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清醒犬心脏功能与血浆儿茶酚胺水平之间的相关性

Correlation between cardiac performance and plasma catecholamine levels in conscious dogs.

作者信息

Young M A, Hintze T H, Vatner S F

出版信息

Am J Physiol. 1985 Jan;248(1 Pt 2):H82-8. doi: 10.1152/ajpheart.1985.248.1.H82.

Abstract

We correlated levels of circulating norepinephrine (NE) and epinephrine (Epi) induced by 1) infusions, 2) treadmill exercise, and 3) hemorrhage with left ventricular (LV) function in conscious dogs instrumented for the measurement of LV and arterial pressures, LV diameter, and calculations of indexes of myocardial contractility. With infusions of NE, significant hemodynamic changes were observed only when plasma levels of NE exceeded 1,000 pg/ml. While statistically significant, the increase in rate of rise of LV pressure (LV dP/dt) at these levels was relatively slight, i.e., 8 +/- 2.3%. With further increases in catecholamines (greater than 1,000 pg/ml) good correlations were observed with increases in arterial pressure and myocardial contractility. Similar results occurred with infusions of Epi. Moderate treadmill exercise doubled LV dP/dt, while NE and Epi rose by only 563 +/- 128 and 292 +/- 50 pg/ml, respectively. Hemorrhage (30 ml/kg) decreased all indexes of contractility but increased plasma NE by 1,108 +/- 206 pg/ml and Epi by 1,475 +/- 266 pg/ml. Despite arterial NE and Epi levels 10-20 times those during exercise, infusions were unable to reproduce the peak changes in contractility seen with exercise. Infusions of NE or Epi to equal the plasma levels during exercise increased contractility by only 5-10%. In view of the marked disparity between levels of circulating catecholamines and LV function during exercise, hemorrhage, and catecholamine infusion, we conclude that circulating catecholamines do not adequately reflect the degree of inotropic stimulation to the myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们将1)输注、2)跑步机运动以及3)出血所诱导的循环去甲肾上腺素(NE)和肾上腺素(Epi)水平,与清醒犬的左心室(LV)功能进行了关联分析。这些犬被植入用于测量左心室和动脉压力、左心室直径以及计算心肌收缩性指标的仪器。输注NE时,仅当血浆NE水平超过1000 pg/ml时才观察到显著的血流动力学变化。虽然具有统计学意义,但在这些水平下左心室压力上升速率(LV dP/dt)的增加相对较小,即8±2.3%。随着儿茶酚胺水平进一步升高(大于1000 pg/ml),观察到与动脉压和心肌收缩性增加具有良好的相关性。输注Epi时出现了类似结果。适度的跑步机运动使LV dP/dt增加了一倍,而NE和Epi仅分别上升了563±128 pg/ml和292±50 pg/ml。出血(30 ml/kg)降低了所有收缩性指标,但使血浆NE增加了1108±206 pg/ml,使Epi增加了1475±266 pg/ml。尽管动脉NE和Epi水平比运动时高10 - 20倍,但输注无法再现运动时所见的收缩性峰值变化。输注NE或Epi使其血浆水平与运动时相等,仅使收缩性增加了5 - 10%。鉴于运动、出血和儿茶酚胺输注期间循环儿茶酚胺水平与左心室功能之间存在明显差异,我们得出结论,循环儿茶酚胺不能充分反映对心肌的变力性刺激程度。(摘要截短于250字)

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