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在犬类充血性心力衰竭发展过程中,心房利钠肽对交感肾上腺的抑制作用并未减弱。

Sympathoadrenal inhibition by atrial natriuretic peptide is not attenuated during development of congestive heart failure in dogs.

作者信息

Holtz J, Münzel T, Sommer O, Bassenge E

机构信息

Institute of Applied Physiology, University of Freiburg, FRG.

出版信息

Circulation. 1989 Dec;80(6):1862-9. doi: 10.1161/01.cir.80.6.1862.

Abstract

The feedback control of neuroendocrine activity by cardiopulmonary blood volume is disturbed in congestive heart failure. By analyzing plasma catecholamine kinetics, we tested in 11 chronically instrumented conscious dogs whether attenuations in the sympathoadrenal inhibition induced by atrial natriuretic peptide (ANP) contributed to this disturbance. Low-output failure was brought about by continuous ventricular pacing at 265 beats/min for 2 weeks. This resulted in a decline in aortic flow by 37 +/- 5% (SEM), an increase in peripheral vascular resistance by 48 +/- 4%, a 13 +/- 3-fold elevation in plasma ANP, a 9 +/- 3-fold elevation in plasma renin activity, and an augmentation of the norepinephrine-release rate into plasma by 132 +/- 17%. During ANP infusion, the epinephrine-release rate declined by 26 +/- 5% per 10-fold elevation in plasma ANP before pacing and by 31 +/- 7% (not significantly different) after 2 weeks of pacing. Before pacing, ANP attenuated plasma renin activity and caused hypotension without a rise in norepinephrine-release rate. After 2 weeks of pacing, ANP lowered norepinephrine release (by 16 +/- 6%) without affecting blood pressure or plasma renin activity, and vascular nonresponsiveness to ANP was verified under autonomic blockade. These data indicate that, during the development of heart failure, an inhibitory action of ANP on norepinephrine release is unmasked by an ANP-specific vascular desensitization, whereas the inhibition of epinephrine release is observed throughout. It is concluded that ANP-induced sympathoadrenal inhibition is not attenuated and, therefore, does not contribute to the disturbed regulation observed early in the development of failure.

摘要

在充血性心力衰竭中,心肺血容量对神经内分泌活动的反馈控制受到干扰。通过分析血浆儿茶酚胺动力学,我们在11只长期植入仪器的清醒犬中测试了心房利钠肽(ANP)诱导的交感肾上腺抑制减弱是否导致了这种干扰。通过以265次/分钟的频率持续心室起搏2周来造成低输出量衰竭。这导致主动脉血流量下降37±5%(标准误),外周血管阻力增加48±4%,血浆ANP升高13±3倍,血浆肾素活性升高9±3倍,血浆去甲肾上腺素释放率增加132±17%。在输注ANP期间,起搏前血浆ANP每升高10倍,肾上腺素释放率下降26±5%,起搏2周后下降31±7%(无显著差异)。起搏前,ANP可减弱血浆肾素活性并导致低血压,而去甲肾上腺素释放率无升高。起搏2周后,ANP降低了去甲肾上腺素释放(降低16±6%),但不影响血压或血浆肾素活性,并且在自主神经阻滞下证实了血管对ANP无反应。这些数据表明,在心力衰竭发展过程中,ANP特异性血管脱敏揭示了ANP对去甲肾上腺素释放的抑制作用,而对肾上腺素释放的抑制作用则始终存在。得出的结论是,ANP诱导的交感肾上腺抑制并未减弱,因此,它对心力衰竭早期观察到的调节紊乱没有影响。

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