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冠状动脉微循环中内皮依赖性和非内皮依赖性血管反应的纵向梯度。

Longitudinal gradients for endothelium-dependent and -independent vascular responses in the coronary microcirculation.

作者信息

Kuo L, Davis M J, Chilian W M

机构信息

Department of Medical Physiology, Texas A&M University Health Science Center, College Station 77843-1114, USA.

出版信息

Circulation. 1995 Aug 1;92(3):518-25. doi: 10.1161/01.cir.92.3.518.

Abstract

BACKGROUND

Coronary microvessels (< 300 microns in diameter) have been demonstrated to be important in the regulation of local resistance and flow. Recent studies also suggest that these microvessels are more responsive to physiological and pharmacological stimuli than conduit vessels. However, little is known regarding the relative sensitivity of different microvascular segments in response to flow (shear stress) and agonists. The goal of this study was to test the hypothesis that a longitudinal gradient for shear stress- and agonist-induced dilation exists in the coronary microcirculation.

METHODS AND RESULTS

Experiments were performed in four different sizes of porcine subepicardial coronary arterial microvessels: small arterioles (40 +/- 1-micron ID with resting tone); intermediate arterioles (60 +/- 1 micron); large arterioles (106 +/- 4 micron); and small arteries (179 +/- 9 microns). Vessels were isolated and cannulated to allow luminal pressure and flow to be independently controlled. All vessels developed active tone (to approximately 65% to 75% of maximum diameter) at their control luminal pressures and showed graded dilations to stepwise increases in shear stress (0 to 10 dynes/cm2). For arterioles, the magnitude of the dilations increased as vessel size increased. The highest shear stress produced 21 +/- 3%, 32 +/- 2%, and 52 +/- 5% increases in diameter in small, intermediate, and large arterioles, respectively. Small arteries dilated only 22 +/- 6%. The endothelium-dependent vasodilator substance P (SP) produced dose-dependent dilation of all vessels with a threshold at 10(-16) mol/L. Arterioles were maximally dilated at 10(-9) mol/L SP. However, this dose produced only 80% dilation in small arteries. The ED50 for SP was shifted to the right by two orders of magnitude in small arteries compared with the arterioles. Adenosine preferentially dilated small arterioles, and the dose-response curves shifted to the right for larger vessels. The thresholds for adenosine-induced dilation were 10(-12), 10(-11), and 10(-9) mol/L for small, intermediate, and large arterioles, respectively. The endothelium-independent vasodilator nitroprusside produced identical dose-dependent dilations in all vessel segments.

CONCLUSIONS

The results indicate that the pig coronary circulation exhibits a heterogeneity in physiological and pharmacological responses along the microvascular network. Small arterioles are more sensitive to adenosine, but large arterioles are more responsive to shear-stress stimulation. We speculate that site-specific preferential responses may play a crucial role in coordinating overall vascular function in the coronary microvascular network.

摘要

背景

已证实冠状动脉微血管(直径<300微米)在局部阻力和血流调节中起重要作用。近期研究还表明,这些微血管比传导血管对生理和药理刺激更敏感。然而,关于不同微血管节段对血流(剪切应力)和激动剂的相对敏感性知之甚少。本研究的目的是检验冠状动脉微循环中存在剪切应力和激动剂诱导的扩张的纵向梯度这一假说。

方法与结果

在四种不同大小的猪心外膜下冠状动脉微血管中进行实验:小动脉(内径40±1微米,有静息张力);中动脉(60±1微米);大动脉(106±4微米);小动脉(179±9微米)。分离并插管血管,以便独立控制管腔内压力和血流。所有血管在对照管腔内压力下均产生主动张力(至最大直径的约65%至75%),并对剪切应力(0至10达因/平方厘米)的逐步增加呈现分级扩张。对于小动脉,扩张幅度随血管大小增加而增大。最高剪切应力分别使小、中、大动脉的直径增加21±3%、32±2%和52±5%。小动脉仅扩张22±6%。内皮依赖性血管舒张物质P(SP)使所有血管产生剂量依赖性扩张,阈值为10-16摩尔/升。小动脉在10-9摩尔/升SP时达到最大扩张。然而,该剂量在小动脉中仅产生80%的扩张。与小动脉相比,小动脉中SP的半数有效剂量(ED50)向右移动了两个数量级。腺苷优先使小动脉扩张,且剂量反应曲线在较大血管中向右移动。小、中、大动脉中腺苷诱导扩张的阈值分别为10-12、10-11和10-9摩尔/升。非内皮依赖性血管舒张剂硝普钠在所有血管节段产生相同的剂量依赖性扩张。

结论

结果表明猪冠状动脉循环在微血管网络中沿生理和药理反应表现出异质性。小动脉对腺苷更敏感,而大动脉对剪切应力刺激更敏感。我们推测位点特异性优先反应可能在协调冠状动脉微血管网络的整体血管功能中起关键作用。

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