EFFECTS OF ATRIAL NATRIURETIC PEPTIDE ON THE CORONARY ARTERIAL VASCULATURE IN HUMANS
EFFECTS OF ATRIAL NATRIURETIC PEPTIDE ON THE CORONARY ARTERIAL VASCULATURE IN HUMANS
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DOI：
10.1161/01.cir.80.6.1627
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发表时间：
1989-12-01
期刊：
影响因子：
37.8
通讯作者：
COBB, FR
中科院分区：
文献类型：
--
作者：
CHU, A;MORRIS, KG;COBB, FR
合成的28-氨基酸α-对17例患者进行了近端冠状动脉心钠素（ANP）和冠状动脉血流量的测定。通过数字血管造影术定量近端冠状动脉尺寸，并且用3F多普勒血流导管定量冠状动脉血流，当在左心室中以2.5 μ g/kg推注给予时，ANP引起从3.49 ± 0.0001 μ g/kg持续显著的近端冠状动脉扩张。0.57到4.09 .+-. 0.76 mm，持续时间超过30分钟。冠状动脉内注射0.3 mg硝酸甘油后，近端冠状动脉直径没有进一步增加（4.08 ± 0.05）。0.79 mm）。在ANP后5分钟，冠状动脉血流（阻力冠状动脉扩张）没有显著增加（87 ± 0.01）。55到102 .+-. 54 vol流量单位），表明近端冠状动脉扩张不是流量依赖性的。持续性近端冠状动脉扩张与主动脉压和左心室舒张末期压的轻微和短暂降低以及心率、心输出量和左心室收缩力的轻微和短暂增加相关。血浆心钠素水平从39.8 ± 0.01显著增加了6倍以上。8.8至245.8 .+-。168.5 pg ml。近端冠状动脉扩张的时间进程与血浆环磷酸鸟苷的增加时间进程的关系比血浆心钠素的关系更密切。该研究表明，ANP（2.5 μ g/kg）（一种内源性血管扩张剂）的推注引起显著的持续优先近端冠状动脉扩张和心脏和全身血液动力学的短暂微小变化。虽然还需要更多的研究来评估其作为冠状动脉扩张剂在治疗冠状动脉疾病中的临床疗效，但这些数据表明ANP在缺血治疗中的潜力。
The effects of the synthetic 28-amino-acid .alpha.-human atrial natriuretic peptide (ANP) on the proximal coronary arteries and coronary blood flow were evaluated in 17 patients. Proximal coronary dimension was quantitated by digital angiography, and coronary flow was quantitated with 3F Doppler flow catheters ANP, when given as a 2.5-.mu.g/kg bolus in the left ventricle, caused sustained significant proximal coronary dilations from 3.49 .+-. 0.57 to 4.09 .+-. 0.76 mm, lasting more than 30 minutes. The proximal coronary diameter did not increase further after intrcoronary injection of 0.3 mg nitroglycerin (4.08 .+-. 0.79 mm). Coronary flow (resistance coronary dilation) was not significantly increased at 5 minutes after ANP (87 .+-. 55 to 102 .+-. 54 vol flow units), indicating that the proximal coronary dilations were not flow dependent. The persistent proximal coronary dilations were associated with minor and transient decreases in aortic pressure and left ventricular end-diastolic pressure and with minor and transient increases in heart rate, cardiac output, and left ventricular contractility. Plasma ANP level increased significantly by more than sixfold from 39.8 .+-. 8.8 to 245.8 .+-. 168.5 pg ml. The time course of proximal coronary dilations was related more closely to the time course of increase in plasma cyclic guanosine monophosphate than that of plasma ANP. This study demonstrates that bolus injection of ANP (2.5 .mu.g/kg), an endogenous vasodilator, caused marked sustained preferential proximal coronary dilations and brief minor changes in cardiac and systemic hemodynamics. Although additional studies are needed to assess its clinical efficacy as a coronary dilator in the treatment of coronary artery disease, these data suggest a potential of ANP in the therapy of ischemia.