Effects of intravenous atrial natriuretic peptide and nitroglycerin on coronary vasdilation and flow velocity determined using 3 T magnetic resonance imaging in patients with nonischemic heart failure
Effects of intravenous atrial natriuretic peptide and nitroglycerin on coronary vasdilation and flow velocity determined using 3 T magnetic resonance imaging in patients with nonischemic heart failure
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静脉注射心钠肽和硝酸甘油对非缺血性心力衰竭患者冠状动脉舒张和血流速度的影响（3 T 磁共振成像测定）
DOI：
10.1007/s00380-012-0292-z
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发表时间：
2013
期刊：
影响因子：
1.5
通讯作者：
Minoru Yoshiyama
中科院分区：
文献类型：
--
作者：
Shoichi Ehara;Yasuhiro Nakamura;Kenji Matsumoto;Takao Hasegawa;Kenei Shimada;Masahiko Takagi;Akihisa Hanatani;Yasukatsu Izumi;Masahiro Terashima;Minoru Yoshiyama
虽然心房钠尿肽（ANP）被广泛应用于充血性心力衰竭（CHF）患者，但其对心外膜冠状动脉的影响却知之甚少。磁共振成像（MRI）能够精确测量冠状动脉血管舒张和流速。本研究应用3 T磁共振成像技术，观察心力衰竭患者静脉滴注心钠素（ANP）或硝酸甘油（NTG）后，心外膜冠状动脉直径和血流速度的变化。研究队列共包括14名受试者，其中8名CHF患者和6名健康志愿者作为对照，随机分为两组：ANP组（0.03 μg/kg/min）和NTG组（0.3 μg/kg/min）。在基线、药物输注期间和停止药物输注后的两个后续时间点，在同一平面内切片中获得右冠状动脉的横截面MR血管造影和相位对比流速。两组药物输注后15 min冠状动脉截面积均较基线显著增加，但ANP组停药后15 min出现晚峰。两组的血流速度无显著差异。此外，NTG虽然增加了心率，但在ANP组中没有发现这种变化。3 T MRI可同时测量冠状动脉血管舒张和血流速度.结果表明，ANP对冠状动脉的舒张作用和对血流速度的影响不亚于NTG，且对心率无明显影响。
Although atrial natriuretic peptide (ANP) is widely used in patients with congestive heart failure (CHF), little is known about its effect on epicardial coronary arteries. Magnetic resonance imaging (MRI) enables precise measurement of coronary vasodilation and flow velocity. In this study, we examined the changes in epicardial coronary artery size and flow velocity in response to intravenous infusion of ANP or nitroglycerin (NTG) by using 3 T MRI in patients with CHF. The study cohort contained a total of 14 subjects: 8 patients with CHF and 6 healthy volunteers as controls, randomly divided into two groups: the ANP group (0.03 μg/kg/min) and the NTG group (0.3 μg/kg/min). Cross-sectional MR angiography and phase-contrast flow velocity of the right coronary artery in the same in-plane slice were obtained at the baseline, during drug infusion, and at two subsequent time points after stopping drug infusion. A significant increase was observed in the coronary cross-sectional area at 15 min after drug infusion in both groups compared with that at baseline; however, a late peak was observed at 15 min after stopping infusion in the ANP group. No significant differences were detected in the flow velocity in both groups. Furthermore, although NTG increased the heart rate, this change was not found in the ANP group. Coronary vasodilation and flow velocity can be measured simultaneously using 3 T MRI. Using this method, we showed that the effects of ANP on the coronary artery vasodilation and flow velocity were not inferior to those of NTG, with no significant alteration in heart rate.