Sata Yusuke, Kawada Toru, Shimizu Shuji, Kamiya Atsunori, Akiyama Tsuyoshi, Sugimachi Masaru
Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center; Department of Artificial Organ Medicine, Faculty of Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Circ J. 2015;79(3):592-9. doi: 10.1253/circj.CJ-14-1013. Epub 2014 Dec 27.
There is ongoing controversy over whether neural or peripheral factors are the predominant cause of hypertension. The closed-loop negative feedback operation of the arterial baroreflex hampers understanding of how arterial pressure (AP) is determined through the interaction between neural and peripheral factors. METHODS AND RESULTS: A novel analysis of an isolated open-loop baroreceptor preparation to examine sympathetic nervous activity (SNA) and AP responses to changes in carotid sinus pressure (CSP) in adult spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) was conducted. In the neural arc (CSP-SNA relationship), the midpoint pressure (128.9±3.8 vs. 157.9±8.1 mmHg, P<0.001) and the response range of SNA to CSP (90.5±3.7 vs. 115.4±7.6%/mmHg, P=0.011) were higher in SHR. In the peripheral arc (SNA-AP relationship), slope and intercept did not differ. A baroreflex equilibrium diagram was obtained by depicting neural and peripheral arcs in a pressure-SNA plane with rescaled SNA (% in WKY). The operating-point AP (111.3±4.4 vs. 145.9±5.2 mmHg, P<0.001) and SNA (90.8±3.2 vs. 125.1±6.9% in WKY, P<0.001) were shifted towards a higher level in SHR.
The shift of the neural arc towards a higher SNA range indicated a predominant contribution to baroreflex resetting in SHR. Notwithstanding the resetting, the carotid sinus baroreflex in SHR preserved an ability to reduce AP if activated with a high enough pressure.
关于神经因素还是外周因素是高血压的主要病因,目前仍存在争议。动脉压力感受器反射的闭环负反馈操作妨碍了对通过神经和外周因素之间的相互作用来确定动脉血压(AP)方式的理解。
对成年自发性高血压大鼠(SHR)和正常血压的Wistar Kyoto大鼠(WKY)进行了一项新颖的分析,该分析采用孤立的开环压力感受器制备方法,以检查交感神经活动(SNA)以及对颈动脉窦压力(CSP)变化的AP反应。在神经弧(CSP-SNA关系)中,SHR的中点压力(128.9±3.8 vs. 157.9±8.1 mmHg,P<0.001)和SNA对CSP的反应范围(90.5±3.7 vs. 115.4±7.6%/mmHg,P=0.011)更高。在外周弧(SNA-AP关系)中,斜率和截距没有差异。通过在压力-SNA平面中描绘神经弧和外周弧,并对SNA进行重新标度(以WKY中的百分比表示),获得了压力感受器反射平衡图。SHR的工作点AP(111.3±4.4 vs. 145.9±5.2 mmHg,P<0.001)和SNA(相对于WKY中的90.8±3.2 vs. 125.1±6.9%,P<0.001)向更高水平偏移。
神经弧向更高SNA范围的偏移表明对SHR中压力感受器反射重调定起主要作用。尽管发生了重调定,但如果用足够高的压力激活,SHR中的颈动脉窦压力感受器反射仍保留降低AP的能力。