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Wang H, Wang W, Gao X, Wu D, Lu Q, Li C, Zheng S, Wang H. Effects of Postural Resonance on Skin Sympathetic Nerve Activity and Blood Pressure: A Pilot Study Evaluating Vascular Tone Baroreflex Stimulation Through Biofeedback. Appl Psychophysiol Biofeedback 2024; 49:205-218. [PMID: 38159163 DOI: 10.1007/s10484-023-09614-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
Heart rate and vascular tension baroreflex exhibit resonance characteristics at approximately 0.1 and 0.03 Hz. In this study, we aimed to induce postural resonance (PR) through rhythmic postural adjustments. To assess the viability of this technique, we investigated the acute impacts of postural resonance on blood pressure, sympathetic nerve activity, and mood. Fifteen healthy study participants, consisting of 8 males and 7 females, were selected for this self-controlled study. Skin sympathetic nerve activity was continuously monitored during both the intervention and stress test on the experimental day. After PR intervention, the diastolic blood pressure and mean arterial pressure in the PR group exhibited significant reductions compared to the CON group (P = 0.032, CON = 71.67 ± 2.348, PR = 64.08 ± 2.35; P = 0.041, CON = 75.00 ± 2.17, PR = 81.67 ± 2.17). After PR intervention both left brachial ankle pulse wave velocity and right brachial ankle pulse wave velocity exhibited a significant reduction compared to pre-intervention levels (from 1115.86 ± 150.08 to 1048.43 ± 127.40 cm/s, p < 0.001; 1103.86 ± 144.35 to 1060.43 ± 121.35 cm/s, p = 0.018). PR intervention also led to a significant decrease in burst frequency and duration (P = 0.049; CON = 8.96 ± 1.17, PR = 5.51 ± 1.17) and a noteworthy decrease in burst amplitude and burst threshold during the cold-pressor test (P = 0.002; P = 0.002). Additionally, VAS scores exhibited a substantial increase following PR (P = 0.035, CON = 28.4 ± 4.49, PR = 42.17 ± 4.10). PR can induce resonance effects within the cardiovascular system, resulting in the effective reduction of blood pressure, skin sympathetic nerve activity and pulse wave velocity, and decreased burst amplitude and burst threshold of the sympathetic nerve during the cold-pressor test.
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Affiliation(s)
- Hao Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Wendi Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Xiaolin Gao
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China.
| | - Dongzhe Wu
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China.
| | - Qiaopei Lu
- Sports Training Center, Institute of Sport Science, Beijing, China
| | - Chuangtao Li
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Sainan Zheng
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Haoruo Wang
- School of Sport Science, Beijing Sport University, Beijing, China
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Marôco JL, Arrais I, Silvestre T, Pinto M, Laranjo S, Magalhães J, Santa-Clara H, Fernhall B, Melo X. Post-acute exercise cardiovagal modulation in older male adults with and without type 2 diabetes. Eur J Appl Physiol 2024; 124:1475-1486. [PMID: 38117338 PMCID: PMC11055715 DOI: 10.1007/s00421-023-05357-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 10/28/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE We examined heart rate variability (HRV) and baroreflex sensitivity (BRS) disease- and age-related response at 10-and 60-min after an acute high-intensity interval (HIIE) and moderate continuous exercise (MICE) in older adults with and without type 2 diabetes mellitus (T2DM) and healthy young adults. METHODS Twelve older male adults with (57-84 years) and without T2DM (57-76 years) and 12 healthy young male adults (20-40 years) completed an isocaloric acute bout of HIIE, MICE, and a non-exercise condition in a randomized order. Time and Wavelets-derived frequency domain indices of HRV and BRS were obtained in a supine position and offline over 2-min time-bins using Matlab. RESULTS HIIE but not MICE reduced natural logarithm root mean square of successive differences (Ln-RMSSD) (d = - 0.85; 95% CI - 1.15 to - 0.55 ms, p < 0.001), Ln-high-frequency power (d = - 1.60; 95% CI - 2.24 to - 0.97 ms2; p < 0.001), and BRS (d = - 6.32; 95% CI - 9.35 to - 3.29 ms/mmHg, p < 0.001) in adults without T2DM (averaged over young and older adults without T2DM), returning to baseline 60 min into recovery. These indices remained unchanged in older adults with T2DM after HIIE and MICE. Older adults with T2DM had lower resting Ln-RMSSD and BRS than aged-matched controls (Ln-RMSSD, d = - 0.71, 95% CI - 1.16 to - 0.262 ms, p = 0.001; BRS d = - 3.83 ms/mmHg), 95% CI - 6.90 to - 0.76, p = 0.01). CONCLUSIONS Cardiovagal modulation following acute aerobic exercise is intensity-dependent only in adults without T2DM, and appears age-independent. These findings provide evidence of cardiac autonomic impairments in older adults with T2DM at rest and following aerobic exercise.
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Affiliation(s)
- João Luís Marôco
- Integrative Human Physiology Laboratory, Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, USA
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisbon, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana-Universidade de Lisboa, Oeiras, Portugal
| | - Inês Arrais
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisbon, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana-Universidade de Lisboa, Oeiras, Portugal
| | - Tiago Silvestre
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisbon, Portugal
- Faculdade de Ciências da Saúde e do Desporto, Universidade Europeia, Lisbon, Portugal
| | - Marco Pinto
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisbon, Portugal
| | - Sérgio Laranjo
- Department of Physiology, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center. NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - João Magalhães
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana-Universidade de Lisboa, Oeiras, Portugal
| | - Helena Santa-Clara
- Ginásio Clube Português, Research & Development Department, GCP Lab, Lisbon, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana-Universidade de Lisboa, Oeiras, Portugal
| | - Bo Fernhall
- Integrative Human Physiology Laboratory, Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Xavier Melo
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana-Universidade de Lisboa, Oeiras, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, Caparica, 2829-511, Almada, Portugal.
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Philbois SV, Facioli TP, De Lucca I, Veiga AC, Chinellato N, Simões MV, Tank J, Souza HCD. What do we know about the role of menopause in cardiovascular autonomic regulation in hypertensive women? Menopause 2024; 31:408-414. [PMID: 38564706 DOI: 10.1097/gme.0000000000002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE We investigated the systemic arterial hypertension effects on cardiovascular autonomic modulation and baroreflex sensitivity (BRS) in women with or without preserved ovarian function. METHODS A total of 120 women were allocated into two groups: middle-aged premenopausal women (42 ± 3 y old; n = 60) and postmenopausal women (57 ± 4 y old; n = 60). Each group was also divided into two smaller groups (n = 30): normotensive and hypertensive. We evaluated hemodynamic and anthropometric parameters, cardiorespiratory fitness, BRS, heart rate variability (HRV), and blood pressure variability. The effects of hypertension and menopause were assessed using a two-way analysis of variance. Post hoc comparisons were performed using the Student-Newman-Keuls test. RESULTS Comparing premenopausal groups, women with systemic arterial hypertension showed lower BRS (9.1 ± 4.4 vs 13.4 ± 4.2 ms/mm Hg, P < 0.001 ) and HRV total variance (1,451 ± 955 vs 2,483 ± 1,959 ms 2 , P = 0.005) values than normotensive; however, the vagal predominance still remained. On the other hand, both postmenopausal groups showed an expressive reduction in BRS (8.3 ± 4.2 vs 11.3 ± 4.8 ms/mm Hg, P < 0.001) and HRV characterized by sympathetic modulation predominance (low-frequency oscillations; 56% ± 17 vs 44% ± 17, P < 0.001), in addition to a significant increase in blood pressure variability variance (28.4 ± 14.9 vs 22.4 ± 12.5 mm Hg 2 , P = 0.015) compared with premenopausal groups. Comparing both postmenopausal groups, the hypertensive group had significantly lower values of HRV total variance (635 ± 449 vs 2,053 ± 1,720 ms 2 , P < 0.001) and BRS (5.3 ± 2.8 vs 11.3 ± 3.2 ms/mm Hg) than the normotensive. CONCLUSIONS Hypertensive middle-aged premenopausal women present HRV autonomic modulation impairment, but they still maintain a vagal predominance. After menopause, even normotensive women show sympathetic autonomic predominance, which may also be associated with aging. Furthermore, postmenopausal women with hypertension present even worse cardiac autonomic modulation.
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Affiliation(s)
- Stella V Philbois
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Tabata P Facioli
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Izabella De Lucca
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Ana C Veiga
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Naiara Chinellato
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Marcus V Simões
- Division of Cardiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Hugo C D Souza
- From the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
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彭 圣, 祁 雨, 孙 丽, 李 丹, 王 新, 韩 江, 陈 宝, 张 媛. [Afferent baroreflex failure with hyponatremia: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2024; 56:357-361. [PMID: 38595258 PMCID: PMC11004967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 04/11/2024]
Abstract
Afferent baroreflex failure (ABF) is a rare disease. It refers to the clinical syndrome caused by the impairment of the afferent limb of the baroreflex or its central connections at the level of the medulla. The recognized causes include trauma, surgery in related areas (radical neck tumor surgery, carotid endarterectomy), neck radiotherapy, brain stem stroke, tumor growth paraganglioma and hereditary diseases, among which the most common cause is extensive neck surgery or radiotherapy for neck cancer. The main manifestations are fluctuating hypertension, orthostatic hypotension, paroxysmal tachycardia and bradycardia. This case is a young man, whose main feature is blood pressure fluctuation, accom-panied by neurogenic orthostatic hypotension (nOH). After examination, the common causes of hypertension and nOH were ruled out. Combined with the previous neck radiotherapy and neck lymph node dissection, it was considered that the blood pressure regulation was abnormal due to the damage of carotid sinus baroreceptor after radiotherapy for nasopharyngeal carcinoma and neck lymph node dissection, which was called ABF. At the same time, the patient was complicated with chronic hyponatremia. Combined with clinical and laboratory examination, the final consideration was caused by syndrome of in- appropriate antidiuretic hormone (SIADH). Baroreceptors controlled the secretion of heart rate, blood pressure and antidiuretic hormone through the mandatory "inhibition" signal. We speculate that the carotid sinus baroreceptor was damaged after neck radiotherapy and surgery, which leads to abnormal blood pressure regulation and nOH, while the function of inhibiting ADH secretion was weakened, resulting in higher ADH than normal level and mild hyponatremia. The goal of treating ABF patients was to reduce the frequency and amplitude of sudden changes in blood pressure and heart rate, and to alleviate the onset of symptomatic hypotension. At present, drug treatment is still controversial, and non-drug treatment may alleviate some patients' symptoms, but long-term effective treatment still needs further study. The incidence of ABF is not high, but it may lead to serious cardiovascular and cerebrovascular events, and the mechanism involved is extremely complicated, and there are few related studies. The reports of relevant medical records warn that patients undergoing neck radiotherapy or surgery should minimize the da-mage to the baroreceptor in the carotid sinus in order to reduce the adverse prognosis caused by complications.
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Affiliation(s)
- 圣嘉 彭
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 雨 祁
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 丽杰 孙
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 丹 李
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 新宇 王
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 江莉 韩
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 宝霞 陈
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
| | - 媛 张
- />北京大学第三医院心内科, 卫生部心血管分子生物学与调节肽重点实验室, 北京 100191Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, Beijing 100191, China
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Crossley DA, Bagatto BP, Dzialowski EM, Burggren WW, Hicks JW. Short communication: Baroreflex function in embryonic emus (Dromiceius novaehollandiae). Comp Biochem Physiol A Mol Integr Physiol 2024; 290:111576. [PMID: 38220129 DOI: 10.1016/j.cbpa.2024.111576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
The baroreflex involves cardiovascular homeostatic mechanisms that buffer the system against acute deviations in arterial blood pressure. It is comprised of the cardiac limb which involves adjustments in heart rate and the peripheral limb which involves adjustments in vascular resistance. This negative feedback loop mechanism has been investigated in numerous species of adult vertebrates, however our understanding of the maturation and functional importance of the reflex in developing animals remains poorly understood. In egglaying species, our knowledge of this mechanism is limited to the domestic chicken embryo and the embryonic alligator. While each of these species possess a cardiac baroreflex prior to hatching, they differ in the timing when it becomes functional, with the embryonic chicken possessing the reflex at 90% of incubation, while the alligator possesses the reflex at 70% of incubation. In an effort to determine if bird species might share similar patterns of active baroreflex function, we studied embryonic emus (Dromiceius novaehollandiae). However, we hypothesized that emus would possess a pattern of baroreflex function similar to that of the American alligator given the emu embryo possesses functional vagal tone at 70% of incubation, possibly indicating a more mature collection of cardiovascular control mechanism than those found in embryonic chickens. Our findings illustrate that emu embryos possess a hypotensive baroreflex at 90% of incubation. Therefore, our data fail to support our original hypothesis. While only two species of birds have been studied in this context, it could indicate that baroreflex function is not essential for cardiovascular homeostasis in birds for the majority of in ovo development.
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Affiliation(s)
- Dane A Crossley
- Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, 1155 Union Circle #305220, Denton, TX 76203-5017, USA.
| | - Brian P Bagatto
- Department of Biology, The University of Akron, Akron, OH 44325, USA
| | - Ed M Dzialowski
- Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, 1155 Union Circle #305220, Denton, TX 76203-5017, USA
| | - Warren W Burggren
- Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, 1155 Union Circle #305220, Denton, TX 76203-5017, USA
| | - James W Hicks
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA 92697, USA
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Cordero Pereda D, de Rueda Panadero C, de Juan Bagudá J, Gómez Bueno M, Robles-Mezcua A, Álvarez-García J. Baroreflex activation therapy in patients with heart failure and reduced ejection fraction. Rev Esp Cardiol (Engl Ed) 2024; 77:342-344. [PMID: 37981190 DOI: 10.1016/j.rec.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023]
Affiliation(s)
- David Cordero Pereda
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | - Clemencia de Rueda Panadero
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Javier de Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | - Manuel Gómez Bueno
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Ainhoa Robles-Mezcua
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Servicio de Cardiología, Área del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Jesús Álvarez-García
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. https://twitter.com/@j_alvarezgarcia
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Takeda R, Hissen SL, Akins JD, Washio T, Hearon CM, MacNamara JP, Sarma S, Levine BD, Fadel PJ, Fu Q. Sympathetic Neural Control at Rest and During the Cold Pressor Test in Patients With Heart Failure With Preserved Ejection Fraction. Hypertension 2024; 81:917-926. [PMID: 38385250 PMCID: PMC10954398 DOI: 10.1161/hypertensionaha.123.21918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/06/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND We tested the hypothesis that patients with heart failure with preserved ejection fraction (HFpEF) would have greater muscle sympathetic nerve activity (MSNA) at rest and sympathetic reactivity during a cold pressor test compared with non-heart failure controls. Further, given the importance of the baroreflex modulation of MSNA in the control of blood pressure (BP), we hypothesized that patients with HFpEF would exhibit a reduced sympathetic baroreflex sensitivity. METHODS Twenty-eight patients with HFpEF and 44 matched controls (mean±SD: 71±8 versus 70±7 years; 9 men/19 women versus 16 men/28 women) were studied. BP, heart rate, and MSNA (microneurography) were measured during 6 to 10 minutes of supine rest and the 2-minute cold pressor test. Spontaneous sympathetic baroreflex sensitivity was assessed during supine rest. RESULTS Patients with HFpEF had higher resting MSNA burst frequency (39±14 versus 31±12 bursts/min; P=0.020) and lower sympathetic baroreflex sensitivity (-2.83±0.76 versus -3.57±1.19 bursts/100 heartbeats/mm Hg; P=0.019) than controls, but burst incidence was not different between groups (56±19 versus 50±20 bursts/100 heartbeats; P=0.179). During the cold pressor test, increases in MSNA indices did not differ between groups (P=0.135-0.998), but patients had a smaller increase in diastolic BP (Δ4±6 versus Δ14±11 mm Hg; P<0.001) compared with controls. CONCLUSIONS Despite augmented resting MSNA burst frequency, burst incidence was not significantly different between groups, and sympathetic baroreflex sensitivity was reduced in patients with HFpEF. Furthermore, patients had preserved sympathetic reactivity but attenuated diastolic BP responses during the cold pressor test. These data suggest that, during physiological stress, sympathetic reactivity is intact, but the peripheral pathway for sympathetic vasoconstriction may be impaired in HFpEF.
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Affiliation(s)
- Ryosuke Takeda
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah L. Hissen
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John D. Akins
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Takuro Washio
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Christopher M. Hearon
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - James P. MacNamara
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin D. Levine
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Paul J. Fadel
- University of Texas at Arlington, Arlington, Texas, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Katayama K, Shiozawa K, Lee JB, Seo N, Kondo H, Saito M, Ishida K, Millar PJ, Banno R, Ogoh S. Influence of sex on sympathetic vasomotor outflow responses to passive leg raising in young individuals. J Physiol Sci 2024; 74:19. [PMID: 38500058 PMCID: PMC10949681 DOI: 10.1186/s12576-024-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
The purpose of this study was to clarify sex differences in the inhibition of sympathetic vasomotor outflow which is caused by the loading of cardiopulmonary baroreceptors. Ten young males and ten age-matched females participated. The participants underwent a passive leg raising (PLR) test wherein they were positioned supine (baseline, 0º), and their lower limbs were lifted passively at 10º, 20º, 30º, and 40º. Each angle lasted for 3 min. Muscle sympathetic nerve activity (MSNA) was recorded via microneurography of the left radial nerve. Baseline MSNA was lower in females compared to males. MSNA burst frequency was decreased during the PLR in both males (- 6.2 ± 0.4 bursts/min at 40º) and females (- 6.5 ± 0.4 bursts/min at 40º), but no significant difference was detected between the two groups (P = 0.61). These results suggest that sex has minimal influence on the inhibition of sympathetic vasomotor outflow during the loading of cardiopulmonary baroreceptors in young individuals.
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Affiliation(s)
- Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, 464-8601, Japan.
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan.
| | - Kana Shiozawa
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Jordan B Lee
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Canada
| | - Natsuki Seo
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan
| | - Haruna Kondo
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, 464-8601, Japan
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Ryoichi Banno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, 464-8601, Japan
- Graduate School of Medicine, Nagoya University, Nagoya, 464-8601, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe, Japan
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9
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Chukwuemeka UM, Benjamin CP, Uchenwoke CI, Okonkwo UP, Anakor AC, Ede SS, Fabunmi AA, Amaechi IA, Akobundu UN. Impact of squatting on selected cardiovascular parameters among college students. Sci Rep 2024; 14:5669. [PMID: 38454093 PMCID: PMC10920734 DOI: 10.1038/s41598-024-56186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
Squatting is an active posture test used in assessing baroreflex sensitivity, and the array of patients a physiotherapist handles may benefit from this test to avoid the adverse effects of exercise. Therefore, this study is designed to evaluate the effect of squatting on heart rate and blood pressure among undergraduate students. 35 males (mean age = 22.94 ± 1.846) and 40 females (mean age = 22.28 ± 2.075) participated in this experimental study. Demographic data and baseline cardiovascular parameters (blood pressure and heart rate) were taken before exercise. The exercise protocol, the squatting stress test, was done for 2 min, after which post-exercise blood pressure and heart rate were taken at one minute each. A repeated measure ANOVA and independent t-test were used to analyse the difference at the 0.05 alpha level. It was found that there was a significant difference between pre-exercise in lying and squatting post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), pre-exercise in lying and standing post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), pre-exercise in standing and standing post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01), and pre-exercise in standing and squatting post-exercise blood pressure and heart rate in the first and second minutes (p < 0.01). Also, there was a significant difference in pre-exercise heart rate between lying and standing (p < 0.05) and not between the first minute and second minute post-squatting or standing exercise systolic blood pressure (p = 0.588) or diastolic blood pressure (p = 0.22-1). In conclusion, squatting trials among undergraduates revealed some statistically significant changes, especially between the cardiopulmonary parameters obtained in a standing position compared to lying and those measured after one minute. Therefore, caution should be observed when administering exercises that require changes in posture.
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Affiliation(s)
- Uchechukwu M Chukwuemeka
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
| | - Chimdindu P Benjamin
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Chigozie I Uchenwoke
- Department of Medical Rehabilitation, University of Nigeria, Enugu, Enugu State, Nigeria
| | - Uchenna P Okonkwo
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Anthony C Anakor
- Department of Physiology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Stephen S Ede
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
- School of Sports and Health Sciences, University of Central Lancashire, Preston, UK
| | - Ayodeji A Fabunmi
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ifeoma A Amaechi
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Uzoamaka N Akobundu
- Department of Medical Rehabilitation (Physiotherapy), Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
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10
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Brito LC, Azevêdo LM, Amaro-Vicente G, Costa LR, da Silva Junior ND, Halliwill JR, Rondon MUPB, Forjaz CLM. Evening but not morning aerobic training improves sympathetic activity and baroreflex sensitivity in elderly patients with treated hypertension. J Physiol 2024; 602:1049-1063. [PMID: 38377223 DOI: 10.1113/jp285966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
The blood pressure-lowering effect of aerobic training is preceded by improving cardiovascular autonomic control. We previously demonstrated that aerobic training conducted in the evening (ET) induces a greater decrease in blood pressure than morning training (MT). To study whether the greater blood pressure decrease after ET occurs through better cardiovascular autonomic regulation, this study aimed to compare MT versus ET on muscle sympathetic nerve activity (MSNA) and baroreflex sensitivity (BRS) in treated patients with hypertension. Elderly patients treated for hypertension were randomly allocated into MT (n = 12, 07.00-10.00 h) or ET (n = 11, 17.00-20.00 h) groups. Both groups trained for 10 weeks, 3 times/week, cycling for 45 min at moderate intensity. Beat-to-beat blood pressure (finger photoplethysmography), heart rate (electrocardiography) and MSNA (microneurography) were assessed at the initial and final phases of the study at baseline and during sequential bolus infusions of sodium nitroprusside and phenylephrine (modified-Oxford technique) to evaluate cardiac and sympathetic BRS. Mean blood pressure decreased significantly after ET but not after MT (-9 ± 11 vs. -1 ± 8 mmHg, P = 0.042). MSNA decreased significantly only after ET with no change after MT (-12 ± 5 vs. -3 ± 7 bursts/100 heart beats, P = 0.013). Sympathetic BRS improved after ET but not after MT (-0.8 ± 0.7 vs. 0.0 ± 0.8 bursts/100 heart beats/mmHg, P = 0.052). Cardiac BRS improved similarly in both groups (ET: +1.7 ± 1.8 vs. MT: +1.4 ± 1.9 ms/mmHg, Pphase ≤ 0.001). In elderly patients treated for hypertension, only ET decreased mean blood pressure and MSNA and improved sympathetic BRS. These findings revealed that the sympathetic nervous system has a key role in ET's superiority to MT in blood pressure-lowering effect. KEY POINTS: Reducing muscle nerve sympathetic activity and increasing sympathetic baroreflex sensitivity plays a key role in promoting the greater blood pressure reduction observed with evening training. These findings indicated that simply changing the timing of exercise training may offer additional benefits beyond antihypertensive medications, such as protection against sympathetic overdrive and loss of baroreflex sensitivity, independent markers of mortality. Our new findings also suggest new avenues of investigation, such as the possibility that evening aerobic training may be beneficial in other clinical conditions with sympathetic overdrive, such as congestive heart failure and hypertrophic cardiomyopathy.
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Affiliation(s)
- Leandro C Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Luan M Azevêdo
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Graziela Amaro-Vicente
- Laboratory of Autonomic Control of Circulation, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Luis R Costa
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Natan D da Silva Junior
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Maria U P B Rondon
- Laboratory of Autonomic Control of Circulation, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Cláudia L M Forjaz
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
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11
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Darling AM, Dominguez CM, Skow RJ, Mogle J, Saunders EFH, Fadel PJ, Greaney JL. Cardiac autonomic function is preserved in young adults with major depressive disorder. Am J Physiol Heart Circ Physiol 2024; 326:H648-H654. [PMID: 38214903 DOI: 10.1152/ajpheart.00762.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
The prevalence of major depressive disorder (MDD) is highest in young adults and contributes to an increased risk of developing future cardiovascular disease (CVD). However, the underlying mechanisms remain unclear. The studies examining cardiac autonomic function that have included young unmedicated adults with MDD report equivocal findings, and few have considered the potential influence of disease severity or duration. We hypothesized that heart rate variability (HRV) and cardiac baroreflex sensitivity (BRS) would be reduced in young unmedicated adults with MDD (18-30 yr old) compared with healthy nondepressed young adults (HA). We further hypothesized that greater symptom severity would be related to poorer cardiac autonomic function in young adults with MDD. Heart rate and beat-to-beat blood pressure were continuously recorded during 10 min of supine rest to assess HRV and cardiac BRS in 28 HA (17 female, 22 ± 3 yr old) and 37 adults with MDD experiencing current symptoms of mild-to-moderate severity (unmedicated; 28 female, 20 ± 3 yr old). Neither HRV [root mean square of successive differences between normal heartbeats (RMSSD): 63 ± 34 HA vs. 79 ± 36 ms MDD; P = 0.14] nor cardiac BRS (overall gain, 21 ± 10 HA vs. 23 ± 7 ms/mmHg MDD; P = 0.59) were different between groups. In young adults with MDD, there was no association between current depressive symptom severity and either HRV (RMSSD, R2 = 0.004, P = 0.73) or cardiac BRS (overall gain, R2 = 0.02, P = 0.85). Taken together, these data suggest that cardiac autonomic dysfunction may not contribute to elevated cardiovascular risk factor profiles in young unmedicated adults with MDD of mild-to-moderate severity.NEW & NOTEWORTHY This study investigated cardiac autonomic function in young unmedicated adults with major depressive disorder (MDD). The results demonstrated that both heart rate variability and cardiac baroreflex sensitivity were preserved in young unmedicated adults with MDD compared with healthy nondepressed young adults. Furthermore, in young adults with MDD, current depressive symptom severity was not associated with any indices of cardiac autonomic function.
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Affiliation(s)
- Ashley M Darling
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Cynthia M Dominguez
- Department of Bioengineering, The University of Texas at Arlington, Arlington, Texas, United States
| | - Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jacqueline Mogle
- Department of Psychology, Clemson University, Clemson, South Carolina, United States
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, United States
| | - Paul J Fadel
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
| | - Jody L Greaney
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, Delaware, United States
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12
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Kawada T, Matsushita H, Yokota S, Yoshida Y, Fukumitsu M, Alexander J, Saku K. Short-term dynamic characteristics of diuresis during exogenous pressure perturbations with and without arterial baroreflex control. Am J Physiol Regul Integr Comp Physiol 2024; 326:R230-R241. [PMID: 38223938 DOI: 10.1152/ajpregu.00229.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/16/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Although body fluid volume control by the kidneys may be classified as a long-term arterial pressure (AP) control system, it does not necessarily follow that the urine flow (UF) response to changes in AP is slow. We quantified the dynamic characteristics of the UF response to short-term AP changes by changing mean AP between 60 mmHg and 100 mmHg every 10 s according to a binary white noise sequence in anesthetized rats (n = 8 animals). In a baro-on trial (the carotid sinus baroreflex was enabled), the UF response represented the combined synergistic effects of pressure diuresis (PD) and neurally mediated antidiuresis (NMA). In a baro-fix trial (the carotid sinus pressure was fixed at 100 mmHg), the UF response mainly reflected the effect of PD. The UF step response was quantified using the sum of two exponential decay functions. The fast and slow components had time constants of 6.5 ± 3.6 s and 102 ± 85 s (means ± SD), respectively, in the baro-on trial. Although the gain of the fast component did not differ between the two trials (0.49 ± 0.21 vs. 0.66 ± 0.22 µL·min-1·kg-1·mmHg-1), the gain of the slow component was greater in the baro-on than in the baro-fix trial (0.51 ± 0.14 vs. 0.09 ± 0.39 µL·min-1·kg-1·mmHg-1, P = 0.023). The magnitude of NMA relative to PD was calculated to be 32.2 ± 29.8%. In conclusion, NMA contributed to the slow component, and its magnitude was approximately one-third of that of the effect of PD.NEW & NOTEWORTHY We quantified short-term dynamic characteristics of the urine flow (UF) response to arterial pressure (AP) changes using white noise analysis. The UF step response approximated the sum of two exponential decay functions with time constants of ∼6.5 s and 102 s. The neurally mediated antidiuretic (NMA) effect contributed to the slow component of the UF step response, with the magnitude of approximately one-third of that of the pressure diuresis (PD) effect.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroki Matsushita
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shohei Yokota
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuki Yoshida
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Fukumitsu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Joe Alexander
- Medical and Health Informatics, NTT Research, Inc., Sunnyvale, California, United States
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
- Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Osaka, Japan
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13
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Kissell CE, Young BE, Jarrard CP, Huang M, Allen DR, Okuda DT, Smith SA, Fadel PJ, Davis SL. Reduced resting beat-to-beat blood pressure variability in females with relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2024; 83:105416. [PMID: 38244526 DOI: 10.1016/j.msard.2023.105416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Relapsing-remitting multiple sclerosis (RRMS) is a demyelinating disease of the central nervous system and cardiovascular autonomic dysfunction has been well documented in this population. The sympathetic nervous system contributes to beat-to-beat blood pressure regulation primarily by baroreflex control of the peripheral vasculature which may be impaired in females with RRMS. Even at rest, attenuated sympathetic control of vasomotor tone may result in large and frequent blood pressure excursions (i.e., greater blood pressure variability). Therefore, the primary purpose of this investigation was to test the following hypotheses; (1) females with RRMS have augmented beat-to-beat blood pressure variability compared to healthy controls and (2) reduced sympathetic baroreflex sensitivity in females with RRMS is related to augmented blood pressure variability. METHODS Electrocardiogram and beat-to-beat blood pressure were continuously recorded during 8-10 min of supine rest in 26 females with clinically definite RRMS and 24 sex-, age- and BMI- matched healthy controls. Muscle sympathetic nerve activity (MSNA) was recorded in a subset of participants (MS, n = 15; CON, n = 14). Traditional statistical measurements of dispersions were used to index beat-to-beat blood pressure variability. Spontaneous sympathetic baroreflex sensitivity was quantified by sorting diastolic blood pressures into 3 mmHg bins and calculating MSNA burst incidence within each bin. Weighted linear regression was then used to account for the number of cardiac cycles in each bin and calculate slopes. Spontaneous cardiac baroreflex sensitivity was determined using the sequence method. RESULTS Groups had similar resting mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), MSNA burst frequency and MSNA burst incidence (All P > 0.05). The standard deviation and interquartile range of MAP, SBP and DBP were less in females with RRMS compared to healthy controls (All P < 0.05). There were no between groups differences in sympathetic baroreflex sensitivity or cardiac baroreflex sensitivity (Both P > 0.05) and baroreflex sensitivity measures were not related to any indices of blood pressure variability (Both P > 0.05). CONCLUSION These data suggest that females with RRMS have reduced beat-to-beat blood pressure variability. However, this does not appear to be related to changes in sympathetic or cardiac baroreflex sensitivity.
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Affiliation(s)
- Claire E Kissell
- Department of Applied Physiology and Sport Management, Southern Methodist University, Dallas, TX, USA
| | - Benjamin E Young
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Caitlin P Jarrard
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mu Huang
- Office of Science, Medicine, and Health, American Heart Association, Dallas, TX, USA
| | - Dustin R Allen
- Department of Health Sciences, Boston University, Boston, Massachusetts, USA
| | - Darin T Okuda
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Scott A Smith
- Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Scott L Davis
- Department of Applied Physiology and Sport Management, Southern Methodist University, Dallas, TX, USA; Department of Applied Clinical Research, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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14
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Nardone M, Foster M, O'Brien MW, Coovadia Y, Xie S, Usselman CW, Kimmerly DS, Taylor CE, Millar PJ. Sympathetic determinants of resting blood pressure in males and females. Am J Physiol Heart Circ Physiol 2024; 326:H612-H622. [PMID: 38214907 DOI: 10.1152/ajpheart.00497.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
Discharge of postganglionic muscle sympathetic nerve activity (MSNA) is related poorly to blood pressure (BP) in adults. Whether neural measurements beyond the prevailing level of MSNA can account for interindividual differences in BP remains unclear. The current study sought to evaluate the relative contributions of sympathetic-BP transduction and sympathetic baroreflex gain on resting BP in young adults. Data were analyzed from 191 (77 females) young adults (18-39 years) who underwent continuous measurement of beat-to-beat BP (finger photoplethysmography), heart rate (electrocardiography), and fibular nerve MSNA (microneurography). Linear regression analyses were computed to determine associations between sympathetic-BP transduction (signal-averaging) or sympathetic baroreflex gain (threshold technique) and resting BP, before and after controlling for age, body mass index, and MSNA burst frequency. K-mean clustering was used to explore sympathetic phenotypes of BP control and consequential influence on resting BP. Sympathetic-BP transduction was unrelated to BP in males or females (both R2 < 0.01; P > 0.67). Sympathetic baroreflex gain was positively associated with BP in males (R2 = 0.09, P < 0.01), but not in females (R2 < 0.01; P = 0.80), before and after controlling for age, body mass index, and MSNA burst frequency. K-means clustering identified a subset of participants with average resting MSNA, yet lower sympathetic-BP transduction and lower sympathetic baroreflex gain. This distinct subgroup presented with elevated BP in males (P < 0.02), but not in females (P = 0.10). Sympathetic-BP transduction is unrelated to resting BP, while the association between sympathetic baroreflex gain and resting BP in males reveals important sex differences in the sympathetic determination of resting BP.NEW & NOTEWORTHY In a sample of 191 normotensive young adults, we confirm that resting muscle sympathetic nerve activity is a poor predictor of resting blood pressure and now demonstrate that sympathetic baroreflex gain is associated with resting blood pressure in males but not females. In contrast, signal-averaged measures of sympathetic-blood pressure transduction are unrelated to resting blood pressure. These findings highlight sex differences in the neural regulation of blood pressure.
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Affiliation(s)
- Massimo Nardone
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Monique Foster
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Myles W O'Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Physiotherapy (Faculty of Health) and Division of Geriatric Medicine (Faculty of Medicine), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Shengkun Xie
- Global Management Studies, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Derek S Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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15
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Grabov E, Sullivan P, Wang S, Goldstein DS. Tilt-evoked, breathing-driven blood pressure oscillations: Independence from baroreflex-sympathoneural function. Clin Auton Res 2024; 34:125-135. [PMID: 38446362 PMCID: PMC10944440 DOI: 10.1007/s10286-024-01022-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/24/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Orthostasis increases the variability of continuously recorded blood pressure (BP). Low-frequency (LF) BP oscillations (Mayer waves) in this setting are related to the vascular-sympathetic baroreflex. Mechanisms of increased high-frequency (HF) BP oscillations at the periodicity of respiration during orthostasis have received less research attention. A previously reported patient with post-neurosurgical orthostatic hypotension (OH) and vascular-sympathetic baroreflex failure had large tilt-evoked, breathing-driven BP oscillations, suggesting that such oscillations can occur independently of vascular-sympathetic baroreflex modulation. In the present study we assessed effects of orthostasis on BP variability in the frequency domain in patient cohorts with or without OH. METHODS Power spectral analysis of systolic BP variability was conducted on recordings from 73 research participants, 42 with neurogenic OH [13 pure autonomic failure, 14 Parkinson's disease (PD) with OH, 12 parkinsonian multiple system atrophy, and 3 status post-brainstem neurosurgery] and 31 without OH (control group of 16 healthy volunteers and 15 patients with PD lacking OH), before, during, and after 5' of head-up tilt at 90 degrees from horizontal. The data were log transformed for statistical testing. RESULTS Across all subjects, head-up tilting increased HF power of systolic BP variability (p = 0.001), without a difference between the neurogenic OH and control groups. LF power during orthostasis was higher in the control than in the OH groups (p = 0.009). CONCLUSIONS The results of this observational cohort study confirm those based on our case report and lead us to propose that even in the setting of vascular-sympathetic baroreflex failure orthostasis increases HF power of BP variability.
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Affiliation(s)
- Edward Grabov
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892-1620, USA
| | - Patti Sullivan
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892-1620, USA
| | - Siqi Wang
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA
| | - David S Goldstein
- Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive MSC-1620, Building 10 Room 8N260, Bethesda, MD, 20892-1620, USA.
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16
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Salman IM. Key challenges in exploring the rat as a preclinical neurostimulation model for aortic baroreflex modulation in hypertension. Hypertens Res 2024; 47:399-415. [PMID: 37919429 DOI: 10.1038/s41440-023-01486-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
Electrode-based electrophysiological interfaces with peripheral nerves have come a long way since the 1960s, with several neurostimulation applications witnessing widespread clinical implementation since then. In resistant hypertension, previous clinical trials have shown that "carotid" baroreflex stimulation using device-based baroreflex activation therapy (BAT) can effectively lower blood pressure (BP). However, device-based "aortic" baroreflex stimulation remains untouched for clinical translation. The rat is a remarkable animal model that facilitates exploration of mechanisms pertaining to the baroreceptor reflex and preclinical development of novel therapeutic strategies for BP modulation and hypertension treatment. Specifically, the aortic depressor nerve (ADN) in rats carries a relatively pure population of barosensitive afferent neurons, which enable selective investigation of the aortic baroreflex function. In a rat model of essential hypertension, the spontaneously hypertensive rat (SHR), we have recently investigated the aortic baroreceptor afferents as an alternate target for BP modulation, and showed that "low intensity" stimulation is able to evoke clinically meaningful reductions in BP. Deriving high quality short-term and long-term data on aortic baroreflex modulation in rats is currently hampered by a number of unresolved experimental challenges, including anatomical variations across rats which complicates identification of the ADN, the use of unrefined neurostimulation tools or paradigms, and issues arising from anesthetized and conscious surgical preparations. With the goal of refining existing experimental protocols designed for preclinical investigation of the baroreflex, this review seeks to outline current challenges hindering further progress in aortic baroreflex modulation studies in rats and present some practical considerations and recently emerging ideas to overcome them. Aortic baroreflex modulation.
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Affiliation(s)
- Ibrahim M Salman
- Department of Pharmaceutical Sciences, College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia.
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17
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Braga VHDS, Armelin VA, Noll IG, Florindo LH, Milsom WK. Cardiorespiratory reflexes in white sturgeon (Acipenser transmontanus): Lack of cardiac baroreflex response to blood pressure manipulation? Comp Biochem Physiol A Mol Integr Physiol 2024; 288:111554. [PMID: 37989399 DOI: 10.1016/j.cbpa.2023.111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023]
Abstract
Arterial pressure (Pa) regulation is essential to adequately distribute nutrients to metabolizing tissues, remove wastes and avoid lesions associated with hypertension. In vertebrates, short-term Pa regulation is achieved through the baroreflex, which elicits inversely proportional changes in heart rate (fH) and vascular resistance to restore Pa. The cardiac limb of this reflex has been reported in all vertebrate groups studied to date: teleosts, amphibians, snakes, lizards, crocodiles, birds and mammals - which led to the suggestion that the baroreflex is an ancient trait present in all vertebrate species. However, it is not clear whether more basal groups of vertebrates, such as cyclostomes, elasmobranchs and chondrosteans, manifest baroreflex regulation of fH. Thus, the aim of this study was to determine whether the white sturgeon (Acipenser transmontanus; Chondrostei: Acipenseridae) exhibits a cardiac baroreflex. To do so, we induced Pa perturbations through injections of phenylephrine, sodium nitroprusside (SNP) and saline solution (hypervolemia), and examined possible fH baroreflex responses. We also investigated whether fH responses triggered by fright and chemoreflex were present in this species, in order to confirm the potential of sturgeon to perform reflexive cardiac adjustments. The findings indicate that A. transmontanus exhibits reflex bradycardia in response to fright and chemoreceptor stimulation, illustrating its capacity for short-term cardiac regulation. However, this species does not display baroreflex control of fH across its physiological range. This dissociation suggests that while the nervous and cardiovascular systems of A. transmontanus are primed for rapid reflex responses, a cardiac baroreflex mechanism remains absent.
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Affiliation(s)
- Victor Hugo da Silva Braga
- Department of Biological Sciences, São Paulo State University (UNESP), Rua Cristóvão Colombo, 2265, São José do Rio Preto, SP 15054-000, Brazil. https://twitter.com/b07855682
| | - Vinicius Araújo Armelin
- Department of Physiology, University of São Paulo (USP), Rua do Matão - Travessa 14 - N. 101, Cidade Universitária, São Paulo, SP 05508-090, Brazil
| | - Igor Guagnoni Noll
- Department of Biological Sciences, São Paulo State University (UNESP), Rua Cristóvão Colombo, 2265, São José do Rio Preto, SP 15054-000, Brazil
| | - Luiz Henrique Florindo
- Department of Biological Sciences, São Paulo State University (UNESP), Rua Cristóvão Colombo, 2265, São José do Rio Preto, SP 15054-000, Brazil; Department of Physiological Sciences, Federal University of São Carlos (UFSCar), Rodovia Washington Luiz, km 235, São Carlos, SP 13565-905, Brazil; Aquaculture Centre (CAUNESP), São Paulo State University (UNESP), Rodovia Prof. Paulo Donato Castellane, n/n, Jaboticabal, SP 14884-900, Brazil.
| | - William Kenneth Milsom
- Department of Zoology, University of British Columbia (UBC), 4200 - 6270 University Blvd, V6T 1Z4 Vancouver, Canada
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Hamaoka T, Leuenberger UA, Drew RC, Murray M, Blaha C, Luck JC, Sinoway LI, Cui J. Glucose metabolism and autonomic function in healthy individuals and patients with type 2 diabetes mellitus at rest and during exercise. Exp Physiol 2024; 109:214-226. [PMID: 38050866 PMCID: PMC10841625 DOI: 10.1113/ep091444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
Autonomic dysfunction is a common complication of type 2 diabetes mellitus (T2DM). However, the character of dysfunction varies in different reports. Differences in measurement methodology and complications might have influenced the inconsistent results. We sought to evaluate comprehensively the relationship between abnormal glucose metabolism and autonomic function at rest and the response to exercise in healthy individuals and T2DM patients. We hypothesized that both sympathetic and parasympathetic indices would decrease with the progression of abnormal glucose metabolism in individuals with few complications related to high sympathetic tone. Twenty healthy individuals and 11 T2DM patients without clinically evident cardiovascular disease other than controlled hypertension were examined. Resting muscle sympathetic nerve activity (MSNA), heart rate variability, spontaneous cardiovagal baroreflex sensitivity (CBRS), sympathetic baroreflex sensitivity and the MSNA response to handgrip exercise were measured. Resting MSNA was lower in patients with T2DM than in healthy control subjects (P = 0.011). Resting MSNA was negatively correlated with haemoglobin A1c in all subjects (R = -0.45, P = 0.024). The parasympathetic components of heart rate variability and CBRS were negatively correlated with glycaemic/insulin indices in all subjects and even in the control group only (all, P < 0.05). In all subjects, the MSNA response to exercise was positively correlated with fasting blood glucose (R = 0.69, P < 0.001). Resting sympathetic activity and parasympathetic modulation of heart rate were decreased in relationship to abnormal glucose metabolism. Meanwhile, the sympathetic responses to handgrip were preserved in diabetics. The responses were correlated with glucose/insulin parameters throughout diabetic and control subjects. These results suggest the importance of a comprehensive assessment of autonomic function in T2DM.
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Affiliation(s)
- Takuto Hamaoka
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Urs A. Leuenberger
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Rachel C. Drew
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
- Department of Exercise and Health SciencesUniversity of Massachusetts BostonBostonMassachusettsUSA
| | - Matthew Murray
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Cheryl Blaha
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jonathan Carter Luck
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Lawrence I. Sinoway
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jian Cui
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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19
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Sesa-Ashton G, Macefield VG. Sympathetic vascular transduction and baroreflex sensitivity in the context of severe COPD. Clin Auton Res 2024; 34:219-222. [PMID: 38044409 DOI: 10.1007/s10286-023-01003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Gianni Sesa-Ashton
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
| | - Vaughan G Macefield
- Department of Neuroscience, Central Clinical School, Monash University, Level 6, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
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20
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Iellamo F. Acute responses and chronic adaptations to exercise in humans: a look from the autonomic nervous system window. J Sports Med Phys Fitness 2024; 64:137-150. [PMID: 37791830 DOI: 10.23736/s0022-4707.23.15353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The objective of this review was to give an overview on the current knowledge on the neural mechanisms of cardiovascular regulation during acute exercise and the autonomic adaptations brought about by chronic exercise, that is, exercise training. Evidence derived mainly from human studies, which supports the contribution of the different control mechanisms, namely the centralcommand, the reflex drive from active muscles and the arterial baroreflex, with the attendant modifications in autonomic nervous system activity, in determining the acute cardiovascular responses to exercise are discussed, along with some controversial issues and evolving concepts in exercise physiology. In particular, data that show how the various neural mechanisms involved in cardiovascular regulation during exercise are differently modulated by factors related to the muscular activity being performed, such as the type and intensity of exercise and the size of the active muscle masses are presented, stressing the plasticity of the neural network. Thereafter, the clinical implications pertaining neural cardiovascular adaptations to exercise training are presented and discussed, in the context of cardiac diseases. In particular, I will summarize a series of investigations performed in our laboratory that utilized a new training methodology and different exercise formats to quantify the training load in cardiac patients. The way by which individualized exercise training doses affects the autonomic nervous system and the cardiorespiratory adaptations is highlighted.
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Affiliation(s)
- Ferdinando Iellamo
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy -
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21
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Kawada T, Miyamoto T, Fukumitsu M, Saku K. Input-size dependence of the baroreflex neural arc transfer characteristics during Gaussian white noise inputs. Am J Physiol Regul Integr Comp Physiol 2024; 326:R121-R133. [PMID: 38047314 DOI: 10.1152/ajpregu.00199.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/23/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023]
Abstract
Although Gaussian white noise (GWN) inputs offer a theoretical framework for identifying higher-order nonlinearity, an actual application to the data of the neural arc of the carotid sinus baroreflex did not succeed in fully predicting the well-known sigmoidal nonlinearity. In the present study, we assumed that the neural arc can be approximated by a cascade of a linear dynamic (LD) component and a nonlinear static (NS) component. We analyzed the data obtained using GWN inputs with a mean of 120 mmHg and standard deviations (SDs) of 10, 20, and 30 mmHg for 15 min each in anesthetized rats (n = 7). We first estimated the linear transfer function from carotid sinus pressure to sympathetic nerve activity (SNA) and then plotted the measured SNA against the linearly predicted SNA. The predicted and measured data pairs exhibited an inverse sigmoidal distribution when grouped into 10 bins based on the size of the linearly predicted SNA. The sigmoidal nonlinearity estimated via the LD-NS model showed a midpoint pressure (104.1 ± 4.4 mmHg for SD of 30 mmHg) lower than that estimated by a conventional stepwise input (135.8 ± 3.9 mmHg, P < 0.001). This suggests that the NS component is more likely to reflect the nonlinearity observed during pulsatile inputs that are physiological to baroreceptors. Furthermore, the LD-NS model yielded higher R2 values compared with the linear model and the previously suggested second-order Uryson model in the testing dataset.NEW & NOTEWORTHY We examined the input-size dependence of the baroreflex neural arc transfer characteristics during Gaussian white noise inputs. A linear dynamic-static nonlinear model yielded higher R2 values compared with a linear model and captured the well-known sigmoidal nonlinearity of the neural arc, indicating that the nonlinear dynamics contributed to determining sympathetic nerve activity. Ignoring such nonlinear dynamics might reduce our ability to explain underlying physiology and significantly limit the interpretation of experimental data.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tadayoshi Miyamoto
- Department of Sport and Health Sciences, Faculty of Sport and Health Sciences, Osaka Sangyo University, Osaka, Japan
| | - Masafumi Fukumitsu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
- Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Osaka, Japan
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22
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Mastrandrea CJ, Greaves DK, Shoemaker JK, Blaber AP, Arbeille P, Hughson RL. Lower body negative pressure identifies altered central vein characteristics without accompanying changes to baroreflexes in astronauts within hours of landing. Sci Rep 2024; 14:1215. [PMID: 38216637 PMCID: PMC10786840 DOI: 10.1038/s41598-024-51643-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024] Open
Abstract
Cardiovascular deconditioning and altered baroreflexes predispose returning astronauts to Orthostatic Intolerance. We assessed 7 astronauts (1 female) before and following long-duration spaceflight (146 ± 43 days) with minimal upright posture prior to testing. We applied lower body negative pressure (LBNP) of up to - 30 mmHg to supine astronauts instrumented for continual synchronous measurements of cardiovascular variables, and intermittent imaging the Portal Vein (PV) and Inferior Vena Cava (IVC). During supine rest without LBNP, postflight elevations to total peripheral resistance (TPR; 15.8 ± 4.6 vs. 20.8 ± 7.1 mmHg min/l, p < 0.05) and reductions in stroke volume (SV; 104.4 ± 16.7 vs. 87.4 ± 11.5 ml, p < 0.05) were unaccompanied by changes to heart rate (HR) or estimated central venous pressure (CVP). Small increases to systolic blood pressure (SBP) and diastolic blood pressure (DBP) were not statistically significant. Autoregressive moving average modelling (ARMA) during LBNP did not identify differences to either arterial (DBP → TPR and SBP → HR) or cardiopulmonary (CVP → TPR) baroreflexes consistent with intact cardiovascular control. On the other hand, IVC and PV diameter-CVP relationships during LBNP revealed smaller diameter for a given CVP postflight consistent with altered postflight venous wall dynamics.
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Affiliation(s)
- C J Mastrandrea
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada.
- University of Waterloo, Waterloo, ON, Canada.
| | - D K Greaves
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
| | - J K Shoemaker
- School of Kinesiology and Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
| | - A P Blaber
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - P Arbeille
- Unite Médecine Physiologie Spatiale, CERCOM, Faculté de Médecine-Université de Tours, Tours, France
| | - R L Hughson
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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23
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Banks NF, Rogers EM, Berry AC, Jenkins NDM. Progressive iso-inertial resistance exercise promotes more favorable cardiovascular adaptations than traditional resistance exercise in young adults. Am J Physiol Heart Circ Physiol 2024; 326:H32-H43. [PMID: 37889252 DOI: 10.1152/ajpheart.00402.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
We compared the cardiovascular adaptations to resistance training (RT) using either traditional isotonic or iso-inertial resistance exercise in a randomized controlled study. Thirty-one healthy young adults (means ± SD, age = 24 ± 3 yr) completed 10 wk of traditional isotonic RT (TRT; n = 7 female/5 male), iso-inertial flywheel RT (FWRT; n = 7 female/4 male), or a habitual activity control (Con; n = 5 female/3 male). Before and following the intervention period, blood pressure, blood pressure reactivity, flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cfPWV), baroreflex sensitivity (BRS), and heart rate variability (RMSSD) were assessed. TRT and FWRT similarly improved isometric muscle strength. TRT significantly increased systolic blood pressure reactivity during isometric exercise compared with both FWRT (mean difference ± 95% CI, +10.8 ± 8.8 mmHg) and Con (+11.8 ± 9.1 mmHg). Cardiovagal BRS was significantly reduced in TRT versus FWRT (-6.82 ± 4.9 ms/mmHg; P = 0.006) but not between TRT versus Con (P = 0.12) or FWRT versus Con (P = 0.43). Resting heart rate (RHR) and RMSSD worsened in TRT compared with FWRT (RHR, +8 ± 5.8 beats/min, P = 0.006; RMSSD, -22.3 ± 15.6 ms, P = 0.004). Changes in BRS and RMSSD were associated with changes in blood pressure reactivity in the RT groups (r = -0.51 to -0.52). There were no significant changes in FMD or cfPWV in any group (P > 0.13). In conclusion, 10 wk of TRT and FWRT resulted in similar improvements in strength, but TRT caused impairments in blood pressure reactivity compared with FWRT and Con and parasympathetic nervous system activity compared with FWRT.NEW & NOTEWORTHY We characterized the cardiovascular effects of traditional, isotonic resistance training (TRT) versus flywheel-based iso-inertial resistance training (FWRT) in young healthy adults. Both TRT and FWRT improved strength, but TRT reduced cardiovagal baroreflex sensitivity and heart rate variability while increasing exercising blood pressure compared with FWRT. Our data indicate that TRT and FWRT result in different cardiovascular adaptations, where TRT, but not FWRT, may impair cardiovagal function and blood pressure reactivity in healthy, active young adults.
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Affiliation(s)
- Nile F Banks
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, United States
- Department of Kinesiology, The University of Wisconsin, Madison, Wisconsin, United States
| | - Emily M Rogers
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, United States
- Department of Kinesiology, The University of Wisconsin, Madison, Wisconsin, United States
| | - Alexander C Berry
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, United States
| | - Nathaniel D M Jenkins
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, United States
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24
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Ruddy JM, Kroman A, Baicu CF, Zile MR. Baroreflex Activation Therapy in Patients with Heart Failure with a Reduced Ejection Fraction. Heart Fail Clin 2024; 20:39-50. [PMID: 37953020 DOI: 10.1016/j.hfc.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
A randomized, controlled trial of baroreflex activation therapy (BAT) in patients with heart failure and reduced ejection fraction demonstrated that BAT was safe and significantly improved patient-centered symptomatic outcomes, increasing exercise capacity, improving quality of life, decreasing n-terminal pro B-type natriuretic peptide (NT-proBNP), and improving functional class. BAT was approved by the FDA for improvement of symptoms of heart failure for patients who remain symptomatic despite treatment with guideline-directed management, are New York Heart Association Class III or Class II (with a recent history of Class III), have a left ventricular ejection fraction ≤ 35%, an NT-proBNP < 1600 pg/mL and excluding patients indicated for cardiac resynchronization therapy.
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Affiliation(s)
- Jean M Ruddy
- Division of Vascular Surgery, Department of Surgery, Medical University of South Carolina, 30 Courtenay Drive, Charleston, SC 29425, USA; Ralph H Johnson Department of Veterans Affairs Health Care System, 109 Bee Street, Charleston, SC 29401, USA.
| | - Anne Kroman
- Ralph H Johnson Department of Veterans Affairs Health Care System, 109 Bee Street, Charleston, SC 29401, USA; Division of Cardiology, Department of Medicine, Medical University of South Carolina, 30 Courtenay Drive, Charleston, SC 29425, USA
| | - Catalin F Baicu
- Ralph H Johnson Department of Veterans Affairs Health Care System, 109 Bee Street, Charleston, SC 29401, USA; Division of Cardiology, Department of Medicine, Medical University of South Carolina, 30 Courtenay Drive, Charleston, SC 29425, USA
| | - Michael R Zile
- Ralph H Johnson Department of Veterans Affairs Health Care System, 109 Bee Street, Charleston, SC 29401, USA; Division of Cardiology, Department of Medicine, Medical University of South Carolina, 30 Courtenay Drive, Charleston, SC 29425, USA
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25
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Suarez-Roca H, Mamoun N, Watkins LL, Bortsov AV, Mathew JP. Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery. J Pain 2024; 25:187-201. [PMID: 37567546 PMCID: PMC10841280 DOI: 10.1016/j.jpain.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/05/2023] [Accepted: 08/06/2023] [Indexed: 08/13/2023]
Abstract
Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-mediated anti-inflammatory reflexes. To investigate this relationship, we conducted a study with 55 patients undergoing minimally invasive cardiothoracic surgery to evaluate whether cardiovagal baroreflex sensitivity (BRS) can predict postoperative pain. We assessed the spontaneous cardiovagal BRS under resting pain-free conditions before surgery. We estimated postoperative pain outcomes with the Pain, Enjoyment, and General Activity scale and pressure pain thresholds on the first (POD1) and second (POD2) postoperative days and persistent pain 3 and 6 months after hospital discharge. We also measured circulating levels of relevant inflammatory biomarkers (C-reactive protein, albumin, cytokines) at baseline, POD1, and POD2 to assess the contribution of inflammation to the relationship between BRS and postoperative pain. Our mixed-effects model analysis showed a significant main effect of preoperative BRS on postoperative pain (P = .013). Linear regression analysis revealed a significant positive association between preoperative BRS and postoperative pain on POD2, even after adjusting for demographic, surgical, analgesic treatment, and psychological factors. Moreover, preoperative BRS was linked to pain interfering with general activity and enjoyment but not with other pain parameters (pain intensity and pressure pain thresholds). Preoperative BRS had modest associations with postoperative C-reactive protein and IL-10 levels, but they did not mediate its relationship with postoperative pain. These findings indicate that preoperative BRS can independently predict postoperative pain, which could serve as a modifiable criterion for optimizing postoperative pain management. PERSPECTIVE: This article shows that preoperative BRS predicts postoperative pain outcomes independently of the inflammatory response and pain sensitivity to noxious pressure stimulation. These results provide valuable insights into the role of baroreceptors in pain and suggest a helpful tool for improving postoperative pain management.
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Affiliation(s)
- Heberto Suarez-Roca
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, North Carolina
| | - Negmeldeen Mamoun
- Division of Cardiothoracic Anesthesia and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Lana L Watkins
- Psychiatry and Behavioral Sciences Department, Duke University Medical Center, Durham, North Carolina
| | - Andrey V Bortsov
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, North Carolina
| | - Joseph P Mathew
- Division of Cardiothoracic Anesthesia and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
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26
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Schumann A, Gupta Y, Gerstorf D, Demuth I, Bär KJ. Sex differences in the age-related decrease of spontaneous baroreflex function in healthy individuals. Am J Physiol Heart Circ Physiol 2024; 326:H158-H165. [PMID: 37947436 DOI: 10.1152/ajpheart.00648.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
The baroreflex is a powerful physiological mechanism for rapidly adjusting heart rate in response to changes in blood pressure. Spontaneous baroreflex sensitivity (BRS) has been shown to decrease with age. However, studies of sex differences in these age-related changes are rare. Here we investigated several markers of spontaneous baroreflex function in a large sample of healthy individuals. Cardiovascular signals were recorded in the supine position under carefully controlled resting conditions. After quality control, n = 980 subjects were divided into five age groups [age < 30 yr (n = 612), 30-39 yr (n = 140), 40-49 yr (n = 95), 50-59 yr (n = 61), and >60 yr (n = 72)]. Spontaneous baroreflex function was assessed in the time domain (bradycardic and tachycardic slope) and in the frequency domain in the low- and high-frequency band (LF-α, HF-α) applying the transfer function. General linear models showed a significant effect of factor age (P < 0.001) and an age × sex interaction effect (P < 0.05) on each indicator of the baroreflex function. Simple main effects showed a significantly higher BRS as indicated by tachycardic slope, LF-α and HF-α in middle-aged women compared with men (30-39 yr) and higher LF-α, bradycardic and tachycardic slope in men compared with women of the oldest age group (>60 yr). Changes in BRS over the lifespan suggest that baroreflex function declines more slowly but earlier in life in men than in women. Our findings could be linked to age-related changes in major sex hormone levels, suggesting significant implications for diverse cardiovascular outcomes and the implementation of targeted preventive strategies.NEW & NOTEWORTHY In this study, we demonstrate that the age-related decrease of spontaneous baroreflex sensitivity is different in men and women by analyzing resting state cardiovascular data of a large sample of healthy individuals.
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Affiliation(s)
- Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition, Department for Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Yubraj Gupta
- Lab for Autonomic Neuroscience, Imaging and Cognition, Department for Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Denis Gerstorf
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ilja Demuth
- Department of Endocrinology and Metabolic Diseases, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition, Department for Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
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27
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Sharifi H, Lee LC, Campbell KS, Wenk JF. A multiscale finite element model of left ventricular mechanics incorporating baroreflex regulation. Comput Biol Med 2024; 168:107690. [PMID: 37984204 PMCID: PMC11017291 DOI: 10.1016/j.compbiomed.2023.107690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/11/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Cardiovascular function is regulated by a short-term hemodynamic baroreflex loop, which tries to maintain arterial pressure at a normal level. In this study, we present a new multiscale model of the cardiovascular system named MyoFE. This framework integrates a mechanistic model of contraction at the myosin level into a finite-element-based model of the left ventricle pumping blood through the systemic circulation. The model is coupled with a closed-loop feedback control of arterial pressure inspired by a baroreflex algorithm previously published by our team. The reflex loop mimics the afferent neuron pathway via a normalized signal derived from arterial pressure. The efferent pathway is represented by a kinetic model that simulates the net result of neural processing in the medulla and cell-level responses to autonomic drive. The baroreflex control algorithm modulates parameters such as heart rate and vascular tone of vessels in the lumped-parameter model of systemic circulation. In addition, it spatially modulates intracellular Ca2+ dynamics and molecular-level function of both the thick and the thin myofilaments in the left ventricle. Our study demonstrates that the baroreflex algorithm can maintain arterial pressure in the presence of perturbations such as acute cases of altered aortic resistance, mitral regurgitation, and myocardial infarction. The capabilities of this new multiscale model will be utilized in future research related to computational investigations of growth and remodeling.
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Affiliation(s)
- Hossein Sharifi
- Department of Mechanical and Aerospace Engineering, University of Kentucky, Lexington, KY, USA
| | - Lik Chuan Lee
- Department of Mechanical Engineering, Michigan State University, East Lansing, MI, USA
| | - Kenneth S Campbell
- Division of Cardiovascular Medicine and Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Jonathan F Wenk
- Department of Mechanical and Aerospace Engineering, University of Kentucky, Lexington, KY, USA; Department of Surgery, University of Kentucky, Lexington, KY, USA.
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Dellacqua LO, Gomes PM, Batista JS, Michelini LC, Antunes VR. Exercise-induced neuroplasticity in autonomic nuclei restores the cardiac vagal tone and baroreflex dysfunction in aged hypertensive rats. J Appl Physiol (1985) 2024; 136:189-198. [PMID: 38059293 DOI: 10.1152/japplphysiol.00433.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023] Open
Abstract
Aging is accompanied by considerable deterioration of homeostatic systems, such as autonomic imbalance characterized by heightened sympathetic activity, lower parasympathetic tone, and depressed heart rate (HR) variability, which are aggravated by hypertension. Here, we hypothesized that these age-related deficits in aged hypertensive rats can be ameliorated by exercise training, with benefits to the cardiovascular system. Therefore, male 22-mo-old spontaneously hypertensive rats (SHRs) and age-matched Wistar Kyoto (WKY) submitted to moderate-intensity exercise training (T) or kept sedentary (S) for 8 wk were evaluated for hemodynamic/autonomic parameters, baroreflex sensitivity, cardiac sympathetic/parasympathetic tone and analysis of dopamine β-hydroxylase (DBH+) and oxytocin (OT+) pathways of autonomic brain nuclei. Aged SHR-S versus WKY-S exhibited elevated mean arterial pressure (MAP: +51%) and HR (+20%), augmented pressure/HR variability, no cardiac vagal tone, and depressed reflex control of the heart (HR range, -28%; gain, -49%). SHR-T exhibited a lower resting HR, a partial reduction in the MAP (-14%), in the pressure/HR variabilities, and restored parasympathetic modulation, with improvement of baroreceptor reflex control when compared with SHR-S. Exercise training increased the ascending DBH+ projections conveying peripheral information to the paraventricular nucleus of hypothalamus (PVN), augmented the expression of OT+ neurons, and reduced the density of DBH+ neurons in the rostral ventrolateral medulla (RVLM) of SHR-T. Data indicate that exercise training induces beneficial neuroplasticity in brain autonomic circuitry, and it is highly effective to restore the parasympathetic tone, and attenuation of age-related autonomic imbalance and baroreflex dysfunction, thus conferring long-term benefits for cardiovascular control in aged hypertensive individuals.NEW & NOTEWORTHY Exercise training reduces high blood pressure and cardiovascular autonomic modulation in aged hypertensive rats. The dysfunction in the baroreflex sensitivity and impaired parasympathetic tone to the heart of aged hypertensive rats are restored by exercise training. Exercise induces beneficial neuroplasticity in the brain nuclei involved with autonomic control of cardiovascular function of aged hypertensive rats.
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Affiliation(s)
- Lais Oliveira Dellacqua
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Paula Magalhães Gomes
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Julia Santos Batista
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Lisete Compagno Michelini
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Vagner Roberto Antunes
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Chao-Ecija A, Dawid-Milner MS. BaroWavelet: An R-based tool for dynamic baroreflex evaluation through wavelet analysis techniques. Comput Methods Programs Biomed 2023; 242:107758. [PMID: 37688995 DOI: 10.1016/j.cmpb.2023.107758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Baroreflex sensitivity constitutes an indicator of the function of the baroreceptor control mechanism of blood pressure levels. It can be computed after estimating heart rate and blood pressure variability. We propose a novel tool for the evaluation of baroreflex sensitivity using wavelet analysis methods. This tool, known as BaroWavelet, incorporates an algorithm proposal based on the analysis methodology of the RHRV software package, as well as other conventional techniques. Our objectives are to develop and evaluate the tool, by testing its ability to detect changes in baroreflex sensitivity in humans. METHODS The code for this tool was designed in the R programming environment and was organized into two analysis routines and a graphical interface. Simulated recordings of blood pressure and inter-beat intervals were employed for an initial evaluation of the tool in a controlled environment. Finally, similar recordings obtained during supine and orthostatic postural evaluations, from patients that belonged to the open-access EUROBAVAR data set, were analyzed. RESULTS BaroWavelet identified the scripted changes of the baroreflex sensitivity in the simulated data. The algorithm proposal was also able to better retain additional information regarding the dynamics of the baroreflex. In the EUROBAVAR subjects, baroreflex sensitivity components were significantly smaller during orthostatism when compared with the supine position. CONCLUSIONS BaroWavelet managed to characterize baroreflex dynamics from the recordings, which were consistent with the findings reported in the literature. This demonstrates its effectiveness to perform these analyses. We suggest that this tool may be of use in research and for the evaluation of baroreflex sensitivity with clinical and therapeutic purposes. The new tool is available at the official GitHub repository of the Autonomic Nervous System Unit of the University of Málaga (https://github.com/CIMES-USNA-UMA/BaroWavelet).
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Affiliation(s)
- A Chao-Ecija
- Autonomic Nervous System Unit, CIMES, School of Medicine, University of Málaga, Spain
| | - M S Dawid-Milner
- Autonomic Nervous System Unit, CIMES, School of Medicine, University of Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
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Belna H, Fortrat JO, Augusto JF, Brilland B. Post-traumatic hypertension: when nerves break down. J Nephrol 2023; 36:2629-2632. [PMID: 37308776 DOI: 10.1007/s40620-023-01662-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/28/2023] [Indexed: 06/14/2023]
Affiliation(s)
- Hugo Belna
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, 4 rue Larrey, 49033, Angers CEDEX 09, France
| | - Jacques-Olivier Fortrat
- Service de Médecine Vasculaire, Mitovasc UMR INSERM 1083-CNRS 6015, CHU Angers, Angers, France
| | - Jean-François Augusto
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, 4 rue Larrey, 49033, Angers CEDEX 09, France
- Université d'Angers Inserm, CNRS, Nantes Université, CRCI2NA, Angers, France
| | - Benoit Brilland
- Service de Néphrologie-Dialyse-Transplantation, Université d'Angers, CHU Angers, 4 rue Larrey, 49033, Angers CEDEX 09, France.
- Université d'Angers Inserm, CNRS, Nantes Université, CRCI2NA, Angers, France.
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Butler JM, Frampton CM, Moore G, Barclay ML, Jardine DL. Immediate effect of caffeine on sympathetic nerve activity: why coffee is safe? A single-centre crossover study. Clin Auton Res 2023; 33:623-633. [PMID: 37598402 PMCID: PMC10751260 DOI: 10.1007/s10286-023-00967-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023]
Abstract
PURPOSES Habitual coffee drinking is ubiquitous and generally considered to be safe despite its transient hypertensive effect. Our purpose was to determine the role of the sympathetic nervous system in the hypertensive response. METHODS In a single-centre crossover study, medical caregivers were studied after consumption of standard coffee (espresso), water and decaffeinated coffee (decaff) given in random order at least 1 month apart. Plasma caffeine levels, mean arterial pressure, heart rate, total peripheral resistance and muscle sympathetic activity were recorded. Baroreflex activity was assessed using burst incidence and RR interval changes to spontaneous blood pressure fluctuations. RESULTS A total of 16 subjects (mean [± standard error] age 34.4 ± 2 years; 44% female) were recruited to the study. Three agents were studied in ten subjects, and two agents were studied in six subjects. Over a 120-min period following the consumption of standard coffee, mean (± SE) plasma caffeine levels increased from 2.4 ± 0.8 to 21.0 ± 4 µmol/L and arterial pressure increased to 103 ± 1 mmHg compared to water (101 ± 1 mmHg; p = 0.066) and decaff (100 ± 1 mmHg; p = 0.016). Peripheral resistance in the same period following coffee increased to 120 ± 4% of the baseline level compared to water (107 ± 4; p = 0.01) and decaff (109 ± 4; p = 0.02). Heart rate was lower after both coffee and decaff consumption: 62 ± 1 bpm compared to water (64 bpm; p = 0.01 and p = 0.02, respectively). Cardio-vagal baroreflex activity remained stable after coffee, but sympathetic activity decreased, with burst frequency of 96 ± 3% versus water (106 ± 3%; p = 0.04) and decaff (112 ± 3%; p = 0.001) despite a fall in baroreflex activity from - 2.2 ± 0.1 to - 1.8 ± 0.1 bursts/100 beats/mmHg, compared to water (p = 0.009) and decaff (p = 0.004). CONCLUSION The hypertensive response to coffee is secondary to peripheral vasoconstriction but this is not mediated by increased sympathetic nerve activity. These results may explain why habitual coffee drinking is safe.
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Affiliation(s)
- Jennifer M Butler
- Department of General Medicine, Christchurch Hospital, 2 Riccarton Ave, Private Bag 4710, Christchurch, New Zealand
| | - Christopher M Frampton
- Department of Medicine, Christchurch School of Medicine, University of Otago, Dunedin, New Zealand
| | - Grant Moore
- Department of Toxicology, Christchurch Hospital, 2 Riccarton Ave, Christchurch, New Zealand
| | - Murray L Barclay
- Department of Medicine, Christchurch School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Clinical Pharmacology, Christchurch Hospital, 2 Riccarton Ave, Christchurch, New Zealand
| | - David L Jardine
- Department of General Medicine, Christchurch Hospital, 2 Riccarton Ave, Private Bag 4710, Christchurch, New Zealand.
- Department of Medicine, Christchurch School of Medicine, University of Otago, Dunedin, New Zealand.
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Fonkoue IT, Tahsin CT, Jones TN, King KN, Tahmin CI, Jeong J, Dixon D, DaCosta DR, Park J. Sex differences in Black Veterans with PTSD: women versus men have higher sympathetic activity, inflammation, and blunted cardiovagal baroreflex sensitivity. Clin Auton Res 2023; 33:757-766. [PMID: 37898568 DOI: 10.1007/s10286-023-00995-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Post-traumatic stress disorder (PTSD) is associated with greater risk of incident hypertension and cardiovascular disease (CVD). Inflammation and autonomic derangements are suggested as contributing mechanisms. Women and Black adults have higher CVD risk associated with stress; however, whether there is a sex difference in autonomic and inflammatory mechanisms among Black individuals with PTSD is not known. We hypothesized that Black women with PTSD have higher inflammation, sympathetic nervous system (SNS) activity and impaired baroreflex sensitivity (BRS). METHODS In 42 Black Veterans with PTSD (Women, N = 18 and Men, N = 24), we measured inflammatory biomarkers, continuous blood pressure (BP), heart rate (HR) and muscle sympathetic nerve activity (MSNA) at rest and during arterial BRS testing via the modified Oxford technique. RESULTS Groups were matched for age and body mass index (BMI). Resting BP was similar between groups, but HR was higher (76 ± 12 vs. 68 ± 9 beats/min, p = 0.021) in women compared to men. Although women had lower PTSD symptoms severity (57 ± 17 vs. 68 ± 12 a.u.), resting MSNA (27 ± 13 vs. 16 ± 5 bursts/min, p = 0.003) was higher in women compared to men, respectively. Likewise, cardiovagal BRS was blunted (p = 0.002) in women (7.6 ± 4.3 ms/mmHg) compared to men (15.5 ± 8.4 ms/mmHg) while sympathetic BRS was not different between groups (p = 0.381). Black women also had higher (p = 0.020) plasma levels of interleukin-2 (IL-2). CONCLUSION Black women with PTSD have higher resting HR and MSNA, greater impairment of cardiovagal BRS and possibly higher inflammation. These findings suggest a higher burden of autonomic and inflammatory derangements in Black women compared to Black men with PTSD.
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Affiliation(s)
- Ida T Fonkoue
- Physical Therapy Division, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- Rehabilitation Science Division, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Chowdhury Tasnova Tahsin
- Rehabilitation Science Division, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Toure N Jones
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Keyona N King
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Chowdhury Ibtida Tahmin
- Rehabilitation Science Division, Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jinhee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Deirdre Dixon
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Dana R DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA.
- Research Service Line, Atlanta VA Healthcare System, Decatur, GA, USA.
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Porta A, Gelpi F, Bari V, Cairo B, De Maria B, Tonon D, Rossato G, Faes L. Concomitant evaluation of cardiovascular and cerebrovascular controls via Geweke spectral causality to assess the propensity to postural syncope. Med Biol Eng Comput 2023; 61:3141-3157. [PMID: 37452270 PMCID: PMC10746785 DOI: 10.1007/s11517-023-02885-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
The evaluation of propensity to postural syncope necessitates the concomitant characterization of the cardiovascular and cerebrovascular controls and a method capable of disentangling closed loop relationships and decomposing causal links in the frequency domain. We applied Geweke spectral causality (GSC) to assess cardiovascular control from heart period and systolic arterial pressure variability and cerebrovascular regulation from mean arterial pressure and mean cerebral blood velocity variability in 13 control subjects and 13 individuals prone to develop orthostatic syncope. Analysis was made at rest in supine position and during head-up tilt at 60°, well before observing presyncope signs. Two different linear model structures were compared, namely bivariate autoregressive and bivariate dynamic adjustment classes. We found that (i) GSC markers did not depend on the model structure; (ii) the concomitant assessment of cardiovascular and cerebrovascular controls was useful for a deeper comprehension of postural disturbances; (iii) orthostatic syncope appeared to be favored by the loss of a coordinated behavior between the baroreflex feedback and mechanical feedforward pathway in the frequency band typical of the baroreflex functioning during the postural challenge, and by a weak cerebral autoregulation as revealed by the increased strength of the pressure-to-flow link in the respiratory band. GSC applied to spontaneous cardiovascular and cerebrovascular oscillations is a promising tool for describing and monitoring disturbances associated with posture modification.
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Affiliation(s)
- Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy.
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Via R. Morandi 30, San Donato Milanese, 20097, Milan, Italy.
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Via R. Morandi 30, San Donato Milanese, 20097, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | | | - Davide Tonon
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Gianluca Rossato
- Department of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024, Negrar, Verona, Italy
| | - Luca Faes
- Department of Engineering, University of Palermo, 90128, Palermo, Italy
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Haas AV, Koefoed A, Easly RM, Celli J, Heydarpour M, Bonyhay I, Freeman R, Adler GK. Effect of hypoglycemia on baroreflex sensitivity in individuals with type 2 diabetes: implications for autonomic control of cardiovascular function in diabetes. Clin Auton Res 2023; 33:727-735. [PMID: 37733159 DOI: 10.1007/s10286-023-00983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Hypoglycemia is associated with increased mortality, though the mechanisms underlying this association are not established. Hypoglycemia impairs the counterregulatory hormonal and autonomic responses to subsequent hypoglycemia. It is unknown whether hypoglycemia elicits a generalized impairment in autonomic control of cardiovascular function in individuals with type 2 diabetes. We tested the hypothesis that in individuals with type 2 diabetes, hypoglycemia impairs a key measure of cardiovascular autonomic homeostasis, baroreflex sensitivity. METHODS Sixteen individuals with well-controlled type 2 diabetes and without known cardiovascular disease were exposed to two 90-min episodes of experimental hypoglycemia (2.8 mmol/L, 50 mg/dL) on the same day. All individuals experienced a hypoglycemic-hyperinsulinemic clamp in the morning (AM clamp) and again in the afternoon (PM clamp). Baroreflex sensitivity was assessed using the modified Oxford method before the initiation of each hypoglycemic-hyperinsulinemic clamp, during the last 30 min of hypoglycemia, and the following morning. A mixed effects model adjusting for sex, age, BMI, and insulin level, demonstrated a significant effect of hypoglycemia on baroreflex sensitivity. The study is registered at ClinicalTrials.gov (NCT03422471). RESULTS Baroreflex sensitivity during PM hypoglycemia was reduced compared to baseline, during AM hypoglycemia, and the next day. Insulin levels positively correlated with baroreflex sensitivity at baseline and during AM hypoglycemia. CONCLUSION Exposure to hypoglycemia impairs a key measure of autonomic control of cardiovascular function and, thus, may increase the risk of cardiac arrhythmias and blood pressure lability in individuals with type 2 diabetes. This effect is attenuated in part by increased insulin levels.
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Affiliation(s)
- Andrea V Haas
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA.
| | - Andrew Koefoed
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Rebecca M Easly
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Johanna Celli
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Mahyar Heydarpour
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Istvan Bonyhay
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Gail K Adler
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA
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Blanco C, Madej T, Mangner N, Hommel J, Grimm S, Knaut M, Linke A, Winzer EB. Baroreflex activation therapy in patients with heart failure with reduced ejection fraction: a single-centre experience. ESC Heart Fail 2023; 10:3373-3384. [PMID: 37667319 PMCID: PMC10682889 DOI: 10.1002/ehf2.14508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/20/2023] [Accepted: 08/07/2023] [Indexed: 09/06/2023] Open
Abstract
AIMS Heart failure with reduced ejection fraction (HFrEF) is associated with excessive sympathetic and impaired parasympathetic activity. The Barostim Neo™ device is used for electronical baroreflex activation therapy (BAT) to counteract autonomic nervous system dysbalance. Randomized trials have shown that BAT improves walking distance and reduces N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels at least in patients with only moderate elevation at baseline. Its impact on the risk of heart failure hospitalization (HFH) and death is not yet established, and experience in clinical routine is limited. METHODS AND RESULTS We report on patient characteristics and clinical outcome in a retrospective, non-randomized single-centre registry of BAT in HFrEF. Patients in the New York Heart Association (NYHA) Classes III and IV with a left ventricular ejection fraction (LVEF) <35% despite guideline-directed medical therapy were eligible. Symptom burden, echocardiography, and laboratory testing were assessed at baseline and after 12 months. Clinical events of HFH and death were recorded at routine clinical follow-up. Data are shown as number (%) or median (inter-quartile range). Between 2014 and 2020, 30 patients were treated with BAT. Median age was 67 (63-77) years, and 27 patients (90%) were male. Most patients (83%) had previous HFH. Device implantation was successful in all patients. At 12 months, six patients had died and three were alive but did not attend follow-up. NYHA class was III/IV in 26 (87%)/4 (13%) patients at baseline, improved in 19 patients, and remained unchanged in 5 patients (P < 0.001). LVEF improved from 25.5 (20.0-30.5) % at baseline to 30.0 (25.0-36.0) % at 12 months (P = 0.014). Left ventricular end-diastolic diameter remained unchanged. A numerical decrease in NT-proBNP [3165 (880-8085) vs. 1001 (599-3820) pg/mL] was not significant (P = 0.526). Median follow-up for clinical events was 16 (10-33) months. Mortality at 1 (n = 6, 20%) and 3 years (n = 10, 33%) was as expected by the Meta-Analysis Global Group in Chronic Heart Failure risk score. Despite BAT, event rate was high in patients with NYHA Class IV, NT-proBNP levels >1600 pg/mL, or estimated glomerular filtration rate (eGFR) <30 mL/min at baseline. NYHA class and eGFR were independent predictors of mortality. CONCLUSIONS Patients with HFrEF who are selected for BAT are in a stage of worsening or even advanced heart failure. BAT appears to be safe and improves clinical symptoms and-to a modest degree-left ventricular function. The risk of death remains high in advanced disease stages. Patient selection seems to be crucial, and the impact of BAT in earlier disease stages needs to be established.
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Affiliation(s)
- Carola Blanco
- Department of Internal Medicine and CardiologyHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Tomas Madej
- Department of Cardiac SurgeryHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Norman Mangner
- Department of Internal Medicine and CardiologyHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Jennifer Hommel
- Faculty of MedicineTechnische Universität DresdenDresdenGermany
| | - Susanna Grimm
- Department of Internal Medicine and CardiologyHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Michael Knaut
- Department of Cardiac SurgeryHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Axel Linke
- Department of Internal Medicine and CardiologyHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
| | - Ephraim B. Winzer
- Department of Internal Medicine and CardiologyHeart Centre Dresden, University Hospital, Technische Universität DresdenDresdenGermany
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Sabino-Carvalho JL, Jeong J, Sprick J, DaCosta D, Nardone M, Park J. Augmented resting beat-to-beat blood pressure variability in patients with chronic kidney disease. Clin Auton Res 2023; 33:705-714. [PMID: 37776374 PMCID: PMC10993989 DOI: 10.1007/s10286-023-00979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/24/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE Our aim was to test the hypothesis that patients with chronic kidney disease (CKD) would exhibit augmented resting beat-to-beat blood pressure variability (BPV) that is associated with poor clinical outcomes independent of mean blood pressure (BP). In addition, since the arterial baroreflex plays a critical role in beat-to-beat BP regulation, we further hypothesized that an impaired baroreflex control would be associated with an augmented resting beat-to-beat BPV. METHODS In 25 sedentary patients with CKD stages III-IV (62 ± 9 years) and 20 controls (57 ± 10 years), resting beat-to-beat BP (finger photoplethysmography) and heart rate (electrocardiography) were continuously measured for 10 min. We calculated the standard deviation (SD), average real variability (ARV) and other indices of BPV. The sequence technique was used to estimate spontaneous cardiac baroreflex sensitivity. RESULTS Compared with controls (CON), the CKD group had significantly increased resting BPV. The ARV (2.2 ± 0.6 versus 1.6 ± 0.5 mmHg, P < 0.001; 1.6 ± 0.7 versus 1.3 ± 0.3 mmHg, P = 0.039; 1.4 ± 0.5 versus 1.0 ± 0.2 mmHg, P < 0.001) of systolic, diastolic and mean BP, respectively, was increased in CKD versus controls. Other traditional measures of variability showed similar results. The cardiac baroreflex sensitivity was lower in CKD compared with controls (CKD: 8.4 ± 4.5 ms/mmHg versus CON: 14.0 ± 8.2 ms/mmHg, P = 0.008). In addition, cardiac baroreflex sensitivity was negatively associated with BPV [systolic blood pressure (SBP) ARV; r = -0.44, P = 0.003]. CONCLUSION In summary, our data demonstrate that patients with CKD have augmented beat-to-beat BPV and lower cardiac baroreflex sensitivity. BPV and cardiac baroreflex sensitivity were negatively correlated in this cohort. These findings may further our understanding about cardiovascular dysregulation observed in patients with CKD.
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Affiliation(s)
- Jeann L Sabino-Carvalho
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Jinhee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Justin Sprick
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX, USA
| | - Dana DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Massimo Nardone
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA.
- Department of Veterans Affairs Health Care System, Decatur, Georgia.
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De Maria B, Dalla Vecchia LA, Bari V, Cairo B, Gelpi F, Perego F, Takahashi ACM, Milan-Mattos JC, Minatel V, Rehder-Santos P, Esler M, Lambert E, Baumert M, Catai AM, Porta A. The degree of engagement of cardiac and sympathetic arms of the baroreflex does not depend on the absolute value and sign of arterial pressure variations. Physiol Meas 2023; 44:114002. [PMID: 37922536 DOI: 10.1088/1361-6579/ad0976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/03/2023] [Indexed: 11/07/2023]
Abstract
Objective.The percentages of cardiac and sympathetic baroreflex patterns detected via baroreflex sequence (SEQ) technique from spontaneous variability of heart period (HP) and systolic arterial pressure (SAP) and of muscle nerve sympathetic activity (MSNA) burst rate and diastolic arterial pressure (DAP) are utilized to assess the level of the baroreflex engagement. The cardiac baroreflex patterns can be distinguished in those featuring both HP and SAP increases (cSEQ++) and decreases (cSEQ--), while the sympathetic baroreflex patterns in those featuring a MSNA burst rate decrease and a DAP increase (sSEQ+-) and vice versa (sSEQ-+). The present study aims to assess the modifications of the involvement of the cardiac and sympathetic arms of the baroreflex with age and postural stimulus intensity.Approach.We monitored the percentages of cSEQ++ (%cSEQ++) and cSEQ-- (%cSEQ--) in 100 healthy subjects (age: 21-70 years, 54 males, 46 females), divided into five sex-balanced groups consisting of 20 subjects in each decade at rest in supine position and during active standing (STAND). We evaluated %cSEQ++, %cSEQ--, and the percentages of sSEQ+- (%sSEQ+-) and sSEQ-+ (%sSEQ-+) in 12 young healthy subjects (age 23 ± 2 years, 3 females, 9 males) undergoing incremental head-up tilt.Main results.We found that: (i) %cSEQ++ and %cSEQ-- decreased with age and increased with STAND and postural stimulus intensity; (ii) %sSEQ+- and %sSEQ-+ augmented with postural challenge magnitude; (iii) the level of cardiac and sympathetic baroreflex engagement did not depend on either the absolute value of arterial pressure or the direction of its changes.Significance.This study stresses the limited ability of the cardiac and sympathetic arms of the baroreflex in controlling absolute arterial pressure values and the equivalent ability of both positive and negative arterial pressure changes in soliciting them.
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Affiliation(s)
| | | | - Vlasta Bari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Beatrice Cairo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Francesca Gelpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Vinicius Minatel
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Murray Esler
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Science, Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Australia
| | - Mathias Baumert
- Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Nuhn EM, Wallbach M, Elger F, Koziolek MJ. Successful baroreflex activation therapy in a case of therapy-resistant renovascular hypertension. Clin Res Cardiol 2023; 112:1710-1712. [PMID: 36547755 PMCID: PMC10584732 DOI: 10.1007/s00392-022-02137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/22/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Eva Maria Nuhn
- Department of Nephrology and Rheumatology, University Medical Centre, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Manuel Wallbach
- Department of Nephrology and Rheumatology, University Medical Centre, Robert-Koch-Str. 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 30, 37075, Göttingen, Germany
| | - Florian Elger
- Department of Cardiac, Thoracic and Vascular Surgery, University Medical Centre, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Michael Johann Koziolek
- Department of Nephrology and Rheumatology, University Medical Centre, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 30, 37075, Göttingen, Germany.
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Bunsawat K, Skow RJ, Kaur J, Wray DW. Neural control of the circulation during exercise in heart failure with reduced and preserved ejection fraction. Am J Physiol Heart Circ Physiol 2023; 325:H998-H1011. [PMID: 37682236 PMCID: PMC10907034 DOI: 10.1152/ajpheart.00214.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
Patients with heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF) exhibit severe exercise intolerance that may be due, in part, to inappropriate cardiovascular and hemodynamic adjustments to exercise. Several neural mechanisms and locally released vasoactive substances work in concert through complex interactions to ensure proper adjustments to meet the metabolic demands of the contracting skeletal muscle. Specifically, accumulating evidence suggests that disease-related alterations in neural mechanisms (e.g., central command, exercise pressor reflex, arterial baroreflex, and cardiopulmonary baroreflex) contribute to heightened sympathetic activation and impaired ability to attenuate sympathetic vasoconstrictor responsiveness that may contribute to reduced skeletal muscle blood flow and severe exercise intolerance in patients with HFrEF. In contrast, little is known regarding these important aspects of physiology in patients with HFpEF, though emerging data reveal heightened sympathetic activation and attenuated skeletal muscle blood flow during exercise in this patient population that may be attributable to dysregulated neural control of the circulation. The overall goal of this review is to provide a brief overview of the current understanding of disease-related alterations in the integrative neural cardiovascular responses to exercise in both HFrEF and HFpEF phenotypes, with a focus on sympathetic nervous system regulation during exercise.
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Affiliation(s)
- Kanokwan Bunsawat
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, United States
| | - D Walter Wray
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
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Tapio J, Kiviniemi AM, Perkiömäki J, Junttila MJ, Huikuri HV, Ukkola O, Koivunen P, Tulppo MP. Lower hemoglobin levels associate with higher baroreflex sensitivity and heart rate variability. Am J Physiol Heart Circ Physiol 2023; 325:H629-H634. [PMID: 37566112 PMCID: PMC10659262 DOI: 10.1152/ajpheart.00415.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
The aim of this study was to cross-sectionally examine whether hemoglobin (Hb) levels within the normal variation associate with heart rate variability (HRV) measures and baroreflex sensitivity (BRS). The study population included 733 Finnish subjects of the OPERA cohort (aged 41-59 yr, 53% males, 51.7% treated for hypertension) of whom HRV was measured from a standardized 45-min period and whose Hb levels were within the Finnish reference intervals. The low Hb tertile (mean Hb, 135 g/L) had an overall healthier metabolic profile compared with the high Hb tertile (mean Hb, 152 g/L). BRS was higher in the low Hb tertile compared with the high Hb tertile (P < 0.05). R-R interval (RRi) and standard deviation (SD) of the RRi (SDNN)index were the longest in the low Hb tertile regardless of posture. Of the spectral components of HRV, HF power was the highest in the low Hb tertile regardless of posture (P < 0.05). In a stepwise logistic regression model, BRS associated negatively with Hb levels after adjusting for covariates (B = -0.160 [-0.285; -0.035]). Similar associations were observed for SDNNindex when lying down (B = -0.105 [-0.207; -0.003]) and walking (B = -0.154 [-0.224; -0.083]). For HF power negative associations with Hb levels were observed when lying down (B = -0.110 [-0.180; -0.040]), sitting (B = -0.150 [-0.221; -0.079]), and in total analysis (B = -0.124 [-0.196; -0.053]). Overall, lower Hb levels associated independently with healthier cardiac autonomic function.NEW & NOTEWORTHY Heart rate variability (HRV) and baroreflex sensitivity (BRS), which can be measured noninvasively, can predict cardiac and metabolic diseases. Our findings show that within normal variation subjects with lower hemoglobin (Hb) levels have an overall healthier HRV profile and increased cardiac parasympathetic activity in middle age, independent of age, sex, smoking status, and key metabolic covariates. These findings support our previous findings that Hb levels can be used in assessing long-term risks for cardiometabolic diseases.
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Affiliation(s)
- Joona Tapio
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, Oulu, Finland
| | - Antti M Kiviniemi
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - M Juhani Junttila
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Heikki V Huikuri
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Olavi Ukkola
- Medical Research Center Oulu, Faculty of Medicine, Oulu University Hospital and Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
| | - Peppi Koivunen
- Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, Oulu, Finland
| | - Mikko P Tulppo
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Abstract
The cardiovascular response to exercise is largely determined by neurocirculatory control mechanisms that help to raise blood pressure and modulate vascular resistance which, in concert with regional vasodilatory mechanisms, promote blood flow to active muscle and organs. These neurocirculatory control mechanisms include a feedforward mechanism, known as central command, and three feedback mechanisms, namely, 1) the baroreflex, 2) the exercise pressor reflex, and 3) the arterial chemoreflex. The hemodynamic consequences of these control mechanisms result from their influence on the autonomic nervous system and subsequent alterations in cardiac output and vascular resistance. Although stimulation of the baroreflex inhibits sympathetic outflow and facilitates parasympathetic activity, central command, the exercise pressor reflex, and the arterial chemoreflex facilitate sympathetic activation and inhibit parasympathetic drive. Despite considerable understanding of the cardiovascular consequences of each of these mechanisms in isolation, the circulatory impact of their interaction, which occurs when various control systems are simultaneously activated (e.g., during exercise at altitude), has only recently been recognized. Although aging and cardiovascular disease (e.g., heart failure, hypertension) have both been recognized to alter the hemodynamic consequences of these regulatory systems, this review is limited to provide a brief overview on the action and interaction of neurocirculatory control mechanisms in health.
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Affiliation(s)
- Hsuan-Yu Wan
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah, United States
| | - Kanokwan Bunsawat
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Markus Amann
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
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Hughes GW, Moore JP, Lord RN. Barosensory vessel mechanics and the vascular sympathetic baroreflex: Impact on blood pressure homeostasis. Exp Physiol 2023; 108:1245-1249. [PMID: 37031381 PMCID: PMC10988470 DOI: 10.1113/ep089686] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/09/2023] [Indexed: 04/10/2023]
Abstract
NEW FINDINGS What is the topic of this review? We review barosensory vessel mechanics and their role in blood pressure regulation across the lifespan. What advances does it highlight? In young normotensive men, aortic unloading mechanics contribute to the resting operating point of the vascular sympathetic baroreflex; however, with advancing age, this contribution is removed. This suggests that barosensory vessel unloading mechanics are not driving the well-documented age-related increase in resting muscle sympathetic nerve activity. ABSTRACT An age-associated increase in arterial blood pressure is evident for apparently healthy humans. This is frequently attributed to stiffening of the central arteries and a concurrent increase in sympathetic outflow, potentially mediated by a reduced ability of the baroreceptive vessels to distend. This is supported, in part, by a reduced mechanical component of the vascular sympathetic baroreflex (i.e., a reduction in distension for a given pressure). Previous characterization of the mechanical component has assessed only carotid artery distension; however, evidence suggests that both the aortic and carotid baroreflexes are integral to blood pressure regulation. In addition, given that baroreceptors are located in the vessel wall, the change in wall tension, comprising diameter, pressure and vessel wall thickness, and the mechanics of this change might provide a better index of the baroreceptor stimulus than the previous method used to characterize the mechanical component that relies on diameter alone. This brief review summarizes the data using this new method of assessing barosensory vessel mechanics and their influence on the vascular sympathetic baroreflex across the lifespan.
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Affiliation(s)
- Guto W. Hughes
- School of Human and Behavioural SciencesBangor UniversityBangorUK
| | | | - Rachel N. Lord
- Centre for Activity, Health and Wellbeing ResearchCardiff Metropolitan UniversityCardiffUK
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Estrada JA, Hotta N, Kim HK, Ishizawa R, Fukazawa A, Iwamoto GA, Smith SA, Vongpatanasin W, Mizuno M. Blockade of endogenous insulin receptor signaling in the nucleus tractus solitarius potentiates exercise pressor reflex function in healthy male rats. FASEB J 2023; 37:e23141. [PMID: 37566482 PMCID: PMC10430879 DOI: 10.1096/fj.202300879rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
Insulin not only regulates glucose and/or lipid metabolism but also modulates brain neural activity. The nucleus tractus solitarius (NTS) is a key central integration site for sensory input from working skeletal muscle and arterial baroreceptors during exercise. Stimulation of the skeletal muscle exercise pressor reflex (EPR), the responses of which are buffered by the arterial baroreflex, leads to compensatory increases in arterial pressure to supply blood to working muscle. Evidence suggests that insulin signaling decreases neuronal excitability in the brain, thus antagonizing insulin receptors (IRs) may increase neuronal excitability. However, the impact of brain insulin signaling on the EPR remains fully undetermined. We hypothesized that antagonism of NTS IRs increases EPR function in normal healthy rodents. In decerebrate rats, stimulation of the EPR via electrically induced muscle contractions increased peak mean arterial pressure (MAP) responses 30 min following NTS microinjections of an IR antagonist (GSK1838705, 100 μM; Pre: Δ16 ± 10 mmHg vs. 30 min: Δ23 ± 13 mmHg, n = 11, p = .004), a finding absent in sino-aortic baroreceptor denervated rats. Intrathecal injections of GSK1838705 did not influence peak MAP responses to mechano- or chemoreflex stimulation of the hindlimb muscle. Immunofluorescence triple overlap analysis following repetitive EPR stimulation increased c-Fos overlap with EPR-sensitive nuclei and IR-positive cells relative to sham operation (p < .001). The results suggest that IR blockade in the NTS potentiates the MAP response to EPR stimulation. In addition, insulin signaling in the NTS may buffer EPR stimulated increases in blood pressure via baroreflex-mediated mechanisms during exercise.
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Affiliation(s)
- Juan A. Estrada
- Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Norio Hotta
- College of Life and Health Sciences, Chubu University, Kasugai 487-850, Japan
| | - Han-Kyul Kim
- Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Rie Ishizawa
- Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Ayumi Fukazawa
- Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Gary A. Iwamoto
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Scott A. Smith
- Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Wanpen Vongpatanasin
- Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Masaki Mizuno
- Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Salman IM. Functional symmetry of the aortic baroreflex in female spontaneously hypertensive rats. J Hypertens 2023; 41:1456-1465. [PMID: 37382160 DOI: 10.1097/hjh.0000000000003493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Altered baroreflex function is well documented in hypertension; however, the female sex remains far less studied compared with males. We have previously demonstrated a left-sided dominance in the expression of aortic baroreflex function in male spontaneously hypertensive rats (SHRs) and normotensive rats of either sex. If lateralization in aortic baroreflex function extends to hypertensive female rats remains undetermined. This study, therefore, assessed the contribution of left and right aortic baroreceptor afferents to baroreflex modulation in female SHRs. METHOD Anesthetized female SHRs (total n = 9) were prepared for left, right and bilateral aortic depressor nerve (ADN) stimulation (1-40 Hz, 0.2 ms, 0.4 mA for 20 s) and measurement of reflex mean arterial pressure (MAP), heart rate (HR), mesenteric vascular resistance (MVR) and femoral vascular resistance (FVR). All rats were also matched for the diestrus phase of the estrus cycle. RESULTS Reflex (%) reductions in MAP, HR, MVR and FVR were comparable for both left-sided and right-sided stimulation. Bilateral stimulation evoked slightly larger ( P = 0.03) reductions in MVR compared with right-sided stimulation; however, all other reflex hemodynamic measures were similar to both left-sided and right-sided stimulation. CONCLUSION These data show that female SHRs, unlike male SHRs, express similar central integration of left versus right aortic baroreceptor afferent input and thus show no laterization in the aortic baroreflex during hypertension. Marginal increases in mesenteric vasodilation following bilateral activation of the aortic baroreceptor afferents drive no superior depressor responses beyond that of the unilateral stimulation. Clinically, unilateral targeting of the left or right aortic baroreceptor afferents may provide adequate reductions in blood pressure in female hypertensive patients.
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Affiliation(s)
- Ibrahim M Salman
- Department of Pharmaceutical Sciences, College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
- Division of Pulmonology, Allergy and Immunology, Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Yokoi A, Kawada T, Yokota S, Kakuuchi M, Matsushita H, Nishiura A, Li M, Uemura K, Alexander J, Tanaka R, Saku K. Impact of vericiguat on baroreflex-mediated sympathetic circulatory regulation: An open-loop analysis. PLoS One 2023; 18:e0286767. [PMID: 37566583 PMCID: PMC10420376 DOI: 10.1371/journal.pone.0286767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/23/2023] [Indexed: 08/13/2023] Open
Abstract
AIMS To quantify in vivo the effects of the soluble guanylate cyclase (sGC) stimulator, vericiguat, on autonomic cardiovascular regulation in comparison with the nitric oxide (NO) donor, sodium nitroprusside. METHODS In anesthetized Wistar-Kyoto rats, baroreflex-mediated changes in sympathetic nerve activity (SNA), arterial pressure (AP), central venous pressure (CVP), and aortic flow (AoF) were examined before and during the intravenous continuous administration (10 μg·kg-1·min-1) of vericiguat or sodium nitroprusside (n = 8 each). Systemic vascular resistance (SVR) was calculated as SVR = (AP-CVP) / AoF. RESULTS Neither vericiguat nor sodium nitroprusside affected fitted parameters of the baroreflex-mediated SNA response. Both vericiguat and sodium nitroprusside decreased the AP mainly through their peripheral effects. Vericiguat halved the slope of the SNA-SVR relationship from 0.012 ± 0.002 to 0.006 ± 0.002 mmHg·min·mL-1·%-1 (P = 0.008), whereas sodium nitroprusside caused a near parallel downward shift in the SNA-SVR relationship with a reduction of the SVR intercept from 1.235 ± 0.187 to 0.851 ± 0.123 mmHg·min/mL (P = 0.008). CONCLUSION Neither vericiguat nor sodium nitroprusside significantly affected the baroreflex-mediated SNA response. The vasodilative effect of vericiguat became greater toward high levels of SNA and AP, possibly reflecting the increased sGC sensitivity to endogenous NO. By contrast, the effect of sodium nitroprusside was more uniform over the range of SNA. These results help better understand cardiovascular effects of vericiguat.
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Affiliation(s)
- Aimi Yokoi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shohei Yokota
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Midori Kakuuchi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hiroki Matsushita
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akitsugu Nishiura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Meihua Li
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazunori Uemura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Joe Alexander
- Medical and Health Informatics, NTT Research, Inc., Sunnyvale, CA, United States of America
| | - Ryou Tanaka
- Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Ferreira MJ, dos Santos Ferreira Silva MP, da Silva Dias D, Bernardes N, Irigoyen MC, De Angelis K. Concurrent exercise training induces additional benefits to hydrochlorothiazide: Evidence for an improvement of autonomic control and oxidative stress in a model of hypertension and postmenopause. PLoS One 2023; 18:e0289715. [PMID: 37549182 PMCID: PMC10406179 DOI: 10.1371/journal.pone.0289715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate whether exercise training could contribute to a better modulation of the neurohumoral mechanisms linked to the pathophysiology of arterial hypertension (AH) in postmenopausal hypertensive rats treated with hydrochlorothiazide (HCTZ). METHODS Female spontaneously hypertensive rats (SHR) (150-200g, 90 days old) were distributed into 5 hypertensive groups (n = 7-8 rats/group): control (C), ovariectomized (O), ovariectomized treated with HCTZ (OH), ovariectomized submitted to exercise training (OT) and ovariectomized submitted to exercise training and treated with HCTZ (OTH). Ovarian hormone deprivation was performed through bilateral ovariectomy. HCTZ (30mg/kg/day) and concurrent exercise training (3d/wk) were conducted lasted 8 weeks. Arterial pressure (AP) was directly recorded. Cardiac effort was evaluated using the rate-pressure product (RPP = systolic AP x heart rate). Vasopressin V1 receptor antagonist, losartan and hexamethonium were sequentially injected to evaluate the vasopressor systems. Inflammation and oxidative stress were evaluated in cardiac tissue. RESULTS In addition to the reduction in AP, trained groups improved RPP, AP variability, bradycardic (OT: -1.3 ± 0.4 and OTH: -1.6 ± 0.3 vs. O: -0.6 ± 0.3 bpm/mmHg) and tachycardic responses of baroreflex sensitivity (OT: -2.4 ± 0.8 and OTH: -2.4 ± 0.8 vs. O: -1.3 ± 0.5 bpm/mmHg), NADPH oxidase and IL-10/TNF-α ratio. Hexamethonium injection revealed reduced sympathetic contribution on basal AP in OTH group (OTH: -49.8 ± 12.4 vs. O: -74.6 ± 18.1 mmHg). Furthermore, cardiac sympathovagal balance (LF/HF ratio), IL-10 and antioxidant enzymes were enhanced in OTH group. AP variability and baroreflex sensitivity were correlated with systolic AP, RPP, LF/HF ratio and inflammatory and oxidative stress parameters. CONCLUSION The combination of HCTZ plus concurrent exercise training induced additional positive adaptations in cardiovascular autonomic control, inflammation and redox balance in ovariectomized SHR. Therefore, combining exercise and medication may represent a promising strategy for managing classic and remaining cardiovascular risks in AH.
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Affiliation(s)
- Maycon Junior Ferreira
- Exercise Physiology Laboratory, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Danielle da Silva Dias
- Hypertension Unit, Heart Institute (InCor), School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Nathalia Bernardes
- Human Movement Laboratory, Universidade São Judas Tadeu (USJT), São Paulo, SP, Brazil
| | - Maria Claudia Irigoyen
- Hypertension Unit, Heart Institute (InCor), School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Kátia De Angelis
- Exercise Physiology Laboratory, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Translational Physiology Laboratory, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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47
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Latchman PL, Yang Q, Morgenthaler D, Kong L, Sebagisha J, Melendez L, Green CA, Bernard S, Mugno R, De Meersman R. Autonomic modulation, spontaneous baroreflex sensitivity and fatigue in young men after COVID-19. Physiol Res 2023; 72:329-336. [PMID: 37449746 PMCID: PMC10669003 DOI: 10.33549/physiolres.935051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/16/2023] [Indexed: 08/26/2023] Open
Abstract
Impaired autonomic modulation and baroreflex sensitivity (BRS) have been reported during and after COVID-19. Both impairments are associated with negative cardiovascular outcomes. If these impairments were to exist undetected in young men after COVID-19, they could lead to negative cardiovascular outcomes. Fatigue is associated with autonomic dysfunction during and after COVID-19. It is unclear if fatigue can be used as an indicator of impaired autonomic modulation and BRS after COVID-19. This study aims to compare parasympathetic modulation, sympathetic modulation, and BRS between young men who had COVID-19 versus controls and to determine if fatigue is associated with impaired autonomic modulation and BRS. Parasympathetic modulation as the high-frequency power of R-R intervals (lnHFR-R), sympathetic modulation as the low-frequency power of systolic blood pressure variability (LFSBP), and BRS as the -index were measured by power spectral density analysis. These variables were compared between 20 young men who had COVID-19 and 24 controls. Independent t-tests and Mann-Whitney U tests indicated no significant difference between the COVID-19 and the control group in: lnHFR-R, P=0.20; LFSBP, P=0.11, and -index, P=0.20. Fatigue was not associated with impaired autonomic modulation or BRS. There is no difference in autonomic modulations or BRS between young men who had COVID-19 compared to controls. Fatigue did not seem to be associated with impaired autonomic modulation or impaired BRS in young men after COVID-19. Findings suggest that young men might not be at increased cardiovascular risk from COVID-19-related dysautonomia and impaired BRS.
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Affiliation(s)
- P L Latchman
- Southern Connecticut State University, New Haven, Connecticut, U.S.A.
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48
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Salman IM, Ameer OZ, McMurray S, Hassan SF, Sridhar A, Lewis SJ, Hsieh YH. Differential central integration of left versus right baroreceptor afferent input in spontaneously hypertensive rats. J Hypertens 2023; 41:1191-1200. [PMID: 37074354 PMCID: PMC10241432 DOI: 10.1097/hjh.0000000000003448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/07/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The blood pressure (BP) regulatory impact of the arterial baroreflex has been well established in health and disease. Under normotensive conditions, we have previously demonstrated functional differences in the central processing of the left versus right aortic baroreceptor afferent input. However, it is unknown if lateralization in aortic baroreflex function remains evident during hypertension. METHOD We therefore, investigated the effects of laterality on the expression of baroreflex-driven cardiovascular reflexes in a genetic model of essential hypertension, the spontaneously hypertensive rat (SHR). Anesthetized male SHRs (total n = 9) were instrumented for left, right, and bilateral aortic depressor nerve (ADN) stimulation (1-40 Hz, 0.2 ms, and 0.4 mA for 20 s) and measurement of mean arterial pressure (MAP), heart rate (HR), mesenteric vascular resistance (MVR), and femoral vascular resistance (FVR). RESULTS Left right, and bilateral ADN stimulation evoked frequency-dependent decreases in MAP, HR, MVR, and FVR. Left and bilateral ADN stimulation evoked greater reflex reductions in MAP, HR, MVR, and FVR compared with right-sided stimulation. Reflex bradycardia to bilateral stimulation was larger relative to both left-sided and right-sided stimulation. Reflex depressor and vascular resistance responses to bilateral stimulation mimicked those of the left-sided stimulation. These data indicate a left-side dominance in the central integration of aortic baroreceptor afferent input. Furthermore, reflex summation due to bilateral stimulation is only evident on the reflex bradycardic response, and does not drive further reductions in BP, suggesting that reflex depressor responses in the SHRs are primarily driven by changes in vascular resistance. CONCLUSION Together, these results indicate that lateralization in aortic baroreflex function is not only evident under normotensive conditions but also extends to hypertensive conditions.
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Affiliation(s)
- Ibrahim M. Salman
- Department of Pharmaceutical Sciences, College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
| | - Omar Z. Ameer
- Department of Pharmaceutical Sciences, College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
| | | | | | - Arun Sridhar
- Galvani Bioelectronics, Stevenage, Hertfordshire, UK
| | - Stephen J. Lewis
- Division of Pulmonology, Allergy and Immunology, Department of Pediatrics, School of Medicine
- Electrical Stimulation Center
| | - Yee-Hsee Hsieh
- Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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49
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Cai M, Wang H, Kline G, Ding Y, Ross SE, Davis S, Mallet RT, Shi X. Habitual physical activity improves vagal cardiac modulation and carotid baroreflex function in elderly women. Exp Biol Med (Maywood) 2023; 248:991-1000. [PMID: 37092743 PMCID: PMC10525404 DOI: 10.1177/15353702231160334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/10/2023] [Indexed: 04/25/2023] Open
Abstract
The impact of habitual physical activity on vagal-cardiac function and baroreflex sensitivity in elderly women is poorly characterized. This study compared vagal-cardiac modulation and carotid baroreflex (CBR) function in eight physically active (67.6 ± 1.9 years; peak O2 uptake 29.1 ± 2.5 mL/min/kg) versus eight sedentary (67.3 ± 1.8 years; peak O2 uptake 18.6 ± 0.9 mL/min/kg) elderly women. Heart rate (HR) variabilities and maximal changes of HR and mean arterial pressure (MAP) elicited by 5-s pressure pulses between +40 and -80 mmHg applied to the carotid sinus were measured at rest and during carotid baroreceptor unloading effected by -15 mmHg lower-body negative pressure (LBNP). HR variability was greater in active than sedentary women in both low (0.998 ± 0.286 versus 0.255 ± 0.063 bpm2; P = 0.036) and high (0.895 ± 0.301 versus 0.156 ± 0.045 bpm2; P = 0.044) frequency domains. CBR-HR gains (bpm/mmHg) were greater (fitness factor P < 0.001) in active versus sedentary women at rest (-0.146 ± 0.014 versus -0.088 ± 0.011) and during LBNP (-0.105 ± 0.014 versus -0.065 ± 0.008). CBR-MAP gains (mmHg/mmHg) tended to be greater (fitness factor P = 0.077) in active versus sedentary women at rest (-0.132 ± 0.013 versus -0.110 ± 0.011) and during LBNP (-0.129 ± 0.015 versus -0.113 ± 0.013). However, LBNP did not potentiate CBR-MAP gains in either sedentary or active women (LBNP factor P = 0.94), and it depressed CBR-HR gains in both groups (LBNP factor P = 0.003). CBR-HR gains in the sedentary women did not differ (sex factor P = 0.65) from gains reported in age-matched sedentary men, although CBR-MAP gains tended to be greater (sex factor P = 0.109) in the men. Thus, tonic vagal modulation indicated by HR variability and dynamic vagal responses assessed by CBR-HR gain were augmented in physically active women. Enhanced vagal-cardiac function may protect against senescence-associated cardiac electrical and hemodynamic instability in elderly women.
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Affiliation(s)
- Ming Cai
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Hong Wang
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Geoffrey Kline
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Yanfeng Ding
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Sarah E Ross
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Sandra Davis
- Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Robert T Mallet
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX 76107-2699, USA
| | - Xiangrong Shi
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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50
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Giannoni A, Borrelli C, Gentile F, Sciarrone P, Spießhöfer J, Piepoli M, Richerson GB, Floras JS, Coats AJS, Javaheri S, Emdin M, Passino C. Autonomic and respiratory consequences of altered chemoreflex function: clinical and therapeutic implications in cardiovascular diseases. Eur J Heart Fail 2023; 25:642-656. [PMID: 36907827 PMCID: PMC10989193 DOI: 10.1002/ejhf.2819] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/10/2023] [Accepted: 02/26/2023] [Indexed: 03/14/2023] Open
Abstract
The importance of chemoreflex function for cardiovascular health is increasingly recognized in clinical practice. The physiological function of the chemoreflex is to constantly adjust ventilation and circulatory control to match respiratory gases to metabolism. This is achieved in a highly integrated fashion with the baroreflex and the ergoreflex. The functionality of chemoreceptors is altered in cardiovascular diseases, causing unstable ventilation and apnoeas and promoting sympathovagal imbalance, and it is associated with arrhythmias and fatal cardiorespiratory events. In the last few years, opportunities to desensitize hyperactive chemoreceptors have emerged as potential options for treatment of hypertension and heart failure. This review summarizes up to date evidence of chemoreflex physiology/pathophysiology, highlighting the clinical significance of chemoreflex dysfunction, and lists the latest proof of concept studies based on modulation of the chemoreflex as a novel target in cardiovascular diseases.
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Affiliation(s)
- Alberto Giannoni
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, Italy
- Fondazione Toscana G. Monasterio, Pisa, Italy
| | | | - Francesco Gentile
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | - Jens Spießhöfer
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, Italy
- University of Aachen, Aachen, Germany
| | | | | | - John S Floras
- Division of Cardiology, Mount Sinai Hospital, University of Toronto, Ontario, Canada
| | | | - Shahrokh Javaheri
- Division of Pulmonary and Sleep Medicine, Bethesda North Hospital, Cincinnati, Ohio, Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio, and Division of Cardiology, The Ohio State University, Columbus, Ohio USA
| | - Michele Emdin
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, Italy
- Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Claudio Passino
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa, Italy
- Fondazione Toscana G. Monasterio, Pisa, Italy
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