Enhanced coronary arteriolar contraction to vasopressin in patients with diabetes after cardiac surgery.
Enhanced coronary arteriolar contraction to vasopressin in patients with diabetes after cardiac surgery.
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DOI：
10.1016/j.jtcvs.2018.05.090
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Feng J
中科院分区：
文献类型：
--
作者：
Sellke N;Kuczmarski A;Lawandy I;Cole VL;Ehsan A;Singh AK;Liu Y;Sellke FW;Feng J
在接受心脏手术的糖尿病患者中心脏骤停（CP）和体外循环（CPB）与冠状动脉血管舒缩功能障碍有关。我们假设在CP/CPB的情况下，糖尿病可能上调抗利尿激素受体的表达并改变冠状动脉对抗利尿激素的收缩反应。取行心脏手术的糖尿病（DM）和非糖尿病（ND）患者（n = 8/每组）在CP/CPB前后的右心房组织样本。取右心房组织标本中分离的冠状动脉（80-150μm），在无血流状态下插管加压（40 mmHg）。用视频显微镜测量直径的变化。免疫印迹法和免疫组织化学法检测抗利尿激素V1A和1B受体在心房组织中的蛋白表达/定位。ND组和DM组cp /CPB后冠状动脉对抗利尿激素的收缩反应均显著增加。糖尿病患者的血管比非糖尿病患者的血管更明显（P<0.05）。在ND和DM血管中存在特异性V1A拮抗剂SR 49059（10−7M）时，抗利尿激素诱导的冠状动脉收缩反应均被抑制（P<0.05）。ND组和DM组大鼠cp后/CPB蛋白水平均显著高于cp前/CPB水平（P<0.05）， DM组V1A蛋白水平高于ND组（P<0.05）。免疫组化染色进一步表明，V1B受体主要在心肌中表达，而在血管平滑肌中不表达。CP/CPB和糖尿病都与人心肌V1受体表达/定位上调有关。抗利尿激素可能通过V1A受体诱导冠状动脉收缩。这种改变可能导致接受CP/CPB和心脏手术的糖尿病患者冠状动脉痉挛增加。
Cardioplegic arrest (CP) and cardiopulmonary bypass (CPB) are associated with vasomotor dysfunction of coronary arterioles in diabetic patients undergoing cardiac surgery. We hypothesized that diabetes may up-regulate vasopressin receptor expression and alter the contractile response of coronary arterioles to vasopressin in the setting of CP/CPB. Right atrial tissue samples of diabetic (DM) and non-diabetic (ND) patients (n = 8/ each group) undergoing cardiac surgery were harvested before and after CP/CPB. The isolated coronary arterioles (80–150μm) dissected from the harvested right atrial tissue samples, were cannulated and pressurized (40 mmHg) in a no-flow state. The changes in diameter were measured with video microscopy. The protein expression/localization of vasopressin V1A and 1B receptors in the atrial tissue were measured by immune-blotting and immunohistochemistry. The pre-CP/CPB contractile responses of the coronary arterioles to vasopressin were significantly increased post-CP/CPB in both ND and DM groups. This effect was more pronounced in the vessels from patients with diabetes than that of vessels from nondiabetic patients (P<0.05). Vasopressin-induced contractile response of the coronary arterioles was inhibited in the presence of the specific V1A antagonist SR 49059 (10−7M) in both ND and DM vessels (P<0.05). The post-CP/CPB protein levels of V1A were significantly increased compared with pre-CP/CPB values in both ND and DM groups (P<0.05), whereas, this increase was higher in DM than that of ND (P<0.05). Immunohistochemistry staining further indicates that V1B receptors were mainly expressed in the myocardium, but not in vascular smooth muscle. CP/CPB and diabetes are both associated with up-regulation in V1 receptor expression/localization in human myocardium. Vasopressin may induce coronary arteriolar constriction via V1A receptors. This alteration may lead to increased coronary arteriolar spasm in diabetic patients undergoing CP/CPB and cardiac surgery.
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发表时间：
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期刊：
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影响因子：
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