Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Hypertens Res. 2013 May;36(5):408-13. doi: 10.1038/hr.2012.191. Epub 2013 Jan 31.
Certain β-adrenergic blockers have proven useful in the regression of ventricular remodeling when administered as long-term treatment. However, early regression of left ventricular hypertrophy (LVH) has not been reported, following short-term administration of these drugs. We tested the hypothesis that short-term administration of the cardioselective β-blocker esmolol induces early regression of LVH in spontaneously hypertensive rats (SHR). Fourteen-month-old male SHRs were treated i.v. with vehicle (SHR) or esmolol (SHR-E) (300 μg kg(-1) min(-1)). Age-matched vehicle-treated male Wistar-Kyoto (WKY) rats served as controls. After 48 h, left ventricular morphology and function were assessed using M-mode echocardiograms (left ventricular mass index (LVMI), ejection fraction and transmitral Doppler (early-to-atrial filling velocity ratio (E/A), E-wave deceleration time (Edec time)). The standardized uptake value (SUV) was applied to evaluate FDG (2-deoxy-2[18F]fluoro-D-glucose) uptake by the heart using PET/CT. Left ventricular subendocardial and subepicardial biopsies were taken to analyze changes in cross-sectional area (CSA) of left ventricular cardiomyocytes and the fibrosis was expressed as collagen volume fraction (CVF). LVMI was lower in SHR-E with respect to SHR (P=0.009). There were no significant differences in EF, E/A ratio or Edec time in SHR-E compared with SHR (P=0.17, 0.55 and P=0.80, respectively). PET acquisitions in SHR-E showed lower (18)F-FDG uptake than SHR (P=0.003). Interestingly, there were no significant differences in SUV in either SHR-E or WKY (P=0.63). CSA in subendocardial and subepicardial regions was minor in SHR-E with respect to SHR (P<0.001), and there were no significant differences in CVF between both groups. Esmolol reverses early LVH in the SHR model of stable compensated ventricular hypertrophy. This is the first study to associate early regression of LVH with administration of a short-term β-blocker.
某些β肾上腺素能阻滞剂已被证明在长期治疗时可有效逆转心室重构。然而，这些药物短期给药后，左心室肥厚（LVH）的早期逆转尚未报道。我们检验了一个假设，即短期给予心脏选择性β受体阻滞剂艾司洛尔可诱导自发性高血压大鼠（SHR）的 LVH 早期逆转。14 月龄雄性 SHR 经静脉内给予载体（SHR）或艾司洛尔（SHR-E）（300μg·kg-1·min-1）。年龄匹配的载体处理雄性 Wistar-Kyoto（WKY）大鼠作为对照。48 小时后，使用 M 模式超声心动图评估左心室形态和功能（左心室质量指数（LVMI）、射血分数和经二尖瓣多普勒（早期至心房充盈速度比（E/A）、E 波减速时间（Edec 时间））。应用标准化摄取值（SUV）评估 PET/CT 检测的心脏 2-脱氧-2[18F]氟-D-葡萄糖（FDG）摄取。取左心室心内膜和心外膜活检，分析左心室心肌细胞的横截面积（CSA）变化，并以胶原容积分数（CVF）表示纤维化。与 SHR 相比，SHR-E 的 LVMI 较低（P=0.009）。与 SHR 相比，SHR-E 的 EF、E/A 比值或 Edec 时间无显著差异（P=0.17、0.55 和 P=0.80）。SHR-E 的 PET 采集显示（18）F-FDG 摄取低于 SHR（P=0.003）。有趣的是，SHR-E 或 WKY 的 SUV 无显著差异（P=0.63）。与 SHR 相比，SHR-E 的心内膜下和心外膜下区域 CSA 较小（P<0.001），两组之间的 CVF 无显著差异。艾司洛尔逆转了稳定代偿性心室肥厚 SHR 模型中的早期 LVH。这是第一项将 LVH 的早期逆转与短期β受体阻滞剂给药相关联的研究。
