Levenson J, Simon A C, Safar M E, Bouthier J D, London G M
Circulation. 1985 Apr;71(4):663-8. doi: 10.1161/01.cir.71.4.663.
Simultaneous determinations of cardiac output and brachial arterial blood flow were performed in patients with hypertension and high cardiac output in comparison with normal subjects of the same age. Brachial arterial blood flow was measured with a previously described pulsed Doppler apparatus that permitted the noninvasive determination of arterial diameter and blood flow velocity. In patients with borderline hypertension, brachial blood flow was significantly increased (136 +/- 11 vs 72 +/- 8 ml/min; p less than .001). After short-term administration of indomethacin, cardiac output decreased while brachial blood flow remained constant. After short-term administration of a selective beta 1-receptor antagonist (primidolol) and nonselective blocker (propranolol), cardiac output decreased significantly in both cases but the decrease in brachial blood flow was significant only after the administration of the nonselective beta-blocking agent. The study strongly suggested that in patients with borderline hypertension, the increased cardiac output is related to a prostaglandin and beta 1-adrenergic mechanisms whereas the increased brachial blood flow depends mainly on beta 2-adrenergic mechanisms.
对高血压和高心输出量患者与同龄正常受试者同时进行心输出量和肱动脉血流测定。使用先前描述的脉冲多普勒仪器测量肱动脉血流,该仪器可无创测定动脉直径和血流速度。临界高血压患者的肱动脉血流显著增加(136±11 vs 72±8 ml/min;p<0.001)。短期给予吲哚美辛后,心输出量下降而肱动脉血流保持不变。短期给予选择性β1受体拮抗剂(普米洛尔)和非选择性阻滞剂(普萘洛尔)后,两种情况下心输出量均显著下降,但仅在给予非选择性β阻滞剂后肱动脉血流下降才显著。该研究强烈提示,临界高血压患者的心输出量增加与前列腺素和β1肾上腺素能机制有关,而肱动脉血流增加主要取决于β2肾上腺素能机制。