Suppr超能文献

高血压和衰老过程中的软脑膜侧支循环反应性:理解侧支循环在中风治疗中的作用

Pial Collateral Reactivity During Hypertension and Aging: Understanding the Function of Collaterals for Stroke Therapy.

作者信息

Chan Siu-Lung, Sweet Julie G, Bishop Nicole, Cipolla Marilyn J

机构信息

From the Departments of Neurological Sciences (S.-L.C., J.G.S., N.B., M.J.C.), Obstetrics, Gynecology, and Reproductive Sciences (M.J.C.), and Pharmacology (M.J.C.), University of Vermont College of Medicine, Burlington.

出版信息

Stroke. 2016 Jun;47(6):1618-25. doi: 10.1161/STROKEAHA.116.013392. Epub 2016 Apr 21.

Abstract

BACKGROUND AND PURPOSE

We investigated vasoactive properties of leptomeningeal arterioles (LMAs) under normotensive conditions and during hypertension and aging that are known to have poor collateral flow and little salvageable tissue.

METHODS

LMAs, identified as distal anastomotic arterioles connecting middle and anterior cerebral arteries, were studied isolated and pressurized from young (18 weeks) or aged (48 weeks) normotensive Wistar Kyoto (WKY18, n=14; WKY48, n=6) rats and spontaneously hypertensive rats (SHR18, n=16; SHR48, n=6). Myogenic tone and vasoactive responses to pressure as well as endothelial function and ion channel activity were measured.

RESULTS

LMAs from WKY18 had little myogenic tone at 40 mm Hg (8±3%) that increased in aged WKY48 (30±6%). However, LMAs from both WKY groups dilated to increased pressure and demonstrated little myogenic reactivity, a response that would be conducive to collateral flow. In contrast, LMAs from both SHR18 and SHR48 displayed considerable myogenic tone (56±8% and 43±7%; P<0.01 versus WKY) and constricted to increased pressure. LMAs from both WKY and SHR groups had similar basal endothelial nitric oxide and IK channel activity that opposed tone. However, dilation to sodium nitroprusside, diltiazem and 15 mmol/L KCl was impaired in LMAs from SHR18.

CONCLUSIONS

This study shows for the first time that LMAs from young and aged SHR are vasoconstricted and have impaired vasodilatory responses that may contribute to greater perfusion deficit and little penumbral tissue. These results also suggest that therapeutic opening of pial collaterals is possible during middle cerebral artery occlusion to create penumbral tissue and prevent infarct expansion.

摘要

背景与目的

我们研究了在正常血压条件下以及高血压和衰老过程中软脑膜小动脉(LMA)的血管活性特性,已知高血压和衰老会导致侧支循环不良且可挽救组织较少。

方法

LMA被识别为连接大脑中动脉和大脑前动脉的远端吻合小动脉,从年轻(18周)或老年(48周)正常血压的Wistar Kyoto大鼠(WKY18,n = 14;WKY48,n = 6)和自发性高血压大鼠(SHR18,n = 16;SHR48,n = 6)中分离并施加压力进行研究。测量肌源性张力、对压力的血管活性反应以及内皮功能和离子通道活性。

结果

WKY18的LMA在40 mmHg时肌源性张力很小(8±3%),在老年WKY48中增加(30±6%)。然而,两个WKY组的LMA均随压力升高而扩张,且肌源性反应性较小,这种反应有利于侧支循环。相比之下,SHR18和SHR48的LMA均表现出相当大的肌源性张力(56±8%和43±7%;与WKY相比,P<0.01),并随压力升高而收缩。WKY和SHR组的LMA具有相似的基础内皮一氧化氮和IK通道活性,可对抗张力。然而,SHR18的LMA对硝普钠、地尔硫䓬和15 mmol/L KCl的扩张反应受损。

结论

本研究首次表明,年轻和老年SHR的LMA血管收缩且血管舒张反应受损,这可能导致更大的灌注不足和半暗带组织较少。这些结果还表明,在大脑中动脉闭塞期间,有可能通过治疗性开放软脑膜侧支循环来创建半暗带组织并防止梗死灶扩大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4c0/4878286/63879b821413/str-47-1618-g001.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验