Norton G R, Tsotetsi J, Trifunovic B, Hartford C, Candy G P, Woodiwiss A J
Department of Physiology, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Circulation. 1997 Sep 16;96(6):1991-8. doi: 10.1161/01.cir.96.6.1991.
The relative contributions of increases in myocardial collagen, collagen cross-linking, and the ratio of type I to type III collagen to the stiff myocardium in hypertension were determined.
We compared the action of hydralazine (0.07 mmol x kg(-1) x d(-1)) with that of captopril (0.22 mmol x kg(-1) x d(-1)) on the left ventricular end-diastolic (LVED) myocardial stiffness constant, k (g x cm(-2)) and LV myocardial interstitial characteristics in spontaneously hypertensive rats (SHRs) and Wistar Kyoto (WKY) control rats. LVED k (SHR, 27.9+/-1; WKY, 19.5+/-1.2; P<.01), myocardial hydroxyproline concentrations (HPRO; microg/mg dry wt) (SHR, 4.19+/-0.16; WKY, 3.17+/-0.09; P<.001), and collagen type I/III ratios (SHR, 7.1+/-0.7; WKY, 2.1+/-0.2; P<.001) were increased, whereas the percentage of myocardial collagen extracted after cyanogen bromide digestion (an index of cross-linked collagen) was decreased (SHR, 17+/-3; WKY, 41+/-4; P<.001) in SHRs compared with WKY controls. Captopril therapy reduced LVED k, myocardial HPRO, collagen type I/III, and augmented collagen solubility (43+/-4) in SHRs to values similar to those measured in WKY controls. Hydralazine therapy, despite a favorable effect on LVED k in SHRs (20.+/-1.6, P<.01 compared with untreated SHRs), failed to influence either myocardial HPRO (4.18+/-0.18) or collagen type I/III (8+/-1) but did improve collagen solubility (31+/-2).
An association between alterations in LVED k and collagen solubility but not between changes in LVED k and total collagen or phenotype ratios after antihypertensive therapy in SHRs suggests that myocardial stiffness in hypertension is the consequence of an enhanced myocardial collagen cross-linking rather than of an increase in total collagen or type I phenotype concentrations.
确定了心肌胶原增加、胶原交联以及I型与III型胶原比例对高血压患者心肌僵硬的相对作用。
我们比较了肼屈嗪(0.07 mmol·kg⁻¹·d⁻¹)与卡托普利(0.22 mmol·kg⁻¹·d⁻¹)对自发性高血压大鼠(SHR)和Wistar Kyoto(WKY)对照大鼠左心室舒张末期(LVED)心肌硬度常数k(g·cm⁻²)及左心室心肌间质特征的作用。与WKY对照大鼠相比,SHR的LVED k(SHR为27.9±1;WKY为19.5±1.2;P<0.01)、心肌羟脯氨酸浓度(HPRO;μg/mg干重)(SHR为4.19±0.16;WKY为3.17±0.09;P<0.001)以及I型/III型胶原比例(SHR为7.1±0.7;WKY为2.1±0.2;P<0.001)均升高,而溴化氰消化后提取的心肌胶原百分比(交联胶原指标)降低(SHR为17±3;WKY为41±4;P<0.001)。卡托普利治疗可使SHR的LVED k、心肌HPRO、I型/III型胶原降低,并增加胶原溶解度(43±4),使其值与WKY对照大鼠测得的值相似。肼屈嗪治疗尽管对SHR的LVED k有有益作用(20.±1.6,与未治疗的SHR相比P<0.01),但未能影响心肌HPRO(4.18±0.18)或I型/III型胶原(8±1),但确实改善了胶原溶解度(31±2)。
SHR降压治疗后LVED k变化与胶原溶解度之间存在关联,但LVED k变化与总胶原或表型比例之间无关联,这表明高血压患者的心肌僵硬是心肌胶原交联增强的结果,而非总胶原或I型表型浓度增加的结果。