Kyriakides Z S, Sbarouni E, Antoniadis A, Iliodromitis E K, Mitropoulos D, Kremastinos D T
Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
Clin Cardiol. 1998 Oct;21(10):737-42. doi: 10.1002/clc.4960211008.
In vitro studies have shown that atrial natriuretic peptide (ANP) causes relaxation of preconstricted blood vessel strips and inhibits the contraction of isolated vessels in response to norepinephrine and angiotensin II. The present study examined the effects of exogenous ANP on the coronary collateral blood flow during angioplasty.
We studied 15 patients undergoing elective balloon angioplasty during the second and third balloon inflations. A Doppler flow guidewire was advanced distal to the lesion and used for the estimation of coronary blood flow velocity. After the second balloon inflation, 25 ng/kg/min of ANP were administered intracoronarily for 8 min. Electrocardiogram, pressure, and flow velocity were recorded immediately before each balloon deflation. Fourteen other patients served as controls and received normal saline infusion.
Velocity time integral increased from 65 +/- 40 to 79 +/- 46 mm (p < 0.05) during the third balloon inflation, whereas ST deviation decreased from 1.3 +/- 0.9 to 0.7 +/- 1.0 mV (p < 0.05). These variables did not change in the control group during the two tested balloon inflations.
Exogenous ANP augments coronary collateral blood flow and ameliorates myocardial ischemia during angioplasty.
体外研究表明，心房利钠肽（ANP）可使预收缩的血管条松弛，并抑制离体血管对去甲肾上腺素和血管紧张素II的收缩反应。本研究探讨了外源性ANP在血管成形术期间对冠状动脉侧支血流的影响。
我们研究了15例接受择期球囊血管成形术的患者，在第二次和第三次球囊充盈期间进行观察。将多普勒血流导丝推进至病变远端，用于估计冠状动脉血流速度。在第二次球囊充盈后，以25 ng/kg/min的剂量冠状动脉内给予ANP，持续8分钟。在每次球囊放气前立即记录心电图、压力和血流速度。另外14例患者作为对照组，接受生理盐水输注。
在第三次球囊充盈期间，速度时间积分从65±40增加至79±46 mm（p<0.05），而ST段偏移从1.3±0.9降低至0.7±1.0 mV（p<0.05）。在两次测试的球囊充盈期间，对照组的这些变量没有变化。
外源性ANP可增加血管成形术期间的冠状动脉侧支血流并改善心肌缺血。
