Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706-1609, USA.
Ann Biomed Eng. 2010 May;38(5):1854-61. doi: 10.1007/s10439-010-9960-2. Epub 2010 Feb 17.
Hypoxic pulmonary hypertension is a disease of the lung vasculature that is usually quantified by pulmonary vascular resistance (PVR). However, a more complete description of lung vascular function and right ventricular afterload is provided by pulmonary vascular impedance (PVZ) from spectral analysis of pulsatile pressure-flow relationships. We studied pulsatile pressure-flow relationships in isolated, perfused lungs of mice in normoxia, after induction of hypoxic pulmonary hypertension by 10 days of hypoxic exposure, and after the administration of the vasoactive agents sodium nitroprusside and serotonin in order to gain insight into the effects of disease and vasoactive agents on afterload. Chronic hypoxia exposure increased 0 Hz impedance (Z(0)) from 2.0 +/- 0.2 to 3.3 +/- 0.2 mmHg min/mL but decreased characteristic impedance (Z(C)) from 0.21 +/- 0.02 to 0.18 +/- 0.01 mmHg min/mL (both p < 0.05). Sodium nitroprusside only slightly decreased Z(0) but increased Z(C) in normal lungs (p < 0.05) and did not affect Z(C) and decreased Z(0) in hypertensive lungs (p < 0.05). Serotonin increased Z(C) in normal and hypertensive lungs but decreased Z(0) in hypertensive lungs (p < 0.05). There was an inverse correlation between mean pulmonary artery pressure and Z(C) in all circumstances. These findings demonstrate that vasoactive interventions can have different sites of action (i.e., proximal vs. distal segments) in the normal and chronically hypoxic pulmonary vasculature, and the pressure-dependency of Z(C) and R(W). The measurement of PVZ in isolated lungs allows for an improved understanding of the modes of action of drugs and hypoxia on the pulmonary circulation.
低氧性肺动脉高压是一种肺部血管疾病,通常通过肺血管阻力(PVR)来量化。然而,通过对脉动压力-流量关系的频谱分析得到的肺血管阻抗(PVZ)可以更全面地描述肺血管功能和右心室后负荷。我们研究了在常氧、慢性缺氧暴露 10 天后诱导低氧性肺动脉高压以及给予硝普钠和 5-羟色胺等血管活性药物后,离体灌注小鼠的脉动压力-流量关系,以便深入了解疾病和血管活性药物对后负荷的影响。慢性缺氧暴露使 0 Hz 阻抗(Z(0))从 2.0±0.2 增加到 3.3±0.2 mmHg min/mL,但使特征阻抗(Z(C))从 0.21±0.02 降低到 0.18±0.01 mmHg min/mL(均 p<0.05)。硝普钠仅轻微降低正常肺中的 Z(0),但增加 Z(C)(p<0.05),且对高血压肺中的 Z(C)和 Z(0)无影响(p<0.05)。5-羟色胺增加正常和高血压肺中的 Z(C),但降低高血压肺中的 Z(0)(p<0.05)。在所有情况下,平均肺动脉压与 Z(C)之间均呈负相关。这些发现表明,血管活性干预在正常和慢性低氧性肺血管中可能具有不同的作用部位(即近端与远端节段),以及 Z(C)和 R(W)的压力依赖性。离体肺中的 PVZ 测量可改善对药物和缺氧对肺循环作用方式的理解。