Wang W, Chen J S, Zucker I H
Department of Physiology and Biophysics, University of Nebraska College of Medicine, Omaha 68198-4575.
Circ Res. 1991 May;68(5):1294-301. doi: 10.1161/01.res.68.5.1294.
We have previously demonstrated a decrease in baroreceptor discharge sensitivity in dogs with experimental heart failure. In the present study, we determined the sensitivity of the carotid sinus baroreceptor reflex in dogs with pacing-induced heart failure. The carotid sinus baroreceptor reflex sensitivity was determined by pressurizing one carotid sinus with all other baroreceptor and cardiopulmonary receptor inputs removed. The data were analyzed by plotting carotid sinus pressure-mean arterial pressure curves and carotid sinus pressure-renal sympathetic nerve activity curves in the two groups of dogs. The peak arterial pressure during carotid hypotension was significantly depressed in dogs with heart failure compared with normal dogs (107.1 +/- 5.7 versus 139.8 +/- 7.0 mm Hg, p less than 0.001). Mean arterial pressure range, renal sympathetic nerve activity range, and peak slope were significantly decreased in the heart-failure group. To determine if this depression was completely due to depression of baroreceptor discharge per se, or to alterations in central or end-organ responsiveness, similar experiments were performed by stimulating the carotid sinus nerve and evaluating frequency, voltage, and duration of stimulation on the resultant mean arterial pressure and renal sympathetic nerve activity. As was the case with carotid sinus pressurization, electrical stimulation caused a significantly smaller change in mean arterial pressure in heart-failure dogs compared with the normal dogs. However, there was no significant difference between normal and heart-failure dogs for the renal sympathetic nerve activity-electrical stimulation curves. These data strongly suggest that the depressed carotid sinus baroreceptor reflex in heart failure is not solely the result of depressed baroreceptor responsiveness but may be related to poor end-organ responses and normal central control of renal sympathetic outflow.
我们之前已经证明,实验性心力衰竭犬的压力感受器放电敏感性降低。在本研究中,我们测定了起搏诱导性心力衰竭犬的颈动脉窦压力感受器反射的敏感性。通过在去除所有其他压力感受器和心肺感受器输入的情况下对一侧颈动脉窦加压来测定颈动脉窦压力感受器反射敏感性。通过绘制两组犬的颈动脉窦压力-平均动脉压曲线和颈动脉窦压力-肾交感神经活动曲线来分析数据。与正常犬相比,心力衰竭犬在颈动脉窦低血压期间的动脉压峰值显著降低(107.1±5.7对139.8±7.0 mmHg,p<0.001)。心力衰竭组的平均动脉压范围、肾交感神经活动范围和峰值斜率显著降低。为了确定这种降低是否完全是由于压力感受器放电本身的降低,还是由于中枢或终末器官反应性的改变,通过刺激颈动脉窦神经并评估刺激频率、电压和持续时间对由此产生的平均动脉压和肾交感神经活动的影响,进行了类似的实验。与颈动脉窦加压的情况一样,电刺激导致心力衰竭犬的平均动脉压变化明显小于正常犬。然而,正常犬和心力衰竭犬的肾交感神经活动-电刺激曲线之间没有显著差异。这些数据强烈表明,心力衰竭时颈动脉窦压力感受器反射降低并非仅仅是压力感受器反应性降低的结果,可能与终末器官反应不良以及肾交感神经传出的正常中枢控制有关。