Medina Pascual, Segarra Gloria, Martínez-León Juan B, Vila José M, Otero Eduardo, Lluch Salvador
Departamento de Fisología , Facultad de Medicina y Odontologia, Universidad de Valencia, Spain.
Am J Hypertens. 2002 Sep;15(9):798-802. doi: 10.1016/s0895-7061(02)02977-1.
This study was designed to measure cyclic guanosine 3'5' monophosphate (cGMP) formation and relaxation response to sildenafil given either alone or in combination with sodium nitroprusside in saphenous veins obtained from normotensive and hypertensive patients.
Saphenous vein rings were obtained from 13 hypertensive and nine normotensive patients undergoing coronary artery bypass surgery. The vein rings were suspended in organ bath chambers for isometric recording of tension. The effect of sildenafil on sodium nitroprusside-induced cGMP formation was also assessed.
Sildenafil (10 nmol/L to 100 micromol/L) and sodium nitroprusside (0.01 to 100 nmol/L) caused concentration-dependent relaxations that were of greater magnitude in veins from normotensive patients. Sildenafil (1 to 10 micromol/L) amplified the relaxation induced by sodium nitroprusside in both groups of veins, but this effect was more pronounced in veins from hypertensive patients. Levels of cGMP in response to sodium nitroprusside were significantly lower in veins from hypertensive subjects. However, in the presence of sildenafil, the increase in cGMP levels in response to sodium nitroprusside was significantly greater in the hypertensive as compared with the normotensive group.
Although the relaxant effects of sildenafil are less pronounced in veins from hypertensive patients, the synergistic interaction sildenafil-sodium nitroprusside is more effective in veins from hypertensive patients, mainly due to an increase in cGMP accumulation.
本研究旨在测定环磷酸鸟苷(cGMP)的生成以及单独使用或与硝普钠联合使用西地那非对从血压正常和高血压患者获取的大隐静脉舒张反应的影响。
从13例接受冠状动脉搭桥手术的高血压患者和9例血压正常的患者获取大隐静脉环。将静脉环悬挂于器官浴槽中进行张力的等长记录。还评估了西地那非对硝普钠诱导的cGMP生成的影响。
西地那非(10 nmol/L至100 μmol/L)和硝普钠(0.01至100 nmol/L)引起浓度依赖性舒张,在血压正常患者的静脉中舒张幅度更大。西地那非(1至10 μmol/L)增强了两组静脉中硝普钠诱导的舒张,但这种作用在高血压患者的静脉中更明显。高血压患者静脉中对硝普钠反应的cGMP水平显著较低。然而,在存在西地那非的情况下,与血压正常组相比,高血压组中对硝普钠反应的cGMP水平升高显著更大。
尽管西地那非在高血压患者静脉中的舒张作用不太明显,但西地那非 - 硝普钠的协同相互作用在高血压患者静脉中更有效,主要是由于cGMP积累增加。