Thomas G D, Zhang W, Victor R G
Department of Internal Medicine, Hypertension Division, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Circ Res. 2001 Apr 27;88(8):816-23. doi: 10.1161/hh0801.089341.
Skeletal muscle perfusion during exercise is impaired in heart failure, but the underlying mechanisms are poorly understood. One possibility is that sympathetic vasoconstriction is enhanced in exercising muscle in heart failure as a result of impaired counterregulatory mechanisms that normally act to attenuate vasoconstrictor responses. In healthy animals, sympathetic vasoconstriction in contracting skeletal muscle is attenuated by endogenously produced nitric oxide (NO). Because the NO pathway may be dysfunctional in heart failure, we hypothesized that reduced NO in contracting muscle would result in enhanced sympathetic vasoconstriction. In sham rats and rats with chronic myocardial infarctions (MIs) produced by coronary artery ligation, we measured arterial pressure and femoral artery blood flow responses to sympathetic nerve stimulation (1, 2.5, and 5 Hz) in resting and contracting hindlimb. In resting hindlimb, sympathetic stimulation decreased femoral vascular conductance similarly in sham and MI rats. In contracting hindlimb, these vasoconstrictor responses were attenuated to a greater extent in sham than in MI rats. NO synthase inhibition enhanced sympathetic vasoconstriction in contracting hindlimb of sham, but not MI, rats. Conversely, infusion of L-arginine or a superoxide scavenger, tempol or tiron, attenuated sympathetic vasoconstriction in contracting hindlimb of MI rats. NO synthase expression was similar, but malondialdehyde (a marker of free radical damage) was greater in skeletal muscle from MI than from sham rats. These data suggest that impaired metabolic modulation of sympathetic vasoconstriction in contracting skeletal muscle of MI rats is a consequence of superoxide-mediated disruption of the NO pathway.
心力衰竭患者运动期间骨骼肌灌注受损,但其潜在机制尚不清楚。一种可能性是,由于正常情况下可减弱血管收缩反应的反调节机制受损,心力衰竭患者运动时骨骼肌中的交感神经血管收缩增强。在健康动物中,内源性产生的一氧化氮(NO)可减弱收缩的骨骼肌中的交感神经血管收缩。由于心力衰竭时NO途径可能功能失调,我们推测收缩肌肉中NO减少会导致交感神经血管收缩增强。在假手术大鼠和通过冠状动脉结扎产生慢性心肌梗死(MI)的大鼠中,我们测量了静息和收缩后肢对交感神经刺激(1、2.5和5Hz)的动脉血压和股动脉血流反应。在静息后肢,交感神经刺激使假手术大鼠和MI大鼠的股血管传导率同样降低。在收缩后肢中,与MI大鼠相比,假手术大鼠的这些血管收缩反应减弱程度更大。NO合酶抑制增强了假手术大鼠而非MI大鼠收缩后肢中的交感神经血管收缩。相反,输注L-精氨酸或超氧化物清除剂tempol或tiron可减弱MI大鼠收缩后肢中的交感神经血管收缩。NO合酶表达相似,但MI大鼠骨骼肌中的丙二醛(自由基损伤标志物)含量高于假手术大鼠。这些数据表明,MI大鼠收缩骨骼肌中交感神经血管收缩的代谢调节受损是超氧化物介导的NO途径破坏的结果。