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左心室机械感受器:一项血流动力学研究。

Left ventricular mechanoreceptors: a haemodynamic study.

作者信息

Fox I J, Gerasch D A, Leonard J J

出版信息

J Physiol. 1977 Dec;273(2):405-25. doi: 10.1113/jphysiol.1977.sp012101.

Abstract
  1. To study the function of the left ventricular mechanoreceptors, a working left ventricle preparation was devised in dogs which permitted control of pressure and flow of the isolated perfused coronary circulation and of the flow of the isolated, separately perfused systemic circulation. The systemic circulation was perfused at a constant rate so that changes in systemic pressure reflected changes in systemic resistance.2. Increases in myocardial contractility produced by injection of catecholamines into the isolated, perfused coronary circulation produced a fall in the pressure (resistance) of the isolated, separately perfused (at a constant rate) systemic circulation.3. Completeness of isolation of the coronary and systemic circulations was shown by the marked difference in appearance times between the reflex hypotensive responses from catecholamine injections into the isolated coronary circulation and the direct hypertensive response from a similar injection when the circulations were connected as well as by the marked difference between the pressure pulses recorded simultaneously on both sides of the aortic balloon separating the two circulations.4. Myocardial beta receptor blockade produced by injection of propranolol into the isolated coronary circulation abolished or attenuated the changes in left ventricular myocardial contractility as well as the subsequent hypotensive responses following the similar injection of catecholamines.5. Electrical stimulation of a sympathetic nerve innervating the heart resulted in increases in left ventricular myocardial contractility and subsequent systemic hypotensive responses indistinguishable from those following injection of catecholamines.6. That distortion of the mechano- or stretch receptors in the left ventricular myocardium was the cause of the hypotensive responses was demonstrated by increasing left ventricular myocardial contractility by mechanically obstructing the left ventricular outflow which produced hypotensive responses similar to those following the injection of catecholamines or nerve stimulation.7. Bilateral high cervical vagotomy abolished the hypotensive responses following injection of catecholamines into the isolated coronary circulation or following left ventricular outflow obstruction in all but one instance, indicating the importance of vagal fibres to the afferent arm of the reflex.8. It is suggested that the left ventricular mechanoreceptors function normally to reduce the peripheral resistance in order to prepare the systemic circulation to receive the left ventricular output and, especially during exercise, to prepare the systemic circulation to receive the augmented cardiac output with a minimum alteration in the systemic blood pressure and to distribute this augmented output preferentially to the skeletal muscles.
摘要
  1. 为研究左心室机械感受器的功能,在犬身上设计了一种左心室工作制备方法,该方法可控制孤立灌注冠状动脉循环的压力和流量以及孤立的、单独灌注的体循环的流量。体循环以恒定速率灌注,以便体循环压力的变化反映体循环阻力的变化。

  2. 向孤立的灌注冠状动脉循环中注射儿茶酚胺所引起的心肌收缩力增加,导致孤立的、单独灌注(以恒定速率)的体循环压力(阻力)下降。

  3. 当冠状动脉循环和体循环相连时,向孤立冠状动脉循环注射儿茶酚胺引起的反射性低血压反应与类似注射引起的直接高血压反应在出现时间上有明显差异,以及在分隔两个循环的主动脉球囊两侧同时记录的压力脉冲有明显差异,这表明冠状动脉循环和体循环的隔离是完全的。

  4. 向孤立冠状动脉循环注射普萘洛尔所引起的心肌β受体阻断,消除或减弱了左心室心肌收缩力的变化以及随后注射儿茶酚胺后的低血压反应。

  5. 电刺激支配心脏的交感神经导致左心室心肌收缩力增加以及随后的体循环低血压反应,这些反应与注射儿茶酚胺后的反应无法区分。

  6. 通过机械性阻塞左心室流出道来增加左心室心肌收缩力,从而产生与注射儿茶酚胺或神经刺激后相似的低血压反应,这证明左心室心肌中的机械感受器或牵张感受器的扭曲是低血压反应的原因。

  7. 双侧高位颈迷走神经切断术除了一例之外,消除了向孤立冠状动脉循环注射儿茶酚胺或左心室流出道阻塞后的低血压反应,这表明迷走神经纤维对反射传入臂的重要性。

  8. 有人提出,左心室机械感受器正常发挥作用以降低外周阻力,以便使体循环为接受左心室输出做好准备,特别是在运动期间,使体循环为接受增加的心输出量做好准备,同时使体循环血压的变化最小,并将增加的输出优先分配给骨骼肌。

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