Document Detail


Renin Inhibition and AT(1)R blockade improve metabolic signaling, oxidant stress and myocardial tissue remodeling.
MedLine Citation:
PMID:  23352204     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Strategies that block angiotensin II actions on its angiotensin type 1 receptor or inhibit actions of aldosterone have been shown to reduce myocardial hypertrophy and interstitial fibrosis in states of insulin resistance. Thereby, we sought to determine if combination of direct renin inhibition with angiotensin type 1 receptor blockade in vivo, through greater reductions in systolic blood pressure (SBP) and aldosterone would attenuate left ventricular hypertrophy and interstitial fibrosis to a greater extent than either intervention alone. MATERIALS/METHODS: We utilized the transgenic Ren2 rat which manifests increased tissue expression of murine renin which, in turn, results in increased renin-angiotensin system activity, aldosterone secretion and insulin resistance. Ren2 rats were treated with aliskiren, valsartan, the combination (aliskiren+valsartan), or vehicle for 21days. RESULTS: Compared to Sprague-Dawley controls, Ren2 rats displayed increased systolic blood pressure, elevated serum aldosterone levels, cardiac tissue hypertrophy, interstitial fibrosis and ultrastructural remodeling. These biochemical and functional alterations were accompanied by increases in the NADPH oxidase subunit Nox2 and 3-nitrotyrosine content along with increases in mammalian target of rapamycin and reductions in protein kinase B phosphorylation. Combination therapy contributed to greater reductions in systolic blood pressure and serum aldosterone but did not result in greater improvement in metabolic signaling or markers of oxidative stress, fibrosis or hypertrophy beyond either intervention alone. CONCLUSIONS: Thereby, our data suggest that the greater impact of combination therapy on reductions in aldosterone does not translate into greater reductions in myocardial fibrosis or hypertrophy in this transgenic model of tissue renin overexpression.
Authors:
Adam Whaley-Connell; Javad Habibi; Nathan Rehmer; Sivakumar Ardhanari; Melvin R Hayden; Lakshmi Pulakat; Caroline Krueger; Carlos M Ferrario; Vincent G Demarco; James R Sowers
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  -     ISSN:  1532-8600     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Research Service, Harry S. Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO 65201, USA; University of Missouri-Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212, USA; Department of Internal Medicine, MA415 Medical Sciences Building, One Hospital Drive, Columbia, MO 65212, USA; Division of Nephrology and Hypertension, One Hospital Drive, Columbia, MO 65212, USA; Divisionof Endocrinology, Diabetes and Metabolism, One Hospital Drive, Columbia, MO 65212, USA; Diabetes and Cardiovascular Center, One Hospital Drive, Columbia, MO 65212, USA. Electronic address: whaleyconnella@health.missouri.edu.
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