Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Hypertension. 2012 Oct;60(4):1016-22. doi: 10.1161/HYPERTENSIONAHA.112.200618. Epub 2012 Sep 4.
Aging is associated with increased retrograde and oscillatory shear in peripheral conduit arteries of humans. Although the mechanisms responsible for these age-related changes are not completely understood, augmented downstream α-adrenergic tone likely plays a significant role in this phenomenon. Therefore, in protocol 1, brachial artery diameter and blood velocity were measured via Doppler ultrasound during (1) rest (control), (2) endogenous norepinephrine release via intra-arterial infusions of tyramine, and (3) α-adrenergic blockade via infusions of phentolamine in young healthy humans (n=12). Tyramine increased brachial artery retrograde (-4.0±1.4 to -9.5±1.4 s(-1)) and oscillatory shear (0.05±0.02 to 0.18±0.05 arbitrary units), whereas phentolamine abolished retrograde and oscillatory shear (P<0.05). Additionally, in protocol 2, we examined brachial artery shear patterns in young (n=12; 29±2 years) and older (n=13; 69±2 years) healthy adults during (1) rest (control), (2) sympathetic activation via lower body negative pressure, and (3) infusion of phentolamine. At rest, older adults exhibited greater brachial artery retrograde and oscillatory shear (-9.9±2.7 s(-1) and 0.11±0.03 arbitrary units, respectively) compared with younger adults (-3.1±1.0 s(-1) and 0.05±0.02 arbitrary units, respectively; P<0.05 for both). Lower body negative pressure increased retrograde and oscillatory shear in young (P<0.05), but not older adults (P=0.85-0.97), such that differences between young and older were eliminated (P>0.05). During infusion of phentolamine, retrograde and oscillatory shear were abolished in young adults (P<0.05) and markedly reduced, yet still persistent, in older adults (P<0.01). Our data indicate that α-adrenergic vasoconstriction is a major contributor to age-related discrepancies in conduit artery shear-rate patterns at rest.
衰老是与人类外周导血管逆行和振荡剪切的增加有关。虽然导致这些与年龄相关的变化的机制尚未完全了解,但增强下游的α-肾上腺素能张力可能在这一现象中起着重要作用。因此,在方案 1 中,通过多普勒超声测量了年轻健康人的肱动脉直径和血流速度,(1)在休息时(对照),(2)通过动脉内推注酪胺释放内源性去甲肾上腺素,以及(3)通过推注酚妥拉明进行α-肾上腺素能阻断。酪胺增加肱动脉逆行(-4.0±1.4 至-9.5±1.4 s(-1))和振荡剪切(0.05±0.02 至 0.18±0.05 任意单位),而酚妥拉明则消除了逆行和振荡剪切(P<0.05)。此外,在方案 2 中,我们在年轻(n=12;29±2 岁)和年长(n=13;69±2 岁)健康成年人中检查了肱动脉的剪切模式,(1)在休息时(对照),(2)通过下体负压激活交感神经,以及(3)推注酚妥拉明。在休息时,与年轻成年人相比,年长成年人的肱动脉逆行和振荡剪切(分别为-9.9±2.7 s(-1)和 0.11±0.03 任意单位)更大(分别为-3.1±1.0 s(-1)和 0.05±0.02 任意单位;P<0.05)。下体负压增加了年轻成年人的逆行和振荡剪切(P<0.05),但没有增加年长成年人的(P=0.85-0.97),从而消除了年轻和年长成年人之间的差异(P>0.05)。在推注酚妥拉明时,年轻成年人的逆行和振荡剪切被消除(P<0.05),而年长成年人的则显著减少,但仍持续存在(P<0.01)。我们的数据表明,α-肾上腺素能血管收缩是导致导血管在休息时的剪切率模式与年龄相关差异的主要原因。