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脉动压力对冠状动脉阻力血管的舒张作用。

Vasodilatory effect of pulsatile pressure on coronary resistance vessels.

作者信息

Goto M, VanBavel E, Giezeman M J, Spaan J A

机构信息

Department of Medical Physics, Academic Medical Center, University of Amsterdam The Netherlands.

出版信息

Circ Res. 1996 Nov;79(5):1039-45. doi: 10.1161/01.res.79.5.1039.

DOI:10.1161/01.res.79.5.1039
PMID:8888697
Abstract

Intramyocardial pressure becomes high in systole and decreases in diastole. Therefore, the transmural pressure of the intramyocardial vessels is pulsatile, resulting in the cyclic distension of these vessels. However, the effect of pulsatility on the behavior of the coronary resistance vessels has not been evaluated. To assess the influence of pulsatile pressure on the behavior of the coronary arterioles, we measured the luminal cross-sectional area (CSA) of coronary arterioles under cyclically changing transmural pressure. Isolated porcine coronary arterioles (internal diameter, 100 to 150 microns) were cannulated with two micropipettes and pressurized with square waves (1 Hz) through both pipettes so as not to induce flow-dependent vasodilation. During the presence (active, induced by acetylcholine; n = 7) or absence (passive, abolished by bradykinin; n = 7) of vascular tone, the CSA was measured under the following conditions: (1) The amplitude of the pressure pulse was changed at a fixed mean pressure. (2) The mean pressure was changed at a fixed pressure pulse. With increasing pulse pressure, the mean CSA at steady state increased under active conditions, whereas it decreased under passive conditions (P < .0001). This vasodilatory effect of pulse pressure remained present after endothelial denudation (P < .0001; n = 6 vessels with basal tone, n = 9 vessels with U46619-induced tone). The mean steady state CSA under passive conditions increased with the mean pressure (P < .05), whereas under active conditions it remained constant in the range of mean pressures between 50 and 100 mm Hg, reflecting myogenic responsiveness. These results indicate that an increase in amplitude of the pressure pulse dilates coronary arterioles. The vasodilating effect of the pulsation may compensate partly for the extra compressing effect of cardiac contraction on the intramyocardial vessels.

摘要

心肌内压力在收缩期升高,在舒张期降低。因此,心肌内血管的跨壁压力是搏动性的,导致这些血管周期性扩张。然而,搏动性对冠状动脉阻力血管行为的影响尚未得到评估。为了评估搏动压力对冠状动脉小动脉行为的影响,我们在周期性变化的跨壁压力下测量了冠状动脉小动脉的管腔横截面积(CSA)。用两个微吸管插入分离的猪冠状动脉小动脉(内径100至150微米),并通过两个吸管施加方波(1Hz)加压,以免诱发流量依赖性血管舒张。在存在(主动,由乙酰胆碱诱导;n = 7)或不存在(被动,由缓激肽消除;n = 7)血管张力的情况下,在以下条件下测量CSA:(1)在固定平均压力下改变压力脉冲的幅度。(2)在固定压力脉冲下改变平均压力。随着脉冲压力增加,在主动条件下稳态时的平均CSA增加,而在被动条件下则降低(P <.0001)。内皮剥脱后,脉冲压力的这种血管舒张作用仍然存在(P <.0001;n = 6个具有基础张力的血管,n = 9个具有U46619诱导张力的血管)。被动条件下的平均稳态CSA随平均压力增加(P <.05),而在主动条件下,在50至100 mmHg的平均压力范围内保持恒定,反映了肌源性反应性。这些结果表明,压力脉冲幅度增加会使冠状动脉小动脉扩张。搏动的血管舒张作用可能部分补偿心脏收缩对心肌内血管的额外压缩作用。

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