Witte K, Huser L, Knotter B, Heckmann M, Schiffer S, Lemmer B
Institute of Pharmacology and Toxicology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Germany.
Naunyn Schmiedebergs Arch Pharmacol. 2001 Jan;363(1):101-9. doi: 10.1007/s002100000343.
It is still a controversial issue whether different classes of antihypertensive drugs are equally effective in the regression of cardiac hypertrophy and associated complications. The present study compared the effects of prolonged treatment with the Ca2+-channel blocker amlodipine and the ACE inhibitor enalapril, respectively, in TGR(mREN2)27 rats (TGR), an animal model of renin-dependent hypertension. TGR were divided into three groups and received either amlodipine, enalapril or drinking water without addition, Sprague-Dawley rats (SPRD) served as normotensive control group. Cardiovascular parameters were monitored by radiotelemetry, and drug doses were titrated until 24-h blood pressure was reduced to approximately 140/90 mmHg in both active treatment groups. After 8 weeks of treatment left ventricular (LV) hypertrophy was completely reversed in both treatment groups despite a tenfold increase in plasma angiotensin II in amlodipine-treated TGR. In untreated TGR LV catecholamines were depleted, and beta1-adrenergic stimulation of adenylyl cyclase was blunted. Treatment of TGR with enalapril prevented both the depletion of tissue catecholamines and the desensitisation of LV beta1-adrenoceptors. Amlodipine had no effect on cardiac adrenergic signal transduction. Basal activity of LV soluble guanylyl cyclase was not different between TGR and SPRD, but its sensitivity to stimulation by nitric oxide was slightly reduced in TGR. Treatment had no effect on basal and stimulated guanylyl cyclase activity. The present study in an animal model of renin-dependent hypertension suggests that blood pressure reduction per se is sufficient for a regression of cardiac hypertrophy. However, beta-adrenergic desensitisation was prevented only in the enalapril-treated group, supporting a blood pressure-independent contribution of the renin-angiotensin system to the regulation of beta-adrenergic signal transduction.
不同种类的抗高血压药物在使心脏肥大及相关并发症消退方面是否具有同等疗效仍是一个有争议的问题。本研究比较了分别用钙通道阻滞剂氨氯地平和血管紧张素转换酶抑制剂依那普利对肾素依赖性高血压动物模型TGR(mREN2)27大鼠(TGR)进行长期治疗的效果。将TGR分为三组,分别给予氨氯地平、依那普利或不添加药物的饮用水,Sprague-Dawley大鼠(SPRD)作为正常血压对照组。通过无线电遥测监测心血管参数,并调整药物剂量,直到两个积极治疗组的24小时血压降至约140/90 mmHg。治疗8周后,两个治疗组的左心室(LV)肥大均完全逆转,尽管氨氯地平治疗的TGR血浆血管紧张素II增加了10倍。在未治疗的TGR中,LV儿茶酚胺耗竭,β1-肾上腺素能对腺苷酸环化酶的刺激减弱。用依那普利治疗TGR可防止组织儿茶酚胺耗竭和LVβ1-肾上腺素能受体脱敏。氨氯地平对心脏肾上腺素能信号转导无影响。TGR和SPRD之间LV可溶性鸟苷酸环化酶的基础活性无差异,但TGR中其对一氧化氮刺激的敏感性略有降低。治疗对基础和刺激的鸟苷酸环化酶活性无影响。本研究在肾素依赖性高血压动物模型中的结果表明,血压降低本身足以使心脏肥大消退。然而,仅在依那普利治疗组中β-肾上腺素能脱敏得到预防,这支持了肾素-血管紧张素系统对β-肾上腺素能信号转导调节的血压非依赖性作用。