Böhm M, Castellano M, Agabiti-Rosei E, Flesch M, Paul M, Erdmann E
Klinik III für Innere Medizin, Universität zu Köln, Germany.
Circulation. 1995 Nov 15;92(10):3006-13. doi: 10.1161/01.cir.92.10.3006.
Dose-dependent effects of ACE inhibitors on blood pressure, cardiac hypertrophy, and beta-adrenergic signal transduction were examined in an animal model with beta-adrenergic desensitization, which has been identified in failing hearts and in hypertensive cardiac hypertrophy. It is unknown whether beneficial ACE-inhibitor effects are due to an unloading of the failing heart or a reduction of neuroendocrine activation with beta-adrenergic resensitization.
Low-dose (LD, 1 mg/kg) and high-dose (HD, 25 mg/kg) fosinopril treatment was performed in spontaneously hypertensive rats (SHR) and control (WKY) rats. Myocardial norepinephrine concentrations, adenylyl cyclase activity, beta-adrenergic receptors (radioligand binding), Gs alpha (functional reconstitution), and Gi alpha (pertussis toxin labeling) were determined. Ventricular weights and blood pressures were measured. HD but not LD reduced blood pressure and left ventricular weights in SHR. Isoprenaline- and guanylylim-idodiphosphate-stimulated adenylyl cyclase activities as well as beta 1-adrenergic receptors were reduced in SHR. The catalyst and Gs alpha were unchanged, but Gi alpha and norepinephrine concentrations were increased. Both LD and HD treatments restored beta-adrenergic alteration.
LD treatment with ACE inhibitors restored beta-adrenergic signal transduction defects independently of regression of cardiac hypertrophy. This could contribute to the effects of ACE inhibitors in patients, who are often treated with nonhypotensive doses.
在一种存在β-肾上腺素能脱敏的动物模型中研究了血管紧张素转换酶(ACE)抑制剂对血压、心肌肥厚和β-肾上腺素能信号转导的剂量依赖性作用,这种脱敏现象已在衰竭心脏和高血压性心肌肥厚中得到证实。尚不清楚ACE抑制剂的有益作用是由于减轻了衰竭心脏的负荷,还是由于β-肾上腺素能再敏化而减少了神经内分泌激活。
对自发性高血压大鼠(SHR)和对照(WKY)大鼠进行低剂量(LD,1mg/kg)和高剂量(HD,25mg/kg)福辛普利治疗。测定心肌去甲肾上腺素浓度、腺苷酸环化酶活性、β-肾上腺素能受体(放射性配体结合)、Gsα(功能重建)和Giα(百日咳毒素标记)。测量心室重量和血压。高剂量而非低剂量降低了SHR的血压和左心室重量。异丙肾上腺素和鸟苷酰亚胺二磷酸刺激的腺苷酸环化酶活性以及β1-肾上腺素能受体在SHR中降低。催化亚基和Gsα未改变,但Giα和去甲肾上腺素浓度增加。低剂量和高剂量治疗均恢复了β-肾上腺素能改变。
ACE抑制剂低剂量治疗可独立于心肌肥厚的消退而恢复β-肾上腺素能信号转导缺陷。这可能有助于解释ACE抑制剂在常接受非降压剂量治疗的患者中的作用。