Altman J, Dulas D, Bache R J
Department of Medicine, University of Minnesota Medical School, Minneapolis.
Circ Res. 1992 Jun;70(6):1091-8. doi: 10.1161/01.res.70.6.1091.
Collateral vessels that develop after coronary artery occlusion demonstrate perivascular inflammation, subintimal hyperplasia, and endothelial proliferation. This study was performed to test the hypothesis that these abnormalities are associated with evidence for increased production of vasodilator prostaglandins. Eight dogs were studied 4-6 months after occlusion of the anterior descending coronary artery had been performed to stimulate collateral vessel growth. At the time of study, the anterior descending coronary artery was cannulated at the site of occlusion to allow measurement of retrograde blood flow as an index of interarterial collateral flow. Injection of radioactive microspheres during the retrograde flow collection allowed determination of continuing tissue flow in the collateral-dependent zone as an index of intramural microvascular collateral flow. Retrograde and tissue flows were measured before and 20 minutes after 5 mg/kg i.v. indomethacin, a dose that caused 95 +/- 3% inhibition of the coronary vasodilation in response to a 500 micrograms intracoronary bolus of arachidonic acid. Heart rate and mean aortic pressure were not significantly altered by indomethacin, and blood flow to the normally perfused myocardial region was not changed by administration of indomethacin. However, indomethacin caused a 40 +/- 7% decrease in retrograde flow (p less than 0.01), and microvascular collateral flow to the dependent myocardium decreased by 20 +/- 10% (p less than 0.05). These data indicate that, unlike the normal coronary circulation, well-developed coronary collateral vessels are under the tonic influence of vasodilator prostaglandins.
冠状动脉闭塞后形成的侧支血管表现出血管周围炎症、内膜下增生和内皮细胞增殖。本研究旨在验证这些异常与血管舒张性前列腺素生成增加的证据相关这一假设。在进行冠状动脉前降支闭塞手术以刺激侧支血管生长4 - 6个月后,对8只狗进行了研究。在研究时,在冠状动脉前降支闭塞部位进行插管,以测量逆行血流,作为动脉间侧支血流的指标。在收集逆行血流期间注射放射性微球,可测定侧支依赖区的持续组织血流,作为壁内微血管侧支血流的指标。在静脉注射5mg/kg消炎痛之前和之后20分钟测量逆行血流和组织血流,该剂量可使冠状动脉对500微克冠状动脉内推注花生四烯酸的舒张反应受到95±3%的抑制。消炎痛对心率和平均主动脉压无显著影响,消炎痛给药后,正常灌注心肌区域的血流也未改变。然而,消炎痛使逆行血流减少了40±7%(p<0.01),依赖心肌的微血管侧支血流减少了20±10%(p<0.05)。这些数据表明,与正常冠状动脉循环不同,发育良好的冠状动脉侧支血管受到血管舒张性前列腺素的持续影响。