de Vries R J, Anthonio R, van Veldhuisen D J, Scholtens E, Buikema H, van Gilst W H
Department of Cardiology, University Hospital Groningen, The Netherlands.
J Cardiovasc Pharmacol. 1997 Nov;30(5):683-9. doi: 10.1097/00005344-199711000-00020.
In chronic heart failure, the role of endothelial dysfunction is not yet well established. As calcium metabolism plays an important role in the endothelium, it might be suggested that calcium channel blockers influence endothelial function. Although calcium channel blockers are generally contraindicated in chronic heart failure, because they are believed to stimulate neurohumoral mechanisms and to exert negative inotropic effects, recently it has been suggested that amlodipine might have a favorable affect on mortality in patients with heart failure. The mechanism of amlodipine that contributes to this beneficial effect is not known. Therefore we investigated whether 10 weeks of amlodipine treatment could influence endothelial function in rats with congestive heart failure induced by myocardial infarction. The main finding of our study was that amlodipine, when administered for 10 weeks to rats after a myocardial infarction had been induced, had no significant effects on in vitro and in vivo hemodynamics or neurohormones. The effect of amlodipine on endothelium-intact, norepinephrine-precontracted aortic rings appears to differ from the placebo treatment with respect to the endothelium-dependent relaxation, whereas no differences are seen in endothelium-independent relaxation. We conclude that our data do not support a beneficial role of amlodipine on endothelial function in chronic heart failure.
在慢性心力衰竭中,内皮功能障碍的作用尚未完全明确。由于钙代谢在内皮中起着重要作用,因此有人认为钙通道阻滞剂可能会影响内皮功能。尽管钙通道阻滞剂通常在慢性心力衰竭中被视为禁忌,因为它们被认为会刺激神经体液机制并产生负性肌力作用,但最近有人提出氨氯地平可能对心力衰竭患者的死亡率产生有利影响。氨氯地平产生这种有益作用的机制尚不清楚。因此,我们研究了氨氯地平治疗10周是否会影响心肌梗死所致充血性心力衰竭大鼠的内皮功能。我们研究的主要发现是,在诱导心肌梗死后给大鼠服用10周氨氯地平,对体外和体内血流动力学或神经激素没有显著影响。在依赖内皮的舒张方面,氨氯地平对内皮完整、去甲肾上腺素预收缩的主动脉环的作用似乎与安慰剂治疗不同,而在不依赖内皮的舒张方面未见差异。我们得出结论,我们的数据不支持氨氯地平在慢性心力衰竭中对内皮功能有有益作用的观点。