Anti-Hypertensive Drugs Have Different Effects on Ventricular Hypertrophy Regression

Ferreira, Celso; Abreu, Luíz Carlos de; Valenti, Vítor Engrácia; Ferreira, Marcelo; Meneghini, Adriano; Silveira, José Alexandre; Riera, Andrés Ricardo Pérez; Colombari, Eduardo; Murad, Neif; Silva, Paulo Roberto Santos; Silva, Lovian José Henrique Pereira da; Vanderlei, Luiz Carlos Marques; Carvalho, Tatiana Dias de; Ferreira, Celso

doi:10.1590/s1807-59322010000700012

Cited by 24 publications

(15 citation statements)

References 33 publications

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“…Left ventricular hypertrophy is an increase in myocardial mass that leads to a structural rearrangement of the components of the ventricular wall and may result in ventricular stiffening, thereby compromising systolic and diastolic function 36,37. Analysis of the passive pressure-volume curve confirms that SHRs have increased left ventricular wall stiffness when compared to normotensive rats.…”

Section: Discussionmentioning

confidence: 93%

Effects of spironolactone in spontaneously hypertensive adult rats subjected to high salt intake

Baldo

Zaniqueli

Forechi

et al. 2011

Clinics

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OBJECTIVE:To evaluate the effect of spironolactone on ventricular stiffness in spontaneously hypertensive adult rats subjected to high salt intake.INTRODUCTION:High salt intake leads to cardiac hypertrophy, collagen accumulation and diastolic dysfunction. These effects are partially mediated by cardiac activation of the renin-angiotensin-aldosterone system.METHODS:Male spontaneously hypertensive rats (SHRs, 32 weeks) received drinking water (SHR), a 1% NaCl solution (SHR-Salt), or a 1% NaCl solution with a daily subcutaneous injection of spironolactone (80 mg.kg-1) (SHR-Salt-S). Age-matched normotensive Wistar rats were used as a control. Eight weeks later, the animals were anesthetized and catheterized to evaluate left ventricular and arterial blood pressure. After cardiac arrest, a double-lumen catheter was inserted into the left ventricle through the aorta to obtain in situ left ventricular pressure-volume curves.RESULTS:The blood pressures of all the SHR groups were similar to each other but were different from the normotensive controls (Wistar = 109±2; SHR = 118±2; SHR-Salt = 117±2; SHR-Salt-S = 116±2 mmHg; P<0.05). The cardiac hypertrophy observed in the SHR was enhanced by salt overload and abated by spironolactone (Wistar = 2.90±0.06; SHR = 3.44±0.07; SHR-Salt = 3.68±0.07; SHR-Salt-S = 3.46±0.05 mg/g; P<0.05). Myocardial relaxation, as evaluated by left ventricular dP/dt, was impaired by salt overload and improved by spironolactone (Wistar = -3698±92; SHR = -3729±125; SHR-Salt = -3342±80; SHR-Salt-S = -3647±104 mmHg/s; P<0.05). Ventricular stiffness was not altered by salt overload, but spironolactone treatment reduced the ventricular stiffness to levels observed in the normotensive controls (Wistar = 1.40±0.04; SHR = 1.60±0.05; SHR-Salt = 1.67±0.12; SHR-Salt-S = 1.45±0.03 mmHg/ml; P<0.05).CONCLUSION:Spironolactone reduces left ventricular hypertrophy secondary to high salt intake and ventricular stiffness in adult SHRs.

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Section: Discussionmentioning

confidence: 93%

Effects of spironolactone in spontaneously hypertensive adult rats subjected to high salt intake

Baldo

Zaniqueli

Forechi

et al. 2011

Clinics

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“…Most importantly, the reversal or attenuation of VH is associated with improved clinical outcomes [2,30,31]. Aspirin trials have investigated its vascular effects on the prevention or treatment of CVD [4][5][6]15], although the sequelae of VH resembles overt coronary diseases [2,3,32].…”

Section: Discussionmentioning

confidence: 99%

Acetyl salicylic acid attenuates cardiac hypertrophy through Wnt signaling

Gitau

Zhao

et al. 2015

Front. Med.

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Ventricular hypertrophy is a powerful and independent predictor of cardiovascular morbid events. The vascular properties of low-dose acetyl salicylic acid (aspirin) provide cardiovascular benefits through the irreversible inhibition of platelet cyclooxygenase 1; however, the possible anti-hypertrophic properties and potential mechanism of aspirin have not been investigated in detail. In this study, healthy wild-type male mice were randomly divided into three groups and subjected to transverse aortic constriction (TAC) or sham operation. The TAC-operated mice were treated with the human equivalent of low-dose aspirin (10 mg$kg); the remaining mice received an equal amount of phosphate buffered saline with 0.65% ethanol, which was used as a vehicle. A cardiomyocyte hypertrophy model induced by angiotensin II (10 nmol$L -1 ) was treated with the human equivalent of low (10 or 100 µmol$L ) aspirin concentrations in plasma. Changes in the cardiac structure and function were assessed through echocardiography and transmission electron microscopy. Gene expression was determined through RT-PCR and western blot analysis. Results indicated that aspirin treatment abrogated the increased thickness of the left ventricular anterior and posterior walls, the swelling of mitochondria, and the increased surface area in in vivo and in vitro hypertrophy models. Aspirin also normalized the upregulated hypertrophic biomarkers, β-myosin heavy chain (β-MHC), atrial natriuretic peptide (ANP), and b-type natriuretic peptide (BNP). Aspirin efficiently reversed the upregulation of β-catenin and P-Akt expression and the TAC-or ANG II-induced downregulation of GSK-3β. Therefore, low-dose aspirin possesses significant anti-hypertrophic properties at clinically relevant concentrations for anti-thrombotic therapy. The downregulation of β-catenin and Akt may be the underlying signaling mechanism of the effects of aspirin.

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“…Enalaprilat in particular increased the regression of hypertrophy in the left ventricular, but not in the diaphragm or the gastrocnemius muscles [8]. …”

Section: Discussionmentioning

confidence: 99%

A review of echocardiograms in hypertensive patients greater than 60 years in a community based family medicine program

Doroudi

DeLisi

DeBari

2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Heart disease as a result of Hypertension is known to occur. Anatomical and functional changes of the heart can easily be detected by echocardiography, which is a safe and readily available study.Objectives: The aims of this study were to evaluate the prevalence of common echocardiographic changes in chronic hypertensive patients and to compare these changes in male and female populations.Design/methods: The study was a community-based cross-sectional study, on 227 hypertensive patients, 60 years and older, seen in St. Joseph’s Family Medicine at Clifton, with integrated clinical and echocardiographic data.Results: Study population consisted of 227 hypertensive patients, over the age of 60 years who had echocardiography done. Overall 92.5% of the echocardiograms had abnormal findings including but not limited to TR, Diastolic dysfunction, MR, and LVH. There was significant difference between the rate of MR in male and female population.Conclusion: A variety of echocardiographic abnormalities can be found in hypertensive patients. Drug selection in hypertension should be driven by the underlying cardiac pathology. Certain drugs have more effectiveness for diastolic dysfunction, LVH, systolic dysfunction and pulmonary hypertension and are superior choices when these conditions are present. Echocardiogram is a non-invasive and easily available tool in order to help us to select the best treatment strategy to optimize hypertensive control in the challenging group of elderly patients. The results of our study should influence us to liberally use echocardiography in these patients to guide treatment decision and drug selection.Abbreviations: LVH: left ventricular hypertrophy; MR: mitral valve regurgitation; TR: tricuspidvalve regurgitation; LVD: left ventricular dilation; LVEF: left ventricular ejection fraction

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Anti-Hypertensive Drugs Have Different Effects on Ventricular Hypertrophy Regression

Cited by 24 publications

References 33 publications

Effects of spironolactone in spontaneously hypertensive adult rats subjected to high salt intake

Effects of spironolactone in spontaneously hypertensive adult rats subjected to high salt intake

Acetyl salicylic acid attenuates cardiac hypertrophy through Wnt signaling

A review of echocardiograms in hypertensive patients greater than 60 years in a community based family medicine program

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