Angus J A, Ferrier C P, Sudhir K, Kaye D M, Jennings G L
Baker Medical Research Institute, Prahran, Victoria, Australia.
Cardiovasc Res. 1993 Feb;27(2):204-10. doi: 10.1093/cvr/27.2.204.
The aim was to determine the pharmacological reactivity of human small resistance arteries in patients with cardiac failure.
Small arteries (< 300 microns internal diameter) were removed from gluteal skin biopsy specimens and mounted in a double myograph for isometric force recording.
Arteries from six patients with congestive heart failure contracted to only 65% of the maximum response recorded in nine arteries from normal volunteers when activated by potassium chloride (124 mM), noradrenaline (1 microM), or both. The lesser contraction in congestive heart failure vessels with no significant shift in sensitivity (EC50) was also observed in concentration-response studies with noradrenaline, angiotensin I, and angiotensin II. The concentration-contraction curves for serotonin showed only 40% of the maximum contractility to K+ in normal arteries, and this ratio was similar in congestive heart failure arteries. Normal arteries precontracted with noradrenaline (1 microM) relaxed in response to sodium nitroprusside, calcitonin gene related peptide, and the endothelium dependent agonist acetylcholine; in congestive heart failure vessels there was a marked loss of the relaxation response only to acetylcholine.
These results suggest that in chronic congestive heart failure skin resistance arteries have impaired contraction responses probably independent of any receptor down regulation. The loss of endothelium dependent vasodilatation to acetylcholine suggests that EDRF release is impaired. These changes may well play an important role in the disturbances of peripheral vascular function associated with heart failure.
旨在确定心力衰竭患者人体小阻力动脉的药理反应性。
从臀肌皮肤活检标本中取出内径小于300微米的小动脉，安装在双肌动描记器中进行等长力记录。
当用氯化钾（124 mM）、去甲肾上腺素（1 microM）或两者激活时，6例充血性心力衰竭患者的动脉收缩幅度仅为9例正常志愿者动脉最大反应幅度的65%。在去甲肾上腺素、血管紧张素I和血管紧张素II的浓度-反应研究中，也观察到充血性心力衰竭血管收缩较弱且敏感性（EC50）无明显变化。血清素的浓度-收缩曲线显示，正常动脉对钾离子的最大收缩力仅为40%，充血性心力衰竭动脉中的这一比例相似。用去甲肾上腺素（1 microM）预收缩的正常动脉对硝普钠、降钙素基因相关肽和内皮依赖性激动剂乙酰胆碱有舒张反应；在充血性心力衰竭血管中，仅对乙酰胆碱的舒张反应明显丧失。
这些结果表明，在慢性充血性心力衰竭中，皮肤阻力动脉的收缩反应受损，可能与任何受体下调无关。对乙酰胆碱内皮依赖性血管舒张功能的丧失表明内皮舒张因子释放受损。这些变化很可能在与心力衰竭相关的外周血管功能紊乱中起重要作用。
