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心力衰竭胸段下腔静脉缩窄模型中的内皮素

Endothelin in thoracic inferior vena caval constriction model of heart failure.

作者信息

Underwood R D, Aarhus L L, Heublein D M, Burnett J C

机构信息

Cardiorenal Laboratory, Mayo Clinic, Rochester, Minnesota 55905.

出版信息

Am J Physiol. 1992 Sep;263(3 Pt 2):H951-5. doi: 10.1152/ajpheart.1992.263.3.H951.

Abstract

Recent studies have found endothelin-1 (ET), a potent vasoconstrictor of endothelial cell origin, is increased in congestive heart failure (CHF) in plasma and correlates with increased atrial pressures. Additionally, it has been shown that, despite increased circulating ET concentrations in CHF, a decreased responsiveness to exogenous ET infusion exists in an experimental model of CHF induced by rapid pacing. The present study was designed to determine whether plasma ET would be increased in a model of low cardiac output congestive failure without elevated atrial pressures produced by thoracic inferior vena caval constriction (TIVCC). In addition, we sought to determine whether this model of low cardiac output would show a full vasoconstrictive response to exogenous ET infusion and whether atrial natriuretic factor (ANF) infused acutely to achieve pathophysiological concentrations would modulate the systemic and renal hemodynamic responses to exogenous ET. Dogs were studied in the anesthetized state at 8-9 days after the TIVCC or sham operation. Baseline ET levels were significantly increased in the TIVCC dogs (n = 14) compared with sham operated dogs (n = 6; 41.4 +/- 7.1 vs. 17.9 +/- 1.5 pg/ml, respectively; P less than 0.05). With exogenous ET infusion (5 ng.kg-1.min-1), an intact systemic and renal vasoconstrictor response in the TIVCC dogs was observed. ANF prevented the systemic vascular and arterial pressure responses to ET. However, the potent renal vasoconstricting action of ET was not prevented by ANF. These studies suggest that ET may play an important role in maintaining blood pressure in the setting of low cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

最近的研究发现,内皮素-1(ET)这种源自内皮细胞的强效血管收缩剂,在充血性心力衰竭(CHF)患者血浆中水平升高,且与心房压力升高相关。此外,研究表明,尽管CHF患者循环中ET浓度升高,但在快速起搏诱导的CHF实验模型中,对外源性ET输注的反应性降低。本研究旨在确定在低位腔静脉缩窄(TIVCC)导致的心输出量低的充血性心力衰竭模型中,血浆ET是否会升高,且心房压力未升高。此外,我们试图确定这种心输出量低的模型对外源性ET输注是否会表现出完全的血管收缩反应,以及急性输注心房利钠因子(ANF)以达到病理生理浓度是否会调节对外源性ET的全身和肾脏血流动力学反应。在TIVCC或假手术后8 - 9天,对处于麻醉状态的犬进行研究。与假手术犬(n = 6;分别为41.4 +/- 7.1与17.9 +/- 1.5 pg/ml;P < 0.05)相比,TIVCC犬(n = 14)的基线ET水平显著升高。在外源性ET输注(5 ng·kg-1·min-1)时,观察到TIVCC犬有完整的全身和肾脏血管收缩反应。ANF可预防ET引起的全身血管和动脉压反应。然而,ANF并不能预防ET强大的肾血管收缩作用。这些研究表明,ET可能在维持低心输出量情况下的血压方面发挥重要作用。(摘要截短至250字)

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