Grassi G, Giannattasio C, Failla M, Pesenti A, Peretti G, Marinoni E, Fraschini N, Vailati S, Mancia G
Cattedra di Medicina Interna I, Università di Milano, Italy.
Hypertension. 1995 Aug;26(2):348-54. doi: 10.1161/01.hyp.26.2.348.
Animal studies have suggested that arterial compliance can be modulated by adrenergic influences. Whether this adrenergic modulation also occurs in humans is still a matter of debate. In the present article we address this issue by examining the relationships between sympathetic tone and arterial compliance in a variety of physiological and pathophysiological conditions. We have found that cigarette smoking, ie, an action that produces a marked sympathetic activation, causes a significant reduction in radial artery compliance, as measured by an echotracking device capable of providing continuous beat-to-beat evaluation of this hemodynamic variable. When expressed as compliance index, ie, as the ratio between the area under the compliance-pressure curve and pulse pressure, the reduction amounted to 35.7 +/- 4.8% (mean +/- SEM) and was independent of the smoking-related blood pressure increase. Furthermore, pharmacological stimulation of adrenergic receptors located in the arterial wall was also shown to affect arterial compliance because the radial artery compliance index was markedly reduced (- 29.5 +/- 3.9%) during phenylephrine infusion in the brachial artery at doses devoid of any systemic blood pressure effect. Evidence was also obtained that the relationship between sympathetic activation and arterial compliance has pathophysiological relevance, because in 17 patients with congestive heart failure (New York Heart Association classes II through IV) there was a significant inverse correlation (r = .62, P < .01) between muscle sympathetic nerve activity (directly measured by microneurography in the peroneal nerve) and radial artery compliance.(ABSTRACT TRUNCATED AT 250 WORDS)
动物研究表明,动脉顺应性可受肾上腺素能影响的调节。这种肾上腺素能调节在人类中是否也会发生仍存在争议。在本文中,我们通过研究各种生理和病理生理条件下交感神经张力与动脉顺应性之间的关系来探讨这个问题。我们发现,吸烟,即一种可引起明显交感神经激活的行为,会导致桡动脉顺应性显著降低,这是通过一种能够对这一血流动力学变量进行逐搏连续评估的回声跟踪装置测量得出的。以顺应性指数表示,即顺应性 - 压力曲线下面积与脉压之比时,降低幅度达35.7±4.8%(均值±标准误),且与吸烟相关的血压升高无关。此外,对位于动脉壁的肾上腺素能受体进行药理刺激也显示会影响动脉顺应性,因为在肱动脉输注去氧肾上腺素期间,桡动脉顺应性指数显著降低(-29.5±3.9%),所用剂量对全身血压无任何影响。还获得了证据表明交感神经激活与动脉顺应性之间的关系具有病理生理学意义,因为在17例充血性心力衰竭患者(纽约心脏协会II至IV级)中,肌肉交感神经活动(通过对腓神经进行微神经图直接测量)与桡动脉顺应性之间存在显著负相关(r = 0.62,P < 0.01)。(摘要截取自250字)