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犬对左心室流出道梗阻的反射性血管反应及心室压力感受器的激活

Reflex vascular responses to left ventricular outflow obstruction and activation of ventricular baroreceptors in dogs.

作者信息

Mark A L, Abboud F M, Schmid P G, Heistad D D

出版信息

J Clin Invest. 1973 May;52(5):1147-53. doi: 10.1172/JCI107281.

Abstract

Reflex vascular responses to acute left ventricular outflow obstruction were studied in anesthetized dogs. The studies were done to compare the effects of activation of ventricular baroreceptors on vascular resistance in skeletal muscle (gracilis muscle) and skin (hindpaw); to identify afferent and efferent pathways which mediate the reflex vasodilatation; and to assess the relative contribution of ventricular baroreceptors and baroreceptors in left atrium and pulmonary vessels in responses to left ventricular outflow obstruction. The gracilis artery and the cranial tibial artery to the paw were perfused separately at constant flow. Changes in perfusion pressure to each bed reflected changes in vascular resistance. Outflow obstruction was produced by inflating a balloon in the left ventricular outflow tract for 15 s while pressures in the left ventricle and aortic arch were measured. Inflation of the balloon increased left ventricular pressure and decreased pressure in the aortic arch. Low and high levels of obstruction produced dilator responses averaging -5+/-3 (SE) and -42+/-11 mm Hg in muscle and -1+/-1 and -3+/-2 mm Hg in paw. Denervation, phentolamine, and glyceryltrinitrate caused greater dilatation in paw than did left ventricular outflow obstruction. This indicates that dilator responses in the paw were not limited by a low level of resting neurogenic constrictor tone or by a negligible dilator capacity of these vessels. Obstruction to left ventricular inflow increased left atrial pressure, but did not cause reflex vasodilatation. This suggests that low pressure baroreceptors in atria or pulmonary vessels did not contribute to vasodilator responses to left ventricular outflow obstruction. Vasodilator responses to outflow obstruction were blocked by bilateral vagotomy, sectioning the sciatic and obturator nerves, and administration of phentolamine, but were not decreased by atropine or tripelennamine. The results indicate that activation of left ventricular baroreceptors produces striking vasodilatation in skeletal muscle, but only slight vasodilatation in skin. The data suggest that the difference in dilator responses in the two beds results from greater withdrawal of adrenergic constrictor tone to skeletal muscle than to skin. Activation of sympathetic cholinergic or histaminergic dilator pathways does not contribute to the dilatation.

摘要

在麻醉犬身上研究了对急性左心室流出道梗阻的反射性血管反应。进行这些研究是为了比较心室压力感受器激活对骨骼肌(股薄肌)和皮肤(后爪)血管阻力的影响;确定介导反射性血管舒张的传入和传出途径;并评估心室压力感受器以及左心房和肺血管中的压力感受器在对左心室流出道梗阻反应中的相对作用。股薄肌动脉和后爪的胫前动脉分别以恒定流量灌注。每个血管床灌注压力的变化反映了血管阻力的变化。通过在左心室流出道内充气球囊15秒来产生流出道梗阻,同时测量左心室和主动脉弓的压力。球囊充气增加了左心室压力并降低了主动脉弓压力。低水平和高水平的梗阻分别在肌肉中产生平均为-5±3(标准误)和-42±1l mmHg的舒张反应,在后爪中分别为-1±1和-3±2 mmHg。去神经、酚妥拉明和硝酸甘油在后爪中引起的舒张作用比左心室流出道梗阻更大。这表明后爪中的舒张反应不受低水平的静息神经源性收缩张力或这些血管可忽略不计的舒张能力的限制。左心室流入道梗阻增加了左心房压力,但未引起反射性血管舒张。这表明心房或肺血管中的低压压力感受器对左心室流出道梗阻的血管舒张反应没有贡献。对流出道梗阻的血管舒张反应被双侧迷走神经切断、切断坐骨神经和闭孔神经以及给予酚妥拉明所阻断,但未被阿托品或曲吡那敏降低。结果表明,左心室压力感受器的激活在骨骼肌中产生显著的血管舒张,但在皮肤中仅产生轻微的血管舒张。数据表明,两个血管床舒张反应的差异是由于肾上腺素能收缩张力从骨骼肌的撤出比从皮肤的撤出更多。交感胆碱能或组胺能舒张途径的激活对舒张没有贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3260/302370/572afccb4711/jcinvest00181-0186-a.jpg

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