Ninomiya Yuichi, Hamasaki Shuichi, Ishida Sanemasa, Kataoka Tetsuro, Saihara Keishi, Okui Hideki, Orihara Koji, Fukudome Tsuyoshi, Shinsato Takuro, Ichiki Tomoko, Mizoguchi Etsuko, Otsuji Yutaka, Tei Chuwa
Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University.
J Cardiol. 2006 Sep;48(3):125-32.
Plasma levels of brain natriuretic peptide (BNP) correlate with left ventricular remodeling, but the relationship between BNP induction and coronary function remains unclear.
The present study assessed BNP production in response to left ventricular enlargement and investigated the relationship between BNP production and coronary vasodilating function in patients with left ventricular remodeling.
Patients (n = 63) with normal or mildly diseased coronary arteries underwent Doppler flow study of the left anterior descending coronary artery. Vascular reactivity was examined using intracoronary acetylcholine, papaverine and nitroglycerin using a Doppler guidewire.
Left ventricular end-diastolic dimension was positively correlated with BNP (r = 0.45, p < 0.001) in all patients. BNP was significantly and inversely correlated with percentage change in coronary artery diameter induced by acetylcholine (r = -0.56, p < 0.001) but not by nitroglycerin (r = -0.20, p = 0.28) in patients with left ventricular end-diastolic dimension > or = 55 mm (n = 32). By contrast, BNP was not significantly correlated with percentage change in coronary artery diameter induced by either acetylcholine or nitroglycerin in patients with left ventricular end-diastolic dimension < 55 mm (n = 31). Further, BNP was not correlated with the percentage change in coronary blood flow induced by acetylcholine or by papaverine in patients with or without left ventricular remodeling.
The elevation in plasma BNP levels that occurs in association with left ventricular enlargement is a predictor of impaired endothelium-dependent vasodilation in conductance coronary arteries.
血浆脑钠肽（BNP）水平与左心室重构相关，但BNP诱导与冠状动脉功能之间的关系仍不清楚。
本研究评估了左心室扩大时BNP的产生情况，并探讨了左心室重构患者中BNP产生与冠状动脉舒张功能之间的关系。
63例冠状动脉正常或轻度病变的患者接受了左前降支冠状动脉的多普勒血流研究。使用多普勒导丝，通过冠状动脉内注射乙酰胆碱、罂粟碱和硝酸甘油来检测血管反应性。
所有患者的左心室舒张末期内径与BNP呈正相关（r = 0.45，p < 0.001）。在左心室舒张末期内径≥55 mm的患者（n = 32）中，BNP与乙酰胆碱诱导的冠状动脉直径百分比变化呈显著负相关（r = -0.56，p < 0.001），但与硝酸甘油诱导的变化无相关性（r = -0.20，p = 0.28）。相比之下，在左心室舒张末期内径<55 mm的患者（n = 31）中，BNP与乙酰胆碱或硝酸甘油诱导的冠状动脉直径百分比变化均无显著相关性。此外，无论有无左心室重构，BNP与乙酰胆碱或罂粟碱诱导的冠状动脉血流百分比变化均无相关性。
与左心室扩大相关的血浆BNP水平升高是传导冠状动脉内皮依赖性血管舒张受损的一个预测指标。
