医学
心肌梗塞
内科学
室性心动过速
心脏病学
缬沙坦
心力衰竭
心脏磁共振成像
心室重构
纤维化
磁共振成像
血压
放射科
作者
Daina Martínez-Falguera,Júlia Aranyó,Albert Teis,Gemma Ferrer-Curriu,Marta Monguió‐Tortajada,Edgar Fadeuilhe,Oriol Rodríguez-Leor,Idoia Dı́az-Güemes,Santiago Roura,Roger Villuendas,Axel Sarrias,Victor Bazan,Victoria Delgado,Antoni Bayés‐Genís,Felipe Bisbal,Carolina Gálvez‐Montón
出处
期刊:Circulation-arrhythmia and Electrophysiology
[Ovid Technologies (Wolters Kluwer)]
日期:2024-04-26
标识
DOI:10.1161/circep.123.012517
摘要
BACKGROUND: Sacubitril/valsartan (Sac/Val) is superior to angiotensin-converting enzyme inhibitors in reducing the risk of heart failure hospitalization and cardiovascular death, but its mechanistic data on myocardial scar after myocardial infarction (MI) are lacking. The objective of this work was to assess the effects of Sac/Val on inflammation, fibrosis, electrophysiological properties, and ventricular tachycardia inducibility in post-MI scar remodeling in swine. METHODS: After MI, 22 pigs were randomized to receive β-blocker (BB; control, n=8) or BB+Sac/Val (Sac/Val, n=9). The systemic immune response was monitored. Cardiac magnetic resonance data were acquired at 2-day and 29-day post MI to assess ventricular remodeling. Programmed electrical stimulation and high-density mapping were performed at 30-day post MI to assess ventricular tachycardia inducibility. Myocardial samples were collected for histological analysis. RESULTS: Compared with BB, BB+Sac/Val reduced acute circulating leukocytes ( P =0.009) and interleukin-12 levels ( P =0.024) at 2-day post MI, decreased C-C chemokine receptor type 2 expression in monocytes ( P =0.047) at 15-day post MI, and reduced scar mass ( P =0.046) and border zone mass ( P =0.043). It also lowered the number and mass of border zone corridors ( P =0.020 and P =0.05, respectively), scar collagen I content ( P =0.049), and collagen I/III ratio ( P =0.040). Sac/Val reduced ventricular tachycardia inducibility ( P =0.026) and the number of deceleration zones ( P =0.016). CONCLUSIONS: After MI, compared with BB, BB+Sac/Val was associated with reduced acute systemic inflammatory markers, reduced total scar and border zone mass on late gadolinium-enhanced magnetic resonance imaging, and lower ventricular tachycardia inducibility.
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