Creager M A
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Am J Cardiol. 1992 Jun 4;69(18):10G-15G; discussion 15G-16G. doi: 10.1016/0002-9149(92)91250-8.
Congestive heart failure is characterized by decreased parasympathetic and increased sympathetic nervous system activity. Impairment of baroreceptor reflex function may be relevant to this altered neural profile. The effect of cardiopulmonary and arterial baroreceptor stimulation on corresponding afferent neural activity is reduced in experimental models of heart failure. In addition, the heart rate and blood pressure responses to perturbations in arterial and carotid sinus pressure are less in animals with heart failure than in control animals. Comparable observations have been made in humans. Unloading cardiopulmonary baroreceptors with lower-body negative pressure causes less forearm vasoconstriction in patients with heart failure than in healthy subjects. The chronotropic response to changes in arterial and carotid sinus pressure induced by drug infusions or by use of a neck chamber is attenuated in heart failure. These data suggest that abnormalities in cardiopulmonary and arterial baroreceptor reflex function contribute importantly to altered autonomic nervous system activity in heart failure.
充血性心力衰竭的特征是副交感神经系统活动减少，交感神经系统活动增加。压力感受器反射功能受损可能与这种神经状态改变有关。在心力衰竭的实验模型中，心肺和动脉压力感受器刺激对相应传入神经活动的影响减弱。此外，与对照动物相比，心力衰竭动物对动脉和颈动脉窦压力扰动的心率和血压反应较小。在人类中也有类似的观察结果。与健康受试者相比，使用下体负压卸载心肺压力感受器时，心力衰竭患者的前臂血管收缩较少。心力衰竭时，由药物输注或使用颈部腔室引起的动脉和颈动脉窦压力变化的变时反应减弱。这些数据表明，心肺和动脉压力感受器反射功能异常在心力衰竭自主神经系统活动改变中起重要作用。
