Adaptation of vasomotor function of human coronary Arterioles to the simultaneous presence of obesity and hypertension
Adaptation of vasomotor function of human coronary Arterioles to the simultaneous presence of obesity and hypertension
复制标题
DOI：
10.1161/atvbaha.107.147991
复制
发表时间：
2007-11-01
影响因子：
8.7
通讯作者：
Bagi, Zsolt
中科院分区：
文献类型：
--
作者：
Fulop, Tibor;Jebelovszki, Eva;Bagi, Zsolt
目的-我们假设肥胖和高血压同时存在会激活影响人类冠状动脉扩张的适应性血管机制。方法和结果-在接受心脏手术的患者（n = 38）的分离加压冠状动脉中评估激动剂诱导的扩张。在血压正常者中，我们发现肥胖受试者对缓激肽 (BK) 和 NO 供体硝普钠 (SNP) 的扩张减少（BK，10(-7) mol/L，瘦：90 +/- 4%，肥胖：64 +/- 7%；SNP，10(-6) mol/L，瘦：89 +/- 7%，肥胖：76 +/- 5%）。然而，在高血压患者中，与瘦个体相比，肥胖患者中 BK 和 SNP 诱导的扩张均显着增强（BK，瘦：71 +/- 7%，肥胖：85 +/- 3%；SNP，瘦：60 +/- 6%，肥胖：83 +/- 2%）。相应地，在高血压患者中，体重指数 (BMI) 与 BK 诱发的 (P = 0.036，r = 0.46) 以及 SNP 诱发的 (P = 0.031，r = 0.44) 冠状动脉扩张之间不存在正相关，但在血压正常的患者中则不然。此外，还对另外 55 名高血压患者的血流介导 (FMD) 和硝酸甘油 (NTG) 诱导的肱动脉扩张进行了评估。在肥胖高血压患者中，FMD 和 NTG 引起的扩张（FMD：6.2 +/- 0.7%，NTG：17.2 +/- 0.9%）比瘦高血压患者（FMD：3.7 +/- 0.6%，NTG：13.6 +/- 1.1%）更大。相应地，FMD 和 NTG 诱导的扩张与 BMI 呈正相关（分别为 P = 0.020，r = 0.31 和 P = 0.033，r = 0.29）。结论——这些发现首次表明肥胖可能导致适应性血管机制的激活，从而增强高血压患者冠状动脉和外周动脉血管的扩张功能。
Objectives-We hypothesized that simultaneous presence of obesity and hypertension activates adaptive vascular mechanisms affecting dilations of human coronary arterioles.Methods and Results-Agonist- induced dilations were assessed in isolated pressurized coronary arterioles from patients (n = 38) who underwent cardiac surgery. Among normotensives we found that dilations to bradykinin (BK) and the NO- donor, sodium- nitroprusside (SNP) were reduced in obese subjects (BK, 10(-7) mol/ L, lean: 90 +/- 4%, obese: 64 +/- 7%; SNP, 10(-6) mol/L, lean: 89 +/- 7%, obese: 76 +/- 5%). However, among hypertensives, both BK- and SNP-induced dilations were significantly enhanced in obese patients, when compared with lean individuals (BK, lean: 71 +/- 7%, obese: 85 +/- 3%; SNP, lean: 60 +/- 6%, obese: 83 +/- 2%). Correspondingly, in hypertensive patients, but not in those of normotensives, a positive correlation was found between body mass index (BMI) and BK- induced (P = 0.036, r = 0.46), and also SNP- evoked (P = 0.031, r = 0.44) coronary dilations. Moreover, in additional 55 hypertensive patients flow- mediated (FMD) and nitroglycerin (NTG)- induced dilations of the brachial artery were assessed. In obese hypertensive individuals, FMD- and NTG- induced dilations were greater (FMD: 6.2 +/- 0.7%, NTG: 17.2 +/- 0.9%), than in lean hypertensive patients (FMD: 3.7 +/- 0.6%, NTG: 13.6 +/- 1.1%). Correspondingly, FMD- and NTG- induced dilations were positively correlated with BMI (P = 0.020, r = 0.31 and P = 0.033, r = 0.29, respectively).Conclusions-These findings are the first to suggest that obesity may lead to activation of adaptive vascular mechanisms to enhance the dilator function of coronary and peripheral arterial vessels in hypertensive patients.