Nishimura Y, Yu Y, Kotani Y, Nishiuma T, Lin S, Maeda H, Yokoyama M
First Department of Internal Medicine, Kobe University School of Medicine, Kobe, Japan.
Respiration. 2001;68(1):41-5. doi: 10.1159/000050461.
Increased concentrations of exhaled nitric oxide (NO) correlate with increased airway inflammation and measurement of exhaled NO is a noninvasive method for the management of bronchial asthma. In various cardiac diseases, bronchial hyperresponsiveness is observed, as is bronchial asthma. However, there have been few studies on the relationship between exhaled NO and bronchial responsiveness in cardiac diseases.
The aim of this study was to clarify the association between exhaled NO and bronchial hyperresponsiveness in patients with cardiac disease.
We measured expired NO and bronchial responsiveness to inhaled methacholine in 19 patients with cardiac diseases and 17 with bronchial asthma. We divided the cardiac disease patients into two groups according to their bronchial responsiveness to inhaled methacholine: BHR(+) group consisted of 12 patients with bronchial hyperresponsiveness and BHR(-) group consisted of 7 patients without bronchial hyperresponsiveness.
The concentration of exhaled NO in the asthmatic patients was significantly higher than that in the BHR(+) and BHR(-) groups (142.0 +/- 17.0, 33.6 +/- 6.4 and 42.3 +/- 10.3 ppb, respectively, p < 0.01). There was no significant difference in exhaled NO between BHR(+) and BHR(-) groups. There were also no significant differences in the parameters of bronchial hyperresponsiveness between the cardiac BHR(+) and bronchial asthma groups. These results indicate that bronchial hyperresponsiveness in patients with cardiac diseases is not a consequence of eosinophilic inflammation or of exhaled NO.
We conclude that bronchial hyperresponsiveness in patients with cardiac diseases can occur independently of NO production.
呼出一氧化氮（NO）浓度升高与气道炎症增加相关，呼出NO的测量是支气管哮喘管理的一种非侵入性方法。在各种心脏疾病中，与支气管哮喘一样，也观察到支气管高反应性。然而，关于心脏疾病中呼出NO与支气管反应性之间的关系，研究较少。
本研究旨在阐明心脏疾病患者呼出NO与支气管高反应性之间的关联。
我们测量了19例心脏疾病患者和17例支气管哮喘患者的呼出NO以及对吸入乙酰甲胆碱的支气管反应性。我们根据心脏疾病患者对吸入乙酰甲胆碱的支气管反应性将其分为两组：BHR(+)组由12例支气管高反应性患者组成，BHR(-)组由7例无支气管高反应性患者组成。
哮喘患者的呼出NO浓度显著高于BHR(+)组和BHR(-)组（分别为142.0±17.0、33.6±6.4和42.3±10.3 ppb，p<0.01）。BHR(+)组和BHR(-)组之间的呼出NO无显著差异。心脏BHR(+)组和支气管哮喘组之间的支气管高反应性参数也无显著差异。这些结果表明，心脏疾病患者的支气管高反应性不是嗜酸性粒细胞炎症或呼出NO的结果。
我们得出结论，心脏疾病患者的支气管高反应性可独立于NO产生而发生。
