Mineralocorticoid receptor blockade improves diastolic function independent of blood pressure reduction in a transgenic model of RAAS overexpression

Am J Physiol Heart Circ Physiol. 2011 Apr;300(4):H1484-91. doi: 10.1152/ajpheart.01000.2010. Epub 2011 Jan 14.

Abstract

There is emerging evidence that aldosterone can promote diastolic dysfunction and cardiac fibrosis independent of blood pressure effects, perhaps through increased oxidative stress and inflammation. Accordingly, this investigation was designed to ascertain if mineralocorticoid receptor blockade improves diastolic dysfunction independently of changes in blood pressure through actions on myocardial oxidative stress and fibrosis. We used young transgenic (mRen2)27 [TG(mRen2)27] rats with increases in both tissue ANG II and circulating aldosterone, which manifests age-related increases in hypertension and cardiac dysfunction. Male TG(mRen2)27 and age-matched Sprague-Dawley rats were treated with either a low dose (∼1 mg·kg(-1)·day(-1)) or a vasodilatory, conventional dose (∼30 mg·kg(-1)·day(-1)) of spironolactone or placebo for 3 wk. TG(mRen2)27 rats displayed increases in systolic blood pressure and plasma aldosterone levels as well as impairments in left ventricular diastolic relaxation without changes in systolic function on cine MRI. TG(mRen2)27 hearts also displayed hypertrophy (left ventricular weight, cardiomyoctye hypertrophy, and septal wall thickness) as well as fibrosis (interstitial and perivascular). There were increases in oxidative stress in TG(mRen2)27 hearts, as evidenced by increases in NADPH oxidase activity and subunits as well as ROS formation. Low-dose spironolactone had no effect on systolic blood pressure but improved diastolic dysfunction comparable to a conventional dose. Both doses of spironolactone caused comparable reductions in ROS/3-nitrotryosine immunostaining and perivascular and interstitial fibrosis. These data support the notion mineralocorticoid receptor blockade improves diastolic dysfunction through improvements in oxidative stress and fibrosis independent of changes in systolic blood pressure.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Blood Pressure / drug effects*
  • Cardiomegaly / drug therapy
  • Cardiomegaly / metabolism
  • Cardiomegaly / pathology
  • Endomyocardial Fibrosis / drug therapy
  • Endomyocardial Fibrosis / metabolism
  • Endomyocardial Fibrosis / pathology
  • Male
  • Mineralocorticoid Receptor Antagonists* / pharmacology
  • NADPH Oxidases / biosynthesis
  • Oxidative Stress / drug effects
  • Oxidative Stress / physiology
  • Rats
  • Rats, Sprague-Dawley
  • Rats, Transgenic
  • Reactive Oxygen Species / metabolism
  • Renin-Angiotensin System / drug effects*
  • Renin-Angiotensin System / physiology
  • Spironolactone / pharmacology
  • Tyrosine / analogs & derivatives
  • Tyrosine / biosynthesis
  • Vasodilator Agents / pharmacology
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / metabolism
  • Ventricular Dysfunction, Left / pathology

Substances

  • Mineralocorticoid Receptor Antagonists
  • Reactive Oxygen Species
  • Vasodilator Agents
  • Spironolactone
  • 3-nitrotyrosine
  • Tyrosine
  • NADPH Oxidases