Title:
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The effects of TRIAC on developing and growing rat heart muscle and its modification by certain therapeutic agents : with reference to a possible pathogenesis of hypertrophic cardiomyopathy
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Hypertrophic cardiomyopathy is a heart muscle disease of
unknown cause. This thesis describes a study, using the
rat, which explores clinical evidence that thyroid hormones,
especially their analogues, may play an important role in
the pathogenesis of the disease.
Triiodothyroacetic acid, triac, has been administered to
pregnant rats and has produced, in the young offspring,
cardiac hypertrophy and, at the ultrastructural level, an
increase in the extent of myofibrillar disarray. Both of
these pathological features are seen in hypertrophic
cardiomyopathy in man.
A series of experiments was designed to define the hitherto
unknown site of action of triac. This compound was
administered concurrently with selected antagonist drugs
with each or all of the following activities; beta
adrenergic blockade, membrane stabilisation and
sympathomimetic activity. Oxprenolol, dl and d propranolol,
and procainamide prevented the disarray but not the
hypertrophy, and timolol had no effect. The results
suggested that the most important property involved in the
prevention of the action of triac was that of membrane
stabilisation. A low dose of the calcium antagonist
verapamil reduced both the triac induced disarray and
hypertrophy, suggesting that triac may act by increasing
intracellular calcium. This suggestion was supported by an experiment using the calcium ionophore A23187. This
compound did not affect the action of triac, but, when
administered alone, produced hypertrophy and disarray in the
hearts of the offspring.
An attempt was made to produce pathological features of
hypertrophic cardiomyopathy, at the histological and
macroscopic levels, by attempting to enhance the actions of
triac so far delineated. For this purpose a beta 1 agonist,
prenalterol, was used together with triac. This combination
was administered to the offspring of treated rats until they
were 3 months old. Severe cardiac hypertrophy was produced
but not disarray.
Additional experiments showed that thyroxine produced the
same effects as triac but that a much higher dose was
required. Triac was also given during different stages of
pregnancy and was shown to be most effective during the
early stage.
These studies have shown the hitherto unknown site of action
of triac on developing rat myocardium. They have also
demonstrated how the influence of chemical and biological
agents may be explored in the search for possible
contributory factors in the pathogenesis of hypertrophic
card iomyopathy.
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