Universidade Federal do Rio Grande do Sul, Porto Alegre, RS - Brasil.
Arq Bras Cardiol. 2024 Jun;121(7):e20230602. doi: 10.36660/abc.20230602.
Adverse remodeling of lung vessels elevates pulmonary pressure and provokes pulmonary arterial hypertension (PAH). PAH results in increased right ventricle (RV) afterload, causing ventricular hypertrophy and the onset of heart failure. There is no specific treatment for maladaptive RV remodeling secondary to PAH.
This study aims to explore two therapeutic approaches, grape juice (GJ) and thyroid hormones (TH), on PAH-induced oxidative stress and cardiac functional changes.
Parameters of echocardiography related to lung vessel resistance (AT/ET ratio), RV contractility (TAPSE), and RV diastolic function (E/A peaks ratio) were evaluated. Also, total ROS, lipid peroxidation, antioxidant enzymes, calcium handling proteins, pro-oxidant and antioxidant protein expression were measured. Values of p<0.05 were considered statistically significant.
Both GJ and TH treatments demonstrated reductions in pulmonary resistance (22%) and improvements in TAPSE (inotropism ~11%) and AT/ET ratio (26%) (p<0.05). There were no changes amongst groups regarding the E/A peak ratio. Although ROS and TBARS were not statistically significant, GJ and TH treatments decreased xanthine oxidase (49%) levels and normalized HSP70 and calcium handling protein expression (p<0.05). However, only TH treatment ameliorated diastolic function (50%) and augmented NRF2 immunocontent (~48%) (p<0.05).
To the best of our knowledge, this study stands as a pioneer in showing that TH administered together with GJ promoted functional and biochemical improvements in a PAH model. Moreover, our data suggest that GJ and TH treatments were cardioprotective, combined or not, and exhibited their beneficial effects by modulating oxidative stress and calcium-handling proteins.
肺血管的不利重构会升高肺压并引发肺动脉高压(PAH)。PAH 导致右心室(RV)后负荷增加,引起心室肥厚和心力衰竭的发生。目前尚无针对 PAH 引起的适应性 RV 重构的特定治疗方法。
本研究旨在探讨两种治疗方法,葡萄汁(GJ)和甲状腺激素(TH),对 PAH 引起的氧化应激和心脏功能变化的影响。
评估与肺血管阻力(AT/ET 比值)、RV 收缩力(TAPSE)和 RV 舒张功能(E/A 峰值比值)相关的超声心动图参数。同时,测量总 ROS、脂质过氧化、抗氧化酶、钙处理蛋白、促氧化剂和抗氧化蛋白的表达。p<0.05 被认为具有统计学意义。
GJ 和 TH 治疗均降低了肺阻力(22%),改善了 TAPSE(变力性11%)和 AT/ET 比值(26%)(p<0.05)。各组间 E/A 峰值比值均无变化。尽管 ROS 和 TBARS 无统计学意义,但 GJ 和 TH 治疗降低了黄嘌呤氧化酶(49%)水平,并使 HSP70 和钙处理蛋白的表达正常化(p<0.05)。然而,只有 TH 治疗改善了舒张功能(50%)并增加了 NRF2 免疫含量(48%)(p<0.05)。
据我们所知,这项研究是首次表明,TH 与 GJ 联合应用可改善 PAH 模型的功能和生化指标。此外,我们的数据表明,GJ 和 TH 治疗具有心脏保护作用,单独或联合使用,通过调节氧化应激和钙处理蛋白发挥其有益作用。