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CARDIOVASCULAR
Cardiovascular Research Group, School of Medicine and Dentistry, Queen's University Belfast, Belfast, United Kingdom
Received July 6, 2006; accepted September 11, 2006.
| Abstract |
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NPY can both decrease and increase the contractile response of electrically stimulated rat ventricular cardiomyocytes (Piper et al., 1989
; Millar et al., 1991
). The negative effect, observed in isoproterenol-treated cells, is due primarily to stimulation of the transient outward current (Ito) and mediated through an inhibitory G protein/adenylate cyclase pathway (Kassis et al., 1987
; Piper et al., 1989
; Millar et al., 1991
). Use of the selective Y2 receptor agonists, PYY336 and NPY1336, inferred Y2 receptor involvement (McDermott et al., 1997
), but the finding that long C-terminal fragments of both PYY and NPY also exhibit high affinity for the Y5 receptor subtype (Hu et al., 1996
) emphasizes the need for clarification of receptor subtypes involved in NPY-stimulated cardiomyocyte contraction. NPY alone does not influence the basal level of contraction of cardiomyocytes, but in the presence of 4-aminopyridine, which selectively inhibits Ito in these cells, a positive response to NPY is unmasked (Millar et al., 1991
). This has been observed also in chicken cardiomyocytes in the absence of rectifier current blockade (Jacques et al., 2000
), and both effects are attributed to influx of Ca2+ via L-type channels and mediated through Y1 receptor stimulation. Furthermore, Y1 receptors are also coupled to mobilization of intracellular calcium stores in cardiomyocytes by a phospholipase C-dependent mechanism (Heredia et al., 2005
).
The number of postsynaptic
1-adrenoceptors and the amount of inositol 1,4,5-triphosphate accumulated in the myocardium in response to
1-adrenoceptor stimulation are markedly increased in hypertension (Hanna and Khairallah, 1986
). The release of NPY from the cardiac sympathetic innervation would also be expected to be enhanced during the pathogenesis of hypertension-induced myocardial hypertrophy; indeed, the plasma concentration (Zukowskagrojec et al., 1993
; Bohm et al., 1995
) and platelet content (Ogawa et al., 1992
; Zukowskagrojec et al., 1993
; Chen and Han, 1995
) of NPY are increased, and alterations in NPY-mediated myocardial contractile responses may be anticipated because receptors for the peptide couple to signal transduction processes known to be altered in hypertrophied cardiomyocytes (Kawaguchi et al., 1992
, 1993
; Bohm et al., 1994
; Cerbai et al., 1994
; Xiao and McArdle, 1994
; Yokoshiki et al., 1997
).
The spontaneously hypertensive rat (SHR) is a useful model of pressure overload (Okamoto and Aoki, 1963
; Pfeffer et al., 1976
), in which hypertension, evident at
7 weeks of age, is followed by development of ventricular hypertrophy; a "hypertrophic window" at 12 to 20 weeks, which encompasses baseline and developmental characteristics at cardiomyocyte level, has been identified (Bell et al., 2004
). Furthermore, the Y5 receptor becomes coupled transiently to the stimulation of protein synthesis by NPY during the active phase of development of ventricular cell hypertrophy in the SHR, although receptor number is unaltered (Bell et al., 2002
).
It was hypothesized that NPY receptor-mediated contraction responses become altered during progression of LVH. Focusing on the hypertrophic window above, effects on electrically stimulated contractile function were investigated in cardiomyocytes under basal conditions and when the cells were stimulated using Ca2+, the positive inotrope, isoproterenol, and NPY. In combination with Ca2+ or isoproterenol, use of selective NPY receptor agonists (Y1 receptor, Leu31 Pro34NPY; Y2 receptor, PYY336; Y5 receptor, D-Trp34NPY) and antagonists (Y1 receptor, BIBP3226; Y2 receptor, BIIE246) allowed differentiation of receptor-subtype mediated effects. Expression of NPY Y1 and NPY Y2 receptors was examined at mRNA and protein level.
| Materials and Methods |
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Isolation and Culture of Cardiomyocytes. After deep anesthesia of the rat using isoflurane (Abbott Laboratories, Kent, UK), the heart was excised quickly and placed in ice-cold 0.9% (w/v) NaCl. The heart was cannulated through the ascending aorta, and ventricular cardiomyocytes were isolated by the Langendorff retrograde perfusion method described previously (Bell et al., 2002
). After purification, cells were suspended at a concentration of 1.5 x 105 viable cardiomyocytes/ml in creatinine-carnitine-taurine medium.
Analysis of Contraction Function. An aliquot of myocyte suspension (
150 µl) was placed in a transparent recording chamber mounted on an inverted phase-contrast microscope (Axiovert IM35; Carl Zeiss GmbH, Jena, Germany) and allowed to settle for 10 min before being bathed with oxygenated (95% O2, 5% CO2) Krebs-Henseleit buffer. Cells were field-stimulated at 0.5 Hz with biphasic pulses of 0.5-ms duration at 60 V via Ag/AgCl2 wires embedded in the wall of the chamber. After initial stimulation, contractile amplitude was determined after incubation for 4 min (under basal conditions or with isoproterenol) or after 15 min (with NPY receptor agonists or antagonists). Responses to NPY receptor agonists were demonstrated in the presence of elevated Ca2+ (3 x 103 M) or a submaximal concentration of isoproterenol (108 M), as indicated. Concentration-effect relationships were obtained in a cumulative manner. The video edge detection equipment and the procedure used in the measurement of contraction amplitude were those described by Kelso et al. (2000
).
Real-Time PCR. Total cellular RNA was isolated using acid guanidinium thiocyanate-phenol-chloroform extraction, and alterations in mRNA expression were determined by RT-PCR and expressed relative to glyceraldehyde-3-phosphate dehydrogenase mRNA. Reported sequences for each gene (Table 1) were used to design on Primer Express software (Applied Biosystems, Foster City, CA), rat-specific primers adapted to RT-PCR conditions, which were synthesized by Invitrogen (Carlsbad, CA). RT-PCR and subsequent analysis were performed as described previously (Zhao et al., 2006
).
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Immunodetection and Quantification of Membrane Protein. membranes were prepared from viable left ventricular cardiomyocytes as described previously (Zhao et al., 2006
). Membrane protein concentration was determined by the method of Lowry. Protein samples were separated by 12% SDS-polyacrylamide gel electrophoresis (80 µg of protein per lane) as described previously (Zhao et al., 2006
) and transferred to polyvinylidene difluoride membrane (0.45 µm; Millipore Corporation, Billerica, MA). The polyvinylidene difluoride membrane was washed with phosphate-buffered saline containing 0.1% (v/v) Tween 20 (Sigma Chemical Co. Ltd., Poole, Dorset, UK)) and blocked overnight in phosphate-buffered saline/0.1% (v/v) Tween 20 solution containing 5% (w/v) Marvel. Immunoblotting was performed using primary antibodies directed specifically against rodent NPY Y1 and Y2 receptors (Santa Cruz Biotechnology; sc-21992 and sc-14736, respectively, raised in goat) used at a dilution of 1:500. Immunocomplexes were detected using secondary antibodies conjugated to horseradish peroxidase (donkey anti-goat sc-2020 used at a dilution of 1:20,000; Santa-Cruz Biotechnology) and ECL plus (GE Healthcare, Little Chalfont, Buckinghamshire, UK) as substrate and quantified by densitometry (Analytical Imaging System) normalized for protein loading using
-actin (Santa Cruz Biotechnology; sc-1616 raised in goat).
Chemicals. Medium M199 (glutamine-free with Earle's salts) and penicillin (5000 IU)/streptomycin (5 mg/ml) were supplied by Gibco BRL (Paisley, Renfrewshire, UK). Carnitine, creatine, taurine, 4-aminopyridine, isoproterenol hydrochloride, and BIBP3226 were obtained from the Sigma Chemical Co. Ltd. NPY (human, rat), Leu31Pro34NPY (human, rat), and PYY336 were purchased from Bachem (St. Helens, Merseyside, UK). BIIE246 was kindly supplied by Dr. Henri Doods (Boehringer Ingelheim Pharmaceuticals, Biberach, Germany). D-Trp34NPY was synthesized in the laboratory of Professor Ambikaipakan Balasubramaniam (University of Cincinnati Medical Center, Cincinnati, OH). All other chemicals were of analytical grade and purchased from BDH Chemicals (Poole, Dorset, UK).
Solutions. Serum-free creatinine-carnitine-taurine medium consisted of modified glutamine-free medium M199 supplemented with Earle's salts and containing 15 mM HEPES, 5 mM creatine, 2 mM l-carnitine, 5 mM taurine, and 100 µg/ml penicillin/100 IU/ml streptomycin. The composition of the Krebs-Henseleit solution was 120 mM NaCl, 4.7 mM KCl, 25 mM NaHCO3, 0.97 mM MgSO4, 1.2 mM KH2PO4, 11 mM glucose, and 1 or 3 mM Ca2+. Before use, this solution was gassed with 95% O2/5% CO2 for 20 min and maintained at pH 7.4.
Data Analysis. All data are presented as mean ± S.E.M. Contraction amplitude was measured in micrometers and expressed as a percentage change from the diastolic length, as an absolute value (%
L), or as a change from the baseline (
%
L), and n denotes the number of cell preparations used. Concentration-response data were analyzed by nonlinear regression using GraphPad Prism (version 4; GraphPad Software Inc., San Diego, CA). Statistical analyses were preformed by analysis of variance to detect significant differences for between-group (age, strain) or within-group (treatment) effects and post hoc comparisons by Bonferroni or an unpaired Student's t test as appropriate, using an SPSS package (version 11.5; SPSS Inc., Chicago, IL). Values of p < 0.05 were considered significant.
| Results |
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L%) of cardiomyocytes (data are given as mean ± S.E.M. and were obtained in cardiomyocytes from 12-week-old animals following 15-min incubation with agonist versus time-matched baseline values): NPY (107 M: 3.86 ± 0.86 versus 4.04 ± 0.35, n = 6 WKY; 3.38 ± 0.96 versus 3.98 ± 1.07, n = 6 SHR; 3 x 109 M: 3.84 ± 0.50 versus 3.79 ± 0.75, n = 6 WKY; 2.00 ± 0.42 versus 1.56 ± 0.40, n = 6 SHR), Leu31Pro34NPY (107 M: 3.43 ± 0.66 versus 3.40 ± 0.57, n = 6 WKY; 2.84 ± 0.48 versus 3.19 ± 0.42, n = 6 SHR), PYY336 (3 x 109 M: 5.57 ± 1.69 versus 5.53 ± 1.68, n = 5 WKY; 2.83 ± 0.60 versus 2.79 ± 0.46, n = 6 SHR), and D-Trp34NPY (107 M: 1.00 ± 0.29 versus 1.25 ± 0.30, n = 5 WKY; 2.04 ± 0.26 versus 2.22 ± 0.21, n = 6 SHR). Likewise, there were no effects of the antagonists, BIBP3226 (107 M: 4.19 ± 1.35 versus 4.29 ± 1.22, n = 4 WKY; 6.57 ± 1.01 versus 6.67 ± 1.18, n = 4 SHR) or BIIE246 (107 M: 5.92 ± 1.38 versus 6.03 ± 1.06, n = 4 WKY; 3.26 ± 1.29 versus 3.37 ± 1.30, n = 4 SHR) per se with Ca2+ (103 M); also BIIE246 (107 M) did not antagonize the response to isoproterenol (108 M) (4.79 ± 0.78 in the presence of BIIE246 versus 3.70 ± 0.63 alone, n = 4 WKY; 4.24 ± 0.56 in the presence of BIIE versus 3.63 ± 0.35 alone, n = 4 SHR). Therefore, BIBP3226 and BIIE246 can be used appropriately to test the Y1 and Y2 receptor subtype specificity, respectively, of NPY responses. Leu31Pro34NPY (107 M) with Ca2+ (103 M) did not alter the positive effect of isoproterenol (108 M) on amplitude of contraction (5.53 ± 0.41 in the presence of Leu31Pro34NPY versus 5.46 ± 0.49 alone, n = 6 WKY; 4.40 ± 0.77 in the presence of Leu31Pro34NPY versus 4.01 ± 0.58 alone, n = 4 SHR). Therefore, it is apparent that the Y1 receptor-selective compound does not have activity at Y2 receptors in this experimental system. For experiments with BIIE246, concentrations of NPY and PYY336 that produced maximal attenuation of isoproterenol (108 M)-stimulated contraction amplitude were initially determined because potency increased with increasing age of SHRs, the concentration used in 16- and 20-week-old rats was 3 x 1010 M but was 3 x 109 M in 12-week-old SHRs and all WKY rats.
Receptor Subtype-Mediated Effects on Electrically Stimulated Contraction of Rat Cardiomyocytes. Data obtained in our laboratory establishing the temporal development of hypertension and cardiomyocyte hypertrophy in SHRs during the period 12 to 20 weeks employed in the contraction experiments below have been published previously (Bell et al., 2004
).
Temporal and Concentration Dependence of the Positive Contraction Response. A representative original tracing of the stimulation of contractile activity by NPY is shown in Fig. 1a. In the presence of Ca2+ (3 x 106 M), NPY (Fig. 2a) and Leu31Pro34NPY (Fig. 2b) stimulated concentration-dependent increases in contraction amplitude in cardiomyocytes from SHRs and WKY rats of all ages. At 12 weeks, increases were observed in the range, 1010 to 107 M, and EC50 values (in the 109 M range) were similar. The potency of NPY was unaltered with the progression of age in WKY rat cardiomyocytes but significantly increased in cardiomyocytes from 20-week-old SHRs (2500- and 2800-fold greater than observed at 12 and 16 weeks of age, respectively). Age-matched between-strain comparisons showed that the potency of NPY was significantly elevated at 20 (2300-fold) but not at 12 and 16 weeks of age in cardiomyocytes from SHRs. Comparison of the effects of NPY and Leu31Pro34NPY with increased contraction amplitude showed that the potencies were similar under all conditions. As such, the potency of Leu31Pro34NPY to increase contraction amplitude was unchanged in WKY rat cardiomyocytes but enhanced in cardiomyocytes obtained from SHRs at 20 weeks of age (380-fold versus age-matched controls). Maximal responses to NPY and to Leu31Pro34NPY did not differ significantly between SHR and WKY rats at any age. The Y1 receptor-selective antagonist, BIBP3226, abolished the positive contraction effects of NPY (Fig. 3a) and Leu31Pro34NPY (Fig. 3b) across the range of concentration used (1013 to 107 M) in both SHR and WKY rat cardiomyocytes at all ages.
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Temporal and Concentration Dependence of the Negative Contraction Response to NPY Unmasked in the Presence of BIBP3226. NPY in the presence of BIBP3226 elicited a negative, concentration-dependent effect in all cases (Fig. 3a), observed over the same range of concentration in which application of NPY alone had increased contraction amplitude in the presence of Ca2+ (3 x 106 M) (Fig. 2a). In cardiomyocytes from SHRs and WKY rats at 12 weeks of age, decreases in contraction amplitude stimulated by NPY in the presence of BIBP3226 had similar EC50 values (in the 1010 M range). In WKY rat cardiomyocytes, the EC50 value was unaltered with increasing age but in SHR cardiomyocytes, increased significantly at 20 weeks of age (100- to 800-fold greater than observed at 12 and 16 weeks of age). In age-matched comparisons between strains, the potency value in SHR cardiomyocytes was significantly altered compared with that observed in cardiomyocytes from WKY rats at 20 but not at 12 and 16 weeks of age. In the presence of BIBP3226, Leu31Pro34NPY applied over the same concentration range, which, when used alone, had increased contraction amplitude in SHR and WKY rat cardiomyocytes, had no effect on amplitude of contraction (Fig. 3b).
Temporal and Concentration Dependence of the Negative Contraction Response to PYY336 Alone. PYY336 (1012 to 3 x 109 M) elicited a concentration-dependent, negative contraction effect in cardiomyocytes from SHRs and WKY rats of all ages (Fig. 4). Maximal responses to PYY336 did not differ significantly between SHR and WKY rats at any age. The potency of PYY336 was similar in cardiomyocytes from 12-week-old rats of each strain, in the region of 3 x 1010 M, and in WKY rat cardiomyocytes was unchanged with progression of age, whereas potency increased in SHRs, becoming significantly elevated (x400) in cardiomyocytes from 20-compared with 12-week-old rats. The potency of PYY336 was similar in cardiomyocytes from age-matched 12-week-old SHRs and WKY rats but was noticeably increased (x10) at 16 weeks, becoming significantly elevated (x400) in cardiomyocytes from 20-week-old SHRs compared with that found in WKY rats. The potencies of PYY336 and NPY in the presence of BIBP3226 (Figs. 4 and 3, respectively) under any condition were not different.
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L%) of cardiomyocyte contraction (5.12 ± 0.87 in the presence of D-Trp34NPY versus 4.89 ± 0.70 alone, n = 6 WKY; 4.99 ± 0.66 in the presence of D-Trp34NPY versus 4.31 ± 0.63 alone, n = 6 SHR); data are given as mean ± S.E.M. and were obtained in cardiomyocytes from 20-week-old animals.
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Gene Expression of NPY and Receptors. NPY-Y1 receptors were expressed more abundantly than NPY-Y2 receptors at mRNA and protein levels in left ventricular cardiomyocytes from WKY rats at 20 weeks of age (Fig. 7). Expression of NPY-Y1 and NPY-Y2 receptor mRNAs was decreased by 55 (p < 0.05) and 69% (p < 0.05), respectively, in left ventricular cardiomyocytes from 20-week-old SHRs relative to that of age-matched WKY rats; parallel decreases of 32 (p = N.S.) and 80% (p < 0.05), respectively, were observed at the protein level.
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| Discussion |
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Altered Potency at NPY Receptors during the Development of Hypertrophy. Under normal conditions when hypertensive disease is absent, the positive contraction effect of NPY was maintained at a constant level. This may arise because in the absence of pressure overload, there is no need to potentiate the contraction performance of cardiomyocytes. Plasma levels of circulating NPY in WKY rats are approximately 4 x 1011 M (Ogawa et al., 1989
), which lies just outside the range (1010 to 107 M) in which the peptide stimulates increased contraction function in WKY rat myocytes. Therefore, it seems that modulation of contraction function by NPY is a redundant mechanism in normotensive animals. The SHR myocardium could undergo a stress-induced change in which the importance of peptidic regulation of function is of greater importance. The NPY level in SHR plasma (Ogawa et al., 1989
) would certainly stimulate the maximal positive contraction effect of the peptide in 20-week-old SHR cardiomyocytes. Therefore, the hypertrophied myocardium may adapt so that NPY may play a part in the modulation of contractile function via Y1 receptors. Likewise, the concentration range (1010 to 3 x 109 M) in which NPY (and PYY336) stimulated their negative contraction effects in WKY rat myocytes is less than the in vivo plasma concentration of NPY (Ogawa et al., 1989
). Therefore, the Y2 receptor-mediated negative contraction effect may also be a redundant mechanism in normotensive animals. However, the potency of both peptides to elicit this negative effect was up-regulated in cardiomyocytes from 20-week-old SHRs to a level at which the observed circulatory concentration of NPY would be expected to elicit a maximal negative effect. Again, this is consistent with the hypothesis that in hypertensive disease, peptidic regulation of the myocardium is enhanced. Augmented activity of the sympathetic neurotransmitter norepinephrine (possibly in combination with NPY acting via Y1 receptors) would promote myocardial contractility during systole and help initially to maintain cardiac output despite increased after-load, working alongside the progressive unloading of muscle fibers achieved by the more gradual development of compensatory LVH in an attempt to normalize wall stress. However, prolonged activation of sympathetic drive would be expected to increase myocardial oxygen demand and energy expenditure of the hypertrophied myocardium, thereby contributing to cardiomyocyte ischemia and eventually cell death due to apoptosis or necrosis, resulting in impaired contractility of the residual myocardium and reduced ability to sustain the increased load because adult cardiomyocytes have only limited potential for self-renewal (Anversa et al., 2006
). Enhancement of the negative contraction effect of NPY during early compensated hypertensive LVH could therefore represent a protective measure to help to counter the excessive shortening and energy expenditure of cardiomyocytes in response to norepinephrine. However, impaired intrinsic myocardial contractility has also been observed in patients with prolonged hypertension despite fully compensated ventricular hypertrophy, normal wall stress, and apparently normal pump function (Aoyagi et al., 1993
). The possibility should be considered that chronic enhancement of the negative contraction effects of NPY could instead represent a pathophysiological phenomenon, such that sustained depression of contractility mediated via Y2 receptor stimulation may exacerbate progressive mechanical dysfunction and impair ventricular emptying during systole and ultimately accelerate transition to overt failure.
Reduced NPY Receptor Numbers in Established Cardiomyocyte Hypertrophy. Decreased Y2 and, to a lesser extent, Y1 receptor numbers in SHR cardiomyocytes at 20 weeks might reflect receptor down-regulation that could arise by negative feedback as a consequence of increased receptor activity in SHR due to the observed increased potency of agonist-receptor complex interactions. However, maximal contractile responses to NPY and receptor subtypeselective antagonists were not reduced significantly, indicating either that residual receptor numbers are probably still surplus to functional requirements or that up-regulation of downstream signaling components coupled to Y receptors might offset any consequences of reduced receptor number. In regard to the latter, phospholipase C-
-mediated mobilization of intracellular calcium stores is enhanced in SHR myocardium (Kawaguchi et al., 1992
, 1993
). Because Y1 receptors are known to couple to mobilization of intracellular calcium stores in cardiomyocytes by a phospholipase C-dependent mechanism (Heredia et al., 2005
), enhanced activity downstream of the receptor-involvement could compensate for, or alternatively may contribute to, recruitment of processes responsible for the modest reduction in Y1 receptor number. Expression of Gi-
subunit protein is also enhanced, and Gi-mediated inhibition of adenylate cyclase is augmented (Bohm et al., 1994
), implying enhanced activity downstream of the Y2 receptor. Again, this could compensate for, or alternatively may contribute to, the regulation of processes responsible for the modest reduction in Y2 receptor number. However, Ito current is blunted (Cerbai et al., 1994
; Yokoshiki et al., 1997
); conversely, L-type calcium channel current is enhanced (Xiao and McArdle, 1994
) in hypertrophied SHR myocardium. These effects would oppose the negative contraction effect of NPY, mediated via the Y2 receptor subtype. This observation, together with the greater reduction in Y2 than Y1 receptor protein in hypertrophied cardiomyocytes, indicates that the balance between the opposing actions of the peptide may shift toward the Y1-mediated positive contractile response to assist the myocardium in potentiation of normal contractile performance and attempt to offset a potentially detrimental influence of Y2 receptor stimulation.
Future Studies and Clinical Significance. The sympathetic nervous system cotransmitter, NPY, can elicit in SHR cardiomyocytes, an increase in the amplitude of contraction through the Y1 receptor subtype, and also a negative effect on contraction parameters through the Y2 receptor subtype, which both involve modulation of intracellular Ca2+ signaling. The potency of NPY to elicit positive and negative contraction effects is dramatically increased during the established phase of hypertrophic growth. As a compensatory strategy, the positive effect of NPY may contribute to maintenance of normal circulatory function, at least initially, in hypertension, whereas the negative contraction effect may contribute to the pathophysiological changes occurring within the myocardium, which ultimately contribute to the transition to overt failure. This study has focused on the early phase of compensated LVH in the SHR. Clearly, it would now be important to explore NPY-mediated contraction responses in aged SHR during the transition into overt failure to determine whether the alterations identified in regard to each NPY receptor subpopulation persist and are enhanced. To further elucidate the respective roles of pressure loading and LVH on the changes observed, parallel studies in an appropriate model of volume-overload LVH should also be conducted. Intervention with suitable Y2-selective antagonists in SHRs in vivo together with transgenic overexpression or knockout of the Y2 receptor in aortic banded mice should help to clarify whether the influence of this receptor is cardioprotective or ultimately detrimental in the setting of pressure overload and, provided such findings can be extrapolated to humans, might indicate the rationale for therapeutic intervention with agents targeting this receptor subpopulation.
| Footnotes |
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Article, publication date, and citation information can be found at http://jpet.aspetjournals.org.
ABBREVIATIONS: NPY, neuropeptide Y; LVH, left ventricular hypertrophy; SHR, spontaneously hypertensive rat; BIBP3226, R-N2-(diphenylacetyl)-N-(4-hydroxyphenyl)methyl-argininamide); BIIE246, (S)-N2-([1-{2-(4-[(r,s)-5,11-dihydro-6(6H)-oxodibenz(b,e)azepin-11-yl]-1-piperazinyl)-2-oxoethyl}cyclopentyl]acetyl)-N-(2-[1,2-dihydro-3,5(4H)-dioxo-1,2-diphenyl-3H-1,2,4-triazol-4-yl]ethyl)-argininamide; WKY, Wistar Kyoto; PCR, polymerase chain reaction; RT, reverse transcriptase.
Address correspondence to: Dr. David Bell, Division of Medicine and Therapeutics, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, UK. E-mail: d.bell{at}qub.ac.uk
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