Davidson W R, Kawashima S, Banerjee S P, Liang C S
Hypertension. 1987 May;9(5):467-72. doi: 10.1161/01.hyp.9.5.467.
To determine the mechanism of blunted sympathetic reflex responses in early renovascular hypertension, we measured inotropic and chronotropic responses of the heart to beta-adrenergic stimulation in vivo and myocardial beta-adrenergic receptor number and adenylate cyclase activity in 10 dogs during an early stage of one-kidney renal hypertension. Mean aortic pressure was higher in the hypertensive dogs (152 +/- 4 mm Hg) than in eight sham-operated dogs (122 +/- 1 mm Hg; p less than 0.001), but heart rate, cardiac output, and left atrial pressure did not differ between the two groups. Blood pressure reduction with a direct-acting vasodilator, pinacidil, resulted in marked increases in heart rate (+97 +/- 12 beats/min) and rate of change of left ventricular pressure (dP/dt; +1447 +/- 367 mm Hg/sec) in normotensive dogs but only blunted heart rate (+54 +/- 12 beats/min) and minimal left ventricular dP/dt (+376 +/- 264 mm Hg/sec) responses in hypertensive dogs. In contrast, intravenously administered isoproterenol produced similar increases in heart rate and left ventricular dP/dt in the two groups. These two groups also did not differ in either left ventricular beta-adrenergic receptor number and affinity or basal, isoproterenol-stimulated, and fluoride-stimulated adenylate cyclase activity. Thus, despite blunted reflex responses to blood pressure reduction, hypertensive dogs showed neither reduction in chronotropic and inotropic responses to direct beta-adrenergic stimulation nor beta-adrenergic desensitization of the myocardium, as assessed by beta-adrenergic receptor number and adenylate cyclase activity. Blunted reflex responses in this model of early hypertension must be due to factors operating at some locus other than the beta-adrenergic receptor-adenylate cyclase complex.
为了确定早期肾血管性高血压时交感反射反应减弱的机制,我们在10只单肾肾性高血压早期的犬中,测量了心脏对体内β-肾上腺素能刺激的变力性和变时性反应,以及心肌β-肾上腺素能受体数量和腺苷酸环化酶活性。高血压犬的平均主动脉压(152±4mmHg)高于8只假手术犬(122±1mmHg;p<0.001),但两组之间的心率、心输出量和左心房压并无差异。直接作用的血管扩张剂匹那地尔降低血压后,正常血压犬的心率显著增加(+97±12次/分钟),左心室压力变化率(dP/dt;+1447±367mmHg/秒)显著增加,但高血压犬的心率仅轻度增加(+54±12次/分钟),左心室dP/dt反应最小(+376±264mmHg/秒)。相反,静脉注射异丙肾上腺素在两组中引起的心率和左心室dP/dt增加相似。两组在左心室β-肾上腺素能受体数量和亲和力,或基础、异丙肾上腺素刺激及氟化物刺激的腺苷酸环化酶活性方面也无差异。因此,尽管对血压降低的反射反应减弱,但通过β-肾上腺素能受体数量和腺苷酸环化酶活性评估,高血压犬对直接β-肾上腺素能刺激的变时性和变力性反应并未降低,心肌也未出现β-肾上腺素能脱敏。在这个早期高血压模型中,反射反应减弱必定是由于在β-肾上腺素能受体-腺苷酸环化酶复合物以外的某些部位起作用的因素所致。