Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah;
Am J Physiol Heart Circ Physiol. 2014 Mar 1;306(5):H771-6. doi: 10.1152/ajpheart.00782.2013. Epub 2014 Jan 10.
Ultrasound Doppler and near-infrared spectroscopy (NIRS) are routinely used for noninvasive monitoring of peripheral hemodynamics in both clinical and experimental settings. However, the comparative ability of these methodologies to detect changes in microvascular and whole limb hemodynamics during pharmacological manipulation of vascular smooth muscle receptors located at varied locations within the arterial tree is unknown. Thus, in 10 healthy subjects (25 ± 2 yr), changes in resting leg blood flow (ultrasound Doppler; femoral artery) and muscle oxygenation (oxyhemoglobin + oxymyoglobin; vastus lateralis) were simultaneously evaluated in response to intra-arterial infusions of phenylephrine (PE, 0.025-0.8 μg·kg(-1)·min(-1)), BHT-933 (2.5-40 μg·kg(-1)·min(-1)), and angiotensin II (ANG II, 0.5-8 ng·kg(-1)·min(-1)). All drugs elicited significant dose-dependent reductions in leg blood flow and oxyhemoglobin + oxymyoglobin. Significant relationships were found between ultrasound Doppler and NIRS changes across doses of PE (r(2) = 0.37 ± 0.08), BHT-933 (r(2) = 0.74 ± 0.06), and ANG II (r(2) = 0.68 ± 0.13), with the strongest relationships evident with agonists for receptors located preferentially "downstream" in the leg microcirculation (BHT-933 and ANG II). Analyses of drug potency revealed similar EC50 between ultrasound Doppler and NIRS measurements for PE (0.06 ± 0.02 vs. 0.10 ± 0.01), BHT-933 (5.0 ± 0.9 vs. 4.5 ± 1.3), and ANG II (1.4 ± 0.8 vs. 1.3 ± 0.3). These data provide evidence that both ultrasound Doppler and NIRS track pharmacologically induced changes in peripheral hemodynamics and are equally capable of determining drug potency. However, considerable disparity was observed between agonist infusions targeting different levels of the arterial tree, suggesting that receptor landscape is an important consideration for proper interpretation of hemodynamic monitoring with these methodologies.
超声多普勒和近红外光谱(NIRS)常用于临床和实验环境中对外周血液动力学的非侵入性监测。然而,这些方法在检测位于动脉树不同位置的血管平滑肌受体的药理学操作期间,对微血管和整个肢体血液动力学变化的比较能力尚不清楚。因此,在 10 名健康受试者(25 ± 2 岁)中,同时评估了股动脉(超声多普勒)和肌肉氧合(氧合血红蛋白+氧合肌红蛋白;股外侧肌)在动脉内输注苯肾上腺素(PE,0.025-0.8 μg·kg(-1)·min(-1))、BHT-933(2.5-40 μg·kg(-1)·min(-1))和血管紧张素 II(ANG II,0.5-8 ng·kg(-1)·min(-1))时的变化。所有药物均引起腿部血流量和氧合血红蛋白+氧合肌红蛋白的显著剂量依赖性降低。在 PE(r(2) = 0.37 ± 0.08)、BHT-933(r(2) = 0.74 ± 0.06)和 ANG II(r(2) = 0.68 ± 0.13)的剂量范围内,超声多普勒和 NIRS 之间存在显著的关系,与位于腿部微循环下游的受体激动剂(BHT-933 和 ANG II)的关系最强。药物效力分析表明,PE(0.06 ± 0.02 与 0.10 ± 0.01)、BHT-933(5.0 ± 0.9 与 4.5 ± 1.3)和 ANG II(1.4 ± 0.8 与 1.3 ± 0.3)的超声多普勒和 NIRS 测量的 EC50 相似。这些数据表明,超声多普勒和 NIRS 均能跟踪外周血液动力学的药理学诱导变化,并且都能够确定药物效力。然而,在针对动脉树不同水平的激动剂输注之间观察到相当大的差异,这表明受体景观是正确解释这些方法的血液动力学监测的重要考虑因素。