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1 Cardiology Section of the Department of Medicine and the Department of Physiology, Gazes Cardiac Research Institute, Medical University of South Carolina and the Veterans Affairs Medical Center, Charleston, South Carolina 29401; 2 Veterans Affairs Medical Center, Boston, Massachusetts 02130; 3 Department of Anatomy and Cell Biology, University of Iowa College of Medicine, Iowa City, Iowa 52242; and 4 Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294
Myocardial
hypertrophy is one of the basic mechanisms by which the heart
compensates for hemodynamic overload. The mechanisms by which
hemodynamic overload is transduced by the cardiac muscle cell and
translated into cardiac hypertrophy are not completely understood.
Candidates include activation of the renin-angiotensin system (RAS) and
angiotensin II receptor (AT1)
stimulation. In this study, we tested the hypothesis that load,
independent of the RAS, is sufficient to stimulate cardiac growth. Four
groups of cats were studied: 14 normal controls, 20 pulmonary
artery-banded (PAB) cats, 7 PAB cats in whom the
AT1 was concomitantly and
continuously blocked with losartan, and 8 PAB cats in whom the
angiotensin-converting enzyme (ACE) was concomitantly and continuously
blocked with captopril. Losartan cats had at least a one-log order
increase in the ED50 of the blood
pressure response to angiotensin II infusion. Right ventricular (RV)
hypertrophy was assessed using the RV mass-to-body weight ratio and
ventricular cardiocyte size. RV hemodynamic overload was assessed by
measuring RV systolic and diastolic pressures. Neither the extent of RV
pressure overload nor RV hypertrophy that resulted from PAB was
affected by AT1 blockade with
losartan or ACE inhibition with captopril. RV systolic pressure was
increased from 21 ± 3 mmHg in normals to 68 ± 4 mmHg in PAB, 65 ± 5 mmHg in PAB plus losartan and 62 ± 3 mmHg in PAB plus
captopril. RV-to-body weight ratio increased from 0.52 ± 0.04 g/kg
in normals to 1.11 ± 0.06 g/kg in PAB, 1.06 ± 0.06 g/kg in PAB
plus losartan and 1.06 ± 0.06 g/kg in PAB plus captopril. Thus
1) pharmacological modulation of the
RAS with losartan and captopril did not change the extent of the
hemodynamic overload or the hypertrophic response induced by PAB;
2) neither RAS activation nor
angiotensin II receptor stimulation is an obligatory and necessary
component of the signaling pathway that acts as an intermediary
coupling load to the hypertrophic response; and
3) load, independent of the RAS, is
capable of stimulating cardiac growth.
myocardial hypertrophy; angiotensin II; pulmonary artery band
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