Effects of Two Inhibitors of Renin‐Angiotensin System on Attenuation of Postoperative Remodeling after Left Ventricular Aneurysm Repair in Rats
Effects of Two Inhibitors of Renin‐Angiotensin System on Attenuation of Postoperative Remodeling after Left Ventricular Aneurysm Repair in Rats
复制标题
两种肾素-血管紧张素系统抑制剂对大鼠左心室动脉瘤修复术后重构的减弱作用
DOI：
10.1046/j.1540-8191.18.s2.9.x
复制
发表时间：
2003
影响因子：
1.6
通讯作者：
M. Komeda
中科院分区：
文献类型：
--
作者：
T. Nomoto;T. Nishina;H. Tsuneyoshi;S. Miwa;K. Nishimura;M. Komeda
摘要我们报道了心肌梗死(MI)后左室壁瘤行左室修复术(LVR)后，由于术后左室重构，其最初的有益效果并不持久。肾素-血管紧张素系统(RAS)在心肌梗死后左室重构中起重要作用。抑制RAS可能有助于通过阻止重塑来保护左心功能。我们研究了两种RAS抑制剂的作用，以期改善LVR的手术效果。结扎左前降支建立大鼠左室动脉瘤模型。采用夹闭法复制大鼠左室动脉瘤模型，分别给予不治疗、血管紧张素转换酶抑制剂(ACE-I)(赖诺普利10 mg/(kg·d))和血管紧张素II受体阻滞剂(ARB)(坎地沙坦5 mg/(kg·d))治疗。LVR术后1周，超声心动图显示较术前左室大小缩小，运动良好。LVR后4周，未治疗组的LV大小恢复到术前水平，但治疗组的LV大小恢复到术前水平。心导管术显示治疗组左室舒张末压降低，E-max升高。ACE-I组和ARB组之间除收缩压外，其余指标均无差异。LVR仅在早期缩小左心室内径，改善收缩功能。辅助应用血管紧张素转换酶I或血管紧张素转换酶B可减轻左心室重构，并使左心室功能维持在相同水平。这可能表明组织RAS与术后重塑有关。同时使用RAS抑制剂可能会使LVR成为治疗LV动脉瘤的一种更持久的方法。(J Card SURG 2003；18(Suppl 2)：S61-S68)
Abstract We reported that the initial beneficial effects of left ventricular repair (LVR) surgery for LV aneurysm after myocardial infarction (MI) did not persist because of postoperative LV remodeling in a rat model. The renin‐angiotensin system (RAS) plays an important role in postinfarction LV remodeling. Inhibition of RAS may be useful to preserve LV function by preventing remodeling. We studied the effects of two inhibitors of RAS in an attempt to improve the operative results of LVR. LV aneurysms were created in rats after ligating the left anterior descending artery. These rats underwent LVR by plicating the LV aneurysm and were treated by three methods: no treatment, treatment with angiotensin‐converting enzyme inhibitor (ACE‐I) (lisinopril 10 mg/kg per day), and treatment with angiotensin II receptor blocker (ARB) (candesartan 5 mg/kg per day). One week after LVR, echocardiography revealed smaller LV size and better LV motion than before surgery. Four weeks after LVR, LV size returned to the preoperative value in the untreated group, but not as much in the treated groups. Cardiac catheterization revealed lower LV end‐diastolic pressure and higher E‐max in the treated groups. There was no difference between ACE‐I and ARB groups except for systolic blood pressure. LVR decreased LV size and improved systolic function only in the early phase. Adjuvant therapy of ACE‐I or ARB‐attenuated LV remodeling and maintained LV function at the same level after LVR. This probably indicates that tissue RAS is associated with postoperative remodeling. Concomitant use of RAS inhibitors may make LVR a longer‐lasting procedure for LV aneurysm. (J CARD SURG 2003;18 (Suppl 2):S61‐S68)
DOI：
10.1152/ajpheart.2000.279.1.h422
发表时间：
2000-07-01
影响因子：
4.8
作者：
Sam, F;Sawyer, DB;Colucci, WS
通讯作者：
Colucci, WS