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Bradycardia induces angiogenesis, increases coronary reserve, and preserves function of the postinfarcted heart
Journal article   Open access   Peer reviewed

Bradycardia induces angiogenesis, increases coronary reserve, and preserves function of the postinfarcted heart

Li Lei, Ruifeng Zhou, Wei Zheng, Lance P Christensen, Robert M Weiss and Robert J Tomanek
Circulation (New York, N.Y.), Vol.110(7), pp.796-802
08/17/2004
DOI: 10.1161/01.CIR.0000138933.85923.36
PMID: 15302788
url
https://doi.org/10.1161/01.CIR.0000138933.85923.36View
Published (Version of record) Open Access

Abstract

We tested the hypothesis that induction of chronic bradycardia would trigger an upregulation of key growth factors and receptors, which would then lead to angiogenesis and improve coronary reserve in the left ventricle after myocardial infarction. Bradycardia was induced in rats by administering alinidine via osmotic pumps beginning 1 day after coronary artery ligation. Echocardiographic analysis was conducted before and after treatment. Morphometric analysis was used in perfusion-fixed hearts to document arteriolar and capillary growth. Western blots were used to evaluate growth factor and receptor changes. During the first week of treatment, vascular endothelial growth factor (VEGF), VEGF receptor 1 (Flt-1), and basic fibroblast growth factor proteins were higher in the treated group, whereas VEGF receptor 2 (Flk-1), angiopoietin-1, and angiopoietin-2 were not affected by treatment. After 3 weeks, VEGF protein remained elevated, and bradycardia was associated with a higher capillary length density in the border (40%) and remote (14%) regions and a higher arteriolar length density in the septum (62%), despite a greater increase in left ventricular mass. Although arteriolar length density increased in all size classes, the greatest increase occurred in the smallest (terminal) arterioles. This vascular growth was associated with a 23% greater coronary reserve. Echocardiography revealed a smaller increase in ventricular volume and a greater preservation of ejection fraction in rats treated with bradycardia. Pharmacologic induction of bradycardia enhances vascularity and coronary reserve, preserves function of surviving myocardium, and therefore, is a noninvasive, therapeutic avenue that provides an alternative to gene therapy.
Neovascularization, Physiologic - drug effects Male Heart Ventricles - diagnostic imaging Coronary Vessels Vascular Endothelial Growth Factor Receptor-1 Hypertrophy, Left Ventricular - chemically induced Ligation Ultrasonography Angiopoietin-1 - blood Clonidine - pharmacology Models, Animal Myocardial Infarction - physiopathology Drug Evaluation, Preclinical Angiopoietin-2 - blood Vascular Endothelial Growth Factor A - blood Bradycardia - physiopathology Rats Vascular Endothelial Growth Factor Receptor-2 - blood Extracellular Matrix Proteins - blood Clonidine - therapeutic use Fibroblast Growth Factor 2 - blood Rats, Sprague-Dawley Cardiovascular Agents - pharmacology Stroke Volume Cardiovascular Agents - therapeutic use Clonidine - analogs & derivatives Myocytes, Cardiac - pathology Bradycardia - chemically induced Animals Angiopoietin-1 - analogs & derivatives Hypertrophy, Left Ventricular - physiopathology

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