Monahan Kevin D, Ray Chester A
Penn State College of Medicine, Div. of Cardiology H047, The Milton S. Hershey Medical Center, 500 University Dr., Hershey, PA 17033-2390, USA.
Am J Physiol Heart Circ Physiol. 2004 Mar;286(3):H895-901. doi: 10.1152/ajpheart.00719.2003. Epub 2003 Nov 6.
Leg venous compliance is a determinant of peripheral venous pooling during orthostatic stress such that high venous compliance could contribute to reduced orthostatic tolerance. We tested the hypotheses that 1) calf venous compliance is reduced during baroreceptor unloading, and 2) calf venous compliance is greater in women than men. Twelve men (27 +/- 2 yr) and 12 women (25 +/- 2 yr) were studied in the supine posture. Calf venous compliance was determined by inflating a thigh venous collecting cuff to 60 mmHg for 8 min and then decreasing cuff pressure at a rate of 1 mmHg/s to 0 mmHg. The slope of the pressure-compliance relation (compliance = beta(1) + 2.beta(2).cuff pressure), which is the first derivative of the quadratic pressure-volume relation [(Deltalimb volume) = beta(0) + beta(1).(cuff pressure) + beta(2).(cuff pressure)(2)] during the reduction in collecting cuff pressure, was used to assess venous compliance at baseline and during one-legged lower body negative pressure (LBNP; -50 mmHg). At baseline, calf venous compliance was 48% lower (P < 0.001) in women than men and decreased in men (Delta-25 +/- 8%; P < 0.05) but not women (Delta1 +/- 11%) during LBNP. Rhythmic ischemic handgrip (Delta6 +/- 9%) and cold pressor testing (Delta-9 +/- 7%) did not alter calf venous compliance in a subgroup of men (n = 6). These data indicate gender-dependent effects on calf venous compliance under conditions associated with low sympathetic outflow (i.e., rest) and high sympathetic outflow (i.e., LBNP). However, they cannot explain gender-associated differences in orthostatic tolerance.
腿部静脉顺应性是直立应激期间外周静脉淤积的一个决定因素,因此高静脉顺应性可能导致直立耐力降低。我们检验了以下假设:1)在压力感受器卸载期间小腿静脉顺应性降低;2)女性的小腿静脉顺应性高于男性。对12名男性(27±2岁)和12名女性(25±2岁)进行仰卧位研究。通过将大腿静脉收集袖带充气至60 mmHg并持续8分钟,然后以1 mmHg/s的速率将袖带压力降至0 mmHg来测定小腿静脉顺应性。在收集袖带压力降低期间,压力-顺应性关系的斜率(顺应性=β1 + 2β2·袖带压力),即二次压力-容积关系[(肢体容积变化)=β0 + β1·(袖带压力)+ β2·(袖带压力)²]的一阶导数,用于评估基线和单腿下身负压(LBNP;-50 mmHg)期间的静脉顺应性。在基线时,女性的小腿静脉顺应性比男性低48%(P<0.001),在LBNP期间男性的小腿静脉顺应性降低(Δ-25±8%;P<0.05),而女性则未降低(Δ1±11%)。在一组男性(n = 6)中,有节律的缺血性握力(Δ6±9%)和冷加压试验(Δ-9±7%)并未改变小腿静脉顺应性。这些数据表明,在交感神经低输出(即休息)和高输出(即LBNP)相关条件下,性别对小腿静脉顺应性有不同影响。然而,它们无法解释直立耐力方面的性别差异。