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on December 29, 2003

Hypertension. 2003
Published online before print December 29, 2003, doi: 10.1161/01.HYP.0000111831.50834.93
A more recent version of this article appeared on February 1, 2004
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Submitted on September 29, 2003
Revised on October 31, 2003

Pressure-Independent Effects of Angiotensin II on Hypertensive Myocardial Fibrosis

Keisuke Tokuda; Hisashi Kai*; Fumitaka Kuwahara; Hideo Yasukawa; Nobuhiro Tahara; Hiroshi Kudo; Kiyoko Takemiya; Mitsuhisa Koga; Tomoka Yamamoto; and Tsutomu Imaizumi

From the Department of Internal Medicine III and Cardiovascular Research Institute, Kurume University School of Medicine, Kurume, Japan.

* To whom correspondence should be addressed. E-mail: naikai{at}med.kurume-u.ac.jp.

Abstract--Angiotensin II (Ang II) is implicated in the proinflammatory process in various disease situations. Thus, we sought to determine the role of Ang II in early inflammation-induced fibrosis of pressure-overloaded (PO) hearts. PO was induced by suprarenal aortic constriction (AC) at day 0 in male Wistar rats, and they were orally administered 0.1 mg/kg per day candesartan every day from day -7. This was the maximum dose of candesartan that did not change arterial pressure in hypertensive rats with AC (AC rats). In AC rats, cardiac angiotensin-converting enzyme (ACE) activity was transiently enhanced after day 1 and peaked at day 3, declining to lower levels by day 14, whereas serum ACE activity was not changed. In AC rats, PO induced early fibroinflammatory changes (monocyte chemoattractant factor [MCP]-1 and transforming growth factor [TGF]-{beta} expression, perivascular macrophage accumulation, and fibroblast proliferation), and thereafter, left ventricular hypertrophy developed, featuring myocyte hypertrophy, intramyocardial arterial wall thickening, and perivascular and interstitial fibroses. Candesartan suppressed the induction of MCP-1 and TGF-{beta} and reduced macrophage accumulation and fibroblast proliferation in PO hearts. Candesartan significantly prevented perivascular and interstitial fibrosis. However, candesartan did not affect myocyte hypertrophy and arterial wall thickening. In conclusion, a subdepressor dose of candesartan prevented the MCP-1-mediated inflammatory process and reactive myocardial fibrosis in PO hearts. Ang II might play a key role in reactive fibrosis in hypertensive hearts, independent of arterial pressure changes.


Key words: angiotensin II • fibrosis • hypertension, experimental • macrophages • inflammation




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