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Cilazapril prevents cardiac hypertrophy and postischemic myocardial dysfunction in hyperthyroid rats
T Asahi1, M Shimabukuro, Y Oshiro
1Second Department of Internal Medicine, Faculty of Medicine, University of The Ryukyus, Nishihara, Okinawa, Japan.
Insights
Hyperthyroidism causes cardiac hypertrophy and impairs heart function after ischemia. An ACE inhibitor, cilazapril, mitigates these effects by targeting the renin-angiotensin system, not sympathetic nerves.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
- Pharmacology
Background:
- Hyperthyroidism is associated with cardiac structural and functional changes.
- The role of the renin-angiotensin system (RAS) and sympathetic nervous system in hyperthyroid cardiomyopathy is not fully understood.
Purpose of the Study:
- To investigate the impact of hyperthyroidism on cardiac structure and post-ischemic function.
- To determine the efficacy of an angiotensin-converting enzyme (ACE) inhibitor, cilazapril, in mitigating these hyperthyroidism-induced changes.
- To elucidate the involvement of the RAS and sympathetic nervous system in hyperthyroid cardiac dysfunction.
Main Methods:
- Hyperthyroidism was induced in rats using thyroxine (T4) injections.
- Rats received either T4 alone, T4 plus cilazapril, or vehicle.
- Cardiac structure (heart weight to body weight ratio) and function (post-ischemic recovery of left ventricular pressure-rate product and cardiac work) were assessed.
- The effects of propranolol were also evaluated.
Main Results:
- T4 treatment increased blood pressure and heart weight to body weight ratio (HW:BW).
- Cilazapril normalized blood pressure and reduced HW:BW, improving post-ischemic cardiac function recovery.
- Propranolol reduced blood pressure but did not affect HW:BW or post-ischemic dysfunction.
- Cardiac work recovery was inversely correlated with HW:BW.
Conclusions:
- Thyroxine-induced cardiac hypertrophy exacerbates post-ischemic myocardial dysfunction.
- The renin-angiotensin system, not sympathetic nerve activation, plays a significant role in cardiac hypertrophy and dysfunction in hyperthyroid rats.
- ACE inhibition offers a therapeutic strategy for hyperthyroid cardiomyopathy.
Abstract:
We evaluated the effects of hyperthyroidism on cardiac structural changes and postischemic myocardial function, and also studied how an angiotensin-converting enzyme (ACE) inhibitor, cilazapril, can alter these changes. Hyperthyroidism was induced by daily intraperitoneal injection of thyroxine (T4) (600 microg/kg) with or without cilazapril (10 mg/kg per day, orally), and control rats were given by vehicle. After 2 weeks of treatment, T4-treated rats showed increases in blood pressure and heart weight to body weight ratio (HW:BW). Cilazapril decreased blood pressure to control values and reduced HW:BW. In the isolated working heart preparation, T4-treated rats showed a poor postischemic recovery of left ventricular pressure-rate product (14% of baseline at 30 minutes of reperfusion vs. vehicle 85%) and cardiac work (6% vs. 71%). Cilazapril recovered both values to 49% and 43%. Propranolol (500 mg/L in drinking water) decreased blood pressure to the same extent as cilazapril in hyperthyroid rats, but changed neither HW:BW nor the postischemic myocardial dysfunction. Percent recovery of cardiac work was inversely well correlated with HW:BW (R2 = 0.998, p < 0.001). Results indicate that T4-induced cardiac hypertrophy enhances postischemic cardiac dysfunction. Results also indicate renin-angiotensin system (RAS), but not sympathetic nerve activation, is involved in cardiac hypertrophy and postischemic myocardial dysfunction in hyperthyroid rats.
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