Role of nitric oxide on the central hemodynamic response to acute volume expansion in the pregnant rat

OBJECTIVES

Our hypothesis was that during pregnancy nitric oxide acts as mediator in the hemodynamic response to volume expansion.

STUDY DESIGN

The study was performed on 12 rats on days 19 to 20 of pregnancy. Six rats were injected intravenously with hexamethonium bromide plus the inhibitor of nitric oxide synthase L-nitro-arginine methyl ester. For a control group, six rats were injected with hexamethonium bromide plus the L-nitro-arginine methyl ester vehicle. A volume expansion (1.2% body weight) was performed in both groups by intravenous infusion of bovine albumin (6%) solution.

RESULTS

In the control group volume expansion induced a hyperdynamic circulation characterized by increased cardiac output, decreased total vascular resistance, and no change in arterial pressure; however, in the study group volume expansion induced a pressor response without hyperdynamic circulation.

CONCLUSION

During pregnancy volume expansion induces a hyperdynamic circulatory state possibly mediated by nitric oxide release. A defect in the release of nitric oxide may be responsible for an inadequate hemodynamic response to volume expansion.

Role of nitric oxide and prostaglandins in the regulation of blood pressure in conscious rats

The present study was designed to investigate the possible role of endothelium-derived vasodilators, nitric oxide and prostaglandins, in the regulation of blood pressure during the presence and absence of the major pressor systems. Conscious rats were infused with a cocktail of inhibitors of the sympathetic nervous system, renin-angiotensin system, and V1 vascular receptor to vasopressin (achieved with hexamethonium, captopril, phentolamine, propranolol, and the V1 vasopressin (AVP) antagonist des-(CH2)5Tyr(Me)-AVP). The cocktail of vasoconstrictor inhibitors induced a marked fall of mean arterial pressure (MAP) from 109 +/- 2 to 52 +/- 2 mmHg (1 mmHg = 133.3 Pa) (n = 24). In animals with blockade, the specific inhibitor of nitric oxide synthesis, NG-nitro-L-arginine methyl ester (L-NAME), induced a significant increase of MAP from 51 +/- 1 to 84 +/- 2 mmHg (n = 6). In the presence of indomethacin, a cyclooxygenase inhibitor, the pressor response to L-NAME was from 52 +/- 2 to 126 +/- 4 mmHg (n = 6). Neither indomethacin (n = 6) nor vehicle (n = 6) alone altered MAP. In intact animals without blockade, L-NAME caused a similar increase of MAP when it was injected alone (from 107 +/- 3 to 144 +/- 4 mmHg, n = 7) or with indomethacin (from 113 +/- 3 to 144 +/- 3, n = 6). Indomethacin alone (n = 8) did not change MAP. In conclusion, in the absence of the major pressor systems, the pressor effect of the inhibition of the production of endogenous nitric oxide and vasodilator prostanoid synthesis appears to be synergistic. These results suggest that these two endogenous vasodilators are involved in the maintenance of blood pressure.

Evaluation of vascular tone in portacaval shunts comparing the index of contractility and resistance in cats

A model of prehepatic chronic portal hypertension in cats was used to determine portacaval shunt responses to infused norepinephrine and to possible transmitter overflow into portal blood from nerves supplying the gut. Responses are compared using a new index of contractility. Four weeks after application of a slowly constricting occluder, the portal vein was completely occluded and acute experiments were carried out under pentobarbital anesthesia. Portal pressure was elevated to 15.0 +/- 0.9 mmHg and all portal flow passed through the shunts. In response to intraportal norepinephrine (0.25, 0.5 and 1.25 micrograms.min-1.kg-1) shunt resistance rose by 6% +/- 3%, 19% +/- 4% and 26% +/- 5%, respectively, whereas the index of contractility rose (by 22% +/- 8%, 46% +/- 10% and 89% +/- 20%, respectively), the distending blood pressure also rose (5% +/- 1%, 7% +/- 1% and 14% +/- 3%, respectively). The difference in percentage increase of resistance and the index of contractility is a result of the passive dilator effect of the elevated distending pressure acting on the distensible shunt vessels. Stimulation of mesenteric nerves caused the mesenteric artery to constrict, but the shunt vessels showed no effect. In conclusion, the shunt vessels respond actively to norepinephrine and passively to altered distending pressure. However, transmitter overflow from nerves supplying the intestines is unlikely to play a role in determining resistance in the shunts. Vascular resistance is affected by both active and passive effects, so that the active contractile responses are best evaluated using the index of contractility, which is not altered passively.

N-acetyl-L-cysteine potentiates depressor response to captopril and enalaprilat in SHRs

Recently, in vivo and in vitro studies have implicated nitric oxide as a mediator of the vascular effects of angiotensin-converting enzyme inhibitors (ACEIs). In the present study we hypothesized that N-acetyl-L-cysteine (NAC), by increasing the availability of reduced sulfhydryl groups, would enhance the antihypertensive response to the ACEIs captopril and enalaprilat by a mechanism dependent on nitric oxide. The experiments were performed on instrumented, indomethacin-pretreated, awake spontaneously hypertensive rats (SHRs). Thirty minutes after a bolus of captopril (10 mg/kg iv) was administered, blood pressure decreased from 167 +/- 5 to 147 +/- 6 mmHg (n = 8). The pretreatment with the donor of thiol groups NAC (300 mg/kg iv) potentiated the depressor response to captopril because blood pressure decreased from 172 +/- 3 to 139 +/- 4 mmHg (n = 6). At the dose of 60 micrograms/kg iv, the ACEI enalaprilat did not acutely modify the blood pressure of SHRs (from 172 +/- 5 to 167 +/- 4 mmHg; n = 6). However, when the SHRs were pretreated with NAC, the same dose of enalaprilat significantly reduced blood pressure from 176 +/- 5 to 151 +/- 5 mmHg (n = 6). This potentiation of the depressor response to ACEIs, due to NAC, was not observed when SHRs were pretreated with the nitric oxide inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 50 micrograms.kg-1.min-1 iv). The results of this study suggest that NAC, a donor of sulfhydryl groups, potentiates the antihypertensive response to captopril and enalaprilat in SHR by a nitric oxide-dependent mechanism.

Distensibility of portacaval shunts in portal hypertensive cats: index of contractility model

Complete shunting of portal blood flow through portacaval shunts was obtained using a constrictor around the portal vein to gradually produce a total occlusion. After 4 weeks, acute experiments were conducted in anesthetized cats. Blood from the femoral artery was shunted through a pump to supply and control the entire portal blood flow. As shunted portal blood flow was varied over a wide range, the portal shunt resistance showed distensibility. Decreasing portal venous pressure from 15.0 +/- 0.9 to 11.1 +/- 0.6 mmHg (1 mmHg = 133.3 Pa) resulted in elevations of resistance of 58%. The relation between the resistance (R) and the distending pressure (Pd) was a constant, the index of contractility (IC), where IC = R.Pd3. In steady state, the IC was 485 +/- 55 mmHg4.mL-1.min.kg and did not change passively in response to changes in portal blood flow. In conclusion, portacaval shunts are passively distensible, and resistance is altered as a cubic function of the distending pressure. Because resistance is altered both actively and passively, the IC should prove useful to differentiate these alternatives for evaluation of changes in portal hypertensive therapy.

Cardiovascular effects of angiotensin II and vasopressin in intact awake rats

1. In this study we evaluated, in intact awake rats, the effects of angiotensin II (AII) and vasopressin (AVP) on venous tone to explain their different hemodynamic effects. 2. Cardiac index (CI) was measured by thermodilution. AII and AVP were infused at the doses adjusted to increase mean arterial pressure 25, 50 and 70% above baseline. Lower doses of AVP than AII were necessary to increase mean arterial pressure at the same levels. 3. To study whether the different effects of AII and AVP on CI may be explained by their different actions on the venous system, changes in venous tone were evaluated by measuring mean circulatory filling pressure (MCFP) and determining the pressure gradient for venous return (PGVR). 4. AVP induced a decrease in CI from 32.5 +/- 2.2 to 23.1 +/- 1.7 and 15.4 +/- 0.8 ml/min/100 g (P < 0.01) with the second and third level of increase in afterload respectively, whereas AII at the same levels of afterload decreased CI from 34.8 +/- 1.3 to 28.3 +/- 2.3 and 23.4 +/- 1.7 ml/min/100 g (P < 0.01). Furthermore, the rise in total peripheral resistances (TPR) was greater with AVP than with AII at the highest level of afterload (P < 0.05). Heart rate significantly decreased more in the animals infused with AVP than with AII. 5. There were no changes in MCFP and PGVR with either AII or AVP. 6. These results indicate that in intact awake rats the larger fall in CI induced by AVP can not be explained only by a greater decrease in HR since at highest levels of afterload AVP decreased SV.(ABSTRACT TRUNCATED AT 250 WORDS)

Indomethacin does not modify the role of nitric oxide on blood pressure regulation of SHR

1. The endothelium-dependent relaxation is impaired in spontaneously hypertensive rats (SHR) by the release of a vasoconstrictor prostanoid. We evaluated whether such a vasoconstrictor prostanoid is masking the vasodilatation induced by nitric oxide (NO). 2. For this we observed, in SHR, whether indomethacin (INDO) modified both the pressor response to the inhibition of NO biosynthesis with L-nitro-arginine methyl ester (L-NAME) and the acute hypotensive response to acetylcholine. 3. INDO did not modify basal mean arterial pressure (MAP), either the pressor response to L-NAME, or the depressor response to acetylcholine. 4. It shows that, in awake SHR, a vasoconstrictor prostanoid, did not seem to affect the acute regulatory function of NO on MAP.

Development of portacaval shunts in portal-stenotic cats

The goal of the present study was to investigate the formation of portacaval shunts in a new experimental model of chronic portal hypertension, portal vein stenosis in the cat. The procedure gradually occluded the portal vein by use of an Ameroid constrictor around the portal vein. After 4 weeks, the portal vein was completely occluded and portal venous pressure was elevated to 15.6 +/- 0.3 mmHg (1 mmHg = 133.3 Pa) (n = 8). The hemodynamic changes did not affect the functional capacity of the liver. Latex injection was used to study the shunts. This revealed the spontaneous development of porta-systemic collaterals in all hypertensive cats, mainly between the gastrosplenic and right gastroepiploic veins and the left renal vein. Fine small branches also drained directly into the cava. The left renal vein was markedly dilated in all cats. Collateral circulation also developed between the inferior vena cava and the inferior mesenteric vein through both left internal testicular and iliolumbar veins. Some branches of the inferior mesenteric vein were connected directly to the cava. Esophageal varices in the mucosa or submucosa were not demonstrated. However, the presence of latex in the pulmonary veins and the visualization of periesophageal collaterals suggest the opening of porta-pulmonary shunts. A constant feature in all cats was the presence of a dilated azygos vein, which drained collaterals retroperitoneally and from the abdominal wall. In conclusion, an experimental model of prehepatic portal hypertension of gradual onset has been developed in cats. The formation of the porta-systemic shunts mimics other animal models and the human form of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Limited cardiac preload reserve in conscious cirrhotic rats

In conscious rats with experimental cirrhosis without ascites, we have studied whether there is a limited cardiac preload reserve by performing cardiac output (CO) curves. CO was determined by thermodilution at basal, 5, 7.5, and 10 cmH2O of right atrial pressure (RAP). RAP was elevated by dextran infusion (1 ml/min iv, 30 min). CO curves were performed by plotting changes in CO with changes in RAP. In the basal state, cirrhotic rats showed a hyperdynamic circulation defined by increased CO and stroke volume, decreased total peripheral resistances, and normotension without changes in heart rate. Blood volume was also elevated in cirrhotic rats compared with the control animals. Between the limits of RAP studied, the CO curve of control rats presented a typical ascending limb. In contrast, the CO curve of the cirrhotic animals showed first an ascending shifted upward limb and afterward a descending limb. These alterations were accompanied by changes in the inotropic state as measured as left ventricular (LV) peak dP/dt in hexamethonium-pretreated animals submitted to the same volume loads described above. With the same increases in RAP, LV dP/dt changed, in every group, in a manner similar to CO. The results of the present study indicate that cirrhotic rats with high blood volume and hyperdynamic circulation show, in the steady state, a limited preload reserve. The partial utilization of the preload reserve can make the cirrhotic heart unable to modulate cardiac performance with changes in loading conditions, thus determining a state of heart failure.

Effects of converting-enzyme inhibitor on hemodynamic actions of ANP in renal hypertensive rats

In the present study, we have evaluated whether the hemodynamic effects of atrial natriuretic peptide (ANP) infusion in two-kidney, one-clip (2K, 1C) hypertensive rats are mediated by inhibition of the renin-angiotensin system (RAS). Hemodynamic determinations were performed by thermodilution in conscious, chronically instrumented animals. ANP (1.5 micrograms.kg-1.min-1) and converting-enzyme (CE) inhibitor captopril (1 mg/kg plus 1 mg.kg-1.h-1), produced a similar fall of blood pressure through different hemodynamic mechanisms. ANP induced hypotension by decreasing cardiac index (CI; from 337.3 +/- 24.9 to 255.1 +/- 21.3 ml.min-1.kg-1, P less than 0.001), whereas a fall in total peripheral resistance (TPR) was observed during CE inhibition (from 0.568 +/- 0.02 to 0.488 +/- 0.02 mmHg.min.ml-1.kg, P less than 0.05). In addition, the ANP-induced decrease in CI was not significantly modified by previous CE inhibition. Furthermore, the decrease in TPR induced by CE inhibition did not change when CE inhibitor was administered during ANP treatment. The results of the present study indicate that the acute hemodynamic responses to ANP in 2K, 1C hypertensive rats are not mediated through antagonism of the vasoconstrictor actions of the RAS.