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短暂性心肌缺血对交感神经介导的冠状动脉收缩的影响。

Effect of brief myocardial ischemia on sympathetic coronary vasoconstriction.

作者信息

Gutterman D D, Morgan D A, Miller F J

机构信息

Department of Internal Medicine, Veterans Affairs Medical Center, Iowa City.

出版信息

Circ Res. 1992 Oct;71(4):960-9. doi: 10.1161/01.res.71.4.960.

Abstract

The purpose of the present study was to determine whether sympathetic coronary vasoconstrictor responses are altered after brief ischemia and reperfusion. Adult mongrel dogs were anesthetized and instrumented for measurements of heart rate, arterial pressure, left ventricular pressure, left ventricular dP/dt, anterior myocardial wall thickening, and left circumflex coronary artery (LCX) and left anterior descending coronary artery (LAD) blood flow velocities. Changes in coronary vascular resistance were recorded during intravenous bolus doses of norepinephrine and bilateral electrical stimulation of the stellate ganglia. After beta-adrenergic blockade and bilateral vagotomy, electrical stimulation of the stellate ganglia increased coronary vascular resistance in the LAD and LCX beds by 38 +/- 5% and 39 +/- 5%, respectively. After a 15-minute LAD occlusion, repeat electrical stimulation produced increases in coronary resistance of 16 +/- 3% and 45 +/- 8%, respectively (p less than 0.05 for the LAD before versus after the occlusion). The peak increase in coronary vascular resistance to two doses of norepinephrine was unchanged. After a shorter period of myocardial ischemia (7 minutes), similar increase in coronary resistance to stellate stimulation were observed before (27 +/- 4%) and after (26 +/- 6%) myocardial ischemia. The mechanism of this impaired sympathetic coronary vasoconstriction was further tested by examining the responses to bretylium and tyramine. Brief ischemia did not alter the coronary constrictor responses to either bretylium or tyramine, suggesting that mechanisms governing prejunctional release of norepinephrine are intact in the postischemic coronary arterial bed.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是确定短暂缺血和再灌注后交感神经介导的冠状动脉血管收缩反应是否发生改变。成年杂种犬麻醉后,安装测量心率、动脉压、左心室压力、左心室压力变化率、前壁心肌增厚以及左旋冠状动脉(LCX)和左前降冠状动脉(LAD)血流速度的仪器。在静脉推注去甲肾上腺素和双侧星状神经节电刺激期间记录冠状动脉血管阻力的变化。在β肾上腺素能阻断和双侧迷走神经切断术后,星状神经节电刺激使LAD和LCX床的冠状动脉血管阻力分别增加38±5%和39±5%。在LAD闭塞15分钟后,重复电刺激分别使冠状动脉阻力增加16±3%和45±8%(LAD闭塞前后相比,p<0.05)。两剂去甲肾上腺素引起的冠状动脉血管阻力峰值增加未改变。在较短时间的心肌缺血(7分钟)后,心肌缺血前后对星状神经节刺激的冠状动脉阻力增加相似(分别为27±4%和26±6%)。通过检查对溴苄铵和酪胺的反应,进一步测试了这种交感神经介导的冠状动脉血管收缩受损的机制。短暂缺血并未改变对溴苄铵或酪胺的冠状动脉收缩反应,这表明缺血后冠状动脉床中去甲肾上腺素的节前释放调节机制完好无损。(摘要截断于250字)

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