Features of the structure of arteries of the lower extremities in man

A comparative investigation has been performed on structural peculiarities of muscle arteries having various caliber in the lower extremities and in the anterior thoracic wall (section material, 40 observations). An essential predominance of the muscle tunic thickness and deterioration of blood supply has been stated in the arterial wall and in the distal parts of the lower extremities. The structural peculiarities revealed in the arteries of the extremities are connected with functional conditions of blood supply in the zone at the vertical position of the human body (orthostatic arterial hypertension).     

Polymorphism of the angiotensin-converting enzyme gene in cardiovascular pathology

The aim of the study was to investigate influence of polymorphism of angiotensin-converting enzyme (ACE) gene on peculiarities of clinical process of such cardiovascular pathology as hypertrophic cardiomyopathy, coronary arterial disease and arterial hypertension. The polymorphism of ACE gene was studied in 98 patients: 38 with hypertrophic cardiomyopathy, 35 with coronary arterial disease and 25 with arterial hypertension. Nuclear DNA was extracted from blood leukocytes by phenol-chloroform method. Genotypes of ACE gene were determined by polymeraze chain reaction, followed with electrophoresis in agarose gel. It has been established, that I/D polymorphism of ACE gene has important modificative significance in clinical process at the mentioned diseases.     

Zinc content in lymphocytes and the activity of zinc ion efflux from lymphocytes in primary arterial hypertension

Clinical observations and experimental data show that zinc (Zn) plays a role in regulating arterial blood pressure and in arterial hypertension etiopathogenesis. To determine the direction of changes in Zn metabolism in primary arterial hypertension, Zn absorption from the alimentary tract, Zn levels in blood serum, its content in lymphocytes, Zn efflux rate constants from lymphocytes, and urinary Zn excretion in patients with hypertension and in healthy subjects were studied. In this article, Zn levels in blood serum, its content in lymphocytes, and Zn efflux rate constants from lymphocytes are presented. In primary arterial hypertension, on the basis of this study, decreasing Zn levels in blood serum and its decreasing content in lymphocytes were found. The Zn efflux rate constants from lymphocytes increased at the initial stage of hypertension (mild arterial hypertension) and decreased in the late stage of the hypertension disease (severe arterial hypertension). Taking into consideration all of the directions of changes and the fact that Zn can be a factor that increases arterial blood pressure, the changes in Zn distribution can be regarded as having, to a certain extent, a protective character leading to weakening of the pressor reaction, assuming a genetic existence of relative or absolute Zn excess in the body. The changes of Zn distribution can lead, after some time, to Zn deficiency and the resulting metabolic changes (e.g., carbohydrate intolerance).     

Role of zinc in regulation of arterial blood pressure and in the etiopathogenesis of arterial hypertension

Increased gastrointestinal absorption and urinary excretion of zinc has been confirmed in experimental and clinical studies on primary arterial hypertension as a result from changes of intracellular and extracellular zinc content. In arterial hypertension, the levels of zinc in serum, lymphocyte, and bone decrease while increasing in heart, erythrocytes, kidney, liver, suprarenal glands and spleen. These changes result in the loss of zinc homeostasis that leads to various degrees of deficiency, not entirely compensated by nutritional factors or increased absorption in the gastrointestinal tract. Loss of zinc homeostasis can be both cause and effect of high blood pressure. In the present review, the role of zinc metabolism changes and its mechanisms in arterial hypertension are discussed.     

Usefulness of determining conjugated amine catecholamines in blood platelets for diagnosis of pheochromocytoma]

The studies included 14 patients with pheochromocytoma (mean age 39.5 years), 32 patients with arterial hypertension (mean age 39.5 years), and 9 healthy volunteers (mean age 39.5 years). Free and conjugated noradrenaline and adrenaline in blood platelets have been assayed with RIA technique. It was shown that mean concentrations of conjugated noradrenaline and adrenaline in blood platelets are significantly higher in patients with pheochromocytoma than those in hypertensive patients and healthy individuals. However, such test may be used with limitations as there is high percentage of increased values in patients with the primary arterial hypertension. A decreased noradrenaline inactivation in blood platelets of patients with pheochromocytoma has also been observed. This may exert some effect on the diversified clinical course of this type of arterial hypertension.     

Genetic correlation between the arterial pressure response during emotional stress and the alpha1-adrenoreceptor concentration in brain regions]

Arterial blood pressure reactivity to the emotional stress and brain alpha 1-adrenoreceptors concentrations were studied in hypertensive (ISIAH strain) and normotensive (Wistar strain) rats and their F1 and F2 hybrids. Significant correlations between the stress-induced increase in the arterial blood pressure and the amount of alpha 1-adrenoreceptors in hypothalamus (+0.46) and medulla (+0.38) were found in the F2. This cosegregation may point to the significant role of genetically determined peculiarities of expression of alpha 1-adrenoreceptors in brain regions during pathogenesis of arterial hypertension in the ISIAH strain.     

Recent insights into the interactions between the baroreflex and the kidneys in hypertension

Recent findings in chronically instrumented animals challenge the classic concept that baroreflexes do not play a role in the chronic regulation of arterial pressure. As alterations in renal excretory function are of paramount importance in the chronic regulation of arterial pressure, several of these recent studies have focused on the long-term interactions between the baroreflex and the kidneys during chronic perturbations in arterial pressure and body fluid volumes. An emerging body of evidence indicates that the baroreflex is chronically activated in several experimental models of hypertension, but in most cases, the duration of these studies has not exceeded 2 wk. Although these studies suggest that the baroreflex may play a compensatory role in attenuating the severity of the hypertension, possibly even in primary hypertension with uncertain causes of sympathetic activation, there has been only limited assessment of the quantitative importance of this interaction in the regulation of arterial pressure. In experimental models of secondary hypertension, baroreflex suppression of renal sympathetic nerve activity is sustained and chronically promotes sodium excretion. This raises the possibility that the renal nerves may be the critical efferent link for baroreceptor-induced suppression of central sympathetic output through which long-term compensatory reductions in arterial pressure are produced. This contention is supported by strong theoretical evidence but must be corroborated by experimental studies. Finally, although it is now clear that pressure-induced increases in baroreflex activity persist for longer periods of time than previously suggested, studies using new tools and novel approaches and extending beyond 2 wk of hypertension are needed to elucidate the true role of the baroreflex in the pathogenesis of clinical hypertension.     

Early abnormalities of pulmonary vascular development in the Fawn-Hooded rat raised at Denver's altitude

The Fawn-Hooded rat (FHR) is a genetic strain that has been extensively studied as a model of primary pulmonary hypertension in adult rats. Based on our recent observations that alveolar number and pulmonary arterial density are reduced in FHRs raised at Denver's altitude, we hypothesized that early abnormalities in pulmonary vascular development contribute to the progression of pulmonary hypertension in the FHR. We found that endothelial nitric oxide synthase (eNOS) protein content was lower in the lungs of fetal, 1- and 7-day-old, 3-week-old, and adult FHRs compared with that in the normal Sprague-Dawley (SDR) and Fischer rat strains, all raised at Denver's altitude. In contrast, lung expression of the endothelial proteins kinase insert domain-containing receptor/fetal liver kinase-1 (KDR/Flk-1) and platelet endothelial cell adhesion molecule-1 (CD31) was not different between strains. Barium arteriograms showed that pulmonary arterial density was reduced in 3-week-old FHRs compared with SDRs. Perinatal treatment of FHRs with mild hyperbaria to simulate sea-level alveolar PO(2) improved lung eNOS content and pulmonary vascular growth and reduced right ventricular hypertrophy. We conclude that the development of pulmonary hypertension in Denver-raised FHRs is characterized by reductions in lung eNOS expression and abnormal pulmonary vascular growth during the fetal, neonatal, and postnatal periods.     

Augmented chemoreceptor reflex tonic drive in early human hypertension and in normotensive subjects with family background of hypertension

The study was carried out in 30 subjects with mild primary hypertension and in 82 normotensive age-matched volunteers, 18-20 years of age. Hyperoxia test was used to withdraw the tonic chemoreceptor reflex drive. The following circulatory and respiratory effects of short lasting hyperoxia were observed in the hypertensive group and in most of the normotensive subjects yet with a family background of hypertension: a decrease in the mean arterial pressure, in total peripheral vascular resistance, and in forearm vascular resistance, and a significantly greater reduction of the resting ventilation as compared to the normotensive group. Our results suggest that the augmented arterial chemoreceptor drive is one of the mechanisms responsible for the elevated arterial blood pressure and total peripheral resistance in early human hypertension. The positive response to hyperoxia test in healthy subjects with a family background of hypertension suggests a familial occurrence of the hyperactivity of the arterial chemoreceptors.     

The analysis of digital-palmar dermatoglyphics in a sample of individuals affected by essential hypertension

In this research the digital and palmar dermatoglyphics of a sample of 97 individuals from Sardinia affected by essential hypertension were examined with the aim of identifying possible peculiarities. As already observed by other authors, the tendency towards a distal position of the axial triradius, a dermatoglyphic characteristic common in many pathologies, was also confirmed in our sample. Furthermore, some characteristics not observed in previous works which are distinctive to hypertensive subjects of both sexes are identified: a transversal tendency of the ridges and a greater asymmetry of the TRC (total ridge count). The asymmetry of the TRC is usually explained as a consequence of disturbances during embryologic development; in our case these disturbances seem to be represented by changes in arterial pressure levels originating during the prenatal period.     

The behavioral and neuromorphological characteristics of rats with spontaneous hypertension

Rats with spontaneous hypertension (strain SHR) reveal retarded somatic growth at early stages of ontogenesis. However, in further postnatal life, after transition to self-feeding, these animals exhibit larger body mass. Significant correlation was found between the arterial pressure and body mass. Some peculiarities in the behaviour of rats from the strain SHR were found already at early stages of ontogenesis. In 2-month animals, the brain exhibits some unusual features: lateral ventricles are enlarged, the corpus callosum is thinner, the volume of the pyramids in the dorsal hippocamp (field CA3) is less than in normal rats, the structure of the lateral hypothalamus being also different. It is suggested that unusual behaviour of hypertensive strain is due to the observed structural differences, as well as to changes in noradrenergic system of the brain.     

Disorders of hormone reception and intracellular signaling in hypertension

This article discusses the disruption taking place due to hypertension in regulatory cell systems. These can either participate in development of the pathology or, on the opposite, provide compensation, be part of the mechanism that brings to normal the functional and metabolic state of cells under this disease. Data on increased level of Ca2+, higher reactivity of cells in relation of Ca2+ mobilizing hormones, alkalinisation of cytoplasma, activation of phosphoinozitide metabolism and stimulation of proteinkinaze C evidence in favour of the suggestion that these disruptions of regulatory cell systems are the material basis of the phenomenon of "structural support" to arterial hypertension.     

An easy diagnostic approach to primary aldosteronism.

The infusion of 40 mEq potassium (aspartate) in 250 ml isotonic 1-fructose at a rate of 20 mEq/h into 5 patients (34-56 years old) with aldosteronoma and 2 patients with bilateral primary aldosteronism consistently raised their mean arterial pressure by 15-20 mmHg. Their pressure values returned to the baseline levels 4-5 h after the infusion. In contrast, in controls (10 patients with idiopathic arterial hypertension, matched for age, sex, and magnitude of the untreated hypertension, and 7 patients with inactive adrenal nodules as incidental findings on upper abdomen ultrasound or computerized tomography) the same procedure caused negligible arterial pressure changes. The cause of the rise in blood pressure observed uniquely in patients with primary aldosteronism after infusion of potassium (aspartate) cannot be accounted for by an increase in plasma aldosterone, blood volume, or plasma angiotensin II. The cause of this response thus remains obscure; nonetheless, this simple procedure may prove useful in differentiating primary aldosteronism from idiopathic hypertension, in excluding the adrenal disorder, and in revealing even its mildest forms.     

Morphofunctional characteristics of the microcirculatory bed of the human spinal dura mater]

Some morphofunctional peculiarities in microcirculatory pathways of the dura mater of the human spinal cord are described. They are concerned with the structure of arteriolo-venular anastomoses through which a rather large amount of arterial blood is transported into the venous bed. Around the vessels of arterial type running at an angle to the longitudinal axis of the vessel connective tissue fibres of the dura mater, there is a tissue layer intensively impregnated with silver salts and stained PAS-positively. The venous part of the dura mater microcirculatory pathways has a large number of accessory reservoirs in the form of venous "lakes". Functional importance of the peculiarities mentioned above for the dura mater and the perimedullar apparatus is clarified.     

Coronary sinus of the heart in various anomalies of the conotruncus

Thirty-one hearts with anomalous conotruncus (common arterial trunk, hypoplasia of the aorta with transposition, atresia of the pulmonary trunk) have been studied. There are some peculiarities in anatomy and topography of the coronary sinus, concerning its sources, that is veins forming the venous sinus, position and interrelations with the venous sulcus and with the interatrial septum, size and form of the ostium and valve of the coronary sinus. The most amount of the anatomical peculiarities of the sinus are observed in the preparations, where the anomalous conotruncus is combined with absence of one or both cardiac septa.     

BMPR-II heterozygous mice have mild pulmonary hypertension and an impaired pulmonary vascular remodeling response to prolonged hypoxia

Heterozygous mutations of the bone morphogenetic protein type II receptor (BMPR-II) gene have been identified in patients with primary pulmonary hypertension. The mechanisms by which these mutations contribute to the pathogenesis of primary pulmonary hypertension are not fully elucidated. To assess the impact of a heterozygous mutation of the BMPR-II gene on the pulmonary vasculature, we studied mice carrying a mutant BMPR-II allele lacking exons 4 and 5 (BMPR-II(+/-) mice). BMPR-II(+/-) mice had increased mean pulmonary arterial pressure and pulmonary vascular resistance compared with their wild-type littermates. Histological analyses revealed that the wall thickness of muscularized pulmonary arteries (<100 mum in diameter) and the number of alveolar-capillary units were greater in BMPR-II(+/-) than in wild-type mice. Breathing 11% oxygen for 3 wk increased mean pulmonary arterial pressure, pulmonary vascular resistance, and hemoglobin concentration to similar levels in BMPR-II(+/-) and wild-type mice, but the degree of muscularization of small pulmonary arteries and formation of alveolar-capillary units were reduced in BMPR-II(+/-) mice. Our results suggest that, in mice, mutation of one copy of the BMPR-II gene causes pulmonary hypertension but impairs the ability of the pulmonary vasculature to remodel in response to prolonged hypoxic breathing.     

Sequential growth of fetal sheep cardiac myocytes in response to simultaneous arterial and venous hypertension

While the fetal heart grows by myocyte enlargement and proliferation, myocytes lose their capacity for proliferation in the perinatal period after terminal differentiation. The relationship between myocyte enlargement, proliferation, and terminal differentiation has not been studied under conditions of combined arterial and venous hypertension, as occurs in some clinical conditions. We hypothesize that fetal arterial and venous hypertension initially leads to cardiomyocyte proliferation, followed by myocyte enlargement. Two groups of fetal sheep received intravascular plasma infusions for 4 or 8 days (from 130 days gestation) to increase vascular pressures. Fetal hearts were arrested in diastole and dissociated. Myocyte size, terminal differentiation (%binucleation), and cell cycle activity (Ki-67[+] cells as a % of mononucleated myocytes) were measured. We found that chronic plasma infusion greatly increased venous and arterial pressures. Heart (but not body) weights were approximately 30% greater in hypertensive fetuses than controls. The incidence of cell cycle activity doubled in hypertensive fetuses compared with controls. After 4 days of hypertension, myocytes were (approximately 11%) longer, but only after 8 days were they wider (approximately 12%). After 8 days, %binucleation was approximately 50% greater in hypertensive fetuses. We observed two phases of cardiomyocyte growth and maturation in response to fetal arterial and venous hypertension. In the early phase, the incidence of cell cycle activity increased and myocytes elongated. In the later phase, the incidence of cell cycle activity remained elevated, %binucleation increased, and cross sections were greater. This study highlights unique fetal adaptations of the myocardium and the importance of experimental duration when interpreting fetal cardiac growth data.     

Intrarenal renin-angiotensin system and counteracting protective mechanisms in angiotensin II-dependent hypertension

It is now well accepted that alterations in kidney function, due either to primary renal disease or to inappropriate hormonal influences on the kidney, are a cardinal characteristic in all forms of hypertension, and lead to a reduced ability of the kidneys to excrete sodium and the consequent development of elevated arterial pressures. However, it is also apparent that many extrarenal factors are important contributors to altered kidney function and hypertension. Central to many hypertensinogenic processes is the inappropriate activation of the renin-angiotensin system (RAS) and its downstream consequences by various pathophysiologic mechanisms. There may also be derangements in arachidonic acid metabolites, endothelium derived factors such as nitric oxide and carbon monoxide, and various paracrine and neural systems that normally interact with or provide a counteracting balance to the actions of the RAS. Thus, when the capacity of the kidneys to maintain sodium balance and extracellular fluid volume within appropriate ranges is compromised, increases in arterial pressure become necessary to re-establish normal balance.     

TRPC6介导肺动脉高压大鼠肺动脉张力和肺动脉平滑肌细胞Ca~(2+)浓度的升高

经典瞬时感受器电位通道6(transient receptor potential channel6,TRPC6)蛋白是受体操纵性Ca2+通道(ROCC)的分子基础。本文旨在研究TRPC6/ROCC在野百合碱(monocrotaline,MCT)诱发的肺动脉高压大鼠模型中的作用。Sprague-Dawley大鼠随机分为正常对照组(CON组)和MCT组,CON组正常饲养三周,而MCT组按60mg/kg剂量一次性腹腔注射2%MCT,建立MCT诱导的慢性肺动脉高压大鼠模型。通过测定右心室收缩压(RVSP)和右心室重量指数(RVMI)、HE染色观察肺动脉血管形态,分析肺动脉结构重建。半定量RT-PCR和Western blot检测大鼠肺动脉TRPC6 mRNA和蛋白表达水平。血管张力实验中用可特异性激活ROCC、可透膜的DAG拟似物1-oleoyl-2-acetyl-sn-glycerol(OAG)检测大鼠离体肺动脉环的收缩效应。用荧光探针Fluo3-AM测定OAG诱导大鼠肺动脉平滑肌细胞(PASMCs)胞浆游离Ca2+浓度([Ca2+]i)。结果显示,与CON组相比,MCT组的RVSP、RVMI均明显增高(P0.01);形态学观察可见肺小动脉平滑肌层明显增厚,管腔减小;TRPC6的mRNA和蛋白质表达无明显变化。在CON组,OAG几乎不引起肺动脉环收缩,而在MCT组,肺动脉环的收缩反应显著增强,差别有显著性意义(P0.01)。相比较于CON组,MCT也可使OAG触发的PASMCs[Ca2+]i增量值显著升高(P0.05)。上述结果提示,MCT预处理对肺动脉TRPC6mRNA和蛋白质水平的表达无显著增强效应,但可促进TRPC6/ROCC介导的PASMCsCa2+内流和肺动脉张力升高,诱导大鼠产生肺动脉高压,并进一步诱发肺血管及右心室重构。