Petr Kala, Olga Gawrys, Matúš Miklovič, Zdenka Vaňourková, Petra Škaroupková, Šárka Jíchová, Janusz Sadowski, Elzbieta Kompanowska-Jezierska, Agnieszka Walkowska, Josef Veselka, Miloš Táborský, Hana Maxová, Ivana Vaněčková, and Luděk Červenka
Objective: Evaluation of the effect of endothelin type A (ETA) receptor blockade on the course of volume-overload heart failure in rats with angiotensin II-dependent hypertension. Methods: Ren-2 renin transgenic rats (TGR) were used as a model of hypertension. Heart failure was induced by creating an aorto-caval fistula (ACF). Selective ETA receptor blockade was achieved by atrasentan. For comparison, other rat groups received trandolapril, an angiotensinconverting enzyme inhibitor (ACEi). Animals first underwent ACF creation and 2 weeks later the treatment with atrasentan or trandolapril, alone or combined, was applied; the follow-up period was 20 weeks. Results: Eighteen days after creating ACF, untreated TGR began to die, and none was alive by day 79. Both atrasentan and trandolapril treatment improved the survival rate, ultimately to 56% (18 of 31 animals) and 69% (22 of 32 animals), respectively. Combined ACEi and ETA receptor blockade improved the final survival rate to 52% (17 of 33 animals). The effects of the three treatment regimens on the survival rate did not significantly differ. All three treatment regimens suppressed the development of cardiac hypertrophy and lung congestion, decreased left ventricle (LV) end-diastolic volume and LV end-diastolic pressure, and improved LV systolic contractility in ACF TGR as compared with their untreated counterparts. Conclusion: The treatment with ETA receptor antagonist delays the onset of decompensation of volume-overload heart failure and improves the survival rate in hypertensive TGR with ACF-induced heart failure. However, the addition of ETA receptor blockade did not enhance the beneficial effects beyond those obtained with standard treatment with ACEi alone. Keywords: endothelin system, hypertension, Ren-2 renin transgenic rat, renin–angiotensin system, volume-overload heart failure Abbreviations: ACE, angiotensin-converting enzyme; ACF, aorto-caval fistula; ACEi, angiotensin-converting enzyme inhibitor; ANG II, angiotensin II; ANG 1–7, angiotensin-(1–7); (þdP/dt)max, maximum rates of pressure rise; (dP/dt)max, maximum rates of pressure fall; ESPVR, end-systolic pressure–volume relationship; ETA, endothelin type A; ET-1, endothelin 1; HanSD, Hannover Sprague- Dawley rats; LV, left ventricle; LVEDP, left ventricle enddiastolic pressure; LVEDV, left ventricle end-diastolic volume; PRSW, preload recruitable stroke work; RAAS, renin–angiotensin–aldosterone system; RV, right ventricle; SNS, sympathetic nervous system; TGR, Ren-2 renin transgenic rats; TPR, total peripheral resistance