Kubota T, Imaizumi T, Oyama J, Ando S, Takeshita A
Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Jpn Circ J. 1997 Jun;61(6):471-80. doi: 10.1253/jcj.61.471.
To determine whether L-arginine, a precursor of nitric oxide, can improve exercise-induced vasodilation of the forearm in patients with heart failure, we measured forearm blood flow in 9 patients with heart failure and in 7 age-matched control subjects before and after intra-arterial infusion of L-arginine. Resting forearm blood flow was significantly lower in patients with heart failure than in control subjects (2.34 +/- 0.85 (SD) vs 4.76 +/- 0.77 ml/min per 100 ml, p < 0.001). Endothelium-dependent vasodilation induced by acetylcholine was attenuated in patients with heart failure (p < 0.05). Exercise-induced vasodilation after handgrip exercise was significantly lower in patients with heart failure (p < 0.05). Intra-arterial infusion of L-arginine did not change basal forearm blood flow but significantly augmented acetylcholine-induced vasodilation in both patients with heart failure and control subjects (p < 0.05). Although L-arginine did not affect maximum forearm blood flow after handgrip exercise in control subjects (before, 26.2 +/- 13.5; after, 25.7 +/- 14.3; p = NS), it was increased in patients with heart failure (from 15.2 +/- 4.9 to 24.7 +/- 14.6, p < 0.01). The finding that L-arginine increased both acetylcholine- and exercise-induced vasodilation in patients with heart failure suggests that endothelial dysfunction might play an important role in impaired exercise-induced vasodilation in patients with heart failure.
为了确定一氧化氮的前体L-精氨酸是否能改善心力衰竭患者运动诱导的前臂血管舒张功能，我们测量了9例心力衰竭患者和7例年龄匹配的对照受试者在动脉内输注L-精氨酸前后的前臂血流量。心力衰竭患者静息时的前臂血流量显著低于对照受试者（分别为2.34±0.85（标准差）与4.76±0.77 ml/min per 100 ml，p<0.001）。心力衰竭患者中由乙酰胆碱诱导的内皮依赖性血管舒张减弱（p<0.05）。心力衰竭患者在握力运动后运动诱导的血管舒张显著降低（p<0.05）。动脉内输注L-精氨酸并未改变基础前臂血流量，但在心力衰竭患者和对照受试者中均显著增强了乙酰胆碱诱导的血管舒张（p<0.05）。尽管L-精氨酸对对照受试者握力运动后的最大前臂血流量没有影响（输注前为26.2±13.5；输注后为25.7±14.3；p=无显著差异），但在心力衰竭患者中其增加了（从15.2±4.9增至24.7±14.6，p<0.01）。L-精氨酸增加了心力衰竭患者乙酰胆碱诱导和运动诱导的血管舒张这一发现表明，内皮功能障碍可能在心力衰竭患者运动诱导的血管舒张受损中起重要作用。
