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. In the heart of uremic animals and patients, the number of capillaries per volume of myocardium is reduced. Immunohistochemical studies demonstrated increased cardiac endothelin-1 (ET-1) expression in the left ventricle of uremic animals. Therefore, whether treatment with a selective ET A -receptor antagonist prevented such capillary-myocyte mismatch was investigated. Twenty-four h after subtotal nephrectomy, rats were left untreated or started on treatment with the ET A -receptor antagonist LU 135252 (20 mg/kg per d) and with the angiotensin-converting enzyme (ACE) inhibitor trandolapril (0.3 mg/kg per d), respectively. BP was monitored by telemetry. Myocardial capillary length density was analyzed by stereologic techniques that avoid anisotropy artifacts. In addition, cardiac ET-1 protein and mRNA were measured using immunohistochemistry, in situ hybridization, and quantitative reverse transcription—PCR. Changes in cardiac ET A -and ET B -PCR. receptor mRNA were measured using reverse transcription—PCR. Fifteen wk after subtotal nephrectomy, significantly reduced left ventricular capillary length density (3307 ± 535 mm/mm 3 ) was found compared with sham-operated controls (3995 ± 471 mm/mm 3 ); this was also seen in animals that were treated with trandolapril (3503 ± 533 mm/mm 3 ) but not in animals that were treated with LU 135252 (3800 ± 303 mm/mm 3 ). The results support a role of ET-1 in the genesis of left ventricular capillary/myocyte mismatch in uremia.

Endothelin A Receptor Blockade Prevents Capillary/Myocyte Mismatch in the Heart of Uremic Animals