Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39047, USA.
Hypertension. 2011 Dec;58(6):1126-31. doi: 10.1161/HYPERTENSIONAHA.111.181453. Epub 2011 Nov 7.
One potential mechanism contributing to the increased risk for encephalopathies in women with preeclampsia is altered cerebral vascular autoregulation resulting from impaired myogenic tone. Whether placental ischemia, a commonly proposed initiator of preeclampsia, alters cerebral vascular function is unknown. This study tested the hypothesis that placental ischemia in pregnant rats (caused by reduced uterine perfusion pressure [RUPP]) leads to impaired myogenic responses in middle cerebral arteries. Mean arterial pressure was increased by RUPP (135±3 mm Hg) compared with normal pregnant rats (103±2 mm Hg) and nonpregnant controls (116±1 mm Hg). Middle cerebral arteries from rats euthanized on gestation day 19 were assessed in a pressure arteriograph under active (+Ca(2+)) and passive (0 Ca(2+)) conditions, whereas luminal pressure was varied between 25 and 150 mm Hg. The slope of the relationship between tone and pressure in the middle cerebral artery was 0.08±0.01 in control rats and was similar in normal pregnant rats (0.05±0.01). In the RUPP model of placental ischemia, this relationship was markedly reduced (slope=0.01±0.00; P<0.05). Endothelial dependent and independent dilation was not different between groups, nor was there evidence of vascular remodeling assessed by the wall:lumen ratio and calculated wall stress. The impaired myogenic response was associated with brain edema measured by percentage of water content (RUPP P<0.05 versus control and normal pregnant rats). This study demonstrates that placental ischemia in pregnant rats leads to impaired myogenic tone in the middle cerebral arteries and that the RUPP model is a potentially important tool to examine mechanisms leading to encephalopathy during preeclamptic pregnancies.
一种可能导致先兆子痫妇女脑病风险增加的机制是,由于肌源性张力受损,导致大脑血管自动调节功能改变。胎盘缺血(一种普遍认为的先兆子痫起始因素)是否会改变大脑血管功能尚不清楚。本研究检验了这样一个假设,即大鼠(由子宫灌注压降低引起)胎盘缺血会导致大脑中动脉的肌源性反应受损。与正常妊娠大鼠(103±2mmHg)和未妊娠对照组(116±1mmHg)相比,RUPP 导致平均动脉压升高(135±3mmHg)。在活性(+Ca2+)和被动(0 Ca2+)条件下,通过压力血管描记术评估妊娠第 19 天处死的大鼠大脑中动脉,而管腔压力在 25 至 150mmHg 之间变化。在对照组大鼠中,大脑中动脉的张力与压力之间的关系斜率为 0.08±0.01,在正常妊娠大鼠中也相似(0.05±0.01)。在胎盘缺血的 RUPP 模型中,这种关系明显降低(斜率=0.01±0.00;P<0.05)。各组之间的内皮依赖性和非依赖性扩张没有差异,也没有证据表明通过壁:腔比和计算的壁应力评估血管重塑。受损的肌源性反应与通过水含量百分比测量的脑水肿有关(RUPP P<0.05 与对照组和正常妊娠大鼠相比)。本研究表明,妊娠大鼠的胎盘缺血会导致大脑中动脉的肌源性张力受损,RUPP 模型可能是研究导致子痫前期妊娠中脑病发生机制的重要工具。