Wang W, Ma R
Department of Physiology and Biophysics, University of Nebraska College of Medicine, Omaha, NE 68198-4575, USA.
Heart Fail Rev. 2000 Mar;5(1):57-71. doi: 10.1023/A:1009898107964.
Heart failure is characterized by an elevation in sympathetic tone. The mechanisms responsible for this sympatho-excitation of heart failure are not completely understood. Several studies from this laboratory have compared differences in the cardiac "sympathetic afferent" reflex between sham dogs and dogs with pacing-induced heart failure. We found 1) that the cardiac sympathetic afferent reflex is augmented in heart failure, 2) tonic cardiac sympathetic afferent inputs play an important role in the elevated sympathetic tone in heart failure, 3) cardiac sympathetic afferents are sensitized in heart failure and 4) the central gain of the cardiac sympathetic afferent reflex in heart failure is sensitized and that this sensitization may be related to augmented central Ang II and blunted NO mechanisms. These studies integrate into the regulation of sympathetic outflow in heart failure which is likely to be mediated by a variety of peripheral inputs modulated by central substances. If the cardiac sympathetic afferent reflex is one of the excitatory reflexes which contribute to sympathetic activation in heart failure, a comprehensive understanding of neuro-humoral regulation of this reflex may result in more definitives and rational therapy targeted to the sympathetic nervous system in this disease state.
心力衰竭的特征是交感神经张力升高。导致心力衰竭时这种交感神经兴奋的机制尚未完全明了。本实验室的多项研究比较了假手术犬和起搏诱导性心力衰竭犬心脏“交感传入”反射的差异。我们发现：1）心力衰竭时心脏交感传入反射增强；2）持续性心脏交感传入输入在心力衰竭时交感神经张力升高方面起重要作用；3）心力衰竭时心脏交感传入神经敏感化；4）心力衰竭时心脏交感传入反射的中枢增益敏感化，且这种敏感化可能与中枢血管紧张素II增加和一氧化氮机制减弱有关。这些研究整合到心力衰竭时交感神经输出的调节中，这可能由多种受中枢物质调节的外周输入介导。如果心脏交感传入反射是导致心力衰竭时交感神经激活的兴奋性反射之一，那么全面了解该反射的神经体液调节可能会产生更明确、更合理的针对这种疾病状态下交感神经系统的治疗方法。
