Matsui Hiromitsu, Shimosawa Tatsuo, Uetake Yuzaburo, Wang Hong, Ogura Sayoko, Kaneko Tomoyo, Liu Jing, Ando Katsuyuki, Fujita Toshiro
Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Hypertension. 2006 Aug;48(2):225-31. doi: 10.1161/01.HYP.0000232617.48372.cb. Epub 2006 Jul 3.
Potassium supplementation has a potent protective effect against cardiovascular disease, but the precise mechanism of it against left ventricular abnormal relaxation, relatively early functional cardiac alteration in hypertensive subjects, has not been fully elucidated. In the present study, we investigated the effect of potassium against salt-induced cardiac dysfunction and the involved mechanism. Seven- to 8-week-old Dahl salt sensitive rats were fed normal diet (0.3% NaCl) or high-salt diet (8% NaCl) with or without high potassium (8% KCl) for 8 weeks. Left ventricular relaxation was evaluated by the deceleration time of early diastolic filling obtained from Doppler transmitral inflow, the slope of the pressure curve, and the time constant at the isovolumic relaxation phase. High-salt loading induced a significant elevation of blood pressure and impaired left ventricular relaxation, accompanied by augmentation of reduced nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase activity in the cardiac tissue, measured by the lucigenin chemiluminescence method. Blood pressure lowering by hydralazine could not ameliorate NADPH oxidase activity and resulted in no improvement of left ventricular relaxation. Interestingly, although the blood pressure remained high, potassium supplementation as well as treatment with 4-hydroxy-2,2,6,6-tetramethyl-piperidine-N-oxyl, a superoxide dismutase mimetic, not only reduced the elevated NADPH oxidase activity but also improved the left ventricular relaxation. In conclusion, a high-potassium diet has a potent protective effect on left ventricular active relaxation independent of blood pressure, partly through the inhibition of cardiac NADPH oxidase activity. Sufficient potassium supplementation might be an attractive strategy for cardiac protection, especially in the salt-sensitive hypertensive subjects.
补钾对心血管疾病具有强大的保护作用,但其针对左心室舒张异常(高血压患者相对早期的心脏功能改变)的确切机制尚未完全阐明。在本研究中,我们调查了钾对盐诱导的心脏功能障碍的影响及其相关机制。将7至8周龄的Dahl盐敏感大鼠喂食正常饮食(0.3%氯化钠)或高盐饮食(8%氯化钠),添加或不添加高钾(8%氯化钾),持续8周。通过多普勒二尖瓣流入血流获得的早期舒张期充盈减速时间、压力曲线斜率和等容舒张期时间常数来评估左心室舒张功能。高盐负荷导致血压显著升高和左心室舒张功能受损,同时通过光泽精化学发光法测量发现心脏组织中还原型烟酰胺腺嘌呤二核苷酸磷酸(NADPH)氧化酶活性增强。肼屈嗪降压并不能改善NADPH氧化酶活性,也不能改善左心室舒张功能。有趣的是,尽管血压仍然很高,但补钾以及用超氧化物歧化酶模拟物4-羟基-2,2,6,6-四甲基哌啶-N-氧基治疗,不仅降低了升高的NADPH氧化酶活性,还改善了左心室舒张功能。总之,高钾饮食对左心室主动舒张具有强大的保护作用,且独立于血压,部分是通过抑制心脏NADPH氧化酶活性实现的。充足的钾补充可能是一种有吸引力的心脏保护策略,尤其是对于盐敏感型高血压患者。