鱼油可改善心脏移植受者的内皮依赖性冠状动脉血管舒张功能。

Fish oil improves endothelium-dependent coronary vasodilation in heart transplant recipients.

作者信息

Fleischhauer F J, Yan W D, Fischell T A

机构信息

Division of Cardiovascular Medicine, Stanford University Medical Center, California.

出版信息

J Am Coll Cardiol. 1993 Mar 15;21(4):982-9. doi: 10.1016/0735-1097(93)90357-7.

DOI:10.1016/0735-1097(93)90357-7

PMID:8450169

Abstract

OBJECTIVES

The purpose of this study was to determine whether dietary fish oil supplementation enhances endothelium-mediated vasodilator responses in human heart transplant recipients, a group known to have coronary artery disease and endothelial dysfunction.

BACKGROUND

Omega-3 fatty acid supplementation has been shown to enhance endothelium-dependent coronary vasodilation in animal models of atherosclerosis.

METHODS

Endothelium-dependent vasodilator responses to intracoronary acetylcholine infusion and endothelium-independent responses to nitroglycerin were evaluated in heart transplant recipients who received a high dose of dietary supplementation with omega-3 fatty acids for 3 weeks (5 g of eicosapentaenoic acid plus docosahexaenoic acid/day, n = 7) and compared with responses in a group of matched heart transplant recipients who did not receive fish oil (control patients, n = 7). Acetylcholine was selectively infused into the midportion of the left anterior descending or left circumflex coronary artery, with the noninfused left coronary artery serving as a control vessel. Serial coronary angiograms were performed after infusion with increasing doses of acetylcholine (infused concentrations 10(-6) to 10(-3) mol/liter) and after intracoronary nitroglycerin administration.

RESULTS

The patients treated with fish oil showed a normal vasodilator response to acetylcholine with 14 +/- 2.5% and 15 +/- 7% vasodilation (vs. baseline diameter) at infused acetylcholine concentrations of 10(-5) and 10(-4) mol/liter, respectively. In contrast, the control patients demonstrated vasoconstrictor responses (-1 +/- 1% and -9 +/- 4%) to acetylcholine at these same doses (p < 0.05 and < 0.005, respectively, for treated vs. control patients). There were no differences in the response to nitroglycerin between the control and treated patients.

CONCLUSIONS

Dietary supplementation with fish oil significantly alters endothelium-dependent coronary vasodilation in heart transplant recipients without alteration of the responses to endothelium-independent vasodilation. Whether this enhancement of endothelial function can beneficially alter the natural history of heart transplant atherosclerosis warrants further study.

摘要

目的

本研究旨在确定补充膳食鱼油是否能增强心脏移植受者内皮介导的血管舒张反应，这是一组已知患有冠状动脉疾病和内皮功能障碍的人群。

背景

在动脉粥样硬化动物模型中，补充ω-3脂肪酸已被证明可增强内皮依赖性冠状动脉舒张。

方法

对接受高剂量ω-3脂肪酸膳食补充3周（5克二十碳五烯酸加二十二碳六烯酸/天，n = 7）的心脏移植受者，评估其对冠状动脉内注入乙酰胆碱的内皮依赖性血管舒张反应以及对硝酸甘油的非内皮依赖性反应，并与一组未接受鱼油的匹配心脏移植受者（对照患者，n = 7）的反应进行比较。将乙酰胆碱选择性注入左前降支或左旋支冠状动脉中部，未注入的左冠状动脉作为对照血管。在注入递增剂量的乙酰胆碱（注入浓度为10⁻⁶至10⁻³摩尔/升）后以及冠状动脉内给予硝酸甘油后，进行系列冠状动脉血管造影。

结果

接受鱼油治疗的患者对乙酰胆碱显示出正常的血管舒张反应，在注入乙酰胆碱浓度为10⁻⁵和10⁻⁴摩尔/升时，血管舒张分别为14±2.5%和15±7%（相对于基线直径）。相比之下，对照患者在相同剂量下对乙酰胆碱表现出血管收缩反应（-1±1%和-9±4%）（治疗组与对照组患者相比，p分别<0.05和<0.005）。对照组和治疗组患者对硝酸甘油的反应没有差异。