Berlin I, Lechat P, Deray G, Landault C, Maistre G, Chermat V, Brouard R, Ressayre C, Puech A J
Department of Clinical Pharmacology, Hôpital Pitié-Salpêtrière, Paris, France.
Eur J Clin Pharmacol. 1993;44(2):127-33. doi: 10.1007/BF00315469.
The role of atrial distension and/or adrenergic mechanisms in the regulation of atrial natriuretic peptide (ANP) secretion, plasma immunoreactive ANP, norepinephrine (NE), epinephrine (E) and left atrial diameter at rest, during and after graded bicycle exercise has been studies in 8 healthy male subjects after single doses of placebo, tertatolol 5 mg (a non-selective beta-adrenoceptor blocker), prazosin 1 mg (an alpha 1-adrenoceptor antagonist) and their combination. Systolic and diastolic left atrial diameters were measured before, during and just after exercise by bidimensional echocardiography. Exercise caused an increase in plasma ANP, which was greater after tertatolol alone, and tertatolol plus prazosin, than after placebo or prazosin alone; the mean area under the plasma ANP concentration curve was increased by 35% after tertatolol alone, by 45% after tertatolol and prazosin compared to placebo, and by 82% and 94%, respectively when compared to prazosin alone. The rise in plasma ANP was more marked during the post-exercise period: 80% after tertatolol alone, 67% after tertatolol and prazosin compared to placebo, and 133% and 115%, respectively, compared to prazosin alone. The rise in plasma ANP was accompanied by an increase in both the systolic and diastolic atrial diameter, which was also significantly greater after tertatolol alone and the combination than placebo, or after prazosin alone. beta-Adrenoceptor blockade alone did not affect the plasma catecholamine concentrations, but the exercise-induced increase in plasma norepinephrine was significantly potentiated by prazosin and by prazosin plus tertatolol, and that of plasma epinephrine by the drug combination.(ABSTRACT TRUNCATED AT 250 WORDS)
在8名健康男性受试者中,研究了心房扩张和/或肾上腺素能机制在分级自行车运动期间及运动后静息状态下对心房利钠肽(ANP)分泌、血浆免疫反应性ANP、去甲肾上腺素(NE)、肾上腺素(E)和左心房直径的调节作用。这些受试者在单剂量服用安慰剂、5毫克替他洛尔(一种非选择性β-肾上腺素能受体阻滞剂)、1毫克哌唑嗪(一种α1-肾上腺素能受体拮抗剂)及其组合后进行了上述研究。通过二维超声心动图在运动前、运动期间和运动刚结束后测量左心房的收缩期和舒张期直径。运动导致血浆ANP升高,单独使用替他洛尔以及替他洛尔加哌唑嗪后升高幅度大于单独使用安慰剂或哌唑嗪;与安慰剂相比,单独使用替他洛尔后血浆ANP浓度曲线下平均面积增加35%,替他洛尔和哌唑嗪联合使用后增加45%,与单独使用哌唑嗪相比分别增加82%和94%。运动后血浆ANP升高更为明显:单独使用替他洛尔后升高80%,替他洛尔和哌唑嗪联合使用后与安慰剂相比升高67%,与单独使用哌唑嗪相比分别升高133%和115%。血浆ANP升高伴随着心房收缩期和舒张期直径的增加,单独使用替他洛尔及其联合使用后心房直径增加也显著大于安慰剂或单独使用哌唑嗪后的增加幅度。单独的β-肾上腺素能受体阻滞不影响血浆儿茶酚胺浓度,但哌唑嗪以及哌唑嗪加替他洛尔可显著增强运动诱导的血浆去甲肾上腺素升高,药物组合可增强血浆肾上腺素升高。(摘要截短至250字)