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心肌梗死后,小动脉的改变先于肢体骨骼肌的变化。

Alterations in small arterioles precede changes in limb skeletal muscle after myocardial infarction.

作者信息

Thomas D P, Hudlicka O, Brown M D, Deveci D

机构信息

Department of Physiology, University of Birmingham, Birmingham B15 2TT, United Kingdom.

出版信息

Am J Physiol. 1998 Sep;275(3):H1032-9. doi: 10.1152/ajpheart.1998.275.3.H1032.

Abstract

We tested the hypothesis that alterations in arterioles in locomotor skeletal muscles in rats with myocardial infarction (MI), but before development of congestive heart failure (CHF), precede structural and functional changes commonly observed in limb muscle in association with CHF. Resting diameters of third- (A3) and fourth-order arterioles (A4) in extensor digitorum longus (EDL) muscle were significantly smaller in rats with nonfailing small and medium-sized MI compared with control animals. Dilation of A4 in response to 10(-4) M adenosine was significantly attenuated in both groups (P < 0.05), whereas dilation of A3 was unaltered. Microvessels from both groups of infarcted rats constricted to all doses of acetylcholine (10(-9), 10(-8), and 10(-7) M) and showed a significantly exaggerated vasoconstrictor response to norepinephrine (10(-9), 10(-8), and 10(-7) M) compared with microvessels in control rats (P < 0.05). Peak isometric tension of combined tibialis anterior and EDL muscles and muscle fatigue (final/peak tension x 100), measured during 5-min isometric supramaximal twitch contractions at 4 Hz, were similar in control and MI rats (218 +/- 7 vs. 213 +/- 15 g/g muscle and 52 +/- 1 vs. 51 +/- 9%, respectively; n = 5 for both). There was also no difference with respect to the proportion of oxidative fibers or capillary-to-fiber ratios. Our results indicate that, in rats with left ventricular dysfunction but without failure, decreased diameter and perturbations in reactivity of small arterioles precede alterations in skeletal muscle performance often seen at a later date in association with CHF. These findings are consistent with the notion of aberrant endothelial and smooth muscle function and may contribute to the maintenance of blood pressure after MI but before CHF.

摘要

我们检验了这样一个假设

在心肌梗死(MI)但尚未发展为充血性心力衰竭(CHF)的大鼠中,运动性骨骼肌小动脉的改变先于与CHF相关的肢体肌肉中常见的结构和功能变化。与对照动物相比,非衰竭性中小面积MI大鼠的趾长伸肌(EDL)中三级(A3)和四级小动脉(A4)的静息直径显著更小。两组中A4对10⁻⁴ M腺苷的舒张反应均显著减弱(P < 0.05),而A3的舒张未改变。与对照大鼠的微血管相比,两组梗死大鼠的微血管对所有剂量的乙酰胆碱(10⁻⁹、10⁻⁸和10⁻⁷ M)均收缩,且对去甲肾上腺素(10⁻⁹、10⁻⁸和10⁻⁷ M)的血管收缩反应显著增强(P < 0.05)。在4 Hz下进行5分钟等长超最大抽搐收缩期间测量的胫前肌和EDL联合肌肉的峰值等长张力以及肌肉疲劳(终末/峰值张力×100),在对照大鼠和MI大鼠中相似(分别为218±7 vs. 213±15 g/g肌肉和52±1 vs. 51±9%;两组n = 5)。氧化纤维比例或毛细血管与纤维比率也无差异。我们的结果表明,在左心室功能障碍但未衰竭的大鼠中,小动脉直径减小和反应性紊乱先于后期与CHF相关的骨骼肌性能改变。这些发现与内皮和平滑肌功能异常的观点一致,可能有助于MI后但CHF前的血压维持。

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