Key result
AT1R blockade with valsartan abrogated the surge in interstitial MMP activity following disengagement of a transiently increased LV load (0.07 vs 3.03 MMP units/hr, P<0.05).
Why the study?
Does AT1R blockade with valsartan reduce interstitial MMP activity after a discrete increase in LV load in pigs?
RCT (n=17)
randomized
Does AT1R blockade with valsartan reduce interstitial MMP activity after a discrete increase in LV load in pigs?
Absolute Event Rate: 0.07% vs 3.03%
p-value: p=<0.05
AT1R blockade with valsartan abrogates the surge in myocardial interstitial MMP activity following a transient increase in LV load in a porcine model.
AT1R blockade modulates MMP activity after transient LV loading in pigs; leaves open relevance to human remodeling therapies.
LV myocardial remodeling is a structural hallmark of hypertensive hypertrophy, but molecular mechanisms driving this process are not well understood. The matrix metalloproteinases (MMPs) can cause myocardial remodeling in chronic disease states, but how MMP activity is altered with a mechanical load remains unknown. The present study quantified interstitial MMP activity after a discrete increase in LV load and dissected out the contributory role of the angiotensin II Type 1 receptor (AT1R). Pigs (38 kg) were randomized to undergo (1) increased LV load by insertion of an intra-aortic balloon pump (IABP) triggered at systole for 3 hours, then deactivated (n=11); (2) IABP and AT1R blockade (AT1RB; valsartan, 3 ng/kg/hr; n=6). MMP activity was directly measured in the myocardial interstitium using a validated inline digital fluorogenic microdialysis system. IABP engagement increased LV peak pressure from 92+/-3 to 113+/-5 and 123+/-7 mm Hg in the vehicle and AR1RB group, respectively, and remained elevated throughout the IABP period (P<0.05). With IABP disengagement, segmental shortening (% change from baseline of 0) remained depressed in the vehicle group (-32.2+/-11.8%, P<0.05) but returned to baseline in the AT1RB group (2.3+/-12.5%). MMP activity decreased with IABP in both groups. At IABP disengagement, a surge in MMP activity occurred in the vehicle group that was abrogated with AT1RB (3.03+/-0.85 versus 0.07+/-1.55 MMP units/hr, P<0.05). A transient increase in LV load caused a cyclic variation in interstitial MMP activity that is regulated in part by the AT1R. These temporally dynamic changes in MMP activity likely influence myocardial function and structure with increased LV load.
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Deschamps et al. (2005) conducted an RCT in Increased LV load (n=17). AT1R blockade (valsartan) with IABP vs. Vehicle with IABP was evaluated on Interstitial MMP activity at IABP disengagement (p=<0.05). AT1R blockade with valsartan abrogated the surge in interstitial MMP activity following disengagement of a transiently increased LV load (0.07 vs 3.03 MMP units/hr, P<0.05).
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