Chen J S, Wang W, Bartholet T, Zucker I H
Department of Physiology and Biophysics, University of Nebraska College of Medicine, Omaha.
Circulation. 1991 Jan;83(1):260-7. doi: 10.1161/01.cir.83.1.260.
The autonomic components of the baroreflex control of heart rate were evaluated in conscious mongrel dogs before and after 4-6 weeks of ventricular pacing (250 beats/min). Arterial baroreflex sensitivity (BRS) was determined by the slopes of linear regression of pulse interval versus the preceding systolic arterial pressure in response to bolus injections of either phenylephrine or nitroglycerin. BRS was significantly depressed in the heart failure state [nitroglycerin slope, 5.0 +/- 2.7 (mean +/- SD) versus 16.6 +/- 5.1 msec/mm Hg, p less than 0.005; phenylephrine slope, 15.0 +/- 14.8 versus 32.0 +/- 26.7 msec/mm Hg, p less than 0.005]. There was no depression in BRS in dogs that were used as time controls or were acutely paced for 30 minutes. After beta 1-adrenergic blockade with metoprolol, the resting heart rate in the heart failure state was depressed more than in the normal state (-17.0 +/- 5.0% versus -3.2 +/- 3.4%, p less than 0.001). Atropine significantly increased resting heart rate more in the normal state than in the heart failure state (115.8 +/- 36.7% versus 25.4 +/- 14.5%, p less than 0.005). Thus, dogs in the heart failure state appear to have high resting cardiac sympathetic tone and low resting vagal tone. For nitroglycerin administration, metoprolol depressed BRS by 47.6 +/- 26.3% in the normal state and by 63.6 +/- 58.5% in the heart failure state. Atropine decreased the BRS by 86.7 +/- 7.8% in the normal state and by 39.5 +/- 30.2% in the heart failure state.(ABSTRACT TRUNCATED AT 250 WORDS)
在有意识的杂种犬心室起搏(250次/分钟)4 - 6周前后,对心率压力反射控制的自主神经成分进行了评估。动脉压力反射敏感性(BRS)通过在静脉注射去氧肾上腺素或硝酸甘油后,脉搏间期与前一个收缩期动脉压的线性回归斜率来确定。在心力衰竭状态下,BRS显著降低[硝酸甘油斜率,5.0±2.7(平均值±标准差)对16.6±5.1毫秒/毫米汞柱,p<0.005;去氧肾上腺素斜率,15.0±14.8对32.0±26.7毫秒/毫米汞柱,p<0.005]。用作时间对照或急性起搏30分钟的犬,其BRS没有降低。在用美托洛尔进行β1 - 肾上腺素能阻断后,心力衰竭状态下的静息心率比正常状态下降得更多(-17.0±5.0%对-3.2±3.4%,p<0.001)。阿托品在正常状态下比心力衰竭状态下更显著地增加静息心率(115.8±36.7%对25.4±14.5%,p<0.005)。因此,心力衰竭状态下的犬似乎具有较高的静息心脏交感神经张力和较低的静息迷走神经张力。对于硝酸甘油给药,美托洛尔在正常状态下使BRS降低47.6±26.3%,在心力衰竭状态下降低63.6±58.5%。阿托品在正常状态下使BRS降低86.7±7.8%,在心力衰竭状态下降低39.5±30.2%。(摘要截取自250字)