Intravenous injection of nicardipine changed the distribution of coronary artery endothelial shear stress and fluid dynamics in patients with unstable angina  

作　　者：CHEN Shao-liang HU Zuo-ying ZHANG Jun-jie KAN Jing XU Tian LIU Zhi-zhong XU Hai-mei 

机构地区：[1]Department of Cardiology, Nanjing First Hospital, NanjingMedical University, Nanjing, China Jiangsu 210006

出　　处：《Chinese Medical Journal》2012年第18期3240-3245,共6页中华医学杂志（英文版）

摘　　要：Background Coronary endothelial shear stress （ESS） triggered the development of atherosclerosis. However, the effect of calcium channel antagonist on the distribution of ESS remained unclear. Methods Twenty consecutive patients with acute coronary syndrome （ACS） 48 hours after maximal medication with single left anterior descending artery stenosis 〈50% were studied. Nicardipine was intravenously injected at 1 μg/kg after a bolus of 10 mg in order to achieve mean blood pressure （MBP） reduced by 10% or more, or the heart rate increased by 10-15 beats/min. Hemodynamic variables and angiogram at baseline and during injection of nicardipine were recorded, respectively. Coronary artery 3-D reconstruction was used for the analysis of ESS. Results Distal reference-vessel-diameter and minimal lumen diameter decreased significantly from （2.42±0.41） mm and （1.47±0.49） mm at baseline to （2.22±0.35） mm and （1.35±0.49） mm at maximal drug-dosage （P=0.018 and 0.020, respectively）. Nicardipine did not change blood velocity. Lowest mean shear stress at segments 2-mm distal to plaque increased significantly from （0.034±0.519） Pa at baseline to （0.603±0.728） Pa （P=0.013） at peak effect of drug. Conclusions Nicardipine was associated with the constriction of diseased vessel segment that adapted to the reduction of blood pressure, without dynamic change of blood velocity at each stage of whole cardiac cycle. Increased ESS value at segments distal to plaque reflected the cardioprotection by nicardipine （ChiCTR-TRC-10000964）.Background Coronary endothelial shear stress （ESS） triggered the development of atherosclerosis. However, the effect of calcium channel antagonist on the distribution of ESS remained unclear. Methods Twenty consecutive patients with acute coronary syndrome （ACS） 48 hours after maximal medication with single left anterior descending artery stenosis 〈50% were studied. Nicardipine was intravenously injected at 1 μg/kg after a bolus of 10 mg in order to achieve mean blood pressure （MBP） reduced by 10% or more, or the heart rate increased by 10-15 beats/min. Hemodynamic variables and angiogram at baseline and during injection of nicardipine were recorded, respectively. Coronary artery 3-D reconstruction was used for the analysis of ESS. Results Distal reference-vessel-diameter and minimal lumen diameter decreased significantly from （2.42±0.41） mm and （1.47±0.49） mm at baseline to （2.22±0.35） mm and （1.35±0.49） mm at maximal drug-dosage （P=0.018 and 0.020, respectively）. Nicardipine did not change blood velocity. Lowest mean shear stress at segments 2-mm distal to plaque increased significantly from （0.034±0.519） Pa at baseline to （0.603±0.728） Pa （P=0.013） at peak effect of drug. Conclusions Nicardipine was associated with the constriction of diseased vessel segment that adapted to the reduction of blood pressure, without dynamic change of blood velocity at each stage of whole cardiac cycle. Increased ESS value at segments distal to plaque reflected the cardioprotection by nicardipine （ChiCTR-TRC-10000964）.

关 键 词：NICARDIPINE endothelial shear stress  blood hemodynamics 

分 类 号：TQ460.72[医药卫生—药物分析学] Q954.561[化学工程—制药化工]