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自发性高血压和易中风大鼠中心血管肥大与心脏压力反射功能之间的关系。

Relationship between cardiovascular hypertrophy and cardiac baroreflex function in spontaneously hypertensive and stroke-prone rats.

作者信息

Minami N, Head G A

机构信息

Baker Medical Research Institute, Prahran, Victoria, Australia.

出版信息

J Hypertens. 1993 May;11(5):523-33. doi: 10.1097/00004872-199305000-00008.

Abstract

OBJECTIVE

To determine whether the reduced baroreceptor-heart rate reflex sensitivity in genetically hypertensive rats is related to the level of cardiac or vascular hypertrophy.

DESIGN

Young spontaneously hypertensive rats (SHR), stroke-prone hypertensive rats (SHRSP) and Wistar-Kyoto (WKY) rats were treated chronically with the angiotensin converting enzyme (ACE) inhibitor perindopril in different regimens in order to produce a wide-ranging combination of cardiac and vascular hypertrophy.

METHODS

All strains were treated with perindopril (0.1, 0.3, 1 or 3 mg/kg per day) in their drinking water from 4 until 9 weeks of age. Additional groups of SHR were treated with perindopril (3 mg/kg per day) from 4 until 12 weeks and from 4 until 14 weeks of age. At 13 weeks of age all animals were chronically instrumented with arterial and venous catheters. One week later, steady-state sigmoidal mean arterial pressure-heart rate reflex curves were obtained in the conscious rats by the injection of pressor and depressor agents before and after the administration of atenolol (1 mg/kg, intravenously) to determine the vagal component. The minimum and the maximum blood pressure produced by nitroprusside and methoxamine, respectively, after simultaneous ganglion and beta-adrenoceptor blockade were used as an index of whole body vascular hypertrophy. The left ventricular to body weight ratio was measured at the end of the experiment.

RESULTS

At 14 weeks of age, mean arterial pressure, the maximum and minimum autonomically blocked blood pressure and the left ventricular to body weight ratio were 34, 20, 9 and 17% higher, respectively, in SHR, and 56, 35, 27 and 39% higher, respectively, in SHRSP than in WKY rats. Perindopril treatment dose-dependently reduced both cardiac and vascular hypertrophy but to different extents. The highest doses reduced mean arterial pressure and the autonomically blocked maximum and minimum blood pressure in both hypertensive strains to the levels of untreated WKY rats but approximately 50% of the cardiac hypertrophy was still present. The left ventricular to body weight ratio was normalized in SHR only with the longer term perindopril treatments. A comparison of the baroreflex function curves in untreated SHR and SHRSP showed that the vagal component of the heart rate range was markedly reduced compared to that in WKY rats. Treated SHRSP had a normal mean arterial pressure and a normal autonomically blocked maximum and minimum blood pressure, but their vagal heart rate range was only 63% of that in WKY rats. The heart rate range in SHR treated from 4 to 9 weeks of age was only marginally greater than that of untreated SHR, despite prevention of hypertension and vascular hypertrophy. In SHR treated from 4 until 12 weeks of age, which prevented cardiac hypertrophy, the vagal heart rate range was markedly greater. With perindopril from the age of 4 to 14 weeks, the vagal baroreflex heart rate range was similar to that of WKY rats. Thus the improvement in the vagal heart rate range was more closely related to the prevention of cardiac hypertrophy (r = 0.73, P < 0.001) than vascular hypertrophy or a blood pressure elevation. Since there were no further changes in the indices of hypertrophy, the presence of the ACE inhibitor was likely to have been responsible for restoring the remaining 35% of the vagal baroreflex not affected by structural factors.

CONCLUSIONS

These results suggest that prevention of cardiac rather than vascular hypertrophy is the major requirement for normalizing the vagal component of the baroreceptor-heart rate reflex in hypertensive rats. However, structural changes accounted for only about two-thirds of the vagal deficit. The remainder was restored by the presence of an ACE inhibitor, suggesting that the vagal component of the baroreceptor-heart rate reflex is normally suppressed by the renin-angiotensin system.

摘要

目的

确定遗传性高血压大鼠压力感受器 - 心率反射敏感性降低是否与心脏或血管肥大水平有关。

设计

将年轻的自发性高血压大鼠(SHR)、易中风高血压大鼠(SHRSP)和Wistar - Kyoto(WKY)大鼠长期用不同方案的血管紧张素转换酶(ACE)抑制剂培哚普利治疗,以产生广泛的心脏和血管肥大组合。

方法

所有品系从4周龄至9周龄在饮用水中给予培哚普利(0.1、0.3、1或3mg/kg/天)。另外几组SHR从4周龄至12周龄以及从4周龄至14周龄用培哚普利(3mg/kg/天)治疗。在13周龄时,所有动物均长期植入动脉和静脉导管。一周后,在清醒大鼠中通过注射升压药和降压药在静脉注射阿替洛尔(1mg/kg)前后获得稳态S形平均动脉压 - 心率反射曲线,以确定迷走神经成分。在同时进行神经节和β - 肾上腺素能受体阻断后,分别由硝普钠和甲氧明产生的最小和最大血压用作全身血管肥大的指标。在实验结束时测量左心室与体重比。

结果

在14周龄时,SHR的平均动脉压、自主神经阻断后的最大和最小血压以及左心室与体重比分别比WKY大鼠高34%、20%、9%和17%,SHRSP分别比WKY大鼠高56%、35%、27%和39%。培哚普利治疗剂量依赖性地减轻心脏和血管肥大,但程度不同。最高剂量将两种高血压品系的平均动脉压以及自主神经阻断后的最大和最小血压降低到未治疗的WKY大鼠水平,但仍存在约50%的心脏肥大。仅通过长期培哚普利治疗,SHR的左心室与体重比才恢复正常。未治疗的SHR和SHRSP的压力反射功能曲线比较显示,与WKY大鼠相比,心率范围的迷走神经成分明显降低。治疗后的SHRSP平均动脉压正常,自主神经阻断后的最大和最小血压正常,但其迷走神经心率范围仅为WKY大鼠的63%。从4周龄至9周龄治疗的SHR,尽管预防了高血压和血管肥大,其心率范围仅略大于未治疗的SHR。从4周龄至12周龄治疗的SHR,预防了心脏肥大,其迷走神经心率范围明显更大。从4周龄至14周龄用培哚普利治疗,迷走神经压力反射心率范围与WKY大鼠相似。因此,迷走神经心率范围的改善与心脏肥大的预防(r = 0.73,P < 0.001)比与血管肥大或血压升高更密切相关。由于肥大指标没有进一步变化,ACE抑制剂的存在可能是恢复了不受结构因素影响的其余35%的迷走神经压力反射的原因。

结论

这些结果表明,预防心脏肥大而非血管肥大是使高血压大鼠压力感受器 - 心率反射的迷走神经成分正常化的主要要求。然而,结构变化仅占迷走神经缺陷的约三分之二。其余部分通过ACE抑制剂的存在得以恢复,这表明压力感受器 - 心率反射的迷走神经成分通常被肾素 - 血管紧张素系统抑制。

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