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完全性心脏去传入神经后迷走神经心肺反射

Vagal cardiopulmonary reflexes after total cardiac deafferentation.

作者信息

Minisi A J

机构信息

Department of Internal Medicine (Cardiology), Medical College of Virginia/Virginia Commonwealth University and Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, VA, USA.

出版信息

Circulation. 1998 Dec 8;98(23):2615-20. doi: 10.1161/01.cir.98.23.2615.

Abstract

BACKGROUND

There are conflicting data regarding whether the primary source of afferent input for the vagal cardiopulmonary reflex emanates from receptors located in the ventricles, atria, and/or lungs. This study evaluated the effects of total cardiac deafferentation on the reflex control of efferent renal sympathetic nerve activity (RSNA) in response to a stimulus that affected all vagal receptors in the cardiopulmonary region.

METHODS AND RESULTS

Experiments were performed in 14 chloralose-anesthetized dogs with sinoaortic denervation. Reflex control of RSNA in response to blood volume expansion was measured before and after interruption of cardiac vagal afferents by pericardial lidocaine (PL). Reflex sensitivity (% change in RSNA/mm Hg change in left atrial pressure) was markedly attenuated after PL (pre, -10.9+/-2.2; post, -1.6+/-0. 6; P=0.002). RSNA responses to intracoronary nicotine and left atrial balloon inflation were abolished after PL, confirming that cardiac afferents were interrupted. RSNA responses to lung inflation were not affected by PL, indicating that pulmonary afferents remained intact. In 8 experiments, reflex sensitivity values returned to baseline levels after the effects of PL had worn off.

CONCLUSIONS

These results indicate that the heart provides the primary source of afferent input for the control of sympathetic outflow by the vagal cardiopulmonary reflex during changes in thoracic blood volumes and pressures.

摘要

背景

关于迷走神经心肺反射的传入输入主要来源是位于心室、心房和/或肺的受体,存在相互矛盾的数据。本研究评估了完全心脏去传入神经对肾交感神经传出活动(RSNA)反射控制的影响,该反射控制是对影响心肺区域所有迷走神经受体的刺激做出的反应。

方法与结果

在14只接受氯醛糖麻醉且去窦主动脉神经支配的犬身上进行实验。在通过心包内利多卡因(PL)中断心脏迷走神经传入之前和之后,测量RSNA对血容量扩张的反射控制。PL后反射敏感性(RSNA变化百分比/左心房压力变化毫米汞柱)显著减弱(PL前,-10.9±2.2;PL后,-1.6±0.6;P = 0.002)。PL后,对冠状动脉内尼古丁和左心房球囊扩张的RSNA反应消失,证实心脏传入神经被中断。对肺扩张的RSNA反应不受PL影响,表明肺传入神经保持完整。在8个实验中,PL作用消失后,反射敏感性值恢复到基线水平。

结论

这些结果表明,在胸内血容量和压力变化期间,心脏为迷走神经心肺反射控制交感神经流出提供了主要的传入输入来源。

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