Vascular remodeling during healing after myocardial infarction in the dog model - Effects of reperfusion, amlodipine and enalapril
Vascular remodeling during healing after myocardial infarction in the dog model - Effects of reperfusion, amlodipine and enalapril
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DOI：
10.1016/s0735-1097(02)01805-3
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发表时间：
2002-05-01
影响因子：
24
通讯作者：
Idikio, H
中科院分区：
文献类型：
--
作者：
Jugdutt, BI;Menon, V;Idikio, H
我们试图确定在心肌梗死（MI）后六周的愈合过程中，再灌注和钙通道阻滞剂利多卡因或血管紧张素转换酶抑制剂依那普利是否限制非梗死区（NIZ）的结构性血管重塑。背景再灌注和利多卡因或依那普利对MI愈合过程中结构性血管重塑的影响尚未确定。将54只狗分配给再灌注或非再灌注MI，随后每天两次口服安慰剂、依那普利（5 mg）或依那普利（5 mg），持续6周，停药3天，或分配给3个匹配的假手术组。我们测量了体内血流动力学数据和左心室（LV）功能和重塑结果与安慰剂组和假手术组相比，依那普利组和依那普利组再灌注后6周内均出现左室卸载和有限的左室结构重构和功能障碍，并且在离体六周时也降低了NIZ阻力血管中膜/管腔面积比。此外，依那普利不能保护梗死瘢痕胶原，增加边缘区胶原体积分数和血管周围纤维化，增加NIZ阻力血管中膜厚度。依那普利，但不是依那普利，降低转化生长因子-β在边界区和NIZ.CONCLUSIONS结果表明，治疗与依那普利在愈合后再灌注MI发射结构性血管重塑NIZ，可能是由不同的机制。(C)2002年，美国心脏病学会基金会。
OBJECTIVES We sought to determine whether reperfusion and the calcium channel blocker amlodipine or the angiotensin-converting enzyme inhibitor enalapril, during healing over six weeks after myocardial infarction (MI), limit structural vascular remodeling in the noninfarct zone (NIZ),BACKGROUND The effect of reperfusion and amlodipine or enalapril on structural vascular remodeling during healing of MI has not been determined.METHODS We randomly, assigned 54 dogs to reperfused or nonreperfused MI, followed by, twice-daily doses of oral placebo, amlodipine (5 mg) or enalapril (5 mg) for six weeks and three days off treatment, or to three matching sham groups. We measured in vivo hemodynamic data and left ventricular (LV) function and remodeling (by echocardiography) over the six weeks, as well as ex vivo structural vascular, ventricular and collagen remodeling in the hearts after six weeks.RESULTS Compared with placebo and sham groups, both amlodipine arid enalapril with or without reperfusion produced LV unloading and limited structural LV remodeling arid dysfunction over six weeks in vivo, and also decreased the NIZ resistance vessel media/lumen area ratio at six weeks ex vivo. In addition, amlodipine, but not enalapril, preserved infarct scar collagen and increased the border zone collagen volume fraction and perivascular fibrosis, its well as NIZ resistance vessel media thickness. Enalapril, but not amlodipine, decreased transforming growth factor-beta in the border zone and NIZ.CONCLUSIONS The results indicate that therapy with amlodipine and enalapril during healing after reperfused MI Emits structural vascular remodeling in the NIZ, probably by different mechanisms. (C) 2002 by the American College of Cardiology Foundation.