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左心房压力升高时小肺动脉对急性肺动脉高压的收缩反应。

Constrictor response of small pulmonary arteries to acute pulmonary hypertension during left atrial pressure elevation.

作者信息

Shirai M, Ninomiya I, Sada K

机构信息

Department of Cardiac Physiology, National Cardiovascular Center Research Institute, Suita, Japan.

出版信息

Jpn J Physiol. 1991;41(1):129-42. doi: 10.2170/jjphysiol.41.129.

DOI:10.2170/jjphysiol.41.129
PMID:1857016
Abstract

Acute elevations in left atrial pressure (LAP) were induced by altering the volume of air within a balloon inserted into the left atrium; the changes in internal diameter (ID) of small muscular pulmonary arteries (100-600 microns ID) in response to the associated rises of pulmonary arterial pressure (PAP) were measured using an X-ray TV system on the in vivo cat lung. When LAP was elevated to 14 +/- 1, 24 +/- 1, and 30 +/- 1 mmHg, PAP was increased to 21 +/- 1, 30 +/- 1, and 37 +/- 1 mmHg, respectively. With PAP ranging from 16 (control value) to 21 mmHg the ID did not dilate significantly. With PAP of 30-37 mmHg significant ID dilation occurred. The magnitude of the ID dilation (16%) with PAP of 37 mmHg, however, was significantly smaller than that (20%) with PAP of 30 mmHg despite the greater pressure rise. When the elevated PAP of 30-37 mmHg was quickly returned to the control level by rapid balloon deflation, the ID constricted significantly below the control level. The magnitude of the ID constriction was proportional to the degree of the preceding PAP rise and was maximal in the arteries of 200-400 microns ID. A papaverine hydrochloride injection combined with the balloon deflation completely abolished the ID constriction. A phentolamine injection, on the other hand, significantly attenuated the constriction with approximately half of the constriction persisting. The results indicate that an increase in vascular smooth muscle tone occurred in the small muscular pulmonary arteries, particularly those of 200-400 microns ID, in response to the acute rise of PAP above 30 mmHg during the LAP elevation. In addition, the data suggest the partial participation of catecholamines in the active contraction of vascular smooth muscle. The arterial contraction may serve to protect the pulmonary capillaries from an excessive hydrostatic pressure and pulmonary edema.

摘要

通过改变插入左心房的球囊内空气量来诱导左心房压力(LAP)急性升高;使用X射线电视系统在活体猫肺上测量小肌性肺动脉(内径100 - 600微米)内径(ID)对伴随的肺动脉压力(PAP)升高的变化。当LAP升高到14±1、24±1和30±1 mmHg时,PAP分别升高到21±1、30±1和37±1 mmHg。当PAP在16(对照值)至21 mmHg范围内时,内径没有明显扩张。当PAP为30 - 37 mmHg时,内径出现明显扩张。然而,尽管压力升高幅度更大,但PAP为37 mmHg时内径扩张幅度(16%)明显小于PAP为30 mmHg时的扩张幅度(20%)。当通过快速放气使30 - 37 mmHg的升高的PAP迅速恢复到对照水平时,内径明显收缩至对照水平以下。内径收缩幅度与先前PAP升高程度成正比,在200 - 400微米内径的动脉中最大。注射盐酸罂粟碱并结合球囊放气可完全消除内径收缩。另一方面,注射酚妥拉明可显著减轻收缩,仍有大约一半的收缩持续存在。结果表明,在LAP升高期间,当PAP急性升高超过30 mmHg时,小肌性肺动脉,特别是内径为200 - 400微米的动脉中血管平滑肌张力增加。此外,数据表明儿茶酚胺部分参与了血管平滑肌的主动收缩。动脉收缩可能有助于保护肺毛细血管免受过高的静水压力和肺水肿的影响。

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