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(Circulation. 2002;105:975.)
© 2002 American Heart Association, Inc.
Basic Science Reports |
From the First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan.
Correspondence to Yukio Maruyama, MD, First Department of Internal Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima, 960-1295, Japan. E-mail maruyama{at}fmu.ac.jp
Background Although carvedilol attenuates left ventricular (LV) remodeling in coronary occlusion-reperfusion, it is not known whether it attenuates ischemic LV remodeling because of coronary stenosis (CS) or permanent coronary occlusion (CO).
Methods and Results We administered a vehicle, carvedilol, propranolol (2, 10, and 30 mg/kg per day, each), metoprolol (6, 30, and 90 mg/kg per day), or bunazosin (0.2 and 1 mg/kg per day), orally for 12 weeks to a total of 608 rats with CS or CO. In these groups and the sham (n=40), we assessed LV function by echocardiography, CS severity, myocardial blood flow and coronary flow reserve, serum ascorbyl free radical, and vitamin C. Both CS and CO increased LV end-diastolic and end-systolic diameters and decreased ejection fraction. The 4 agents failed to attenuate LV remodeling caused by CO. In contrast, the 3 ß-blockers attenuated (P<0.01) or tended to attenuate the increase in LV end-diastolic diameters caused by CS. With similar blood pressure and heart rate lowering by 3 ß-blockers, carvedilol additionally attenuated the increase in end-systolic diameters and improved ejection fraction. The CS reduced myocardial blood flow and coronary flow reserve, which was reversed by carvedilol without modifying the CS severity. Among the 4 agents, only carvedilol decreased ascorbyl free radical and increased vitamin C.
Conclusions The effects of ß blockade on ischemic cardiac dysfunction seem to depend on the different properties of the ß-blockers and the doses used. Among the ß-blockers tested, carvedilol provided potent cardioprotection for compromised ischemic but viable myocardium rather than for infarcted myocardium.
Key Words: stenosis infarction remodeling receptors, ardrenergic, beta ischemia
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