Urocortin 2 combined with angiotensin-converting enzyme inhibition in experimental heart failure

Clin Sci (Lond). 2008 May;114(10):635-42. doi: 10.1042/CS20070364.

Abstract

Ucn2 (urocortin 2) is a recently discovered peptide with therapeutic potential in heart failure. As any new treatment is likely to be used in conjunction with standard ACEI (angiotensin-converting enzyme inhibitor) therapy, it is important that the combined effects of these agents are assessed. In the present study, we investigated the effects of Ucn2 and an ACEI (captopril) administered for 3 h, both separately and together, in eight sheep with pacing-induced heart failure. Ucn2 and captopril alone both increased CO (cardiac output; Ucn2>captopril) and decreased arterial pressure (captopril>Ucn2), left atrial pressure (Ucn2>captopril) and peripheral resistance (Ucn2=captopril) relative to controls. Compared with either treatment alone, combined treatment further improved CO and reduced peripheral resistance and cardiac preload, without inducing further falls in blood pressure. In contrast with the marked increase in plasma renin activity observed with captopril alone, Ucn2 administration reduced renin activity, whereas the combined agents resulted in intermediate renin levels. All active treatments decreased circulating levels of aldosterone (Ucn2+captopril>Ucn2=captopril), endothelin-1 and the natriuretic peptides (Ucn2+captopril=Ucn2>captopril), whereas adrenaline (epinephrine) fell only with Ucn2 (Ucn2+captopril=Ucn2), and vasopressin increased during captopril alone. Ucn2, both separately and in conjunction with captopril, increased urine output, sodium and creatinine excretion and creatinine clearance. Conversely, captopril administered alone adversely affected these renal indices. In conclusion, co-treatment with Ucn2 and an ACEI in heart failure produced significantly greater improvements in haemodynamics, hormonal profile and renal function than achieved by captopril alone. These results indicate that dual treatment with these two agents is beneficial.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aldosterone / blood
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • Arginine Vasopressin / blood
  • Atrial Natriuretic Factor / blood
  • Blood Pressure / drug effects
  • Captopril / therapeutic use*
  • Cardiac Output / drug effects
  • Cardiac Pacing, Artificial
  • Drug Therapy, Combination
  • Endothelin-1 / blood
  • Epinephrine / blood
  • Female
  • Heart Failure / blood
  • Heart Failure / drug therapy*
  • Models, Animal
  • Renin / blood
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology
  • Sheep
  • Urocortins / therapeutic use*
  • Vascular Resistance / drug effects

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Endothelin-1
  • Urocortins
  • Arginine Vasopressin
  • Aldosterone
  • Atrial Natriuretic Factor
  • Captopril
  • Renin
  • Epinephrine