Angiotensin-converting enzyme inhibition restores flow-dependent and cold pressor test-induced dilations in coronary arteries of hypertensive patients
Angiotensin-converting enzyme inhibition restores flow-dependent and cold pressor test-induced dilations in coronary arteries of hypertensive patients
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DOI：
10.1161/01.cir.94.12.3115
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发表时间：
1996-12-15
期刊：
影响因子：
37.8
通讯作者：
Nitenberg, A
中科院分区：
文献类型：
--
作者：
Antony, I;Lerebours, G;Nitenberg, A
背景：高血压患者冷加压试验（CPT）诱导的和流量依赖性的心外膜冠状动脉扩张受损。ACE抑制可以减弱交感神经冠状动脉收缩并增强或恢复内皮依赖性舒张。本研究的目的是确定是否可以恢复正常的冠状动脉扩张反应的ACE抑制剂培哚普利拉在高血压patients.Methods和结果冠状动脉血管反应CPT和罂粟碱诱导的最大增加血流量进行了研究，在10个未经治疗的原发性高血压患者，没有其他危险因素，和血管造影正常冠状动脉之前和之后静脉ACE抑制培哚普利拉。采用定量血管造影术测量冠状动脉左前降支（LAD）和回旋支近端和远端的直径。冠状动脉血流和阻力指数的估计计算与冠状动脉内多普勒导管在远端LAD。培哚普利拉没有改变CPT和罂粟碱的血流动力学反应。作为CPT的反应，培哚普利拉改变了心外膜冠状动脉收缩（-8.4+/-5.8%，P
Background Cold presser test (CPT)-induced and flow-dependent epicardial coronary artery dilations are impaired in patients with hypertension. ACE inhibition can attenuate sympathetic coronary constriction and potentiate or restore endothelium-dependent relaxations. This study was designed to determine whether the ACE inhibitor perindoprilat can restore normal coronary dilative responses in hypertensive patients.Methods and Results Coronary vasomotor responses to CPT and to maximal increase of blood flow induced by papaverine were studied in 10 untreated patients with essential hypertension, no other risk factors, and angiographically normal coronary arteries before and after intravenous ACE inhibition by perindoprilat. Diameters of proximal and distal left anterior descending (LAD) and circumflex coronary arteries were measured by quantitative angiography. Estimates of coronary blood flow and resistance index were calculated with an intracoronary Doppler catheter in the distal LAD. Perindoprilat did not modify the hemodynamic responses to CPT and papaverine. In response to CPT, perindoprilat changed the epicardial coronary constriction (-8.4+/-5.8%, P