Effects of angiotensin converting enzyme inhibitor, angio- tensin II type I receptor blocker and the

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Background Transforming growth factor (TGF) β1-Smads signal plays an important role in cardiac remodeling following myocardial infarction (MI). In addition, both angiotensin converting enzyme inhibitor (ACEI) and angiotensin II type I receptor blocker (ARB) can effectively prevent left ventricular remodeling. The current study focused on whether the combination of ACEI and ARB is more beneficial for preventing ventricular remodeling and whether Smad proteins mediate this beneficial effect.Results VW/BW significantly increased in the placebo groups compared with that in the control group (P<0.01). This increase was limited in ACEI, ARB, and combined groups (P<0.01 compared with placebo group). There was no significant difference among the three actively treated groups. Collagen was increased in placebo group (5.68±0.5)% compared with that in control group (P<0.01). ACEI, ARB and combined treatment attenuated this increase of collagen [(4.3±0.5)%, (3.5±0.5)%, (3.2±0.4)%] in comparison with that in placebo group (P<0.01 respectively). Combined treatment showed more significant effect on collagen deposition. EF and FS significantly decreased, LVDd and E/A significantly increased in placebo group compared with that in control group (P<0.01 respectively). ACEI, ARB and combined treatment ameliorated these indexes (P<0.01 compared with placebo group). The mRNA expression of TGFβ1, Smad 2, and Smad 3 (0.700±0.045, 0.959±0.037 and 0.850±0.051) increased in placebo group compared with that in control group (P<0.01). ACEI, ARB and combined treatment normalized the increase (P<0.01). Furthermore, ARB and combined treatment proved to be more effective in decreasing TGF β1 and Smad mRNA expression than ACEI treatment (P<0.01). The expression of Smad 2 and Smad 3 protein increased in placebo group compared with that in control group (P<0.01). ACEI, ARB and combined treatment normalized the increase (P<0.01). Furthermore, ARB and combined treatment proved to be more effective than ACEI alone (P<0.01).Conclusions TGFβ1-Smads signal activation is correlated with ventricular remodeling following MI. ACEI and ARB treatment prevents ventricular remodeling by inhibiting expression of Smad 2 and Smad 3. ARB and combined treatment are more effective than ACEI alone.
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