Angiotensin-converting enzyme inhibition but not angiotensin II type 1 receptor antagonism augments coronary release of tissue plasminogen activator in hypertensive patients
Angiotensin-converting enzyme inhibition but not angiotensin II type 1 receptor antagonism augments coronary release of tissue plasminogen activator in hypertensive patients
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DOI：
10.1016/s0735-1097(03)00162-1
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发表时间：
2003-04-16
影响因子：
24
通讯作者：
Horie, M
中科院分区：
文献类型：
--
作者：
Matsumoto, T;Minai, K;Horie, M
目的比较培哚普利和氯沙坦对内皮依赖性冠状动脉血管舒张功能和纤溶功能的影响。方法将45例高血压患者随机分为3组：培哚普利组16例，对照组30例，观察培哚普利对高血压患者冠脉纤溶功能的影响15例患者接受氯沙坦（50 mg/d）治疗4周; 14例患者未接受培哚普利或氯沙坦治疗（对照组）。在左冠状动脉内给予不同剂量的缓激肽（BK）（0.2、0.6和2.0 μ g/min）。结果缓激肽可使各组大鼠冠状动脉血流量呈剂量依赖性增加。培哚普利组和氯沙坦组BK引起的CBF增加均显著大于对照组。BK可增加各组冠脉组织型纤溶酶原激活物（t-PA）的净释放，培哚普利组的增加幅度大于氯沙坦组和对照组。缓激肽并没有改变纤溶酶原激活物抑制物1型在任何groups.CONCLUSIONS培哚普利和，氯沙坦同样增加BK诱导的冠状动脉血管舒张水平。培哚普利可能比氯沙坦更有可能增强BK诱导的冠脉t-PA释放。(C)2003年由美国心脏病学会基金会。
OBJECTIVES We compared the effects of perindopril and losartan on endothelium-dependent coronary vasomotor and fibrinolytic function.BACKGROUND The renin-angiotensin system regulates the vascular fibrinolytic balance. However, the effects of angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor antagonists on coronary fibrinolytic function have not been compared in hypertensive patients.METHODS Forty-five patients with hypertension were randomly assigned to three groups: 16 patients were treated with perindopril (4 mg/day) for four weeks; 15 were treated with losartan (50 mg/day) for four weeks; and 14 were not treated with either perindopril or losartan (control group). Graded doses of bradykinin (BK) (0.2, 0.6, and 2.0 mug/min) were administered into the left coronary artery. Coronary blood flow (CBF) was evaluated by Doppler flow velocity measurement.RESULTS Bradykinin induced dose-dependent increases in CBF in all groups. The increases in CBF induced by BK in the perindopril and losartan groups were significantly greater than those in the control group. Net coronary tissue-type plasminogen activator (t-PA) release was enhanced by BK in all groups, and the increase in the perindopril group was greater than that in the losartan and control groups. Bradykinin did not alter plasminogen activator inhibitor type 1 levels in any of the groups.CONCLUSIONS Perindopril and, losartan similarly augment BK-induced coronary vasodilation. Perindopril may have a greater potential to enhance the BK-induced coronary release of t-PA than losartan. (C) 2003 by the American College of Cardiology Foundation.