Vatner S F, Pasipoularides A, Mirsky I
Ann Biomed Eng. 1984;12(5):521-34. doi: 10.1007/BF02363921.
Currently, considerable clinical interest exists in the vasoactivity of large coronary arteries due to the prevalence of coronary vasospasm in mediating angina pectoris and even myocardial infarction. Although arterial elastic properties have been studied extensively in acute, anesthetized animal experiments and in vitro preparations, few data are available on these properties in conscious, chronically instrumented animals, where the complicating influences of anesthesia, recent surgery, and acute manipulation of the vessel are minimized. To study vascular smooth muscle in the conscious animal we modified the transit-time dimension measurement technique by designing smaller, higher frequency (7 MHz) transducers, and introducing electronic refinements to accurately measure smaller dimensions (2 mm minimum). We applied this technique to the left circumflex coronary (LCC) artery, along with arterial pressure measurements from either chronically implantable strain-gauge manometers, or microtip catheter manometers, to study dynamic compliance and vascular control mechanisms of these arteries for periods of months in conscious, chronically instrumented animals. Infusion of an alpha-adrenergic vasoconstrictor, methoxamine (50 micrograms/kg/min), caused sustained reduction in LCC diameter (9% +/- 2%) at a time when mean arterial pressure rose by 65% +/- 5% and heart rate and mean coronary blood flow (electromagnetic flow probe) were returned to control levels. Methoxamine induced a marked leftward shift in the pressure-diameter and stress-radius relationships, reducing vascular caliber for any given stress and pressure level. Moreover, smooth-muscle activation raised the effective incremental modulus (Einc) of the coronary arterial wall when compared at similar radii, but it reduced Einc when compared at similar stress or pressure levels. Thus, for any given arterial pressure level the Einc of the LCC artery wall can be reduced considerably by the enhanced smooth-muscle activation elicited by methoxamine. Nitroglycerin (25 micrograms/kg) induced an initial decrease in LCC diameter as pressure fell and LCC blood flow rose. However, dimensions then increased, reaching a maximum 5 minutes later, when LCC blood flow was reduced, and heart rate and left ventricular dP/dt were at control levels. The calcium-channel antagonist, nifedipine, caused similar early changes, with the increase in LCC caliber persisting for 46 +/- 5 minutes while LCC blood flow returned to control in 15 +/- 3 minutes.(ABSTRACT TRUNCATED AT 400 WORDS)
目前,由于冠状动脉痉挛在介导心绞痛甚至心肌梗死中普遍存在,人们对大冠状动脉的血管活性有着浓厚的临床兴趣。尽管在急性、麻醉动物实验和体外制剂中对动脉弹性特性进行了广泛研究,但在清醒的、长期植入仪器的动物中,关于这些特性的数据却很少,因为在这类动物中麻醉、近期手术和血管急性操作的复杂影响被降至最低。为了研究清醒动物的血管平滑肌,我们通过设计更小、更高频率(7兆赫)的换能器,并引入电子改进措施以准确测量更小尺寸(最小2毫米),对渡越时间尺寸测量技术进行了改进。我们将这项技术应用于左旋冠状动脉(LCC),同时通过长期可植入应变片压力计或微尖端导管压力计测量动脉血压,以研究清醒的、长期植入仪器的动物在数月时间里这些动脉的动态顺应性和血管控制机制。输注α-肾上腺素能血管收缩剂甲氧明(50微克/千克/分钟),在平均动脉压升高65%±5%且心率和平均冠状动脉血流量(电磁血流探头)恢复到对照水平时,导致LCC直径持续减小(9%±2%)。甲氧明使压力-直径和应力-半径关系显著向左移位,在任何给定的应力和压力水平下减小血管管径。此外,与在相似半径处比较时相比,平滑肌激活提高了冠状动脉壁的有效增量模量(Einc),但与在相似应力或压力水平下比较时相比,它降低了Einc。因此,对于任何给定的动脉压水平,甲氧明引起的平滑肌激活增强可使LCC动脉壁的Einc大幅降低。硝酸甘油(25微克/千克)在压力下降且LCC血流量增加时导致LCC直径最初减小。然而,随后尺寸增大,5分钟后达到最大值,此时LCC血流量减少,心率和左心室dP/dt处于对照水平。钙通道拮抗剂硝苯地平引起类似的早期变化,LCC管径增加持续长达46±5分钟,而LCC血流量在15±3分钟内恢复到对照水平。(摘要截取自400字)