Regulation of Organ Blood Flow

Mark T Ziolo, PhD, FAHA

Associate Professor, Physiology & Cell Biology 019 Hamilton Hall 614-688-7905 ziolo.1@osu.edu

Objectives
Describe the regulation of organ blood flow by myogenic regulation and autoregulation (intrinsic tone, neuronal influence, local or metabolic influence, hormonal influence) Describe active and reactive hyperemia

Detailed Objectives
Understand the myogenic regulation and the autoregulation of blood flow Know the mechanism of myogenic regulation Know how the different factors (intrinsic tone, neuronal influence, local (metabolic) influence, and hormonal influence) responsible for autoregulation regulate blood flow Understand the role of active and reactive hyperemia Understand how control of flow is different between organs with strong local (metabolic) control of arterial tone and organs with strong neuronal control of arterial tone

References
Mohrman DE, Heller LJ. Cardiovascular Physiology Seventh Edition. Lange Medical Books/McGraw-Hill Publishers, 2010. Berne RM, Levy MN. Cardiovascular Physiology Sixth Edition. Mosby-Year Book, Inc., 2010. MediaPhys 3.0. An Introduction to Human Physiology. The McGraw-Hill Publishers, 2010.

Myogenic Regulation

Myogenic Regulation

Vital Organ

Myogenic Regulation

Vital Organ Pressure

Myogenic Regulation

Vital Organ Pressure

Myogenic Regulation

Autoregulation

Myogenic Regulation
Smooth muscle contracts in response to an increase in transmural pressure Smooth muscle relaxes in response to a decrease in transmural pressure

Autoregulation- with metabolic demand

Muscle

Autoregulation- with metabolic demand

Muscle

Working

Autoregulation- with metabolic demand

Muscle

Working

Autoregulation
Factors Responsible:

Intrinsic tone Neuronal Influences Local Influences Hormonal Influences

Intrinsic Tone
Arterioles remain partially constricted even when all external influences are removed This baseline is what external influences adjust

Neuronal Influences
Fibers innervate arterioles in ALL systemic organs These fibers release NE proportionally to their electrical activity

Acts via a-adrenergic receptors Via decrease membrane potential & increase in AP frequency

Increases vascular tone

Parasympathetic may act on the external genitalia for vasodilation

Local (metabolic) Influences

Smooth muscle is exposed to the chemical composition of the interstitial fluid of the organ These substances reflect the balance of the organs metabolic activity and blood supply to that organ

O2*, CO2, H+, K+, lactic acid, phosphate adenosine

* Pulmonary circulation

Local (metabolic) Influences

Release proportional to tissue metabolism

Tissue Cells

Vasodilator factors Removal rate proportional to blood flow

Blood Flow

Other Local Influences

Influences from Endothelial cells

Nitric oxide, endothelin

Prostaglandins (COX pathway)

Other influences

Some vasodilate, others vasoconstrict Vasodilation and increases permeability (swelling) Vasodilation via nitric oxide

Histamine

Bradykinin

Hyperemia

Active Hyperemia

Increased blood flow caused by enhanced tissue activity Metabolic (local) influence

Reactive Hyperemia
Increased blood flow after removal of occlusion Metabolic (local) influence AND myogenic regulation Reduced intravascular pressure Decreased stretch

Reactive Hyperemia

Metabolic vs Neuronal Control

Hormonal Influences
Under normal circumstances play a minor role in regulating blood flow Following hormones are vasoconstrictors

NE and E (hemorrhagic shock) ADH (hemorrhage) Angiotensin II (hypertension?)

Summary
Myogenic regulation maintains a constant organ blood flow (at constant levels of tissue metabolism) with changes in perfusion pressure. Changes in transmural pressure will change smooth muscle contraction Autoregulation is maintaining constant organ blood flow which occurs via myogenic regulation Intrinsic tone is the remaining constriction of the arterioles when all external influences are removed. This is what the other influences adjust Neuronal tone is activation of the sympathetic fibers increasing vascular tone (i.e., vasoconstriction) Local influence is the degree of smooth muscle contraction dependent upon the chemical composition of the interstitial fluid of the organ Hormonal influence plays a minor role in regulating blood flow except under various physiological (e.g., exercise) and/or pathological stresses

Summary, cont
Active hyperemia is increased blood flow caused by enhanced tissue activity due to local (metabolic) influence Reactive hyperemia is increased blood flow after removal of occlusion due to local (metabolic) influence and myogenic regulation Blood flow to some organs such as heart and skeletal muscle has a higher responsiveness to metabolic than neuronal control. Blood flow to other organs such as GI tract, spleen, pancreas, and liver has a higher responsiveness to neuronal than metabolic control

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Questions- mark.ziolo@osumc.edu

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