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清醒犬冠脉循环中的α-肾上腺素能张力

Alpha-adrenergic tone in the coronary circulation of the conscious dog.

作者信息

Vatner S F

出版信息

Fed Proc. 1984 Nov;43(14):2867-72.

PMID:6092145
Abstract

To examine the role of neural factors in the control of coronary vasoactivity in conscious animals, dogs were supplied with miniature pressure gauges in the aorta and left ventricle (to measure aortic and left ventricular pressures, respectively and with a flow probe on the left circumflex coronary artery (to measure coronary blood flow). The experiments were conducted several weeks after recovery from operation. Stimulation of the carotid chemoreceptor and pulmonary inflation elicited a biphasic reflex response. Initially, coronary vasodilation was observed; coronary blood flow tripled even after changes in metabolic factors were minimized by pretreatment with propranolol. A similar response occurred after a spontaneous deep breath. The coronary vasodilation could be blocked by alpha-adrenergic receptor blockade. The second phase of the response involved an increase in coronary vascular resistance, associated with elevated arterial pressure and an absolute reduction in coronary blood flow and coronary sinus oxygen content. The secondary coronary vasoconstriction was also abolished by alpha-adrenergic blockade. Paradoxically, alpha-adrenergic receptor blockade with phentolamine (at constant heart rate and after beta-adrenergic receptor blockade) did not increase coronary blood flow and reduced coronary vascular resistance only slightly. Selective alpha 1-adrenergic receptor blockade with prazosin and trimazosin on different days induced progressively greater reductions in coronary vascular resistance. Trimazosin was the only alpha-adrenergic receptor blocker to elevate coronary blood flow significantly. It is conceivable, but speculative, that withdrawal of alpha-adrenergic tone may involve activation of an intermediate agent, which is a potent coronary vasodilator. Alternatively, withdrawal of alpha-adrenergic tone may be an important mechanism for immediate control of the coronary circulation, but under more chronic conditions it plays a lesser role as a result of suppression by metabolic factors.

摘要

为研究神经因素在清醒动物冠状动脉血管活性调控中的作用,给犬的主动脉和左心室植入微型压力计(分别用于测量主动脉压和左心室压),并在左旋冠状动脉上安装流量探头(用于测量冠状动脉血流量)。实验在术后恢复数周后进行。刺激颈动脉化学感受器和肺充气可引发双相反射反应。起初,观察到冠状动脉扩张;即便通过普萘洛尔预处理将代谢因素的变化降至最低,冠状动脉血流量仍增加了两倍。自发深呼吸后也出现类似反应。冠状动脉扩张可被α-肾上腺素能受体阻断所抑制。反应的第二阶段涉及冠状动脉血管阻力增加,伴有动脉压升高以及冠状动脉血流量和冠状窦氧含量绝对降低。继发性冠状动脉收缩也可被α-肾上腺素能阻断所消除。矛盾的是,用酚妥拉明进行α-肾上腺素能受体阻断(在心率恒定且β-肾上腺素能受体阻断后)并未增加冠状动脉血流量,仅略微降低了冠状动脉血管阻力。在不同日期用哌唑嗪和曲马唑嗪进行选择性α1-肾上腺素能受体阻断可逐渐更大程度地降低冠状动脉血管阻力。曲马唑嗪是唯一能显著增加冠状动脉血流量的α-肾上腺素能受体阻断剂。可以想象但具有推测性的是,α-肾上腺素能张力的撤除可能涉及一种中间介质的激活,该介质是一种强效冠状动脉扩张剂。或者,α-肾上腺素能张力的撤除可能是冠状动脉循环即时调控的重要机制,但在更慢性的情况下,由于代谢因素的抑制作用,其作用较小。

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