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长期使用氯沙坦治疗不会影响压力超负荷诱导的心肌肥厚的发展。

Development of pressure overload induced cardiac hypertrophy is unaffected by long-term treatment with losartan.

作者信息

Turcani M, Rupp H

机构信息

Institute of Pathophysiology, Medical School, Comenius University, Bratislava, Slovak Republic.

出版信息

Mol Cell Biochem. 1998 Nov;188(1-2):225-33.

PMID:9823028
Abstract

Left ventricular hypertrophy with adequate wall thickness, preserved adult phenotype and extracellular matrix may be useful in the prevention of heart failure. Because activation of subtype 1 of angiotensin II (AT1) receptors is thought to be involved in the hypertrophic response of cardiomyocytes, we tested the potential of systemic AT1 blockade to modify the development of left ventricular hypertrophy due to pressure overload. Sham-operated rats and rats with ascending aorta constriction were treated with losartan (30 mg/kg/day) for 8 weeks. Left ventricular geometry, dynamics of isovolumic contractions, hydroxyproline concentration as well as myosin isozymes (marker of fetal phenotype) were assessed. Rats with aortic constriction exhibited a marked increase in left ventricular weight and the diastolic pressure-volume relationship was shifted to smaller volumes. An enlarged ventricular pressure-volume area and increased (p < 0.05) peak values of +dP/dtmax and- dP/dtmax demonstrated an enhanced overall ventricular performance. Signs of congestive heart failure were not apparent. In contrast, parameters of myocardial function (normalized length-stress area, +d delta /dtmax and -d delta /dtmax) were depressed (p < 0.05), indicating an impaired myocardial contractility. The hydroxyproline concentration remained unaltered. However, the proportion of beta-myosin heavy chains (MHC) was increased (p < 0.05). Administration of losartan decreased (p < 0.05) blood pressure and body weight in sham operated and pressure overloaded rats. By contrast, neither the concentric left ventricular hypertrophy or depressed myocardial function nor the increased beta-MHC expression were significantly altered. Thus, activation of AT1 receptors appears not to be involved in the initial expression of the fetal phenotype of pressure overloaded heart which may be responsible for the progressive functional deterioration of the hypertrophied ventricle.

摘要

具有足够壁厚、保留成年表型和细胞外基质的左心室肥厚可能有助于预防心力衰竭。由于血管紧张素II(AT1)受体1亚型的激活被认为参与了心肌细胞的肥厚反应,我们测试了全身性AT1阻断对因压力超负荷导致的左心室肥厚发展的影响。对假手术大鼠和升主动脉缩窄大鼠用氯沙坦(30毫克/千克/天)治疗8周。评估左心室几何形状、等容收缩动力学、羟脯氨酸浓度以及肌球蛋白同工酶(胎儿表型标志物)。主动脉缩窄大鼠的左心室重量显著增加,舒张期压力-容积关系向较小容积偏移。增大的心室压力-容积面积以及 +dP/dtmax 和 -dP/dtmax 的峰值增加(p < 0.05)表明整体心室功能增强。充血性心力衰竭的体征不明显。相比之下,心肌功能参数(归一化长度-应力面积、+dδ/dtmax 和 -dδ/dtmax)降低(p < 0.05),表明心肌收缩力受损。羟脯氨酸浓度保持不变。然而,β-肌球蛋白重链(MHC)的比例增加(p < 0.05)。氯沙坦给药降低了(p < 0.05)假手术和压力超负荷大鼠的血压和体重。相比之下,同心性左心室肥厚、心肌功能降低以及β-MHC表达增加均未显著改变。因此,AT1受体的激活似乎不参与压力超负荷心脏胎儿表型的初始表达,而这种表型可能是肥厚心室进行性功能恶化的原因。

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