Wilson J R, Lanoce V, Frey M J, Ferraro N
Cardiovascular Section, Hospital of the University of Pennsylvania, Philadelphia 19104.
Am Heart J. 1990 May;119(5):1122-30. doi: 10.1016/s0002-8703(05)80243-1.
Heart failure is known to impair arterial baroreceptor control of heart rate. To determine if baroreceptor control of peripheral vascular resistance is also impaired, heart rate and hind limb vascular responses to phenylephrine and nitroglycerin administration were compared in control dogs and in dogs with heart failure produced by chronic rapid ventricular pacing. Baroreflex control of the heart rate was depressed in the dogs with heart failure, as evidenced by a reduced slope of the blood pressure-to-heart rate relationship (controls: -2.5 +/- 0.3 beats/mm Hg versus heart failure: -1.5 +/- 0.2 beats/mm Hg [(p less than 0.04)]). Arterial blood pressure in the dogs with heart failure was also reduced (controls: 90 +/- 3 mm Hg versus heart failure: 75 +/- 3 mm Hg [(p less than 0.01)]). Nevertheless, dogs with heart failure exhibited normal slopes of the blood pressure versus hind limb vascular resistance relationship (controls: -2.4 +/- 0.4 units/mm Hg versus heart failure: -2.9 +/- 0.5 units/mm Hg [(p = NS)]), consistent with preserved baroreflex control of the peripheral vasculature. These data suggest that heart failure impairs arterial baroreflex control of heart rate and lowers the baroreflex pressure operating range but does not alter baroreflex control of peripheral resistance.
已知心力衰竭会损害动脉压力感受器对心率的控制。为了确定压力感受器对外周血管阻力的控制是否也受到损害,研究人员比较了对照犬和慢性快速心室起搏诱导的心力衰竭犬对去氧肾上腺素和硝酸甘油给药的心率和后肢血管反应。心力衰竭犬的压力反射对心率的控制受到抑制,这可通过血压与心率关系斜率的降低得到证明(对照组:-2.5±0.3次/毫米汞柱,心力衰竭组:-1.5±0.2次/毫米汞柱 [(p<0.04)])。心力衰竭犬的动脉血压也降低了(对照组:90±3毫米汞柱,心力衰竭组:75±3毫米汞柱 [(p<0.01)])。然而,心力衰竭犬的血压与后肢血管阻力关系斜率正常(对照组:-2.4±0.4单位/毫米汞柱,心力衰竭组:-2.9±0.5单位/毫米汞柱 [(p = 无显著性差异)]),这与外周血管系统压力反射控制得以保留一致。这些数据表明,心力衰竭会损害动脉压力反射对心率的控制,降低压力反射压力的作用范围,但不会改变压力反射对外周阻力的控制。