Tsoporis J, Yuan B X, Leenen F H
Division of Clinical Pharmacology, Toronto Western Hospital, Ontario, Canada.
Am J Physiol. 1989 Mar;256(3 Pt 2):H876-80. doi: 10.1152/ajpheart.1989.256.3.H876.
To assess a possible involvement of cardiac volume overload in the development of cardiac hypertrophy during chronic arterial vasodilator treatment, changes in indexes of cardiac volume load in relation to changes in cardiac anatomy were evaluated during treatment of normotensive rats with 120 mg/l hydralazine or 120 mg/l minoxidil, with drinking water. Long-term treatment with hydralazine, but not minoxidil, caused small decreases in systolic blood pressure; neither vasodilator affected heart rate with chronic treatment. Arterial vasodilator treatment for 2 wk or more resulted in increases in plasma and blood volumes by 10-20%. Both arterial vasodilators increased right atrial pressure and left ventricular end-diastolic pressure in the initial weeks of treatment. Only the minoxidil group showed a persistent increase in right atrial pressure throughout the treatment period. These hemodynamic changes were associated with increases in left ventricular (LV) internal diameter and right ventricular (RV) weight, and with minoxidil these changes were also associated with increased LV weight. LV wall thickness did not increase. Cardiac volume overload therefore indeed occurs during treatment with arterial vasodilators and may contribute to their effects on cardiac anatomy (i.e., development of RV hypertrophy and, in the case of minoxidil, also, eccentric LV hypertrophy), which are consistent with cardiac volume overload.
为评估慢性动脉血管扩张剂治疗期间心脏容量超负荷在心脏肥大发展过程中可能的作用,在用120mg/l肼屈嗪或120mg/l米诺地尔的饮用水治疗正常血压大鼠的过程中,评估了心脏容量负荷指标相对于心脏解剖结构变化的改变。长期使用肼屈嗪治疗可使收缩压小幅下降,但米诺地尔无此作用;两种血管扩张剂长期治疗均不影响心率。动脉血管扩张剂治疗2周或更长时间会使血浆和血容量增加10%-20%。在治疗的最初几周,两种动脉血管扩张剂均会使右心房压力和左心室舒张末期压力升高。只有米诺地尔组在整个治疗期间右心房压力持续升高。这些血流动力学变化与左心室内径和右心室重量增加有关,使用米诺地尔治疗时,这些变化还与左心室重量增加有关。左心室壁厚度未增加。因此,在动脉血管扩张剂治疗期间确实会发生心脏容量超负荷,这可能导致其对心脏解剖结构产生影响(即右心室肥大的发展,以及使用米诺地尔时出现的离心性左心室肥大),这些均与心脏容量超负荷相符。