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Cardiovascular Research 2003 57(1):48-54; doi:10.1016/S0008-6363(02)00644-2
© 2003 by European Society of Cardiology
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Copyright © 2003, European Society of Cardiology

Beneficial effects of combination of ACE inhibitor and angiotensin II type 1 receptor blocker on cardiac remodeling in rat myocardial infarction

Yasuhiro Nakamuraa, Minoru Yoshiyamaa,*, Takashi Omuraa, Ken Yoshidaa, Yasukatsu Izumia, Kazuhide Takeuchia, Shokei Kimb, Hiroshi Iwaob and Junichi Yoshikawaa

aDepartment of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
bDepartment of Pharmacology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan

* Corresponding author. Tel.: +81-6-6645-3801; fax: +81-6-6646-6808 yoshiyama{at}med.osaka-cu.ac.jp

Objective: Angiotensin-converting enzyme (ACE) inhibitor and angiotensin II type I receptor blockers (ARB) prevent cardiac remodeling after myocardial infarction (MI). However, it is controversial whether combination therapy of ACE inhibitor and ARB is more effective on cardiac remodeling than each agent alone. In this study, we compared the effects of an ACE inhibitor (temocapril), an ARB (CS-866), and their combination on cardiac remodeling after MI. Methods: Temocapril at 3 or 30 mg/kg/day, CS-866 at 1 or 10 mg/kg/day, or combined temocapril and CS-866 at 1.5 and 0.5 mg/kg/day or at 15 and 5 mg/kg/day, respectively, were administered to rats after MI. At 4 weeks after MI, we assessed hemodynamics, cardiac function by Doppler echocardiography and non-infarcted myocardial mRNA expression. Results: Animals treated with a combination of the two drugs had hemodynamics, heart weights and dimensions similar to the other treated animals. However, the combination of the two drugs suppressed ANP, BNP and other gene expressions related to contractile proteins of fetal type and collagens more effectively than ACE inhibitor or ARB alone. Conclusion: These data suggest that combination of the two drugs, independent of the hemodynamic effect, may improve left ventricular phenotypic change, collagen accumulation and diastolic function.

KEYWORDS ACE inhibitors; Adrenergic (ant)agonists; Infarction; Remodeling; Ventricular function


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