Kugiyama K, Ohgushi M, Sugiyama S, Motoyama T, Kawano H, Hirashima O, Yasue H
Division of Cardiology, Kumomoto University School of Medicine, Japan.
Am J Cardiol. 1997 Mar 1;79(5):606-10. doi: 10.1016/s0002-9149(96)00824-7.
It has been shown that there is the supersensitivity of the dilator effect of nitrovasodilators in the coronary arteries of patients with coronary spastic angina. This study was aimed to elucidate its mechanism(s) by examination of dilator response of spastic coronary arteries to atrial natriuretic peptide (ANP), which is known to dilate arteries by the same final common pathway through cyclic guanosine monophosphate (cGMP) as nitrovasodilators. Effects of infusion of nitroglycerin and ANP on epicardial coronary diameter of left coronary arteries were thus examined by quantitative coronary angiography in 20 patients with coronary spastic angina, who had spasm in left coronary arteries, and in 27 control subjects. Dilator response of coronary diameter to intracoronary infusion of ANP (0.5 microgram/kg) was found to be comparable between spastic coronary arteries and control arteries, whereas dilator response to nitroglycerin (250 micrograms) was enhanced in the spastic arteries compared with control arteries. The results indicate that spastic coronary arteries exhibit supersensitive dilator response to nitroglycerin but not to ANP. There is a possibility that dilator response to cGMP may be comparable between spastic and control coronary arteries and that soluble guanylate cyclase activity and/or conversion of nitric oxide bio-activity from nitroglycerin may be enhanced in spastic coronary arteries.
研究表明，在冠状动脉痉挛性心绞痛患者的冠状动脉中，硝基血管扩张剂的扩张作用存在超敏现象。本研究旨在通过检测痉挛性冠状动脉对心房利钠肽（ANP）的扩张反应来阐明其机制，已知ANP与硝基血管扩张剂通过环磷酸鸟苷（cGMP）的相同最终共同途径扩张动脉。因此，通过定量冠状动脉造影术，对20例左冠状动脉痉挛的冠状动脉痉挛性心绞痛患者和27例对照者进行了硝酸甘油和ANP输注对左冠状动脉心外膜直径的影响研究。发现冠状动脉直径对冠状动脉内输注ANP（0.5微克/千克）的扩张反应在痉挛性冠状动脉和对照动脉之间相当，而与对照动脉相比，痉挛性动脉对硝酸甘油（250微克）的扩张反应增强。结果表明，痉挛性冠状动脉对硝酸甘油表现出超敏扩张反应，但对ANP没有。痉挛性冠状动脉和对照冠状动脉对cGMP的扩张反应可能相当，并且痉挛性冠状动脉中可溶性鸟苷酸环化酶活性和/或硝酸甘油的一氧化氮生物活性转化可能增强。
