부산대학교 도서관

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(01)01202-5 Byline: Kazuo Minai (a), Tetsuya Matsumoto (a), Hajime Horie (a), Naoto Ohira (a), Hiroyuki Takashima (a), Hiroshi Yokohama (a), Masahiko Kinoshita (a) Abbreviations: ACE, angiotensin-converting enzyme; ACh, acetylcholine; ANOVA, analysis of variance; Ao, aorta; BK, bradykinin; CBF, coronary blood flow; CS, coronary sinus; LAD, left anterior descending; MAP, mean arterial pressure; NO, nitric oxide; PAI-1, plasminogen activator inhibitor-1; PARC, plasma active renin concentration; tPA, tissue plasminogen activator Abstract: OBJECTIVES The goal of this study was to determine: 1) whether bradykinin (BK) directly stimulates tissue plasminogen activator (tPA) secretion in human coronary circulation, and 2) whether angiotensin-converting enzyme (ACE) inhibition favorably alters the fibrinolytic balance regulated by BK. BACKGROUND Bradykinin is a potent stimulator of tPA secretion in endothelial cells; however, the effect of BK on tPA release in the human coronary circulation has not been studied. METHODS Fifty-six patients with atypical chest pain were randomly assigned to two groups: 25 patients were treated with the ACE inhibitor enalapril (ACE inhibitor group), and 31 were not treated with ACE inhibitors (non-ACE inhibitor group). Graded doses of BK (0.2, 0.6, 2.0 [mu]g/min), acetylcholine (ACh) (30 [mu]g/min) and papaverine (PA) (12 mg) were administered into the left coronary artery. Coronary blood flow (CBF) was evaluated by Doppler flow velocity measurement. Blood samples were taken from the aorta (Ao) and the coronary sinus (CS). RESULTS Bradykinin induced similar increases in CBF in both groups. The net tPA release induced by BK was dose-dependently increased in both groups, and the extent of that increase in the ACE inhibitor group was greater than that in the non-ACE inhibitor group. Bradykinin did not alter plasminogen activator inhibitor-1 (PAI-1) levels in the Ao or CS in either group. Neither ACh nor PA altered tPA levels or PAI-1 levels in either group. CONCLUSIONS Intracoronary infusion of BK stimulates tPA release without causing any change in PAI-1 levels in the human coronary circulation. In addition, this effect of BK is augmented by an ACE inhibitor. Author Affiliation: (a) First Department of Internal Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, Japan Article History: Received 12 September 2000; Revised 12 January 2001; Accepted 29 January 2001