(Hypertension. 1997;29:458.)
© 1997 American Heart Association, Inc.
State-of-the-Art-Lecture |
From the Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan, and the Kidney Disease Center, Saitama (Japan) Medical School (H.S.).
Correspondence to Takao Saruta, MD, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan
Impaired baroreflex function is a factor responsible for poor prognosis in myocardial infarction patients. Using logistic function curves, we calculated the maximal gain of the baroreflex control of renal sympathetic nerve activity (RSNA) and heart rate in conscious Wistar-Kyoto and spontaneously hypertensive rats whose left anterior descending artery had been ligated 4 weeks earlier. We further investigated whether 3-week oral treatment with the angiotensin II type I receptor antagonist TCV-116 would improve the baroreflex in rats with myocardial infarction. The maximal gain of the mean arterial pressure-RSNA relation in spontaneously hypertensive rats with myocardial infarction and treated with vehicle (1.7±0.1% control per mm Hg) was smaller than the gain in sham-operated hypertensive rats (2.3±0.1% control per mm Hg). After 3-week oral treatment with TCV-116, the maximal gain of the arterial pressure-RSNA relation in hypertensive rats with myocardial infarction was 2.3±0.1% control per mm Hg and significantly greater than the gain in infarcted and vehicle-treated hypertensive rats. In hypertensive rats, the maximal gain of the arterial pressure-heart rate relation of infarcted and TCV-116-treated rats was larger than in infarcted and vehicle-treated rats but significantly smaller than in sham-operated rats. These results demonstrate that oral treatment with an angiotensin receptor antagonist is effective in restoring the impaired baroreflex caused by myocardial infarction and that endogenous angiotensin II is one of the critical factors involved in the impaired baroreflex in myocardial infarction.
Key Words: baroreflex angiotensin antagonist myocardial infarction sympathetic nervous system rats heart rate
Abbreviations: Ang II = angiotensin II Gmax = maximal gain HR = heart rate MAP = mean arterial pressure MI = myocardial infarction RSNA = renal sympathetic nerve activity SHR = spontaneously hypertensive rat(s) WKY = Wistar-Kyoto rat(s)
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