Mueller P J, Cunningham J T, Patel K P, Hasser E M
Department of Biomedical Sciences, Dalton Cardiovascular Research Center, University of Missouri-Columbia, 134 Research Park Drive, Columbia, MO 65211-3300, USA.
Acta Physiol Scand. 2003 Jan;177(1):27-35. doi: 10.1046/j.1365-201X.2003.01044.x.
Cardiovascular deconditioning occurs in individuals exposed to prolonged spaceflight or bedrest and is associated with the development of orthostatic intolerance. Although the precise mechanisms remain to be fully elucidated, astronauts returning from space or bedrest patients returning to normal upright posture present with decreases in plasma volume and alterations in autonomic function. The hindlimb unloaded (HU) rat has been a useful model to study the effects of cardiovascular deconditioning as it mimics many of the changes that occur after spaceflight and bedrest.
Experiments performed in HU rats suggest that cardiovascular deconditioning attenuates baroreflex mediated sympathoexcitation and enhances cardiopulmonary receptor mediated sympathoinhibition. These alterations appear to be due to changes in the central nervous system and may contribute to the pre disposition towards orthostatic intolerance associated with cardiovascular deconditioning. The paraventricular nucleus (PVN) of the hypothalamus is important in basal and reflex control of sympathetic outflow. Recent evidence suggests that nitric oxide (NO) is an important inhibitory neurotransmitter in the PVN and that alterations in nitroxidergic transmission in the PVN may be involved in elevated sympathetic tone in certain disease states.
Based on evidence from other laboratories and published and preliminary data from our own laboratories, this review proposes a role for the PVN in cardiovascular deconditioning. In particular, we discuss the hypothesis that increased NO in the PVN contributes to the altered cardiovascular reflexes observed following deconditioning and how these reflexes may be related to the orthostatic intolerance observed after prolonged spaceflight or bedrest.
心血管失健发生于长期暴露于太空飞行或卧床休息的个体中,并与直立不耐受的发展相关。尽管确切机制仍有待充分阐明,但从太空返回的宇航员或从卧床休息恢复到正常直立姿势的患者会出现血浆量减少和自主神经功能改变。后肢去负荷(HU)大鼠已成为研究心血管失健影响的有用模型,因为它模拟了太空飞行和卧床休息后发生的许多变化。
在HU大鼠身上进行的实验表明,心血管失健会减弱压力反射介导的交感神经兴奋,并增强心肺感受器介导的交感神经抑制。这些改变似乎是由于中枢神经系统的变化引起的,可能导致与心血管失健相关的直立不耐受倾向。下丘脑室旁核(PVN)在交感神经输出的基础和反射控制中起重要作用。最近的证据表明,一氧化氮(NO)是PVN中的一种重要抑制性神经递质,PVN中氮氧化能传递的改变可能参与某些疾病状态下交感神经张力的升高。
基于其他实验室的证据以及我们自己实验室已发表和初步的数据,本综述提出PVN在心血管失健中起作用。特别是,我们讨论了PVN中NO增加导致失健后观察到的心血管反射改变的假说,以及这些反射如何与长期太空飞行或卧床休息后观察到的直立不耐受相关。