Ames Marisa K, Atkins Clarke E, Lantis Andrea C, zum Brunnen James
Department of Clinical Sciences, Colorado State University, USA
Department of Clinical Sciences, North Carolina State University, USA.
J Renin Angiotensin Aldosterone Syst. 2016 Mar 23;17(1):1470320316633897. doi: 10.1177/1470320316633897. Print 2016 Jan-Mar.
The objective of this study was to evaluate subacute changes in renin-angiotensin-aldosterone system (RAAS) activity during angiotensin-converting enzyme inhibitor (ACEI) therapy in dogs with experimental RAAS activation.
Analysis of data (urine aldosterone:creatinine ratio (UAldo:C) and serum angiotensin-converting enzyme activity), in 31 healthy dogs with furosemide or amlodipine-activated RAAS that received an ACEI. When furosemide or amlodipine activation of RAAS preceded ACEI administration, incomplete RAAS blockade (IRB) was defined as a UAldo:C greater than (a) the dog's 'activated' baseline value or (b) a population-derived cut-off value (mean + 2 SD (>1.0 μg/g) of pretreatment UAldo:C from our population of research dogs). In studies where RAAS activation occurred concurrently with ACEIs, IRB was defined as (a) a UAldo:C greater than either twofold the dog's prestimulation baseline value or (b) 1.0 µg/g. Dogs were followed for 7-17 days.
Serum angiotensin-converting enzyme activity was measured in 19 dogs and was significantly reduced (P<0.0001) after ACEI administration. The overall incidence of IRB, when RAAS activation preceded ACEI administration, was 33% and 8% for definitions (a) and (b), respectively. The overall incidence of IRB, when ACEIs were concurrent with RAAS activation, was 65% and 61% for definitions (a) and (b), respectively.
Increases in UAldo:C, despite ACEI administration, is evidence of IRB in this subacute model of experimental RAAS activation and suppression.
本研究的目的是评估在实验性肾素-血管紧张素-醛固酮系统（RAAS）激活的犬中，血管紧张素转换酶抑制剂（ACEI）治疗期间RAAS活性的亚急性变化。
对31只接受了ACEI治疗的、通过速尿或氨氯地平激活RAAS的健康犬的数据（尿醛固酮：肌酐比值（UAldo:C）和血清血管紧张素转换酶活性）进行分析。当RAAS通过速尿或氨氯地平激活先于ACEI给药时，不完全RAAS阻断（IRB）被定义为UAldo:C大于（a）犬的“激活”基线值或（b）一个基于群体的临界值（来自我们研究犬群体的预处理UAldo:C的均值 + 2标准差（>1.0 μg/g））。在RAAS激活与ACEI同时发生的研究中，IRB被定义为（a）UAldo:C大于犬刺激前基线值的两倍或（b）1.0 µg/g。对犬进行了7至17天的随访。
对19只犬测量了血清血管紧张素转换酶活性，ACEI给药后其显著降低（P<0.0001）。当RAAS激活先于ACEI给药时，对于定义（a）和（b），IRB的总体发生率分别为33%和8%。当ACEI与RAAS激活同时发生时，对于定义（a）和（b），IRB的总体发生率分别为65%和61%。
在这个实验性RAAS激活和抑制的亚急性模型中，尽管给予了ACEI，但UAldo:C升高是IRB的证据。
