氨氯地平对人体内乳动脉的影响及其临床意义。

Effect of amlodipine in human internal mammary artery and clinical implications.

机构信息

TEDA International Cardiovascular Hospital, Medical College, Nankai University, Tianjin, China.

出版信息

Ann Thorac Surg. 2010 Dec;90(6):1952-7. doi: 10.1016/j.athoracsur.2010.08.007.

DOI:10.1016/j.athoracsur.2010.08.007

PMID:21095344

Abstract

BACKGROUND

Graft spasm remains challenging in CABG (coronary artery bypass grafting) surgery. We investigated the inhibitory effect of a dihydropyridine calcium antagonist amlodipine on the vasoconstriction mediated by potassium chloride (KCl), human urotensin-II (hU-II), and U46619 in human internal mammary artery (IMA) from patients undergoing CABG.

METHODS

Isolated IMA rings (n = 78, taken from 42 patients) were studied in organ baths in two ways: the relaxing effect of amlodipine on vasoconstrictor-induced precontraction by KCl, hU-II, and U46619 and the depressing effect of amlodipine on the contraction.

RESULTS

Amlodipine caused full relaxation in KCl-contracted (98.0% ± 2.1%), in hU-II-contracted (98.5% ± 2.4%), and in U46619-contracted (96.3% ± 1.3%) IMA rings (n = 8) with 15.5-fold higher potency to KCl than to hU-II (effective concentration causing 50% of maximal response [EC(50)]: -8.17 ± 0.28 vs -6.98 ± 0.01 log M, p < 0.001) and 19.5-fold that to U46619 (EC(50): -8.17 ± 0.28 vs -6.88 ± 0.08 log M, p < 0.001). Pretreatment of IMA with plasma concentrations of amlodipine (-6.6 log M) significantly depressed subsequent contraction to KCl (from 20.8 ± 2.5 mN to 7.6 ± 3.0 mN, p = 0.004) and hU-II (from 14.1 ± 4.2 mN to 3.8 ± 2.0 mN, p = 0.026), but did not significantly affect the contraction to U46619.

CONCLUSIONS

We conclude that in human IMA amlodipine has a potent inhibitory effect on the vasoconstriction mediated by a variety of vasoconstrictors. Thus, use of amlodipine in CABG patients is favored in treating and preventing graft spasm.

摘要

背景

在冠状动脉旁路移植术（CABG）中，移植物痉挛仍然是一个挑战。我们研究了二氢吡啶类钙拮抗剂氨氯地平对氯化钾（KCl）、人尿促素-II（hU-II）和 U46619 介导的人内乳动脉（IMA）血管收缩的抑制作用，这些患者正在接受 CABG。

方法

采用两种方法在器官浴中研究了 78 个 IMA 环（来自 42 名患者）：KCl、hU-II 和 U46619 引起的预收缩的氨氯地平舒张作用，以及氨氯地平对收缩的抑制作用。

结果

氨氯地平使 KCl 收缩（98.0%±2.1%）、hU-II 收缩（98.5%±2.4%）和 U46619 收缩（96.3%±1.3%）的 IMA 环完全松弛（n=8），其对 KCl 的效力比 hU-II 高 15.5 倍（引起最大反应 50%的有效浓度[EC（50）]：-8.17±0.28 对-6.98±0.01 log M，p<0.001），比 U46619 高 19.5 倍（EC（50）：-8.17±0.28 对-6.88±0.08 log M，p<0.001）。IMA 用氨氯地平的血浆浓度预处理（-6.6 log M）显著抑制了随后对 KCl（从 20.8±2.5 mN 到 7.6±3.0 mN，p=0.004）和 hU-II（从 14.1±4.2 mN 到 3.8±2.0 mN，p=0.026）的收缩，但对 U46619 的收缩没有显著影响。