Why the study?
Hypertension and coronary events are increasingly prevalent in aging societies, with myocardial infarction frequently occurring in CCB-treated hypertensive patients.
Does cilnidipine improve post-infarct left ventricular remodelling compared to amlodipine in spontaneously hypertensive rats?
Does cilnidipine improve post-infarct left ventricular remodelling compared to amlodipine in spontaneously hypertensive rats?
In a hypertensive rat model, the L/N-type calcium channel blocker cilnidipine attenuated post-infarct left ventricular remodelling more effectively than the L-type blocker amlodipine, likely via sympathoinhibition and renin-angiotensin system suppression.
Hypothesis-generating for L/N-type CCB preference post-MI in hypertension; leaves open translation to human outcomes.
Hypertension and coronary events are becoming more prevalent in aging societies, and myocardial infarction usually occurs in calcium channel blocker (CCB)-treated hypertensive patients. We herein compared the effects of cilnidipine, an L/N-type CCB and amlodipine, an L-type CCB, on post-infarct left ventricular (LV) remodelling in spontaneously hypertensive rats (SHRs). Male SHRs were subjected to 30 minutes of left coronary artery occlusion followed by reperfusion (MI group). The administration of cilnidipine (10 mg/kg/d; MI + Cil group) or amlodipine (10 mg/kg/d; MI + Aml group) was initiated one week before surgery and continued for five weeks. Both CCBs decreased blood pressure. Four weeks after surgery, cilnidipine, but not amlodipine, attenuated LV dilatation, fractional shortening impairments, end-diastolic pressure elevations, and tau elongation. In the non-infarct region, myocyte hypertrophy and brain natriuretic peptide (BNP) mRNA levels were similarly attenuated by both CCBs. On the other hand, interstitial fibrosis, the mRNA expression of collagen type III and transforming growth factor (TGF) β and immunohistological TGF β protein expression in the non-infarct region were reduced more in the MI + Cil group than in the MI + Aml group. Additionally, elevated angiotensin-converting enzyme activity and interstitial noradrenaline concentrations in the non-infarct region were reduced by cilnidipine. These results suggest that cilnidipine reduced cardiac noradrenaline concentrations and inhibited the renin-angiotensin system, which attenuated post-infarct remodelling more than amlodipine in hypertensive rats.
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Naseratun et al. (2020) studied this question.
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