Expertos Invitados





BETABLOQUEANTES Y MIOCARDITIS

(especial para SIIC © Derechos reservados)
Los efectos cardioprotectores del carvedilol sobre la fisiopatología de la miocarditis viral aguda no se deberían solamente al bloqueo de los adrenoceptores beta 1 sino también a las propiedades pleiotrópicas de la droga.
Autor:
a Riad
Columnista Experto de SIIC
Artículos publicados por a Riad
Coautores
D Westermann* HP Schultheiss* C Tschöpe* 
Charité - Universitätsmedizin Berlin, Berlín, Alemania*
Recepción del artículo
27 de Septiembre, 2006 		Aprobación
12 de Diciembre, 2006
Primera edición
14 de Junio, 2007 		Segunda edición, ampliada y corregida
7 de Junio, 2021

BETABLOQUEANTES Y MIOCARDITIS

Resumen
Las citoquinas proinflamatorias inducen la expresión de metaloproteinasas de la matriz que juegan un papel crucial en la remodelación miocárdica. La estimulación del receptor beta adrenérgico influye sobre la producción de citoquinas y predice la posibilidad de producción de citoquinas moduladoras mediante la administración de bloqueantes beta adrenérgicos. Algunos de los betabloqueantes de tercera generación también ejercen un efecto antiinflamatorio directo que podría ser de especial interés en relación con la miocardiopatía inflamatoria. Esta revisión se centra en nuestro trabajo previo de interpretación del fenotipo cardíaco en la miocarditis inducida por coxsackievirus y en la comparación del tratamiento con betabloqueantes selectivos y no selectivos.

Palabras clave
betabloqueantes, miocarditis, carvedilol


Artículo completo
(castellano)
Extensión:  +/-9.61 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

The Influence of Beta-Adrenergic Inhibition on Cardiac Performance in Experimental Myocarditis

Abstract
Proinflammatory cytokines induce the expression of matrix metalloproteinases that play a crucial role in myocardial remodelling. ß-adrenergic receptor stimulation influences the production of cytokines heralding the possibility of modulating cytokine production by ß-adrenergic blockers. Some of the ß-blockers of the third generation exert also direct anti-inflammatory properties which could be from special interest e.g. inflammatory cardiomyopathy. This review focused on our previous work performing cardiac phenotype in coxsackievirus-induced myocarditis and comparing the intervention with selective and unselective ß-blockers.

Key words
myocarditis, carvedilol, beta-blockers


Full text
(english)
 para suscriptores/ assinantes
Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología
Relacionadas: Bioquímica, Farmacología, Medicina Farmacéutica, Medicina Interna



Comprar este artículo
Extensión: 9.61 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Carsten Tschöpe, Department of Cardiology and Pneumology, Charité - Universitätsmedizin Berlin, 12200, Hindenburgdamm 30, Berlín, Alemania
Patrocinio y reconocimiento:
El presente estudio fue financiado por un subsidio perteneciente al Deutsche Forschungsgesellschaft (DFG; TR-SFB 19; proyecto B5/Z3).
Bibliografía del artículo
1. López Sendon J, Swedberg K, McMurray J, Tamargo J, Maggioni AP, Dargie H, Tendera M, Waagstein F, Kjekshus J, Lechat P et al. Expert consensus document on beta-adrenergic receptor blockers. Eur Heart J 25:1341-62, 2004.
2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560-72, 2003.
3. Ellison KE, Gandhi G. Optimising the use of beta-adrenoceptor antagonists in coronary artery disease. Drugs 65:787-97, 2005.
4. Soriano JB, Hoes AW, Meems L, Grobbee DE. Increased survival with beta-blockers: importance of ancillary properties. Prog Cardiovasc Dis 39:445-56, 1997.
5. Freemantle N, Cleland J, Young P, Mason J, Harrison J. Beta blockade after myocardial infarction: systematic review and meta regression analysis. BMJ 318:1730-7, 1999.
6. Brixius K, Bundkirchen A, Bolck B, Mehlhorn U, Schwinger RH. Nebivolol, bucindolol, metoprolol and carvedilol are devoid of intrinsic sympathomimetic activity in human myocardium. Br J Pharmacol 133:1330-8, 2001.
7. McDevitt DG. Pharmacologic aspects of cardioselectivity in a beta-blocking drug. Am J Cardiol 59:10F-12F, 1987.
8. Bristow MR. Beta-adrenergic receptor blockade in chronic heart failure. Circulation 101:558-69, 2000.
9. Bowman AJ, Chen CP, Ford GA. Nitric oxide mediated venodilator effects of nebivolol. Br J Clin Pharmacol 38:199-204, 1994.
10. Cockcroft JR, Chowienczyk PJ, Brett SE, Chen CP, Dupont AG, Van Nueten L, Wooding SJ, Ritter JM. Nebivolol vasodilates human forearm vasculature: evidence for an L-arginine/NO-dependent mechanism. J Pharmacol Exp Ther 274:1067-71, 1995.
11. Dawes M, Brett SE, Chowienczyk PJ, Mant TG, Ritter JM. The vasodilator action of nebivolol in forearm vasculature of subjects with essential hypertension. Br J Clin Pharmacol 48:460-3, 1999.
12. Metra M, Giubbini R, Nodari S, Boldi E, Modena MG, Dei Cas L. Differential effects of beta-blockers in patients with heart failure: A prospective, randomized, double-blind comparison of the long-term effects of metoprolol versus carvedilol. Circulation 102:546-51, 2000.
13. Intengan HD, Schiffrin EL. Disparate effects of carvedilol versus metoprolol treatment of stroke-prone spontaneously hypertensive rats on endothelial function of resistance arteries. J Cardiovasc Pharmacol 35:763-8, 2000.
14. Parenti A, Filippi S, Amerini S, Granger HJ, Fazzini A, Ledda F. Inositol phosphate metabolism and nitric-oxide synthase activity in endothelial cells are involved in the vasorelaxant activity of nebivolol. J Pharmacol Exp Ther 292:698-703, 2000.
15. Altwegg LA, D'Uscio LV, Barandier C, Cosentino F, Yang Z, Luscher TF. Nebivolol induces NO-mediated relaxations of rat small mesenteric but not of large elastic arteries. J Cardiovasc Pharmacol 36:316-20, 2000.
16. Broeders MA, Doevendans PA, Bekkers BC, Bronsaer R, Van Gorsel E, Heemskerk JW, Egbrink MG, Van Breda E, Reneman RS, Van der Zee R. Nebivolol: a third-generation beta-blocker that augments vascular nitric oxide release: endothelial beta(2)-adrenergic receptor-mediated nitric oxide production. Circulation 102:677-84, 2000.
17. Frishman WH. Carvedilol. N Engl J Med 339:1759-65, 1998.
18. Ohtsuka T, Hamada M, Saeki H, Ogimoto A, Hiasa G, Hara Y, Shigematsu Y, Hiwada K. Comparison of effects of carvedilol versus metoprolol on cytokine levels in patients with idiopathic dilated cardiomyopathy. Am J Cardiol 89:996-9, 2002.
19. Sia YT, Parker TG, Tsoporis JN, Liu P, Adam A, Rouleau JL. Long-term effects of carvedilol on left ventricular function, remodeling, and expression of cardiac cytokines after large myocardial infarction in the rat. J Cardiovasc Pharmacol 39:73-87, 2002.
20. Nakano A, Matsumori A, Kawamoto S, Tahara H, Yamato E, Sasayama S, Miyazaki JI. Cytokine gene therapy for myocarditis by in vivo electroporation. Hum Gene Ther 12:1289-97, 2001.
21. Pauschinger M, Rutschow S, Chandrasekharan K, Westermann D, Weitz A, Peter Schwimmbeck L, Zeichhardt H, Poller W, Noutsias M, Li J et al. Carvedilol improves left ventricular function in murine coxsackievirus-induced acute myocarditis association with reduced myocardial interleukin-1beta and MMP-8 expression and a modulated immune response. Eur J Heart Fail 7:444-52, 2005.
22. Nishio R, Shioi T, Sasayama S, Matsumori A. Carvedilol increases the production of interleukin-12 and interferon-gamma and improves the survival of mice infected with the encephalomyocarditis virus. J Am Coll Cardiol 41:340-5, 2003.
23. Pauschinger M, Doerner A, Kuehl U, Schwimmbeck PL, Poller W, Kandolf R, Schultheiss HP. Enteroviral RNA replication in the myocardium of patients with left ventricular dysfunction and clinically suspected myocarditis. Circulation 99:889-95, 1999.
24. Noutsias M, Pauschinger M, Poller WC, Schultheiss HP, Kuhl U. Current insights into the pathogenesis, diagnosis and therapy of inflammatory cardiomyopathy. Heart Fail Monit 3:127-35, 2003.
25. Pauschinger M, Bowles NE, Fuentes García FJ, Pham V, Kuhl U, Schwimmbeck PL, Schultheiss HP, Towbin JA. Detection of adenoviral genome in the myocardium of adult patients with idiopathic left ventricular dysfunction. Circulation 99:1348-54, 1999.
26. Seong IW, Choe SC, Jeon ES. Fulminant coxsackieviral myocarditis. N Engl J Med 345:379, 2001.
27. Liu PP, Mason JW. Advances in the understanding of myocarditis. Circulation 104:1076-82, 2001.
28. Tschöpe C, Westermann D, Steendijk P, Noutsias M, Rutschow S, Weitz A, Schwimmbeck PL, Schultheiss HP, Pauschinger M. Hemodynamic characterization of left ventricular function in experimental coxsackieviral myocarditis: effects of carvedilol and metoprolol. Eur J Pharmacol 491:173-9, 2004.
29. Afanasyeva M, Georgakopoulos D, Rose NR. Autoimmune myocarditis: cellular mediators of cardiac dysfunction. Autoimmun Rev 3:476-86, 2004.
30. Nishio R, Sasayama S, Matsumori A. Left ventricular pressure-volume relationship in a murine model of congestive heart failure due to acute viral myocarditis. J Am Coll Cardiol 40:1506-14, 2002.
31. Li J, Schwimmbeck PL, Tschöpe C, Leschka S, Husmann L, Rutschow S, Reichenbach F, Noutsias M, Kobalz U, Poller W et al. Collagen degradation in a murine myocarditis model: relevance of matrix metalloproteinase in association with inflammatory induction. Cardiovasc Res 56:235-47, 2002.
32. Huber SA, Polgar J, Schultheiss P, Schwimmbeck P. Augmentation of pathogenesis of coxsackievirus B3 infections in mice by exogenous administration of interleukin-1 and interleukin-2. J Virol 68:195-206, 1994.
33. Huber SA. Coxsackievirus-induced myocarditis is dependent on distinct immunopathogenic responses in different strains of mice. Lab Invest 76:691-701, 1997.
34. Mikami S, Kawashima S, Kanazawa K, Hirata K, Hotta H, Hayashi Y, Itoh H, Yokoyama M. Low-dose N omega-nitro-L-arginine methyl ester treatment improves survival rate and decreases myocardial injury in a murine model of viral myocarditis induced by coxsackievirus B3. Circ Res 81:504-11, 1997.
35. Agocha A, Sigel AV, Eghbali-Webb M. Characterization of adult human heart fibroblasts in culture: a comparative study of growth, proliferation and collagen production in human and rabbit cardiac fibroblasts and their response to transforming growth factor-beta1. Cell Tissue Res 288:87-93, 1997.
36. Thomas CV, Coker ML, Zellner JL, Handy JR, Crumbley AJ 3rd, Spinale FG. Increased matrix metalloproteinase activity and selective upregulation in LV myocardium from patients with end-stage dilated cardiomyopathy. Circulation 97:1708-15, 1998.
37. Bradham WS, Moe G, Wendt KA, Scott AA, Konig A, Romanova M, Naik G, Spinale FG. TNF-alpha and myocardial matrix metalloproteinases in heart failure: relationship to LV remodeling. Am J Physiol Heart Circ Physiol 282:H1288-95, 2002.
38. Lee TS, Chau LY. Heme oxygenase-1 mediates the anti-inflammatory effect of interleukin-10 in mice. Nat Med 8:240-6, 2002.
39. Santin AD, Hermonat PL, Ravaggi A, Bellone S, Pecorelli S, Roman JJ, Parham GP, Cannon MJ. Interleukin-10 increases Th1 cytokine production and cytotoxic potential in human papillomavirus-specific CD8(+) cytotoxic T lymphocytes. J Virol 74:4729-37, 2000.
40. Stumpf C, Lehner C, Yilmaz A, Daniel WG, Garlichs CD. Decrease of serum levels of the anti-inflammatory cytokine interleukin-10 in patients with advanced chronic heart failure. Clin Sci (Lond) 105:45-50, 2003.
41. Weng NP, Liu K, Catalfamo M, Li Y, Henkart PA. IL-15 is a growth factor and an activator of CD8 memory T cells. Ann N Y Acad Sci 975:46-56, 2002.
42. Korholz D, Banning U, Bonig H, Grewe M, Schneider M, Mauz-Korholz C, Klein-Vehne A, Krutmann J, Burdach S. The role of interleukin-10 (IL-10) in IL-15-mediated T-cell responses. Blood 90:4513-21, 1997.
43. Kanda T, Adachi H, Ohno T, Suzuki T, Murata K. Myocardial beta-receptor and cardiac angiotensin alterations during the acute and chronic phases of viral myocarditis. Eur Heart J 15:686-90, 1994.
44. Popovic Z, Miric M, Vasiljevic J, Sagic D, Bojic M, Popovic AD. Acute hemodynamic effects of metoprolol +/- nitroglycerin in patients with biopsy-proven lymphocytic myocarditis. Am J Cardiol 81:801-4, 1998.
45. Andersson B, Caidahl K, Di Lenarda A, Warren SE, Goss F, Waldenstrom A, Persson S, Wallentin I, Hjalmarson A, Waagstein F. Changes in early and late diastolic filling patterns induced by long-term adrenergic beta-blockade in patients with idiopathic dilated cardiomyopathy. Circulation 94:673-82, 1996.
46. Eichhorn EJ, Bedotto JB, Malloy CR, Hatfield BA, Deitchman D, Brown M, Willard JE, Grayburn PA. Effect of beta-adrenergic blockade on myocardial function and energetics in congestive heart failure. Improvements in hemodynamic, contractile, and diastolic performance with bucindolol. Circulation 82:473-83, 1990.
47. Feuerstein GZ, Ruffolo RR Jr. Carvedilol, a novel multiple action antihypertensive agent with antioxidant activity and the potential for myocardial and vascular protection. Eur Heart J 16(Suppl F):38-42, 1995.
48. Panina-Bordignon P, Mazzeo D, Lucia PD, D'Ambrosio D, Lang R, Fabbri L, Self C, Sinigaglia F. Beta2-agonists prevent Th1 development by selective inhibition of interleukin 12. J Clin Invest 100:1513-9, 1997.
49. Watanabe K, Takahashi T, Nakazawa M, Wahed MI, Fuse K, Tanabe N, Kodama M, Aizawa Y, Ashino H, Tazawa S. Effects of carvedilol on cardiac function and cardiac adrenergic neuronal damage in rats with dilated cardiomyopathy. J Nucl Med 43:531-5, 2002.
50. Lim BK, Choe SC, Shin JO, Ho SH, Kim JM, Yu SS, Kim S, Jeon ES. Local expression of interleukin-1 receptor antagonist by plasmid DNA improves mortality and decreases myocardial inflammation in experimental coxsackieviral myocarditis. Circulation 105:1278-81, 2002.
51. Barth W, Deten A, Bauer M, Reinohs M, Leicht M, Zimmer HG. Differential remodeling of the left and right heart after norepinephrine treatment in rats: studies on cytokines and collagen. J Mol Cell Cardiol 32:273-84, 2000.
52. Grimm D, Huber M, Jabusch HC, Shakibaei M, Fredersdorf S, Paul M, Riegger GA, Kromer EP. Extracellular matrix proteins in cardiac fibroblasts derived from rat hearts with chronic pressure overload: effects of beta-receptor blockade. J Mol Cell Cardiol 33:487-501, 2001.
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008