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Qin X, Cai P, Liu C, Chen K, Jiang X, Chen W, Li J, Jiao X, Guo E, Yu Y, Sun L, Tian H. Cardioprotective effect of ultrasound-targeted destruction of Sirt3-loaded cationic microbubbles in a large animal model of pathological cardiac hypertrophy. Acta Biomater 2023; 164:604-625. [PMID: 37080445 DOI: 10.1016/j.actbio.2023.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
Pathological cardiac hypertrophy occurs in response to numerous increased afterload stimuli and precedes irreversible heart failure (HF). Therefore, therapies that ameliorate pathological cardiac hypertrophy are urgently required. Sirtuin 3 (Sirt3) is a main member of histone deacetylase class III and is a crucial anti-oxidative stress agent. Therapeutically enhancing the Sirt3 transfection efficiency in the heart would broaden the potential clinical application of Sirt3. Ultrasound-targeted microbubble destruction (UTMD) is a prospective, noninvasive, repeatable, and targeted gene delivery technique. In the present study, we explored the potential and safety of UTMD as a delivery tool for Sirt3 in hypertrophic heart tissues using adult male Bama miniature pigs. Pigs were subjected to ear vein delivery of human Sirt3 together with UTMD of cationic microbubbles (CMBs). Fluorescence imaging, western blotting, and quantitative real-time PCR revealed that the targeted destruction of ultrasonic CMBs in cardiac tissues greatly boosted Sirt3 delivery. Overexpression of Sirt3 ameliorated oxidative stress and partially improved the diastolic function and prevented the apoptosis and profibrotic response. Lastly, our data revealed that Sirt3 may regulate the potential transcription of catalase and MnSOD through Foxo3a. Combining the advantages of ultrasound CMBs with preclinical hypertrophy large animal models for gene delivery, we established a classical hypertrophy model as well as a strategy for the targeted delivery of genes to hypertrophic heart tissues. Since oxidative stress, fibrosis and apoptosis are indispensable in the evolution of cardiac hypertrophy and heart failure, our findings suggest that Sirt3 is a promising therapeutic option for these diseases. STATEMENT OF SIGNIFICANCE: : Pathological cardiac hypertrophy is a central prepathology of heart failure and is seen to eventually precede it. Feasible targets that may prevent or reverse disease progression are scarce and urgently needed. In this study, we developed surface-filled lipid octafluoropropane gas core cationic microbubbles that could target the release of human Sirt3 reactivating the endogenous Sirt3 in hypertrophic hearts and protect against oxidative stress in a pig model of cardiac hypertrophy induced by aortic banding. Sirt3-CMBs may enhance cardiac diastolic function and ameliorate fibrosis and apoptosis. Our work provides a classical cationic lipid-based, UTMD-mediated Sirt3 delivery system for the treatment of Sirt3 in patients with established cardiac hypertrophy, as well as a promising therapeutic target to combat pathological cardiac hypertrophy.
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Affiliation(s)
- Xionghai Qin
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Peian Cai
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Chang Liu
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Kegong Chen
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Department of Thoracic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xingpei Jiang
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Wei Chen
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Jiarou Li
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Department of Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Xuan Jiao
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Erliang Guo
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Yixiu Yu
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Lu Sun
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Hai Tian
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China; Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
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Li S, Dong L, Tang K, Lan Z, Liu R, Wang Y, Wang R, Lin H. Simultaneous and trace level quantification of two potential genotoxic impurities in valsartan drug substance using UPLC-MS/MS. J Pharm Biomed Anal 2022; 212:114630. [DOI: 10.1016/j.jpba.2022.114630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/27/2022]
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Bao J, Kan R, Chen J, Xuan H, Wang C, Li D, Xu T. Combination pharmacotherapies for cardiac reverse remodeling in heart failure patients with reduced ejection fraction: A systematic review and network meta-analysis of randomized clinical trials. Pharmacol Res 2021; 169:105573. [PMID: 33766629 DOI: 10.1016/j.phrs.2021.105573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 12/22/2022]
Abstract
Pharmacotherapies, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor II blockers (ARBs), β-blockers (BBs), mineralocorticoid receptor antagonists (MRAs) and angiotensin receptor blocker-neprilysin inhibitor (ARNI), have played a pivotal role in reducing in-hospital and mortality in heart failure patients with reduced ejection fraction (HFrEF). However, effects of the five drug categories used alone or in combination for cardiac reverse remodeling (CRR) in these patients have not been systematically evaluated. A Bayesian network meta-analysis was conducted based on 55 randomized controlled trials published between 1989 and 2019 involving 12,727 patients from PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov. The study is registered with PROSPERO (CRD42020170457). Our primary outcomes were CRR indicators, including changes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV) and end-systolic volume (LVESV), indexed LVEDV (LVEDVI) and LVESV (LVESVI), and left ventricular end-diastolic dimension (LVEDD) and end-systolic dimension (LVESD); Secondary outcomes were functional capacity comprising New York Heart Association (NYHA) class and 6-min walking distance (6MWD); cardiac biomarkers involving B type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP). The effect sizes were presented as the mean difference with 95% credible intervals. According to the results, all dual-combination therapies except ACEI+ARB were significantly more associated with LVEF or NYHA improvement than placebo, ARB+BB and ARNI+BB were the top two effective dual-combinations in LVEF improvement (+7.59% [+4.27, +11.25] and +7.31% [+3.93, +10.97] respectively); ACEI+BB was shown to be superior to ACEI in reducing LVEDVI and LVESVI (-6.88 mL/m2 [-13.18, -1.89] and -10.64 mL/m2 [-18.73, -3.54] respectively); ARNI+BB showed superiority over ACEI+BB in decreasing the level of NT-proBNP (-240.11 pg/mL [-456.57, -6.73]). All tri-combinations were significantly more effective than placebo in LVEF improvement, and ARNI+BB+MRA ranked first (+21.13% [+14.34, +28.13]); ACEI+BB+MRA was significantly more associated with a decrease in LVEDD than ACEI (-6.57 mm [-13.10, -0.84]). A sensitivity analysis ignoring concomitant therapies for LVEF illustrated that all the five drug types except ARB were shown to be superior to placebo, and ARNI ranked first (+4.83% [+1.75, +7.99]). In conclusion, combination therapies exert more benefits on CRR for patients with HFrEF. Among them, ARNI+BB, ARB+BB, ARNI+BB+MRA and ARB+BB+MRA were the top two effective dual and triple combinations in LVEF improvement, respectively; The new "Golden Triangle" of ARNI+BB+MRA was shown to be superior to ACEI+BB+MRA or ARB+BB+MRA in LVEF improvement.
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Affiliation(s)
- Jieli Bao
- The Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu, PR China; The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China
| | - Rongsheng Kan
- The Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu, PR China
| | - Junhong Chen
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China
| | - Haochen Xuan
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China
| | - Chaofan Wang
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China
| | - Dongye Li
- The Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, Jiangsu, PR China; The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China.
| | - Tongda Xu
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, PR China
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Pleiotropic Properties of Valsartan: Do They Result from the Antiglycooxidant Activity? Literature Review and In Vitro Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5575545. [PMID: 33763167 PMCID: PMC7946482 DOI: 10.1155/2021/5575545] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022]
Abstract
Valsartan belongs to angiotensin II type 1 (AT1) receptor blockers (ARB) used in cardiovascular diseases like heart failure and hypertension. Except for its AT1-antagonism, another mechanism of drug action has been suggested in recent research. One of the supposed actions refers to the positive impact on redox balance and reducing protein glycation. Our study is aimed at assessing the antiglycooxidant properties of valsartan in an in vitro model of oxidized bovine serum albumin (BSA). Glucose, fructose, ribose, glyoxal (GO), methylglyoxal (MGO), and chloramine T were used as glycation or oxidation agents. Protein oxidation products (total thiols, protein carbonyls (PC), and advanced oxidation protein products (AOPP)), glycooxidation products (tryptophan, kynurenine, N-formylkynurenine, and dityrosine), glycation products (amyloid-β structure, fructosamine, and advanced glycation end products (AGE)), and albumin antioxidant activity (total antioxidant capacity (TAC), DPPH assay, and ferric reducing antioxidant power (FRAP)) were measured in each sample. In the presence of valsartan, concentrations of protein oxidation and glycation products were significantly lower comparing to control. Moreover, albumin antioxidant activity was significantly higher in those samples. The drug's action was comparable to renowned antiglycation agents and antioxidants, e.g., aminoguanidine, metformin, Trolox, N-acetylcysteine, or alpha-lipoic acid. The conducted experiment proves that valsartan can ameliorate protein glycation and oxidation in vitro in various conditions. Available animal and clinical studies uphold this statement, but further research is needed to confirm it, as reduction of protein oxidation and glycation may prevent cardiovascular disease development.
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Peeters LEJ, Kester MP, Feyz L, Van Den Bemt PMLA, Koch BCP, Van Gelder T, Versmissen J. Pharmacokinetic and pharmacodynamic considerations in the treatment of the elderly patient with hypertension. Expert Opin Drug Metab Toxicol 2019; 15:287-297. [PMID: 30880496 DOI: 10.1080/17425255.2019.1588249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Hypertension is an important risk factor for developing cardiovascular diseases. It is more prevalent in the elderly population. Recently updated American and European guidelines recommend treating every elderly patient with hypertension independent of age, starting with a low dose of antihypertensive drugs. However, little information is available on the optimal dosages of antihypertensive drugs to treat the elderly safely. Areas covered: Comorbidities, co-medication and frailty status can alter the clinical outcome of drug treatment and can cause adverse events in the elderly. Also, due to pharmacokinetic and pharmacodynamic changes the interpatient variability when using antihypertensive drugs is considerable. In this review, an overview is given on the extent to which the previously mentioned parameters are changed in elderly patients and what this means for the exposure to antihypertensive medication. Also, recommendations on the starting dose of the most frequently used antihypertensive drugs are given based on literature data. Expert opinion: We believe that recommendations on starting dosages followed by a stepwise increase of dosages will lead to improved blood pressure control and less adverse drug reactions in the elderly patient. This may improve adherence to antihypertensive therapy.
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Affiliation(s)
- L E J Peeters
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.,b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - M P Kester
- b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - L Feyz
- c Department of Cardiology , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - P M L A Van Den Bemt
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - B C P Koch
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - T Van Gelder
- a Department of Hospital Pharmacy , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands.,b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - J Versmissen
- b Department of Internal Medicine , Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
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Fast disintegrating tablet of Valsartan for the treatment of pediatric hypertension: In vitro and in vivo evaluation. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2017.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Serbest H, Bakırdere S, Keyf S. Development of an analytical method for the determination of valsartan in commercial drug and sewage sludge samples by HPLC and evaluation of its stability under simulated gastric conditions. J LIQ CHROMATOGR R T 2016. [DOI: 10.1080/10826076.2016.1202265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hakan Serbest
- Department of Chemical Engineering, Faculty of Chemical and Metallurgical Engineering, Yıldız Technical University, İstanbul, Turkey
| | - Sezgin Bakırdere
- Department of Chemistry, Faculty of Art and Science, Yıldız Technical University, İstanbul, Turkey
| | - Seyfullah Keyf
- Department of Chemical Engineering, Faculty of Chemical and Metallurgical Engineering, Yıldız Technical University, İstanbul, Turkey
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Babu CS, Kalaivani P, Ranju V, Sathiya S, Anbarasi C, Mahadevan MV, Vijayakumar H, Sunil AG, Thanikachalam S. Venthamarai chooranam, a polyherbal Siddha medicine, alleviates hypertension via AT₁R and eNOS signaling pathway in 2K1C hypertensive rats. Exp Biol Med (Maywood) 2015; 239:758-69. [PMID: 24719376 DOI: 10.1177/1535370214525317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study was aimed to scientifically demonstrate the anti-hypertensive action of Venthamarai chooranam (VMC) in renal hypertensive rats. Two Kidney One Clip (2K1C) Goldblatt model was adopted to induce hypertension in rats. Male Sprague Dawley rats (270-320 g) were randomized into sham (n = 6), vehicle-treated 2K1C (n = 9) and VMC-treated 2K1C (400 mg/kg, p.o; n = 8) and monitored for nine weeks. Systolic blood pressure (SBP), plasma nitrate/nitrite, carotid endothelial nitric oxide synthetase (eNOS), renal angiotensin type 1 receptor (AT₁R), angiotensin type 2 receptor (AT₂R), TNFα, IL-6, thioredoxin 1 (TRX1), and thioredoxin reductase 1 (TRXR1) mRNA expressions were studied. VMC upregulated eNOS expression which in turn improved plasma nitric oxide and decreased SBP in hypertensive rats. It down-regulated AT₁R and simultaneously upregulated AT₂R expression in comparison to vehicle-treated 2K1C rats. Further, renal TNFα and IL-6 expressions were down-regulated while TRX1 and TRXR1 were upregulated by VMC. VMC potentially interacts with renin-angiotensin components and endothelial functions, and thereby exerts its antihypertensive action. This is the first study to demonstrate the mechanism of anti-hypertensive action of VMC in an animal model of renovascular hypertension.
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MESH Headings
- Animals
- Blood Pressure/drug effects
- Disease Models, Animal
- Gene Expression Regulation/drug effects
- Hypertension, Renovascular/drug therapy
- Hypertension, Renovascular/metabolism
- Hypertension, Renovascular/pathology
- Interleukin-6/biosynthesis
- Male
- Medicine, Ayurvedic
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Nitric Oxide Synthase Type III/metabolism
- Plant Preparations/pharmacology
- Rats
- Rats, Sprague-Dawley
- Receptor, Angiotensin, Type 1/metabolism
- Receptor, Angiotensin, Type 2/metabolism
- Signal Transduction/drug effects
- Thioredoxins/biosynthesis
- Tumor Necrosis Factor-alpha/biosynthesis
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Sharma MC, Kohli DV. Comprehensive structure–activity relationship analysis of substituted 5-(biphenyl-4-ylmethyl) pyrazoles derivatives as AT1 selective angiotensin II receptor antagonists: 2D and kNNMFA QSAR approach. Med Chem Res 2012. [DOI: 10.1007/s00044-012-0206-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Sharma MC, Kohli D. WITHDRAWN: QSAR studies on substituted benzimidazoles as angiotensin II receptor antagonists: kNN-MFA approach. ARAB J CHEM 2011. [DOI: 10.1016/j.arabjc.2011.05.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Saleem TSM, Bharani K, Gauthaman K. ACE inhibitors - angiotensin II receptor antagonists: A useful combination therapy for ischemic heart disease. Open Access Emerg Med 2010; 2:51-9. [PMID: 27147838 PMCID: PMC4806827 DOI: 10.2147/oaem.s10507] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Morbidity and mortality from cardiovascular diseases are still high, even with the use of the best available therapies. There is mounting evidence that excessive renin-angiotensin system activation triggers much of the damaging and progressive nature of cardiovascular and kidney diseases through expression of angiotensin II. Moreover, angiotensin II play a major role in the development of end organ damage through a variety of inflammatory mechanisms. Today, angiotensins-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists have clearly demonstrated their efficacy in preventing target organ damage and in reducing cardiovascular morbidity and mortality in ischemic heart disease (IHD). Moreover, the development of angiotensin II receptor antagonists has enabled a large gain in tolerability and safety. Several clinical trials have firmly established that these drugs act on the renin–angiotensin system, reducing the incidence of coronary events with monotherapy and combination therapy. In this review we summarize the role mono- and combined therapy of ACE inhibitors and angiotensin II receptor antagonists play in ischemic heart disease. In this respect the review will improve ideas for developing new formulations with combinations of these drugs in the future.
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Affiliation(s)
- T S Mohamed Saleem
- Department of Pharmacology, Annamacharya College of Pharmacy, Rajampet-516126, Kadapa Dist, Andhra Pradesh, India
| | - K Bharani
- Department of Pharmacology, Annamacharya College of Pharmacy, Rajampet-516126, Kadapa Dist, Andhra Pradesh, India
| | - K Gauthaman
- Department of Drug Technology, Higher Institute of Medical Technology, Derna, Libya
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Clapp C, Thebault S, Jeziorski MC, Martínez De La Escalera G. Peptide hormone regulation of angiogenesis. Physiol Rev 2009; 89:1177-215. [PMID: 19789380 DOI: 10.1152/physrev.00024.2009] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
It is now apparent that regulation of blood vessel growth contributes to the classical actions of hormones on development, growth, and reproduction. Endothelial cells are ideally positioned to respond to hormones, which act in concert with locally produced chemical mediators to regulate their growth, motility, function, and survival. Hormones affect angiogenesis either directly through actions on endothelial cells or indirectly by regulating proangiogenic factors like vascular endothelial growth factor. Importantly, the local microenvironment of endothelial cells can determine the outcome of hormone action on angiogenesis. Members of the growth hormone/prolactin/placental lactogen, the renin-angiotensin, and the kallikrein-kinin systems that exert stimulatory effects on angiogenesis can acquire antiangiogenic properties after undergoing proteolytic cleavage. In view of the opposing effects of hormonal fragments and precursor molecules, the regulation of the proteases responsible for specific protein cleavage represents an efficient mechanism for balancing angiogenesis. This review presents an overview of the actions on angiogenesis of the above-mentioned peptide hormonal families and addresses how specific proteolysis alters the final outcome of these actions in the context of health and disease.
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Affiliation(s)
- Carmen Clapp
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico.
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Su KH, Tsai JY, Kou YR, Chiang AN, Hsiao SH, Wu YL, Hou HH, Pan CC, Shyue SK, Lee TS. Valsartan regulates the interaction of angiotensin II type 1 receptor and endothelial nitric oxide synthase via Src/PI3K/Akt signalling. Cardiovasc Res 2009; 82:468-75. [PMID: 19307231 DOI: 10.1093/cvr/cvp091] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Valsartan, a selective angiotensin II type 1 receptor (AT1R) blocker, has beneficial effects in the cardiovascular system in part by its increase of nitric oxide (NO) bioavailability, yet the mechanisms are unclear. We investigated the molecular mechanisms underlying this effect in endothelial cells (ECs). METHODS AND RESULTS NO production was examined by Griess reagent assay, DAF-2 DA fluorescence staining and cGMP ELISA kits. Protein interaction was determined by western blotting and immunoprecipitation. Treating bovine or human aortic ECs with valsartan increased NO production, as evidenced by elevated level of stable NO metabolites and intracellular cGMP. Valsartan increased the phosphorylation but not the protein level of endothelial NO synthase (eNOS). Inhibition of phosphoinositide-3 kinase (PI3K)/Akt and Src pathways by specific inhibitors suppressed valsartan-induced NO release. In addition, valsartan increased the tyrosine residue phosphorylation of AT1R, which was attenuated by inhibition of Src but not PI3K activities. Valsartan also suppressed the interaction of eNOS and AT1R, which was blocked by Src or PI3K inhibition. CONCLUSION Valsartan-induced NO production in ECs is mediated through Src/PI3K/Akt-dependent phosphorylation of eNOS. Valsartan-induced AT1R phosphorylation depends on Src but not PI3K, whereas valsartan-induced suppression of AT1R-eNOS interaction depends on Src/PI3K/Akt signalling. These results indicate a novel vasoprotective mechanism of valsartan in upregulating NO production in ECs.
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Affiliation(s)
- Kuo-Hui Su
- Department of Physiology, National Yang-Ming University, Taipei, Taiwan, ROC
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Potamitis C, Zervou M, Katsiaras V, Zoumpoulakis P, Durdagi S, Papadopoulos MG, Hayes JM, Grdadolnik SG, Kyrikou I, Argyropoulos D, Vatougia G, Mavromoustakos T. Antihypertensive Drug Valsartan in Solution and at the AT1 Receptor: Conformational Analysis, Dynamic NMR Spectroscopy, in Silico Docking, and Molecular Dynamics Simulations. J Chem Inf Model 2009; 49:726-39. [DOI: 10.1021/ci800427s] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Constantinos Potamitis
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Maria Zervou
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Vassilis Katsiaras
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Panagiotis Zoumpoulakis
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Serdar Durdagi
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Manthos G. Papadopoulos
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Joseph M. Hayes
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Simona Golic Grdadolnik
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Ioanna Kyrikou
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Dimitris Argyropoulos
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Georgia Vatougia
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
| | - Thomas Mavromoustakos
- National Hellenic Research Foundation, Institute of Organic and Pharmaceutical Chemistry, Vas, Constantinou 48, 11635, Athens, Greece, Department of Biology Chemistry and Pharmacy, Free University of Berlin, Takustrasse, 3, 14195 Berlin, Germany, Laboratory of Biomolecular Structure, National Institute of Chemistry, Hajdrihova 19, POB 30 SI-1115 Ljubljana, Slovenia, Varian Ltd., 10 Mead Road, Oxford Industrial Park, Yarnton, Oxford OX5 1QU, United Kingdom, Chemistry Department, National & Kapodistrian
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15
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Beutler U, Boehm M, Fuenfschilling PC, Heinz T, Mutz JP, Onken U, Mueller M, Zaugg W. A High-Throughput Process for Valsartan. Org Process Res Dev 2007. [DOI: 10.1021/op700120n] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ulrich Beutler
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | - Matthias Boehm
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | | | - Thomas Heinz
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | - Jean-Paul Mutz
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | - Ulrich Onken
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | - Martin Mueller
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
| | - Werner Zaugg
- Novartis Pharma AG, Chemical and Analytical Development, CH-4002 Basel, Switzerland
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16
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Abstract
The cardiovascular continuum describes the progression of pathophysiologic events from cardiovascular risk factors to symptomatic cardiovascular disease (CVD) and life-threatening events. Pharmacologic intervention early in the continuum may prevent or slow CVD development and improve quality of life. The renin-angiotensin-aldosterone system (RAAS) is central to the pathophysiology of CVD at many stages of the continuum. Numerous clinical trials of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have shown that RAAS blockade provides benefits to patients across the continuum. ARBs are as effective as ACE inhibitors in the treatment of hypertension; however tolerability and adherence to therapy appear to be improved with ARBs. Large clinical trials have shown that ARBs may provide therapeutic benefits beyond blood pressure control in patients with diabetes, heart failure or at risk of heart failure following a myocardial infarction. In addition, ARBs have been shown to provide protective effects in patients with impaired renal function or left ventricular hypertrophy. Additional clinical trials are ongoing to further characterize the role of ARBs in CVD management.
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Affiliation(s)
- Aldo P Maggioni
- ANMCO Research Center, Italian Association of Hospital Cardiologists, Via La Marmora 34, 50121, Florence, Italy.
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17
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Cheng H, Harris RC. Potential side effects of renin inhibitors – mechanisms based on comparison with other renin–angiotensin blockers. Expert Opin Drug Saf 2006; 5:631-41. [PMID: 16907653 DOI: 10.1517/14740338.5.5.631] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Angiotensin (Ang) II plays important roles in the development of hypertension and cardiovascular and renal injury. Pharmaceutical approaches to block its activity led to the development of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Numerous trials have documented their efficacy in controlling blood pressure, minimising left ventricular remodelling, preventing progression to heart failure, ameliorating proteinuria and retarding renal disease progression. Although they are considered safe in general, there remain concerns about the potential for adverse events in certain target populations. Recently, several novel, low molecular weight renin inhibitors without the extended peptide-like backbone of previous renin inhibitors were developed with favourable pharmacokinetic properties. They have been shown to successfully reduce Ang II levels in normal volunteers and to lower blood pressure in patients with mild-to-moderate hypertension. In this review, the authors summarise current knowledge about these renin inhibitors.
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Affiliation(s)
- Huifang Cheng
- George M. O'Brien Kidney and Urologic Diseases Center and Division of Nephrology, Vanderbilt University School of Medicineand Nashville Veterans Affairs Hospital, Nashville, TN 37232, USA.
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18
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Young CH, Zhang K, Poret AW. Patterns of antihypertensive therapy in new users of angiotensin II-receptor blockers. Am J Health Syst Pharm 2005; 62:2381-5. [PMID: 16278329 DOI: 10.2146/ajhp040583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The patterns of angiotensin II-receptor blocker (ARB) therapy in patients with and without a history of antihypertensive use were studied. METHODS Data for this retrospective cohort study were obtained from Caremark's data warehouse. Patients were included in the analysis if they filled prescriptions for ARBs only, did not receive ARB therapy within the 6 months before the filling of the first ARB prescription (index date), were continuously eligible for benefits for 6 months before the index date, were eligible for prescription benefits for the 12 months following the index date, and were age 20-80 years. RESULTS Of the 174,573 patients sampled, 53.4% were new to all antihypertensive therapies. Of the patients receiving an ARB, 67.9% received another antihypertensive during the evaluation period. Over 40% of patients new to all antihypertensive therapies had no other antihypertensive added to their ARB regimen. Of the patients with a history of antihypertensive use, 22.3% discontinued all antihypertensives before starting therapy with an ARB. Patients starting therapy with losartan and valsartan were less likely to be treated with mono-therapy and more likely to be treated with ARB-diuretic therapy than were patients starting therapy with telmisartan, irbesartan, or candesartan. CONCLUSION Patients who started antihypertensive therapy with ARBs tended to be new to antihypertensive therapy and, in a plurality of cases, continued to receive therapy with ARBs only. More than a fifth of patients who received antihypertensive therapy in the recent past were switched from that therapy to treatment with ARBs only. Treatment patterns differed by initial ARB used and the demographic profile of the patient.
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19
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Chrysant SG, Chrysant GS. Clinical Experience With Angiotensin Receptor Blockers With Particular Reference to Valsartan. J Clin Hypertens (Greenwich) 2004; 6:445-51. [PMID: 15308883 DOI: 10.1111/j.1524-6175.2004.03449.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The angiotensin II receptor blockers (ARBs), are highly selective for the AT1 subtype and will block the effects of angiotensin II on peripheral vessels. Several short- and long-term studies have shown these agents to be safe and effective antihypertensive drugs. Since monotherapy of hypertension may be ineffective in lowering the blood pressure to goal, the use of an ARB, especially in combination with a diuretic or another medication, is frequently necessary to bring the blood pressure <140/90 mm Hg (<130/80 mm Hg among people with diabetes mellitus or chronic renal failure), according to JNC 7 guidelines. Besides hypertension, the ARBs have been shown to reduce left ventricular hypertrophy in hypertensive patients. Other benefits of these medications, as well as the angiotensin I converting enzyme inhibitors (ACEIs), include a decrease in cardiovascular morbidity and mortality in patients with heart failure, or hypertensive diabetic nephropathy with proteinuria. Some of the beneficial effects noted with the ACEIs and ARBs (congestive heart failure, left ventricular hypertrophy), have also been demonstrated with the use of b blockers alone and in combination with a diuretic. These drugs, i.e., b blockers, ARBs, and ACEIs, seem to exert their beneficial action through the blockade of the renin-angiotensin-aldosterone system. The role of this system in cardiovascular remodeling and its blockade will be discussed in this review, which will specifically summarize data with the ARB, valsartan.
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Affiliation(s)
- Steven G Chrysant
- The University of Oklahoma School of Medicine, 5850 W. Wilshire Boulevard, Oklahoma City, OK 73132, USA.
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Chrysant SG. Fixed combination therapy of hypertension: focus on valsartan/hydrochlorothiazide combination (Diovan/HCT). Expert Rev Cardiovasc Ther 2004; 1:335-43. [PMID: 15030262 DOI: 10.1586/14779072.1.3.335] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypertension is a major risk factor for cardiovascular morbidity and mortality. Monotherapy of hypertension is often ineffective, since it controls approximately 50% of the blood pressure of hypertensive patients. For lowering blood pressure to less than 140/90 mmHg (or <130/80 mmHg among people with diabetes or chronic renal disease) according to JNC-7 guidelines, combination therapy of two or more drugs is often necessary. The combination of a diuretic with an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB) is effective and provides the additional benefit of blocking the effects of angiotensin II, which is responsible for cardiovascular remodeling and its complications. ARBs may have an advantage over the ACEIs because they block the action of all angiotensin II directly, whereas ACEIs are ineffective in blocking angiotensin II generated by nonclassical ACE pathways. Valsartan (Diovan, Novartis) is one of the seven currently approved ARBs in the USA for the treatment of hypertension, and it has been shown to be very effective in controlling blood pressure given once-daily in doses of 80-160 or 320 mg. Its fixed combination with hydrochlorothiazide (HCT) is even more effective in controlling blood pressure in 70% of the cases. The most commonly used combinations are valsartan/HCT (Diovan/HCT), 80/12.5 and 160/12.5 mg given once-daily.
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Affiliation(s)
- Steven G Chrysant
- University of Oklahoma, Oklahoma Cardiovascular and Hypertension Center, 5850 W Wilshire Blvd, Oklahoma City, OK 73132-4904, USA.
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21
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Abstract
We review the macroscopic and microscopic anatomy of myocardial disease associated with heart failure (HF) and sudden cardiac death (SCD) and focus on the prevention of SCD in light of its structural pathways. Compared to patients without SCD, patients with SCD exhibit 5- to 6-fold increases in the risks of ventricular arrhythmias and SCD. Epidemiologically, left ventricular hypertrophy by ECG or echocardiography acts as a potent dose-dependent SCD predictor. Dyslipidemia, a coronary disease risk factor, independently predicts echocardiographic hypertrophy. In adult SCD autopsy studies, increases in heart weight and severe coronary disease are constant findings, whereas rates of acute coronary thrombi vary remarkably. The microscopic myocardial anatomy of SCD is incompletely defined but may include prevalent changes of advanced myocardial disease, including cardiomyocyte hypertrophy, cardiomyocyte apoptosis, fibroblast hyperplasia, diffuse and focal matrix protein accumulation, and recruitment of inflammatory cells. Hypertrophied cardiomyocytes express "fetospecific" genetic programs that can account for acquired long QT physiology with risk for polymorphic ventricular arrhythmias. Structural heart disease associated with HF and high SCD risk is causally related to an up-regulation of the adrenergic renin-angiotensin-aldosterone pathway. In outcome trials, suppression of this pathway with combinations of beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, and mineralocorticoid receptor blockers have achieved substantial total mortality and SCD reductions. Contrarily, trials with ion channel-active agents that are not known to reduce structural heart disease have failed to reduce these risks. Device therapy effectively prevents SCD, but whether biventricular pacing-induced remodeling decreases left ventricular mass remains uncertain.
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MESH Headings
- Animals
- Anti-Arrhythmia Agents/therapeutic use
- Apoptosis
- Cardiac Output, Low/drug therapy
- Cardiac Output, Low/etiology
- Cardiac Output, Low/pathology
- Cardiac Output, Low/physiopathology
- Cardiac Output, Low/prevention & control
- Cardiomegaly/complications
- Cardiomegaly/physiopathology
- Coronary Artery Disease/complications
- Coronary Artery Disease/physiopathology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Heart Diseases/complications
- Heart Diseases/pathology
- Heart Diseases/physiopathology
- Humans
- Mitosis
- Myocytes, Cardiac/metabolism
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Affiliation(s)
- Antonio Pacifico
- Texas Arrhythmia Institute and Baylor College of Medicine, Scorlock Tower, Suite 620, 6560 Fannin Street, Houston, TX 77030, USA.
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