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Nitroglycerin reduces augmentation index and central blood pressure independent of effects on cardiac preload

Journal of Pharmaceutical Analysis 2009年第2期21卷 114-119页

作者： Mike Saddon Karen McNeil philip chowienczyk Cardiovascular Division King's College London School of MedicineSt Thomas' Hospital

Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest,during LBNP (10,20 and 30 mmHg,each for 15 min) and after NTG (10,30 and 100 μg/min,each dose for 15 min) in ten healthy volunteers. Cardiac pre-load,stroke volume and cardiac output were assessed by echocardiography. Central pressure augmentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results LBNP (20 mmHg) and NTG (30 μg/min) reduced pre-load (as measured by the peak velocity of the S wave in the superior vena cava) to a similar degree [by (26.8±3.8)% and (23.9±3.4)%,respectively]. Compared to LBNP,NTG reduced systemic vascular resistance [by (32.9±7.5)%,P<0.01],decreased peripheral and central pressure augmentation [by (20.8±3.4)% units and (12.9±2.9)% units,respectively,each P<0.01]. Conclusion These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.

关键词： augmentation index central blood pressure nitroglycerine cardiac preload lower body negative pressure

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Evaluation of global cardiac systolic performance and diastolic filling in central hypovolumia by lower body negative pressure with Doppler echocardiography

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Journal of Nanjing Medical University 2007年第4期21卷 227-232页

作者： Baomin Liu Xiaolin Niu Benyu Jiang Mike Seddon Keren McNeil philip chowienczyk Department of cardiology the second hospital of Xi＇n Jiaotong university Xi＇an 710004 Shanxi Province China Department of Clinical Pharmacology St. Thomas hospital of King＇s College London SEI 7EH U.K.

Objective ：To overall evaluate the change of global cardiac systolic performance and diastolic filling in hypovoleamia by LBNP, Methods：10 healthy male subjects were placed in a standard LBNP chamber. Baseline haemodynamic and echocardiographic measurements were made after a period of least 10 min resting supine within the chamber. Pressure was then decreased to -10,-20 and -30 mmHg, with each pressure maintained for 15 rain. The indices of four transvalvular and SVC flow were measured using Doppler echocardiography. Results ：The results showed that S wave, Re wave ,and VTI of SVC progressively decreased with increasing LBNP. At -30 mmHg stage, S wave decreased by 35.4 % （change of 0.21±0.03 m/s, P 〈 0.001）. This reduction in pre-load Was associated with a progressive decrease in SV（by 21.5 ± 4.5 ml at -30 mmHg,P 〈 0.001 ）, decrease in CO（by 1.2 ± 0.2 L min^-1 at -30 mmHg LBNP,P 〈 0.001 ）. The diastolic filling of mitral and tricuspid flow also reduced significantly. At -30 mmHg stage, the E wave of MVF and TVF decreased 31% and 32% respectively （change of 0.23 ± 0.05 m/s,P 〈 0.001 and 0.18 ± 0.01 m/s,P 〈 0.001）. VTI of MVF and TVF decreased 27% and 27.7% respectively（change of 5.55 ± 1.41cm,P 〈 0.01 and 4.25 ± 0.44 cm,P 〈 0.01）. A wave of both sides did not change significantly. Conclusion：Doppler indices changes in different LBNP stage can roughly reflect the degree of hypovoleamia caused by blood volume redistribution. The indices of Doppler echocardiography are more sensitive than traditional physiological indexes in evaluating cardiovascular responses of LBNP. Echocardiography techniques overall can evaluate the global cardiac function including systolic performance and diastolic filling.

关键词： function heart echocardiography lower body negative pressure

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心脏前负荷减低对主动脉压及主动脉扩增指数的影响

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西安交通大学学报（医学版） 2009年第1期30卷 74-78页

作者：刘保民牛小麟 JIANG Ben-yu SADDON Mike MCNEIL Karen chowienczyk philip 西安交通大学医学院第二附属医院心内科陕西西安710004 英国国王学院临床药理心血管中心伦敦SE1 7EH英国

目的了解心脏前负荷减低对中心动脉压及主动脉扩增指数的影响。方法10例健康志愿者,行下肢负压(LB-NP)抽吸造成不同程度前负荷减低。采用超声心动图检测心输出量的变化;采用中心动脉压力分析系统(SphymoCor)检测桡动脉压力波形,经平均... 详细信息

目的了解心脏前负荷减低对中心动脉压及主动脉扩增指数的影响。方法10例健康志愿者,行下肢负压(LB-NP)抽吸造成不同程度前负荷减低。采用超声心动图检测心输出量的变化;采用中心动脉压力分析系统(SphymoCor)检测桡动脉压力波形,经平均转换功能形成中心动脉压力波形。结果①随着下肢负压的加大,上腔静脉血流进行性减低,在-30mmHg阶段,S波减低22.4%,VTIs+d减低了15.8%,同时SV减少24.7%,CO减少18.7%;②中心动脉收缩压(CSBP)除在-30mmHg阶段轻度下降外,在-10及-20mmHg阶段没有明显改变,中心动脉舒张压(CDBP)在各个负压阶段没有明显改变;③主动脉压力波P1在各个负压阶段均明显下降,在-30mmHg阶段,P1减少了19.6%[(28.2±5.02)mmHgvs.(22.65±3.08)mmHg,P<0.01],而总外周阻力(TPR)在各负压阶段均较基础阶段明显升高,在-30mmHg阶段升高21.3%[(16.0±2.9)(***)/Lvs.(20.3±3.4)(***)/L,P<0.001]。主动脉扩增指数(AI)无明显改变。结论前负荷减低使中心主动脉压及主动脉压力波P1降低,同时使TPR升高,由于TPR的升高抵消了P1的降低,因而AI保持不变。

关键词：前负荷中心动脉压扩增压扩增指数下肢负压主动脉压总外周阻力

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Hypertension：健康人的血压是由酶nNOS调节的

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现代生物医学进展 2017年第11期17卷 I0003-I0004页

作者： Husain Shabeeh Sitara Khan Benyu Jiang Sally Brett Narbeh Melikian Barbara Casadei philip J. chowienczyk Ajay M. Shah From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.). From the King’s College London British Heart Foundation Centre Cardiovascular Division United Kingdom (H.S. S.K. B.J. S.B. N.M. P.J.C. A.M.S.) and Department of Cardiovascular Medicine University of Oxford United Kingdom (B.C.).

在一项新的研究中。来自英国伦敦国王学院的研究人员发现调节血压的一氧化氮（NO）是在神经组织中而不是在血管壁中形成的。这一发现可能导致人们开发出更加有效地治疗高血压的方法。

关键词：高血压 nNOS 健康人神经组织一氧化氮研究人员酶血管壁

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