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肾血管性高血压运动后肌肉缺血期间,减弱的肌肉代谢反射诱导的升压反应。

Attenuated muscle metaboreflex-induced pressor response during postexercise muscle ischemia in renovascular hypertension.

作者信息

Spranger Marty D, Kaur Jasdeep, Sala-Mercado Javier A, Machado Tiago M, Krishnan Abhinav C, Alvarez Alberto, O'Leary Donal S

机构信息

Department of Physiology and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan.

Department of Physiology and Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan

出版信息

Am J Physiol Regul Integr Comp Physiol. 2015 Apr 1;308(7):R650-8. doi: 10.1152/ajpregu.00464.2014. Epub 2015 Jan 28.

Abstract

During dynamic exercise, muscle metaboreflex activation (MMA; induced via partial hindlimb ischemia) markedly increases mean arterial pressure (MAP), and MAP is sustained when the ischemia is maintained following the cessation of exercise (postexercise muscle ischemia, PEMI). We previously reported that the sustained pressor response during PEMI in normal individuals is driven by a sustained increase in cardiac output (CO) with no peripheral vasoconstriction. However, we have recently shown that the rise in CO with MMA is significantly blunted in hypertension (HTN). The mechanisms sustaining the pressor response during PEMI in HTN are unknown. In six chronically instrumented canines, hemodynamic responses were observed during rest, mild exercise (3.2 km/h), MMA, and PEMI in the same animals before and after the induction of HTN [Goldblatt two kidney, one clip (2K1C)]. In controls, MAP, CO and HR increased with MMA (+52 ± 6 mmHg, +2.1 ± 0.3 l/min, and +37 ± 7 beats per minute). After induction of HTN, MAP at rest increased from 97 ± 3 to 130 ± 4 mmHg, and the metaboreflex responses were markedly attenuated (+32 ± 5 mmHg, +0.6 ± 0.2 l/min, and +11 ± 3 bpm). During PEMI in HTN, HR and CO were not sustained, and MAP fell to normal recovery levels. We conclude that the attenuated metaboreflex-induced HR, CO, and MAP responses are not sustained during PEMI in HTN.

摘要

在动态运动期间,肌肉代谢反射激活(MMA;通过部分后肢缺血诱导)会显著增加平均动脉压(MAP),并且在运动停止后维持缺血状态(运动后肌肉缺血,PEMI)时,MAP会持续升高。我们之前报道过,正常个体在PEMI期间持续的升压反应是由心输出量(CO)持续增加驱动的,而没有外周血管收缩。然而,我们最近发现,高血压(HTN)患者中MMA引起的CO升高明显减弱。HTN患者在PEMI期间维持升压反应的机制尚不清楚。在六只长期植入仪器的犬中,在诱导HTN [Goldblatt双肾一夹(2K1C)]前后,观察了同一动物在静息、轻度运动(3.2 km/h)、MMA和PEMI期间的血流动力学反应。在对照组中,MAP、CO和HR随MMA增加(分别为+52±6 mmHg、+2.1±0.3 l/min和+37±7次/分钟)。诱导HTN后,静息时的MAP从97±3 mmHg升高到130±4 mmHg,代谢反射反应明显减弱(分别为+32±5 mmHg、+0.6±0.2 l/min和+11±3次/分钟)。在HTN患者的PEMI期间,HR和CO没有持续,MAP降至正常恢复水平。我们得出结论,HTN患者在PEMI期间,代谢反射诱导的HR、CO和MAP反应减弱且不持续。

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