Ito B R, Feigl E O
Circ Res. 1985 Apr;56(4):486-95. doi: 10.1161/01.res.56.4.486.
The hypothesis that neurally mediated coronary vasodilation occurs as part of the carotid baroreceptor reflex was investigated. The left main coronary artery was cannulated and perfused at constant pressure (100 mm Hg) in closed-chest, chloralose-anesthetized dogs. The heart was paced at a constant rate between 60 and 70 beats/min after atrioventricular heart block. Propranolol (1 mg/kg) was given to prevent beta-receptor-mediated alterations in contractility. Aortic blood pressure was stabilized with a blood reservoir. The aortic depressor nerves were cut bilaterally to prevent the buffering influence of aortic arch baroreceptors on the carotid baroreceptor reflex. The carotid sinuses were vascularly isolated and perfused with arterial blood at controlled pressures. Under these conditions, a step change in carotid sinus pressure from 70 to 210 mm Hg produced a 0.29 ml/min per g increase in coronary flow above control and a 10 mm Hg increase in coronary sinus blood oxygen tension. A step in carotid sinus pressure from 70 to 150 mm Hg resulted in a flow increase of 0.13 ml/min per g and a coronary sinus oxygen tension increase of 5.3 mm Hg relative to prestimulation values. Atropine (0.5 mg/kg, iv) blocked most of the reflex coronary vasodilation, indicating a parasympathetic component, and the addition of adrenergic alpha-receptor blockade with phenoxybenzamine (0.25 mg/kg, ic) abolished the remaining response, demonstrating sympathetic participation. The reflex nature of the coronary response was confirmed with carotid sinus denervation and vagotomy. It is concluded that carotid sinus hypertension results in a graded reflex neural coronary vasodilation independent of myocardial metabolic factors. The major component is due to activation of parasympathetic coronary vasodilator fibers, but there is also inhibition of sympathetic vasoconstrictor fibers.
研究了神经介导的冠状动脉舒张作为颈动脉压力感受器反射一部分而发生的假说。在开胸、氯醛糖麻醉的犬中,将左冠状动脉主干插管并在恒定压力(100 mmHg)下进行灌注。在房室传导阻滞之后,以60至70次/分钟的恒定速率对心脏进行起搏。给予普萘洛尔(1 mg/kg)以防止β受体介导的心肌收缩力改变。用储血器稳定主动脉血压。双侧切断主动脉减压神经,以防止主动脉弓压力感受器对颈动脉压力感受器反射的缓冲作用。将颈动脉窦进行血管分离,并用控制压力的动脉血进行灌注。在这些条件下,颈动脉窦压力从70 mmHg阶跃变化至210 mmHg,使冠状动脉流量比对照增加0.29 ml/(min·g),冠状窦血氧张力增加10 mmHg。颈动脉窦压力从70 mmHg阶跃变化至150 mmHg,导致流量增加0.13 ml/(min·g),冠状窦氧张力相对于刺激前值增加5.3 mmHg。阿托品(0.5 mg/kg,静脉注射)阻断了大部分反射性冠状动脉舒张,表明存在副交感神经成分,而加入苯氧苄胺(0.25 mg/kg,腹腔注射)进行肾上腺素能α受体阻断则消除了剩余反应,表明有交感神经参与。通过颈动脉窦去神经支配和迷走神经切断术证实了冠状动脉反应的反射性质。得出的结论是,颈动脉窦高血压导致分级的反射性神经源性冠状动脉舒张,与心肌代谢因素无关。主要成分是由于副交感神经冠状动脉舒张纤维的激活,但也存在交感神经血管收缩纤维的抑制。