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Zhou J, Zhang B, Zhou X, Zhang F, Shu Q, Wu Y, Chang HM, Hu L, Cai RL, Yu Q. Electroacupuncture pretreatment mediates sympathetic nerves to alleviate myocardial ischemia-reperfusion injury via CRH neurons in the paraventricular nucleus of the hypothalamus. Chin Med 2024; 19:43. [PMID: 38448912 PMCID: PMC10916233 DOI: 10.1186/s13020-024-00916-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Myocardial ischemia-reperfusion can further exacerbate myocardial injury and increase the risk of death. Our previous research found that the paraventricular nucleus (PVN) of the hypothalamus plays a crucial role in the improvement of myocardial ischemia-reperfusion injury (MIRI) by electroacupuncture (EA) pretreatment, but its mechanism of action is still unclear. CRH neurons exhibit periodic concentrated expression in PVN, but further research is needed to determine whether they are involved in the improvement of MIRI by EA pretreatment. Meanwhile, numerous studies have shown that changes in sympathetic nervous system innervation and activity are associated with many heart diseases. This study aims to investigate whether EA pretreatment improves MIRI through sympathetic nervous system mediated by PVNCRH neurons. METHODS Integrated use of fiber-optic recording, chemical genetics and other methods to detect relevant indicators: ECG signals were acquired through Powerlab standard II leads, and LabChart 8 calculated heart rate, ST-segment offset, and heart rate variability (HRV); Left ventricular ejection fraction (LVEF), left ventricular short-axis shortening (LVFS), left ventricular end-systolic internal diameter (LVIDs) and interventricular septal thickness (IVSs) were measured by echocardiography; Myocardial infarct area (IA) and area at risk (AAR) were calculated by Evans-TTC staining. Pathological changes in cardiomyocytes were observed by HE staining; Changes in PVNCRH neuronal activity were recorded by fiber-optic photometry; Sympathetic nerve discharges were recorded for in vivo electrophysiology; NE and TH protein expression was assayed by Western blot. RESULTS Our data indicated that EA pretreatment can effectively alleviate MIRI. Meanwhile, we found that in the MIRI model, the number and activity of CRH neurons co labeled with c-Fos in the PVN area of the rat brain increased, and the frequency of sympathetic nerve discharge increased. EA pretreatment could reverse this change. In addition, the results of chemical genetics indicated that inhibiting PVNCRH neurons has a similar protective effect on MIRI as EA pretreatment, and the activation of PVNCRH neurons can counteract this protective effect. CONCLUSION EA pretreatment can inhibit PVNCRH neurons and improve MIRI by inhibiting sympathetic nerve, which offers fresh perspectives on the application of acupuncture in the management of cardiovascular disease.
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Affiliation(s)
- Jie Zhou
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Bin Zhang
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Xiang Zhou
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Fan Zhang
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Qi Shu
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Yan Wu
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Hui-Min Chang
- College of Acupuncture and Moxibustion, Anhui University of Chinese Medicine, Hefei, 230012, China
| | - Ling Hu
- Institute of Acupuncture and Meridian Research, Anhui Academy of Chinese Medicine, Hefei, 230038, China
- Key Laboratory of Xin'an Medicine, Ministry of Education, Hefei, 230038, China
| | - Rong-Lin Cai
- Center for Xin'an Medicine and Modernization of Traditional Chinese Medicine, Insitute of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, 230601, China.
- Institute of Acupuncture and Meridian Research, Anhui Academy of Chinese Medicine, Hefei, 230038, China.
- Anhui Province Key Laboratory of Meridian Viscera Correlationship, Hefei, 230038, China.
- Key Laboratory of Xin'an Medicine, Ministry of Education, Hefei, 230038, China.
| | - Qing Yu
- Institute of Acupuncture and Meridian Research, Anhui Academy of Chinese Medicine, Hefei, 230038, China.
- Anhui Province Key Laboratory of Meridian Viscera Correlationship, Hefei, 230038, China.
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Grassi G, Dell'Oro R, Bombelli M, Cuspidi C, Quarti-Trevano F. High blood pressure with elevated resting heart rate: a high risk "Sympathetic" clinical phenotype. Hypertens Res 2023; 46:2318-2325. [PMID: 37500715 DOI: 10.1038/s41440-023-01394-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/04/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
Epidemiological studies have unequivocally shown that elevated heart rate values measured at rest have an adverse prognostic impact in the hypertensive patient, being associated with an increased risk of cardiovascular events and complications. In recent years new data have been collected on this issue, strengthening the clinical relevance of elevated heart rate as a specific hypertensive phenotype. The present paper will review old and new data on the prognostic importance of resting tachycardia in the hypertensive patient. It will also examine the role of the sympathetic nervous system in the development of this alteration as well as its therapeutic implications. The different approaches to dynamically assess heart rate values in the clinical setting will be finally discussed.
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Affiliation(s)
- Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
| | - Raffaella Dell'Oro
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Michele Bombelli
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Cesare Cuspidi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Fosca Quarti-Trevano
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Seravalle G, Vanoli J, Molisano C, Merati V, Grassi G. Heart rate thresholds for cardiovascular risk and sympathetic activation in the metabolic syndrome. Acta Diabetol 2022; 59:1429-1435. [PMID: 35904642 PMCID: PMC9519654 DOI: 10.1007/s00592-022-01945-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/14/2022] [Indexed: 12/03/2022]
Abstract
AIMS We examined whether to what extent resting heart rate (HR) values are capable to reflect in the metabolic syndrome (MS) a different degree of sympathetic activation. We also thought to determine at which HR cutoff values the sympathetic nervous system becomes more activated in the MS. METHODS In 70 MS patients aged 55.5 ± 1.8 (mean ± SEM) years we evaluated muscle sympathetic nerve traffic (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC assay), subdividing the study population in three different subgroups according to resting clinic and 24-h HR values (< 70, 70-79 and ≥ 80 beats/min). RESULTS MS patients with clinic HR values ≥ 80 beats/min displayed MSNA and NE values significantly increased when compared to those found in MS with HR between 70 and 79 beats/min or below 70 beats/min (MSNA: 55.2 ± 0.9 vs 44.6 ± 0.6 and 39.2 ± 0.6 bursts/min, P < 0.01, NE: 403.9 ± 6.9 vs 330.1 ± 4.3 and 258.3 ± 6.8 pg/ml, respectively, P < 0.01). A similar behavior was observed for 24-h HR. In the group as a whole both MSNA and plasma NE showed highly significant direct relationships with clinic HR, the correlation being similar for MSNA and NE (r = 0.89 and r = 0.91, P < 0.01 for both) Similar significant relationships were also found between 24-h HR values and MSNA or NE. CONCLUSIONS In the MS HR values ≥ 80 beats/min are associated with an increased sympathetic activation, both when assessed by direct recording of MSNA and when evaluated as plasma NE. The sympathetic overdrive parallels for magnitude the HR elevations, this being the case for both clinic and 24-h HR.
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Affiliation(s)
- Gino Seravalle
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Jennifer Vanoli
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Concetta Molisano
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Valeria Merati
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy.
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Seravalle G, Facchetti R, Cappellini C, Annaloro A, Gelfi E, Grassi G. Elevated heart rate as sympathetic biomarker in human obesity. Nutr Metab Cardiovasc Dis 2022; 32:2367-2374. [PMID: 35970685 DOI: 10.1016/j.numecd.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIM The present study was aimed at determining whether and to what extent a specific heart rate (HR) cutoff value allows to identify in obeses a more pronounced level of adrenergic overdrive. METHODS AND RESULTS In 86 obese subjects aged 44.7 ± 0.9 (mean ± SEM) years and in 45 heathy lean controls of similar age we evaluated muscle sympathetic nerve traffic (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC assay), subdividing the subjects in 3 different groups according to their resting clinic and 24-h HR values (<70, 70-79 and 80-89 beats/minute). MSNA and plasma NE values detected in the three obese groups were almost superimposable each other, no significant difference between groups being observed. A similar behavior was observed when HR values were assessed during the 24-h Holter monitoring. In the group as a whole no significant relationship was detected between MSNA, plasma NE and clinic HR, this being the case also when 24-h HR replaced clinic HR in the correlation analysis. In contrast lean controls displayed a progressive significant increase in MSNA values form the group with clinic (and 24 Holter) values below 70 beats/minute to the ones with HR values between 70 and 79 and above 80 beats/minute. CONCLUSIONS In the obese state measurement of resting HR may allow to provide some general information on the functional status of the adrenergic cardiovascular drive. When the information required, however, are more subtle the sensitivity of the approach appears to be reduced and HR cannot be regarded as a faithful sympathetic biomarker.
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Affiliation(s)
- Gino Seravalle
- IRCCS Istituto Auxologico Italiano, Cardiology Department, St Luca Hospital, Piazza Brescia Milan, Italy
| | - Rita Facchetti
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Cecilia Cappellini
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessandra Annaloro
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Elia Gelfi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
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