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钾离子通道开放剂雷马卡林对清醒犬全身、冠状动脉及局部血管动力学的影响:与硝苯地平、腺苷、硝酸甘油及乙酰胆碱的比较

Effects of a K+ATP channel opener, lemakalim, on systemic, coronary and regional vascular dynamics in conscious dogs: comparison with nifedipine, adenosine, nitroglycerin and acetylcholine.

作者信息

Shen Y T, Vatner S F

机构信息

Department of Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts.

出版信息

J Pharmacol Exp Ther. 1993 May;265(2):1026-37.

PMID:8496801
Abstract

The systemic, coronary and regional vascular responses to the K+ATP channel opener lemakalim were compared to other potent vasodilators (i.e., nifedipine, adenosine, nitroglycerin and acetylcholine). Experiments were performed in 12 conscious dogs 2 to 4 weeks after implantation of aortic catheters and flow probes on the ascending aorta, left circumflex coronary, celiac, mesenteric, renal and iliac arteries, and solid-state miniature pressure gauges in the left ventricular cavity. Dose-response curves induced by bolus injection (i.v.) were examined. For doses that reduced total peripheral resistance by 22%, lemakalim reduced celiac (-28 +/- 2%), mesenteric (-24 +/- 3%), renal (-17 +/- 3%) and iliac (-18 +/- 3%) vascular resistances (i.e., by amounts similar to those observed with the other vasodilators, except for adenosine, which increased renal resistance). At these doses, lemakalim induced a greater decrease (-52 +/- 3%) (P < .05) in coronary resistance, as compared with nifedipine (-35 +/- 3%), adenosine (-38 +/- 3%), nitroglycerin (-25 +/- 2%) and acetylcholine (-32 +/- 3%). However, when near maximal vasodilation was elicited, adenosine elicited the greatest (P < .05) decrease in coronary resistance (-81 +/- 1%), as compared with lemakalim (-74 +/- 2%), nifedipine (-67 +/- 2%), nitroglycerin (-63 +/- 2%) and acetylcholine (-72 +/- 1%). Both the time to maximal increases in regional blood flow and the time for recovery in all vascular beds were significantly prolonged for lemakalim compared with the other vasodilators. Thus, the K+ATP channel opener lemakalim dilates the coronary bed out of proportion to other vascular beds, is relatively more potent at lower doses than other vasodilators and exhibits a delayed and more prolonged action in all regional vascular beds.

摘要

将钾离子通道开放剂雷马卡林的全身、冠状动脉和局部血管反应与其他强效血管扩张剂(即硝苯地平、腺苷、硝酸甘油和乙酰胆碱)进行了比较。实验在12只清醒犬身上进行,这些犬在主动脉导管和流量探头植入升主动脉、左旋冠状动脉、腹腔动脉、肠系膜动脉、肾动脉和髂动脉2至4周后,以及在左心室腔内植入固态微型压力计。检查了静脉推注诱导的剂量反应曲线。对于使总外周阻力降低22%的剂量,雷马卡林降低了腹腔动脉(-28±2%)、肠系膜动脉(-24±3%)、肾动脉(-17±3%)和髂动脉(-18±3%)的血管阻力(即降低幅度与其他血管扩张剂观察到的相似,但腺苷除外,腺苷增加了肾阻力)。在这些剂量下,与硝苯地平(-35±3%)、腺苷(-38±3%)、硝酸甘油(-25±2%)和乙酰胆碱(-32±3%)相比,雷马卡林使冠状动脉阻力降低幅度更大(-52±3%)(P<.05)。然而,当引发接近最大程度的血管扩张时,与雷马卡林(-74±2%)、硝苯地平(-67±2%)、硝酸甘油(-63±2%)和乙酰胆碱(-72±1%)相比,腺苷使冠状动脉阻力降低幅度最大(P<.05)(-81±1%)。与其他血管扩张剂相比,雷马卡林使所有血管床达到局部血流最大增加的时间和恢复时间均显著延长。因此,钾离子通道开放剂雷马卡林使冠状动脉床扩张的程度超过其他血管床,在较低剂量下比其他血管扩张剂相对更有效,并且在所有局部血管床中表现出延迟且更持久的作用。

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