-
[show abstract]
[hide abstract]
ABSTRACT: The calcium antagonist felodipine, the lipid-peroxidation inhibitor H290/51, and the angiotensin II type 1 (AT1)-receptor antagonist candesartan all exert beneficial effects on myocardial ischemia/reperfusion injury. This study was undertaken to test the hypothesis that a combination of these drugs with different pharmacologic properties could exert additive cardioprotective effects. Anesthetized pigs were subjected to 45 min of left anterior descending coronary artery occlusion followed by 240 min of reperfusion. Five groups of pigs were randomly given either 0.65 microM (7 nmol/kg) felodipine, 1.0 microM (3.1 microg/kg) H 290/51, 4.2 microM (20 microg/kg) candesartan, a cocktail of these three drugs, or vehicle (n = 6 for each) for 30 min starting at 5 min before reperfusion by coronary venous retroinfusion, which delivers drugs specifically to the ischemic regions. Systolic segment shortening (%SS) was measured by sonomicrometer. The myocardial area at risk and the final infarct size were determined by Evans blue and 2,3,5-triphenyl tetrazolium chloride staining. The hemodynamics did not change significantly during the study. In the vehicle group, the recovery of coronary flow was not maintained during reperfusion, and it was significantly lower after 240 min of reperfusion than during the preischemic period (p < 0.05). The coronary flow in the drug-treated groups was approximately the same by the end of the reperfusion period as that before the induction of ischemia. In the ischemic myocardium, %SS slightly recovered during reperfusion in the four drug-treated groups, but not in the vehicle group. The infarct size, expressed as a percentage of the myocardial area at risk, was smaller in all four drug-treated groups compared with the vehicle group. The infarct size in the cocktail group was significantly smaller than that in the groups given felodipine, H290/51, or candesartan alone. These results demonstrate that a combination of a calcium antagonist, a lipid-peroxidation inhibitor, and an angiotensin AT1-receptor antagonist has an additive effect on infarct limitation, indicating that combined therapy with agents having different pharmacologic modes of action may provide better cardioprotection than any of the drugs alone. The findings also support the view that reperfusion injury is possibly mediated by a combination of mechanisms.
Journal of Cardiovascular Pharmacology 11/1999; 34(4):512-7. · 2.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It is not yet clear if cardiac angiotensin II is involved in the pathophysiology of myocardial ischemia/ reperfusion injury. The aim of this study was to investigate the effect of the angiotensin II AT1-receptor antagonist candesartan on myocardial functional recovery in isolated rat hearts subjected to ischemia and reperfusion. Three groups of hearts perfused in the Langendorff mode with Krebs-Henseleit buffer under constant pressure received either vehicle (n = 7), candesartan, 1 nM (n = 6), or 100 nM (n = 7) at the start of 30 min of global ischemia. The recovery of the double product was significantly higher in the candesartan, 100 nM, group (75+/-9.2%) than in the vehicle group (40+/-5.1%; p < 0.05). At the end of 30 min of reperfusion, left ventricular end diastolic pressure was lower in rats given candesartan, 100 nM, than in rats given vehicle (10+/-4.3 vs. 38+/-4.8 mm Hg; p < 0.05). After ischemia and reperfusion, there was a large no-reflow area in the vehicle group (28+/-3.1% of the left ventricle), which was reduced by candesartan, 100 nM (12+/-1.3%; p < 0.05). In rats given candesartan, 1 nM, there was a trend toward a higher recovery of the double product (73+/-13.4%), a lower left ventricular end-diastolic pressure (29+/-6.6 mm Hg), and a smaller no-reflow area (19+/-3.5% of the left ventricle) compared with the rats receiving vehicle. These trends did, however, not reach statistical significance. Our results demonstrate that candesartan reduces myocardial ischemia/reperfusion injury, thus indicating that endogenous cardiac angiotensin II is involved in the tissue injury after myocardial ischemia and reperfusion.
Journal of Cardiovascular Pharmacology 07/1999; 34(1):78-81. · 2.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The effect of the insurmountable angiotensin II AT1 receptor blocker candesartan on ischemic/reperfusion injury was investigated in isolated rat hearts and in anesthetized pigs. The possible additive effect of candesartan on the cardioprotection by a calcium antagonist and a lipid peroxidation inhibitor was also studied. In Langendorff-perfused rat hearts, candesartan, in a dose-related manner, improved left ventricular functional recovery and reduced the no-reflow area following global ischemia and reperfusion. A similar degree of cardioprotection by candesartan (10 nM) and an equipotent concentration of another AT1 receptor blocker losartan (3 microM) was observed when ischemia was begun immediately after drug pretreatment. When a washout period was implemented between pretreatment and ischemia, the protective effect of candesartan, but not that of losartan, remained, suggesting that candesartan may provide a more efficient cardioprotection than losartan. In anesthetized pigs subjected to 45 min of coronary artery occlusion followed by 240 min of reperfusion, local coronary venous retroinfusion (0.042, 0.42, and 4.2 microM) of candesartan starting just before reperfusion improved, in a dose-related manner, the recovery of myocardial segment shortening (sonomicrometer) and reduced infarct size without persistent effect on regional myocardial blood flow (microspheres). A combination of candesartan, felodipine, and the lipid peroxidation inhibitor H290/51 produced a more pronounced infarct limitation than each of these agents alone. In conclusion, candesartan exerts a cardioprotective effect, via a local mechanism within the ischemic myocardium. A combination of drugs with different pharmacologic profiles may provide a better cardioprotection in the setting of myocardial ischemic/reperfusion compared with each individual compound.
Journal of the American Society of Nephrology 02/1999; 10 Suppl 11:S137-42. · 9.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Angiotensin-converting enzyme (ACE) inhibitors reduce myocardial ischemia/reperfusion injury. It is unclear whether reduced formation of angiotensin II or attenuated degradation of bradykinin is responsible for the beneficial effects. We investigated the role of endogenous angiotensin II in ischemia/reperfusion injury by studying the effects of the angiotensin II type 1 receptor antagonist candesartan on myocardial function, infarct size, and perfusion after ischemia/reperfusion. Anesthetized pigs were subjected to 45 min of regional ischemia and 240 min of reperfusion. Starting 5 min before reperfusion, four groups of pigs (n = 6 in each) received coronary venous retroinfusion of candesartan (0.2, 2, or 20 microg/kg) or vehicle for 30 min. Myocardial regional blood flow was measured with radioactive microspheres in two separate groups (n = 6 in each) given 20 microg/kg candesartan or vehicle. Retroinfusion of 20 microg/kg of candesartan improved recovery of left ventricular systolic segment shortening measured by sonomicrometry in the ischemic area compared with 0.2 microg/kg of candesartan and vehicle. Infarct size, as a percentage of the area at risk, was smaller in the 2 and 20 microg/kg groups than in the vehicle group (39.1 +/- 11.6% and 34.8 +/- 10.2% vs. 78.3 +/- 8.9%, p < 0.01). There was no difference between candesartan and vehicle in their effects on regional myocardial blood flow. Angiotensin II type 1 receptor blockade supports myocardial functional recovery and reduces infarct size. This effect is not related to improved regional myocardial blood flow during reperfusion.
Journal of Cardiovascular Pharmacology 08/1998; 32(2):231-8. · 2.29 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The possible involvement of endothelin-1 (ET-1) and angiotensin II in the coronary vasoconstriction induced by nitric oxide synthase (NOS) inhibition was investigated in isolated Langendorff-perfused rat hearts. Fifteen minutes of perfusion with the NOS inhibitor NG-nitro-L-arginine (L-NNA, 0.1 mM) reduced coronary flow by 31%. Pre-treatment with the non-selective ETA/ETB receptor antagonist bosentan (1 and 10 microM) attenuated this reduction in coronary flow to 16% (P < 0.05) and 8% (P < 0.01), respectively. The selective ETA receptor antagonist BQ-123 (1 microM) induced a similar inhibitory action, whereas the selective ETB receptor antagonist BQ-788 and the angiotensin II type 1 receptor antagonist candesartan did not affect the vasoconstrictor response to L-NNA. In addition, bosentan administered after 15 min of L-NNA perfusion reversed the L-NNA-induced reduction in coronary flow in a dose-dependent manner. The high concentration of bosentan (10 microM) increased the basal coronary flow by 17%, while the lower concentration of bosentan, BQ-123, BQ-788 and candesartan did not affect basal coronary flow. Bosentan (10 microM) increased the level of ET-like immunoreactivity (-LI) in the coronary effluent twofold. L-NNA did not affect ET-LI level. These results indicate that ET-1 contributes to the coronary vasoconstrictor effect of L-NNA in the isolated rat heart, and that this action of ET-1 is mediated through ETA receptor activation. Angiotensin II does not seem to contribute to L-NNA-induced vasoconstriction under the present condition.
Acta Physiologica Scandinavica 08/1998; 163(4):325-30. · 2.55 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of the study was to investigate the efficacy of the novel non-peptide selective endothelin A (ETA) receptor antagonist LU 135,252 to limit the extent of myocardial ischaemic and reperfusion injury. Administration of LU 135,252 (1 and 5 mg kg-1 i.v.) to anaesthetised pigs reduced mean arterial pressure (MAP) from 91 +/- 4 to 79 +/- 3 mmHg (P < 0.05) and 96 +/- 3-82 +/- 3 mmHg (P < 0.01), respectively. Heart rate, coronary blood flow and coronary vascular resistance were not affected by LU 135,252. The infarct size induced by 45-min ligation of the left anterior descending coronary artery (LAD) followed by 4-h reperfusion in pigs was 81 +/- 5% of the area at risk in control animals given vehicle (n = 8). In pigs receiving 1 mg kg-1 (n = 6) or 5 mg kg-1 (n = 8) of LU 135,252 i.v. 20 min before ischaemia the infarct size was reduced to 64 +/- 3% (P < 0.05) and 35 +/- 4% (P < 0.001), respectively, of the area at risk. During the reperfusion period there was a non-significant trend towards a higher coronary blood flow and a lower coronary vascular resistance in the groups given LU 135,252 compared to controls. Myocardial overflow of ET-like immunoreactivity was increased during the reperfusion period but it was not affected by administration of LU 135,252. It is concluded that administration of the selective ETA receptor antagonist LU 135,252 effectively protects the myocardium from ischaemia/reperfusion injury, indicating that the ETA receptor subtype is involved in the development of ischaemia/reperfusion injury.
Acta Physiologica Scandinavica 06/1998; 163(2):131-7. · 2.55 Impact Factor
