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長期喫煙が心筋の血流,冠動脈血管運動,血管拡張能力に及ぼす影響
R Campisi1, J Czernin, H Schöder
1Ahmanson Biological Imaging Clinic/Nuclear Medicine, Department of Molecular and Medical Pharmacology, UCLA School of Medicine, Los Angeles, CA 90095-6948, USA.
Circulation
|July 29, 1998
まとめ
長期喫煙は冠動脈血管運動,特に内皮に依存する反応を阻害し,内皮に依存しない血管拡張を保持します. 喫煙の期間は,この障害の重要な要因です.
科学分野:
- 心臓病学 心臓病学
- 血管生理学 血管生理学
- 核心臓病の心臓病学について
背景:
- 健康な個人の冠動脈血管運動と血管拡張能力に対する長期的な喫煙の影響は不明である.
- 喫煙者の内皮機能の評価は,心血管疾患のリスクを理解するために重要です.
研究 の 目的:
- 冠動脈血管運動と血管拡張能力に対する長期喫煙の影響を調査する.
- 喫煙者におけるエンドセリウム依存およびエンドセリウム独立の血管反応を区別する.
主な方法:
- 心筋血流 (MBF) は,長期間喫煙者16人と非喫煙者17人の[13N]アンモニアとポジトロン放出トモグラフィ (PET) を使用して測定されました.
- 静脈運動の反応は,静止状態,冷圧器試験 (内皮質依存) および二ピリダモール誘発性高血症 (内皮質依存) 時に評価された.
- 心筋の血流は,心筋の作業負荷の変化を考慮するために,速度-圧力積 (RPP) に正常化されました.
主要な成果:
- 休息中のMBFは,グループによって違いはなかった. コールドプレッサー検査は,喫煙者における内皮に依存した血管運動の障害を明らかにし,非喫煙者と比較してMBFが低かった.
- コールドプレッサーテストで喫煙者の正常化されたMBFは低下し,冠動脈血管運動の欠陥を示し,喫煙年数と強く相関しています.
- ダイピリダモール誘発性高血症および心筋循環準備期間中のエンドセリウム独立性血管拡張は,長期喫煙者において保存された.
結論:
- 長期喫煙は,おそらく内皮機能不全による内皮に依存する冠動脈血管運動を損なう.
- 内皮から独立する血管拡張は無傷のままであり,滑らかな筋肉のリラックスが保存されていることを示唆しています.
- 冠動脈血管運動障害の重症度は,喫煙による累積的な暴露と直接関係しています.
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