Piana R N, Shafique T, Dai H B, Sellke F W
Department of Surgery, Beth Israel Hospital, Boston, Massachusetts 02215.
J Cardiovasc Pharmacol. 1994 Apr;23(4):539-46. doi: 10.1097/00005344-199404000-00004.
To examine whether endocardial microvascular function is preferentially impaired by ischemia and reperfusion, we studied endothelium-dependent responses of epicardial and endocardial coronary microvessels (130-220 microns) from control pigs and from pigs subjected to 1-h regional myocardial ischemia (circumflex occlusion) followed by 1-h reperfusion (n = 8) in vitro using videomicroscopy. In control animals (n = 8), no significant transmural differences were apparent in microvascular responses to the endothelium-dependent agents bradykinin or the calcium ionophore A23187, to the endothelium-independent agent sodium nitroprusside (SNP), or to adenosine. Serotonin caused a slight but statistically insignificant greater relaxation of endocardial than of epicardial microvessels. After ischemia-reperfusion, relaxations to all endothelium-dependent agents (serotonin, bradykinin, A23187) and to adenosine were significantly reduced (p < 0.05 for all agents) as compared with the respective control responses. There were no significant differences between epicardial and endocardial responses in the ischemia-reperfusion group for any of the vasoactive agents. Endothelium-independent responses to SNP were not affected by ischemia-reperfusion, indicating no alteration in the ability of vascular smooth muscle to relax through guanylate cyclase-mediated mechanisms. Control epicardial microvascular responses were examined after endothelial denudation and after pretreatment with NG-monomethyl-L-arginine (L-NMMA), indomethacin, or glibenclamide.(ABSTRACT TRUNCATED AT 250 WORDS)
为了研究心内膜微血管功能是否优先受到缺血和再灌注的损害,我们使用视频显微镜在体外研究了对照猪以及经历1小时局部心肌缺血(回旋支闭塞)随后1小时再灌注的猪(n = 8)的心外膜和心内膜冠状动脉微血管(130 - 220微米)的内皮依赖性反应。在对照动物(n = 8)中,微血管对内皮依赖性药物缓激肽或钙离子载体A23187、对内皮非依赖性药物硝普钠(SNP)或对腺苷的反应,未显示出明显的跨壁差异。5-羟色胺引起的心内膜微血管舒张比心外膜微血管稍大,但在统计学上无显著差异。缺血再灌注后,与各自的对照反应相比,对所有内皮依赖性药物(5-羟色胺、缓激肽、A23187)和对腺苷的舒张反应均显著降低(所有药物p < 0.05)。在缺血再灌注组中,对于任何血管活性药物,心外膜和心内膜反应之间均无显著差异。对SNP的内皮非依赖性反应不受缺血再灌注影响,表明通过鸟苷酸环化酶介导机制的血管平滑肌舒张能力未改变。在内皮剥脱后以及用NG-单甲基-L-精氨酸(L-NMMA)、吲哚美辛或格列本脲预处理后,检测了对照心外膜微血管反应。(摘要截断于250字)