Importance of antioxidant and antiapoptotic effects of beta-receptor blockers in heart failure therapy

The present study was carried out to determine whether beneficial effects of carvedilol in congestive heart failure (CHF) are mediated via its beta-adrenergic blocking, antioxidant, and/or alpha-adrenergic blocking action. Rabbits with heart failure induced by rapid cardiac pacing were randomized to...

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Bibliographic Details
Published in:American journal of physiology. Heart and circulatory physiology 2004-09, Vol.287 (3), p.H1003-H1012
Main Authors: Kawai, Keisuke, Qin, Fuzhong, Shite, Junya, Mao, Weike, Fukuoka, Shuji, Liang, Chang-Seng
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Animals
Antioxidants - therapeutic use
Apoptosis - drug effects
bcl-2-Associated X Protein
Cell Size
Deoxyguanosine - analogs & derivatives
Deoxyguanosine - metabolism
DNA, Mitochondrial - metabolism
Echocardiography
Glutathione - metabolism
Glutathione Disulfide - metabolism
Heart Failure - diagnostic imaging
Heart Failure - drug therapy
Heart Failure - etiology
Heart Failure - physiopathology
Hemodynamics
Myocardium - metabolism
Myocytes, Cardiac - pathology
Proto-Oncogene Proteins - metabolism
Proto-Oncogene Proteins c-bcl-2 - metabolism
Rabbits
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Summary:The present study was carried out to determine whether beneficial effects of carvedilol in congestive heart failure (CHF) are mediated via its beta-adrenergic blocking, antioxidant, and/or alpha-adrenergic blocking action. Rabbits with heart failure induced by rapid cardiac pacing were randomized to receive subcutaneous carvedilol, metoprolol, propranolol plus doxazosin, or placebo pellets for 8 wk and compared with sham-operated rabbits without pacing. We found rapid cardiac pacing produced clinical heart failure, left ventricular dilation, and decline of left ventricular fractional shortening. This was associated with an increase in left ventricular end-diastolic pressure, decrease in left ventricular first derivative of left ventricular pressure, and myocyte hypertrophy. Tissue oxidative stress measured by GSH/GSSG was increased in the heart with increased oxidation product of mitochondrial DNA, 8-oxo-7,8-dihydro-2'-deoxyguanosine, increase of Bax, decrease of Bcl-2, and increase of apoptotic myocytes as measured by anti-single-stranded DNA monoclonal antibody. Administration of carvedilol and metoprolol, which had no effect in sham animals, attenuated cardiac ventricular remodeling, cardiac hypertrophy, oxidative stress, and myocyte apoptosis in CHF. In contrast, propranolol plus doxazosin, which has less antioxidant effects, produced smaller effects on left ventricular function and myocyte apoptosis. In all animals, GSH/GSSG correlated significantly with changes of left ventricular end-diastolic dimension (r = -0.678, P < 0.0001), fractional shortening (r = 0.706, P < 0.0001), and apoptotic myocytes (r = -0.473, P = 0.0001). Thus our findings suggest antioxidant and antiapoptotic actions of carvedilol and metoprolol are important determinants of clinical beneficial effects of beta-receptors in the treatment of CHF.
ISSN:0363-6135
1522-1539
DOI:10.1152/ajpheart.00797.2003