Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
J Cardiovasc Pharmacol. 2018 Jul;72(1):22-31. doi: 10.1097/FJC.0000000000000586.
Heart failure is a common adverse effect associated with doxorubicin treatment. The aim of this study is to investigate the effect of ivabradine treatment on doxorubicin-induced heart failure in conscious rats. Rats were treated with doxorubicin (2.5 mg/kg/d) or ivabradine (10 mg/kg/d) alone or along with doxorubicin injections. Changes in heart rate variability (HRV), baroreflex sensitivity, left ventricular (LV) function, serum cardiac troponin T, and cardiac histological features were taken as index parameters for the development of heart failure. Ivabradine significantly reduced the elevated heart rate; normalized the parameters of LV function, dP/dtmax and the relaxation time constant (Tau); reduced the elevated serum level of cardiac troponin T; and minimized the cardiac structural abnormalities in doxorubicin-treated rats. Moreover, ivabradine significantly increased the diminished time domain parameters of HRV, SDNN and rMSSD, and decreased the elevated low frequency power and the low frequency/high frequency while having no effect on the reduced high frequency power. Consistently, ivabradine significantly lowered the elevated baroreflex sensitivity measured by sodium nitroprusside. In conclusion, ivabradine ameliorated the LV dysfunction induced by doxorubicin. Moreover, ivabradine increased the overall HRV and restored the autonomic balance by reducing the sympathetic over activation. Therefore, ivabradine may have a possible therapeutic potential against doxorubicin-induced heart failure.
心力衰竭是多柔比星治疗相关的常见不良反应。本研究旨在探讨伊伐布雷定对阿霉素诱导的清醒大鼠心力衰竭的影响。大鼠单独或联合阿霉素注射用多柔比星(2.5mg/kg/d)或伊伐布雷定(10mg/kg/d)治疗。将心率变异性(HRV)、压力反射敏感性、左心室(LV)功能、血清心肌肌钙蛋白 T 和心脏组织学特征的变化作为心力衰竭发展的指标参数。伊伐布雷定可显著降低心率升高;使 LV 功能参数、dP/dtmax 和松弛时间常数(Tau)正常化;降低血清心肌肌钙蛋白 T 水平升高;并最小化阿霉素处理大鼠的心脏结构异常。此外,伊伐布雷定还显著增加了 HRV 的时域参数 SDNN 和 rMSSD,降低了低频功率和低频/高频比值的升高,同时对高频功率的降低没有影响。同样,伊伐布雷定显著降低了硝普钠测量的升高的压力反射敏感性。总之,伊伐布雷定改善了多柔比星引起的 LV 功能障碍。此外,伊伐布雷定通过降低交感神经过度激活增加了整体 HRV,并恢复了自主平衡。因此,伊伐布雷定可能对多柔比星诱导的心力衰竭具有潜在的治疗作用。