Okamoto K, Abe M, Haneda T
First Department of Internal Medicine, Asahikawa Medical College, Japan.
Jpn Circ J. 1993 Feb;57(2):147-60. doi: 10.1253/jcj.57.147.
Effects of reduction of blood pressure and regression of left ventricular hypertrophy following hydralazine and captopril therapy on ischemic cardiac function and myocardial metabolism were studied in spontaneously hypertensive rats (SHR). Hydralazine (1.5 or 3 mg/kg/day) and captopril (50 or 100 mg/kg/day) were administered to SHR from 19 to 26 weeks of age. Both hydralazine and captopril significantly decreased arterial blood pressure in SHR, but only captopril significantly reduced left ventricular weight. The percentage of V3 myosin isozyme significantly decreased in captopril-treated SHR compared to hydralazine-treated SHR. At the end of long-term treatment, hearts were removed and perfused for 15 min by the working heart technique, and then global ischemia was induced for 30 min. The ischemic heart was reperfused for 30 min. In hydralazine-treated SHR and captopril-treated SHR, the pressure-rate product and extent of recovery of the coronary flow during reperfusion following 30 min of ischemia were higher than those in control SHR, but this difference was significant only in captopril-treated SHR. Hydralazine and captopril treatment improved the restoration of the levels of ATP, creatine phosphate, total adenine nucleotide and energy charge potential in SHR after reperfusion following 30 min of ischemia, but only captopril had a significant effect. In conclusion, regression of left ventricular hypertrophy is more important than lowering of blood pressure in order to improve the ischemic myocardial damage.
在自发性高血压大鼠(SHR)中研究了肼屈嗪和卡托普利治疗后血压降低和左心室肥厚消退对缺血性心脏功能和心肌代谢的影响。从19至26周龄开始,给SHR施用肼屈嗪(1.5或3mg/kg/天)和卡托普利(50或100mg/kg/天)。肼屈嗪和卡托普利均显著降低了SHR的动脉血压,但只有卡托普利显著降低了左心室重量。与肼屈嗪治疗的SHR相比,卡托普利治疗的SHR中V3肌球蛋白同工酶的百分比显著降低。长期治疗结束时,取出心脏并通过工作心脏技术灌注15分钟,然后诱导全心缺血30分钟。缺血心脏再灌注30分钟。在肼屈嗪治疗的SHR和卡托普利治疗的SHR中,缺血30分钟后再灌注期间的压力-心率乘积和冠状动脉血流恢复程度高于对照SHR,但这种差异仅在卡托普利治疗的SHR中显著。肼屈嗪和卡托普利治疗改善了缺血30分钟后再灌注的SHR中ATP、磷酸肌酸、总腺嘌呤核苷酸和能荷电位水平的恢复,但只有卡托普利有显著作用。总之,为了改善缺血性心肌损伤,左心室肥厚的消退比降低血压更重要。