The aim of the present study was to investigate the contribution of the renin angiotensin system to maintenance of pressure overload left ventricular hypertrophy (LVH). Rats with fixed ascending aortic stenosis were treated with either vehicle (VEH, N = 36), hydralazine (HYD, 20 mg/kg/d, N = 35), ramipril (RAM, 10 mg/kg/d, N = 35), or losartan (LOS, 40 mg/kg/d, N = 16) during weeks 6-12 after banding. We have previously demonstrated that compared to sham (n = 36), VEH and HYD rats were characterized by a 1.8- 1.9-fold increase of left ventricular to body weight ratios (LV/BW), whereas those aortic stenosis rats treated with RAM or LOS displayed a blunted increase of LV/BW (1.4-fold; p < 0.05, each vs. HYD). We now extend these observations demonstrating that myocyte cross sectional widths were increased by 150 % in VEH and HYD rats (p < 0.001, vs. sham), whereas ramipril and losartan treatment resulted in myocyte widths that were only midly elevated (53 % and 28 % , respectively). Furthermore, VEH and HYD displayed a 14-15 fold increase of LV atrial natriuretic peptide (ANP) mRNA as well as a 44 % decrease of sarcoplasmatic reticulum (SR) Ca
2+-ATPase (p < 0.001, vs. sham). In contrast, alterations of ANP and SR-Ca
2+-ATPase mRNA levels were significantly blunted by both RAM and LOS. The attenuation of LVH by RAM or LOS was not explained by blood pressure reduction that was similar in the HYD group. Finally, RAM and LOS decreased mortality (6 out of 51 animals; 11 % ) as compared to 20 % in HYD and 31 % in VEH groups (p < 0.05).
In summary, blockade of the renin angiotensin system may promote regression of pressure overload LVH on the macro-, and microscopical, as well as the molecular level by mechanisms that are, in part, independent of hemodynamic drug effects. LVH regression may improve survival despite persisting pressure overload.
