Effects of calcimimetic combined with an angiotensin-converting enzyme inhibitor on uremic cardiomyopathy progression

Am J Nephrol. 2011;34(3):256-67. doi: 10.1159/000330188. Epub 2011 Apr 11.

Abstract

Background/aims: Angiotensin-converting enzyme (ACE) inhibitors have cardioprotective properties and functional calcium-sensing receptors express in cardiac myocytes.

Methods: Rats were made uremic by 5/6 nephrectomy and treated as follows: uremic rats were fed on a regular diet (UC), uremic + enalapril (E), uremic + calcimimetic agent R-568 (R-568), and uremic + enalapril + R-568 (E+R-568). A group of normal rats served as controls (NC).

Results: Blood pressure (BP) and left ventricle mass were elevated significantly in the UC and R-568 groups compared with those in the NC group, but were indistinguishable from normal controls in the E and E+R-568 groups. Cardiac fibrosis was significantly increased in the UC group compared with that in the NC group. This increase was significantly attenuated in the R-568 and E groups, and the attenuation was further enhanced in the E+R-568 group. Factors associated with cardiac hypertrophy such as proliferating cell nuclear antigen, cyclin D1, and cyclin D2, as well as factors associated with cardiac fibrosis such as type I collagen, fibronectin, and transforming growth factor-β1 were significantly increased in the UC group compared with those in the NC group. Monotherapy with R-568 or E attenuated this increase and the combination further attenuated these measures.

Conclusions: Calcimimetics can suppress the progression of uremic cardiomyopathy and this effect is amplified when BP is controlled via renin-angiotensin system blockade.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Aniline Compounds / administration & dosage
  • Aniline Compounds / therapeutic use*
  • Animals
  • Calcium / agonists
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / prevention & control*
  • Disease Progression
  • Drug Therapy, Combination
  • Enalapril / administration & dosage
  • Enalapril / therapeutic use*
  • Male
  • Phenethylamines
  • Propylamines
  • Rats
  • Rats, Sprague-Dawley
  • Uremia / complications*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Aniline Compounds
  • N-(2-chlorophenylpropyl)-1-(3-methoxyphenyl)ethylamine
  • Phenethylamines
  • Propylamines
  • Enalapril
  • Calcium