Boudart Céline, Su Fuhong, Pitisci Lorenzo, Dhoine Arnaud, Duranteau Olivier, Jespers Pascale, Herpain Antoine, Vanderpool Rebecca, Brimioulle Serge, Creteur Jacques, Naeije Robert, Van Obbergh Luc, Dewachter Laurence
Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
Front Physiol. 2021 Dec 3;12:754570. doi: 10.3389/fphys.2021.754570. eCollection 2021.
Sepsis is a common condition known to impair blood flow regulation and microcirculation, which can ultimately lead to organ dysfunction but such contribution of the coronary circulation remains to be clarified. We investigated coronary blood flow regulatory mechanisms, including autoregulation, metabolic regulation, and endothelial vasodilatory response, in an experimental porcine model of early hyperdynamic sepsis. Fourteen pigs were randomized to sham ( = 7) or fecal peritonitis-induced sepsis ( = 7) procedures. At baseline, 6 and 12 h after peritonitis induction, the animals underwent general and coronary hemodynamic evaluation, including determination of autoregulatory breakpoint pressure and adenosine-induced maximal coronary vasodilation for coronary flow reserve and hyperemic microvascular resistance calculation. Endothelial-derived vasodilatory response was assessed both and using bradykinin. Coronary arteries were sampled for pathobiological evaluation. Sepsis resulted in a right shift of the autoregulatory breakpoint pressure, decreased coronary blood flow reserve and increased hyperemic microvascular resistance from the 6th h after peritonitis induction. and endothelial vasomotor function was preserved. Sepsis increased coronary arteries expressions of nitric oxide synthases, prostaglandin I receptor, and prostaglandin F receptor. Autoregulation and metabolic blood flow regulation were both impaired in the coronary circulation during experimental hyperdynamic sepsis, although endothelial vasodilatory response was preserved.
脓毒症是一种常见病症,已知会损害血流调节和微循环,最终可导致器官功能障碍,但冠状动脉循环的这种作用仍有待阐明。我们在早期高动力型脓毒症的实验猪模型中研究了冠状动脉血流调节机制,包括自动调节、代谢调节和内皮舒张反应。14只猪被随机分为假手术组(n = 7)或粪性腹膜炎诱导的脓毒症组(n = 7)。在基线、诱导腹膜炎后6小时和12小时,对动物进行全身和冠状动脉血流动力学评估,包括测定自动调节断点压力以及腺苷诱导的最大冠状动脉舒张以计算冠状动脉血流储备和充血性微血管阻力。使用缓激肽在基线和诱导腹膜炎后6小时评估内皮源性舒张反应。采集冠状动脉样本进行病理生物学评估。脓毒症导致自动调节断点压力右移,冠状动脉血流储备从诱导腹膜炎后第6小时开始降低,充血性微血管阻力增加。内皮血管舒缩功能在基线和诱导腹膜炎后6小时得以保留。脓毒症增加了冠状动脉中一氧化氮合酶、前列腺素I受体和前列腺素F受体的表达。在实验性高动力型脓毒症期间,冠状动脉循环中的自动调节和代谢性血流调节均受损,尽管内皮舒张反应得以保留。