(Hypertension. 1997;30:1621-1627.)
© 1997 American Heart Association, Inc.
Articles |
From the Research Institute of Angiocardiology and Cardiovascular Clinic (M.T., K.E., H.T., M.U., H.S., A.T.) and the First Department of Pathology (K.S.), Kyushu University School of Medicine, Fukuoka, Japan, and the Department of Cardiovascular Medicine (H.O., A.K.), Hokkaido University School of Medicine, Sapporo, Japan.
Correspondence to Kensuke Egashira, MD, PhD, Research Institute of Angiocardiology and Cardiovascular Clinic, Kyushu University School of Medicine 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-82, Japan. E-mail egashira{at}cardiol.med.kyushu-u.ac.jp
| Abstract |
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-nitro-L-arginine methyl
ester (L-NAME). ACE inhibitors inhibit both the formation
of angiotensin II and the catabolism of bradykinin. In this
study, we aimed to determine the relative contribution of the latter
two mechanisms to the beneficial effects of an ACE
inhibitor on structural remodeling. First, we examined the
effects of the ACE inhibitor temocapril and the
angiotensin II AT1 subtype receptor
antagonist CS-866 on the structural remodeling induced by
administering L-NAME for 8 weeks. Temocapril and CS-866 were equally
effective in preventing remodeling. Second, we examined whether the
effect of temocapril on the remodeling induced by L-NAME was reduced by
the bradykinin receptor antagonist HOE140. The latter drug
did not alter the beneficial effect of temocapril on remodeling. In
conclusion, although species differences must be considered to apply
our conclusion to clinical conditions, the present results suggest
that the inhibition of angiotensin II activity, mediated
via the AT1 receptors, is responsible for the beneficial
effects of an ACE inhibitor in our animal model of
coronary vascular and myocardial remodeling induced by the
long-term inhibition of NO synthesis.
Key Words: angiotensin endothelium-derived factors bradykinin collagen hypertrophy remodeling
| Introduction |
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We10 11 12 and other investigators13 14 15 have reported that the long-term blockade of NO synthesis with chronically administered L-NAME produces vascular structural changes (thickening of the media and perivascular fibrosis) and hypertrophy and fibrosis of the myocardium in animals. More recently, we have reported that the increase in tissue ACE activity precedes the development of vascular and myocardial remodeling and that ACEIs, but not hydralazine, prevent the coronary vascular and myocardial remodeling observed in this experimental model.16 Michel et al17 also have demonstrated that ACEIs prevent the vascular structural changes in the kidney and spinal cord induced by long-term administration of L-NAME. Evidence indicates therefore that activation of tissue ACE activity plays an important role in mediating the cardiac remodeling observed in certain disorders.
There are two possible mechanisms by which ACEIs might have exerted their beneficial effects in those studies: (1) inhibition of Ang II formation and (2) inhibition of bradykinin breakdown. Ang II produces vascular and myocardial fibroproliferative changes via an action on the AT1 receptor subtype.18 19 The increase in bradykinin concentration resulting from inhibition of its breakdown by ACEIs20 would increase NO synthesis via stimulation of the bradykinin B2 receptor subtype and therefore may contribute to the inhibition of vascular and myocardial structural changes. Evidence suggests that vascular tissue contains an intrinsic kinin-kallikrein system21 and that endogenous bradykinin contributes to the endothelium-dependent and flow-mediated dilation of human coronary circulation in vivo.22 However, it is not known whether the beneficial effects of an ACEI observed in our model result from inhibition of Ang IIinduced actions, the catabolism of bradykinin, or both.
The purpose of this study was to determine the relative roles of Ang II and bradykinin in the effects of an ACEI on vascular and myocardial remodeling in rats induced by long-term administration of an NO synthase inhibitor. Our specific aims were (1) to examine whether a selective antagonist of the Ang II type 1 receptors caused the similar effects as ACEIs and (2) to examine whether the beneficial effects of an ACEI were reduced by a selective antagonist of the bradykinin receptor.
| Methods |
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Drugs
L-NAME was purchased from Sigma. The ACE inhibitor
temocapril23 and the Ang II AT1 receptor
antagonist CS-86624 were gifts from Sankyo
Pharmaceutical Co. The bradykinin B2 receptor
antagonist HOE14025 was a gift from Hoechst
Pharmaceutical Co..
Experimental Animal Preparation
Male Wistar-Kyoto rats (20 weeks old, 320 to 350 g) were
obtained from an established colony at the Animal Research Institution
of Kyushu University Faculty of Medicine. Eight groups of rats (20 to
25 animals in each group) were studied. The control group received
untreated regular chow and drinking water. The second group (L)
received L-NAME in its drinking water (1 mg/mL). At this
concentration, the daily intake of L-NAME for the latter group was
approximately 30 to 40 mg/d. The third group (L+ACEI) received
L-NAME and 0.1 mg/mL temocapril in its drinking water. The
fourth group (L+ATRA1) received L-NAME in its drinking water and a high
dose (75 µg/g) of CS-866 in its chow. The fifth group
(L+ATRA2) received L-NAME in its drinking water and a low dose (7.5
µg/g) of CS-866 in its chow. The sixth group (ATRA) received
CS-866 alone (7.5 µg/g) in its chow. The doses of temocapril
and CS-866 were determined empirically, but we found them to be
effective as described below. The seventh group (L+ACEI+HOE) received
L-NAME, temocapril, and HOE140 at 70 µg/kg per day infused by
an osmotic minipump. The eighth group (HOE) received HOE140 alone by
the minipump. The minipump was implanted in the peritoneal cavity under
anesthesia 2 days before the initiation of treatment. This
dose of HOE140 has been used successfully by other
investigators.26 All rats were single-housed in a special
pyrogen-free facility. We monitored and confirmed that the rats drank
approximately 30 to 40 mL of water and ate 20 g of chow regardless
of the treatment. We also confirmed that their drinking and eating
patterns were unaffected by any treatment protocol.
To determine whether the dose of HOE140 was sufficient to inhibit the vascular effect of bradykinin, we examined the bradykinin-induced decrease in arterial pressure with and without HOE140 treatment. At the eighth week of treatment, eight rats each from the L+ACEI and the L+ACEI+HOE groups were anesthetized with pentobarbital. Catheters (PE-50) were placed in a carotid artery to measure the pressure and into a jugular vein to administer drugs. Blood pressure was measured by a calibrated pressure transducer (Nihon-Kohden Inc). All rats were pretreated with temocaprilat (200 µg/kg IV) to potentiate the effect of bradykinin. After the blood pressure stabilized, bradykinin (100 ng in 0.1 mL saline) was administered intravenously, and the change in blood pressure was recorded. In this preliminary study, the intravenous administration of bradykinin reduced the mean arterial pressure by 31±2 mm Hg in the L+ACEI group and by 2±2 mm Hg in the L+ACEI+HOE group (P<.01), indicating that HOE140 blocked the bradykinin-induced dilation of the systemic vasculatures under the experimental conditions.
Systolic blood pressure (the tail-cuff method), heart rate, and body weight were measured every week. Morphometric, immunohistochemical, and biochemical analyses were performed at the eighth week of treatment.
Histopathology and Morphometry
Histopathology and morphometry were performed by a single
investigator who was blind to all treatment protocols. Findings were
evaluated in 10 rats from each group as previously
described.16 After each animal was anesthetized
with pentobarbital, its abdomen was opened and the abdominal aorta was
cannulated. The chest was opened and an incision made in the right
atrium. The heart was perfused via the aorta with
oxygenated Krebs' solution at a pressure of 90
mm Hg, and then the coronary vasculature was fixed for 30
minutes with 6% formaldehyde solution. After completion of the
fixation, the heart was removed, the left and right ventricles were
separated from the atria, and the great vessels and were weighed. The
left ventricle was cut into five pieces perpendicular to its long axis.
All tissues were fixed in 6% formaldehyde for a few days and then
dehydrated, embedded in paraffin, and cut into 5-µm-thick slices that
were mounted on slides and stained with hematoxylin-eosin and Masson's
trichrome staining solutions. The whole areas of all histopathologic
sections were scanned using a light microscope (Microphot-FXA, Nikon
Co) equipped with a computer-based image analyzer.
To evaluate the thickening of the coronary arterial wall and perivascular fibrosis, short-axis images of the large (ID >200 µm) and small coronary arteries (ID <200 µm) were studied. The inner border of the lumen and the outer border of the tunica media were traced at 100x to 200x magnification in each arterial image, and the areas encircled by the tracings were calculated. During the quantification procedure, only round vessels were studied and any nonround vessels due to oblique transsection or branching were excluded. We then calculate the wall-to-lumen ratio (defined as the medial thickness of the vessel divided by its internal diameter) and the area of fibrosis (defined as amount of collagen deposition stained with aniline blue that immediately surrounded the blood vessels) of the blood vessels. Perivascular fibrosis was determined as the ratio of the area of fibrosis surrounding the vessel wall to the total vessel area. In each heart, approximately 40 small arteries and 10 large arteries were examined. Average values for each size of vessel were used for analysis.
Myocardial interstitial fibrosis was determined by quantitative morphometry.16 Each section was scanned at 400x magnification. The collagen fraction was calculated as the sum of the total area of interstitial fibrosis in the entire visual field of the section divided by the sum of the total connective tissue area plus the myocardial area in the entire visual field of the section. The areas of perivascular fibrosis and reparative fibrosis, which were clearly distinguishable from myocardial interstitial fibrosis, were excluded from this latter measurement. The reparative fibrosis that follows myocyte necrosis was also determined in this study at 10x magnification.16 The areas of myocardial reparative fibrosis were determined. This area was calculated as the sum of the total areas of fibrosis in the entire visual field of the section divided by the sum of the total area of connective tissue plus the myocardial area in the entire visual field of the section. The areas of perivascular fibrosis in arteries and veins were excluded from the latter measurements.
Morphometry of left ventricular myocytes was performed to measure the myocyte cross-sectional area.16 This morphometry was done on sections of the lateral mid-free wall of the left ventricle. The myocyte cross-sectional area was measured from myocytes that were cut transversely and had both a visible nucleus and an unbroken cellular membrane. The outer borders of the myocytes were traced, and the myocyte areas were calculated. Approximately 100 cells were counted per heart, and the average value was used for analysis.
Biochemical Analysis
Biochemical analysis was performed on 10 separate rats
from each group. At the eighth week of treatment, the animals were
anesthetized and a blood sample was taken from the femoral
artery. The chest was then opened and the heart removed. The left
ventricle was put into liquid nitrogen. Serum and tissue ACE activities
were measured by the rate of generation of His-Leu from a
hippuryl-His-Leu substrate using a fluorometric
assay.27
Statistical Analysis
Data are expressed as mean±SEM. Paired data were compared by
Student's t tests. Differences in a single
parameter among groups (myocyte size, heart weight, etc.)
were compared by using a one-way ANOVA followed by a Bonferroni test
for multiple comparisons. Differences in multiple
parameters (eg, changes in blood pressure and body weight)
among groups were compared with a two-way ANOVA followed by a
Bonferroni multiple-comparison t test. A level of
P<.05 was considered statistically significant.
| Results |
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Changes in systolic arterial pressure are shown in
Fig 1
. The L group showed a progressive
rise in systolic arterial pressure. Increases in
systolic arterial pressure observed in the L+ATRA2
group resembled those in the L group. The systolic
arterial pressure showed no significant change in the
control, L+ACEI, L+ATRA1, L+ACEI+HOE, ATRA, or HOE group. The heart
rates were similar among the eight groups throughout the treatments
(Table
).
|
Coronary Vascular Remodeling
Micrographs of the coronary arteries obtained in the
control, L, L+ATRA1, L+ACEI, and L+ACEI+HOE groups are shown in Fig 2
. The wall-to-lumen ratios and the
perivascular fibrosis in the coronary arteries were
significantly greater after the eighth week of treatment in the L group
than in the control group. These vascular structural changes were
reduced significantly by treatment with ACEI, as well as by the low and
high doses of ATRA (Fig 3
). Treatment
with ATRA alone had no effect on the coronary vascular
structure. Treatment with HOE140 did not alter the beneficial effect of
ACEI (Fig 3
). Treatment with HOE140 alone did not affect
coronary vascular structure.
|
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Myocardial Interstitial and Reparative
Fibrosis
Both myocardial interstitial fibrosis and reparative
fibrosis were increased significantly at the eighth week of treatment
in the L group (see Fig 4
). These two types of cardiac fibrosis were
significantly reduced by treatment with ACEI as well as by the low and
high doses of ATRA. Treatment with ATRA alone did not alter the cardiac
fibrosis. Treatment with HOE140 did not alter the beneficial effect of
ACEI (Fig 4
). Treatment with HOE140 alone
had no effect on cardiac fibrosis.
|
Myocardial Hypertrophy
The relative weights of the left and right ventricles and the
cross-sectional areas of the myocytes were increased significantly in
the L group (Fig 5
). The increases in
these parameters induced by long-term administration of
L-NAME were blunted to a similar extent by ACEI and by both the low and
the high doses of ATRA. The relative left and right
ventricular weights and the myocyte areas in the ATRA group
did not differ significantly from those of the control group. The
prevention of the myocardial hypertrophy induced by ACEI
was not altered by HOE140 (Fig 5
). Treatment with HOE140 alone did not
affect the relative ventricular weights or the myocyte
cross-sectional area.
|
Serum and Cardiac Tissue ACE Activity
Serum ACE activity was decreased significantly in the L+ACEI and
L+ACEI+HOE groups compared with the control group but it was not
altered significantly in other groups (Table
). ACE activity was
markedly increased in the cardiac tissue of the L group (Table
). The
increase in ACE activity in cardiac tissue was blunted by ACEI and by
both the low and the high doses of CS-866. Treatment with CS-866 alone
did not alter cardiac ACE activity. Treatment with HOE140 did not alter
the effect of ACEI on cardiac ACE activity. Treatment with HOE140 alone
had no effect on cardiac ACE activity.
| Discussion |
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Several reports have demonstrated that the effects of ACE inhibition on cardiovascular remodeling are different from those of AT1 receptor antagonism. Spinale et al29 30 showed that an effect of AT1 receptor blockade was less than ACE inhibition on cardiac dilatation and myocardial dysfunction in a canine model of pacing-induced heart failure. McDonald et al31 showed that in dogs with hypertrophic remodeling after direct current shock injury the ACE inhibition attenuates hypertrophic remodeling, but the AT1 receptor inhibition did not affect hypertrophic remodeling. Weinberg et al32 33 demonstrated that the ACE inhibition, but not AT1 inhibition, regressed left-ventricular hypertrophy in rats with persistent systolic pressure overload due to ascending aortic stenosis. In contrast, both ACE inhibition and AT1 antagonism have been shown to display similar inhibitory effects on hypertrophic remodeling in rats after myocardial infarction34 and in rats with ascending aortic banding35 when drugs were used at high doses to reduce systolic arterial pressure. Thus, in those rat models with hypertrophic remodeling,34 35 the effects of AT1 receptor antagonists seem to result at least in part from the reduction in systolic loading conditions. In the present study, however, a low dose of the AT1 receptor antagonist did not affect the increase in systolic blood pressure but rather produced an inhibitory effect identical to that observed with an antihypertensive dose of the AT1 receptor antagonist. Thus, the change in systolic arterial pressure was not responsible for its effects in our experimental model.
The relative roles of Ang II and bradykinin in the pathogenesis of clinical disorders (hypertension, cardiovascular remodeling, and heart failure) are unclear. There is considerable debate concerning the relative contribution of Ang II and bradykinin to the effect of ACEIs on experimental cardiovascular remodeling. Linz and Scholkens36 showed that the specific bradykinin receptor antagonist completely restored the effects of ACE inhibition on preventing the development of left ventricular hypertrophy in rats induced by abdominal aortic banding, whereas AT1 receptor antagonist was less effective than ACEI. Farhy et al26 suggested that the beneficial effect of ACEIs on vascular neointimal formation after balloon injury was due to both the blockade of Ang II formation and the catabolism of bradykinin. In this study, the effects of the ACEI on cardiovascular structural changes were not altered by the bradykinin receptor antagonist. We speculate, therefore, that the relative contributions of the inhibition of Ang II activity and the increase of bradykinin's effect to the beneficial effects of ACEIs depend on the experimental model as well as on the degree of activation of local and systemic renin-angiotensin systems. In addition, we must take species differences into account when applying those experimental findings to clinical conditions.
We considered the possibility that the inhibitory effect of the AT1 receptor antagonist on the cardiac structural changes induced by L-NAME was not due solely to AT1 receptor antagonism. It may be possible that the decreased cardiac ACE activity observed in response to the AT1 receptor antagonist treatment also contributed to the overall beneficial effect of the AT1 receptor antagonist on the cardiac structural changes evoked by the chronic administration of L-NAME. The mechanism by which an AT1 receptor antagonist reduced ACE activity is not known from our study, but it is possible that it was secondary to the improvement in the structural changes mediated by AT1 receptor blockade.
The mechanism by which the renin-angiotensin system is activated after the long-term administration of L-NAME was not explored in the present study. Reports from our laboratory have shown that the increases in both cardiac tissue ACE activity16 and cardiac tissue AT1 receptor number37 precede the development of cardiac structural changes observed in our model. Further studies are needed to elucidate the pathophysiological factors responsible for the upregulation of the local renin-angiotensin system in our experimental model.
In conclusion, the results of the present study indicate that inhibition of Ang II activity, which is mediated by AT1 receptors, is responsible for the beneficial effects of the ACEI temocapril in our model.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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Received March 11, 1997; first decision April 1, 1997; accepted June 12, 1997.
| References |
|---|
|
|
|---|
2. Dzau VJ, Gibbons GH. Endothelium and growth factors in vascular remodeling of hypertension. Hypertension. 1991;18(suppl III):III-115-III-121.
3. Loscarzo J, Welch G. Nitric oxide and its role in the cardiovascular system. Prog Cardiovasc Dis. 1995;38:87104.[Medline] [Order article via Infotrieve]
4. Cohen RA. The role of nitric oxide and other endothelium-derived vasoactive substances in vascular disease. Prog Cardiovasc Dis. 1995;38:105128.[Medline] [Order article via Infotrieve]
5. Egashira K, Inou T, Hirooka Y, Yamada A, Maruoka Y, Kai H, Sugimachi M, Takeshita A. Impaired coronary blood flow response to acetylcholine in patients with coronary risk factors and proximal atherosclerotic lesions. J Clin Invest. 1993;91:2937.
6.
Egashira K, Inou T, Hirooka Y, Kai H, Sugimachi M,
Suzuki S, Kuga T, Urabe Y, Takeshita A. Effects of age on
endothelium-dependent vasodilation of resistance
coronary artery by acetylcholine. Circulation. 1993;88:7781.
7.
Egashira K, Suzuki S, Hirooka Y, Kai H, Sugimachi M,
Imaizumi T, Takeshita A. Impaired endothelium-dependent
vasodilation of large epicardial and resistance coronary
arteries in patients with essential hypertension. Different responses
to acetylcholine and substance P. Hypertension. 1995;25:201206.
8.
Egashira K, Hirooka Y, Kai H, Sugimachi M, Suzuki S,
Inou T, Takeshita A. Reduction in serum cholesterol with
pravastatin improves endothelium-dependent
coronary vasodilation in patients with
hypercholesterolemia. Circulation. 1994;89:25192524.
9. Zeiher AM, Drexler H, Saubier B, Just H. Endothelium-mediated coronary blood flow modulation in humans. Effects of age, atherosclerosis, hypercholesterolemia, and hypertension. J Clin Invest. 1993;92:652662.
10.
Ito A, Egashira K, Kadokami T, Fukumoto Y, Takayanagi
T, Nakaike R, Kuga T, Sueishi K, Shimokawa H, Takeshita A. Chronic
inhibition of endothelium-derived nitric oxide
synthesis causes coronary microvascular structural changes and
hyperreactivity to serotonin in pigs.
Circulation. 1995;92:26362644.
11. Numaguchi K, Egashira K, Takemoto M, Kadokami T, Shimokawa H, Sueishi K, Takeshita A. Chronic inhibition of nitric oxide synthesis causes coronary microvascular remodeling in rats. Hypertension. 1995;26(part 1):957962.
12.
Kadokami T, Egashira K, Kuwata K. Altered
serotonin receptor subtypes contribute to microvascular
hyperreactivity to serotonin in pigs with chronic
inhibition of nitric oxide. Circulation. 1996;94:182189.
13. Arnal JF, Warin L, Michel JB. Determinants of aortic cyclic guanosine monophosphate in hypertension induced by chronic inhibition of nitric oxide synthase. J Clin Invest. 1992;90:647652.
14. Baylis C, Mitruka B, Deng A. Chronic blockade of nitric oxide synthesis in the rat produces systemic hypertension and glomerular damage. J Clin Invest. 1992;90:278281.
15.
Ribeiro MO, Antunes E, Nicci G, Lovisolo SM, Zatz R.
Chronic inhibition of nitric oxide synthesis. A new model of
arterial hypertension. Hypertension. 1992;20:298303.
16. Takemoto M, Egashira K, Usui M, Numaguchi K, Tomita H, Tsutsui H, Shimokawa H, Sueishi K, Takeshita A. Important role of tissue angiotensin-converting enzyme activity in the pathogenesis of coronary vascular and myocardial structural changes induced by long-term blockade of nitric oxide synthesis in rats. J Clin Invest. 1997;99:278287.[Medline] [Order article via Infotrieve]
17. Michel JB, Xu Y, Blot S, Philippe M, Chatellier G. Improved survival in rats administered NG-nitro-L-arginine methyl ester due to converting enzyme inhibition. J Cardiovasc Pharmacol. 1996;28:142148.[Medline] [Order article via Infotrieve]
18.
Griendling KK, Murphy TJ, Alexander RW. Molecular
biology of the renin-angiotensin system.
Circulation. 1993;87:18161828.
19.
Sadoshima J, Izumo S. Molecular characterization of
angiotensin IIinduced hypertrophy of cardiac
myocytes and hyperplasia of cardiac fibroblasts. Critical role of the
AT1 receptor subtype. Circ Res. 1993;73:413423.
20.
Erdös EG. Angiotensin converting
enzyme and the change in our concept through the years.
Hypertension. 1990;26:363370.
21. Oza NB, Schwartz JH, Goud HD, Levinsky NG. Rat aortic smooth muscle cell in culture express kallikrein kininogen and bradykininase activity. J Clin Invest. 1990;85:597600.
22.
Groves P, Kurz S, Just H, Drexler H. Role of bradykinin
in human coronary vasomotor control. Circulation. 1995;92:34243430.
23. Furuta S, Kiyosawa K, Higuchi M, Kasahara H, Saito H, Shioya H, Oguchi H. Pharmacokinetics of temocapril an ACE inhibitor with preferential biliary excretion in patients with impaired liver function. Eur J Clin Pharmacol. 1993;44:383385.[Medline] [Order article via Infotrieve]
24. Mizuno M, Sada T, Ikeda M, Fukuda N, Miyamoto M, Yanagisawa H, Koike H. Pharmacology of CS-866 a novel nonpeptide angiotensin II receptor antagonist. Eur J Pharmacol. 1995;285:181188.[Medline] [Order article via Infotrieve]
25. Wirth K, Hock FJ, Albus U, Linz W, Alpermann HG, Anagnostopoulos H, Henke S, Breipohl G, Konig W, Knolle J, Scholkens BA. HOE 140, a new potent and long-acting bradykinin antagonist: in vivo studies. Br J Pharmacol. 1991;102:774777.[Medline] [Order article via Infotrieve]
26.
Farhy RD, Carretero OA, Ho KL, Scicli G. Role of kinins
and nitric oxide in the effects of angiotensin converting
enzyme inhibitors on neointima formation.
Circ Res. 1993;72:12021210.
27. Cheung HS, Cushman DW. Inhibition of homogenous angiotensin-converting enzyme of rabbit lung by synthetic venom peptides of Bothrops jararaca. Biochim Biophys Acta. 1973;293:451463.
28. Hou J, Kato H, Cohen RA, Chobanian AV, Brecher P. Angiotensin II-induced cardiac fibrosis in rats is increased by chronic inhibition of nitric oxide synthase. J Clin Invest. 1995;96:24692477.
29.
Spinale FG, Holzgrefe HH, Mukherjee R, Hird RB, Walker
JD, Arnim-Barker A, Powell JR, Koster WH.
Angiotensin-converting enzyme inhibition and the
progression of congestive cardiomyopathy: effects
on left ventricular and myocyte structure and function.
Circulation. 1995;92:562578.
30. Spinale FG, Holzgrefe HH, Hird RB, Walker JD, Arnim AE, Eble DM, Powell JR, Koster WH. Differential effects of ACE inhibition and AT1 angiotensin II receptor blockade on LV and myocyte function and structure with dilated cardiomyopathy. Circulation. 1994;90:I-III.
31.
McDonald KM, Garr M, Carlyle PF, Francis GS, Hauer K,
Hunter DW, Parish T, Stillman A, Cohn JN. Relative effects of alpha
1-adrenoceptor blockade, converting enzyme inhibitor
therapy, and angiotensin II subtype 1 receptor blockade on
ventricular remodeling in the dog. Circulation. 1994;90:30343046.
32.
Weinberg EO, Schoen FJ, George D, Kagaya Y, Douglas PS,
Litwin SE, Schunkert H, Benedict CR, Lorell BH.
Angiotensin-converting enzyme inhibition prolongs survival
and modifies the transition to heart failure in rats with pressure
overload hypertrophy due to ascending aortic
stenosis. Circulation. 1994;90:14101422.
33.
Weinberg WO, Lee MA, Weigner M, Lindpaintner K, Bishop
SP, Benedict CR, Ho KKL, Douglas PS, Chafizadeh E, Lorell BH.
Angiotensin AT1 receptor inhibition. Effects on
hypertrophic remodeling and ACE expression in rats with
pressure-overload hypertrophy due to ascending aortic
stenosis. Circulation. 1997;95:15921600.
34.
Schieffer B, Wirger A, Meybrunn M, Seitz S, Holtz J,
Riede UN, Drexler H. Comparative effects of chronic
angiotensin-converting enzyme inhibition and
angiotensin type 1 receptor blockade on cardiac remodeling
after myocardial infarction in the rat. Circulation. 1994;89:22732282.
35.
Bruckschlegel G, Holmer SR, Jandeleit K, Grimm D,
Muders F, Kromer EP, Riegger AJ, Schunkert H. Blockade of the
renin-angiotensin system in cardiac pressure-overload
hypertrophy in rats. Hypertension. 1995;25:250259.
36. Linz W, Scholkens BA. Role of angiotensin II receptor antagonism and converting enzyme inhibition in the progression and regression of cardiac hypertrophy in rats. J Hypertens. 1991;9:S400S401.
37. Katoh M, Egashira K, Usui M. Cardiac angiotensin II receptors is increased in rats with cardiac remodeling induced by long-term blockade of nitric oxide synthesis. Circulation. 1996;94(suppl 1):I-656.
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F. Kuwahara, H. Kai, K. Tokuda, M. Takeya, A. Takeshita, K. Egashira, and T. Imaizumi Hypertensive Myocardial Fibrosis and Diastolic Dysfunction: Another Model of Inflammation? Hypertension, April 1, 2004; 43(4): 739 - 745. [Abstract] [Full Text] [PDF] |
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C. Kataoka, K. Egashira, M. Ishibashi, S. Inoue, W. Ni, K.-i. Hiasa, S. Kitamoto, M. Usui, and A. Takeshita Novel anti-inflammatory actions of amlodipine in a rat model of arteriosclerosis induced by long-term inhibition of nitric oxide synthesis Am J Physiol Heart Circ Physiol, February 1, 2004; 286(2): H768 - H774. [Abstract] [Full Text] [PDF] |
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K. Tokuda, H. Kai, F. Kuwahara, H. Yasukawa, N. Tahara, H. Kudo, K. Takemiya, M. Koga, T. Yamamoto, and T. Imaizumi Pressure-Independent Effects of Angiotensin II on Hypertensive Myocardial Fibrosis Hypertension, February 1, 2004; 43(2): 499 - 503. [Abstract] [Full Text] [PDF] |
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F. Kuwahara, H. Kai, K. Tokuda, H. Niiyama, N. Tahara, K. Kusaba, K. Takemiya, A. Jalalidin, M. Koga, T. Nagata, et al. Roles of Intercellular Adhesion Molecule-1 in Hypertensive Cardiac Remodeling Hypertension, March 1, 2003; 41(3): 819 - 823. [Abstract] [Full Text] [PDF] |
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M. Ishibashi, K. Egashira, K.-i. Hiasa, S. Inoue, W. Ni, Q. Zhao, M. Usui, S. Kitamoto, T. Ichiki, and A. Takeshita Antiinflammatory and Antiarteriosclerotic Effects of Pioglitazone Hypertension, November 1, 2002; 40(5): 687 - 693. [Abstract] [Full Text] [PDF] |
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Y. Li, I. Kishimoto, Y. Saito, M. Harada, K. Kuwahara, T. Izumi, N. Takahashi, R. Kawakami, K. Tanimoto, Y. Nakagawa, et al. Guanylyl Cyclase-A Inhibits Angiotensin II Type 1A Receptor-Mediated Cardiac Remodeling, an Endogenous Protective Mechanism in the Heart Circulation, September 24, 2002; 106(13): 1722 - 1728. [Abstract] [Full Text] [PDF] |
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F. Kuwahara, H. Kai, K. Tokuda, M. Kai, A. Takeshita, K. Egashira, and T. Imaizumi Transforming Growth Factor-{beta} Function Blocking Prevents Myocardial Fibrosis and Diastolic Dysfunction in Pressure-Overloaded Rats Circulation, July 2, 2002; 106(1): 130 - 135. [Abstract] [Full Text] [PDF] |
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C. Kataoka, K. Egashira, S. Inoue, M. Takemoto, W. Ni, M. Koyanagi, S. Kitamoto, M. Usui, K. Kaibuchi, H. Shimokawa, et al. Important Role of Rho-kinase in the Pathogenesis of Cardiovascular Inflammation and Remodeling Induced by Long-Term Blockade of Nitric Oxide Synthesis in Rats Hypertension, February 1, 2002; 39(2): 245 - 250. [Abstract] [Full Text] [PDF] |
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S. Sanada, M. Kitakaze, K. Node, S. Takashima, A. Ogai, H. Asanuma, Y. Sakata, M. Asakura, H. Ogita, Y. Liao, et al. Differential Subcellular Actions of ACE Inhibitors and AT1 Receptor Antagonists on Cardiac Remodeling Induced by Chronic Inhibition of NO Synthesis in Rats Hypertension, September 1, 2001; 38(3): 404 - 411. [Abstract] [Full Text] [PDF] |
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K. T. Weber Cardioreparation in Hypertensive Heart Disease Hypertension, September 1, 2001; 38(3): 588 - 591. [Abstract] [Full Text] [PDF] |
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R. M. Fitch, R. Vergona, M. E. Sullivan, and Y.-X. Wang Nitric oxide synthase inhibition increases aortic stiffness measured by pulse wave velocity in rats Cardiovasc Res, August 1, 2001; 51(2): 351 - 358. [Abstract] [Full Text] [PDF] |
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M. Katoh, K. Egashira, C. Kataoka, M. Usui, M. Koyanagi, S. Kitamoto, Y. Ohmachi, A. Takeshita, and H. Narita Regression by ACE inhibition of arteriosclerotic changes induced by chronic blockade of NO synthesis in rats Am J Physiol Heart Circ Physiol, May 1, 2001; 280(5): H2306 - H2312. [Abstract] [Full Text] [PDF] |
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L. Brown, A. Fenning, A. Shek, and D. Burstow Reversal of cardiovascular remodelling with candesartan Journal of Renin-Angiotensin-Aldosterone System, March 1, 2001; 2(1_suppl): S141 - S147. [Abstract] [PDF] |
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M. Koyanagi, K. Egashira, S. Kitamoto, W. Ni, H. Shimokawa, M. Takeya, T. Yoshimura, and A. Takeshita Role of Monocyte Chemoattractant Protein-1 in Cardiovascular Remodeling Induced by Chronic Blockade of Nitric Oxide Synthesis Circulation, October 31, 2000; 102(18): 2243 - 2248. [Abstract] [Full Text] [PDF] |
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K. T. Weber Targeting Pathological Remodeling : Concepts of Cardioprotection and Reparation Circulation, September 19, 2000; 102(12): 1342 - 1345. [Full Text] [PDF] |
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S. Kitamoto, K. Egashira, C. Kataoka, M. Koyanagi, M. Katoh, H. Shimokawa, R. Morishita, Y. Kaneda, K. Sueishi, and A. Takeshita Increased Activity of Nuclear Factor-{kappa}B Participates in Cardiovascular Remodeling Induced by Chronic Inhibition of Nitric Oxide Synthesis in Rats Circulation, August 15, 2000; 102(7): 806 - 812. [Abstract] [Full Text] [PDF] |
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Y. Iwanaga, Y. Kihara, T. Yoneda, T. Aoyama, and S. Sasayama Modulation of in vivo cardiac hypertrophy with insulin-like growth factor-1 and angiotensin-converting enzyme inhibitor: relationship between change in myosin isoform and progression of left ventricular dysfunction J. Am. Coll. Cardiol., August 1, 2000; 36(2): 635 - 642. [Abstract] [Full Text] [PDF] |
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K. Eshima, Y. Hirooka, H. Shigematsu, I. Matsuo, G. Koike, K. Sakai, and A. Takeshita Angiotensin in the Nucleus Tractus Solitarii Contributes to Neurogenic Hypertension Caused by Chronic Nitric Oxide Synthase Inhibition Hypertension, August 1, 2000; 36(2): 259 - 263. [Abstract] [Full Text] [PDF] |
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K. J. Harmon, L. L. Couper, and V. Lindner Strain-Dependent Vascular Remodeling Phenotypes in Inbred Mice Am. J. Pathol., May 1, 2000; 156(5): 1741 - 1748. [Abstract] [Full Text] [PDF] |
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M. Usui, K. Egashira, H. Tomita, M. Koyanagi, M. Katoh, H. Shimokawa, M. Takeya, T. Yoshimura, K. Matsushima, and A. Takeshita Important Role of Local Angiotensin II Activity Mediated via Type 1 Receptor in the Pathogenesis of Cardiovascular Inflammatory Changes Induced by Chronic Blockade of Nitric Oxide Synthesis in Rats Circulation, January 25, 2000; 101(3): 305 - 310. [Abstract] [Full Text] [PDF] |
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M. Koyanagi, K. Egashira, M. Kubo-Inoue, M. Usui, S. Kitamoto, H. Tomita, H. Shimokawa, and A. Takeshita Role of Transforming Growth Factor-{beta}1 in Cardiovascular Inflammatory Changes Induced by Chronic Inhibition of Nitric Oxide Synthesis Hypertension, January 1, 2000; 35(1): 86 - 90. [Abstract] [Full Text] [PDF] |
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M. Usui, K. Egashira, S. Kitamoto, M. Koyanagi, M. Katoh, C. Kataoka, H. Shimokawa, and A. Takeshita Pathogenic Role of Oxidative Stress in Vascular Angiotensin-Converting Enzyme Activation in Long-Term Blockade of Nitric Oxide Synthesis in Rats Hypertension, October 1, 1999; 34(4): 546 - 551. [Abstract] [Full Text] [PDF] |
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W. Linz, P. Wohlfart, B. A Scholkens, T. Malinski, and G. Wiemer Interactions among ACE, kinins and NO Cardiovasc Res, August 15, 1999; 43(3): 549 - 561. [Full Text] [PDF] |
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S. R. Bryant, R. J. Bjercke, D. A. Erichsen, A. Rege, and V. Lindner Vascular Remodeling in Response to Altered Blood Flow Is Mediated by Fibroblast Growth Factor-2 Circ. Res., February 19, 1999; 84(3): 323 - 328. [Abstract] [Full Text] [PDF] |
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N. H. Anderson, A. M. Devlin, D. Graham, J. J. Morton, C. A. Hamilton, J. L. Reid, N. J. Schork, and A. F. Dominiczak Telemetry for Cardiovascular Monitoring in a Pharmacological Study : New Approaches to Data Analysis Hypertension, January 1, 1999; 33(1): 248 - 255. [Abstract] [Full Text] [PDF] |
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M. Katoh, K. Egashira, M. Usui, T. Ichiki, H. Tomita, H. Shimokawa, H. Rakugi, and A. Takeshita Cardiac Angiotensin II Receptors Are Upregulated by Long-Term Inhibition of Nitric Oxide Synthesis in Rats Circ. Res., October 5, 1998; 83(7): 743 - 751. [Abstract] [Full Text] [PDF] |
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H. Tomita, K. Egashira, Y. Ohara, M. Takemoto, M. Koyanagi, M. Katoh, H. Yamamoto, K. Tamaki, H. Shimokawa, and A. Takeshita Early Induction of Transforming Growth Factor-ß via Angiotensin II Type 1 Receptors Contributes to Cardiac Fibrosis Induced by Long-term Blockade of Nitric Oxide Synthesis in Rats Hypertension, August 1, 1998; 32(2): 273 - 279. [Abstract] [Full Text] [PDF] |
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W. Ni, K. Egashira, C. Kataoka, S. Kitamoto, M. Koyanagi, S. Inoue, and A. Takeshita Antiinflammatory and Antiarteriosclerotic Actions of HMG-CoA Reductase Inhibitors in a Rat Model of Chronic Inhibition of Nitric Oxide Synthesis Circ. Res., August 31, 2001; 89(5): 415 - 421. [Abstract] [Full Text] [PDF] |
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