Declusin R J, Boerboom L E, Olinger G N, Gustafson A B, Bonchek L I
J Am Coll Cardiol. 1987 Apr;9(4):903-9. doi: 10.1016/s0735-1097(87)80249-8.
This study was designed to determine the hemodynamic and hormonal consequences of aortic coarctation at rest and during treadmill exercise. Twelve normal adult dogs served as controls. In eight dogs coarctation was created within 1 week of birth by banding the aorta just proximal to the ductus ligament, thereby fixing luminal diameter at 1 to 2 mm. Studies were performed 18 months after operation. Vascular pressures were monitored proximal and distal to the coarctation, cardiac output and regional blood flow were evaluated with radioactive microspheres and blood samples were collected for determination of hormone levels and blood gases. At rest, systolic pressure in the proximal aorta was 130 +/- 12 mm Hg (mean +/- SD) in the control group and 167 +/- 16 mm Hg in dogs with coarctation (p less than 0.01). During exercise at a level that doubled heart rate and cardiac index, mean aortic pressure increased by 11 and 31% (p less than 0.01) in the control and the coarctation group, respectively. Mean distal aortic pressure increased by 8% during exercise in control dogs but decreased by 29% in dogs with coarctation. Exercise decreased flow to the kidneys and the large intestine in the coarctation group. Plasma norepinephrine concentrations were greater in the coarctation group than in control dogs at rest; during exercise, plasma norepinephrine, epinephrine and renin activity increased in both groups, but to a greater degree in the group with coarctation. These results confirm an abnormality in renal and gut perfusion in experimental coarctation and suggest that this may be related to a decline in perfusion pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在确定静息状态及跑步机运动期间主动脉缩窄的血流动力学和激素变化。12只正常成年犬作为对照。8只犬在出生后1周内通过在动脉韧带近端结扎主动脉造成缩窄,从而将管腔直径固定在1至2毫米。在术后18个月进行研究。监测缩窄部位近端和远端的血管压力,用放射性微球评估心输出量和局部血流,并采集血样测定激素水平和血气。静息时,对照组近端主动脉收缩压为130±12毫米汞柱(均值±标准差),缩窄犬为167±16毫米汞柱(p<0.01)。在使心率和心脏指数加倍的运动水平下,对照组和缩窄组的平均主动脉压分别升高11%和31%(p<0.01)。静息犬运动时远端主动脉平均压升高8%,而缩窄犬则降低29%。运动使缩窄组肾脏和大肠的血流减少。静息时缩窄组血浆去甲肾上腺素浓度高于对照犬;运动期间,两组血浆去甲肾上腺素、肾上腺素和肾素活性均升高,但缩窄组升高幅度更大。这些结果证实实验性缩窄存在肾和肠道灌注异常,并提示这可能与灌注压下降有关。(摘要截短于250字)