Pagani M, Vatner S F, Braunwald E
Circulation. 1978 Jan;57(1):144-51. doi: 10.1161/01.cir.57.1.144.
The hemodynamic effects of 7 min i.v. sodium nitroprusside (NP) were studied in conscious dogs previously instrumented for measurement of arterial pressure, cardiac output, regional blood flow distribution, left ventricular (LV) pressure, and internal dimensions. Nitroprusside, 25 microgram/kg/min, reduced mean arterial pressure by 23 +/- 3%. Cardiac output increased initially by 39 +/- 7% and returned toward control by the end of the infusion. Regional blood flows increased initially; the relative rise was greatest in the coronary (+ 225 +/- 39%), intermediate in the mesenteric (+ 98 +/- 23%) and iliac (+ 38 +/- 6%), and least in the renal (+ 10 +/- 3%) bed. By the end of the infusion period the vasodilation was unchanged in the iliac bed, less intense in the coronary and mesenteric, while in the iliac bed, blood flow was reduced and resistance was actually increased by 33 +/- 11% above control. A generalized vasonconstriction ensued after cessation of infusion. In contrast, when the drug was administered intra-arterially to the iliac bed, arterial pressure did not fall and only iliac vasodilation was observed. Peak cardiac effects were characterized by increases in heart rate and LV dP/dt, along with marked reduction in LV end-systolic diameter (- 13 +/- 2%), and in end-diastolic diameter (-17 +/- 2%) and pressure. LV end-diastolic diameter fell even heart rate was maintained at a constant rate by pacing. Thus, in the conscious dog, NP reduced LV dimensions substantially, while inducing changes in peripheral beds. The differences in these effects depend on interactions between the direct effects of NP and the opposing effects of reflex adjustments which appear sufficiently powerful to result in net constriction of the iliac bed late during the infusion.
对预先植入测量动脉压、心输出量、局部血流分布、左心室(LV)压力及内径装置的清醒犬,研究了静脉注射硝普钠(NP)7分钟的血流动力学效应。硝普钠剂量为25微克/千克/分钟,使平均动脉压降低23±3%。心输出量最初增加39±7%,在输注结束时恢复至对照水平。局部血流最初增加;冠状动脉血流相对增加最大(+225±39%),肠系膜动脉(+98±23%)和髂动脉(+38±6%)次之,肾动脉床(+10±3%)最小。在输注期结束时,髂动脉床的血管舒张未变,冠状动脉和肠系膜动脉的血管舒张减弱,而在髂动脉床,血流减少,阻力实际上比对照增加33±11%。输注停止后随之出现全身性血管收缩。相反,当将该药物动脉内注入髂动脉床时,动脉压未下降,仅观察到髂动脉血管舒张。心脏的峰值效应表现为心率和左心室dp/dt增加,同时左心室收缩末期直径(-13±2%)、舒张末期直径(-17±2%)及压力显著降低。即使通过起搏使心率维持在恒定水平,左心室舒张末期直径仍下降。因此,在清醒犬中,NP可显著减小左心室尺寸,同时引起外周血管床的变化。这些效应的差异取决于NP的直接作用与反射调节的相反作用之间的相互作用,反射调节作用似乎足够强大,以至于在输注后期导致髂动脉床出现净收缩。