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血管活性药物输注期间心肌毛细血管扩散能力的变化

Changes in myocardial capillary diffusion capacity during infusion of vasoactive drugs.

作者信息

Wåhlander H, Friberg P, Haraldsson B

机构信息

Department of Physiology, University of Göteborg, Sweden.

出版信息

Acta Physiol Scand. 1993 Jan;147(1):49-58. doi: 10.1111/j.1748-1716.1993.tb09471.x.

Abstract

The present study investigated how variations in coronary vascular resistance and metabolic demand affected myocardial capillary diffusion capacity. Hearts from Wistar rats were perfused with Krebs-Henseleit-albumin buffer in a Langendorff preparation, where heart rate (HR), contractility (dP/dtmax) and myocardial oxygen consumption (MVO2) were recorded continuously. Myocardial capillary diffusion capacity was measured as the permeability surface area product (PS) for Cr-EDTA and vitamin B12 by the single injection colorimetric indicator dilution method. After base-line recordings without drugs, angiotensin II+Arginine-vasopressin was infused, which increased coronary vascular resistance by 90%, stimulated HR by 11%, decreased dP/dtmax by 21% and reduced MVO2 by 4%. PSCr-EDTA and PSB12 decreased by 24 and 27%, respectively, leaving the ratio PSCr-EDTA/PSB12 unchanged indicating unaltered capillary permeability. Moreover, the reductions in MVO2 and PS correlated significantly. During vasodilation: (1) nitroprusside-NA stimulated HR by 7% and decreased dP/dtmax by 14%; (2) adenosine reduced dP/dtmax by 37% and decreased MVO2 by 9%; and (3) isoproterenol increased HR, dP/dtmax and MVO2 by 53, 76 and 9%, respectively. However, all three vasodilators reduced PSCr-EDTA and PSB12 in parallel by 7-25% leaving PSCR-EDTA/PSB12 unchanged. Thus, maximal estimated diffusion capacities were obtained during spontaneous coronary vascular tone, most likely reflecting maximal capillary recruitment in the Krebs-Henseleit-albumin perfused heart. The derecruiting effects of the vasoconstrictors were partly overridden by metabolic factors, while the reductions of PS after vasodilation more likely were due to increased heterogeneity in coronary flow.

摘要

本研究调查了冠状动脉血管阻力和代谢需求的变化如何影响心肌毛细血管扩散能力。在Langendorff装置中,用Krebs-Henseleit-白蛋白缓冲液灌注Wistar大鼠的心脏,连续记录心率(HR)、收缩性(dP/dtmax)和心肌耗氧量(MVO2)。采用单次注射比色指示剂稀释法,将心肌毛细血管扩散能力测量为Cr-EDTA和维生素B12的通透表面积乘积(PS)。在无药物的基线记录后,输注血管紧张素II+精氨酸加压素,使冠状动脉血管阻力增加90%,刺激心率增加11%,使dP/dtmax降低21%,使MVO2降低4%。PSCr-EDTA和PSB12分别降低了24%和27%,而PSCr-EDTA/PSB12的比值不变,表明毛细血管通透性未改变。此外,MVO2和PS的降低显著相关。在血管舒张期间:(1)硝普钠-去甲肾上腺素刺激心率增加7%,使dP/dtmax降低14%;(2)腺苷使dP/dtmax降低37%,使MVO2降低9%;(3)异丙肾上腺素使心率、dP/dtmax和MVO2分别增加53%、76%和9%。然而,所有三种血管舒张剂均使PSCr-EDTA和PSB12平行降低7%-25%,而PSCR-EDTA/PSB12不变。因此,在冠状动脉自发血管张力期间可获得最大估计扩散能力,这很可能反映了在Krebs-Henseleit-白蛋白灌注心脏中毛细血管的最大募集。血管收缩剂的去募集作用部分被代谢因素所抵消,而血管舒张后PS的降低更可能是由于冠状动脉血流异质性增加所致。

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