Lan Peng, Chen Lina, Zhang Chen, Ni Jun, Yu Peihao, Zhou Jiancang
Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Pharmacol. 2025 Jul 10;16:1533437. doi: 10.3389/fphar.2025.1533437. eCollection 2025.
Vasoactive agents, traditionally recognized for their roles in cardiovascular regulation, have garnered increasing attention for their non-cardiovascular effects across various physiological systems. This review explores the multifaceted roles of vasoactive agents such as catecholamines, vasopressin, and angiotensin II beyond their cardiovascular implications. We examine the mechanisms of action, focusing on receptor interactions and the implications for various physiological systems. Key areas of impact include the central nervous system, where vasoactive agents influence mood, cognition, and neurological function, alongside potential neurotoxicity. Additionally, we discuss gastrointestinal effects, including motility and secretion, as well as renal implications related to blood flow and acute kidney injury risk. The endocrine effects are also addressed, particularly regarding insulin and glucagon secretion. Furthermore, we analyze hematological effects on coagulation and endothelial function, emphasizing the risk factors for thromboembolic events. The clinical implications of this review underscore the importance of monitoring non-cardiovascular effects in patient management and developing strategies to mitigate associated risks. Future research should focus on unraveling the detailed mechanisms of vasoactive agent-receptor interactions and their resulting organ responses, to minimize complications arising from clinical use.
血管活性药物传统上因其在心血管调节中的作用而被认可，但其在各个生理系统中的非心血管效应也越来越受到关注。本综述探讨了儿茶酚胺、血管加压素和血管紧张素 II 等血管活性药物在心血管影响之外的多方面作用。我们研究其作用机制，重点关注受体相互作用以及对各种生理系统的影响。主要影响领域包括中枢神经系统，血管活性药物在其中影响情绪、认知和神经功能，同时存在潜在的神经毒性。此外，我们讨论胃肠道效应，包括蠕动和分泌，以及与血流和急性肾损伤风险相关的肾脏影响。还涉及内分泌效应，特别是关于胰岛素和胰高血糖素的分泌。此外，我们分析对凝血和内皮功能的血液学影响，强调血栓栓塞事件的危险因素。本综述的临床意义强调了在患者管理中监测非心血管效应以及制定减轻相关风险策略的重要性。未来的研究应专注于阐明血管活性药物 - 受体相互作用的详细机制及其导致的器官反应，以尽量减少临床使用中出现的并发症。
