O'Leary D S, Augustyniak R A
Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Am J Physiol. 1998 Jul;275(1):H220-4. doi: 10.1152/ajpheart.1998.275.1.H220.
Ischemia of active skeletal muscle stimulates neuronal afferents within the muscle, which elicits a reflex increase in systemic arterial pressure (SAP), heart rate (HR), and cardiac output (CO) termed the muscle metaboreflex. We investigated whether activation of the muscle metaboreflex elicits increases in ventricular performance using conscious, chronically instrumented dogs trained to run on a treadmill (3.2 km/h, 0% grade). The muscle metaboreflex was activated via progressive partial vascular occlusion of the terminal aorta during control experiments and with HR maintained constant via a pacemaker connected to ventricular electrodes (225 beats/min). In control experiments, hindlimb ischemia elicited substantial increases in SAP, HR, and CO (+53.9 +/- 4.3 mmHg, +32.4 +/- 4.5 beats/min, and +1.57 +/- 0.22 l/min, respectively; all changes P < 0.05), whereas stroke volume (SV) remained unchanged with reflex activation (control 45.9 +/- 2.3 vs. 46.1 +/- 2.4 ml, P > 0.05). During metaboreflex activation at constant HR, SV significantly increased such that the increases in CO and SAP were not significantly different from control experiments (+1.77 +/- 0.56 l/min and +57.4 +/- 3.8 mmHg, P > 0.05 vs. control experiments). No significant change in central venous pressure occurred in either experiment, indicating no Frank-Starling effect on SV. We conclude that muscle metaboreflex-induced increases in ventricular contractility act to sustain SV despite decreases in ventricular filling time due to the tachycardia such that the sustained SV coupled with the tachycardia elicits substantial increases in CO that contribute importantly to the reflex increase in SAP.
活跃骨骼肌的缺血会刺激肌肉内的神经传入纤维,引发全身动脉压(SAP)、心率(HR)和心输出量(CO)的反射性增加,这一反射被称为肌肉代谢反射。我们使用经过长期仪器植入、训练在跑步机上跑步(3.2公里/小时,0%坡度)的清醒犬,研究了肌肉代谢反射的激活是否会引起心室功能的增强。在对照实验中,通过逐渐部分阻断主动脉末端来激活肌肉代谢反射,并通过连接心室电极的起搏器使心率保持恒定(225次/分钟)。在对照实验中,后肢缺血导致SAP、HR和CO显著增加(分别为+53.9±4.3 mmHg、+32.4±4.5次/分钟和+1.57±0.22升/分钟;所有变化P<0.05),而每搏输出量(SV)在反射激活时保持不变(对照为45.9±2.3 vs. 46.1±2.4毫升,P>0.05)。在心率恒定的代谢反射激活过程中,SV显著增加,使得CO和SAP的增加与对照实验无显著差异(+1.77±0.56升/分钟和+57.4±3.8 mmHg,与对照实验相比P>0.05)。两个实验中中心静脉压均无显著变化,表明对SV没有Frank-Starling效应。我们得出结论,尽管由于心动过速导致心室充盈时间减少,但肌肉代谢反射引起的心室收缩力增加可维持SV,使得持续的SV与心动过速共同引起CO的显著增加,这对SAP的反射性增加有重要贡献。