Spironolactone reduces fibrosis of dilated atria during heart failure in rats with myocardial infarction
Spironolactone reduces fibrosis of dilated atria during heart failure in rats with myocardial infarction
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DOI：
10.1093/eurheartj/ehi478
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发表时间：
2005-10-01
影响因子：
39.3
通讯作者：
Hatem, SN
中科院分区：
文献类型：
--
作者：
Milliez, P;DeAngelis, N;Hatem, SN
充血性心力衰竭（CHF）与严重的心房结构改变有关，导致心房功能受损和心律失常的风险。本研究探讨了CHF治疗对心房重构的影响。方法和结果三个月后心肌梗死（MI），大鼠进行了为期1个月的螺内酯，赖诺普利，或阿替洛尔单独或联合治疗。超声心动图-多普勒组织成像、血液动力学测量和24小时霍尔特监测用于描述心肌病的特征。用天狼星红染色定量心房纤维化。左心房直径增加（MI组5.8 +/- 0.6 mm vs.假手术组3.6 +/- 0.3 mm; P < 0.0001），心房纤维化也增加（MI组26.7 +/- 3.8% vs.假手术组10.5 +/- 2.2%; P < 0.0001），这与MI 3个月后的左心室（LV）功能障碍相关。P波持续时间也增加，24小时心电图上频繁出现房性早搏。单独或联合使用安体舒通、ACE抑制剂或β受体阻滞剂治疗1个月后，观察到LV功能障碍有类似的改善。所有治疗均能降低心房兴奋性，但只有螺内酯能减轻慢性CHF所致的心房纤维化，缩短P波时限。
Aims Congestive heart failure (CHF) is associated with severe structural changes of atria, contributing to impaired atrial function and the risk of arrhythmia. This study investigated the effects of CHF treatments on atrial remodelling.Methods and results Three months after myocardial infarction (MI), rats were treated for 1 month with spironolactone, lisinopril, or atenolol alone or in combination. Echocardiography-Doppler tissue imaging, haemodynamic measurements, and 24-h Holter monitoring were used to characterize the cardiomyopathy. Atrial fibrosis was quantified with Picrosirius Red staining. Left atrial diameter was increased (5.8 +/- 0.6 mm in MI vs. 3.6 +/- 0.3 mm in sham; P < 0.0001), as was atrial fibrosis (26.7 +/- 3.8% in MI vs. 10.5 +/- 2.2% in sham; P < 0.0001), which correlated with left ventricular (LV) dysfunction after 3 months of MI. P-wave duration was also increased and premature atrial beats were frequent on the 24-h electrocardiogram. Similar improvements in LV dysfunction were observed after 1 month of spironolactone, ACE-inhibitor, or beta-blocker therapy alone or in combination. Atrial hyperexcitability was reduced by all the treatments, but only spironolactone attenuated atrial fibrosis and reduced P-wave duration.Conclusion Atrial fibrosis caused by chronic CHF is reduced by spironolactone.