Kuoppala Antti, Shiota Naotaka, Lindstedt Ken A, Rysä Jaana, Leskinen Hanna K, Luodonpää Marja, Liesmaa Inka, Ruskoaho Heikki, Kaaja Risto, Kovanen Petri T, Kokkonen Jorma O
Wihuri Research Institute, Helsinki, Finland.
J Hypertens. 2003 Sep;21(9):1729-36. doi: 10.1097/00004872-200309000-00023.
Bradykinin exerts cardioprotective effects through bradykinin type-2 receptors (BK-2Rs). After acute myocardial infarction in rat, the heart adapts by increasing its number of BK-2Rs. However, in human chronic end-stage heart failure, the number of BK-2Rs is significantly decreased. Thus, the presence of a cardioprotective BK-2R signaling system may be critical in the prevention of pressure overload-induced heart failure.
To explain differences in myocardial BK-2R expression during cardiac overload, we studied: (1). spontaneously hypertensive rats (SHRs) of different ages, and (2). normotensive Sprague-Dawley rats subjected to aortic banding or angiotensin II infusion.
The mRNA levels of BK-2Rs were found to be significantly (P < 0.05) increased in the aging (12 and 20-month-old) SHRs (2.9- and 3-fold, respectively). Similarly, in the Sprague-Dawley rats, the expression of BK-2Rs was increased at 12 h (1.8-fold, P < 0.05) and at 3 days (3.1-fold, P < 0.05) after aortic banding, and at 2 weeks (2.2-fold) after angiotensin II infusion. In the 12-month-old SHRs, with compensated left ventricular hypertrophy (no fibrosis or left ventricular dysfunction), the amount of BK-2Rs was also significantly increased (1.8-fold, P < 0.05). However, in the 20-month-old SHRs, with a dramatic increase in fibrosis and development of diastolic dysfunction and heart failure, the amount of BK-2Rs were significantly decreased (63%, P < 0.05) specifically in the cardiac endothelial cells.
The present results show that, during pressure overload and compensated left ventricular hypertrophy, the expression of BK-2Rs is increased. However, ongoing pressure overload leads to a loss of BK-2Rs with a dramatic increase in left ventricular fibrosis followed by diastolic dysfunction and heart failure.
缓激肽通过2型缓激肽受体(BK-2Rs)发挥心脏保护作用。大鼠急性心肌梗死后,心脏通过增加BK-2Rs的数量进行适应性改变。然而,在人类慢性终末期心力衰竭中,BK-2Rs的数量显著减少。因此,心脏保护BK-2R信号系统的存在可能对预防压力超负荷诱导的心力衰竭至关重要。
为了解释心脏超负荷期间心肌BK-2R表达的差异,我们研究了:(1)不同年龄的自发性高血压大鼠(SHRs),以及(2)接受主动脉缩窄或输注血管紧张素II的正常血压的Sprague-Dawley大鼠。
发现衰老的(12和20月龄)SHRs中BK-2Rs的mRNA水平显著(P<0.05)升高(分别为2.9倍和3倍)。同样,在Sprague-Dawley大鼠中,主动脉缩窄后12小时(1.8倍,P<0.05)和3天(3.1倍,P<0.05)以及血管紧张素II输注后2周(2.2倍)时BK-2Rs的表达增加。在12月龄的SHRs中,伴有代偿性左心室肥厚(无纤维化或左心室功能障碍),BK-2Rs的数量也显著增加(1.8倍,P<0.05)。然而,在20月龄的SHRs中,伴有纤维化显著增加以及舒张功能障碍和心力衰竭的发生,BK-2Rs的数量显著减少(63%,P<0.05),特别是在心脏内皮细胞中。
目前的结果表明,在压力超负荷和代偿性左心室肥厚期间,BK-2Rs的表达增加。然而,持续的压力超负荷导致BK-2Rs丧失,同时左心室纤维化显著增加,随后出现舒张功能障碍和心力衰竭。