The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics.
The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics.
复制标题
DOI：
10.1016/j.jacc.2017.09.1064
复制
发表时间：
2017-11-07
影响因子：
24
通讯作者：
Loscalzo J
中科院分区：
文献类型：
--
作者：
Divakaran S;Loscalzo J
硝酸甘油在1847年首次合成后不久就开始用于治疗心绞痛。从那时起，一氧化氮作为一种生物效应物的发现，以及对其在血管舒张、细胞通透性、血小板功能、炎症和其他血管过程中的作用的更好理解，通过一氧化氮依赖和独立的机制，提高了我们对有机硝酸盐治疗的血流动力学（主要通过电容和电导动脉的血管舒张介导）和非血流动力学效应的认识。硝酸盐可从粘膜、胃肠道和皮肤中迅速吸收，因此，硝酸甘油有几种制剂，可通过几种途径给药：口服片剂、舌下片剂、口腔片剂、舌下喷雾剂、透皮软膏和透皮贴剂；它也有静脉注射剂型。有机硝酸盐通常用于治疗心血管疾病，但临床资料限制其主要用于治疗心绞痛。它们也用于治疗心衰和肺动脉高压患者的亚群。使用硝酸盐的一个主要问题是耐受性的发展。虽然已经研究了几种用于预防硝酸盐耐受的药物，但由于缺乏支持性临床数据，目前没有一种药物被推荐使用。只有一种预防硝酸盐耐受性的方法仍然被广泛接受：使用在每24小时内提供无或低硝酸盐暴露间隔的剂量策略。一氧化氮在几种心血管疾病机制中的重要作用继续推动研究寻找新的方法来影响这一关键分子介质的内源性和外源性来源。
The use of nitroglycerin in the treatment of angina pectoris began not long after its original synthesis in 1847. Since then, the discovery of nitric oxide as a biological effector and better understanding of its roles in vasodilation, cell permeability, platelet function, inflammation, and other vascular processes have advanced our knowledge of the hemodynamic (mostly mediated through vasodilation of capacitance and conductance arteries) and non-hemodynamic effects of organic nitrate therapy, via both nitric oxide-dependent and independent mechanisms. Nitrates are rapidly absorbed from mucous membranes, the gastrointestinal tract, and the skin, and, thus, nitroglycerin is available in several preparations for delivery via several routes: oral tablets, sublingual tablets, buccal tablets, sublingual spray, transdermal ointment, and transdermal patch; it is also available in intravenous formulations. The organic nitrates are commonly used in the treatment of cardiovascular disease, but clinical data limit their use mostly to the treatment of angina. They are also used in the treatment of subsets of patients with heart failure and pulmonary hypertension. One major problem with the use of nitrates is the development of tolerance. Although several agents have been studied for use in the prevention of nitrate tolerance, none are currently recommended owing to a paucity of supportive clinical data. Only one method of preventing nitrate tolerance remains widely accepted: the use of a dosing strategy that provides an interval of no or low nitrate exposure during each 24-hour period. Nitric oxide’s important role in several cardiovascular disease mechanisms continues to drive research toward finding novel ways to affect both endogenous and exogenous sources of this key molecular mediator.
登录
查看更多内容
DOI：
10.1073/pnas.74.8.3203
发表时间：
1977-01-01
影响因子：
11.1
作者：
ARNOLD, WP;MITTAL, CK;MURAD, F
通讯作者：
MURAD, F
影响因子：
--
作者：
Chirinos, Julio A;Zamani, Payman
通讯作者：
Zamani, Payman
AVE 3085 是一种新型内皮一氧化氮合酶增强剂，通过 Smad 信号通路减弱小鼠心脏重塑
影响因子：
3.9
作者：
Chen, Yili;Chen, Cong;Dong, Yugang
通讯作者：
Dong, Yugang
DOI：
10.1007/164_2016_100
发表时间：
2017-01-01
期刊：
HEART FAILURE
影响因子：
--
作者：
Breitenstein, Stefanie;Roessig, Lothar;Lewis, Kelly S.
通讯作者：
Lewis, Kelly S.
影响因子：
2.8
作者：
CHRYSANT, SG;GLASSER, SP;CASARETO, R
通讯作者：
CASARETO, R