Navar L G, Champion W J, Thomas C E
Circ Res. 1986 Jun;58(6):874-81. doi: 10.1161/01.res.58.6.874.
We conducted these experiments to evaluate the selectivity of calcium channel blockade on the renal autoregulatory mechanism and on angiotensin II-mediated renal vasoconstriction. Experiments were performed in anesthetized dogs in which renal arterial pressure, renal blood flow, and glomerular filtration rate were measured at normal and reduced renal arterial pressure. At control arterial pressures, renal arterial infusions of verapamil increased renal blood flow and glomerular filtration rate significantly. The decreases in renal vascular resistance elicited with verapamil (n = 13) and nifedipine (n = 4) occurred only at renal arterial pressure levels within the normal autoregulatory range. Renal blood flow autoregulatory efficiency was markedly attenuated, and the pressure-flow relationship obtained during calcium channel blockade approached that of a passive system. Systemic infusions of an angiotensin-converting enzyme inhibitor (captopril) during continued verapamil infusion caused further vasodilation at all renal arterial pressure values, as evidenced by an increase in slope of 27% of the pressure-blood flow relationship. This response was reversed by angiotensin II infusions. This shift indicates a reduction in minimal vascular resistance elicited by captopril, not obtainable with verapamil alone, and sensitive to angiotensin II. The effects of verapamil and nifedipine on renal blood flow autoregulation suggest a specific effect at preglomerular sites of potential operated membrane calcium channels in the autoregulatory phenomenon. The additional vasodilation elicited with captopril and reversed by angiotensin II indicates the presence of an angiotensin-sensitive postglomerular resistance component which is not influenced by calcium entry blockers.
我们进行这些实验以评估钙通道阻滞剂对肾自动调节机制及血管紧张素II介导的肾血管收缩的选择性。实验在麻醉犬身上进行,测量正常及降低肾动脉压时的肾动脉压、肾血流量和肾小球滤过率。在对照动脉压下,肾动脉输注维拉帕米显著增加肾血流量和肾小球滤过率。维拉帕米(n = 13)和硝苯地平(n = 4)引起的肾血管阻力降低仅发生在肾动脉压处于正常自动调节范围内时。肾血流量自动调节效率明显减弱,钙通道阻滞剂作用期间获得的压力-流量关系接近被动系统。在持续输注维拉帕米期间全身输注血管紧张素转换酶抑制剂(卡托普利),在所有肾动脉压值时均引起进一步血管舒张,压力-血流关系斜率增加27%证明了这一点。这种反应被血管紧张素II输注逆转。这种变化表明卡托普利引起的最小血管阻力降低,单独使用维拉帕米无法实现,且对血管紧张素II敏感。维拉帕米和硝苯地平对肾血流量自动调节的作用表明在自动调节现象中对肾小球前潜在操作膜钙通道部位有特定作用。卡托普利引起的额外血管舒张并被血管紧张素II逆转,表明存在对血管紧张素敏感的肾小球后阻力成分,其不受钙内流阻滞剂影响。