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Endothelium-dependent pulmonary artery responses in chronic heart failure: influence of pulmonary hypertension.

Abstract：

OBJECTIVES:The purpose of this study was to determine whether pulmonary artery responses to acetylcholine are abnormal in patients with chronic heart failure. BACKGROUND:Defective pulmonary artery endothelium-dependent responses have been observed in chronic heart failure models in animals. However, pulmonary artery endothelial responses in humans with chronic heart failure are unknown. METHODS:Twenty-two patients with chronic treated heart failure (12 with secondary pulmonary hypertension, Group I; 10 with normal pulmonary artery pressure, Group II) and 8 control patients constituted the study groups. Intravascular ultrasound measurements of pulmonary artery area just beyond the tip of an 8F infusion sheath were obtained in response to acetylcholine (10(-6), 10(-5) and 10(-4) mol/liter). The 10(-6) mol/liter infusion was repeated after methylene blue infusion. Indomethacin (5 micrograms/ml) was sequentially added to this combination in 17 patients. RESULTS:There were no significant differences among the three groups in vascular area responses to the lowest concentration (10(-6) and 10(-5) mol/liter) of acetylcholine, but the 10(-4) mol/liter infusion resulted in significant constriction in Group II patients (p < 0.05, analysis of variance [ANOVA]). Pretreatment with methylene blue in Group II also resulted in significant pulmonary artery vasoconstriction to even the 10(-6) mol/liter acetylcholine infusion (10.4 +/- 7.8% in Group II vs. 1.7 +/- 3.9% in the control group and 0.1 +/- 4.3% in Group I, p < 0.05, ANOVA). The addition of indomethacin resulted in reversal of the constriction in Group II patients. CONCLUSIONS:These responses indicate that the pulmonary artery endothelium may play a significant role in inhibiting vasoconstriction in patients with chronic heart failure who maintain normal pulmonary artery pressure.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Porter TR,Taylor DO,Cycan A,Fields J,Bagley CW,Pandian NG,Mohanty PK

doi

10.1016/0735-1097(93)90552-c

subject

Has Abstract

pub_date

1993-11-01 00:00:00

pages

1418-24

issue

5

eissn

0735-1097

issn

1558-3597

pii

0735-1097(93)90552-C

journal_volume

22

pub_type

杂志文章

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