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交感神经刺激会改变左心室舒张功能和腔室大小。

Sympathetic stimulation alters left ventricular relaxation and chamber size.

作者信息

Burwash I G, Morgan D E, Koilpillai C J, Blackmore G L, Johnstone D E, Armour J A

机构信息

Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Am J Physiol. 1993 Jan;264(1 Pt 2):R1-7. doi: 10.1152/ajpregu.1993.264.1.R1.

Abstract

Alterations in left ventricular (LV) contractility, relaxation, and chamber dimensions induced by efferent sympathetic nerve stimulation were investigated in nine anesthetized open-chest dogs in sinus rhythm. Supramaximal stimulation of acutely decentralized left stellate ganglia augmented heart rate, LV systolic pressure, and rate of LV pressure rise (maximum +dP/dt, 1,809 +/- 191 to 6,304 +/- 725 mmHg/s) and fall (maximum -dP/dt, -2,392 +/- 230 to -4,458 +/- 482 mmHg/s). It also reduced the time constant of isovolumic relaxation, tau (36.5 +/- 4.8 to 14.9 +/- 1.1 ms). Simultaneous two-dimensional echocardiography recorded reductions in end-diastolic and end-systolic LV cross-sectional chamber areas (23 and 31%, respectively), an increase in area ejection fraction (32%), and increases in end-diastolic and end-systolic wall thicknesses (14 and 13%, respectively). End-systolic and end-diastolic wall stresses were unchanged by stellate ganglion stimulation (98 +/- 12 to 95 +/- 9 dyn x 10(3)/cm2; 6.4 +/- 2.4 to 2.4 +/- 0.3 dyn x 10(3)/cm2, respectively). Atrial pacing to similar heart rates did not alter monitored indexes of contractility. Dobutamine and isoproterenol induced changes similar to those resulting from sympathetic neuronal stimulation. These data indicate that when the efferent sympathetic nervous system increases left ventricular contractility and relaxation, concomitant reductions in systolic and diastolic dimensions of that chamber occur that are associated with increasing wall thickness such that LV wall stress changes are minimized.

摘要

在9只处于窦性心律的麻醉开胸犬中,研究了传出交感神经刺激引起的左心室(LV)收缩性、舒张性和腔室尺寸的变化。急性去神经支配的左星状神经节的超最大刺激增加了心率、左心室收缩压和左心室压力上升速率(最大+ dP/dt,从1,809±191至6,304±725 mmHg/s)以及下降速率(最大- dP/dt,从-2,392±230至-4,458±482 mmHg/s)。它还缩短了等容舒张时间常数,τ(从36.5±4.8至14.9±1.1毫秒)。同时二维超声心动图记录到舒张末期和收缩末期左心室横截面积减小(分别为23%和31%),面积射血分数增加(32%),以及舒张末期和收缩末期壁厚增加(分别为14%和13%)。星状神经节刺激后收缩末期和舒张末期壁应力未改变(分别为98±12至95±9 dyn×10(3)/cm2;6.4±2.4至2.4±0.3 dyn×10(3)/cm2)。心房起搏至相似心率未改变所监测的收缩性指标。多巴酚丁胺和异丙肾上腺素引起的变化与交感神经神经元刺激所导致的变化相似。这些数据表明,当传出交感神经系统增加左心室收缩性和舒张性时,该腔室的收缩期和舒张期尺寸会同时减小,且与壁厚增加相关,从而使左心室壁应力变化最小化。

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