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冠状动脉的光诱导血管舒张及其可能的临床意义。

Light-induced vasodilation of coronary arteries and its possible clinical implication.

机构信息

Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.

出版信息

Ann Thorac Surg. 2012 Apr;93(4):1181-6. doi: 10.1016/j.athoracsur.2011.12.062. Epub 2012 Mar 3.

Abstract

BACKGROUND

Low-level laser therapy and light-emitting diodes (LED) are increasingly used in phototherapy. Their therapeutic effects are at least partly mediated by light-induced vasodilation. The aim of this study was to determine the effect of different light sources on coronary arteries.

METHODS

Porcine left coronary arteries were cut into 4-mm rings that were irradiated either by a semiconductor nonthermal gallium-arsenide diode laser or a noncoherent athermic red light source both with the same energy density up to 16 J/cm(2). After precontraction with 9, 11-dideoxy-11α, 9α-epoxymethano-prostaglandin F(2)α, respective relaxation responses were evaluated. The role of endothelium as well as intracellular pathways was investigated.

RESULTS

Maximum vasodilation after exposure to laser was observed at 10 J/cm(2) (56.8% ± 1.2%) and decreased to 43.9% ± 2.8% at 16 J/cm(2) (p < 0.003). After adjusting exposure time to achieve equivalent energy densities in the LED group, vessel segments revealed photorelaxation of 52.9% ± 6.5% and 47.5% ± 0.6%, respectively. Vasodilations achieved by either light source were comparable at 10 J/cm(2) (p < 0.574) and 16 J/cm(2) (p < 0.322). Furthermore, vasodilation could be inhibited by administration of 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (nitric oxide scavenger) and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (guanocyclase inhibitor) but not with L-nitro-arginine methyl ester or deendothelialization.

CONCLUSIONS

Vessels exposed to either light source showed a remarkable as well as comparable photorelaxation at definite energy densities. This effect is mediated by an intracellular nitric oxide-dependent mechanism. As LED sources are of small size, simple, and inexpensive build-up, they may be used during routine coronary artery bypass surgery to ease suturing of anastomosis by target vessel vasodilation.

摘要

背景

低水平激光疗法和发光二极管(LED)越来越多地用于光疗。它们的治疗效果至少部分是通过光诱导的血管扩张介导的。本研究的目的是确定不同光源对冠状动脉的影响。

方法

将猪的左冠状动脉切成 4mm 的环,用半导体非热砷化镓二极管激光或非相干非热红光照射,两种光源的能量密度均高达 16J/cm(2)。在 9,11-二脱氧-11α,9α-环氧甲酰基前列腺素 F(2)α预收缩后,评估各自的舒张反应。研究了内皮细胞和细胞内途径的作用。

结果

激光照射后最大血管扩张发生在 10J/cm(2)(56.8%±1.2%),在 16J/cm(2)时降至 43.9%±2.8%(p<0.003)。在调整暴露时间以在 LED 组中实现等效能量密度后,血管段分别显示出 52.9%±6.5%和 47.5%±0.6%的光松弛。两种光源在 10J/cm(2)(p<0.574)和 16J/cm(2)(p<0.322)时的血管扩张作用相当。此外,一氧化氮清除剂 2-(4-羧基苯基)-4,4,5,5-四甲基咪唑啉-1-氧-3-氧化物和鸟苷环化酶抑制剂 1H-[1,2,4]恶二唑[4,3-a]喹喔啉-1-酮可抑制血管舒张,但不能用 L-硝基-精氨酸甲酯或去内皮化来抑制。

结论

暴露于任一光源的血管在特定能量密度下均显示出显著且相当的光松弛。这种效应是通过细胞内一氧化氮依赖性机制介导的。由于 LED 光源体积小、结构简单、制造成本低,因此在常规冠状动脉旁路手术中可能用于扩张靶血管,以方便吻合口的缝合。

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