Pernow J, Kaijser L, Lundberg J M, Ahlborg G
Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
Circulation. 1996 Nov 1;94(9):2077-82. doi: 10.1161/01.cir.94.9.2077.
Endothelin-1 (ET-1) is a potent vasoconstrictor produced from the precursor big ET-1 in endothelial cells. The coronary effects of these peptides in humans in vivo are unknown. Therefore, the effects of ET-1 and big ET-1 on coronary blood flow in relation to plasma ET-1 and big ET-1 levels were compared in healthy subjects.
The peptides were infused intravenously at the rates of 0.2, 1, and 8 pmol/kg per minute. Each dose administered for 20 minutes except the highest dose of ET-1, which was administered for 10 minutes. ET-1 and big ET-1 evoked dose-related increases in mean arterial blood pressure from 93 +/- 4 to 107 +/- 4 mm Hg and from 89 +/- 2 to 122 +/- 5 mm Hg, respectively, at the highest dose. ET-1 and big ET-1 reduced coronary sinus blood flow, measured with thermodilution by a maximum of 25 +/- 4% and 28 +/- 8% and increased coronary vascular resistance by 50 +/- 9% and 107 +/- 26%, respectively. Coronary sinus, but not arterial, oxygen saturation was reduced in parallel with the coronary sinus blood flow. The effects of ET-1 and big ET-1 were similar at corresponding time points. During infusion of ET-1, a 19 +/- 5% extraction of ET-1 was observed over the coronary vascular bed (P < .05). Administration of big ET-1 elevated arterial plasma ET-1 levels by 2.4-fold, and after correction for the local extraction of ET-1, a myocardial production of ET-1 was observed.
ET-1 and big ET-1 induce comparable increases in blood pressure and coronary constriction in humans in vivo. The results also suggest a net local removal of circulating ET-1 and big ET-1 and a local conversion of big ET-1 into ET-1 within the coronary vascular bed.
内皮素 -1(ET-1)是一种由内皮细胞中前体大内皮素 -1产生的强效血管收缩剂。这些肽类在人体体内对冠状动脉的影响尚不清楚。因此,在健康受试者中比较了ET-1和大内皮素 -1对冠状动脉血流的影响以及与血浆ET-1和大内皮素 -1水平的关系。
以每分钟0.2、1和8 pmol/kg的速率静脉输注这些肽类。除最高剂量的ET-1输注10分钟外,每个剂量均输注20分钟。在最高剂量时,ET-1和大内皮素 -1分别使平均动脉血压从93±4 mmHg升高至107±4 mmHg以及从89±2 mmHg升高至122±5 mmHg,呈剂量相关。ET-1和大内皮素 -1通过热稀释法测量使冠状窦血流量最多减少25±4%和28±8%,并使冠状动脉血管阻力分别增加50±9%和107±26%。冠状窦血氧饱和度而非动脉血氧饱和度与冠状窦血流量平行降低。ET-1和大内皮素 -1在相应时间点的作用相似。在输注ET-1期间,观察到在冠状动脉血管床ET-1的摄取率为19±5%(P < 0.05)。输注大内皮素 -1使动脉血浆ET-1水平升高2.4倍,在校正ET-1的局部摄取后,观察到心肌有ET-1生成。
ET-1和大内皮素 -1在人体体内可引起相当的血压升高和冠状动脉收缩。结果还提示循环中的ET-1和大内皮素 -1在局部有净清除,且在冠状动脉血管床内大内皮素 -1可局部转化为ET-1。