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Intracoronary Ghrelin Infusion Decreases Coronary Blood Flow in Anesthetized Pigs

Dipartimento di Medicina Clinica e Sperimentale (E.G., C.M., D.A.S.G.M., G.B., G.V.), Facoltà di Medicina e Chirurgia, Università del Piemonte Orientale "A. Avogadro," 28100 Novara, Italy; Dipartimento di Medicina Interna (E.G.), Università degli Studi di Torino, 10124 Torino, Italy

Address all correspondence and requests for reprints to: Dr. E. Grossini, Facoltà di Medicina e Chirurgia, Università del Piemonte Orientale "A. Avogadro," via Solaroli 17, I-28100 Novara, Italy. E-mail: grossini{at}med.unipmn.it.

The peptide ghrelin has been linked to the atherosclerotic process and coronary artery disease. We planned to study, for the first time, the primary effects of ghrelin on the intact coronary circulation and determine the mechanisms involved. In 24 sodium pentobarbitone-anesthetized pigs, changes in anterior descending coronary blood flow caused by intracoronary infusion of ghrelin at constant heart rate and arterial pressure were assessed using electromagnetic flowmeters. In 20 pigs, intracoronary infusion of ghrelin decreased coronary blood flow without affecting left ventricular maximum rate of change of left ventricular systolic pressure (dP/dt_max), filling pressures of the heart or plasma levels of GH. In four pigs, this decrease was graded by step increments of infused dose of the hormone. The mechanisms of the above response were studied in the 20 pigs by repeating the experiment after coronary flow had returned to the control values observed before infusion. The ghrelin-induced coronary vasoconstriction was not affected by iv atropine (five pigs) or phentolamine (five pigs). This response was abolished by iv butoxamine (five pigs) and intracoronary N-nitro-L-arginine methyl ester (five pigs), even after reversing the increase in arterial pressure and coronary vascular resistance caused by the two blocking agents with iv infusion of papaverine. The present study showed that intracoronary infusion of ghrelin primarily caused coronary vasoconstriction. The mechanisms of this response were shown to involve the inhibition of a vasodilatory ß₂-adrenergic receptor-mediated effect related to the release of nitric oxide.