This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by lannuzzi, A. Articles by Rubba, P. Search for Related Content PubMed PubMed Citation Articles by lannuzzi, A. Articles by Rubba, P. Social Bookmarking                         What's this?

L-Arginine Improves Post-Ischemic Vasodilation in Coronary Heart Disease Patients Taking Vasodilating Drugs

Gabriella Jannuzzo, MD

Cecilia Sapio, MD

Paolo Pauciullo, MD

Department of Clinical and Experimental Medicine, School of Medicine, Federico II University, Naples, Italy

Domenico Jorio, MD

Nicola Spampinato, MD

Chair of Cardiac Surgery, School of Medicine, Federico II University, Naples, Italy

Mario Mancini, MD

Paolo Rubba, MD

Department of Clinical and Experimental Medicine, Naples, Italy

Background: The hypothesis that intravenous L-arginine infusion improves the vasodilatory response to ischemia in the resistance vessels of human lower limbs in relatively young coronary heart disease patients taking vasodilating drugs was tested.

Methods: Twenty patients with onset of symptoms of coronary artery disease before age 50, operated for aortocoronary bypass and taking vasodilating drugs, were compared with 20 control subjects of comparable age and gender; neither group included heavy smokers (>10 cigarettes/day). Blood flow in the lower limbs was measured noninvasively with strain-gauge plethysmography, both at rest and during a reactive hyperemia test. Intravenous infusion of L-arginine was performed in nine coronary heart disease patients and in nine control subjects.

Results: Resting blood flow to the lower limbs was 2.3 mI,/minIlO0 mL in control subjects vs 3.4 mL/minIlO0 mL in patients (difference not statistically significant). Peak blood flow measured after a 3-minute arterial occlusion was 24.0 mL/min/lO0 mL in control subjects vs 20.3 mL/min/lO0 mL in coronary heart disease patients (P<0.05). Peripheral minimal vascular resistances were 4.28 and 5.46 peripheral resistances units (p.r.u.) in control subjects and patients, respectively (P<0.05). Intravenous infusion of L-arginine was followed by increased resting blood flow in cases and controls (P=0.009), with a parallel reduction in peripheral resting vascular resistances (P=0.009). Coronary heart disease patients showed increased peak blood flow (P=0.04) and reduced minimal vascular resistances (P=0.02), whereas no statistically significant changes in these parameters were detectable in control subjects. Intravenous glucose infusion, leading to increased serum insulin concentration, did not modify any hemodynamic parameter.

Conclusions: Hemodynamic responses in the skeletal muscle are impaired during a reactive hyperemia test in relatively young coronary heart disease patients taking vasodilating drugs. Intravenous L-arginine infusion corrects the impaired vasodilatory response of the lower limbs to an acute increase in flow following a cuff thigh occlusion.

Key Words: I-arginine • vascular reactivity • coronary heart disease • strain-gauge plethysmography

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 6, No. 2, 121-127 (2001)
DOI: 10.1177/107424840100600203


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. J. Ignarro, M. L. Balestrieri, and C. Napoli Nutrition, physical activity, and cardiovascular disease: An update Cardiovasc Res, January 15, 2007; 73(2): 326 - 340. [Abstract] [Full Text] [PDF]

				C. Napoli, S. Williams-Ignarro, F. de Nigris, L. O. Lerman, F. P. D'Armiento, E. Crimi, R. E. Byrns, A. Casamassimi, A. Lanza, F. Gombos, et al. Physical training and metabolic supplementation reduce spontaneous atherosclerotic plaque rupture and prolong survival in hypercholesterolemic mice PNAS, July 5, 2006; 103(27): 10479 - 10484. [Abstract] [Full Text] [PDF]