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维拉帕米:犬冠状动脉中缩血管物质的选择性拮抗剂:对变异型心绞痛的意义。

Verapamil: a selective antagonist of constrictor substances in dog coronary artery: implications for variant angina.

作者信息

Angus J A, Brazenor R M, Le Duc M A

出版信息

Clin Exp Pharmacol Physiol Suppl. 1982;6:15-28.

PMID:6956474
Abstract
  1. Canine circumflex coronary artery ring segments were contracted in vitro by ergometrine, serotonin, phenylephrine, noradrenaline (with propranolol) and a thromboxane A2 analogue, U46619. 2. Ergometrine was classified as a serotonin agonist since concentration-response curves were competitively inhibited by methysergide but not by alpha-adrenoceptor antagonists. 3. Glyceryl trinitrate (IC50 18.6 nmol/l) relaxed the coronary rings precontracted with serotonin, phenylephrine or U46619. In contrast (+/-)-verapamil (0.1-10 mumol/l) was more effective against serotonin than phenylephrine or noradrenaline and was almost inactive against U46619. 4. In a blood perfused left anterior descending coronary artery preparation external diameter was measured by sonomicrometry. Serotonin, U46619 and ergometrine infusions (i.a.) decreased diameter by up to 18% without causing spasm (zero lumen diameter). Lowering the perfusion pressure from 90 to 60 mmHg increased the fall in diameter during serotonin infusions. 5. The negative inotropic potency of verapamil against noradrenaline induced beta-adrenergic stimulation in guinea-pig left atria was compared with the vasodilator potency of verapamil in noradrenaline constricted dog coronary artery rings. Verapamil was eighteen times more potent in cardiac muscle than in coronary smooth muscle. 6. This apparent tissue selectivity of verapamil was confirmed in anaesthetized dogs where plasma concentrations of verapamil 50-150 ng/ml (in the therapeutic range) lowered blood pressure and heart rate and increased P-R interval without greatly reducing the constrictor response to serotonin in the coronary artery. 7. These studies suggest that inhibition of constrictor responses in large coronary vessels may not be an important site of action of verapamil in patients with variant angina.
摘要
  1. 麦角新碱、5-羟色胺、去氧肾上腺素、去甲肾上腺素(与普萘洛尔合用)及血栓素A2类似物U46619可使犬冠状动脉环节段在体外发生收缩。2. 麦角新碱被归类为5-羟色胺激动剂,因为其浓度-反应曲线受到甲基麦角新碱竞争性抑制,但不受α-肾上腺素能受体拮抗剂抑制。3. 硝酸甘油(IC50为18.6 nmol/L)可使预先用5-羟色胺、去氧肾上腺素或U46619收缩的冠状动脉环舒张。相比之下,(±)-维拉帕米(0.1 - 10 μmol/L)对5-羟色胺的作用比对去氧肾上腺素或去甲肾上腺素更有效,而对U46619几乎无作用。4. 在血液灌注的左前降支冠状动脉标本中,用超声测量外径。注入5-羟色胺、U46619和麦角新碱(动脉内)可使直径减小达18%,且不引起痉挛(管腔直径为零)。将灌注压力从90 mmHg降至60 mmHg可增加注入5-羟色胺期间直径的下降幅度。5. 将维拉帕米对豚鼠左心房去甲肾上腺素诱导的β-肾上腺素能刺激的负性肌力作用强度与维拉帕米在去甲肾上腺素收缩的犬冠状动脉环中的血管舒张作用强度进行比较。维拉帕米在心肌中的效力比在冠状动脉平滑肌中强18倍。6. 在麻醉犬中证实了维拉帕米这种明显的组织选择性,血浆中维拉帕米浓度为50 - 150 ng/ml(在治疗范围内)时可降低血压和心率,并延长P-R间期,而不会显著降低冠状动脉对5-羟色胺的收缩反应。7. 这些研究表明,抑制大冠状动脉血管的收缩反应可能不是维拉帕米对变异型心绞痛患者的重要作用部位。

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