論文

国際誌
2020年12月

Heart Rate Reduction Improves Right Ventricular Function and Fibrosis in Pulmonary Hypertension.

American journal of respiratory cell and molecular biology
  • Ryo Ishii
  • Kenichi Okumura
  • Yohei Akazawa
  • Manpreet Malhi
  • Ryota Ebata
  • Mei Sun
  • Tao Fujioka
  • Hideyuki Kato
  • Osami Honjo
  • Golam Kabir
  • Wolfgang M Kuebler
  • Kim Connelly
  • Jason T Maynes
  • Mark K Friedberg
  • 全て表示

63
6
開始ページ
843
終了ページ
855
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1165/rcmb.2019-0317OC

The potential benefit of heart rate reduction (HRR), independent of β-blockade, on right ventricular (RV) function in pulmonary hypertension (PH) remains undecided. We studied HRR effects on RV fibrosis and function in PH and RV pressure-loading models. Adult rats were randomized to 1) sham controls, 2) monocrotaline (MCT)-induced PH, 3) SU5416 + hypoxia (SUHX)-induced PH, or 4) pulmonary artery banding (PAB). Ivabradine (IVA) (10 mg/kg/d) was administered from 2 weeks after PH induction or PAB. Exercise tolerance, echocardiography, and pressure-volume hemodynamics were obtained at a terminal experiment 3 weeks later. RV myocardial samples were analyzed for putative mechanisms of HRR effects through fibrosis, profibrotic molecular signaling, and Ca++ handling. The effects of IVA versus carvedilol on human induced pluripotent stem cell-derived cardiomyocytes beat rate and relaxation properties were evaluated in vitro. Despite unabated severely elevated RV systolic pressures, IVA improved RV systolic and diastolic function, profibrotic signaling, and RV fibrosis in PH/PAB rats. RV systolic-elastance (control, 121 ± 116; MCT, 49 ± 36 vs. MCT+IVA, 120 ± 54; PAB, 70 ± 20 vs. PAB+IVA, 168 ± 76; SUHX, 86 ± 56 vs. SUHX +IVA, 218 ± 111; all P < 0.05), the time constant of RV relaxation, echo indices of RV function, and fibrosis (fibrosis: control, 4.6 ± 1%; MCT, 13.4 ± 6.5 vs. MCT+IVA, 6.7 ± 2.6%; PAB, 11.4 ± 4.5 vs. PAB+IVA, 6.4 ± 5.1%; SUHX, 10 ± 4.6 vs. SUHX+IVA, 3.9 ± 2.2%; all P < 0.001) were improved by IVA versus controls. IVA had a dose-response effect on induced pluripotent stem cell-derived cardiomyocytes beat rate by delaying Ca++ loss from the cytoplasm. In experimental PH or RV pressure loading, HRR improves RV fibrosis, function, and exercise endurance independent of β-blockade. The balance between adverse tachycardia and bradycardia requires further study, but judicious HRR may provide a promising strategy to improve RV function in clinical PH.

リンク情報
DOI
https://doi.org/10.1165/rcmb.2019-0317OC
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32915674
ID情報
  • DOI : 10.1165/rcmb.2019-0317OC
  • PubMed ID : 32915674

エクスポート
BibTeX RIS