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清醒犬大冠状动脉的反应性扩张

Reactive dilation of large coronary arteries in conscious dogs.

作者信息

Hintze T H, Vatner S F

出版信息

Circ Res. 1984 Jan;54(1):50-7. doi: 10.1161/01.res.54.1.50.

Abstract

To study the response of large coronary arteries to short periods of myocardial ischemia a pair of ultrasonic dimension transducers, a flow probe and a hydraulic occluder were implanted around the left circumflex coronary artery for the instantaneous and continuous measurement of external coronary artery dimensions and coronary blood flow, respectively. At 6.1 +/- 0.4 seconds after release of a 15-second occlusion, mean coronary blood flow increased by 255 +/- 30% from a preocclusion flow of 32 +/- 4.1 ml/min. At this time, large coronary arterial cross-sectional area was unchanged but increased slowly, reaching a peak 28 +/- 4.4% above preocclusion levels 61 +/- 3.2 seconds after occlusion, i.e., reactive dilation. During maximal reactive dilation, coronary blood flow had already returned to control levels, and heart rate, mean arterial pressure, left ventricular systolic pressure, and left ventricular dP/dt were not different from control. The reactive dilation was not affected if the occlusion occurred proximal or distal to where diameter was measured, or by combined alpha- and beta-adrenergic receptor blockade, ganglionic blockade, inhibition of prostaglandin synthesis, or by aminophylline. When the reactive hyperemia was prevented by constricting the coronary artery upon release of the coronary occlusion, the reactive dilation was not observed. Thus, large coronary arteries respond to brief periods of occlusion with reactive dilation. The time course of this response is distinctly different from the accompanying reactive hyperemia, and could be eliminated by preventing the marked increase in coronary blood flow following release from the brief period of coronary artery occlusion.

摘要

为研究大冠状动脉对短时间心肌缺血的反应,在左旋冠状动脉周围植入了一对超声尺寸换能器、一个流量探头和一个液压阻塞器,分别用于即时和连续测量冠状动脉外径及冠状动脉血流量。在15秒阻塞解除后6.1±0.4秒时,平均冠状动脉血流量从阻塞前的32±4.1毫升/分钟增加了255±30%。此时,大冠状动脉横截面积未变,但随后缓慢增加,在阻塞后61±3.2秒时达到比阻塞前水平高28±4.4%的峰值,即反应性扩张。在最大反应性扩张时,冠状动脉血流量已恢复至对照水平,心率、平均动脉压、左心室收缩压及左心室dP/dt与对照无差异。若阻塞发生在测量直径部位的近端或远端,或通过联合α和β肾上腺素能受体阻滞、神经节阻滞、抑制前列腺素合成或使用氨茶碱,反应性扩张不受影响。当在冠状动脉阻塞解除时通过收缩冠状动脉来阻止反应性充血时,未观察到反应性扩张。因此,大冠状动脉对短暂阻塞会产生反应性扩张。这种反应的时间进程与伴随的反应性充血明显不同,并且可以通过阻止冠状动脉短暂阻塞解除后冠状动脉血流量的显著增加而消除。

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