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[急性肺动脉高压:血管平滑肌激活的保护作用]

[Acute pulmonary hypertension: protective role of vascular smooth muscle activation].

作者信息

Grignola Juan C, Bia Daniel, Ginés Fernando, Armentano Ricardo L

机构信息

Departamento de Fisiología. Facultad de Medicina. Universidad de la República. Montevideo. Uruguay.

出版信息

Rev Esp Cardiol. 2003 Nov;56(11):1077-84. doi: 10.1016/s0300-8932(03)77018-3.

Abstract

AIM

To characterize the buffering function of the pulmonary artery in vivo and to determine the role of vascular smooth muscle (VSM) activation in vessel wall elasticity.

MATERIAL AND METHOD

Pulmonary artery pressure and diameter were measured in 9 anesthetized sheep. Pulmonary artery hypertension was induced by mechanical occlusion of the pulmonary artery and by phenylephrine infusion (5 microg/kg/min) (PHE). Once the pressure-diameter loop was obtained, hysteresis was reduced to a minimum by increasing the modulus of viscosity. Elasticity was calculated as the first derivative of mean diastolic pressure assuming a purely elastic relation. Pulse wave velocity (PWV) and time constant (tau) were also obtained.

RESULTS

Systolic, diastolic, mean and pulse pressures were similar during pulmonary artery hypertension and PHE infusion, but significantly higher in comparison to baseline conditions. Elasticity and diameter of the pulmonary artery increased significantly. In contrast, during VSM activation elasticity remained unchanged and diastolic diameter was reduced. PWV increased during both pulmonary artery hypertension and PHE infusion (p < 0.05); however, the increase during PHE infusion was smaller (15%) than during induced hypertension (33%). tau was significantly reduced during hypertension, but did not change during VSM activation.

CONCLUSIONS

VSM activation may offset the deleterious effect of pulmonary artery hypertension on arterial wall stiffness by reducing elasticity and PWV. The VSM may modulate the Windkessel function in the pulmonary artery, preserving elasticity indexes during pulmonary artery hypertension.

摘要

目的

在体内表征肺动脉的缓冲功能,并确定血管平滑肌(VSM)激活在血管壁弹性中的作用。

材料与方法

在9只麻醉的绵羊中测量肺动脉压力和直径。通过机械阻塞肺动脉和输注去氧肾上腺素(5微克/千克/分钟)(PHE)诱导肺动脉高压。一旦获得压力-直径环,通过增加粘度模量将滞后现象降至最低。假设为纯弹性关系,弹性计算为平均舒张压一阶导数。还获得了脉搏波速度(PWV)和时间常数(tau)。

结果

肺动脉高压和输注PHE期间的收缩压、舒张压、平均压和脉压相似,但与基线条件相比显著更高。肺动脉的弹性和直径显著增加。相比之下,在VSM激活期间弹性保持不变,舒张期直径减小。肺动脉高压和输注PHE期间PWV均增加(p<0.05);然而,输注PHE期间的增加(15%)小于诱导性高血压期间的增加(33%)。高血压期间tau显著降低,但VSM激活期间未改变。

结论

VSM激活可能通过降低弹性和PWV抵消肺动脉高压对动脉壁僵硬度的有害影响。VSM可能调节肺动脉中的风箱功能,在肺动脉高压期间保持弹性指标。

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