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在麻醉猪中,苯二氢吡啶类药物依高地平静脉注射和冠状动脉内给药后的中枢和局部心血管反应。

The central and regional cardiovascular responses to intravenous and intracoronary administration of the phenyldihydropyridine elgodipine in anaesthetized pigs.

作者信息

Sassen L M, Soei L K, Koning M M, Verdouw P D

机构信息

Laboratory for Experimental Cardiology (Thoraxcenter), Erasmus University, Rotterdam, The Netherlands.

出版信息

Br J Pharmacol. 1990 Feb;99(2):355-63. doi: 10.1111/j.1476-5381.1990.tb14708.x.

Abstract
  1. The central and regional cardiovascular responses to intravenous (0.3, 1.0, 3.0 and 10.0 micrograms kg-1 min-1) and intracoronary (0.3, 0.9, 3.0 and 4.5 micrograms kg-1 min-1) infusions of elgodipine, a phenyldihydropyridine, and its solvent were studied in anaesthetized pigs. 2. Elgodipine (i.v.) caused dose-dependent decreases in arterial blood pressure (up to 44%) and systemic vascular resistance (up to 48%), whereas heart rate, LV dP/dtmax, left ventricular filling pressure, cardiac output and segment length shortening did not change. The absence of a negative inotropic effect with the employed doses was confirmed by the intracoronary infusions; with the lowest dose (0.3 micrograms kg-1 min-1) both LV dP/dtmax and segment length shortening decreased by less than 10%. With 0.9 micrograms kg-1 min-1 (intracoronary) the negative inotropic properties of the drug became apparent as LV dP/dtmax and segment length shortening decreased by 20% and 33%, respectively, whereas heart rate and left ventricular filling pressure were not affected. 3. Transmural myocardial blood flow did not change during intravenous infusion of elgodipine, as vasodilatation, more pronounced in the subepicardial than in the subendocardial layers, compensated for the decrease in arterial perfusion pressure. The intracoronary infusions revealed that the decrease in normalized subendocardial/subepicardial blood flow ratio was not secondary to the fall in arterial blood pressure. 4. Myocardial oxygen consumption decreased during both the i.v. and the intracoronary administration of elgodipine. With the i.v. administration the decrease was secondary to the hypotensive action of the drug, whereas with the intracoronary administration the negative inotropic properties played the dominant role. 5. Elgodipine (i.v.), although not affecting total cardiac output, caused a redistribution in favour of the nutritional blood flow at the expense of the arteriovenous anastomotic (AVA) blood flow. Up to an infusion rate of 3.0upg kg - I min- 1 the decrease in AVA-flow was due to a fall in arterial blood pressure, but at the highest infusion rate both the decrease in arterial perfusion pressure and an increase in their resistance contributed to a further decrease in AVA blood flow. 6. The skeletal muscles benefited most from the elgodipine(i.v.)-induced increase in nutritional blood flow, but vasodilatation was not uniform for all muscle groups. Up to an infusion rate of 3 yg kg - ' min- 1 the vasodilatation in the renal vascular bed was more pronounced in the inner than in the outer cortex, but, at 0 pyg kg-1 min-, vascular resistances of both cortical layers returned to baseline values. In all regions of the brain, blood flow was maintained until the highest infusion rate was given. With 10 yg kg- I min - ' only flow to the vital parts of the brain (diencephalon and brain stem) was maintained. Blood flows to the skin and various abdominal organs were well maintained up to 3 pg kg'- min - 1 but, at the highest dose, a decrease was observed in blood flow to the adrenals and spleen. Vascular resistances of all these organs and tissues decreased dose-dependently. 7. The potent systemic and coronary vasodilator actions of elgodipine during i.v. administration, which were not accompanied by negative inotropic and positive chronotropic properties or decreases in the perfusion of vital organs, warrant further study as this compound could be useful in the treatment of essential hypertension, myocardial ischaemia and, possibly, moderate chronic heart failure.
摘要
  1. 在麻醉猪身上研究了苯二氢吡啶类药物依高地平及其溶剂静脉输注(0.3、1.0、3.0和10.0微克/千克·分钟)和冠状动脉内输注(0.3、0.9、3.0和4.5微克/千克·分钟)时的中枢和局部心血管反应。2. 依高地平静脉注射可引起动脉血压(降幅高达44%)和全身血管阻力(降幅高达48%)的剂量依赖性降低,而心率、左室dp/dtmax、左心室充盈压、心输出量和节段长度缩短均无变化。冠状动脉内输注证实了所用剂量无负性肌力作用;最低剂量(0.3微克/千克·分钟)时,左室dp/dtmax和节段长度缩短的降幅均小于10%。冠状动脉内输注0.9微克/千克·分钟时,药物的负性肌力特性明显显现,左室dp/dtmax和节段长度缩短分别下降20%和33%,而心率和左心室充盈压未受影响。3. 静脉输注依高地平期间,透壁心肌血流未发生变化,因为心外膜下比心内膜下更明显的血管舒张补偿了动脉灌注压的降低。冠状动脉内输注显示,归一化的心内膜下/心外膜下血流比值降低并非继发于动脉血压下降。4. 静脉注射和冠状动脉内注射依高地平期间,心肌耗氧量均降低。静脉注射时,降低继发于药物的降压作用,而冠状动脉内注射时,负性肌力特性起主导作用。5. 依高地平静脉注射虽不影响总心输出量,但导致血流重新分布,有利于营养性血流增加,代价是动静脉吻合(AVA)血流减少。输注速率达3.0微克/千克·分钟时,AVA血流减少是由于动脉血压下降,但在最高输注速率时,动脉灌注压降低和其阻力增加共同导致AVA血流进一步减少。6. 骨骼肌从依高地平静脉注射引起的营养性血流增加中获益最大,但血管舒张对所有肌肉群并不均匀。输注速率达3微克/千克·分钟时,肾血管床内皮质的血管舒张比外皮质更明显,但在10微克/千克·分钟时,两层皮质的血管阻力均恢复至基线值。在脑的所有区域,血流一直维持到给予最高输注速率。静脉注射10微克/千克·分钟时,仅流向脑重要部位(间脑和脑干)的血流得以维持。皮肤和各种腹部器官的血流在输注速率达3微克/千克·分钟时维持良好,但在最高剂量时,肾上腺和脾脏的血流减少。所有这些器官和组织的血管阻力均呈剂量依赖性降低。7. 依高地平静脉注射时强大的全身和冠状动脉血管舒张作用,未伴有负性肌力和正性变时特性,也未导致重要器官灌注减少,鉴于该化合物可能对原发性高血压、心肌缺血以及可能的中度慢性心力衰竭的治疗有用,值得进一步研究。

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