cardiovascular physiology qiang xia (夏强), phd department of physiology room c518, block c,...

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Cardiovascula r Physiology Qiang XIA ( ), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: [email protected]

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Page 1: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Cardiovascular Physiology

Qiang XIA ( 夏强 ), PhDDepartment of Physiology

Room C518, Block C, Research Building, School of MedicineTel: 88208252

Email: [email protected]

Page 2: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Regulation of Cardiovascular Activities

Lecture Outline

•Nervous Regulation

•Humoral Regulation

•Autoregulation

Page 3: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Nervous Regulation

Page 4: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Innervation of cardiovascular system

Page 5: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Nervous regulation of the circulation

Page 6: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Cardiac mechanisms of norepinephrine

Page 7: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Mechanisms of norepinephrine

—increase Na+ & Ca2+ permeability

• If , phase 4 spontaneous depolarization,

autorhythmicity

• Ca2+ influx , phase 0 amplitude & velocity ,

conductivity

• Ca2+ influx , Ca2+ release , [Ca2+ ]i , contractility

Page 8: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Asymmetrical innervation of sympathetic nerve

Page 9: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Cardiac mechanisms of acetylcholine

Page 10: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Mechanisms of acetylcholine

—increase K+ & decrease Ca2+ permeability

• K+ outward , |MRP| , phase 4 spontaneous

depolarization , autorhythmicity

• Inhibition of Ca2+ channel, phase 0 amplitude &

velocity , conductivity

• Ca2+ influx , [Ca2+ ]i , contractility

Page 11: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Cardiac effect of parasympathetic stimulation

Page 12: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Interaction of sympathetic and parasympathetic nerves

Page 13: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Predominance of autonomic nerves

Page 14: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Cardiovascular Center

A collection of functionally similar neurons that

help to regulate HR, SV, and blood vessel tone

Page 15: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Vasomotor center

Located bilaterally mainly in the reticular substance of the medulla and of the lower third of the pons

– Vasoconstrictor area– Vasodilator area– Cardioinhibitor area – dorsal nuclei of the

vagus nerves and ambiguous nucleus

– Sensory area – tractus solitarius

Page 16: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Vasomotor center

Page 17: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

– Reticular substance

of the pons

– Mesencephalon

– Diencephalon

– Hypothalamus

– Cerebral cortex

– Cerebellum

Higher cardiovascular centers

Page 18: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Baroreceptor Reflexes

• Arterial baroreceptors– Carotid sinus receptor– Aortic arch receptor

• Afferent nerves (Buffer nerves)

• Cardiovascular center: medulla• Efferent nerves: cardiac sympathetic nerve,

sympathetic constrictor nerve, vagus nerve• Effector: heart & blood vessels

Page 19: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Baroreceptor neurons function as sensors in the homeostatic maintenance of MAP by constantly monitoring pressure in the aortic arch and carotid sinuses.

Page 20: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 21: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Characteristics of baroreceptors:

Sensitive to stretching of the vessel walls

Proportional firing rate to increased

stretching

Responding to pressures ranging from 60-

180 mmHg

Receptors within the aortic arch are less

sensitive than the carotid sinus receptors

Page 22: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 23: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

The action potential frequency in baroreceptor neurons is represented here as being directly proportional to MAP.

Page 24: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Baroreceptor neurons deliver MAP information to the medulla oblongata’s cardiovascular control center (CVCC);the CVCC determines autonomic output to the heart.

i.e., MAP is above

homeostatic set point

i.e., reduce cardiac output

Page 25: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Reflex pathway

Page 26: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Click here to play theBaroreceptor Reflex Control

of Blood PressureFlash Animation

Page 27: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Typical carotid sinus reflex

Page 28: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Maintaining relatively

constant arterial

pressure, reducing the

variation in arterial

pressure

Physiological Significance

Page 29: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Other Cardiovascular Reflexes

Click here to play theChemoreceptor Reflex Control

of Blood PressureFlash Animation

Page 30: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Humoral Regulation

• Vasoconstrictor agents• Vasodilator agents

Page 31: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Renin-angiotensin system

Page 32: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Juxtaglomerular cell

Renin

Page 33: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

– Constricts resistance vessels

– Acts upon the adrenal cortex to release aldosterone

– Stimulates the release of vasopressin

– Facilitates norepinephrine release from sympathetic nerve endings

– Stimulates thirst centers within the brain

Physiological effects of angiotensin II

Page 34: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Epinephrine & Norepinephrine

• Sources

Epinephrine----

adrenal medulla

Norepinephrine----

adrenal medulla

sympathetic nerves

Page 35: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Catecholamines

Norepinephrine

Epinephrine

Page 36: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Effects Epinephrine Norepinephrine

Receptor -adrenoceptor ++ +++

-adrenoceptor ++ +

Heart heart rate + + (in vitro)

- (in vivo)

cardiac output +++ ±

Vessels constriction (skin, visceral) + +++

relaxation (SM, liver) - +++

total peripheral resistance ± +++

Blood pressure systolic +++ +++

diastolic ± ++

MAP + ++

Clinical application positive inotropic pressor agent

agent

Page 37: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 38: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Vasopressin (antidiuretic hormone, ADH)

Page 39: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 40: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Endothelium-derived vasoactive substances

•Vasodilator factors

PGI2--prostacyclin

EDRF, NO--endothelium-derived relaxing factor, nitric oxide

EDHF--endothelium-dependent hyperpolarizing factor

•Vasoconstrictor factors Endothelin

Page 41: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Atrial natriuretic peptide (ANP)

•Produces natriuresis and diuresis •Decreases renin release•Reduces total peripheral resistance via vasodilatation•Decreases heart rate, cardiac output

Page 42: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

Autoregulation

Definition:

Intrinsic ability of an organ to maintain a constant

blood flow despite changes in perfusion pressure,

independent of any neural or humoral influences

Page 43: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 44: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn
Page 45: Cardiovascular Physiology Qiang XIA (夏强), PhD Department of Physiology Room C518, Block C, Research Building, School of Medicine Tel: 88208252 Email: xiaqiang@zju.edu.cn

The End.