Asai K, Yang G P, Geng Y J, Takagi G, Bishop S, Ishikawa Y, Shannon R P, Wagner T E, Vatner D E, Homcy C J, Vatner S F
Weis Center for Research, Penn State College of Medicine, Danville, Pennsylvania 17822, USA.
J Clin Invest. 1999 Sep;104(5):551-8. doi: 10.1172/JCI7418.
Transgenic (TG) mice with cardiac G(salpha) overexpression exhibit enhanced inotropic and chronotropic responses to sympathetic stimulation, but develop cardiomyopathy with age. We tested the hypothesis that cardiomyopathy in TG mice with G(salpha) overexpression could be averted with chronic beta-adrenergic receptor (beta-AR) blockade. TG mice and age-matched wild-type littermates were treated with the beta-AR blocker propranolol for 6-7 months, starting at a time when the cardiomyopathy was developing but was not yet severe enough to induce significant cardiac depression (9.5 months of age), and ending at a time when cardiac depression and cardiomyopathy would have been clearly manifest (16 months of age). Propranolol treatment, which can induce cardiac depression in the normal heart, actually prevented cardiac dilation and the depressed left ventricular function characteristic of older TG mice, and abolished premature mortality. Propranolol also prevented the increase in myocyte cross-sectional area and myocardial fibrosis. Myocyte apoptosis, already apparent in 9-month-old TG mice, was actually eliminated by chronic propranolol. This study indicates that chronic sympathetic stimulation over an extended period is deleterious and results in cardiomyopathy. Conversely, beta-AR blockade is salutary in this situation and can prevent the development of cardiomyopathy.
心脏中G(salpha)过表达的转基因(TG)小鼠对交感神经刺激表现出增强的变力性和变时性反应,但随着年龄增长会发展为心肌病。我们检验了这样一个假设,即通过慢性β-肾上腺素能受体(β-AR)阻断可以避免G(salpha)过表达的TG小鼠发生心肌病。TG小鼠和年龄匹配的野生型同窝小鼠从心肌病开始发展但尚未严重到足以引起明显心脏抑制时(9.5月龄)开始,用β-AR阻滞剂普萘洛尔治疗6 - 7个月,直至心脏抑制和心肌病明显出现时(16月龄)结束。普萘洛尔治疗在正常心脏中可诱发心脏抑制,但实际上预防了老年TG小鼠典型的心脏扩张和左心室功能抑制,并消除了过早死亡。普萘洛尔还预防了心肌细胞横截面积的增加和心肌纤维化。在9月龄TG小鼠中已经明显的心肌细胞凋亡实际上被慢性普萘洛尔消除了。这项研究表明,长期慢性交感神经刺激是有害的,并会导致心肌病。相反,在这种情况下β-AR阻断是有益的,可以预防心肌病的发展。