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Spontaneous Baroreflex Sensitivity (spontaneous + baroreflex_sensitivity)

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Medical Sciences	88%

Selected Abstracts

Effects of age on the cardiac and vascular limbs of the arterial baroreflex

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2003
C. M. Brown
Abstract Background Healthy ageing has several effects on the autonomic control of the circulation. Several studies have shown that baroreflex-mediated vagal control of the heart deteriorates with age, but so far there is little information regarding the effect of ageing on sympathetically mediated baroreflex responses. The aim of this study was to assess the effects of ageing on baroreflex control of the heart and blood vessels. Materials and Methods In 40 healthy volunteers, aged 20,87 years, we applied oscillatory neck suction at 0·1 Hz to assess the sympathetic modulation of the heart and blood vessels and at 0·2 Hz to assess the effect of parasympathetic stimulation on the heart. Breathing was maintained at 0·25 Hz. Blood pressure, electrocardiographic RR intervals and respiration were recorded continuously. Spectral analysis was used to evaluate the magnitude of the low-frequency (0·03,0·14 Hz) and high-frequency (0·15,0·50 Hz) oscillations in the RR interval and blood pressure. Responses to neck suction were assessed as the change in power of the RR interval and blood pressure fluctuations at the stimulation frequency from baseline values. Results Resting low- and high-frequency powers of the RR interval decreased significantly with age (P < 0·01). However, the low-frequency power of systolic blood pressure did not correlate with age. Spontaneous baroreflex sensitivity (alpha-index) showed a significant inverse correlation with age (r = ,0·46, P < 0·05). Responses of the RR interval and systolic blood pressure to 0·1 Hz neck suction stimulation were not related to age, however, the RR interval response to 0·2 Hz neck suction declined significantly with age (r = ,0·61, P < 0·01). Conclusions These results confirm an age-related decrease in cardiovagal baroreflex responses. However, sympathetically mediated baroreflex control of the blood vessels is preserved with age. [source]

Spontaneous baroreflex sensitivity as a dynamic measure of cardiac anticholinergic drug effect

AUTONOMIC & AUTACOID PHARMACOLOGY, Issue 2 2001
J. Penttilä
1,In this study, the analysis of spontaneous baroreflex sensitivity (BRS) was applied to the dynamic assessment of cardiac anticholinergic drug effect in healthy male volunteers. 2,The anticholinergic effects of single intravenous (i.v.) injections of atropine (10 ,g kg,1), glycopyrrolate (5 ,g kg,1) and scopolamine (5 ,g kg,1), as well as a 2-h infusion of glycopyrrolate (5 ,g kg,1 h,1) were investigated. Baroreflex sensitivity, a validated measure of cardiac parasympathetic reflex regulation, was repeatedly measured from 5-min recordings of electrocardiogram (ECG) and continuous blood pressure by using the sequence technique, a method based on detection of spontaneous fluctuations in blood pressure and heart rate. 3,Single injections of atropine, glycopyrrolate and scopolamine decreased the mean BRS by 71 ± 32, 68 ± 23 and 27 ± 45%, respectively, whereas the slow glycopyrrolate infusion gradually decreased BRS (up to 83 ± 11% reduction) and increased both systolic (SAP) and diastolic arterial pressures (DAP) (on an average, by 9 mmHg). 4,During the withdrawal of the parasympathetic blockade (indicated by increasing BRS), the proportion of baroreflex sequences in the recordings increased transiently from 10 up to 20,25%, probably reflecting the restoration of the baroreflex integrity and the baroreflex-induced attempt to counteract the blood pressure increase. 5,The sequence method to study BRS seems to be feasible in the assessment of cardiac anticholinergic drug effects, and it also provides good time resolution for the dynamic measurements. [source]

Increased baroreflex sensitivity and heart rate variability in migraine patients

ACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009
K. B. Nilsen
Objectives,,, We investigated whether spontaneous baroreflex sensitivity and heart rate variability (HRV) are different in migraine patients compared to healthy controls. Material and methods,,, Sixteen female migraine patients without aura aged 18,30 years and 14 age-matched healthy female controls were included. Continuous finger blood pressure and ECG were measured supine during paced breathing in the laboratory. Continuous finger blood pressure was measured the following 24-h period. Spontaneous baroreflex sensitivity (time-domain cross correlation baroreflex sensitivity) as well as HRV parameters were calculated. Results,,, Spontaneous baroreflex sensitivity measured in the 24-h period was increased in patients (20.6 ms/mmHg) compared to controls (15.7 ms/mmHg, P = 0.031). HRV parameters were increased during paced breathing in patients (P < 0.045). Conclusions,,, The results suggest that central hypersensitivity in migraine also includes cardiovascular reactivity and may be important for the understanding of the mechanisms for the effect of antihypertensive drugs for migraine prophylaxis. [source]

No effect of venoconstrictive thigh cuffs on orthostatic hypotension induced by head-down bed rest

ACTA PHYSIOLOGICA, Issue 2 2000
M.-A. Custaud
Orthostatic intolerance (OI) is the most serious symptom of cardiovascular deconditioning induced by head-down bed rest or weightlessness. Wearing venoconstrictive thigh cuffs is an empirical countermeasure used by Russian cosmonauts to limit the shift of fluid from the lower part of the body to the cardio-cephalic region. Our aim was to determine whether or not thigh cuffs help to prevent orthostatic hypotension induced by head-down bed rest. We studied the effect of thigh cuffs on eight healthy men. The cuffs were worn during the day for 7 days of head-down bed rest. We measured: orthostatic tolerance (stand tests and lower body negative pressure tests), plasma volume (Evans blue dilution), autonomic influences (plasma noradrenaline) and baroreflex sensitivity (spontaneous baroreflex slope). Thigh cuffs limited the loss of plasma volume (thigh cuffs: ,201 ± 37 mL vs. control: ,345 ± 42 mL, P < 0.05), the degree of tachycardia and reduction in the spontaneous baroreflex sensitivity induced by head-down bed rest. However, the impact of thigh cuffs was not sufficient to prevent OI (thigh cuffs: 7.0 min of standing time vs. control: 7.1 min). Decrease in absolute plasma volume and in baroreflex sensitivity are known to be important factors in the aetiology of OI induced by head-down bed rest. However, dealing with these factors, using thigh cuffs for example, is not sufficient to prevent OI. Other factors such as venous compliance, microcirculatory changes, peripheral arterial vasoconstriction and vestibular afferents must also be considered. [source]

Role of Myocardial Contractility and Autonomic Control in the Hypotensive Response to a Limited Access Ethanol Paradigm in SHRs

ALCOHOLISM, Issue 6 2007
Mahmoud M. El-Mas
Background: Previous experimental studies that evaluated the chronic hemodynamic effect of ethanol employed the continuous exposure protocol of ethanol, which does not mimic the pattern of alcohol consumption in humans. This study dealt with the long-term hemodynamic and cardiovascular autonomic effects of ethanol, in a limited-access regimen in telemetered spontaneously hypertensive rats (SHRs). Methods: Changes in blood pressure (BP), heart rate (HR), myocardial contractility (dP/dtmax), and spectral cardiovascular autonomic profiles during the ethanol exposure period (2.5 or 5% w/v, 8 h/d, 8:30 am till 4:30 pm) were followed for 12 weeks. Results: Compared with control pair-fed SHRs, body weight and urine output, osmolality, and potassium levels were decreased in SHRs receiving 5% but not 2.5% ethanol. Blood pressure showed progressive falls during ethanol-feeding periods with a maximum effect observed at week 5. The peak hypotensive effect was maintained thereafter in SHRs receiving 5% ethanol in contrast to steady rises in BP in the 2.5% ethanol group to near-control levels by the conclusion of the study. Heart rate was slightly but significantly increased by ethanol 5% whereas dP/dtmax showed persistent reductions. Power spectral analysis showed that ethanol attenuated the baroreflex gain of HR as suggested by the reductions in index ,, the spectral index of spontaneous baroreflex sensitivity (BRS). Conclusions: It is concluded that limited access ethanol drinking in SHRs elicited hypotension that was concentration dependent and mediated, at least partly, through reductions in myocardial contractility. Baroreflex sensitivity attenuation by ethanol appeared to have limited the tachycardic response to ethanol and perhaps its capacity to offset the evoked hypotension. [source]

Early Detection Of Diminished Baroreflex Sensitivity In Diabetic Patients Without Evidence Of Cardiovascular Autonomic Neuropathy

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2000
D Ziegler
Diabetic cardiovascular autonomic neuropathy (CAN) carries an increased risk of mortality. Decreased baroreflex sensitivity (BRS) has been identified as a predictor of increased mortality following myocardial infarction. We evaluated spontaneous BRS in 39 healthy control subjects (C: age (mean ± SEM): 41.5 ± 1.9 years) and 116 diabetic patients (64% Type 1, 36% Type 2; age: 45.8 ± 1.4 years; diabetes duration: 16.9 ± 1.0 years; HbA1c: 9.2 ± 0.2%) using cross-spectral analysis between systolic blood pressure and heart rate in the low-frequency (LF) and high-frequency (HF) bands as well as time domain (sequence) analysis in the supine and standing positions over 10 min. According to previously suggested definitions based on autonomic function tests (AFTs), 36 patients had definite CAN (CAN+: 3 of 7 indices abnormal), 13 had borderline CAN (CAN[+]: 2 of 7 indices abnormal), and 64 had no evidence of CAN (CAN,: 1 of 7 indices abnormal). Maximum gain in cross-spectral LF band (standing) was significantly reduced in CAN, as compared with C (5.2 ± 0.4 vs. 7.2 ± 0.8 ms/mmHg, p < 0.05). Moreover, maximum gain in cross-spectral HF band was significantly lower in CAN, than in C (supine: 12.0 ± 1.2 vs. 17.9 ± 2.5 ms/mmHg, p < 0.05; standing: 4.9 ± 0.5 vs. 8.7 ± 1.0 ms/mmHg, p < 0.05). The slope of the regression line between defined increases or reductions in systolic blood pressure and R-R intervals was significantly reduced in CAN, compared to C (supine: 10.6 ± 0.7 vs. 14.2 ± 1.6 ms/mmHg, p < 0.05; standing: 5.6 ± 0.4 vs. 8.1 ± 0.7 ms/mmHg, p < 0.05). Similar differences were obtained when comparing the CAN, and CAN[+] groups, the latter showing significantly reduced BRS by both techniques (p < 0.05). In contrast, no such differences were noted when comparing the CAN[+] and CAN+ groups. In conclusion, reduced spontaneous baroreflex sensitivity is an early marker of autonomic dysfunction at a stage when autonomic function tests do not yet indicate the presence of CAN, while cases with borderline CAN show a degree of BRS abnormality that is comparable to the level seen in definite CAN. Prospective studies are needed to evaluate whether reduced BRS is a predictor of mortality in diabetic patients. [source]

Relationship Between Myocardial Beta-Adrenergic Sensitivity and Heart Rate Variability

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2000
Philippe Cabrol M.D.
Background: In congestive heart failure, despite activation of the sympathetic nervous system, heart rate variability parameters reflecting sympathetic modulation on sinus node are decreased. Our goal was to assess the role of beta-adrenergic sensitivity in the modulation of heart rate variability (HRV) in patients with valvular heart diseases. Methods and results: Ten patients with aortic stenosis, 10 patients with heart failure, and 12 controls were included. Baroreflex sensitivity was calculated by the sequency method. Noradrenaline plasma levels were assayed by HPLC. HRV was studied using 24-hour Holter monitoring. Cardiac beta-adrenergic receptivity was assessed by the chronotropic response to dobutamine. Right auricular samples were obtained for determination of beta-adrenergic receptor density by binding study with [125I]-iodocynaopindolol, and beta 1 and beta 2 densities, measured by competition between 125ICP binding by isoprenaline. In multivariate analysis, the dose of dobutamine that increases basal heart rate for 25 beats/min (ED25) is correlated with a parameter of global HRV: SDNN (r = 0.6, P < 0.001) and with indexes reflecting rather sympathetic modulation of HRV: SDANN (r = 0.62, P < 0.001) or SD (r = 0.47, P < 0.0001). All these relations were independent from mean NN, spontaneous baroreflex sensitivity, and noradrenaline plasma levels. No significant correlation existed between dobutamine ED25 and HRV indexes reflecting parasympathic tone. No relationship existed between HRV and beta-adrenergic receptor-binding characteristics. Conclusion: Cardiac beta-adrenergic sensitivity explored by dobutamine ED25 is an important determinant of HRV independent from mean NN, spontaneous baroreflex sensitivity, and noradrenaline plasma levels. [source]