Otsuji S, Nakajima O, Waku S, Kojima S, Hosokawa H, Kinoshita I, Okubo T, Tamoto S, Takada K, Ishihara T
Department of Internal Medicine I, Osaka Medical College, Japan.
Am Heart J. 1995 Jun;129(6):1094-100. doi: 10.1016/0002-8703(95)90388-7.
To determine if L-arginine, a precursor of the endothelium-derived relaxing factor, restores endothelium-dependent dilation in human coronary arteries, we studied 21 patients in whom the lumina of the coronary arteries were angiographically smooth or slightly irregular and in whom there was a constrictor response to acetylcholine (ACh) in the left anterior descending coronary artery or the circumflex coronary artery. We examined the response to intracoronary ACh before and after infusion of L-arginine by measuring coronary diameter with quantitative angiography. Intracoronary injection of ACh produced vasoconstriction in the majority of patients with coronary risk factors. The percentage diameter change in smooth segments in patients with entirely smooth coronary arteries (group 1, n = 44) from baseline was -20.7% +/- 17.4%. During systemic infusion of L-arginine, the constrictor response to ACh in these segments was significantly attenuated (-2.2% +/- 15.1% from baseline, p < 0.01, ACh alone vs ACh during L-arginine infusion). In smooth segments in patients with luminal irregularities in the other coronary arteries (group 2, n = 19), ACh produced a marked constriction (-32.5% +/- 22.5% from baseline, p < 0.05, group 1 vs group 2). Infusion of L-arginine also attenuated ACh-induced vasoconstriction in these segments (-9.7% +/- 14.1% from baseline, p < 0.01, ACh vs ACh during L-arginine infusion). In segments with irregular lumina (group 3, n = 26), ACh produced more prominent vasoconstriction. The percentage diameter change was -40.9% +/- 26.5% from baseline (p < 0.01 vs group 1).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定内皮源性舒张因子的前体L-精氨酸是否能恢复人冠状动脉的内皮依赖性舒张功能，我们研究了21例患者，这些患者冠状动脉造影显示管腔光滑或轻度不规则，且左前降支冠状动脉或回旋支冠状动脉对乙酰胆碱（ACh）有收缩反应。我们通过定量血管造影测量冠状动脉直径，来检测在输注L-精氨酸前后冠状动脉内注射ACh的反应。冠状动脉内注射ACh在大多数有冠心病危险因素的患者中引起血管收缩。冠状动脉完全光滑的患者（第1组，n = 44）的光滑节段直径较基线的变化百分比为-20.7%±17.4%。在全身输注L-精氨酸期间，这些节段对ACh的收缩反应显著减弱（较基线为-2.2%±15.1%，p < 0.01，单独使用ACh与输注L-精氨酸期间使用ACh相比）。在其他冠状动脉存在管腔不规则的患者的光滑节段（第2组，n = 19），ACh引起明显收缩（较基线为-32.5%±22.5%，p < 0.05，第1组与第2组相比）。输注L-精氨酸也减弱了这些节段中ACh诱导的血管收缩（较基线为-9.7%±14.1%，p < 0.01，ACh与输注L-精氨酸期间使用ACh相比）。在管腔不规则的节段（第3组，n = 26），ACh引起更明显的血管收缩。直径变化百分比较基线为-40.9%±26.5%（与第1组相比，p < 0.01）。（摘要截断于250字）
