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Cardiovascular Research Center, Medical College of Wisconsin and Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin 53226
Adrenomedullin (ADM) is a
vasodilator produced by vascular endothelium and smooth muscle cells.
Although plasma ADM levels are increased in patients with hypertension,
heart failure, and myocardial infarction, little information exists
regarding the microvascular response to ADM in the human heart. In the
present study we tested the hypothesis that ADM produces coronary
arteriolar dilation in humans and examined the mechanism of this
dilation. Human coronary arterioles were dissected and cannulated with
micropipettes. Internal diameter was measured by video microscopy. In
vessels constricted with ACh, the diameter response to cumulative doses of ADM (10
12-10
7 M) was measured in
the presence and absence of human ADM-(22-52), calcitonin gene-related peptide-(8-37),
N
-nitro-L-arginine methyl ester
(L-NAME), indomethacin (Indo), 1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one,
SQ-22536, or KCl (60 mM). ADM dilated human coronary arterioles through
specific ADM receptors (maximum dilation = 69 ± 11%).
L-NAME or N-monomethyl-L-arginine attenuated dilation to ADM (for L-NAME, maximum
dilation = 66 ± 7 vs. 41 ± 13%, P < 0.05). Thus the mechanism of ADM-induced dilation involves generation
of nitric oxide. However, neither 1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one,
SQ-22536, nor Indo alone altered dilation to ADM. High concentrations
of KCl blocked dilation to ADM. The magnitude of ADM dilation was
reduced in subjects with hypertension. We propose that, in human
coronary arterioles, ADM elicits vasodilation in part through
production of nitric oxide and in part through activation of
K+ channels, with little contribution from adenylyl
cyclase. The former dilator mechanism is independent of the more
traditional pathway involving activation of soluble guanylate cyclase.
coronary disease; calcitonin gene-related peptide; hypertension; congestive heart failure
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