Department of Anaesthesiology, Institute of Pharmacology and Toxicology, Medical Faculty Aachen, RWTH-Aachen, Aachen, Germany.
PLoS One. 2011;6(12):e29698. doi: 10.1371/journal.pone.0029698. Epub 2011 Dec 27.
Cardiovascular agents are pivotal in the therapy of heart failure. Apart from their action on ventricular contractility and systemic afterload, they affect pulmonary arteries and veins. Although these effects are crucial in heart failure with coexisting pulmonary hypertension or lung oedema, they are poorly defined, especially in pulmonary veins. Therefore, we investigated the pulmonary vascular effects of adrenoceptor agonists, vasopressin and angiotensin II in the model of precision-cut lung slices that allows simultaneous studies of pulmonary arteries and veins.
Precision-cut lung slices were prepared from guinea pigs and imaged by videomicroscopy. Concentration-response curves of cardiovascular drugs were analysed in pulmonary arteries and veins.
Pulmonary veins responded stronger than arteries to α(1)-agonists (contraction) and β(2)-agonists (relaxation). Notably, inhibition of β(2)-adrenoceptors unmasked the α(1)-mimetic effect of norepinephrine and epinephrine in pulmonary veins. Vasopressin and angiotensin II contracted pulmonary veins via V(1a) and AT(1) receptors, respectively, without affecting pulmonary arteries.
Vasopressin and (nor)epinephrine in combination with β(2)-inhibition caused pulmonary venoconstriction. If applicable in humans, these treatments would enhance capillary hydrostatic pressures and lung oedema, suggesting their cautious use in left heart failure. Vice versa, the prevention of pulmonary venoconstriction by AT(1) receptor antagonists might contribute to their beneficial effects seen in left heart failure. Further, α(1)-mimetic agents might exacerbate pulmonary hypertension and right ventricular failure by contracting pulmonary arteries, whereas vasopressin might not.
心血管药物是心力衰竭治疗的关键。除了对心室收缩力和全身后负荷的作用外,它们还影响肺动静脉。尽管这些作用在合并肺动脉高压或肺水肿的心力衰竭中至关重要,但它们的定义很差,尤其是在肺静脉中。因此,我们在允许同时研究肺动静脉的精密切割肺切片模型中研究了肾上腺素能激动剂、血管加压素和血管紧张素 II 的肺血管作用。
从豚鼠中制备精密切割的肺切片,并通过视频显微镜进行成像。分析心血管药物在肺动静脉中的浓度-反应曲线。
肺静脉对 α(1)-激动剂(收缩)和 β(2)-激动剂(松弛)的反应强于动脉。值得注意的是,β(2)-肾上腺素能受体的抑制揭示了去甲肾上腺素和肾上腺素在肺静脉中的 α(1)-拟似作用。血管加压素和血管紧张素 II 通过 V(1a)和 AT(1)受体收缩肺静脉,而不影响肺动脉。
血管加压素和(去)肾上腺素与β(2)-抑制联合引起肺静脉收缩。如果在人类中适用,这些治疗方法会增加毛细血管静水压力并导致肺水肿,提示在左心衰竭中谨慎使用。反之,AT(1)受体拮抗剂预防肺静脉收缩可能有助于其在左心衰竭中的有益作用。此外,α(1)-拟似物可能通过收缩肺动脉加重肺动脉高压和右心室衰竭,而血管加压素可能不会。