Nabel E G, Colucci W S, Lilly L S, Cutler S S, Majzoub J A, St John Sutton M G, Dzau V J, Creager M A
J Clin Endocrinol Metab. 1987 Sep;65(3):475-81. doi: 10.1210/jcem-65-3-475.
The objectives of this study were to examine the effect of incremental lower body negative pressure (LBNP) on cardiac chamber volume and assess the relationship between cardiac chamber volume and baroreflex activation of the neurohormonal axis. Accordingly, echocardiographic determination of cardiac chamber volume and neurohormonal responses were studied in 14 normal subjects during incremental LBNP. LBNP -10 mm Hg decreased left atrial diameter and left ventricular systolic volume index, but did not alter heart rate, systolic or pulse pressure, or stroke volume. During LBNP -10 mm Hg, plasma norepinephrine levels increased, suggesting activation of the sympathetic nervous system. LBNP -40 mm Hg caused a significant decrease in left atrial diameter and left ventricular systolic, diastolic, and stroke volume indices. During LBNP -40 mm Hg, heart rate increased, and systolic and pulse pressure fell. With this more negative level of LBNP, norepinephrine, angiotensin II, aldosterone, and arginine vasopressin concentrations and PRA all increased. The findings that left atrial diameter decreased and plasma norepinephrine concentration increased during LBNP -10 mm Hg suggest that the sympathetic nervous system is sensitive to changes in atrial receptor activity. At higher levels of LBNP (-40 mm Hg), activation of the renin-angiotensin system and release of vasopressin were associated with a fall in left ventricular diastolic volume as well as a decrease in the pressure input to the arterial baroreceptors. Under this condition, the differential contribution of the cardiopulmonary and arterial baroreceptors to the regulation of the renin-angiotensin system and vasopressin release cannot be distinguished.
本研究的目的是检测下肢负压递增(LBNP)对心腔容积的影响,并评估心腔容积与神经激素轴压力反射激活之间的关系。因此,对14名正常受试者在LBNP递增过程中的心腔容积进行了超声心动图测定,并研究了神经激素反应。LBNP -10 mmHg可使左心房直径和左心室收缩容积指数降低,但不改变心率、收缩压或脉压,也不改变每搏输出量。在LBNP -10 mmHg时,血浆去甲肾上腺素水平升高,提示交感神经系统激活。LBNP -40 mmHg可使左心房直径以及左心室收缩、舒张和每搏输出量指数显著降低。在LBNP -40 mmHg时,心率增加,收缩压和脉压下降。随着LBNP负压程度加深,去甲肾上腺素、血管紧张素II、醛固酮和精氨酸加压素浓度以及肾素活性均升高。LBNP -10 mmHg时左心房直径减小且血浆去甲肾上腺素浓度升高,这一结果表明交感神经系统对心房受体活性变化敏感。在更高水平的LBNP(-40 mmHg)时,肾素-血管紧张素系统的激活和加压素的释放与左心室舒张容积下降以及动脉压力感受器压力输入减少有关。在这种情况下,心肺压力感受器和动脉压力感受器对肾素-血管紧张素系统调节和加压素释放的不同贡献无法区分。