Abstract-Hypertension increases oxidative stress, which can impair myocardial microvascular function and integrity.However, it is yet unclear whether long-term antioxidant intervention in early hypertension would preserve myocardial perfusion and vascular permeability responses to challenge. Pigs were studied after 12 weeks of renovascular hypertension without (nϭ8) or with daily supplementation of antioxidants (100 IU/kg vitamin E and 1 g vitamin C, nϭ6), and compared with normal controls (nϭ7). Myocardial perfusion and microvascular permeability were measured in vivo by electron beam computed tomography before and after 2 cardiac challenges (intravenous adenosine and dobutamine). Basal left ventricular muscle mass was also obtained. 4,5 In addition to its effect on vascular reactivity, HT has effects on other functions of the vascular wall. Increases in blood pressure can also lead to alterations in thrombogenesis 6 and increased permeability of the endothelium. 7,8 One of the mechanisms that might be responsible for HT-induced myocardial dysfunction is an increase in oxidative stress, which has been demonstrated in both humans 9 and animal models. 10 Indeed, short-term antioxidant administration improved coronary epicardial endothelial function. 9,11 However, whether long-term antioxidant supplementation might preserve HT-induced myocardial microvascular dysfunction remains unclear.Electron beam computed tomography (EBCT), a fast CT scanner, provides a unique tool to accurately 12 and reproducibly 13 study in vivo transmural myocardial perfusion 14 -16 and myocardial microvascular permeability (MVP) 15-17 noninvasively. This tool provides an opportunity to explore noninvasively the effect of long-term therapeutic interventions on myocardial vascular function. Thus, the present study was designed to test the hypothesis that long-term antioxidant blockade would preserve myocardial vascular function in early HT.
Methods
AnimalsAll of the study procedures were approved by the Institutional Animal Care and Use Committee. Twenty-one female, domestic crossbred pigs (Pork Partners, Stewartville, Minn; 55 to 65 kg each) were studied after a 12-week preparation: one group (normal, nϭ7) was untreated, and in the second (HT, nϭ8), renovascular HT was induced by placing a local-irritant stent in the left renal artery, as previously described. 16,18 In addition to induction of renal artery stenosis, animals from group 3 (HTϩantioxidants [Ao], nϭ6) received daily oral antioxidant supplementation (combination of 100 IU/kg vitamin E and 1 g vitamin C). This dosage was based on our previous studies in pigs that showed that this combination provided