Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Yushima, Bunkyo, Tokyo 113-8519, Japan.
J Cardiovasc Pharmacol. 2012 Apr;59(4):323-30. doi: 10.1097/FJC.0b013e3182422c1a.
Angiotensin converting enzyme inhibitors have been used clinically to prevent myocardial infarction (MI). The angiotensin converting enzyme inhibitors attenuated ventricular remodeling and improved cardiac function by inhibition of matrix metalloproteinases after MI. Although the effect is thought to be a class effect, there are significant differences among the drugs. The aim of this study was to compare the effects of imidapril and ramipril on ventricular remodeling after MI.
The middle portion of left anterior descending artery was ligated to induce a moderate size MI in rats (moderate MI group). The proximal portion of the artery was ligated to induce a large size MI (large MI group). The animals were assigned to subgroups in moderate MI group and large MI group: (1) nontreated group, (2) ramipril group (1 mg/kg daily), and (3) imidapril group (1 mg/kg daily). All rats were killed on day 28 after the MI operation.
Although the nontreated MI group showed impaired ventricular contraction and severe fibrosis, imidapril significantly negated ischemia-induced changes. Imidapril had a superior effect for preventing ventricular remodeling characterized by fibrosis and collagen accumulation in left ventricle compared with ramipril in the moderate and large MI groups, even though the dosage used in this study was too small to reduce systemic blood pressure.
Imidapril can be used as a substitute for ramipril to prevent ventricular remodeling after MI.
血管紧张素转换酶抑制剂已被临床用于预防心肌梗死（MI）。血管紧张素转换酶抑制剂通过抑制 MI 后的基质金属蛋白酶来减轻心室重构并改善心功能。虽然这种作用被认为是一种类效应，但药物之间存在显著差异。本研究旨在比较依那普利和雷米普利对 MI 后心室重构的影响。
结扎大鼠左前降支中段以诱导中等大小 MI（中度 MI 组）。结扎动脉近端以诱导大 MI（大 MI 组）。将动物在中度 MI 组和大 MI 组中分为亚组：（1）未治疗组，（2）雷米普利组（1mg/kg 每日），和（3）依那普利组（1mg/kg 每日）。所有大鼠均在 MI 手术后第 28 天处死。
尽管未治疗的 MI 组显示心室收缩功能受损和严重纤维化，但依那普利显著逆转了缺血引起的变化。与雷米普利相比，依那普利在中度和大 MI 组中对预防纤维化和胶原积累为特征的心室重构具有更好的作用，尽管本研究中使用的剂量太小，无法降低全身血压。
依那普利可替代雷米普利用于预防 MI 后心室重构。
