ENDOTHELIAL DYSFUNCTION OF THE CORONARY MICROVASCULATURE IN HYPERTENSION

血管的衬里，称为内皮，能够 释放允许血管放松的物质，以响应 各种刺激。释放的一种因子被称为内皮细胞衍生 松弛因子(EDRF)。乙酰胆碱能促进药物释放 来自血管的EDRF，我们之前已经表明，在患有 高血压，前臂有内皮依赖性异常 微血管系统。这项研究的目的是调查这样的 患者冠状动脉内皮细胞也存在异常。 患有高血压。我们研究了13例高血压患者和正常患者。 正在接受心外膜导管术的冠状动脉 治疗胸痛。其中一些患者血管扩张剂反应减弱。 到快速心房起搏。同样的患者也对 冠状动脉内注射乙酰胆碱。然而，当一个 使用非内皮依赖性血管扩张剂硝普钠，这些 患者的反应正常。因此，患有胸痛的患者 高血压和血管扩张剂储备减少可能与 心脏小血管内皮细胞异常。不过，这个 在所有的冠脉微血管中发现并不是一致的 高血压患者。

The lining of blood vessels, called the endothelium, is capable of releasing substances which allow blood vessels to relax in response to a variety of stimuli. One factor released is known as endothelium-derived relaxant factor (EDRF). Acetylcholine is capable of promoting release of EDRF from blood vessels and we have previously shown that in patients with hypertension, there is an endothelial-dependent abnormality in the forearm microvasculature. This study was designed to investigate if such an endothelial abnormality also exists in the coronary arteries of patients with hypertension. We studied 13 patients with hypertension and normal epicardial coronary arteries who were undergoing cardiac catheterization for chest pain. Some of these patients had a reduced vasodilator response to rapid atrial pacing. The same patients also had reduced response to intracoronary administration of acetylcholine. However, when an endothelial independent vasodilator, nitroprusside, was administered, these patients had a normal response. Thus, chest pain in patients with hypertension and reduced vasodilator reserve may be associated with an endothelial abnormality of the small vessels of the heart. However, this finding is not uniformly present in the coronary microvasculature of all patients with hypertension.