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Published on: September 28, 2015
Angiotensin II type 1 receptor blockade prevents alcoholic cardiomyopathy
Che-Ping Cheng1, Heng-Jie Cheng, Carol Cunningham
1Cardiology Section, Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA. ccheng@wfubmc.edu
Background:
Activation of the renin-angiotensin system (RAS) may contribute to the development of alcoholic cardiomyopathy. We evaluated the effect of angiotensin II (Ang II) type 1 receptor (AT1) blockade on the development of alcoholic cardiomyopathy.
Methods And Results:
We serially evaluated left ventricular (LV) and cardiomyocyte function and the RAS over 6 months in 3 groups of instrumented dogs. Eight animals received alcohol (once per day orally, providing 33% of total daily caloric intake); 6 received alcohol and irbesartan (5 mg.kg(-1).d(-1) PO); and 8 were controls. Compared with controls, alcohol ingestion caused sustained RAS activation with progressive increases in plasma levels of Ang II, renin activity, LV angiotensin-converting enzyme activity, and LV myocyte Ang II AT(1) receptor expression. The RAS activation was followed by a progressive fall in LV contractility (E(ES), alcohol-fed dogs 3.9+/-0.8 versus control dogs 8.1+/-1.0 mm Hg/mL); reductions in the peak velocity of myocyte shortening (78.9+/-5.1 versus 153.9+/-6.2 microm/s) and relengthening; and decreased peak systolic Ca2+ transient ([Ca2+]iT) and L-type Ca2+ current (I(Ca,L); P<0.05). Irbesartan prevented the alcohol-induced decreases in LV and myocyte contraction, relaxation, peak [Ca2+]iT, and I(Ca,L). With alcohol plus irbesartan, plasma Ang II, cardiac angiotensin-converting enzyme activity, and AT1 remained close to control values.
Conclusions:
Chronic alcohol consumption produces RAS activation followed by progressive cardiac dysfunction. The cardiac dysfunction is prevented by AT1 receptor blockade.
Insights
Alcohol consumption activates the renin-angiotensin system (RAS), leading to alcoholic cardiomyopathy. Blocking the angiotensin II (Ang II) type 1 receptor (AT1) with irbesartan prevents this cardiac dysfunction.
Area of Science:
- Cardiology
- Pharmacology
- Toxicology
Background:
- Alcoholic cardiomyopathy is a potential consequence of chronic alcohol consumption.
- The renin-angiotensin system (RAS) may play a role in the development of alcoholic cardiomyopathy.
Purpose of the Study:
- To investigate the effect of angiotensin II (Ang II) type 1 receptor (AT1) blockade on alcoholic cardiomyopathy development.
- To evaluate the impact of irbesartan on cardiac function and RAS activation in alcohol-fed dogs.
Main Methods:
- Instrumented dogs were divided into three groups: alcohol, alcohol plus irbesartan, and control.
- Left ventricular (LV) and cardiomyocyte function, along with RAS markers, were monitored over six months.
- Measurements included LV contractility, myocyte shortening and relengthening, and calcium transients.
Main Results:
- Alcohol ingestion led to sustained RAS activation, evidenced by increased Ang II, renin activity, and AT1 receptor expression.
- Cardiac dysfunction manifested as decreased LV contractility, impaired myocyte function, and reduced calcium handling.
- Irbesartan treatment prevented alcohol-induced cardiac dysfunction and suppressed RAS activation.
Conclusions:
- Chronic alcohol consumption activates the RAS, causing progressive cardiac dysfunction.
- AT1 receptor blockade effectively prevents the development of alcoholic cardiomyopathy.
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