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Impairment of pulmonary endothelium‐dependent relaxation in patients with Eisenmenger's syndrome
Author(s) -
Xuan A.T. Dinh,
Higenbottam T.W.,
Clelland C.,
PepkeZaba J.,
Cremona G.,
Wallwork J.
Publication year - 1990
Publication title -
british journal of pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.432
H-Index - 211
eISSN - 1476-5381
pISSN - 0007-1188
DOI - 10.1111/j.1476-5381.1990.tb14643.x
Subject(s) - medicine , phenylephrine , sodium nitroprusside , eisenmenger syndrome , endothelium , pulmonary hypertension , cardiology , vasodilation , anesthesia , nitric oxide , blood pressure
A comparison has been made between the endothelium‐dependent relaxation of pulmonary arteries (PA) obtained at heart‐lung transplantation from 4 patients with Eisenmenger's syndrome and secondary pulmonary hypertension, and PA obtained at lobectomy from 4 patients with lung carcinoma, the controls. All vascular rings were studied immediately after lung excision. PA rings from control patients dose‐dependently relaxed to cumulative doses of acetylcholine (ACh, 10 −10 to 10 −5 m ), achieving a maximal relaxation of 80 ± 5% (mean ± s.e.mean) from precontraction with phenylephrine. By contrast, PA rings from Eisenmenger's syndrome patients achieved a maximal relaxation of only 34 ± 12% ( P < 0.05, unpaired t test), with even paradoxical contraction at high doses of ACh (10 −6 to 10 −5 m ). Sodium nitroprusside (10 −4 m ) relaxed all PA rings, with and without endothelium (carefully removed before study), obtained from both control and Eisenmenger's syndrome patients. These results provide the first evidence that endothelium‐dependent relaxation of PA mediated by endothelium‐derived relaxing factors is impaired in Eisenmenger's syndrome patients with secondary pulmonary hypertension.