Susic Dinko, Fares Hassan, Frohlich Edward D
Hypertension Research Laboratory, Institute of Translational Research, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
J Am Soc Hypertens. 2012 Sep-Oct;6(5):316-23. doi: 10.1016/j.jash.2012.06.001.
We have demonstrated previously that a high-salt diet (HS) produces myocardial fibrosis, left ventricular (LV) dysfunction, and renal insufficiency in adult spontaneously hypertensive rats (SHR), and that blockade of the renin-angiotensin system prevented those adverse effects of HS.
Eight-week-old male SHR were divided into four groups: controls received regular rat chow (0.6 NaCl); the other three were given HS. The second group was given placebo; the third, nebivolol (2 × 10 mg/kg/day) orally; and, the fourth, the same dose of nebivolol by osmotic minipump. Rats received respective treatments for 8 weeks. The data demonstrated that the HS induced increased cardiac mass (2.85 ± 0.05 vs. 5.36 ± 0.22 mg/g; P < .05 in control and HS groups, respectively); LV fibrosis as indicated by higher hydroxyproline concentration; further increase in arterial pressure (161 ± 7 vs. 184 ± 8 mm Hg; P < .05); myocardial ischemia; and LV diastolic dysfunction. Nebivolol ameliorated the adverse cardiac effects of HS, demonstrated by decreased LV mass and fibrosis and improved coronary hemodynamics and LV function.
The effects of nebivolol were independent of arterial pressure. The results of this study provide important laboratory data that support a rationale for nebivolol in the treatment of patients with hypertension having diastolic dysfunction with preserved ejection fraction.
我们之前已经证明,高盐饮食(HS)会在成年自发性高血压大鼠(SHR)中导致心肌纤维化、左心室(LV)功能障碍和肾功能不全,并且肾素 - 血管紧张素系统的阻断可预防HS的这些不良影响。
将8周龄雄性SHR分为四组:对照组给予常规大鼠饲料(0.6%氯化钠);其他三组给予HS。第二组给予安慰剂;第三组口服奈必洛尔(2×10毫克/千克/天);第四组通过渗透微型泵给予相同剂量的奈必洛尔。大鼠接受相应治疗8周。数据表明,HS导致心脏重量增加(对照组和HS组分别为2.85±0.05与5.36±0.22毫克/克;P<.05);如羟脯氨酸浓度升高所示的LV纤维化;动脉压进一步升高(161±7与184±8毫米汞柱;P<.05);心肌缺血;以及LV舒张功能障碍。奈必洛尔改善了HS对心脏的不良影响,表现为LV重量和纤维化降低以及冠状动脉血流动力学和LV功能改善。
奈必洛尔的作用独立于动脉压。本研究结果提供了重要的实验室数据,支持奈必洛尔用于治疗射血分数保留的舒张功能障碍高血压患者的理论依据。