N-acetylcysteine improves coronary and peripheral vascular function.
نویسندگان
چکیده
OBJECTIVES We investigated whether N-acetylcysteine (NAC), a reduced thiol that modulates redox state and forms adducts of nitric oxide (NO), improves endothelium-dependent vasomotion. BACKGROUND Coronary atherosclerosis is associated with endothelial dysfunction and reduced NO activity. METHODS In 16 patients undergoing cardiac catheterization, seven with and nine without atherosclerosis, we assessed endothelium-dependent vasodilation with acetylcholine (ACH) and endothelium-independent vasodilation with nitroglycerin (NTG) and sodium nitroprusside (SNP) before and after intracoronary NAC. In 14 patients femoral vascular responses to ACH, NTG and SNP were measured before and after NAC. RESULTS Intraarterial NAC did not change resting coronary or peripheral vascular tone. N-acetylcysteine potentiated ACH-mediated coronary vasodilation; coronary blood flow was 36 +/- 11% higher (p < 0.02), and epicardial diameter changed from -1.2 +/- 2% constriction to 4.7 +/- 2% dilation after NAC (p = 0.03). Acetylcholine-mediated femoral vasodilation was similarly potentiated by NAC (p = 0.001). Augmentation of the ACH response was similar in patients with or without atherosclerosis. N-acetylcysteine did not affect NTG-mediated vasodilation in either the femoral or coronary circulations and did not alter SNP responses in the femoral circulation. In contrast, coronary vasodilation with SNP was significantly greater after NAC (p < 0.05). CONCLUSIONS Thiol supplementation with NAC improves human coronary and peripheral endothelium-dependent vasodilation. Nitroglycerin responses are not enhanced, but SNP-mediated responses are potentiated only in the coronary circulation. These NO-enhancing effects of thiols reflect the importance of the redox state in the control of vascular function and may be of therapeutic benefit in treating acute and chronic manifestations of atherosclerosis.
منابع مشابه
Effect of Heparin Administration during Coronary Angiography on Vascular or Peripheral Complications: A Single-Blind Randomized Controlled Clinical Trial
Background: Coronary angiography consists of the selective injection of contrast agents in coronary arteries. Optimal strategy for heparin administration during coronary angiography has yet to be determined. We assessed the effect of heparin administration during coronary angiography on vascular, hemorrhagic, and ischemic complications.Methods: Five hundred candiates for diagnostic coronary ang...
متن کاملDoes Heart Affect Peripheral Vascular Resistance Following Myocardial Ischemia and Reperfusion?
Objective(s) The aim of this study was to investigate the overall effect of cardiac vasoactive factors during coronary occlusion and reperfusion on peripheral vascular tone, using a sequential isolated rabbit heart-ear perfusion model. Materials and Methods Isolated ears were perfused with the effluent of isolated hearts subjected to ischemia (30 min) and reperfusion (180 min, n=6). The comp...
متن کاملAcetylcysteine for Prevention of Renal Outcomes in Patients Undergoing Coronary and Peripheral Vascular Angiography
متن کامل
Potentiation of nitroglycerin-induced coronary dilatation by N-acetylcysteine.
Previous studies have suggested that (1) nitroglycerin causes vasodilatation by interacting with sulfhydryl groups in vascular smooth muscle, thereby activating guanylate cyclase and increasing the intracellular concentration of cyclic GMP, and (2) N-acetylcysteine, a source of sulfhydryl groups, potentiates the peripheral vasodilatory effect of nitroglycerin. This study was performed to explor...
متن کاملThe Cardioprotective Effects of N acetylcysteine as an Additive to the Blood Cardioplegia During Coronary Artery Bypass Grafting
Introduction: During coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB), the role of cardioplegic solution which results in cardiac arrest, is critical. This study was planned to evaluate the clinical impacts of N acetylcysteine (NAC) enriched cold-blood cardioplegia on early reperfusion injury in patients with ischaemic heart disease undergoing CABG Methods: In a...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of the American College of Cardiology
دوره 37 1 شماره
صفحات -
تاریخ انتشار 2001