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清醒犬中心肌收缩状态的颈动脉窦调节范围

Extent of carotid sinus regulation of the myocardial contractile state in conscious dogs.

作者信息

Vatner S F, Higgins C B, Franklin D, Braunwald E

出版信息

J Clin Invest. 1972 Apr;51(4):995-1008. doi: 10.1172/JCI106893.

Abstract

The effects of bilateral carotid artery occlusion (BCO) and carotid sinus nerve stimulation (CSNS) on left ventricular (LV) pressure (P), diameter (D), velocity of contraction (V), rate of change of pressure (dP/dt), and cardiac output were studied in conscious dogs instrumented with ultrasonic diameter gauges, miniature pressure gauges, and aortic electromagnetic flow transducers. The effects of BCO and CSNS were also studied after automatic blockade and were compared to similar alterations in pressure produced by norepinephrine, methoxamine, and nitroglycerin. When heart rate was maintained constant with atrial stimulation, BCO had little effect on ventricular contractility, increasing isolength systolic pressure (LV P(iso)) by 36% while isolength velocity of myocardial shortening (V(iso)) decreased by 12% and (dP/dt)/P fell by 8%. These effects could be explained largely by vasoconstriction, since elevating systolic pressure with methoxamine produced similar results, while norepinephrine increased V(iso) by 36% and (dP/dt)/P by 56%. CSNS produced directionally opposite results from BCO; it decreased P(iso) by 15%, V(iso) increased by 11%, while (dP/dt)/P remained almost constant. These effects may be explained largely by vasodilatation since reducing systolic pressure to the same level with nitroglycerin produced similar results. When peripheral vasoconstriction was minimized by phenoxybenzamine pretreatment. BCO produced a slight positive inotropic effect (P(iso) increased by 8%, V(iso) by 4%, and (dp/dt)/P by 10%), while CSNS produced a slight negative inotropic effect (P(iso) decreased by 3%, V(iso) decreased by 5%, and (dP/dt)/P by 7%).Thus, in the normal, healthy, conscious dog, the carotid sinuses exert relatively little control of the inotropic state of the left ventricle; moreover, this small inotropic action is masked by the more powerful effects on peripheral resistance.

摘要

在装有超声直径测量仪、微型压力测量仪和主动脉电磁流量传感器的清醒犬中,研究了双侧颈动脉闭塞(BCO)和颈动脉窦神经刺激(CSNS)对左心室(LV)压力(P)、直径(D)、收缩速度(V)、压力变化率(dP/dt)和心输出量的影响。还研究了自动阻断后BCO和CSNS的作用,并与去甲肾上腺素、甲氧明和硝酸甘油产生的类似压力变化进行了比较。当通过心房刺激使心率保持恒定时,BCO对心室收缩性影响很小,等长收缩压(LV P(iso))增加36%,而心肌缩短等长速度(V(iso))下降12%,(dP/dt)/P下降8%。这些效应很大程度上可以用血管收缩来解释,因为用甲氧明升高收缩压会产生类似结果,而去甲肾上腺素使V(iso)增加36%,(dP/dt)/P增加56%。CSNS产生与BCO方向相反的结果;它使P(iso)降低15%,V(iso)增加11%,而(dP/dt)/P几乎保持不变。这些效应很大程度上可以用血管舒张来解释,因为用硝酸甘油将收缩压降低到相同水平会产生类似结果。当用苯氧苄胺预处理使外周血管收缩减至最小时。BCO产生轻微的正性肌力作用(P(iso)增加8%,V(iso)增加4%,(dp/dt)/P增加10%),而CSNS产生轻微的负性肌力作用(P(iso)降低3%,V(iso)降低5%,(dP/dt)/P降低7%)。因此,在正常、健康、清醒的犬中,颈动脉窦对左心室收缩状态的控制相对较小;此外,这种小的变力作用被对外周阻力的更强有力作用所掩盖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14f5/302212/f60afff343b3/jcinvest00176-0323-a.jpg

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