肾交感神经去支配术与血管紧张素转换酶抑制剂对左心室肥厚的影响。自发性高血压大鼠的比较研究。

Effects of renal sympathetic denervation and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy. Comparison in spontaneously hypertensive rats.

作者信息

Ding X, Xu X, Yan Y, Song X, Liu S, Wang G, Su D, Jing Q, Qin Y

机构信息

Department of Cardiology, Changhai Hospital, 2nd Military Medical University, 168 Changhai Road, 200433, Shanghai, PR China.

出版信息

Herz. 2015 Jun;40(4):695-701. doi: 10.1007/s00059-014-4110-5. Epub 2014 Jun 14.

DOI:10.1007/s00059-014-4110-5

PMID:24924395

Abstract

OBJECTIVES

The aim of this study was to investigate whether renal sympathetic denervation (RSD) is more effective on myocardial hypertrophy than the angiotensin-converting enzyme inhibitor (ACEI) perindopril in spontaneously hypertensive rats (SHRs).

METHODS

After bilateral renal denervation blood pressure (BP) was measured every 10 days. On day 50 the heart was (histo)pathologically examined. The ventricular weight to body weight ratios (VW/BW), myocardial diameter and collagen volume fraction (CVF) were calculated, and cardiac hypertrophy marker genes were analyzed by RT-PCR.

RESULTS

At the baseline evaluation all groups had comparable BP. After treatment the BP of the RSD group was significantly reduced (p < 0.05). The BP of the RSD group was lower than that of the perindopril group on days 10, 20 and 30th (p < 0.05) but on day 50 systolic BP of the RSD group was significantly higher (p < 0.05) whereas there were no significant differences in diastolic BP. The VW/BW decreased in the RSD group, whereas the value did not change significantly in the perindopril group. The myocardial diameter of the left ventricular cardiomyocytes was also significantly lower in the RSD group and stayed the same in the perindopril group. Collagen volume fraction (CVF) in the RSD group was significantly lower than in the perindopril group (p < 0.05). Significant changes in the expression levels of NPPA, MYH7, and MYH6 (P < 0.05) were observed in the RD-SHR groups (p < 0.05). There was a significant difference in the expression level of MYH6 (p < 0.05) between the RSD group and the perindopril group but the expression levels of NPPA and MYH7 were not significantly different.

CONCLUSION

In this study, RSD had a significant antihypertensive effect and inhibited hypertensive-induced cardiac hypertrophy in SHRs and showed advantages compared with ACEI in decreasing BP in the early stage and in inhibiting myocardial fibrosis.

摘要

目的

本研究旨在探讨在自发性高血压大鼠（SHR）中，肾交感神经去支配术（RSD）对心肌肥大的作用是否比血管紧张素转换酶抑制剂（ACEI）培哚普利更有效。

方法

双侧肾去神经支配术后，每10天测量一次血压（BP）。在第50天对心脏进行（组织）病理学检查。计算心室重量与体重比（VW/BW）、心肌直径和胶原容积分数（CVF），并通过逆转录聚合酶链反应（RT-PCR）分析心脏肥大标志物基因。

结果

在基线评估时，所有组的血压相当。治疗后，RSD组的血压显著降低（p<0.05）。在第10、20和30天，RSD组的血压低于培哚普利组（p<0.05），但在第50天，RSD组的收缩压显著更高（p<0.05），而舒张压无显著差异。RSD组的VW/BW降低，而培哚普利组的值无显著变化。RSD组左心室心肌细胞的直径也显著更低，而培哚普利组保持不变。RSD组的胶原容积分数（CVF）显著低于培哚普利组（p<0.05）。在RSD-SHR组中观察到NPPA、MYH7和MYH6的表达水平有显著变化（P<0.05）。RSD组和培哚普利组之间MYH6的表达水平有显著差异（p<0.05），但NPPA和MYH7的表达水平无显著差异。