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Open Access Research article

Role of aldosterone on lung structural remodelling and right ventricular function in congestive heart failure

Andreanne Chabot1, Bao Hua Jiang1, Yanfen Shi1, Jean-Claude Tardif12 and Jocelyn Dupuis12*

Author Affiliations

1 Research Center, Montreal Heart Institute/Université de Montréal, 5000 Bélanger Street, Montreal, Quebec, H1T 1C8, Canada

2 Department of Medicine, Université de Montréal, 2910 boul. Edouard-Montpetit, Montreal, Quebec, H3T 1J7, Canada

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BMC Cardiovascular Disorders 2011, 11:72  doi:10.1186/1471-2261-11-72

Published: 2 December 2011

Abstract

Background

The mechanisms of benefit of mineralocorticoid receptors antagonists in congestive heart failure (CHF) are still debated. We hypothesized that aldosterone contributes to pulmonary remodelling and right ventricular (RV) dysfunction associated with CHF by stimulation of lung myofibroblasts (MYFs) proliferation.

Methods

Rats with moderate to large myocardial infarcts (MI) and CHF were studied. Two weeks after MI, spironolactone 100 mg/kg/day (n = 21) or no treatment (n = 24) were given for 3 weeks and compared to sham (n = 8).

Results

Infarct size was similar by ultrasound and pathologic measures in both MI groups.

The MI-untreated group developed important lung remodelling with nearly doubling of dry lung weight (p < 0.01), reduced left ventricular (LV) fractional shortening (16 ± 2% vs. 53 ± 1%; mean ± SEM, p < 0.0001), pulmonary hypertension (RV systolic pressure: 40 ± 3 mmHg vs. 27 ± 1 mmHg, p < 0.01) and RV hypertrophy (RV/(LV + septum): 38 ± 3% vs. 24 ± 1%, p < 0.05). Spironolactone had no effect on these parameters and did not improve LV or RV performance (tricuspid annular plane systolic excursion and RV myocardial performance index) measured by echocardiography. CHF induced a restrictive respiratory syndrome with histological lung fibrosis: this was also unaffected by spironolactone. Finally, isolated lung MYFs did not proliferate after exposure to aldosterone.

Conclusion

Aldosterone does not significantly contribute to pulmonary remodelling and RV dysfunction associated with CHF. Other mechanisms are responsible for the beneficial effects of spironolactone in CHF.

Keywords:
spironolactone; pulmonary heart disease; pulmonary hypertension; myofibroblasts