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Department of Pediatrics and Cardiovascular Research Institute, University of California, San Francisco, California 94143
Calcitonin
gene-related peptide (CGRP) may play a role in regulation of pulmonary
vascular tone in adults. We set out to establish whether or not CGRP
has any effect on the fetal pulmonary circulation. Hemodynamic effects
of exogenous CGRP were studied in seven near-term fetal sheep. Single
CGRP injections into left pulmonary artery (LPA), compared with
acetylcholine, and five repeated CGRP injections were studied. Single
CGRP injections (1.36 ± 0.13 µg/kg) increased LPA blood flow
(transit time ultrasound) significantly, from 26 ± 22 to 202 ± 86 ml/min (P < 0.05), and decreased
pulmonary and aortic pressures, from 58 ± 5 to 48 ± 6 mmHg and from 56 ± 3 to 46 ± 5 mmHg, respectively
(P < 0.05). LPA resistance decreased from 3.69 to 0.24 mmHg · min · ml
1
(P < 0.05). These changes were
similar to those with acetylcholine. Five CGRP injections at 5-min
intervals increased LPA flow significantly, in stepwise fashion, and
LPA resistance decreased. Heart rate increased stepwise, without
changes in pulmonary or carotid arterial pressures. Exogenous CGRP is a
potent pulmonary vasodilator in fetal sheep and increases pulmonary
flow. CGRP-induced increases in heart rate are not secondary to
decreased systemic blood pressure but reflect a positive chronotropic
effect. These findings suggest a role for endogenous CGRP in the
remarkable decrease in pulmonary vascular resistance during the
transition to extrauterine life.
perinatal pulmonary circulation; pulmonary vascular resistance; transitional circulation
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