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2007, Número 4

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Arch Cardiol Mex 2007; 77 (4)


La autorregulación homeométrica. El efecto Anrep. Su posible importancia en la patofisiología en los aumentos de la postcarga del ventrículo derecho

Lupi-Herrera E, Santos MLuis - Efrén, Figueroa SJ, Sandoval ZJ

Idioma: Español
Referencias bibliográficas: 98
Paginas: 330-348
Archivo PDF: 249.31 Kb.


RESUMEN

Uno de los mecanismos intrínsecos que se pueden documentar en el corazón asilado y en el estudiado in situ, es el bien conocido mecanismo de Frank-Starling el cual le permite a la función de las cámaras ventriculares expulsar la magnitud de volumen que le llegue [mecanismo autorregulatorio heterométrico]. Un segundo tipo de proceso de autorregulación que se ha demostrado en los ventrículos y que aparentemente no utiliza el componente de Frank- Starling, será el motivo de esta revisión. Éste requiere para establecerse por lo menos la secuencia de varios latidos hasta poderse concretar su plena actividad. En estas circunstancias, el ventrículo funciona de tal manera que, la presión diastólica final y la longitud de la fibra miocárdica se mantienen, producto de un aumento en la contractilidad. Esta adaptación ventricular, se ha llamado autorregulación homeométrica o efecto Anrep. El conocer los parámetros ventriculares independientes de la pre y de la postcarga, lo que incluye la contractilidad intrínseca, ha resultado muy relevante para comprender mejor la fisiopatología de los incrementos agudos y los crónicos de la postcarga ventricular. En esta revisión, se analiza la posible injerencia del efecto Anrep en la disfunción del ventrículo derecho en enfermos con hipertensión arterial pulmonar primaria y secundaria con cardiopatía hipertensiva pulmonar, mecanismo del que se discute su posible papel, se consigna como una hipótesis a tomar siempre en consideración, como una parte de la fisiopatología del estado agudo y en los crónicos cuando existe incremento de la postcarga del ventrículo derecho.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Armour JA, Pace JB, Randall WC: Interrelationship of architecture and function of the right ventricle. Am J Physiol 1970; 218: 174-179.

  2. Weber KT, Janicki JS, Shroff SG, Likoff MJ, Sutton MGSJ: The right ventricle : Physiologic and pathophysiologic considerations. Crit Care Med 1983; 11: 323-328.

  3. Starling EH: Principles of Human Physiology. 2nd ed. Philadelphia, Lea & Febiger, 1915: 958.

  4. Starling EH: Linacre lecture on the law of the heart. Delivered at Cambridge, 1915. London, Longmans, Green & Co. 1918.

  5. Rosenblueth A, Alanís J, López E, Rubio R: The adaptation of ventricular muscle to different circulatory conditions. Arch Internat Physiol Bioch 1959; 67: 358-373.

  6. Patterson SW, Piper H, Starling EH: Regulation of the heart beat. J Physiol 1914; 48: 465-472.

  7. Sarnoff SJ, Mitchell JH, Gilmore JP, Remensnyder JP: Homeometric autoregulation in the heart. Circ Res 1960; 8: 1077-1091.

  8. Anrep GV: On the part played by the suprarenals in the normal vascular reactions of the body. J Physiol 1912; 45: 307-317.

  9. Stainsby WN, Sarnoff SJ, Braunwald E, Case RB, Welch GH: Effect of independent alterations of stroke volume , aortic pressure and heart rate on left ventricular function. Fed Proc 1956; 15: 177-186.

  10. Kosawa S: Mechanical regulation of the heart beat tortoise. J Physiol 1915; 49 : 233-242.

  11. Perserico E: Influence of mechanical factors of the circulation upon the heart volume. J Physiol 1928; 65: 146-152.

  12. Stella G: Oxygen consumption of the tortoise heart: Its dependence on diastolic volume and on the mechanical conditions of systole. J Physiol 1931; 72: 247-264.

  13. Müller EA: Die Anpassung des Herzvolumens an deu Aortendruck. Arch Ges Physiol 1938; 241: 427-438.

  14. Rosenblueth A, Alanís J, Rubio R, López E: Two staircase phenomena. Arch Internat Physiol Biochem 1959; 67: 374-383.

  15. Monroe RG, Gamble WJ, LaFarge CG, Kumar AE, Stark J, Sanders GL, Phonrphutkul C, Davis M: The Anrep effect reconsidered. J Clin Invest 1972; 51: 2573-2583.

  16. Doménech RJ, Hoffman JIE, Noble IM, Saunders KB, Henson JR, Subijanto S: Total and regional coronary blood flow measured by radioactive microspheres in conscious and anesthetized dogs. Circ Res 1969; 25: 581-591.

  17. Blinks JR, Koch-Weser J: Physical factors in the analysis of the actions of drugs on myocardial contractility. Pharmacol Rev 1963; 15: 531-555.

  18. Gilmore JP, Cingolani HE, Taylor RR, McDonald RH: Physical factors and cardiac adaptation. Am J Physiol 1966; 211: 1219-1232.

  19. Bowditch HP: Über die Eigenthumlichkeiten der Reizbarkeit, welche die Muskelfasern des Herzens zeigen. Arb Physiologischen Anstalt Leipzig 1871; 6: 139-147.

  20. Abel RM , Reis RL: Effects of coronary blood flow and perfusion pressure on left ventricular contractility in dogs. Circ Res 1971; 27: 961-969.

  21. Bacaner MB, Lioy F, Visscher MB: Coronary blood flow , oxygen delivery rate and cardiac performance. Am J Physiol 1971; 216: 111-122.

  22. Sarnoff SJ, Gilmore JP, Mitchell JH, Remensnyder JP: Potassium changes in the heart during homeometric autoregulation and acetyl strophanthidin. Am J Med 1963; 34: 440-451.

  23. Hajdu S: Mechanism of staircase and contracture in ventricular muscle. Am J Physiol 1953; 174: 371-380.

  24. Roelandt JR, Meester GT, Hugenholtz PG: Vmax and dp/dt/ kPmax in patients with coronary artery disease during atrial pacing [AP]. Circulation 1971; 44[II]: 96 [Abst].

  25. Noble MIM, Wyler J, Milne ENC, Tranchard D, Guz A: Effects of changes in heart rate on left ventricular performance in conscious dogs. Circ Res 1969; 24: 285-293.

  26. Higgins CB, Vatner SF, Franklin D, Braunwald E: Extent of regulation of the heart´s contractile state in the conscious dog by alteration in the frequency of contraction. J Clin Invest 1973; 52: 1187–1194.

  27. Vatner SF, Higgins CB, Patrick T, Franklin D, Braunwald E: Effects of cardiac depression and anesthesia on the myocardial action of a cardiac glycoside. J Clin Invest 1971; 50: 2585-2595.

  28. Covell JW, Ross J, Sonnenblick EH, Braunwald E: Comparison of the force – velocity relation and the ventricular function curve as measures of the contractile state of the intact heart. Circulation Res 1966; 19: 364-372.

  29. Ross J, Covell JW, Sonnenblick EH, Braunwald E: Contractile state of the heart characterized by force- velocity relations in variably afterloaded and isovolumic beats. Circ Res 1966; 18: 149–163.

  30. Clancy RL, Graham TP, Ross J, Sonnenblick EH, Braunwald E: Influence of aortic pressure-induced homeometric autoregulation on myocardial performance. Am J Physiol 1968; 214: 1186–1192.

  31. Morris CE: Mechanosensitive ion channels. J Membr Biol 1990; 113: 93-107.

  32. Brutsaert DL, Andries LJ: The endocardial endothelium. Am J Physiol 1992; 263: H985–H1002.

  33. Szabo G, Sebening C, Hagl C, Tochtermann U, Vahl CF, Hagl S: Right ventricular function after brain death: response to an increased afterload. Eur J Cardiothorac Surg 1998; 13: 449-458.

  34. Schipper IB, Steendijk P, Klautz RJM, Van der Velde ET, Baan J: Cardiac sympathetic denervation does not change the load dependence of the left ventricular end-systolic pressure/volume relationship in dogs. Pflügers Arch 1993; 425: 426-433.

  35. Wahler GM, Swayze CR, Fox IJ: A Ca[2+] dependent mechanism for the positive inotropic response to an increase in after-load in cat papillary muscle. Can J Physiol Pharmacol 1984; 62: 296-301.

  36. Biondi JW, Schulman DS, Soufer R, Matthay RA, Hines RL, Kay HR, Barash PG: The effect of incremental positive end-expiratory pressure on right ventricular hemodynamics and ejection fraction. Anesth Analg 1988; 67: 144-151.

  37. Evans N, Kluckow M: Early determinants of right and left ventricular output in ventilated preterm infants. Arch Dis Child Fetal Neonatal Ed 1996; 74: F88-F94.

  38. Lopes-Cardoso RH , Steendijk P, Baan J, Brouwers HAA, De Vromen M, Van Bel F: Right ventricular function in respiratory distress syndrome and subsequent partial liquid ventilation . Homeometric autoregulation in the right ventricle of the newborn animal. Am J Respir Crit Care Med 2000; 162: 374-379.

  39. Klautz RJM, Teitel DF, Steendijk P, Van Bel F, Baan J: Interaction between afterload and contractility in the new born heart: evidence of homeometric autoregulation in the intact circulation. J Am Coll Cardiol 1995; 25: 1428-1435.

  40. Ross J, Sobel BE: Regulation of cardiac contraction. Ann Rev Physiol 1972; 34: 47–90.

  41. Spann JF, Buccino RA, Sonnenblick EH, Braunwald E: Contractile state of cardiac muscle obtained from cats with experimentally produced ventricular hypertrophy and heart failure. Circ Res 1967; 21: 341-354.

  42. Bing OHL, Matsushita S, Fanburg BC, Levine HJ: Mechanical properties of rat cardiac muscle during experimental hypertrophy. Circulation Res 1971; 28: 234-245.

  43. Williams JF, Potter RD: Normal contractile state of hypertrophied myocardium after pulmonary artery constriction in the cat. J Clin Invest 1974; 54: 1266-1272.

  44. Fisher VJ, Kavaler F: Maximal force development by hypertrophied right ventricular papillary muscle remaining in situ. In: Cardiac hypertrophy. Ed. Alpert NR. New York : Academic , 1971: 371-385.

  45. Mason DT, Spann JF, Zelis R, Amsterdam EA: Comparison of the contractile state of the normal, hypertrophied and failing heart in the man. In: Cardiac Hypertrophy. Ed. Alpert NR . New York: Academic , 1971: 433-444.

  46. Levine HJ, McIntyre KM, Lipana JG, Bing OHL: Force-velocity relations in failing and nonfailing hearts of subjects with aortic stenosis. Am J Med Sci 1970; 259: 79-89.

  47. Simon H, Krayenbuehl HP, Rutishauser W, Preter BO: The contractile state of the hypertrophied left ventricular myocardium in aortic stenosis. Am Heart J 1970; 79: 587-602.

  48. Sasayama S, Ross J, Franklin D, Bloor CM, Bishop S, Dilley RB: Adaptation of the left ventricle to chronic pressure overload. Circ Res 1976; 38: 172-178.

  49. Sasayama S, Franklin D, Ross J: Hyperfunction with normal inotropic state of the hypertrophied left ventricle. Am J Physiol 1977; 232: H418-H425.

  50. Hayes CJ, Gersony WM, Driscoll DJ, Keane JF, Kidd L, O’Fallon WM, et al: Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. Circulation 1993; 87: I-28–I–37.

  51. Lorenz CH, Walker ES, Graham TP, Powers TA: Right ventricular performance and mass by use of cine MRI late after atrial repair of transposition of the great arteries. Circulation 1995; 92: II-233–II-239.

  52. Williams WG, Trusler GA, Kirklin JW, Blackstone EH, Coles JG, Izukawa, Freedom RM: Early and late results of a protocol for simple transposition leading to an atrial switch [Mustard] repair. J Thorac Cardiovasc Surg 1988; 95: 717-726.

  53. Leeuwenburgh BPJ, Helbing WA, Steendijk P, Schoof PJ, Baan J: Biventricular systolic function in young lambs subject to chronic systemic right ventricular pressure overload. Am J Physiol Heart Circ Physiol 2001; 281: H2697-H2704.

  54. Assey ME, Wisenbaugh T, Spann JF, Gillette PC, Carabello BA: Unexpected persistence into adulthood of low wall stress in patients with congenital aortic stenosis: is there a fundamental difference in the hypertrophic response to a pressure overload present from birth? Circulation 1987; 75: 973-979.

  55. Flanagan MF, Aoyagi T, Currier JJ, Colan SD, Fujii AM: Effect of young age on coronary adaptations to left ventricular pressure overload hypertrophy in sheep. J Am Coll Cardiol 1994; 24: 1786-1796.

  56. Oparil S, Bishop SP, Clubb FJ: Myocardial cell hypertrophy or hyperplasia. Hypertension 1984; 6: III-38-III-43.

  57. Kodie M, Carabello BA, Conrad CC, Buckley JM, DeFreyte G, Barnes M, et al: Hypertrophic response to hemodynamic overload : role of load vs. renin-angiotensin system activation. Am J Physiol Heart Circ Physiol 1999; 276: H350-H358.

  58. Boxt LM, Katz J, Kolb T, Czegledy FP, Long RW, Behrendt DM, Gallagher KP: Direct quantitation of right and left ventricular volumes with nuclear magnetic resonance imaging in patients with primary pulmonary hypertension. J Am Coll Cardiol 1992; 19: 1508-1515.

  59. Archie JP, Fixler DE, Ullyot DJ, Buckberg GD, Hoffman JI: Regional myocardial blood flow in lambs with concentric right ventricular hypertrophy. Circ Res 1974; 34: 143-154.

  60. Botham MJ, Lemmer JH, Gerren RA, Long RW, Behrendt DM, Gallagher KP: Coronary vasodilator reserve in young dogs with moderate right ventricular hypertrophy. Ann Thorac Surg 1984; 38: 101-107.

  61. King ME, Braun H, Goldblatt A, Liberthonson R, Weyman AE: Interventricular septal configuration as a predictor of right ventricular systolic hypertension in children: a cross-sectional echocardiographic study. Circulation 1983; 68: 68-75.

  62. Francis GS, McDonald K, Chu C, Cohn JN: Pathophysiologic aspects of end-stage heart failure. Am J Cardiol 1995; 75: 11A-16A.

  63. Frank O: Die grund form des arteriellen pulses. Z Biol 1898; 37: 483-492.

  64. Suga H, Sagawa K: Instantaneous pressure-volume relationships and their ratio in excised, supported canine left ventricle. Circ Res 1974; 35: 117-126.

  65. Baan J, Van Der Velde ET, Steendijk P: Ventricular pressure -volume relations in vivo. Eur Heart J 1992; 13: Suppl E: 2-6.

  66. Sarnoff SJ, Mitchell JH: The regulation of the performance of the heart. Am J Med 1961; 30: 747-771.

  67. Sagawa K: The end-systolic pressure-volume relation of the ventricle : Definition , modifications and clinical use. Circulation 1981; 63: 1223-1227.

  68. Takeuchi M, Igarashi Y, Tomimoto S, Odake M, Hayashi T, Tsukamoto T, et al: Single-beat estimation of the slope of the end-systolic pressure – volume relation in the human left ventricle. Circulation 1991; 83: 202-212.

  69. Asanoi H, Sasayama S, Kameyama T: Ventriculoarterial coupling in normal and failing heart in humans. Circ Res 1989; 65: 483-493.

  70. Piene H, Sund T: Does normal pulmonary impedance constitute the optimum load for the right ventricle? Am J Physiol 1982; 242: H154-H160.

  71. Shors SM, Fung CW, Francois CJ, Finn JP, Fieno DS: Accurate quantification of right ventricular mass at MR imaging by using cine true fast imaging with steady –state precession: study in dogs. Radiology 2004; 230: 383-388.

  72. Beerbaum P, Körperich H, Gieseke J, Barth P, Peuster M, Meyer H: Rapid left-to-right shunt quantification in children by phase –contrast magnetic resonance imaging combined with sensitivity encoding. Circulation 2003; 108: 1355-1361.

  73. Razavi R, Hill DLG, Keevil SF, Miquel ME, Muthurangu V, Hegde S, Rhode K, et al: Cardiac catheterization guided by MRI in children and adults with congenital heart disease. Lancet 2003; 362: 1877-1882.

  74. Kuehne T, Yilmaz S, Steendijk P, Moore P, Groenink M, Saaed M, et al: Magnetic resonance imaging analysis of right ventricular pressure- volume loops: In vivo validation and clinical application in patients with pulmonary hypertension. Circulation 2004; 110: 2010-2016.

  75. Geva T, Powell AJ, Crawford EC, Chung T, Colan SD: Evaluation of regional differences in right ventricular systolic function by acoustic quantification echocardiography and cine magnetic resonance imaging. Circulation 1998; 98: 339-345.

  76. Goto Y, Slinker B, Le Winter M: Similar normalized Emax and O2 consumption –pressure volume area relation in rabbit and dog. Am J Physiol 1988; 255: H366-H374.

  77. Fourie PR, Coetzee AR, Bollinger CT: Pulmonary artery compliance :its role in right ventricular-arterial coupling. Cardiovasc Res 1992; 26: 839-844.

  78. Brimioulle S, Wauthy P, Ewalenko P, Rondelet B, Vermeulen F, Kerbaul F, Naeije R: Single-beat estimation of right ventricular end-systolic pressure-volume relationship. Am J Physiol Heart Circ Physiol 2003; 284: H1625-H1630.

  79. Burkohoff D, Sagawa K: Ventricular efficiency predicted by analytical model. Am J Physiol 1986; 250: R1021-R1027.

  80. Milstein JM, Glantz SA: Mechanically increased right ventricular afterload alters left ventricular configuration, not contractility , in neonatal lambs. Pediatr Res 1993; 33: 359-364.

  81. Borden CS, Wilson RH, Ebert RV, Wells HS: Pulmonary hypertension in chronic pulmonary emphysema. Am J Med 1950; 8: 701-709.

  82. Fowler NO, Westcott RN, Scott RC, Hess E: The cardiac output in chronic cor pulmonale. Circulation 1952; 6: 888-893.

  83. Burrows B, Kettel LJ, Niden AH, Rabinowitz M, Diener CF: Patterns of cardiovascular dysfunction in chronic obstructive lung disease. N Engl J Med 1972; 286: 912-918.

  84. Jain D, Zaret BL: Assessment of right ventricular function. Role of nuclear imaging techniques. Cardiol Clin 1992; 10: 23–39.

  85. Lupi HE, Sandoval J, Seoane M, Bialostozky D, Verdejo J: La función ventricular derecha en la neumopatía obstructiva crónica con cardiopatía pulmonar . Su estudio a la altura de la ciudad de México [2,240 metros]. Arch Inst Cardiol Méx 1981; 51: 535-540.

  86. Lupi HE, Seoane M, Verdejo J: Hemodynamic effect of hydralazine in advanced, stable chronic obstructive pulmonary disease with cor pulmonale. Immediate and short-term evaluation at rest and during exercise. Chest 1983; 85: 156-163.

  87. Lupi HE, Sandoval J, Seoane M, Bialostozky D: Behavior of the pulmonary circulation in chronic obstructive pulmonary disease. Pathogenesis of pulmonary hypertension at an altitude of 2,240 meters. Am Rev Respir Dis 1982; 126: 509-514.

  88. Oliver RM, Fleming JS, Waller DG: Right ventricular function at rest and during exercise in chronic obstructive pulmonary disease. Chest 1993; 103: 74-80.

  89. Altschule MD: Limited usefulness of the so-called ejection fraction measurement in clinical practice. Chest 1986; 90: 134-135.

  90. Mathay RA, Niederman MS, Weidermann HP: Cardiovascular pulmonary interaction in chronic obstructive pulmonary disease with special reference to the pathogenesis and management of cor pulmonale. Med Clin North Am 1990; 74: 571-618.

  91. Noordegraaf AV, Marcus JT, Rosenboom B, Postmus PE, Faes TJ, Vries PM: The effect of right ventricular hypertrophy on left ventricular ejection fraction in pulmonary emphysema. Chest 1997; 112: 640-645.

  92. Lupi HE, Sandoval J: Hipertensión Arterial Pulmonar. En: Enfermedad pulmonar obstructiva crónica. Ed. Rodríguez Roisín R. Monografías Clínicas en Neumología 6. Ediciones Doyma Barcelona España, 1993: 33-47.

  93. Fishman AP, Maxwell M, Crowder C, Morales P: Kidney function in cor pulmonale. Particular considerations of changes in renal hemodynamics and sodium excretion during variations in level of oxygenation. Circulation 1951; 3: 703-721.

  94. Lupi HE, Seoane M, Verdejo J, Gómez A, Sandoval J, Barrios R, Martínez W: Hemodynamic effect of hydralazine in interstitial lung disease patients with cor pulmonale. Immediate and short-term evaluation at rest and during exercise. Chest 1985; 87: 564-573.

  95. Santos MLE, Gómez GA, Infante VO, Flores CP, Tena BC, Pulido ZT, et al: Desarrollo de un modelo canino de hipertensión ventricular derecha crónica progresiva. Arch Cardiol Méx 2001; 71: 266-277.

  96. Santos MLE, Bialostozky D, Gómez A, Infante O, Palomar A, Flores P, et al: Analysis of the morphological and functional alterations in the development of right ventricular hypertrophy in a canine experimental model. Chest 1999; 11: 1-4.

  97. Santos MLE, Gotés J, Flores P, Tena C, Graullera V, Pulido T, et al: Modificación de un dispositivo hidráulico para bandaje controlado del tronco de la arteria pulmonar en caninos. Arch Cardiol Méx 2005; 75: S3, 10-20.

  98. de Vroomen M, Cardoso R, Steendijk P, Bel VF, Baan J: Improved contractile performance of the right ventricle in response to increased RV afterload in newborn lambs. Am J Physiol Heart Circ Physiol 2000; 278: H100-H 105.




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