Oral metoprolol administered to rats after myocardial infarction attenuated LV dilatation and systolic dysfunction (P<0.02) and reduced myocardial expression of TNF-alpha and IL-1beta (P<0.025).
Does oral metoprolol improve LV remodeling and modulate myocardial expression of inflammatory cytokines in rats after large myocardial infarction?
In a rat model of post-infarction heart failure, beta-blockade with metoprolol attenuated LV remodeling and reduced myocardial expression of TNF-alpha and IL-1beta, suggesting an anti-inflammatory mechanism independent of nitric oxide.
p-value: p=<0.02
BACKGROUND: Whether beta-adrenergic blockade modulates myocardial expression of inflammatory cytokines and nitric oxide (NO) in heart failure is unclear. METHODS AND RESULTS: We administered oral metoprolol or no therapy to rats for 12 weeks after large myocardial infarction and subsequently examined left ventricular (LV) remodeling; myocardial tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6 expression; and NO. In untreated rats, echocardiography revealed significant (P<0.001) LV dilatation and systolic dysfunction compared with sham. Papillary muscle studies revealed isoproterenol hyporesponsiveness to be unaltered by NO synthase (NOS) inhibition. Circulating NO metabolites were undetectable. In noninfarcted myocardium, although inducible NOS (iNOS) mRNA was absent, TNF-alpha, IL-1beta, and IL-6 mRNA and protein were markedly elevated compared with sham (P<0.001), with 2-fold higher expression (P<0.025) of IL-6 compared with TNF-alpha or IL-1beta. Metoprolol administration starting 48 hours after infarction (1) attenuated (P<0.02) LV dilatation and systolic dysfunction, (2) preserved isoproterenol responsiveness (P<0.025) via NO-independent mechanisms, and (3) reduced myocardial gene expression and protein production of TNF-alpha and IL-1beta (P<0. 025) but not IL-6, which remained high. CONCLUSIONS: During heart failure development, adrenergic activation contributes to increased myocardial expression of TNF-alpha and IL-1beta but not IL-6, and one mechanism underlying the beneficial effects of beta-adrenergic blockade may involve attenuation of TNF-alpha and IL-1beta expression independent of iNOS and NO.
Prabhu et al. (Tue,) conducted a other in Heart failure. Oral metoprolol vs. No therapy was evaluated on Left ventricular (LV) remodeling; myocardial tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6 expression; and NO (p=<0.02). Oral metoprolol administered to rats after myocardial infarction attenuated LV dilatation and systolic dysfunction (P<0.02) and reduced myocardial expression of TNF-alpha and IL-1beta (P<0.025).
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