Basal release of endothelium-derived nitric oxide at site of spasm in patients with variant angina
Basal release of endothelium-derived nitric oxide at site of spasm in patients with variant angina
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DOI：
10.1016/0735-1097(96)00021-6
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发表时间：
1996-05-01
影响因子：
24
通讯作者：
Takeshita, A
中科院分区：
文献类型：
--
作者：
Egashira, K;Katsuda, Y;Takeshita, A
目标。本研究的目的是研究变异型心绞痛患者痉挛部位一氧化氮的基础释放。我们先前报道，在冠状动脉痉挛部位，内皮依赖性的扩张器对乙酰胆碱、P物质和缓激肽的反应被保留下来，然而，目前尚不清楚痉挛部位内皮衍生的一氧化氮的基础释放是否发生改变。方法：观察冠状动脉内注射N-G-单甲基-L-精氨酸(一种一氧化氮合成抑制剂)50、100和200mmol3个累积剂量对冠状动脉基础张力的影响，并与8名对照组比较，用定量冠状动脉造影术评价大的心外膜冠状动脉的内径。结果：所有变异型心绞痛患者冠脉内注射乙酰胆碱均可诱发冠脉痉挛，L-尼莫地平不改变动脉压和心率，但显著缩小痉挛和非痉挛部位的冠状动脉内径。痉挛部位对L-NMMA的收缩反应显著大于非痉挛部位的收缩反应(收缩200mmol22+/-7%，平均+/-7%)。变异型心绞痛患者非痉挛部位对L的收缩反应与对照组相当。这些发现支持变异型心绞痛患者痉挛部位基础一氧化氮释放可能不会减少的假设。
Objectives. The aim of this study was to investigate the basal release of nitric oxide at spastic sites in patients with variant angina.Background. We previously reported that endothelium-dependent dilator responses to acetylcholine, substance P and bradykinin are preserved at the site of coronary artery spasm, However, it is not known whether the basal release of endothelium- derived nitric oxide is altered at the spastic site.Methods, The effects of intracoronary N-G-monomethyl-L-arginine (L-NMMA, an inhibitor of nitric oxide synthesis) at cumulative doses of 50, 100 and 200 mu mol on basal coronary artery tone were investigated in eight patients with variant angina and normal coronary angiograms and in eight control subjects, The lumen diameters of large epicardial coronary arteries were assessed by quantitative coronary arteriography.Results, Coronary spasm was provoked by the intracoronary administration of acetylcholine in all patients with variant angina, L-NMMA did not alter the arterial pressure and heart rate but significantly decreased the coronary artery diameter at spastic and nonspastic sites. Constrictive responses to L-NMMA were significantly greater (p < 0.01) at the spastic site (constriction by 200 mu mol, 22 +/- 7%, mean +/- SD) than at the nonspastic site (10 +/- 7%). Constrictive responses to L-NMMA at the nonspastic site in patients with variant angina were comparable to those in the control subjects.Conclusions. These findings support the hypothesis that the basal release of nitric oxide may not be decreased at the spastic site in patients with variant angina.