Kelm M, Feelisch M, Krebber T, Deussen A, Motz W, Strauer B E
Department of Medicine, Heinrich-Heine Universität Düsseldorf, FRG.
Hypertension. 1995 Feb;25(2):186-93. doi: 10.1161/01.hyp.25.2.186.
In arterial hypertension, coronary flow reserve, expressed by the difference between autoregulated and maximal coronary flow, is frequently impaired. Previous experimental and clinical investigations using acetylcholine as a stimulus for the production of endothelium-derived relaxing factor suggested that an impaired endothelium-dependent vasodilation, presumably caused by a decreased formation of nitric oxide (NO), may account for this microvascular dysfunction. However, so far no study has been performed that quantifies the formation of NO within the coronary circulation of hypertensive hearts to assess its role in setting coronary vascular tone in the hypertensive heart. We therefore quantified NO formation within the coronary circulation of constant flow-perfused, isolated hearts from spontaneously hypertensive rats (SHR, 16th to 26th week), as a model for hypertensive heart disease, and from the normotensive control strain (Wistar-Kyoto, WKY) using the oxyhemoglobin technique. Coronary perfusion pressure and vascular resistance were almost 30% higher in SHR compared with WKY hearts. Intracoronarily applied NO decreased coronary vascular resistance by maximally 45% of resting values in a concentration-dependent manner in both groups. The bradykinin-induced decrease in coronary vascular resistance and the parallel increase in NO release were comparable in SHR and WKY hearts and fell within the vasodilator range of exogenously applied NO. Moreover, basal release of NO normalized to heart wet weight was 50% higher in SHR compared with WKY hearts. Rates of basal NO release were correlated inversely with changes in coronary perfusion pressure and vascular resistance in both groups (r = -.85 and -.84, respectively, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
在动脉高血压中,以自动调节的冠状动脉血流与最大冠状动脉血流之差表示的冠状动脉血流储备常常受损。以往使用乙酰胆碱作为刺激内皮衍生舒张因子生成的实验和临床研究表明,内皮依赖性血管舒张受损,推测是由一氧化氮(NO)生成减少所致,这可能是这种微血管功能障碍的原因。然而,迄今为止,尚未有研究对高血压心脏冠状动脉循环中NO的生成进行量化,以评估其在调节高血压心脏冠状动脉血管张力中的作用。因此,我们使用氧合血红蛋白技术,对来自自发性高血压大鼠(SHR,第16至26周)的恒流灌注离体心脏以及正常血压对照品系(Wistar-Kyoto,WKY)心脏的冠状动脉循环中的NO生成进行了量化,将SHR作为高血压心脏病的模型。与WKY心脏相比,SHR的冠状动脉灌注压和血管阻力高出近30%。两组中,冠状动脉内应用NO均以浓度依赖性方式使冠状动脉血管阻力最大降低静息值的45%。缓激肽诱导的冠状动脉血管阻力降低以及NO释放的平行增加在SHR和WKY心脏中相当,且处于外源性应用NO的血管舒张范围内。此外,以心脏湿重标准化的NO基础释放量,SHR比WKY心脏高50%。两组中,基础NO释放速率均与冠状动脉灌注压和血管阻力的变化呈负相关(r分别为-.85和-.84,P <.05)。(摘要截短于250字)