Effects of angiotensin II type 1-receptor blockade on retinal endothelial function
Effects of angiotensin II type 1-receptor blockade on retinal endothelial function
复制标题
血管紧张素 II 1 型受体阻断对视网膜内皮功能的影响
作者：
C. Ott;M. Schlaich;J. Harazny;B. Schmidt;G. Michelson;R. Schmieder
目的高胆固醇血症是包括卒中在内的动脉粥样硬化性血管疾病的重要危险因素。低密度脂蛋白-胆固醇可诱导血管紧张素II 1型受体表达上调，其激活在动脉粥样硬化中起致病作用，可能是通过促进一氧化氮的分解。我们测试了AT1受体阻断是否改善了正常胆固醇血症和高胆固醇血症受试者视网膜血管的内皮功能。方法31例高胆固醇血症患者和17例正常胆固醇血症患者随机分为厄贝沙坦治疗组和安慰剂对照组，采用双盲交叉研究。扫描激光多普勒血流仪测定视网膜毛细血管血流量。弥漫亮度闪烁被用来刺激部分依赖于一氧化氮的血管扩张。结果高胆固醇血症组和正常胆固醇血症组闪光诱导的视网膜毛细血管流量增加相似。与安慰剂相比，在我们的血压值正常的患者中，使用厄贝沙坦治疗可以显著降低血压。因此，我们根据厄贝沙坦治疗后血压下降的中位数来划分研究队列。收缩压下降幅度高于中位数(>；6 mm Hg)的受试者由闪烁引起的视网膜毛细血管流量增加显著高于收缩压低于中位数(≤为6 mm Hg)的受试者(16.2±16%vs6.88±11%；P=0.042)。结论厄贝沙坦阻断AT1受体可改善视网膜血管内皮细胞功能，可作为脑循环模型。
Objective Hypercholesterolemia is an important risk factor for atherosclerotic vascular disease including stroke. Low-density lipoprotein-cholesterol may induce upregulation of angiotensin II type 1 (AT1)-receptors and their activation plays a pathogenetic role in atherosclerosis, possibly via enhanced breakdown of nitric oxide. We tested whether AT1-receptor blockade improved endothelial function of the retinal vasculature in normocholesterolemic and hypercholesterolemic subjects. Methods Thirty-one hypercholesterolemic and 17 normocholesterolemic subjects were randomly assigned to treatment with irbesartan and placebo in a double-blind crossover study. Retinal capillary flow was measured using scanning laser Doppler flowmetry. Diffuse luminance flicker was applied to provoke vasodilation that is in part nitric oxide dependent. Results Flicker-induced increases in retinal capillary flow were similar between hypercholesterolemic and normocholesterolemic subjects. In contrast to placebo, treatment with irbesartan led to a significant reduction of blood pressure, in our patients with normal blood pressure values. Therefore we divided our study cohort according to the median blood pressure reduction in response to irbesartan. Flicker-induced increases in retinal capillary flow were substantially higher in subjects with a systolic blood pressure reduction above median (> 6 mmHg) than in those with a reduction below median (≤6 mmHg) (16.2 ± 16% versus 6.88 ± 11%; P = 0.042). Conclusion AT1-receptor blockade with irbesartan improves endothelial function of the retinal vasculature, taken as a model of cerebral circulation.
影响因子：
20.1
作者：
GRIENDLING, KK;MINIERI, CA;ALEXANDER, RW
通讯作者：
ALEXANDER, RW