Mathew V, Cannan C R, Miller V M, Barber D A, Hasdai D, Schwartz R S, Holmes D R, Lerman A
Division of Cardiovascular Diseases and Internal Medicine, Mayo Foundation, Rochester, Minn 55905, USA.
Circulation. 1997 Sep 16;96(6):1930-6. doi: 10.1161/01.cir.96.6.1930.
Experimental hypercholesterolemia is associated with coronary vasomotor dysfunction. This study was designed to test the hypothesis that experimental hypercholesterolemia is characterized by altered coronary vasomotor responses to endothelin and inhibition of the endogenous NO pathway.
Endothelin-1 (ET-1) at 5 ng x kg(-1) x min(-1) or N(G)-monomethyl-L-arginine (L-NMMA), a competitive inhibitor of nitric oxide synthase (NOS), at 50 microg x kg(-1) x min(-1) was infused into the left anterior descending coronary artery in pigs before and after 10 weeks of cholesterol diet. There was a significant increase in serum cholesterol. At 10 weeks, ET-1 resulted in an accentuated decrease in coronary blood flow (CBF) and coronary artery diameter (CAD) compared with baseline (-88+/-6% versus -45+/-9%, P<.05, and -77+/-14% versus -18+/-8%, P<.05, respectively) and an increase in coronary vascular resistance (CVR) (242+/-18% versus 110+/-17%, P<.05); ET receptor density and binding affinity in epicardial coronary arteries were unchanged. The effect of L-NMMA on CBF, CAD, and CVR was attenuated at 10 weeks (-7+/-8% versus -48+/-4%, -2+/-3% versus -17+/-5%, and 16+/-10% versus 125+/-32%; each P<.05). Immunohistochemistry staining for constitutive NOS revealed a decrease in immunoreactivity in the coronary arteries of hypercholesterolemic pigs.
The present study demonstrates an enhanced coronary vasoconstrictive response to pathophysiological doses of endothelin and an attenuated response to the inhibition of endogenous NO activity, suggesting an alteration in coronary vascular reactivity in experimental hypercholesterolemia.
实验性高胆固醇血症与冠状动脉血管舒缩功能障碍有关。本研究旨在验证以下假设:实验性高胆固醇血症的特征是冠状动脉对内皮素的血管舒缩反应改变以及内源性一氧化氮(NO)途径受到抑制。
在给予猪10周胆固醇饮食前后,将5 ng·kg⁻¹·min⁻¹的内皮素-1(ET-1)或50 μg·kg⁻¹·min⁻¹的一氧化氮合酶(NOS)竞争性抑制剂N(G)-单甲基-L-精氨酸(L-NMMA)注入左前降支冠状动脉。血清胆固醇显著升高。在10周时,与基线相比,ET-1导致冠状动脉血流量(CBF)和冠状动脉直径(CAD)明显降低(分别为-88±6%对-45±9%,P<0.05;-77±14%对-18±8%,P<0.05),冠状动脉血管阻力(CVR)增加(242±18%对110±17%,P<0.05);心外膜冠状动脉中的ET受体密度和结合亲和力未改变。10周时,L-NMMA对CBF、CAD和CVR的作用减弱(分别为-7±8%对-48±4%、-2±3%对-17±5%、16±10%对125±32%;每组P<0.05)。组成型NOS的免疫组织化学染色显示高胆固醇血症猪冠状动脉中的免疫反应性降低。
本研究表明,对病理生理剂量内皮素的冠状动脉血管收缩反应增强,而对内源性NO活性抑制的反应减弱,提示实验性高胆固醇血症中冠状动脉血管反应性发生改变。