Laurent S, Boutouyrie P
Service de pharmacologie, Hôpital Broussais, Paris.
Rev Prat. 1999 Mar 1;49(5):495-502.
Arterial remodeling has emerged as a key-concept in the pathophysiology of hypertension and its vascular damage. In any given arterial territory, hypertension-induced remodeling is characterized by an increased intima-media thickness, independently of the lumen and wall cross-sectional areas. Functional consequences of hypertension-induced arterial remodeling depend upon the caliber of the artery, and thus upon its function. In essential hypertension, the 2 major functional consequences of large artery remodeling are the long-term enhancement of atherosclerosis and the shorter-term preservation of elastic properties. The functional consequences of resistive arteries remodeling can be either deleterious (structural increase in peripheral vascular resistances, hyperreactivity to vasomotor stimuli, and decrease in perfusion reserve of target organs) or rather compensatory (changes in the autoregulation of regional perfusions).
动脉重塑已成为高血压及其血管损伤病理生理学中的一个关键概念。在任何特定的动脉区域,高血压诱导的重塑特征是内膜中层厚度增加,与管腔和壁横截面积无关。高血压诱导的动脉重塑的功能后果取决于动脉的管径,进而取决于其功能。在原发性高血压中,大动脉重塑的两个主要功能后果是动脉粥样硬化的长期加重和弹性特性的短期保留。阻力动脉重塑的功能后果可能是有害的(外周血管阻力的结构性增加、对血管舒缩刺激的高反应性以及靶器官灌注储备的降低),也可能是代偿性的(区域灌注自身调节的变化)。