n increasing number of clinical studies have revealed that cardiac hypertrophy is a powerful risk factor for sudden cardiac death, probably because of myocardial ischaemia. 1,2-5 Our previous study showed that left ventricular (LV) hypertrophy in the rat increases the animal's vulnerability to ventricular arrhythmias induced by LV ischaemia and reperfusion. 6 Impairment of the coronary circulation, therefore, may play a major role in the cardiac sudden death associated with LV hypertrophy. In the clinical setting, most cases of LV hypertrophy are mediated by systemic hypertension or valve disease, but it is not known if LV hypertrophy mediates coronary disorder and impairs both the left and right coronary circulation. A disorder of the right coronary circulation in the presence of LV hypertrophy should be considered, especially with regard to the treatment of ischemic heart disease. 7 In the rat LV pressure-overload model, LV hypertrophy is associated with impaired coronary circulation 8-13 that can be normalized by administration of an angiotensin converting enzyme (ACE) inhibitor. 11,12,14,15 In previous in vitro studies, [8][9][10][11][12][13] however, the total coronary flow rate (combined flow rate in the left and right coronary beds) was measured with a conventional Langendorff perfusion system in order to calculate the indices of coronary circulation, but such indices may reflect the mean of the left and right coronary beds, which could be very different from each other. The changes in coronary circulation that occur in the individual coronary arterial beds in LV hypertrophy have never been studied and are still unknown.The objectives of this study were to determine, in a rat model of pressure-overload LV hypertrophy, 16 (i) the changes that occur in coronary reserve in the left and right coronary arterial beds, with and without ACE inhibition, and (ii) the concomitant changes that occur in arterial pressure and LV mass. To achieve those objectives, we exploited the advantages of a dual coronary perfusion model 17 that enables independent perfusion of left and right coronary beds, which supply predominantly the hypertrophied LV and non-hypertrophied right ventricle, respectively.
MethodsThis investigation was performed in accordance with the Home Office Guidance on the Operation of the Animals (Scientific Procedures) Act 1986, published by Her Majesty's Stationery Office, London.
Induction of Aortic ConstrictionDetails of the surgical procedure have been described previously. 17 In brief, male Wistar rats (body weight, 170± 9 g) were anesthetized with Hypnorm (0.3 ml/kg body weight im) and diazepam (2.5 mg/kg body weight ip). Via a small abdominal incision, the aorta was isolated and cleared of surrounding tissue. A small titanium clip (Atrauclip, Rusch UK Ltd, High Wycombe, UK) was placed around the suprarenal aorta with specially adapted pliers set to a width of 0.45 mm. The incision was closed with vicryl and silk sutures and the rats were left to recover under a heating lamp. The rats were closely obs...