Wicker P, Tarazi R C, Kobayashi K
Am J Cardiol. 1983 Jun;51(10):1744-9. doi: 10.1016/0002-9149(83)90222-9.
Left ventricular (LV) coronary flow (CF) was determined by left atrial injection of microspheres in conscious rats during the development and after the reversal of LV hypertrophy in 2-kidney, 1-clip Goldblatt hypertension. Two groups of untreated renal hypertensive rats (RHR) were studied, the first (RHR1, n = 17) at 10 weeks and the second (RHR2, n = 9) at 24 weeks after clipping. Beginning 9 weeks after clipping, 2 other groups were treated either with captopril (40 to 60 mg/kg/day) in drinking water (RHR-C, n = 8) or left nephrectomy (RHR-N, n = 9) and followed for 15 weeks. Sham-operated animals followed for similar periods of time served as controls (Sham-1, n = 12, as a control for RHR1, and Sham-2, n = 11, as a control for RHR2). In all groups, LV mass increased or decreased in close correlation with changes in arterial blood pressure, and minimal total LV coronary resistance remained unchanged. The development of hypertrophy was associated with a tendency toward reduction in CF reserve (defined as maximal CF/unit mass); this flow reserve was restored with reversal of hypertrophy. The importance of the relation between pressure and LV mass as a determinant of CF reserve was investigated in a second study in which this relation was changed by altering the periods of captopril therapy; in these cases, CF reserve correlated significantly with the ratio of arterial pressure to LV mass (r = 0.76, n = 12, p less than 0.01). The results suggest that maintenance of CF reserve in LV hypertrophy depends on an appropriate balance between arterial pressure and LV mass, and might be disturbed by antihypertensive therapy that leaves LV hypertrophy unchanged.
在双肾单夹型戈德布拉特高血压大鼠左心室肥厚的发展过程中及肥厚逆转后,通过向清醒大鼠左心房注射微球来测定左心室(LV)冠脉血流(CF)。研究了两组未经治疗的肾性高血压大鼠(RHR),第一组(RHR1,n = 17)在夹闭后10周,第二组(RHR2,n = 9)在夹闭后24周。从夹闭后9周开始,另外两组分别接受饮用水中卡托普利(40至60 mg/kg/天)治疗(RHR-C,n = 8)或左肾切除术(RHR-N,n = 9),并随访15周。随访相似时间的假手术动物作为对照(Sham-1,n = 12,作为RHR1的对照,Sham-2,n = 11,作为RHR2的对照)。在所有组中,左心室质量与动脉血压的变化密切相关地增加或减少,并且左心室冠脉总阻力最小值保持不变。肥厚的发展与冠脉血流储备(定义为最大冠脉血流/单位质量)降低的趋势相关;随着肥厚的逆转,这种血流储备得以恢复。在第二项研究中,通过改变卡托普利治疗时间来改变压力与左心室质量之间的关系,从而研究这种关系作为冠脉血流储备决定因素的重要性;在这些情况下,冠脉血流储备与动脉血压与左心室质量的比值显著相关(r = 0.76,n = 12,p < 0.01)。结果表明,左心室肥厚时冠脉血流储备的维持取决于动脉血压与左心室质量之间的适当平衡,并且可能会因使左心室肥厚保持不变的降压治疗而受到干扰。