Mitręga Katarzyna A, Spałek Adrianna M, Nożyński Jerzy, Porc Maurycy, Stankiewicz Magdalena, Krzemiński Tadeusz F
Silesian Centre for Heart Diseases, Zabrze, Poland.
Chair and Department of Pharmacology, Medical University of Silesia, Zabrze, Poland.
PLoS One. 2017 Jun 21;12(6):e0179633. doi: 10.1371/journal.pone.0179633. eCollection 2017.
During the last 25 years angiotensin-converting enzyme inhibitors spectacularly conquered the field of cardiovascular diseases therapy. Nevertheless, lack of new studies concerning side effects associated with their chronic administration seems to be rather confusing. In our previous research, we proved that the main furnidipines' metabolite (M-2) possess multiple cardioprotective actions. Currently, we compared effects of post-infarction long-term oral treatment with M-2 and captopril on hemodynamic parameters and "ischemic cardiomyopathy" development in rats. Myocardial infarction was evoked by permanent left anterior descending coronary artery occlusion for 35 days. Surviving rats were treated with captopril (2 × 25 mg/kg) or M-2 (4 mg/kg) from 6th- 35th day. At 35th day rats' hearts were tested on working heart setup, where following parameters were measured: heart rate, preload pressure, aortic systolic and diastolic pressures, aortic maximum rise and fall, aortic and coronary flow, myocardial oxygen consumption and oximetry in perfusate. Subsequently, heart tissue specimens were assessed during morphological estimation. Captopril caused significant heart rate increase and markedly diminished preload pressure in comparison to M-2. Both drugs evoked essential aortic pressure increase. Aortic flow was significantly decreased after M-2, whereas captopril increased this parameter in comparison to M-2. Both agents caused marked coronary flow increase. Morphologic examination in captopril revealed cardiomyopathic process in 70% of hearts, whereas in M-2 this value reached 30%. Neovascularization of post-infarcted myocardium was visible only after M-2 therapy. Concluding, M-2 presented itself as more attractive agent in long-term post-infarction treatment by preventing cardiomyopathy development, angiogenesis stimulation and preserving cardiac performance.
在过去25年中,血管紧张素转换酶抑制剂在心血管疾病治疗领域取得了显著成就。然而,关于其长期使用相关副作用的新研究匮乏,这似乎相当令人困惑。在我们之前的研究中,我们证明了主要的福尼地平代谢物(M-2)具有多种心脏保护作用。目前,我们比较了心肌梗死后长期口服M-2和卡托普利对大鼠血流动力学参数和“缺血性心肌病”发展的影响。通过永久性结扎左冠状动脉前降支35天诱发心肌梗死。存活的大鼠从第6天至第35天接受卡托普利(2×25mg/kg)或M-2(4mg/kg)治疗。在第35天,在工作心脏装置上对大鼠心脏进行测试,测量以下参数:心率、前负荷压力、主动脉收缩压和舒张压、主动脉最大上升和下降、主动脉和冠状动脉血流量、心肌耗氧量以及灌注液中的血氧饱和度。随后,在形态学评估期间对心脏组织标本进行评估。与M-2相比,卡托普利导致心率显著增加,前负荷压力明显降低。两种药物均引起主动脉压力显著升高。M-2治疗后主动脉血流量显著降低,而与M-2相比,卡托普利使该参数增加。两种药物均导致冠状动脉血流量显著增加。卡托普利组70%的心脏出现心肌病病变,而M-2组这一比例为30%。仅在M-2治疗后可见梗死心肌的新生血管形成。总之,M-2在心肌梗死后长期治疗中表现为更具吸引力的药物,可预防心肌病发展、刺激血管生成并维持心脏功能。