Summary
Previous investigations suggest that in a normotensive organism the vasopressor effect of 8-arginine-vasopressin (AVP) is very effectively buffered by cardiovascular reflex mechanisms. Exogenous AVP administration shows only small, transient increases in blood pressure in spite of continued AVP-infusion and high plasma AVP concentrations. The present study aims to clarify the mechanism of the observed transient blood pressure elevations which are often referred to as “tachyphylaxis”.
Our results in healthy subjects show a two phase response to exogenous AVP: an initial phase which is characterized by cardiac reflex mechanisms and a second phase during which a normalisation of the elevated total peripheral resistance occurs. Inhibition of prostaglandin synthesis with indomethacin almost completely attenuates this vascular counterregulation to exogenous AVP, thus providing evidence that a prostaglandin mediated vasodilation in response to AVP may be the underlying mechanism for “vasopressin tachyphylaxis”. The role of the renin-angiotensin-system and the importance of different regional hemodynamic effects of AVP are discussed.
Zusammenfassung
Bisher vorliegende Untersuchungen lassen vermuten, daß in einem normotensiven Organismus der vasopressorische Effekt von 8-Arginin-Vasopressin (AVP) effektiv durch cardiovaskuläre Reflexe abgeschwächt wird. Die Gabe von exogenem AVP führt zu nur vorübergehenden Pressorreaktionen trotz fortgeführter ADH-Infusion und deutlich erhöhter Plasma-AVP-Konzentrationen. Die vorliegende Untersuchung versucht den Mechanismus der nur vorübergehenden Blutdruckerhöhungen, die oft als “Tachyphylaxie” bezeichnet werden, weiter zu charakterisieren.
Unsere Ergebnisse bei gesunden Versuchspersonen zeigen einen zweiphasigen Verlauf nach i.v. Gabe von AVP: eine initiale Phase, die durch cardiovaskuläre Reflexe gekennzeichnet ist und eine zweite Phase, während der sich der periphere Gefäßwiderstand normalisiert. Hemmung der Prostaglandin-Synthese mit Indomethacin schwächt die vaskuläre Gegenregulation auf exogenes AVP ab und läßt so eine prostaglandinvermittelte Vasodilatation als Reaktion auf AVP als Ursache der „Vasopressintachyphylaxie“ vermuten. Die Bedeutung des Renin-Angiotensin-Systems und unterschiedlicher regionaler hämodynamischer Effekte von AVP werden diskutiert.
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Dedicated to Professor F. Krück on the occasion of his 60th birthday
Supported by Ministerium für Wissenschaft und Forschung NRW Grant Nr.: FA 8871 and Herbert Reeck-Stiftung Bonn
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Glänzer, K., Prüßing, B., Düsing, R. et al. Hemodynamic and hormonal responses to 8-arginine-vasopressin in healthy man: Effects of indomethacin. Klin Wochenschr 60, 1234–1239 (1982). https://doi.org/10.1007/BF01716729
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DOI: https://doi.org/10.1007/BF01716729