Cardioprotective Effect of Losartan Alone or in Combination with Remote Ischemic Preconditioning on the Biochemical Changes Induced by Ischemic/Reperfusion Injury in a Mutual Prospective Study with a Clinical and Experimental Animal Arm
Journal Title: Heart Research – Open Journal - Year 2017, Vol 4, Issue 3
Abstract
Background and Aims: Losartan is an angiotensin receptor II antagonist used clinically to reduce blood pressure and treat hypertension or hypertrophic cardiomyopathy. It is also proposed to suppress cardiac injury following reperfusion. We evaluated the potential effect of Losartan alone and in combination with remote ischemic preconditioning (RIPC), an established treatment, on the biochemical changes induced by ischemic/reperfusion injury (I/R) in both humans and rabbits. Methods: Thirty consecutive patients undergoing elective percutaneous coronary intervention (PCI) were divided into three groups (10 each): group 1 (control group without any preconditioning), group 2 (patients who were maintained on losartan (50-100 mg /day) for one month before PCI), group 3 (similar to group 2 but PCI was preceded by RIPC). On the other hand, sixty adult male New Zealand white rabbits were divided into 6 groups (10 each): group I (control), group II (sham), group III (I/R as 30 min ischemia followed by 120 min reperfusion), group IV (regular losartan 20 mg/kg for 40 days orally followed by I/R), group V (I/R preceded by RIPC) and group VI (similar to groups IV but I/R was preceded by RIPC). Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), troponin I (cTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP) were measured in blood for all study groups. Results: Clinical and experimental parts showed that groups with RIPC combined with losartan pretreatment enhanced cardioprotective effects of RIPC against I/R injury as evidenced by significant reduction (p<0.001) in the levels of IL-6 and cTnI; also the level of NO was significantly (p<0. 0.001) increased compared with other groups. However, this effect was not significant regarding the level of TNF-α, CK-MB nor CRP. Conclusions: Pretreatment with losartan enhances the cardioprotective effects of RIPC in ischemic reperfusion injury
Authors and Affiliations
Ayman K. M. Hassan
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