Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Pharmacol. 2019 Mar 15;847:61-71. doi: 10.1016/j.ejphar.2019.01.023. Epub 2019 Jan 23.
Following myocardial infarction, the heart undergoes a series of dramatic compensations which may later form a maladaptive picture characterized by ventricular dilation and pump failure. Among several opioid agents, morphine has been shown to confer protection against reperfusion injury and infarct size. Here, we sought to study the cardioprotective effect of post-infarct morphine treatment against left ventricular adverse remodeling. We induced myocardial infarction in male Sprague - Dawley rats by ligating left anterior descending artery and then, treated these animals with three different doses of morphine -0.3, 3 and 10 mg/kg (i.p.). The echocardiographic evaluation depicted improved cardiac performance and lesser chamber dilation in the animals that had received 3 mg/kg of morphine. Next, we studied the effect of 3 mg/kg morphine administration on left ventricular hemodynamics, infarct size, tissue architecture, changes in lung and heart weight, circulating TNF-α level and post-MI mRNA expression of collagen-1, collagen-3, TGF-β, TNF-α, MMP-2 and MMP-9. Five-day morphine administration markedly improved LV function, and also reduced infarct size, myocyte hypertrophy, fibrosis, index of infarct expansion, heart weight and serum TNF-α level. Moreover, morphine alleviated MI-induced increase in wet and dry lung weight. Morphine also altered the mRNA expression of fibrosis-related genes, TNF-α, MMP-2 and MMP-9. In conclusion, post-infarct morphine treatment can mitigate adverse remodeling and cardiac dysfunction after MI. Beside analgesic effect, we may be able to harvest benefits from the antifibrotic and anti-remodeling action of morphine in patients with the acute coronary syndrome.
心肌梗死后,心脏会经历一系列剧烈的代偿反应,这些反应可能会导致心室扩张和泵功能衰竭等不良适应。在几种阿片类药物中,吗啡已被证明可对抗再灌注损伤和梗死面积。在这里,我们研究了梗死后吗啡治疗对左心室不良重构的保护作用。我们通过结扎左前降支在雄性 Sprague - Dawley 大鼠中诱导心肌梗死,然后用三种不同剂量的吗啡(0.3、3 和 10mg/kg,腹腔注射)治疗这些动物。超声心动图评估显示,接受 3mg/kg 吗啡治疗的动物心脏功能得到改善,心室扩张程度较小。接下来,我们研究了 3mg/kg 吗啡给药对左心室血液动力学、梗死面积、组织结构、肺和心脏重量变化、循环 TNF-α 水平以及梗死后心肌胶原-1、胶原-3、TGF-β、TNF-α、MMP-2 和 MMP-9 mRNA 表达的影响。5 天吗啡给药显著改善 LV 功能,同时减少梗死面积、心肌细胞肥大、纤维化、梗死扩张指数、心脏重量和血清 TNF-α 水平。此外,吗啡减轻了 MI 引起的湿肺和干肺重量增加。吗啡还改变了纤维化相关基因、TNF-α、MMP-2 和 MMP-9 的 mRNA 表达。总之,梗死后吗啡治疗可减轻 MI 后不良重构和心功能障碍。除了镇痛作用外,我们还可能从急性冠脉综合征患者吗啡的抗纤维化和抗重构作用中获益。