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[β₁肾上腺素能受体拮抗剂与β₂肾上腺素能受体激动剂联合治疗对心力衰竭大鼠心功能及心肌细胞凋亡的影响]

[The effects of combined beta(1) adrenergic receptor antagonist and beta(2) adrenergic receptor agonist therapy on cardiac function and myocardial apoptosis in heart failure rats].

作者信息

Li Wei-min, Gan Run-tao, Wang Xu, Wu Shuang, Shen Jing-xia, Xiu Chun-hong

机构信息

Department of Cardiology, First Clinical Hospital, Harbin Medical University, Harbin 150001, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2007 Jul;35(7):615-9.

Abstract

OBJECTIVE

To observe the effects of combined beta(1) adrenergic receptor (AR) antagonist with beta(2)AR agonist therapy on cardiac function and cardiomyocyte apoptosis in heart failure rats.

METHODS

Heart failure was induced by isoproterenol and rats were randomly divided into metoprolol group (50 mg/kg twice daily/gavage, n = 11), combined treatment group (fenoterol 125 microg/kg and metoprolol 50 mg/kg twice daily/gavage, n = 11) and placebo group (saline, n = 10), another normal 9 male Wistar rats served as control group. After 8 weeks' treatment, cardiac function, apoptosis index (AI), Caspase-3 activity, expression levels of bcl-2 and bax protein, organ weight/body weight and collagen volume fraction (CVF) were evaluated.

RESULTS

(1) Left ventricular end diastolic dimension, left ventricular end systolic dimension and E/A ratio were significantly increased and fractional shortening, ejection fraction significantly reduced post isoproterenol (all P < 0.05 vs. control) and these changes were significantly attenuated by metoprolol alone (all P < 0.05 vs. placebo) and further attenuated by the metoprolol and fenoterol combination therapy (all P < 0.05 vs. placebo and metoprolol). (2) Left ventricular weight to body weight ratio, lung weight to body weight ratio and CVF were also significantly reduced in metoprolol and combined treatment group than those in placebo group (all P < 0.01). (3) Compared with placebo group, AI and Caspase-3 activity were significantly lower in metoprolol group (all P < 0.01 vs. placebo) and further reduced in combined treatment group (all P < 0.01 vs. metoprolol). (4) The expression level of bax protein was significantly lower in metoprolol group while bcl-2/bax significantly higher than those in placebo group. These changes were more significant in combined treatment group (all P < 0.01 vs. metoprolol).

CONCLUSIONS

beta(1)AR antagonist in combination with beta(2)AR agonist further improved the cardiac function and prevented cardiac remodeling compared with using beta(1)AR antagonist alone in heart failure rats. Downregulated bax and upregulated bcl-2/bax expressions might contribute to the observed beneficial therapy effects by reducing cardiomyocyte apoptosis in these animals.

摘要

目的

观察β₁肾上腺素能受体(AR)拮抗剂与β₂AR激动剂联合治疗对心力衰竭大鼠心功能及心肌细胞凋亡的影响。

方法

采用异丙肾上腺素诱导心力衰竭,将大鼠随机分为美托洛尔组(50 mg/kg,每日2次,灌胃,n = 11)、联合治疗组(非诺特罗125 μg/kg和美托洛尔50 mg/kg,每日2次,灌胃,n = 11)和安慰剂组(生理盐水,n = 10),另取9只正常雄性Wistar大鼠作为对照组。治疗8周后,评估心功能、凋亡指数(AI)、半胱天冬酶-3活性、bcl-2和bax蛋白表达水平、脏器重量/体重及胶原容积分数(CVF)。

结果

(1)异丙肾上腺素处理后左心室舒张末期内径、左心室收缩末期内径及E/A比值显著增加,缩短分数、射血分数显著降低(与对照组相比,均P < 0.05),单独使用美托洛尔可显著减轻这些变化(与安慰剂组相比,均P < 0.05),美托洛尔与非诺特罗联合治疗进一步减轻这些变化(与安慰剂组和美托洛尔组相比,均P < 0.05)。(2)美托洛尔组和联合治疗组的左心室重量与体重比值、肺重量与体重比值及CVF也显著低于安慰剂组(均P < 0.01)。(3)与安慰剂组相比,美托洛尔组的AI和半胱天冬酶-3活性显著降低(与安慰剂组相比,均P < 0.01),联合治疗组进一步降低(与美托洛尔组相比,均P < 0.01)。(4)美托洛尔组bax蛋白表达水平显著低于安慰剂组,而bcl-2/bax显著高于安慰剂组。联合治疗组这些变化更显著(与美托洛尔组相比,均P < 0.01)。

结论

与单独使用β₁AR拮抗剂相比,β₁AR拮抗剂与β₂AR激动剂联合治疗可进一步改善心力衰竭大鼠的心功能并预防心脏重构。下调bax及上调bcl-2/bax表达可能通过减少这些动物的心肌细胞凋亡而有助于观察到的有益治疗效果。

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