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Sripusanapan A, Yanpiset P, Sriwichaiin S, Siri-Angkul N, Chattipakorn SC, Chattipakorn N. Hyperpolarization-activated cyclic nucleotide-gated channel inhibitor in myocardial infarction: Potential benefits beyond heart rate modulation. Acta Physiol (Oxf) 2024; 240:e14085. [PMID: 38230890 DOI: 10.1111/apha.14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/24/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
Myocardial infarction (MI) and its associated complications including ventricular arrhythmias and heart failure are responsible for a significant incidence of morbidity and mortality worldwide. The ensuing cardiomyocyte loss results in neurohormone-driven cardiac remodeling, which leads to chronic heart failure in MI survivors. Ivabradine is a heart rate modulation agent currently used in treatment of chronic heart failure with reduced ejection fraction. The canonical target of ivabradine is the hyperpolarization-activated cyclic nucleotide-gated channels (HCN) in cardiac pacemaker cells. However, in post-MI hearts, HCN can also be expressed ectopically in non-pacemaker cardiomyocytes. There is an accumulation of intriguing evidence to suggest that ivabradine also possesses cardioprotective effects that are independent of heart rate reduction. This review aims to summarize and discuss the reported cardioprotective mechanisms of ivabradine beyond heart rate modulation in myocardial infarction through various molecular mechanisms including the prevention of reactive oxygen species-induced mitochondrial damage, improvement of autophagy system, modulation of intracellular calcium cycling, modification of ventricular electrophysiology, and regulation of matrix metalloproteinases.
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Affiliation(s)
- Adivitch Sripusanapan
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Panat Yanpiset
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirawit Sriwichaiin
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Natthaphat Siri-Angkul
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellent in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Malektaj H, Nour S, Imani R, Siadati MH. Angiogenesis induction as a key step in cardiac tissue Regeneration: From angiogenic agents to biomaterials. Int J Pharm 2023; 643:123233. [PMID: 37460050 DOI: 10.1016/j.ijpharm.2023.123233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/02/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
Cardiovascular diseases are the leading cause of death worldwide. After myocardial infarction, the vascular supply of the heart is damaged or blocked, leading to the formation of scar tissue, followed by several cardiac dysfunctions or even death. In this regard, induction of angiogenesis is considered as a vital process for supplying nutrients and oxygen to the cells in cardiac tissue engineering. The current review aims to summarize different approaches of angiogenesis induction for effective cardiac tissue repair. Accordingly, a comprehensive classification of induction of pro-angiogenic signaling pathways through using engineered biomaterials, drugs, angiogenic factors, as well as combinatorial approaches is introduced as a potential platform for cardiac regeneration application. The angiogenic induction for cardiac repair can enhance patient treatment outcomes and generate economic prospects for the biomedical industry. The development and commercialization of angiogenesis methods often involves collaboration between academic institutions, research organizations, and biomedical companies.
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Affiliation(s)
- Haniyeh Malektaj
- Department of Materials and Production, Aalborg University, Fibigerstraede 16, Aalborg 9220, Denmark
| | - Shirin Nour
- Department of Biomedical Engineering, Graeme Clark Institute, The University of Melbourne, VIC 3010, Australia; Department of Chemical Engineering, The University of Melbourne, VIC 3010, Australia
| | - Rana Imani
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
| | - Mohammad H Siadati
- Materials Science and Engineering Faculty, K. N. Toosi University of Technology, Tehran, Iran
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Yoshida Y, Shimizu I, Minamino T. Capillaries as a Therapeutic Target for Heart Failure. J Atheroscler Thromb 2022; 29:971-988. [PMID: 35370224 PMCID: PMC9252615 DOI: 10.5551/jat.rv17064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Prognosis of heart failure remains poor, and it is urgent to find new therapies for this critical condition. Oxygen and metabolites are delivered through capillaries; therefore, they have critical roles in the maintenance of cardiac function. With aging or age-related disorders, capillary density is reduced in the heart, and the mechanisms involved in these processes were reported to suppress capillarization in this organ. Studies with rodents showed capillary rarefaction has causal roles for promoting pathologies in failing hearts. Drugs used as first-line therapies for heart failure were also shown to enhance the capillary network in the heart. Recently, the approach with senolysis is attracting enthusiasm in aging research. Genetic or pharmacological approaches concluded that the specific depletion of senescent cells, senolysis, led to reverse aging phenotype. Reagents mediating senolysis are described to be senolytics, and these compounds were shown to ameliorate cardiac dysfunction together with enhancement of capillarization in heart failure models. Studies indicate maintenance of the capillary network as critical for inhibition of pathologies in heart failure.
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Affiliation(s)
- Yohko Yoshida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Ippei Shimizu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tohru Minamino
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMEDCREST), Japan Agency for Medical Research and Development
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Lv H, Liu B, Qin Y. Isosorbide mononitrate promotes angiogenesis in embryonic development of zebrafish. Genet Mol Biol 2020; 43:20190233. [PMID: 32706844 PMCID: PMC7380327 DOI: 10.1590/1678-4685-gmb-2019-0233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 05/28/2020] [Indexed: 12/21/2022] Open
Abstract
Coronary heart disease (CHD) is a leading cause of death worldwide, and
angiogenesis plays important roles in CHD. Thus, in the present study, the
angiogenic efficacy of four common cardiovascular medicines (aspirin,
pravastatin, metoprolol and isosorbide mononitrate (ISMN)) was determined by the
number and length of zebrafish intersegmental vessels (ISVs) after immersing
zebrafish embryos in different medicines. Results showed that ISMN significantly
increased the length and number of ISVs. ISMN is a long-acting nitrate ester
drug. It has been used as a vasodilator to dilate arteries and veins to reduce
the cardiac preload and postload. However, the effect of ISMN on angiogenesis
remains unclear. Thus, by in vitro experiments, the angiogenic mechanism of ISMN
was evaluated through detecting the viability and proliferation of human
umbilical vein endothelial cells (HUVECs) and the expression of
angiogenesis-related genes and miRNAs. Results indicated that ISMN could
increase the viability and proliferation of HUVECs by decreasing apoptosis, and
elevated the expressions of vedf, kdrl,
pdgfr in zebrafish embryos. Furthermore, the expressions of
miR-126, miR-130a and miR-210 were also regulated in ISMN-treated HUVECs. In
conclusion, ISMN could promote angiogenesis in zebrafish embryos and HUVECs,
implying ISMN may be a potential therapeutic in treating angiogenesis-related
diseases.
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Affiliation(s)
- Hui Lv
- The Second Affiliated Hospital of ShanXi Medical University, Department of Cardiovascular Disease, Taiyuan, Shanxi, 030001, China
| | - Bo Liu
- Xinhua Hospital Affiliated To Shanghai Jiaotong University School Of Medicine, Department of Cardiovascular Disease, Shanghai 200092, China
| | - Yongwen Qin
- The Second Military Medical University, Department of Cardiovascular Disease , Shanghai 200433, China
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Abstract
OBJECTIVE We investigated the underlying mechanism of ivabradine (IVA) in promoting angiogenesis and reducing cardiac hypertrophy in mice with myocardial infarction (MI). METHODS Nineteen mice were randomly assigned into three groups as follows: sham group (10 ml/kg/day phosphate buffer saline (PBS), n=6), model group (MI and 10 ml/kg/day PBS, n=6) and IVA group (MI and 10 mg/kg/day IVA, n=7). All groups received an intragastric gavage for four weeks. Heart and body mass were measured. Cardiac function and heart rate were assessed by echocardiography and electrocardiography, respectively. The collagen deposition, area of cardiomyocytes, and number of capillaries were evaluated using Masson's staining, anti-wheat germ agglutinin (WGA) staining, and platelet endothelial cell adhesion molecule-1 (CD31) staining, respectively. The protein kinase B (Akt)- endothelial nitric oxide synthase (eNOS) signaling and p-38 mitogen-activated protein kinase (MAPK) family in myocardium were determined by western blot. RESULTS IVA treatment greatly improved cardiac dysfunction and suppressed cardiac hypertrophy at 4 weeks after MI (p<0.05). Heart rate and fibrotic area of IVA group declined notably compared to those of the model group (p<0.05). IVA administration substantially reduced cardiomyocyte size and increased capillary formation (p<0.05). Besides, IVA medication can enhance Akt-eNOS signaling and inhibit p38 MAPK phosphorylation in the heart of mice with MI (p<0.05). CONCLUSION IVA can perform two functions, the promotion of angiogenesis and the reduction of cardiac hypertrophy, both of which were closely associated with Akt-eNOS signaling activation and p38 MAPK inhibition.
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Lu D, Wang K, Wang S, Zhang B, Liu Q, Zhang Q, Geng J, Shan Q. Beneficial effects of renal denervation on cardiac angiogenesis in rats with prolonged pressure overload. Acta Physiol (Oxf) 2017; 220:47-57. [PMID: 27575955 DOI: 10.1111/apha.12793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/20/2016] [Accepted: 08/29/2016] [Indexed: 01/20/2023]
Abstract
AIM Renal denervation (RDN) has beneficial effects on cardiac remodelling and function in resistant hypertension. We aimed to investigate the impact of RDN on cardiac angiogenesis during prolonged pressure overload. METHODS Cardiac pressure overload was reproduced by transverse aorta constriction (TAC) procedure in adult Sprague Dawley male rats (n = 35). RDN/sham-RDN procedure was performed in surviving rats at 5 weeks after TAC. RESULTS Five weeks post-TAC, transthoracic echocardiography revealed that myocardial hypertrophy occurred in TAC rats, with ejection fraction and fractional shortening not significantly changed. At the end of 10 weeks, cardiac systolic function was preserved in RDN group, but not in sham group. CD31 immunohistochemical staining showed that RDN-treated rats had higher cardiac capillary density than sham rats. However, no significant between-group difference was observed in the kidneys. A decreased protein expression of left ventricle vascular endothelial growth factor (VEGF) was observed in sham group, while RDN attenuated this decrease. Compared with sham, RDN resulted in a higher protein expression of VEGF receptor 2 (VEGFR2) and phosphorylated endothelial nitric oxide synthase (p-eNOS) in the heart. CONCLUSION Renal denervation benefits cardiac angiogenesis during sustained pressure overload, involving regulation of VEGF and VEGFR2 expression as well as activation of eNOS.
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Affiliation(s)
- D. Lu
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - K. Wang
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - S. Wang
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - B. Zhang
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - Q. Liu
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - Q. Zhang
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - J. Geng
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
| | - Q. Shan
- Department of Cardiology; The First Affiliated Hospital of Nanjing Medical University; Nanjing Jiangsu China
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Zarifis J, Kallistratos M, Katsivas A. Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina. Clin Cardiol 2016; 39:697-702. [PMID: 27880009 DOI: 10.1002/clc.22585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 07/28/2016] [Accepted: 07/29/2016] [Indexed: 12/11/2022] Open
Abstract
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ-5D questionnaire. From baseline to study completion; ivabradine administration on top of metoprolol decreased heart rate (HR) from 80.8 ± 9.6 to 64.2 ± 6.2 bpm (P < 0.001). Mean number of angina attacks decreased from 2.0 ± 2.0/wk to 0.2 ± 0.6/wk (P < 0.001), whereas nitroglycerin consumption decreased from 1.4 ± 1.9 times/wk to 0.1 ± 0.4 times/wk (P < 0.001). The percentage of patients in Canadian Cardiovascular Society angina class III to IV decreased from 15.4% to 1.9% (P < 0.001). The improvement of symptoms and angina class led to a significant 14.7-point increase in EQ-5D questionnaire score (P < 0.001). Patients with increased HR showed greater improvement (P = 0.001). Adherence to treatment during the entire trial was high (98%). Ivabradine combined with metoprolol significantly decreased angina symptoms and use of nitroglycerin in patients with stable angina and CAD, leading to improved QoL. The benefits observed with this combination explain the high rate of adherence to treatment.
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Affiliation(s)
- John Zarifis
- Cardiology Department, George Papanikolaou General Hospital, Thessaloniki, Greece
| | | | - Apostolos Katsivas
- First Cardiology Department, Korgialeneio-Benakeio E.E.S. General Hospital, Athens, Greece
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Lustosa BB, Polegato B, Minicucci M, Rafacho B, Santos PP, Fernandes AA, Okoshi K, Batista D, Modesto P, Gonçalves A, Pereira EJ, Pires V, Paiva S, Zornoff L, Azevedo PS. Green tea (Cammellia sinensis) attenuates ventricular remodeling after experimental myocardial infarction. Int J Cardiol 2016; 225:147-153. [PMID: 27723532 DOI: 10.1016/j.ijcard.2016.09.092] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/23/2016] [Accepted: 09/24/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Considering the high morbidity and mortality after myocardial infarction (MI), the study of compounds with potential benefits for cardiac remodeling is reasonable. Green tea (GT) (Cammellia sinensis) is the most consumed beverage in the world. The potential action mechanisms of GT include anti-inflammatory, anti-apoptotic, antioxidant, and lipid-lowering properties. OBJECTIVE This study analyzed the effects of GT on cardiac remodeling following coronary occlusion in rats. METHODS Male Wistar rats were divided into four groups: control (C), control green tea (GT), myocardial infarction (MI), and myocardial infarction and green tea (MI-GT). GT and MI-GT were fed with standard chow with 0.25% Polyphenon 60 (Sigma-Aldrich Canada, Oakville, ON, Canada). After 3months of observation, echocardiographic and isolated heart study, oxidative stress, energy metabolism, serum lipids, extracellular matrix, and apoptosis were evaluated. RESULTS GT reduced cardiac hypertrophy and improved systolic and diastolic dysfunction. Concerning oxidative stress, GT reduced protein carbonyl, increased Nrf-2, and restored antioxidant enzyme activity to the control pattern. Energy metabolism was affected by MI that presented with lower fatty acid oxidation and accumulation of triacylglycerol, increased serum lipids, impairment of the citric acid cycle, and oxidative phosphorylation. GT stimulated the glucose pathway and mitochondrial function after MI by increasing pyruvate dehydrogenase, Complex I, ATP synthase, and glycogen storage. In addition, MI changed the extracellular matrix including MMP-2 and TIMP-1 activity and increased apoptosis by 3-caspase, all of which were attenuated by GT. CONCLUSION GT attenuated cardiac remodeling after MI, associated with improvement in systolic and diastolic dysfunction. Oxidative stress, energy metabolism, apoptosis, and extracellular matrix alterations are all potential mechanisms by which GT may take part.
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Affiliation(s)
- Beatriz B Lustosa
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Bertha Polegato
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Marcos Minicucci
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Bruna Rafacho
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Priscila P Santos
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Ana Angélica Fernandes
- Chemistry and Biochemistry Department, Institute of Bioscience, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Katashi Okoshi
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Diego Batista
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Pamela Modesto
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Andrea Gonçalves
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Elenize J Pereira
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Vanessa Pires
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Sergio Paiva
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Leonardo Zornoff
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Paula S Azevedo
- Internal Medicine Department, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.
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Selective Heart Rate Reduction Improves Metabolic Syndrome-related Left Ventricular Diastolic Dysfunction. J Cardiovasc Pharmacol 2016. [PMID: 26222991 DOI: 10.1097/fjc.0000000000000294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Enhanced heart rate observed in metabolic syndrome (MS) contributes to the deterioration of left ventricular (LV) function via impaired LV filling and relaxation, increased myocardial O2 consumption, and reduced coronary perfusion. However, whether heart rate reduction (HRR) opposes LV dysfunction observed in MS is unknown. METHODS We assessed in Zucker fa/fa rats, a rat model of MS, the cardiovascular effects of HRR induced by the If current inhibitor S38844 (3 mg · kg(-1) · d(-1)). RESULTS Delayed short-term (4 days) and long-term (90 days) HRR induced by S38844 reduced LV end-diastolic pressure and LV end-diastolic pressure-volume relation, increased myocardial tissue perfusion, decreased myocardial oxidized glutathione levels, and preserved cardiac output, without modifying LV end-systolic pressure and LV end-systolic pressure-volume relation, although only long-term S38844 opposed LV collagen accumulation. Long-term S38844 improved flow-induced endothelium-dependent dilatation of mesenteric arteries, while metabolic parameters, such as plasma glucose levels, and Hb1c, were never modified. CONCLUSIONS In rats with MS, HRR induced by the If inhibitor S38844 improved LV diastolic function and endothelium-dependent vascular dilatation, independent from modifications in metabolic status. Moreover, this improvement in cardiac function involves not only immediate effects such as improved myocardial perfusion and reduced oxidative stress but also long-term effects such as modifications in the myocardial structure.
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Pereira-Barretto AC. Cardiac and Hemodynamic Benefits: Mode of Action of Ivabradine in Heart Failure. Adv Ther 2015; 32:906-19. [PMID: 26521191 DOI: 10.1007/s12325-015-0257-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Indexed: 01/19/2023]
Abstract
Heart failure has seen a number of therapeutic advances in recent years. Despite this, heart failure is still related to increasing rates of morbidity, repeated hospitalizations, and mortality. Ivabradine is a recent treatment option for heart failure. It has a mode of action that includes reduction in heart rate, and leads to improvement in outcomes related to heart failure mortality and morbidity, as demonstrated by the results of the SHIFT trial in patients with systolic heart failure, functional classes II and III on the New York Heart Association classification, and left ventricular ejection fraction ≤ 35%. These results are intriguing since many heart failure drugs reduce heart rate without such benefits, or with quite different effects, making it more difficult to understand the novelty of ivabradine in this setting. Many of the drugs used in heart failure modify heart rate, but most have other pathophysiological effects beyond their chronotropic action, which affect their efficacy in preventing morbidity and mortality outcomes. For instance, heart rate reduction at rest or exercise with ivabradine prolongs diastolic perfusion time, improves coronary blood flow, and increases exercise capacity. Another major difference is the increase in stroke volume observed with ivabradine, which may underlie its beneficial cardiac effects. Finally, there is mounting evidence from both preclinical and clinical studies that ivabradine has an anti-remodeling effect, improving left ventricular structures and functions. All together, these mechanisms have a positive impact on the prognosis of ivabradine-treated patients with heart failure, making a compelling argument for use of ivabradine in combination with other treatments.
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Wang X, Wu J, Zhu D, You J, Zou Y, Qian J, Ge J. Characterization of coronary flow reserve and left ventricular remodeling in a mouse model of chronic aortic regurgitation with carvedilol intervention. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:483-493. [PMID: 25715369 DOI: 10.7863/ultra.34.3.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES We hypothesized that left ventricular (LV) remodeling might be exaggerated by an impaired coronary flow reserve in mice with chronic severe aortic regurgitation, and carvedilol, a β-adrenoceptor blocker, could regress the course. METHODS Severe aortic regurgitation was induced by retrograde puncture of the aortic valve leaflets under sonographic guidance in 12-week-old male C57BL/6J mice. Four weeks after regurgitation, the mice were treated with carvedilol (30 mg/kg/d) or not treated (control). Before and 4 weeks after carvedilol treatment, the coronary flow reserve and LV structure and function were evaluated by echocardiography. Cardiomyocytes and fibrosis were validated by histologic analysis. RESULTS Four-week aortic regurgitation caused a decreased LV ejection fraction and an increased LV end-systolic volume index. Regurgitation also impaired the coronary flow reserve due to an increase in the basal coronary peak diastolic velocity and velocity-time integral combined with the absence of substantial changes in the hyperemic coronary peak diastolic velocity and velocity-time integral. Four more weeks of regurgitation further deteriorated LV remodeling and coronary perfusion in the control group. In contrast, the carvedilol-treated group showed attenuated LV remodeling and a higher coronary flow reserve by decreasing the basal peak diastolic velocity and velocity-time integral without substantial changes in the hyperemic peak diastolic velocity and velocity-time integral. The coronary flow reserve and its pretreatment versus posttreatment difference were positively correlated with the pretreatment versus posttreatment LV ejection fraction and end-systolic volume index differences. In the carvedilol-treated group, subendocardial fibrosis was significantly reduced (P < .05), and the cardiomyocyte cross-sectional area tended to be smaller. CONCLUSIONS In mice with chronic severe aortic regurgitation, carvedilol therapy significantly improves the impaired coronary flow reserve and sufficiently attenuates adverse LV remodeling. Sustained coronary flow reserve impairment indicates progressive LV remodeling.
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Affiliation(s)
- Xiangfei Wang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Jian Wu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Dan Zhu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Jieyun You
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Yunzeng Zou
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Juying Qian
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.)
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China (X.W., J.W., J.Y., Y.Z., J.Q., J.G.); Department of Physiology, University of Toronto, Toronto, Ontario, Canada (J.W.); and Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China (D.Z.).
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12
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Dedkov EI, Bogatyryov Y, McCooey DS, Christensen LP, Weiss RM, Tomanek RJ. Effect of Chronic Heart Rate Reduction by If Current Inhibitor Ivabradine on Left Ventricular Remodeling and Systolic Performance in Middle-Aged Rats With Postmyocardial Infarction Heart Failure. J Cardiovasc Pharmacol Ther 2014; 20:299-312. [DOI: 10.1177/1074248414553231] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/14/2014] [Indexed: 11/15/2022]
Abstract
Background: A large myocardial infarction (MI) initiates progressive cardiac remodeling that leads to systolic heart failure (HF). Long-term heart rate reduction (HRR) induced by the I f current inhibitor ivabradine (IVA) ameliorates left ventricular (LV) remodeling and improves systolic performance in young post-MI rats. However, the beneficial effects of chronic IVA treatment in middle-aged rats remain to be determined. Methods: A large MI was induced in 12-month-old rats by left coronary artery ligation. Rats were treated with IVA via osmotic pumps intraperitoneal in a dose of 10.5 mg/kg/d (MI + IVA) and compared with MI and sham-operated animals 12 weeks after MI. Results: Heart rate in MI + IVA rats was on average 29% lower than that of rats in the MI group. Left ventricular remodeling was comparable between post-MI groups, although MI + IVA rats did not show the compensatory thickening of the noninfarcted myocardium. Chronic HRR had no effect on transverse cardiac myocyte size and capillary growth, but it reduced the collagen content in noninfarcted myocardium. Left ventricular systolic performance remained similarly impaired in MI and MI + IVA rats. Moreover, abrupt IVA withdrawal led to worsening HF and reduction of coronary reserve. Conclusion: Our data reveal that chronic IVA-induced HRR does not provide sustainable benefits for LV systolic performance in middle-aged rats with post-MI HF.
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Affiliation(s)
- Eduard I. Dedkov
- Department of Biomedical Sciences, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Yevgen Bogatyryov
- Department of Biomedical Sciences, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Daniela Scaldaferri McCooey
- Department of Biomedical Sciences, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Lance P. Christensen
- Department of Anatomy and Cell Biology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Robert M. Weiss
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Cardiovascular Center, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Robert J. Tomanek
- Department of Anatomy and Cell Biology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Cardiovascular Center, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Rengo G, Cannavo A, Liccardo D, Zincarelli C, de Lucia C, Pagano G, Komici K, Parisi V, Scala O, Agresta A, Rapacciuolo A, Perrone Filardi P, Ferrara N, Koch WJ, Trimarco B, Femminella GD, Leosco D. Vascular endothelial growth factor blockade prevents the beneficial effects of β-blocker therapy on cardiac function, angiogenesis, and remodeling in heart failure. Circ Heart Fail 2013; 6:1259-67. [PMID: 24029661 DOI: 10.1161/circheartfailure.113.000329] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Impaired angiogenesis in the post-myocardial infarction heart contributes to the progression to heart failure. The inhibition of vascular endothelial growth factor (VEGF) signaling has been shown to be crucial for the transition from compensatory hypertrophy to cardiac failure. Importantly, β-adrenergic receptor blocker therapy has been also shown to improve myocardial perfusion by enhancing neoangiogenesis in the failing heart. METHODS AND RESULTS Eight weeks from surgically induced myocardial infarction, heart failure rats were randomized to receive bisoprolol (B) or vehicle. At the end of a 10-week treatment period, echocardiography revealed reduced cardiac diameters and improved cardiac function in B-treated compared with vehicle-treated rats. Moreover, B treatment was associated with increased cardiac angiogenesis and in vivo coronary perfusion and reduced cardiac fibrosis. Importantly, 2 weeks after B treatment was started, increased cardiac VEGF expression and Akt and endothelial NO synthase activation were observed by comparing B-treated with drug-untreated failing hearts. To test whether the proangiogenic effects of B act via activation of VEGF pathway, rats were intravenously injected with adenoviral vector encoding a decoy VEGF receptor (Ad-Flk) or a control adenovirus (Ad-C), at the start of the treatment with B. After 10 weeks, histological analysis revealed reduced capillary and coronary perfusion in B-treated plus Ad-Flk rats compared with B-treated plus Ad-C rats. Moreover, VEGF inhibition counteracted the positive effects of B on cardiac function and remodeling. CONCLUSIONS β-Blockade promotes cardiac angiogenesis in heart failure via activation of VEGF signaling pathway. β-Blocker-induced enhancement of cardiac angiogenesis is essential for the favorable effects of this therapy on cardiac function and remodeling.
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Affiliation(s)
- Giuseppe Rengo
- Division of Cardiology, "Salvatore Maugeri" Foundation-IRCCS-Institute of Telese Terme
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Heart rate reduction induced by the if current inhibitor ivabradine improves diastolic function and attenuates cardiac tissue hypoxia. J Cardiovasc Pharmacol 2012; 59:260-7. [PMID: 22075752 DOI: 10.1097/fjc.0b013e31823e5e01] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS Enhanced heart rate (HR) is a compensatory mechanism in chronic heart failure (CHF), preserving cardiac output, but at the cost of increased left ventricular (LV) oxygen consumption and impaired diastolic function. The HR reduction (HRR) induced by the If current inhibitor ivabradine prevents LV systolic dysfunction in CHF, but whether HRR improves LV diastolic function is unknown. METHODS LV diastolic function and remodeling were assessed in rats with CHF after coronary ligation after long-term (90 days, starting 7 days after ligation) and delayed short-term (4 days, starting 93 days after ligation) ivabradine treatment (10 mg·kg·d). RESULTS Long- and short-term HRR reduced LV end-diastolic pressure, LV relaxation, and LV end-diastolic pressure-volume relation. Simultaneously, LV hypoxia-inducible factor-1α expression was reduced. Long-term and, to a more marked extent, short-term HRR increased endothelial cell proliferation, associated after long-term HRR with the prevention of CHF-related LV capillary rarefaction. Long-term and, to a lesser extent, short-term HRR increased endothelial nitric oxide synthase expression, associated after long-term HRR with improved nitric oxide-dependent coronary vasodilatation. CONCLUSIONS Long-term HRR induced by ivabradine improves diastolic LV function probably involving attenuated hypoxia, reduced remodeling, and/or preserved nitric oxide bioavailability, resulting from processes triggered early after HRR initiation: angiogenesis and/or preservation of endothelial nitric oxide synthase expression.
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Yue-Chun L, Teng Z, Na-Dan Z, Li-Sha G, Qin L, Xue-Qiang G, Jia-Feng L. Comparison of effects of ivabradine versus carvedilol in murine model with the Coxsackievirus B3-induced viral myocarditis. PLoS One 2012; 7:e39394. [PMID: 22761780 PMCID: PMC3386276 DOI: 10.1371/journal.pone.0039394] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/19/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Elevated heart rate is associated with increased cardiovascular morbidity. The selective I(f) current inhibitor ivabradine reduces heart rate without affecting cardiac contractility, and has been shown to be cardioprotective in the failing heart. Ivabradine also exerts some of its beneficial effects by decreasing cardiac proinflammatory cytokines and inhibiting peroxidants and collagen accumulation in atherosclerosis or congestive heart failure. However, the effects of ivabradine in the setting of acute viral myocarditis and on the cytokines, oxidative stress and cardiomyocyte apoptosis have not been investigated. METHODOLOGY/PRINCIPAL FINDINGS The study was designed to compare the effects of ivabradine and carvedilol in acute viral myocarditis. In a coxsackievirus B3 murine myocarditis model (Balb/c), effects of ivabradine and carvedilol (a nonselective β-adrenoceptor antagonist) on myocardial histopathological changes, cardiac function, plasma noradrenaline, cytokine levels, cardiomyocyte apoptosis, malondialdehyde and superoxide dismutase contents were studied. Both ivabradine and carvedilol similarly and significantly reduced heart rate, attenuated myocardial lesions and improved the impairment of left ventricular function. In addition, ivabradine treatment as well as carvedilol treatment showed significant effects on altered myocardial cytokines with a decrease in the amount of plasma noradrenaline. The increased myocardial MCP-1, IL-6, and TNF-α. in the infected mice was significantly attenuated in the ivabradine treatment group. Only carvedilol had significant anti-oxidative and anti-apoptoic effects in coxsackievirus B3-infected mice. CONCLUSIONS/SIGNIFICANCE These results show that the protective effects of heart rate reduction with ivabradine and carvedilol observed in the acute phase of coxsackievirus B3 murine myocarditis may be due not only to the heart rate reduction itself but also to the downregulation of inflammatory cytokines.
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Affiliation(s)
- Li Yue-Chun
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Zhang Teng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Zhou Na-Dan
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Ge Li-Sha
- Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Luo Qin
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Guan Xue-Qiang
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Lin Jia-Feng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
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Ma C, Wang Q, Man Y, Kemmner W. Cardiovascular medications in angiogenesis-How to avoid the sting in the tail. Int J Cancer 2012; 131:1249-59. [DOI: 10.1002/ijc.27576] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 03/19/2012] [Indexed: 12/21/2022]
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