| L-arginine ameliorates the abnormal sympathetic response of the dysfunctional human coronary microvasculature. | |
| | |
MedLine Citation:
|
PMID: 14759083 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
A nitric oxide (NO)-related defect may contribute to abnormal coronary sympathetic responses that can cause ischemia in patients with endothelial dysfunction. Because L-arginine, the NO synthase (NOS) precursor, augments NO bioactivity, we hypothesized that L-arginine would improve dysfunctional coronary sympathetic responses. Eleven patients with atherosclerosis or its risk factors were challenged with the cold pressor test, a specific provocative test of cardiac sympathetic activity, after 3 separate and sequential intracoronary infusions, as follows: 1) Normal saline; 2) L-NMMA, a competitive inhibitor of NOS; and 3) L-arginine. Study patients exhibited abnormal microvascular responses with coronary vascular resistance (CVR) increasing by 22.3 +/- 9.7% (mean +/- 1 SEM), p < 0.01. In addition, the change in coronary blood flow (CBF) did not correlate with the change in rate pressure product (RPP), r = -0.29, p = NS, suggesting an uncoupling of CBF from cardiac work. In the presence of L-NMMA, the CVR response, 10.3 +/- 9.8%, did not differ from the baseline response, and there was no relationship between the changes in CBF and RPP, r = 0.13, p = NS. In contrast, L-arginine ameliorated the CVR response, -3.2 +/- 3.1%, p < 0.05 vs baseline response, and restored the normal correlation between the changes in CBF and RPP, r = 0.74, p < 0.01. L-arginine not only improved abnormal microvascular responses to sympathetic activation, but it also restored the coupling that normally exists between coronary blood flow and cardiac work. L-arginine warrants further investigation as a therapy for coronary artery disease. |
| | |
Authors:
|
Joel Gellman; Joshua M Hare; Charles J Lowenstein; Gary Gerstenblith; Vicki Coombs; Patricia Langenberg; Jeffrey A Brinker; Jon R Resar |
Related Documents
:
|
6235383 - Nicorandil releases acetylcholine-induced sustained coronary arterial constriction in m... 2335023 - Coronary microvascular responses to reductions in perfusion pressure. evidence for pers... 6168863 - Effects of long-term, once-daily administration of atenolol on ambulatory blood pressur... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Angiology Volume: 55 ISSN: 0003-3197 ISO Abbreviation: Angiology Publication Date: 2004 Jan-Feb |
Date Detail:
|
Created Date: 2004-02-04 Completed Date: 2004-02-26 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0203706 Medline TA: Angiology Country: United States |
Other Details:
|
Languages: eng Pagination: 1-8 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine, Division of Cardiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. joel_gellman@yahoo.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Arginine
/
pharmacology* Coronary Artery Disease / physiopathology* Female Hemodynamics / drug effects Humans Male Microcirculation / drug effects* Middle Aged Regional Blood Flow / drug effects Sympathetic Nervous System / drug effects* Vascular Resistance / drug effects omega-N-Methylarginine / pharmacology |
| Chemical | |
Reg. No./Substance:
|
17035-90-4/omega-N-Methylarginine; 74-79-3/Arginine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Necrobiosis lipoidica diabeticorum: response to pentoxiphylline.
Next Document: Coronary blood flow in evolving myocardial infarction preceded by preinfarction angina: a critical r...