N-acetylcysteine attenuated sympathetic hyperinnervation and arrhythmogenic response to programmed electrical stimulation in DOCA-salt hypertensive rats.
RCT
Randomized into three groups
Does N-acetylcysteine or triple therapy attenuate sympathetic hyperinnervation and arrhythmias in DOCA-salt hypertensive rats?
N-acetylcysteine attenuates sympathetic hyperinnervation and arrhythmogenic response in DOCA-salt hypertensive rats through a free radical-dependent, blood pressure-independent pathway.
Sympathetic activities are elevated in the central SNSs (sympathetic nervous systems) of hypertensive animals, but it is not known whether sympathetic innervation is also elevated in the heart. Sympathetic hyper-responsiveness in hypertension may result from oxidative stress. The aim of the present study was to investigate sympathetic hyperinnervation in DOCA (deoxycorticosterone acetate)-salt hypertensive rats with established hypertension. At 4 weeks after the start of DOCA-salt treatment and uninephrectomization, male Wistar rats were randomized into three groups for 8 weeks: vehicle, NAC (N-acetylcysteine) and triple therapy (hydralazine, hydrochlorothiazide and reserpine). DOCA-salt was associated with increased oxidant release. DOCA-salt produced concentric left ventricular hypertrophy and cardiomyocyte hypertrophy. Sympathetic hyperinnervation was observed in DOCA-salt rats, as assessed by myocardial noradrenaline levels, immunofluorescent analysis of tyrosine hydroxylase, growth-associated factor 43 and neurofilament and Western blotting and real-time quantitative RT-PCR (reverse transcription-PCR) of NGF (nerve growth factor). Arrhythmic scores during programmed stimulation in DOCA-salt rats were significantly higher than those in the control rats. Triple therapy, despite being effective on BP (blood pressure), offered neither attenuated cardiomyocyte hypertrophy nor anti-arrhythmia. The effects of DOCA-salt treatment on NGF expression, sympathetic hyperinnervation and arrhythmias were attenuated by NAC. Furthermore, the effects of NAC on NGF were abolished by administering BSO (L-buthionine sulfoximine), an inhibitor of glutamate-cysteine ligase. In conclusion, DOCA-salt treatment contributes to up-regulation of NGF proteins probably through a free radical-dependent pathway in a BP-independent manner. DOCA-salt rats treated with NAC attenuate sympathetic hyperinnervation and thus show a beneficial effect on arrhythmogenic response to programmed electrical stimulation.
Lee et al. (Wed,) conducted a rct in Hypertension (DOCA-salt hypertensive rats). N-acetylcysteine (NAC) or triple therapy (hydralazine, hydrochlorothiazide, and reserpine) vs. Vehicle was evaluated on Sympathetic hyperinnervation and arrhythmic scores during programmed stimulation. N-acetylcysteine attenuated sympathetic hyperinnervation and arrhythmogenic response to programmed electrical stimulation in DOCA-salt hypertensive rats.