Nejima J, Uemura N, Vatner D E, Homcy C J, Hintze T H, Vatner S F
Department of Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts 02115.
J Clin Invest. 1990 Dec;86(6):2046-53. doi: 10.1172/JCI114941.
To study chronic catecholamine desensitization, mini-osmotic pumps were implanted subcutaneously to deliver NE, (0.5 micrograms/kg/min) or saline over 3-4 wk in dogs instrumented with left ventricular (LV) pressure gauges and arterial and left atrial pressure catheters. An acute challenge to NE (0.4 micrograms/kg/min) in intact, conscious dogs increased LV dP/dt by 1,531 +/- 208 mmHg/s before NE pumps, and by a similar amount, 1,340 +/- 166 mmHg/s, 3-4 wk after NE pumps. In contrast, an acute challenge to isoproterenol (ISO, 0.4 micrograms/kg/min) increased LV dP/dt by 5,344 +/- 532 mmHg/s before NE pumps, and significantly less (P less than 0.05; 2,425 +/- 175 mmHg/s) after NE pumps. In the presence of ganglionic and alpha 1-adrenergic blockades, NE (0.4 micrograms/kg/min) increased LV dP/dt by 3,656 +/- 468 mmHg/s before NE pumps and significantly less (P less than 0.01; 1,459 +/- 200 mmHg/s) after NE pumps. Confirming this, an acute challenge to NE (0.4 micrograms/kg/min) in dogs with arterial baroreceptor denervation increased LV dP/dt by 3,732 +/- 896 mmHg/s before NE pumps, and significantly less (P less than 0.05, 1,725 +/- 408 mmHg/s) after NE pumps. In addition, in cardiac denervated dogs, NE (0.4 micrograms/kg/min) increased LV dP/dt by 9,901 +/- 1,404 mmHg/s before NE pumps and significantly less (P less than 0.01, 2,690 +/- 306 mmHg/s) after NE pumps. Desensitization of heart rate responses to NE challenge was also more apparent in the absence of reflex mechanisms. Thus, neural reflex mechanisms play a major role in physiological expression of cardiac desensitization to catecholamines in conscious dogs.
为研究慢性儿茶酚胺脱敏作用,将微型渗透泵皮下植入犬体内,在3至4周的时间里持续输注去甲肾上腺素(NE,0.5微克/千克/分钟)或生理盐水,这些犬均安装有左心室(LV)压力计以及动脉和左心房压力导管。在完整清醒的犬中,对NE(0.4微克/千克/分钟)进行急性刺激,在植入NE泵之前左心室dP/dt增加1,531±208 mmHg/s,在植入NE泵3至4周后增加幅度相似,为1,340±166 mmHg/s。相比之下,对异丙肾上腺素(ISO,0.4微克/千克/分钟)进行急性刺激,在植入NE泵之前左心室dP/dt增加5,344±532 mmHg/s,而在植入NE泵之后显著降低(P<0.05;2,425±175 mmHg/s)。在存在神经节和α1肾上腺素能阻断的情况下,NE(0.4微克/千克/分钟)在植入NE泵之前使左心室dP/dt增加3,656±468 mmHg/s,而在植入NE泵之后显著降低(P<0.01;1,459±200 mmHg/s)。同样,在动脉压力感受器去神经支配的犬中,对NE(0.4微克/千克/分钟)进行急性刺激,在植入NE泵之前左心室dP/dt增加3,732±896 mmHg/s,而在植入NE泵之后显著降低(P<0.05,1,725±408 mmHg/s)。此外,在心脏去神经支配的犬中,NE(0.4微克/千克/分钟)在植入NE泵之前使左心室dP/dt增加9,901±1,404 mmHg/s,而在植入NE泵之后显著降低(P<0.01,2,690±306 mmHg/s)。在没有反射机制的情况下,心率对NE刺激的反应脱敏也更加明显。因此,神经反射机制在清醒犬心脏对儿茶酚胺脱敏的生理表现中起主要作用。