Popma J J, Smitherman T C, Bedotto J B, Eichhorn E J, Said S I, Dehmer G J
Cardiac Catheterization Laboratory, Dallas Veterans Administration Medical Center, Texas.
J Cardiovasc Pharmacol. 1990 Dec;16(6):1000-6. doi: 10.1097/00005344-199012000-00021.
Vasoactive intestinal peptide (VIP) is a neurotransmitter that has been identified in epicardial coronary arteries. To evaluate the direct effect of VIP on coronary hemodynamics and blood flow, graded doses of VIP (0.01, 0.03, 0.10, and 0.30 micrograms/min) were infused into the left coronary artery of 7 patients at the time of diagnostic cardiac catheterization for chest pain syndromes. None of the patients had coronary stenoses greater than 50% during subsequent angiography. Coronary sinus VIP concentrations increased during each infusion (22 +/- 28 pg/ml at baseline to 109 +/- 22 pg/ml at 0.30 micrograms/min; p less than 0.05), but arterial VIP was elevated (39 +/- 29 pg/ml) only at the maximal dose of 0.30 micrograms/min. During all dosages of VIP, heart rate, right atrial and left ventricular end-diastolic pressure, and the heart rate x blood pressure product did not change. Moreover, neither mean aortic pressure nor left ventricular peak + dP/dt changed significantly at doses less than 0.30 micrograms/min; at 0.30 micrograms/min, mean aortic pressure decreased (97 +/- 15 to 90 +/- 15 mm Hg; p less than 0.05) and LV peak + dP/dt increased (1,621 +/- 230 to 1,801 +/- 226 mm Hg/s; p less than 0.05). Compared to baseline, the arterial-coronary sinus O2 content difference and myocardial O2 extraction diminished progressively at the 0.03, 0.10, and 0.30 micrograms/min doses of VIP (118 +/- 12 ml O2/L vs. 94 +/- 15, 70 +/- 9, and 61 +/- 26 ml O2/L, respectively, and 0.64 +/- 0.05 vs. 0.53 +/- 0.10, 0.38 +/- 0.06, and 0.34 +/- 0.15, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
血管活性肠肽（VIP）是一种已在心外膜冠状动脉中被鉴定出的神经递质。为评估VIP对冠状动脉血流动力学和血流量的直接影响，在因胸痛综合征进行诊断性心导管检查时，将不同剂量的VIP（0.01、0.03、0.10和0.30微克/分钟）注入7例患者的左冠状动脉。在随后的血管造影检查中，所有患者的冠状动脉狭窄均未超过50%。每次输注期间，冠状窦VIP浓度均升高（基线时为22±28皮克/毫升，在0.30微克/分钟时升至109±22皮克/毫升；p<0.05），但仅在最大剂量0.30微克/分钟时动脉VIP升高（39±29皮克/毫升）。在所有VIP剂量下，心率、右心房和左心室舒张末期压力以及心率×血压乘积均未改变。此外，在剂量小于0.30微克/分钟时，平均主动脉压和左心室峰值+ dP/dt均无显著变化；在0.30微克/分钟时，平均主动脉压降低（97±15至90±15毫米汞柱；p<0.05），左心室峰值+ dP/dt升高（1621±230至1801±226毫米汞柱/秒；p<0.05）。与基线相比，在0.03、0.10和0.30微克/分钟剂量的VIP作用下，动脉-冠状窦氧含量差值和心肌氧摄取逐渐减少（分别为118±12毫升O2/L对94±15、70±9和61±26毫升O2/L，以及0.64±0.05对0.53±0.10、0.38±0.06和0.34±0.15）。（摘要截于250字）
