Kelley K O, Feigl E O
Circ Res. 1978 Dec;43(6):908-17. doi: 10.1161/01.res.43.6.908.
Recent studies from this laboratory have indicated that sympathetic alpha-receptor-mediated coronary vasoconstriction can compete with local metabolic vasodilation to reduce the oxygen supply to the myocardium. In vitro studies from other laboratories on isolated coronary vessel strips suggest that large epicardial vessels are the dominant site of adrenergic alpha-receptor activity. In this study we used anesthetized, open-chest dogs to test the hypothesis that alpha-receptor-mediated vasoconstriction occurs predominantly in epicardial vessels, which are partially removed from the metabolic milieu in the myocardium. Adrenergic beta-receptor blockade was achieved by propranolol (3 mg/kg, iv). The circumflex coronary artery was pump-perfused at constant pressure to minimize passive changes in large vessel resistance. Pressure was measured at the tip of the perfusion cannula sealed in the circumflex artery, and in an apical branch of the circumflex artery. Large vessel resistance was calculated as the pressure gradient along the vessel segment divided by the coronary flow. Intracoronary injections of nitroglycerin were used as an independent measure of the vasomotor responsiveness of the large vessel segment. Adrenergic alpha-receptor activation was produced by intracoronary bolus injections of norepinephrine and by electrical stimulation of the left stellate ganglion. Alpha-receptor stimulation caused an increase in total coronary vascular resistance; however, the relative increase in the resistance of the large vessel was only about 60% of that seen for the entire coronary bed. These data suggest that, contrary to the proposed hypothesis, adrenergic alpha-receptor-mediated vasoconstriction in the large coronary vessels is not proportionally greater than that observed in the total coronary vascular bed.
本实验室最近的研究表明,交感神经α受体介导的冠状动脉收缩可与局部代谢性血管舒张竞争,从而减少心肌的氧供应。其他实验室对离体冠状动脉血管条的体外研究表明,大的心外膜血管是肾上腺素能α受体活性的主要部位。在本研究中,我们使用麻醉的开胸犬来检验以下假设:α受体介导的血管收缩主要发生在心外膜血管,这些血管部分脱离了心肌中的代谢环境。通过静脉注射普萘洛尔(3mg/kg)实现肾上腺素能β受体阻断。对左旋冠状动脉进行恒压泵灌注,以尽量减少大血管阻力的被动变化。在密封于左旋动脉的灌注套管尖端以及左旋动脉的一个心尖分支处测量压力。大血管阻力计算为沿血管段的压力梯度除以冠状动脉血流量。冠状动脉内注射硝酸甘油用作大血管段血管舒缩反应性的独立测量指标。通过冠状动脉内推注去甲肾上腺素以及电刺激左侧星状神经节来产生肾上腺素能α受体激活。α受体刺激导致总冠状动脉血管阻力增加;然而,大血管阻力的相对增加仅约为整个冠状动脉床所见增加的60%。这些数据表明,与所提出的假设相反,大冠状动脉血管中肾上腺素能α受体介导的血管收缩并不比在整个冠状动脉血管床中观察到的收缩成比例地更大。