Document Detail


Effects of fixed-dose isosorbide dinitrate/hydralazine on diastolic function and exercise capacity in hypertension-induced diastolic heart failure.
MedLine Citation:
PMID:  19620510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertension-induced diastolic heart failure accounts for a large proportion of all heart failure presentations. Hypertension also induces left ventricular (LV) hypertrophy. Fixed-dose isosorbide dinitrate/hydralazine (HISDN) decreased mortality in human systolic heart failure but it is unknown whether it improves maladaptive myocardial remodeling. We sought to test the hypothesis that chronic HISDN modulates LV hypertrophy and myocardial remodeling in hypertension-induced diastolic heart failure. FVB mice underwent either saline (n=18) or aldosterone (n=28) infusion. All underwent uninephrectomy and drank 1% salt water for 4 weeks. Mice were randomized after surgery to regular chow or chow containing HISDN (isosorbide dinitrate: 26 mg/kg per day; hydralazine: 50 mg/kg per day) for 4 weeks. Aldosterone infusion increased tail-cuff blood pressure (161+/-3 mm Hg) versus saline-infused mice (129+/-2 mm Hg). Aldosterone induced LV hypertrophy versus saline-infused mice (LV:body weight ratio: 4.2+/-0.1 versus 3.6+/-0.1 mg/g). HISDN attenuated the aldosterone-induced increased in systolic blood pressure (137+/-5 mm Hg) and also lowered blood pressure in saline-infused mice (114+/-2 mm Hg). However, HISDN did not cause LV hypertrophy regression in aldosterone-infused mice. Aldosterone increased LV end-diastolic dimensions that were not attenuated by HISDN. Similarly, neither aldosterone infusion nor HISDN affected LV end-systolic dimensions. LV ejection fraction and wet:dry lung ratio were not different between aldosterone-untreated and aldosterone-HISDN mice. However, mitral Doppler E/A ratio (a measure of diastolic function), exercise capacity, and plasma soluble vascular cell adhesion molecule 1 levels were improved in aldosterone-HISDN hearts. In conclusion, fixed-dose HISDN improved hypertension, diastolic function, and exercise capacity and reduced soluble vascular cell adhesion molecule 1 levels. There were no reductions in LV hypertrophy, cardiac fibrosis, or pulmonary congestion. These functional improvements are likely related to extracardiac effects, such as effects on the vasculature.
Authors:
Richard M Wilson; Deepa S De Silva; Kaori Sato; Yasuhiro Izumiya; Flora Sam
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-07-20
Journal Detail:
Title:  Hypertension     Volume:  54     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-20     Completed Date:  2009-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  583-90     Citation Subset:  IM    
Affiliation:
Whitaker Cardiovascular Institute, Boston University School of Medicine, Evans Department of Medicine and Cardiovascular Section, 715 Albany Street, Boston, MA 02118, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aldosterone / administration & dosage,  toxicity
Animals
Atrial Natriuretic Factor / genetics
Blood Pressure / drug effects*
Cytokines / genetics
Diastole
Drug Therapy, Combination
Echocardiography, Doppler
Exercise Test
Fibrosis
Gene Expression / drug effects
Heart / drug effects,  physiopathology
Heart Failure / drug therapy*,  etiology,  physiopathology
Hydralazine / pharmacology*,  therapeutic use
Hypertension / drug therapy*,  etiology,  physiopathology
Isosorbide Dinitrate / pharmacology*,  therapeutic use
Male
Mice
Myocardium / pathology
Reverse Transcriptase Polymerase Chain Reaction
Sarcoplasmic Reticulum Calcium-Transporting ATPases / genetics
Sodium Chloride, Dietary / administration & dosage,  toxicity
Vascular Cell Adhesion Molecule-1 / blood
Vasodilator Agents / pharmacology,  therapeutic use
Grant Support
ID/Acronym/Agency:
HL 079099/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cytokines; 0/Sodium Chloride, Dietary; 0/Vascular Cell Adhesion Molecule-1; 0/Vasodilator Agents; 52-39-1/Aldosterone; 85637-73-6/Atrial Natriuretic Factor; 86-54-4/Hydralazine; 87-33-2/Isosorbide Dinitrate; EC 3.6.3.8/Atp2a2 protein, mouse; EC 3.6.3.8/Sarcoplasmic Reticulum Calcium-Transporting ATPases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Regional release and clearance of C-type natriuretic peptides in the human circulation and relation ...
Next Document:  Role of mineralocorticoid receptor on experimental cerebral aneurysms in rats.