Kagaya Y, Hajjar R J, Gwathmey J K, Barry W H, Lorell B H
Charles A. Dana Research Institute, Boston, Mass, USA.
Circulation. 1996 Dec 1;94(11):2915-22. doi: 10.1161/01.cir.94.11.2915.
We have previously shown that long-term ACE inhibition with fosinopril prolongs survival and improves ventricular function despite persistent severe left ventricular pressure overload in ascending aortic-banded rats with left ventricular hypertrophy during the transition from compensation to failure.
To study the cellular mechanism of the effects of long-term ACE inhibition on the modification of the transition to failure in pressure-overload hypertrophy, we measured simultaneous intracellular Ca2+ transients and myocyte shortening in isolated left ventricular myocytes from fosinopril-treated aortic-banded rats (n = 9), untreated aortic-banded rats (n = 9), and normal age-matched control rats (n = 10). Fosinopril therapy was begun 6 weeks after banding and was continued until week 21 after banding, when the animals were killed. Collagenase-dissociated myocytes loaded with indo 1-AM were paced at 3 Hz at 36 degrees C and superfused at [Ca2+]o of 0.6, 1.2, and 3.0 mmol/L. In myocytes from untreated aortic-banded rats, peak systolic [Ca2+]i was higher than in control myocytes, and the relationship between myocyte shortening and [Ca2+]i was depressed relative to control myocytes, implicating impaired responsiveness to Ca2+. Long-term fosinopril treatment improved both myocyte shortening and the relationship of shortening to [Ca2+]i (P < .05 versus myocytes from untreated aortic-banded rats). Maximal Ca(2+)-activated force was depressed in chemically skinned left ventricular fibers from untreated aortic-banded hypertrophied rats relative to age-matched controls but not in the fosinopril-treated aortic-banded rats.
Long-term ACE inhibition improves responsiveness to Ca2+ in the presence of normalization of maximal Ca(2+)-activated force in aortic-banded rats subjected to persistent pressure overload. This may contribute to the favorable effects whereby ACE inhibition modifies the transition from compensated hypertrophy to failure.
我们之前已经表明,在升主动脉缩窄导致左心室肥厚的大鼠从代偿期向失代偿期转变过程中,尽管存在持续严重的左心室压力超负荷,长期使用福辛普利进行血管紧张素转换酶(ACE)抑制可延长生存期并改善心室功能。
为研究长期ACE抑制对压力超负荷性肥厚向失代偿转变的影响的细胞机制,我们在来自福辛普利治疗的主动脉缩窄大鼠(n = 9)、未治疗的主动脉缩窄大鼠(n = 9)和年龄匹配的正常对照大鼠(n = 10)的离体左心室肌细胞中,同时测量细胞内Ca2+瞬变和心肌细胞缩短情况。福辛普利治疗在缩窄6周后开始,并持续至缩窄后第21周,此时处死动物。用indo 1-AM负载的胶原酶解离的心肌细胞在36℃下以3 Hz起搏,并在0.6、1.2和3.0 mmol/L的细胞外Ca2+浓度([Ca2+]o)下进行灌流。在未治疗的主动脉缩窄大鼠的心肌细胞中,收缩期峰值[Ca2+]i高于对照心肌细胞,并且相对于对照心肌细胞,心肌细胞缩短与[Ca2+]i之间的关系受到抑制,这意味着对Ca2+的反应性受损。长期福辛普利治疗改善了心肌细胞缩短以及缩短与[Ca2+]i的关系(与未治疗的主动脉缩窄大鼠的心肌细胞相比,P <.05)。相对于年龄匹配的对照,未治疗的主动脉缩窄肥厚大鼠的化学去表皮左心室纤维中的最大Ca2+激活力降低,但在福辛普利治疗的主动脉缩窄大鼠中未降低。
在持续压力超负荷的主动脉缩窄大鼠中,长期ACE抑制在最大Ca2+激活力正常化的情况下改善了对Ca2+的反应性。这可能有助于ACE抑制改变从代偿性肥厚向失代偿转变的有益作用。