1
|
Duchatsch F, Miotto DS, Tardelli LP, Dionísio TJ, Campos DS, Santos CF, Okoshi K, Amaral SL. Blockade of Inflammatory Markers Attenuates Cardiac Remodeling and Fibrosis in Rats with Supravalvular Aortic Stenosis. Biomedicines 2023; 11:3219. [PMID: 38137440 PMCID: PMC10740498 DOI: 10.3390/biomedicines11123219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
Since cardiac inflammation has been considered an important mechanism involved in heart failure, an anti-inflammatory treatment could control cardiac inflammation and mitigate the worsening of cardiac remodeling. This study evaluated the effects of dexamethasone (DEX) and ramipril treatment on inflammation and cardiac fibrosis in an experimental model of heart failure induced by supravalvular aortic stenosis. Wistar rats (21d) were submitted to an aortic stenosis (AS) protocol. After 21 weeks, an echocardiogram and a maximal exercise test were performed, and after 24 weeks, rats were treated with DEX, ramipril or saline for 14d. The left ventricle (LV) was removed for histological and inflammatory marker analyses. The AS group showed exercise intolerance (-32% vs. Sham), higher relative wall thickness (+63%), collagen deposition and capillary rarefaction, followed by cardiac disfunction. Both treatments were effective in reducing cardiac inflammation, but only DEX attenuated the increased relative wall thickness (-17%) and only ramipril reduced LV fibrosis. In conclusion, both DEX and ramipril decreased cardiac inflammatory markers, which probably contributed to the reduced cardiac fibrosis and relative wall thickness; however, treated AS rats did not show any improvement in cardiac function. Despite the complex pharmacological treatment of heart failure, treatment with an anti-inflammatory could delay the patient's poor prognosis.
Collapse
Affiliation(s)
- Francine Duchatsch
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235 Monjolinho, 676, São Carlos 13565-905, SP, Brazil; (F.D.); (D.S.M.); (L.P.T.)
| | - Danyelle S. Miotto
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235 Monjolinho, 676, São Carlos 13565-905, SP, Brazil; (F.D.); (D.S.M.); (L.P.T.)
| | - Lidieli P. Tardelli
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235 Monjolinho, 676, São Carlos 13565-905, SP, Brazil; (F.D.); (D.S.M.); (L.P.T.)
| | - Thiago J. Dionísio
- Department of Biological Sciences, Bauru School of Dentistry, USP—University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9–75, Bauru 17012-901, SP, Brazil; (T.J.D.); (C.F.S.)
| | - Dijon S. Campos
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu 18618-687, SP, Brazil; (D.S.C.); (K.O.)
| | - Carlos F. Santos
- Department of Biological Sciences, Bauru School of Dentistry, USP—University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9–75, Bauru 17012-901, SP, Brazil; (T.J.D.); (C.F.S.)
| | - Katashi Okoshi
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu 18618-687, SP, Brazil; (D.S.C.); (K.O.)
| | - Sandra L. Amaral
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235 Monjolinho, 676, São Carlos 13565-905, SP, Brazil; (F.D.); (D.S.M.); (L.P.T.)
- Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Av. Eng. Luiz Edmundo Carrijo Coube, 14-01—Vargem Limpa, Bauru 17033-360, SP, Brazil
| |
Collapse
|
2
|
Cârstea AP, Mită A, Fortofoiu MC, Doica IP, Cârstea D, Beznă CM, Negroiu CE, Diaconu ID, Georgescu AR, Kamal AM, Mahler B, Grigorie AG, Dobrinescu GA. How Dexamethasone Used in Anti-COVID-19 Therapy Influenced Antihypertensive Treatment in Patients with SARS-CoV-2. Healthcare (Basel) 2023; 11:healthcare11101399. [PMID: 37239685 DOI: 10.3390/healthcare11101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND During the SARS-CoV-2 pandemic period, in the treatment approved by the WHO, along with antivirals, antibiotics, nonsteroidal anti-inflammatory drugs and anticoagulants, dexamethasone was always used. This study started from the professional concern related to the vasopressor effect of cortisone on blood pressure (BP). METHODS The study group was achieved by selecting, from a total of 356 patients hospitalized in the clinic, the patients with known hypertensive status at admission for SARS-CoV-2. Dexamethasone was part of the anti-COVID-19 treatment, with an administration of 4-6-8 mg/day, depending on bodyweight, for 10 days. All patients with hypertension received antihypertensive treatment in adjusted doses according to the recorded BP values. RESULTS Monitoring of BP in hospitalized patients was performed daily, in the morning and evening. If on the 2nd day of treatment, 84% of the patients partially responded to the treatment with a moderate decrease in BP, on the 3rd therapy day, the situation clearly improved: more than 75% of the patients had values of BP that can be classified as high-normal (38.23%) and normal (40.03%). CONCLUSIONS Dexamethasone for treatment of SARS-CoV-2 infection did not have a notable influence on increasing BP, because the doses were low-moderate and prescribed for a short time.
Collapse
Affiliation(s)
- Andrei Puiu Cârstea
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Cardiology, Clinical Municipal Hospital "Philanthropy" of Craiova, 200143 Craiova, Romania
| | - Adrian Mită
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 2-Gastroenterology Compartment, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Mircea-Cătălin Fortofoiu
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 2-Gastroenterology Compartment, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Irina Paula Doica
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Doina Cârstea
- Department of Cardiology, Clinical Municipal Hospital "Philanthropy" of Craiova, 200143 Craiova, Romania
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cristina Maria Beznă
- Department of Cardiology, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Cristina Elena Negroiu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Cardiology, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Ileana-Diana Diaconu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Pediatric Pneumology, National Institute of Pneumology "Marius Nasta" of Bucharest, 050159 Bucharest, Romania
| | - Andreea-Roberta Georgescu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Emergency Medicine, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Adina Maria Kamal
- Department of Internal Medicine, Faculty of Midwives and General Nursing, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 1, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Beatrice Mahler
- Department of Pneumology, University of Medicine and Pharmacy "Carol Davila" Bucharest, 020021 Bucharest, Romania
- National Institute of Pneumophtisiology "Marius Nasta", 050159 Bucharest, Romania
| | - Adriana-Gabriela Grigorie
- Department of Physiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Leamna Pneumophtisiology Hospital, Leamna de Sus, 207129 Dolj, Romania
| | - Gabriel Adrian Dobrinescu
- Department of Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Thoracic Surgery, Clinical County Emergency Hospital of Craiova, 200642 Craiova, Romania
| |
Collapse
|
3
|
Miotto DS, Duchatsch F, Dionizio A, Buzalaf MAR, Amaral SL. Physical Training vs. Perindopril Treatment on Arterial Stiffening of Spontaneously Hypertensive Rats: A Proteomic Analysis and Possible Mechanisms. Biomedicines 2023; 11:biomedicines11051381. [PMID: 37239052 DOI: 10.3390/biomedicines11051381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/21/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Arterial stiffness is an important predictor of cardiovascular events. Perindopril and physical exercise are important in controlling hypertension and arterial stiffness, but the mechanisms are unclear. (2) Methods: Thirty-two spontaneously hypertensive rats (SHR) were evaluated for eight weeks: SHRC (sedentary); SHRP (sedentary treated with perindopril-3 mg/kg) and SHRT (trained). Pulse wave velocity (PWV) analysis was performed, and the aorta was collected for proteomic analysis. (3) Results: Both treatments determined a similar reduction in PWV (-33% for SHRP and -23% for SHRT) vs. SHRC, as well as in BP. Among the altered proteins, the proteomic analysis identified an upregulation of the EH domain-containing 2 (EHD2) protein in the SHRP group, required for nitric oxide-dependent vessel relaxation. The SHRT group showed downregulation of collagen-1 (COL1). Accordingly, SHRP showed an increase (+69%) in the e-NOS protein level and SHRT showed a lower COL1 protein level (-46%) compared with SHRC. (4) Conclusions: Both perindopril and aerobic training reduced arterial stiffness in SHR; however, the results suggest that the mechanisms can be distinct. While treatment with perindopril increased EHD2, a protein involved in vessel relaxation, aerobic training decreased COL1 protein level, an important protein of the extracellular matrix (ECM) that normally enhances vessel rigidity.
Collapse
Affiliation(s)
- Danyelle Siqueira Miotto
- Joint Graduate Program in Physiological Sciences (PIPGCF), Federal University of Sao Carlos and São Paulo State University, UFSCar/UNESP, São Carlos 14801-903, Brazil
| | - Francine Duchatsch
- Joint Graduate Program in Physiological Sciences (PIPGCF), Federal University of Sao Carlos and São Paulo State University, UFSCar/UNESP, São Carlos 14801-903, Brazil
| | - Aline Dionizio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo-USP, Bauru 17012-901, Brazil
| | | | - Sandra Lia Amaral
- Joint Graduate Program in Physiological Sciences (PIPGCF), Federal University of Sao Carlos and São Paulo State University, UFSCar/UNESP, São Carlos 14801-903, Brazil
- Department of Physical Education, School of Sciences, São Paulo State University-UNESP, Bauru 17033-360, Brazil
| |
Collapse
|
4
|
de Paula VF, Tardelli LP, Amaral SL. Dexamethasone-Induced Arterial Stiffening Is Attenuated by Training due to a Better Balance Between Aortic Collagen and Elastin Levels. Cardiovasc Drugs Ther 2023:10.1007/s10557-023-07438-z. [PMID: 36795192 DOI: 10.1007/s10557-023-07438-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE Although the cardioprotective benefits of exercise training are well known, the effects of training on dexamethasone (DEX)-induced arterial stiffness are still unclear. This study was aimed at investigating the mechanisms induced by training to prevent DEX-induced arterial stiffness. METHODS Wistar rats were allocated into 4 groups and submitted to combined training (aerobic and resistance exercises, on alternate days, 60% of maximal capacity, for 74 d) or were kept sedentary: sedentary control rats (SC), DEX-treated sedentary rats (DS), combined training control (CT), and DEX-treated trained rats (DT). During the last 14 d, rats were treated with DEX (50 μg/kg per body weight, per day, s.c.) or saline. RESULTS DEX increased PWV (+44% vs +5% m/s, for DS vs SC, p<0.001) and increased aortic COL 3 protein level (+75%) in DS. In addition, PWV was correlated with COL3 levels (r=0.682, p<0.0001). Aortic elastin and COL1 protein levels remained unchanged. On the other hand, the trained and treated groups showed lower PWV values (-27% m/s, p<0.001) vs DS and lower values of aortic and femoral COL3 compared with DS. CONCLUSION As DEX is widely used in several situations, the clinical relevance of this study is that the maintenance of good physical capacity throughout life can be crucial to alleviate some of its side effects, such as arterial stiffness.
Collapse
Affiliation(s)
- Vinicius F de Paula
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235, São Carlos, SP, 13565-905, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Av. Eng. Luiz Edmundo Carrijo Coube, 14-01, Bauru, SP, 17033-360, Brazil
| | - Lidieli P Tardelli
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Av. Eng. Luiz Edmundo Carrijo Coube, 14-01, Bauru, SP, 17033-360, Brazil
| | - Sandra L Amaral
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, Rodovia Washington Luiz, km 235, São Carlos, SP, 13565-905, Brazil.
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Av. Eng. Luiz Edmundo Carrijo Coube, 14-01, Bauru, SP, 17033-360, Brazil.
| |
Collapse
|
5
|
Tardelli LP, Duchatsch F, Herrera NA, Ruiz TFR, Pagan LU, Vicentini CA, Okoshi K, Amaral SL. Benefits of combined exercise training on arterial stiffness and blood pressure in spontaneously hypertensive rats treated or not with dexamethasone. Front Physiol 2022; 13:916179. [PMID: 36045742 PMCID: PMC9420846 DOI: 10.3389/fphys.2022.916179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Dexamethasone (DEX)-induced arterial stiffness is an important side-effect, associated with hypertension and future cardiovascular events, which can be counteracted by exercise training. The aim of this study was to evaluate the mechanisms induced by combined training to attenuate arterial stiffness and hypertension in spontaneously hypertensive rats treated or not with dexamethasone. Spontaneously hypertensive rats (SHR) underwent combined training for 74 days and were treated with dexamethasone (50 µg/kg s. c.) or saline solution during the last 14 days. Wistar rats were used as controls. Echocardiographic parameters, blood pressure (BP) and pulse wave velocity (PWV), as well as histological analyses of the heart and aorta, carotid and femoral arteries were performed. At the beginning, SHR had higher BP and PWV compared with Wistar rats. After 60 days, while BP increased in sedentary SHR, combined exercise training decreased BP and PWV. After 74d, the higher BP and PWV of sedentary SHR was accompanied by autonomic imbalance to the heart, cardiac remodeling, and higher arterial collagen deposition. DEX treatment did not change these parameters. On the other hand, trained SHR had reduced BP and PWV, which was associated with better autonomic balance to the heart, reduced myocardial collagen deposition, as well as lower arterial collagen deposition. The results of this study suggest that combined training, through the reduction of aortic collagen deposition, is an important strategy to reduce arterial stiffness in spontaneously hypertensive rats, and these lower responses were maintained regardless of dexamethasone treatment.
Collapse
Affiliation(s)
- Lidieli P. Tardelli
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Francine Duchatsch
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Naiara A. Herrera
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Thalles Fernando R. Ruiz
- Joint Graduate Program in Animal Biology, São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
| | - Luana U. Pagan
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Carlos A. Vicentini
- Department of Biological Sciences, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
| | - Katashi Okoshi
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Sandra L. Amaral
- Joint Graduate Program in Physiological Sciences, PIPGCF UFSCar/UNESP, São Carlos, SP, Brazil
- Department of Physical Education, São Paulo State University (UNESP), School of Sciences, Bauru, SP, Brazil
- *Correspondence: Sandra L. Amaral,
| |
Collapse
|