Baumbach G L
University of Iowa College of Medicine, Department of Pathology, Iowa City 52242, USA.
Hypertension. 1996 Feb;27(2):159-67. doi: 10.1161/01.hyp.27.2.159.
The goal of this study was to examine the hypothesis that increases in pulse pressure produce hypertrophy of cerebral arterioles, even in the absence of increases in mean pressure. Sprague-Dawley rats underwent creation of an arteriovenous fistula and clipping of one carotid artery at 1 month of age. Rats that underwent exposure of the abdominal aorta without fistula production and unilateral carotid clipping served as controls. At about 6 months of age, the mechanics of sham and clipped pial arterioles were examined in vivo in anesthetized rats. Stress-strain relations were calculated from measurements of pial arteriolar pressure (servo null) and diameter and cross-sectional area of the arteriolar wall. Point counting stereology was used to quantify individual components in the arteriolar wall. Before deactivation of smooth muscle with EDTA, cross-sectional areas of the vessel wall and pulse pressures in sham pial arterioles were significantly greater (P < .05) in arteriovenous fistula rats than in control rats (cross-sectional area, 1468 +/- 100 versus 1129 +/- 104 microns 2; pulse pressure, 26 +/- 1 versus 14 +/- 1 mm Hg). In contrast, systolic and mean pressures in sham arterioles were not significantly different and diastolic pressure was significantly less in arteriovenous fistula rats (systolic pressure, 69 +/- 1 versus 67 +/- 4 mm Hg; mean pressure, 52 +/- 2 versus 57 +/- 3 mm Hg; diastolic pressure, 43 +/- 2 versus 53 +/- 3 mm Hg). Carotid clipping normalized cross-sectional area of the vessel wall (1083 +/- 86 microns 2) and pulse pressure (12 +/- 1 mm Hg) in pial arterioles of arteriovenous fistula rats. During maximal dilatation, the stress-strain curve in sham arterioles of arteriovenous fistula rats was shifted to the right of the curve in control rats, which indicates that arteriovenous fistulae increase passive distensibility of cerebral arterioles. The proportion of distensible components in the vessel wall (smooth muscle, elastin, and endothelium) was increased in sham arterioles of arteriovenous fistula rats. These findings (1) suggest that increases in pulse pressure, even in the absence of increases in mean pressure, are sufficient to produce hypertrophy of cerebral arterioles and (2) provide support for the concept that increases in distensibility of cerebral arterioles in association with hypertrophy of the vessel wall may be related to alterations in wall composition.
即使平均压力没有升高,脉压升高也会导致脑小动脉肥大。1月龄的Sprague-Dawley大鼠接受动静脉瘘的创建和一侧颈动脉夹闭。未进行瘘管创建但暴露腹主动脉并进行单侧颈动脉夹闭的大鼠作为对照。在约6月龄时,在麻醉大鼠体内检查假手术和夹闭软脑膜小动脉的力学特性。根据软脑膜小动脉压力(伺服零位)、直径和动脉壁横截面积的测量值计算应力应变关系。采用点计数立体学方法对动脉壁的各个成分进行定量分析。在用乙二胺四乙酸(EDTA)使平滑肌失活之前,动静脉瘘大鼠软脑膜假手术小动脉的血管壁横截面积和脉压显著高于对照大鼠(P<0.05)(横截面积,1468±100对1129±104μm2;脉压,26±1对14±1mmHg)。相比之下,动静脉瘘大鼠软脑膜假手术小动脉的收缩压和平均压无显著差异,舒张压显著降低(收缩压,69±1对67±4mmHg;平均压,52±2对57±3mmHg;舒张压,43±2对53±3mmHg)。颈动脉夹闭使动静脉瘘大鼠软脑膜小动脉的血管壁横截面积(1083±86μm2)和脉压(12±1mmHg)恢复正常。在最大扩张期间,动静脉瘘大鼠软脑膜假手术小动脉的应力应变曲线向对照大鼠曲线的右侧移动,这表明动静脉瘘增加了脑小动脉的被动扩张性。动静脉瘘大鼠软脑膜假手术小动脉中血管壁可扩张成分(平滑肌、弹性蛋白和内皮)的比例增加。这些发现(1)表明,即使平均压力没有升高,但脉压升高足以导致脑小动脉肥大;(2)为以下概念提供了支持,即脑小动脉扩张性增加与血管壁肥大相关可能与壁成分改变有关。