Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan.
Eur Heart J. 2010 Dec;31(23):2862-70. doi: 10.1093/eurheartj/ehq156. Epub 2010 May 28.
No direct method has yet been developed to measure real-time plasma nitric oxide (NO) concentration in humans. In this study, we evaluated a new method for measuring plasma NO concentration in patients with dilated cardiomyopathy (DCM) and in normal controls using a catheter-type sensor.
We simultaneously measured average peak velocity (APV) of the coronary artery flow and change in plasma NO concentration using the NO sensor placed in the great cardiac vein of 10 DCM patients and 10 control subjects. These evaluations were performed in response to sequential intracoronary infusions of acetylcholine (ACh, 10⁻⁸-10⁻⁶ M), N(G)-monomethyl-l-arginine (l-NMMA, 200 µmol) and co-infusion of ACh and l-NMMA. The change in plasma NO concentration in DCM patients was significantly impaired compared with the control group (P < 0.01). Pretreatment with l-NMMA completely suppressed the ACh-induced NO concentration, whereas APV in the left anterior descending coronary artery was partially suppressed in both groups. Plasma NO concentration reached its peak value later than the maximum APV following the injection of ACh (10⁻⁶ M) in both groups.
The catheter-type NO sensor could be applied to clinically evaluate the endothelial function (i.e. reduced endothelium-derived NO bioavailability) in patients with cardiovascular diseases.
目前尚无直接方法测量人体实时血浆一氧化氮（NO）浓度。本研究采用导管型传感器评估了一种测量扩张型心肌病（DCM）患者和正常对照者血浆 NO 浓度的新方法。
我们同时测量了 10 例 DCM 患者和 10 例对照者心脏大静脉内 NO 传感器放置处的冠状动脉血流平均峰值速度（APV）和血浆 NO 浓度的变化。这些评估是针对顺序冠状动脉内输注乙酰胆碱（ACh，10⁻⁸-10⁻⁶ M）、N（G）-单甲基-L-精氨酸（l-NMMA，200 μmol）以及 ACh 和 l-NMMA 共同输注而进行的。与对照组相比，DCM 患者的血浆 NO 浓度变化明显受损（P < 0.01）。l-NMMA 预处理完全抑制了 ACh 诱导的 NO 浓度，而两组的左前降支冠状动脉的 APV 均部分抑制。在两组中，ACh（10⁻⁶ M）注射后，NO 浓度的峰值均晚于最大 APV。
导管型 NO 传感器可用于临床评估心血管疾病患者的内皮功能（即内皮衍生的 NO 生物利用度降低）。
