Schiffner René, Nistor Marius, Bischoff Sabine Juliane, Matziolis Georg, Schmidt Martin, Lehmann Thomas
Orthopaedic Department.
Department of Neurology.
Hypoxia (Auckl). 2018 May 22;6:11-22. doi: 10.2147/HP.S165092. eCollection 2018.
Hypoxia induces pulmonary vasoconstriction with a subsequent increase of pulmonary artery pressure (PAP), which can result in pulmonary hypertension. Serelaxin has shown an increase of pulmonary hemodynamic parameters after serelaxin injection. We therefore investigated the response of pulmonary hemodynamic parameters after serelaxin administration in a clinically relevant model.
Six controls and six sheep that received 30 μg/kg serelaxin underwent right heart catheterization during a 12-minute hypoxia period (inhalation of 5% oxygen and 95% nitrogen) and subsequent reoxygenation. Systolic, diastolic, and mean values of both PAP (respectively, PAPs, PAPd, and PAPm) and pulmonary capillary wedge pressure (respectively, PCWPs, PCWPd, and PCWPm), blood gases, heart rate (HR), and both peripheral and pulmonary arterial oxygen saturation were obtained. Cardiac output (CO), stroke volume (SV), pulmonary vascular resistance (PVR), pulmonary arterial compliance (PAcompl), and systemic vascular resistance (SVR) were calculated.
The key findings of the current study are that serelaxin prevents the rise of PAPs (≤0.001), PAPm, PCWPm, PCWPs (≤0.03), and PAPd (≤0.05) during hypoxia, while it simultaneously increases CO and SV (≤0.001). Similar courses of decreases of PAPm, PAPd, PAPs, CO, SVR (≤0.001), and PCWPd (≤0.03) as compared to hypoxic values were observed during reoxygenation. In direct comparison, the experimental groups differed during hypoxia in regard to HR, PAPm, PVR, and SVR (≤0.03), and during reoxygenation in regard to HR (≤0.001), PAPm, PAPs, PAPd, PVR, SVR (≤0.03), and PCWPd (≤0.05).
The findings of this study suggest that serelaxin treatment improves pulmonary hemodynamic parameters during acute hypoxia.
缺氧会诱发肺血管收缩,继而导致肺动脉压力(PAP)升高,这可能会引发肺动脉高压。松弛素注射后已显示出肺血流动力学参数增加。因此,我们在一个临床相关模型中研究了给予松弛素后肺血流动力学参数的反应。
六只对照羊和六只接受30μg/kg松弛素的羊在12分钟的缺氧期(吸入5%氧气和95%氮气)及随后的复氧过程中进行右心导管插入术。获取PAP的收缩压、舒张压和平均值(分别为PAPs、PAPd和PAPm)以及肺毛细血管楔压(分别为PCWPs、PCWPd和PCWPm)、血气、心率(HR)以及外周和肺动脉血氧饱和度。计算心输出量(CO)、每搏输出量(SV)、肺血管阻力(PVR)、肺动脉顺应性(PAcompl)和体循环血管阻力(SVR)。
本研究的关键发现是,松弛素可防止缺氧期间PAPs(≤0.001)、PAPm、PCWPm、PCWPs(≤0.03)和PAPd(≤0.05)升高,同时增加CO和SV(≤0.001)。在复氧过程中,观察到与缺氧值相比,PAPm、PAPd、PAPs、CO、SVR(≤0.001)和PCWPd(≤0.03)有类似的下降过程。直接比较显示,实验组在缺氧期间HR、PAPm、PVR和SVR方面存在差异(≤0.03),在复氧期间HR(≤0.001)、PAPm、PAPs、PAPd、PVR、SVR(≤0.03)和PCWPd(≤0.05)方面存在差异。
本研究结果表明,松弛素治疗可改善急性缺氧期间的肺血流动力学参数。