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犬冠状动脉血管阻力对冠状动脉P CO2局部改变的反应。

The response of canine coronary vascular resistance to local alterations in coronary arterial P CO2.

作者信息

Case R B, Greenberg H

出版信息

Circ Res. 1976 Oct;39(4):558-66. doi: 10.1161/01.res.39.4.558.

Abstract

The effect of hypercapnia on coronary vascular resistance (CVR) was studied in seven open-chest dogs. Coronary blood flow was supplied to the cannulated left main coronary artery from the femoral artery by a precision pump. Coronary arterial PCO2 was locally controlled with a small membrane oxygenator in the coronary perfusion circuit. Each PCO2 change was made at a constant coronary flow, and CVR was calculated from the ratio of perfusion pressure to flow. Coronary sinus (CS) PCO2 and PO2 were recorded continuously from blood withdrawn through a CS catheter. Normocapnia (PCO2 = 42.3 +/- 2.8 mm Hg) was obtained with a membrane oxygenator gas composition of 95% O2-5% CO2, and hypocapnia was produced with 100% O2-0% CO2. In addition to physiology normal coronary flow (determined by a CS PO2 of 20-30 mm Hg) relatively high and low flow states were studied. At a normal control CS PO2, a decrease in coronary arterial PCO2 from 42.3 +/- 2.8 to 23.8 +/- 1.3 mm Hg caused CVR to increase by 84.2%, from 1.27 +/- 0.06 to 2.30 +/- 0.04 units. Since pH was inversely related to PCO2, the effect on CVR may have been mediated through a pH change. CS PCO2 decreased from 65.2 +/- 1.9 to 39.4 +/- 1.3 mm Hg. myocardial oxygen consumption was unchanged. Increases in CVR of 74.5, 119.5, and 69.3% occurred during hypocapnia in three additional experiments in which control arterial PO2 was maintained at 52-90 mm Hg. When CS PO2 was greater than 30 mm Hg, the normocapnic CVR was high, and was only minimally increased by hypocapnia. When coronary flow was reduced to an ischemic level there was little response in CVR to hypocapnia. Thus the level of arterial PCO2 can have an important effect on CVR independent of changes in O2 consumption. Myocardial PCO2, derived from metabolically produced CO2 and contributed to by arterial CO2, may be a major factor in normal control of coronary flow.

摘要

在七只开胸犬身上研究了高碳酸血症对冠状动脉阻力(CVR)的影响。通过精密泵从股动脉向插管的左主冠状动脉供应冠状动脉血流。在冠状动脉灌注回路中使用小型膜式氧合器局部控制冠状动脉动脉血二氧化碳分压(PCO2)。每次PCO2变化均在恒定冠状动脉血流下进行,并根据灌注压力与血流的比值计算CVR。通过经冠状窦(CS)导管抽取的血液连续记录冠状窦(CS)的PCO2和PO2。使用气体成分为95%O2 - 5%CO2的膜式氧合器获得正常碳酸血症(PCO2 = 42.3±2.8 mmHg),使用100%O2 - 0%CO2产生低碳酸血症。除了生理正常冠状动脉血流(由CS PO2为20 - 30 mmHg确定)外,还研究了相对高和低的血流状态。在正常对照CS PO2下,冠状动脉动脉血PCO2从42.3±2.8 mmHg降至23.8±1.3 mmHg,导致CVR增加84.2%,从1.27±0.06单位增至2.30±0.04单位。由于pH与PCO2呈负相关,对CVR的影响可能是通过pH变化介导的。CS PCO2从65.2±1.9 mmHg降至39.4±1.3 mmHg,心肌耗氧量未改变。在另外三个实验中,当对照动脉血PO2维持在52 - 90 mmHg时,低碳酸血症期间CVR分别增加了74.5%、119.5%和69.3%。当CS PO2大于30 mmHg时,正常碳酸血症时的CVR较高,低碳酸血症时仅略有增加。当冠状动脉血流降至缺血水平时,CVR对低碳酸血症几乎没有反应。因此,动脉血PCO2水平可独立于耗氧量变化对CVR产生重要影响。源自代谢产生的CO2并由动脉血CO2贡献的心肌PCO2可能是冠状动脉血流正常调节的主要因素。

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