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新生猪冠状动脉张力的内皮依赖性调节

Endothelium-dependent regulation of coronary tone in the neonatal pig.

作者信息

McGowan F X, Davis P J, del Nido P J, Sobek M, Allen J W, Downing S E

机构信息

Department of Anesthesiology, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, PA 15213-2583.

出版信息

Anesth Analg. 1994 Dec;79(6):1094-101. doi: 10.1213/00000539-199412000-00012.

Abstract

We examined the effects of endothelium-dependent responses on coronary perfusion pressure (CPP) in isolated, blood-perfused neonatal pig hearts under conditions of controlled coronary flow. Baseline CPP was increased 8%-21% by the cyclooxygenase inhibitor indomethacin (10-100 microM), and 30%-92% by NG-monomethyl-L-arginine (L-NMMA, 10-100 microM), an inhibitor of nitric oxide (NO) synthase, suggesting that both prostaglandin and nitric oxide synthesis contribute to basal coronary tone. Both acetylcholine (ACh) and bradykinin (BK) decreased CPP. These effects were enhanced by preconstriction with endothelin-1. L-NMMA markedly attenuated BK-induced coronary vasodilation and converted the ACh response to constriction, indicating a significant role for NO release in these responses. After 1 h of total, global normothermic ischemia and 45 min of reperfusion, vasoconstrictor responses to endothelin-1 and ACh were enhanced, while BK-induced dilation was significantly reduced. L-Arginine supplementation during reperfusion did not restore vasodilatory responses to ACh or BK. The magnitude of L-NMMA-induced coronary vasoconstriction during reperfusion was similar to that observed without ischemia-reperfusion. Coronary vasodilation in response to sodium nitroprusside, a NO precursor that causes endothelium-independent vasodilation by directly activating smooth muscle guanylate cyclase, was unaffected by ischemia-reperfusion. We conclude that NO production in the neonatal coronary circulation contributes to both basal tone and the response to ACh and BK. After ischemia-reperfusion, basal NO production and smooth muscle relaxation mediated by guanylate cyclase are intact, whereas agonist-stimulated dilation is significantly impaired.

摘要

我们在冠状动脉血流受控的条件下,研究了内皮依赖性反应对离体、血液灌注的新生猪心脏冠状动脉灌注压(CPP)的影响。环氧合酶抑制剂吲哚美辛(10 - 100微摩尔)使基础CPP升高8% - 21%,一氧化氮(NO)合酶抑制剂NG - 单甲基 - L - 精氨酸(L - NMMA,10 - 100微摩尔)使基础CPP升高30% - 92%,这表明前列腺素和一氧化氮的合成均有助于维持基础冠状动脉张力。乙酰胆碱(ACh)和缓激肽(BK)均降低CPP。内皮素 - 1预收缩可增强这些效应。L - NMMA显著减弱BK诱导的冠状动脉舒张,并使ACh反应转变为收缩,表明NO释放在此类反应中起重要作用。在进行1小时的完全性、全身性常温缺血及45分钟再灌注后,内皮素 - 1和ACh引起的血管收缩反应增强,而BK诱导的舒张显著减弱。再灌注期间补充L - 精氨酸未能恢复对ACh或BK的舒张反应。再灌注期间L - NMMA诱导的冠状动脉收缩幅度与未进行缺血 - 再灌注时观察到的相似。硝普钠是一种NO前体,通过直接激活平滑肌鸟苷酸环化酶引起不依赖内皮细胞的血管舒张,其诱导的冠状动脉舒张不受缺血 - 再灌注影响。我们得出结论,新生猪冠状动脉循环中NO的产生有助于维持基础张力以及对ACh和BK的反应。缺血 - 再灌注后,基础NO产生及由鸟苷酸环化酶介导的平滑肌舒张功能完好,而激动剂刺激引起的舒张显著受损。

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