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高血压中血流介导的血管重塑:与血流动力学的关系

Flow-mediated vascular remodeling in hypertension: relation to hemodyamics.

作者信息

Ibrahim Jamila, Berk Bradford C

机构信息

Aab Cardiovascular Research Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.

出版信息

Stroke. 2009 Feb;40(2):582-90. doi: 10.1161/STROKEAHA.108.529826. Epub 2008 Dec 18.

Abstract

BACKGROUND AND PURPOSE

Changes in shear and medial wall stress induced by blood flow contribute to vascular remodeling, but details of these relations remain undefined. We hypothesized that remodeling has a strong genetic component and that phenotypic responses to hemodynamic stress will differ among rat strains. Here, we characterized phenotypic traits related to carotid remodeling in the 2 rat strains that we previously showed the greatest difference in shear stress regulation: Genetically Hypertensive (GH) and Brown Norway (BN) rat strains.

METHODS

Left internal and external carotid arteries were ligated and blood flow was reduced in the left common (LCA) by 90% and increased in the right common carotid artery (RCA) by 60%. Rats were studied for up to 28 days after flow modification and carotid outer diameters were measured in vivo, and wall and luminal components by histomorphometry, to obtain indices of remodeling. Blood flow and pressure measurements were made at corresponding time points.

RESULTS

By day 28, remodeling in the GH was greater in response to high flow than in BN, and shear stress was normalized. In contrast, remodeling in the BN was greater in the low flow LCA than in GH. Media stress was greater in GH than BN for any value of carotid shear stress and remained relatively unchanged in low flow, but markedly increased in high flow remodeling. Importantly, pressure was not a major determinant of flow remodeling in these conditions.

CONCLUSIONS

There are key differences in the ability of carotids in GH and BN rats to adhere to hemodynamic laws during vascular remodeling. GH rats exhibit intact regulatory mechanisms for increased, but not reduced, shear stress. Moreover, the ability to maintain physiological shear and media stresses during vascular remodeling in response to modified flow appears to be intrinsically "genetically" determined.

摘要

背景与目的

血流引起的剪切力和血管内壁应力变化有助于血管重塑,但这些关系的细节仍不明确。我们推测重塑具有很强的遗传成分,并且不同大鼠品系对血流动力学应激的表型反应会有所不同。在此,我们对与颈动脉重塑相关的表型特征进行了表征,这两个大鼠品系是我们之前发现的在剪切应力调节方面差异最大的:遗传性高血压(GH)大鼠品系和棕色挪威(BN)大鼠品系。

方法

结扎左颈内动脉和颈外动脉,使左颈总动脉(LCA)血流减少90%,右颈总动脉(RCA)血流增加60%。在血流改变后对大鼠进行长达28天的研究,体内测量颈动脉外径,并通过组织形态计量学测量血管壁和管腔成分,以获得重塑指标。在相应时间点进行血流和压力测量。

结果

到第28天,GH大鼠对高血流的重塑反应比BN大鼠更大,且剪切应力恢复正常。相比之下,BN大鼠低血流LCA的重塑比GH大鼠更明显。对于任何颈动脉剪切应力值,GH大鼠的血管壁应力都比BN大鼠大,在低血流时相对保持不变,但在高血流重塑时显著增加。重要的是,在这些情况下,压力不是血流重塑的主要决定因素。

结论

GH大鼠和BN大鼠的颈动脉在血管重塑过程中遵循血流动力学规律的能力存在关键差异。GH大鼠对增加的剪切应力表现出完整的调节机制,但对降低的剪切应力则不然。此外,在血管重塑过程中,响应血流改变而维持生理剪切力和血管壁应力的能力似乎本质上是由“遗传”决定的。

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