Yu Zai-xin, Ou Shu-qi, Lü Yin-zhu
Department of Cardiology, Xiangya Hospital, Central South University, Changsha 410008, China.
Hunan Yi Ke Da Xue Xue Bao. 2003 Jun;28(3):251-4.
To investigate the plasma calcitonin gene-related peptide (CGRP) and endothelin (ET) levels and the effects of nitroglycerin on CGRP and ET in congestive heart failure (CHF), and to make clear the mechanism of nitroglycerin in vasodilation and cardiac protection.
The fast blood samples were taken from the peripheral vein of 40 volunteers and 40 CHF patients to estimate the basal level of CGRP and ET. Infusion of nitroglycerin of 25 to 50 micrograms/min started in the forearm vein of CHF patients. Blood samples were taken at the end of the 1 hour infusion and (12 +/- 2) days of nitroglycerin treatment. Plasma concentrations of CGRP and ET were measured by radioimmunoassay.
In patients with CHF before the treatment, the plasma concentration of CGRP was significantly lower than that in the controls (P < 0.001), but the concentration of ET significantly higher than that in the controls (P < 0.001). During the nitroglycerin treatment, the plasma concentration of CGRP significantly increased (P < 0.001), whereas the concentration of ET significantly decreased (P < 0.01). The mean arterial pressure significantly decreased (P < 0.001).
Nitroglycerin can increase the peripheral plasma CGRP level and decrease the concentration of ET when treating CHF. Intravenous nitroglycerin may be beneficial to the improvement of abnormal haemodynamics and neurohormonal derangement.
探讨充血性心力衰竭(CHF)患者血浆降钙素基因相关肽(CGRP)和内皮素(ET)水平以及硝酸甘油对CGRP和ET的影响,以明确硝酸甘油血管舒张和心脏保护作用的机制。
采集40例志愿者和40例CHF患者外周静脉血样本,测定CGRP和ET基础水平。对CHF患者在前臂静脉开始输注25至50微克/分钟的硝酸甘油。在输注1小时结束时以及硝酸甘油治疗(12±2)天后采集血样。采用放射免疫分析法测定血浆CGRP和ET浓度。
治疗前CHF患者血浆CGRP浓度显著低于对照组(P<0.001),但ET浓度显著高于对照组(P<0.001)。硝酸甘油治疗期间,血浆CGRP浓度显著升高(P<0.001),而ET浓度显著降低(P<0.01)。平均动脉压显著降低(P<0.001)。
硝酸甘油治疗CHF时可升高外周血浆CGRP水平并降低ET浓度。静脉应用硝酸甘油可能有助于改善异常血流动力学和神经激素紊乱。