Zhuang X F, Yin C Q, Wang H Y, Sun Ning Ling
Department of Cardiology, Peking University People's Hospital, Beijing, China.
J Int Med Res. 2009 Sep-Oct;37(5):1354-64. doi: 10.1177/147323000903700510.
In this study, an experimental rat ligated heart model was used to observe the effect of treatment with carvedilol, metoprolol and metoprolol plus a highly selective alpha(1)-adrenergic blocking agent, bunazosin, after acute myocardial infarction (MI). Compared with an untreated MI group, all drug-treated groups demonstrated attenuation of inflammatory mediators, activation of nuclear factor-kappaB (NF-kappaB), and increased levels of mRNA and active protein for the collagenases matrix metallopeptidase (MMP)-8 and MMP-13 in the non-infarct zone of the ventricle, as well as inhibition of the increase of left ventricular end-diastolic pressure. Supplementation of metoprolol with bunazosin did not add greatly to the effects of metoprolol alone. Of the three drug treatments, carvedilol showed a uniquely potent antioxidant activity that may strengthen its capacity to inhibit oxidative stress, the release of inflammatory mediators and activation of NF-kappaB. This study may help provide a mechanistic explanation for the greater benefits shown by carvedilol compared with metoprolol in treating heart failure.
在本研究中,使用实验性大鼠结扎心脏模型观察卡维地洛、美托洛尔以及美托洛尔加用高选择性α₁肾上腺素能阻滞剂布那唑嗪在急性心肌梗死(MI)后进行治疗的效果。与未治疗的MI组相比,所有药物治疗组均显示炎症介质减少、核因子κB(NF-κB)激活、心室非梗死区基质金属蛋白酶(MMP)-8和MMP-13的mRNA及活性蛋白水平升高,以及左心室舒张末期压力升高受到抑制。美托洛尔加用布那唑嗪并未比单独使用美托洛尔的效果有显著增强。在这三种药物治疗中,卡维地洛显示出独特的强效抗氧化活性,这可能增强其抑制氧化应激、炎症介质释放及NF-κB激活的能力。本研究可能有助于为卡维地洛在治疗心力衰竭方面比美托洛尔显示出更大益处提供机制解释。