Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization
Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization
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DOI：
10.1152/ajpheart.00625.2004
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发表时间：
2005-03-01
影响因子：
4.8
通讯作者：
Sinoway, LI
中科院分区：
文献类型：
--
作者：
McNulty, PH;King, N;Sinoway, LI
补氧对心导管术患者冠脉血流量的影响。Am J Physiol心圈Physiol288：H1057-H1062,2005年；DOI：10.1152/ajpheart。00625.2004。心脏病患者经常需要补充氧气。尽管氧气可以在许多血管床上表现出血管活性，但它对冠脉循环的影响还没有完全确定。为了研究临床上补充氧气对冠状动脉血流量(CBF)的影响，我们对18例稳定性冠心病患者进行了面罩吸氧15min对CBF的影响(通过冠状动脉多普勒血流导线)、导管冠状动脉内径、CBF对血管内皮依赖性扩张剂和非内皮依赖性扩张剂腺苷的反应，以及动脉和冠状动脉静脉中一氧化氮(NO)代谢产物硝基酪氨酸、亚硝酸根和硝酸根的浓度。与呼吸室内空气相比，呼吸100%氧气使冠脉阻力增加约40%，使脑血流量减少约30%，增加冠脉静脉血浆中硝基酪氨酸的出现，并显著钝化CBF对ACh的反应。吸氧可引起这些改变，但不影响大管状冠状动脉的内径、冠脉静脉中NO2-和NO3-的浓度，也不影响冠脉血管扩张剂对腺苷的反应。给接受心导管置入术的患者补充氧气可显著增加冠脉血管阻力，其机制可能涉及冠脉微循环内一氧化氮的氧化猝灭。
Effects of supplemental oxygen administration on coronary blood flow in patients undergoing cardiac catheterization. Am J Physiol Heart Circ Physiol 288: H1057 - H1062, 2005; doi: 10.1152/ ajpheart. 00625.2004. Patients with heart disease are frequently treated with supplemental oxygen. Although oxygen can exhibit vasoactive properties in many vascular beds, its effects on the coronary circulation have not been fully characterized. To examine whether supplemental oxygen administration affects coronary blood flow ( CBF) in a clinical setting, we measured in 18 patients with stable coronary heart disease the effects of breathing 100% oxygen by face mask for 15 min on CBF ( via coronary Doppler flow wire), conduit coronary diameter, CBF response to intracoronary infusion of the endothelium- dependent dilator ACh and to the endothelium- independent dilator adenosine, as well as arterial and coronary venous concentrations of the nitric oxide ( NO) metabolites nitrotyrosine, NO2-, and NO3-. Relative to breathing room air, breathing of 100% oxygen increased coronary resistance by similar to 40%, decreased CBF by similar to 30%, increased the appearance of nitrotyrosine in coronary venous plasma, and significantly blunted the CBF response to ACh. Oxygen breathing elicited these changes without affecting the diameter of large- conduit coronary arteries, coronary venous concentrations of NO2- and NO3-, or the coronary vasodilator response to adenosine. Administering supplemental oxygen to patients undergoing cardiac catheterization substantially increases coronary vascular resistance by a mechanism that may involve oxidative quenching of NO within the coronary microcirculation.