previous studies have demonstrated that hydrogen sulfide (H<jats:sub>2<\/jats:sub>S) can suppress oxidative stress of diabetic rats through increasing the expression of silent information regulator factor 2\u2010related enzyme 1 (SIRT1), but whether cardioprotection by SPC can be restored afterward remains unclear. Diabetic rat was subjected to IRI (30\u2009min of ischemia followed by 120\u2009min reperfusion). Postconditioning treatment with sevoflurane was administered for 15\u2009min upon the onset of reperfusion. The diabetic rats were treated with GYY4137 (H<jats:sub>2<\/jats:sub>S donor) 5 days before the experiment. Myocardial infarct size, mitochondrial structure and function, ATP content, activities of complex I\u2010IV, marker of oxidative stress, SIRT1, nuclear factor E2\u2010related factor 2 (Nrf2), heme oxygenase\u20101 (HO\u20101), and NADPH Oxidase\u20102 (Nox\u20102) protein expression were detected after reperfusion, and cardiac function was evaluated by echocardiography at 24\u2009h after reperfusion. After H<jats:sub>2<\/jats:sub>S activated SIRT1 in the impaired myocardium of diabetic rats, SPC significantly upregulated the expression of Nrf2 and its downstream mediator HO\u20101, thus reduced the expression of Nox\u20102. In addition, H<jats:sub>2<\/jats:sub>S remarkably increased cytoplasmic and nuclear SIRT1 which was further enhanced by SPC. Furthermore, H<jats:sub>2<\/jats:sub>S combined with SPC reduced the production of reactive oxygen species, increased the content of ATP, and maintained mitochondrial enzyme activity. Finally, myocardial infarct size and myocardium damage were decreased, and cardiac function was improved. Taken together, our study proved that H<jats:sub>2<\/jats:sub>S could restore SPC\u2010induced cardioprotection in diabetic rats by enhancing and promoting SIRT1\/Nrf2 signaling pathway mediated mitochondrial dysfunction and oxidative stress.<\/jats:p>","DOI":"10.1002\/jcp.30214","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T08:38:17Z","timestamp":1608107897000},"page":"5052-5068","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Hydrogen sulfide restores sevoflurane postconditioning mediated cardioprotection in diabetic rats: Role of SIRT1\/Nrf2 signaling\u2010modulated mitochondrial dysfunction and oxidative stress"],"prefix":"10.1002","volume":"236","author":[{"given":"Jing","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology The Second Affiliated Hospital of Nanchang University Nanchang Jiangxi 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