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.

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Antihypertensive Drugs: Thiazide-Class Diuretics01:15

Antihypertensive Drugs: Thiazide-Class Diuretics

Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...