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热应激状态下人体肌肉交感神经活动的心肺压力感受器控制

Cardiopulmonary baroreceptor control of muscle sympathetic nerve activity in heat-stressed humans.

作者信息

Crandall C G, Etzel R A, Farr D B

机构信息

Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, Dallas 75231, Texas.

出版信息

Am J Physiol. 1999 Dec;277(6 Pt 2):H2348-52. doi: 10.1152/ajpheart.1999.277.6.h2348.

Abstract

Whole body heating decreases central venous pressure (CVP) while increasing muscle sympathetic nerve activity (MSNA). In normothermia, similar decreases in CVP elevate MSNA, presumably via cardiopulmonary baroreceptor unloading. The purpose of this project was to identify whether increases in MSNA during whole body heating could be attributed to cardiopulmonary baroreceptor unloading coincident with the thermal challenge. Seven subjects were exposed to whole body heating while sublingual temperature, skin blood flow, heart rate, arterial blood pressure, and MSNA were monitored. During the heat stress, 15 ml/kg warmed saline was infused intravenously over 7-10 min to increase CVP and load the cardiopulmonary baroreceptors. We reported previously that this amount of saline was sufficient to return CVP to pre-heat stress levels. Whole body heating increased MSNA from 25 +/- 3 to 39 +/- 3 bursts/min (P < 0. 05). Central blood volume expansion via rapid saline infusion did not significantly decrease MSNA (44 +/- 4 bursts/min, P > 0.05 relative to heat stress period) and did not alter mean arterial blood pressure (MAP) or pulse pressure. To identify whether arterial baroreceptor loading decreases MSNA during heat stress, in a separate protocol MAP was elevated via steady-state infusion of phenylephrine during whole body heating. Increasing MAP from 82 +/- 3 to 93 +/- 4 mmHg (P < 0.05) caused MSNA to decrease from 36 +/- 3 to 15 +/- 4 bursts/min (P < 0.05). These data suggest that cardiopulmonary baroreceptor unloading during passive heating is not the primary mechanism resulting in elevations in MSNA. Moreover, arterial baroreceptors remain capable of modulating MSNA during heat stress.

摘要

全身加热会降低中心静脉压(CVP),同时增加肌肉交感神经活动(MSNA)。在正常体温下,类似的CVP降低会升高MSNA,推测是通过心肺压力感受器卸载实现的。本项目的目的是确定全身加热期间MSNA的增加是否可归因于与热刺激同时发生的心肺压力感受器卸载。七名受试者接受全身加热,同时监测舌下温度、皮肤血流量、心率、动脉血压和MSNA。在热应激期间,在7 - 10分钟内静脉输注15 ml/kg温热盐水以增加CVP并加载心肺压力感受器。我们之前报道过,这个量的盐水足以使CVP恢复到热应激前的水平。全身加热使MSNA从25±3次/分钟增加到39±3次/分钟(P < 0.05)。通过快速输注盐水进行的中心血容量扩张并未显著降低MSNA(44±4次/分钟,相对于热应激期P > 0.05),也未改变平均动脉血压(MAP)或脉压。为了确定在热应激期间动脉压力感受器加载是否会降低MSNA,在另一个方案中,在全身加热期间通过持续输注去氧肾上腺素使MAP升高。将MAP从82±3 mmHg升高到93±4 mmHg(P < 0.05)导致MSNA从36±3次/分钟降低到15±4次/分钟(P < 0.05)。这些数据表明,被动加热期间的心肺压力感受器卸载不是导致MSNA升高的主要机制。此外,在热应激期间动脉压力感受器仍能够调节MSNA。

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