Left ventricular reverse remodeling after surgical therapy for aortic stenosis: Correlation to renin-angiotensin system gene expression

Article

关键词: CARDIAC FIBROBLASTS;    CELL-PROLIFERATION;    VALVE REPLACEMENT;    HYPERTROPHY;    HYPERTENSION;    REGRESSION;    DISEASE;    MASS;    RECEPTOR;    FIBROSIS;   

DOI  :  10.1161/01.cir.0000032919.33237.4d

来源: SCIE

【 摘 要 】

Background-Surgical therapy for aortic stenosis leads to reverse remodeling, with normalization of left ventricular hypertrophy (LVH). The aim of this study was to examine Renin-Angiotensin system (RAS) gene expression in this setting. Methods-Growing sheep (n=44) underwent supracoronary aortic banding for controlled induction of LVH at the age of 6 to 8 months (A=baseline). Surgical revision to completely release the pressure gradient was performed 8.3+/-1 months later (B). The animals were sacrificed after another 10.1+/-2 months (C). Along with hemodynamic measurements, subtractive hybridization and competitive polymerase chain reaction were applied to quantify mRNA expression for angiotensin-converting enzyme (ACE) and angiotensin receptors 1 and 2 (AT(1)-R and AT(2)-R). Results-Left ventricular mass index was 82+/-21 g (A), 150+/-33 g (B), and 78+/-18 g (C), P<0.01. Left ventricular function and cardiac index remained stable. Myocardial fiber diameter was 11.31+/-0.8 (A), 15.9+/-1.2 (B), and 11.4+/-11 (C) mum, P<0.01. Gene expression was as follows: ACE 0.8+/-0.05 (A); 1.3+/-0.08 (B), and 0.9+/-0.06 (C), P<0.01; AT(1)-R 0.7+/-0.06 (A), 0.9+/-0.07 (B), and 0.3+/-0.04 (C), P<0.01; AT(2)-R 0.5+/-0.05 (A), 0.2+/-0.04 (B), and 0.5+/-0.05 (C), P<0.01. Conclusion-LVH in aortic stenosis coincides with significant alterations of the RAS. Surgical therapy leads to reverse remodeling, which is paralleled by regression of RAS gene expression.

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