酸化窒素は,左心室機能不全を有するヒトにおけるβ-アドレネルジック刺激に対する陽性イノトロプ的反応を阻害する

J M Hare¹, E Loh, M A Creager

¹Cardiomyopathy Center, Boston University School of Medicine, MA 02118, USA.

Circulation

|October 15, 1995

まとめ

心臓中の酸化窒素 (NO) は,左心室 (LV) 機能不全の患者のベータアドレナージック刺激に対する反応を低下させる. NOを阻害すると,この反応が強化され,NOが過敏反応に寄与することを示唆する.

科学分野:

心臓病学心臓病学
生理学生理学とは
薬理学薬理学とは

背景:

酸化窒素 (NO) は,ベータ-アドレネルジック刺激への反応として,心臓の収縮性を減少させることが知られている.
この効果は,細胞培養や動物モデルで観察されています.

研究の目的:

人間の心臓で内在的に生成される窒素酸化物 (NO) がベータアドレネルゲン刺激の陽性イノトロピー効果を阻害するかどうかを調査する.
左心室 (LV) 機能不全の患者でこれをテストするために.

主な方法:

LV機能不全の患者は,ドブタミン注入 (冠内または外周) を受けました.
酸化窒素合成酵素阻害剤NG-モノメチル-L-アルギニン (L-NMMA) を冠内注入した.
収縮性を評価するために,左心房圧とdP/dtを測定した.

主要な成果:

冠内ドブタミンは,LVピーク+dP/dtを33%増加させた.
L-NMMA単独は,ベースラインの心臓機能に影響を与えませんでした.
同時にL-NMMAを注入すると,ドブタミンの+dP/dtに対する効果が30%~37%増加した.

結論:

心臓に由来する酸化窒素 (NO) は,LV機能不全のヒトにおけるβ-アドレナージ刺激に対する陽性イノトロピック反応を弱める.
NOは,これらの患者で観察されるベータアドレナージック剤に対する反応の低下に役割を果たす可能性があります.

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