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血压调节 V:长期压力加载和卸载对小动脉血管体内力学特性的影响。

Blood pressure regulation V: in vivo mechanical properties of precapillary vessels as affected by long-term pressure loading and unloading.

机构信息

Department of Environmental Physiology and Swedish Aerospace Physiology Centre, KTH, Royal Institute of Technology, Berzelius v 13, Solna, 17165, Stockholm, Sweden,

出版信息

Eur J Appl Physiol. 2014 Mar;114(3):499-509. doi: 10.1007/s00421-013-2758-9. Epub 2013 Dec 7.

Abstract

Recent studies are reviewed, concerning the in vivo wall stiffness of arteries and arterioles in healthy humans, and how these properties adapt to iterative increments or sustained reductions in local intravascular pressure. A novel technique was used, by which arterial and arteriolar stiffness was determined as changes in arterial diameter and flow, respectively, during graded increments in distending pressure in the blood vessels of an arm or a leg. Pressure-induced increases in diameter and flow were smaller in the lower leg than in the arm, indicating greater stiffness in the arteries/arterioles of the leg. A 5-week period of intermittent intravascular pressure elevations in one arm reduced pressure distension and pressure-induced flow in the brachial artery by about 50%. Conversely, prolonged reduction of arterial/arteriolar pressure in the lower body by 5 weeks of sustained horizontal bedrest, induced threefold increases of the pressure-distension and pressure-flow responses in a tibial artery. Thus, the wall stiffness of arteries and arterioles are plastic properties that readily adapt to changes in the prevailing local intravascular pressure. The discussion concerns mechanisms underlying changes in local arterial/arteriolar stiffness as well as whether stiffness is altered by changes in myogenic tone and/or wall structure. As regards implications, regulation of local arterial/arteriolar stiffness may facilitate control of arterial pressure in erect posture and conditions of exaggerated intravascular pressure gradients. That increased intravascular pressure leads to increased arteriolar wall stiffness also supports the notion that local pressure loading may constitute a prime mover in the development of vascular changes in hypertension.

摘要

最近的研究综述了健康人体动脉和小动脉的活体壁硬度,以及这些特性如何适应局部血管内压力的反复递增或持续降低。采用了一种新的技术,通过该技术,在手臂或腿部血管的扩张压力逐渐增加的过程中,分别通过动脉直径和流量的变化来确定动脉和小动脉的硬度。与手臂相比,小腿的血管在压力下直径和流量的增加较小,表明小腿的动脉/小动脉硬度较大。为期 5 周的间歇性血管内压力升高会使肱动脉的压力扩张和压力诱导的血流减少约 50%。相反,通过 5 周的持续水平卧床休息来长时间降低下肢的动脉/小动脉压力,会使胫骨动脉的压力扩张和压力流量反应增加三倍。因此,动脉和小动脉的壁硬度是易于适应流行的局部血管内压力变化的塑性特性。讨论涉及局部动脉/小动脉硬度变化的机制,以及硬度是否因肌源性张力和/或壁结构的变化而改变。就其影响而言,局部动脉/小动脉硬度的调节可能有助于控制直立姿势和血管内压力梯度夸张时的动脉血压。增加的血管内压力导致小动脉壁硬度增加也支持这样一种观点,即局部压力负荷可能是高血压中血管变化发展的主要动力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb9/3929772/29b1ae9533d2/421_2013_2758_Fig1_HTML.jpg

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