Weintraub W S, Cluley S, Naccarella F, Akizuki S, Agarwal J B, Bodenheimer M M, Banka V S, Helfant R H
Cardiovasc Res. 1985 Mar;19(3):169-76. doi: 10.1093/cvr/19.3.169.
To investigate the effects of nitroglycerin on collateral blood flow 10 open chest dogs underwent coronary occlusion followed by nitroglycerin infusion (80 to 300 micrograms . min-1) to lower mean systemic blood pressure by 20 mmHg, followed by phenylephrine infusion (10 to 40 micrograms . min-1) to restore blood pressure to the pre-nitroglycerin level. Myocardial blood flow was measured with microspheres. The contribution of overlapping normal zone tissue in the ischaemic zone was evaluated with the balloon perfusion technique. Collateral flow was measured with microspheres in the most ischaemic tissue. In addition "load line" analysis was used to calculate collateral flow from retrograde flow. Nitroglycerin lowered blood flow to non-ischaemic tissue, and tended to lower blood flow to ischaemic tissue. Phenylephrine restored blood flow to the value after coronary occlusion. Load line analysis data was similar to data on myocardial blood flow from the microspheres. Collateral resistance changed little during the experiment. Th effects of nitroglycerin on collateral blood flow are, thus, minimal. While it is possible that under special circumstances there may be some decrease in collateral resistance, the bulk of data from this study and others do not support the idea that systemic infusion of nitroglycerin in the setting of an acute myocardial infarction will affect collateral flow.
为研究硝酸甘油对侧支血流的影响，对10只开胸犬进行冠状动脉闭塞，随后输注硝酸甘油（80至300微克·分钟-1）以使平均体循环血压降低20 mmHg，接着输注去氧肾上腺素（10至40微克·分钟-1）将血压恢复至硝酸甘油给药前水平。用微球测量心肌血流。用球囊灌注技术评估缺血区内重叠正常区组织的贡献。在最缺血的组织中用微球测量侧支血流。此外，采用“负荷线”分析从逆向血流计算侧支血流。硝酸甘油降低了非缺血组织的血流，并倾向于降低缺血组织的血流。去氧肾上腺素使血流恢复至冠状动脉闭塞后的数值。负荷线分析数据与微球测量的心肌血流数据相似。实验过程中侧支阻力变化很小。因此，硝酸甘油对侧支血流的影响极小。虽然在特殊情况下侧支阻力可能会有所降低，但本研究及其他研究的大量数据并不支持在急性心肌梗死时全身输注硝酸甘油会影响侧支血流这一观点。
