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Lansdown AJ, Warnert EAH, Sverrisdóttir Y, Wise RG, Rees DA. Regional Cerebral Activation Accompanies Sympathoexcitation in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2019; 104:3614-3623. [PMID: 31127833 DOI: 10.1210/jc.2019-00065] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/18/2019] [Indexed: 02/07/2023]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is associated with increased sympathetic nervous system activation, but the cerebral pathways involved are unclear. OBJECTIVE To compare cerebral [blood oxygen level-dependent (BOLD) functional MRI], pressor [blood pressure (BP), heart rate (HR], and muscle sympathetic nerve activity (MSNA) responses to isometric forearm contraction (IFC) in women with PCOS and matched control subjects. DESIGN Case-control study. SETTING Referral center. PARTICIPANTS Patients with PCOS (n = 20; mean ± SD data: age, 29.8 ± 4.8 years; body mass index (BMI), 26.1 ± 4.9 kg/ m2) and 20 age- and BMI-matched control subjects (age, 29.7 ± 5.0 years; BMI, 26.1 ± 4.8 kg/ m2). MAIN OUTCOME MEASURES BP, HR, catecholamine, and MSNA responses to 30% IFC. BOLD signal change was modeled for BP response to 30% IFC. RESULTS Although HR and BP increased to a similar extent in both groups after IFC, MSNA burst frequency increased by 68% in the PCOS group compared with 11.9% in control subjects (n = 7 in both groups; P = 0.002). Brain activation indexed by the BOLD signal in response to IFC was significantly greater in the PCOS group (n = 15) compared with controls (n = 15) in the right orbitofrontal cortex (P < 0.0001). Adjustment for insulin sensitivity, but not hyperandrogenism, abolished these between-group differences. CONCLUSION Our study confirms enhanced sympathoexcitation in women with PCOS and demonstrates increased regional brain activation in response to IFC. The right orbitofrontal cortex BOLD signal change in women with PCOS is associated with insulin sensitivity. Additional studies are warranted to clarify whether this may offer a novel target for cardiovascular risk reduction.
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Affiliation(s)
- Andrew J Lansdown
- Department of Endocrinology, University Hospital of Wales, Cardiff, United Kingdom
| | - Esther A H Warnert
- Department of Radiology, Erasmus Medical Center, CA Rotterdam, Netherlands
| | - Yrsa Sverrisdóttir
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford United Kingdom
| | - Richard G Wise
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - D Aled Rees
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
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52
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Grimaldi D, Goldstein MR, Carter JR. Insomnia and cardiovascular autonomic control. Auton Neurosci 2019; 220:102551. [DOI: 10.1016/j.autneu.2019.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 01/13/2023]
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Kidoguchi S, Sugano N, Hayashi-Ishikawa N, Morisawa N, Tokudome G, Yokoo T. The characteristics of captopril challenge test-positive patients using various criteria. J Renin Angiotensin Aldosterone Syst 2019; 20:1470320319870891. [PMID: 31434530 PMCID: PMC6709445 DOI: 10.1177/1470320319870891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: The captopril challenge test (CCT) is the major confirmatory test for primary
aldosteronism (PA), and frequently carried out because of its convenience.
However, it presents false-negative results with a certain probability, and
as there are many criteria for CCT, it is not concluded yet which criteria
to use. Materials and methods: A total of 71 PA patients were evaluated. We compared CCT-positive and
CCT-negative patients in the following three criteria: plasma
aldosterone/renin ratio (ARR) >200 after the CCT (criterion 1); plasma
aldosterone concentration (PAC) >120 pg/ml after the CCT (criterion 2);
and PAC suppression <30% of PAC before CCT (criterion 3). Results: The positive rate was 70.4%, 64.8% and 54.9% for criterion 1, criterion 2 and
criterion 3, respectively. With criterion 1, the baseline plasma renin
activity was lower, thus baseline ARR was higher in CCT-positive patients.
With criterion 2, PAC was higher and estimated sodium intake and K were
lower in CCT-positive patients. With criterion 3, K and PAC were lower in
CCT-positive patients. Although it was not significant, in the patients with
high sodium intake, the positive rate of criterion 1 was higher than that of
the other criteria. Conclusions: ARR>200 is the valuable criterion for the diagnosis of PA.
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Affiliation(s)
- Satoshi Kidoguchi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Naoki Sugano
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Naomi Hayashi-Ishikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Norihiko Morisawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Goro Tokudome
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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54
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FIFA World Cup 2018: effect of emotional stress on conventional heart rate variability metrics. Clin Res Cardiol 2019; 109:266-270. [PMID: 31388740 DOI: 10.1007/s00392-019-01533-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022]
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55
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Contreras-Aguilar MD, Vialaret J, Deville de Périère D, Escribano D, Lehmann S, Tecles F, Cerón JJ, Hirtz C. Variation of human salivary alpha-amylase proteoforms in three stimulation models. Clin Oral Investig 2019; 24:475-486. [PMID: 31388762 DOI: 10.1007/s00784-019-03021-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/11/2019] [Indexed: 12/08/2022]
Abstract
OBJECTIVES To evaluate the sAA proteoforms' expression during different stimulation situations. MATERIALS AND METHODS This study evaluated the salivary alpha-amylase (sAA) proteoforms' behavior by western blot (WB) analysis and high-resolution mass spectrometry (LC-MS/MS) in different situations that produce increases in sAA activity. For this purpose, six healthy women with a similar body mass index, age, and fit, underwent different sAA stimulation tests, such as acetic acid stimulation, psychological stress using the standardized Trier social stress test, and physical effort using the Cooper treadmill test. RESULTS The three models showed an increase in sAA activity. The WB demonstrated seven common bands observed in the six women (band one at 59 kDa, two at 56 kDa, three at 48 kDa, four at 45 kDa, five at 41 kDa, six at 36 kDa, and seven at 14 kDa), in which sAA protein was identified. The individual WB analysis showed that band two, which corresponded to the native non-glycosylated sAA proteoform, had a higher increase after the three sAA stimulation inducers, and this band was also the only proteoform correlated with sAA activity (r = 0.56, P = 0.001). In addition, when the label-free quantification analysis was performed, the different proteoforms showed different responses depending on the type of stimulation. CONCLUSIONS This preliminary study showed that the diverse sAA proteoforms' expression depends on the different stimulation models. CLINICAL RELEVANCE This study opens new perspectives and challenges for the use of the different alpha-amylase proteoforms as possible biomarkers in addition to the sAA activity.
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Affiliation(s)
- María D Contreras-Aguilar
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - Jerome Vialaret
- LBPC/PPC - IRMB, CHU de Montpellier, INSERM, Montpellier University, 80 rue Augustin Fliche, Montpellier, France
| | - Dominique Deville de Périère
- LBPC/PPC - IRMB, CHU de Montpellier, INSERM, Montpellier University, 80 rue Augustin Fliche, Montpellier, France
| | - Damián Escribano
- Department of Animal and Food Science, Veterinary School, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sylvain Lehmann
- LBPC/PPC - IRMB, CHU de Montpellier, INSERM, Montpellier University, 80 rue Augustin Fliche, Montpellier, France
| | - Fernando Tecles
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain
| | - Jose J Cerón
- Clinic Analysis Interdisciplinary Laboratory (Interlab-UMU), Campus of Excellence Mare Nostrum, Murcia, Spain.
| | - Christophe Hirtz
- LBPC/PPC - IRMB, CHU de Montpellier, INSERM, Montpellier University, 80 rue Augustin Fliche, Montpellier, France
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Yousif D, Bellos I, Penzlin AI, Hijazi MM, Illigens BMW, Pinter A, Siepmann T. Autonomic Dysfunction in Preeclampsia: A Systematic Review. Front Neurol 2019; 10:816. [PMID: 31447757 PMCID: PMC6691156 DOI: 10.3389/fneur.2019.00816] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Preeclampsia (PE) is a major obstetric complication that leads to severe maternal and fetal morbidity. Early detection of preeclampsia can reduce the severity of complications and improve clinical outcomes. It is believed that the autonomic nervous system (ANS) is involved in the pathogenesis of PE. We aimed to review the current literature on the prevalence and nature of ANS dysfunction in women with PE and the possible prognostic value of ANS testing in the early detection of PE. Methods: Literature search was performed using Medline (1966–2018), EMBase (1947–2018), Google Scholar (1970–2018), BIOSIS (1926–2018), Web of science (1900–2018); CINAHL (1937–2018); Cochrane Library, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Methodology Register (1999–2018). Additionally, the reference lists of articles included were screened. Results: A total of 26 studies were included in the present review presenting data of 1,854 pregnant women. Among these women, 453 were diagnosed with PE, 93.6% (424/453) of which displayed autonomic dysfunction. ANS function was assessed by cardiovascular reflex tests (n = 9), heart rate variability (n = 11), cardiac baroreflex gain (n = 5), muscle sympathetic nerve activity (MSNA) (n = 3), and biomarkers of sympathetic activity (n = 4). Overall, 21 studies (80.8%) reported at least one of the following abnormalities in ANS function in women diagnosed with PE compared to healthy pregnant control women: reduced parasympathetic activity (n = 16/21, 76%), increased sympathetic activity (n = 12/20, 60%), or reduced baroreflex gain (n = 4/5, 80%). Some of these studies indicated that pressor and orthostatic stress test may be useful in early pregnancy to help estimate the risk of developing PE. However, autonomic function tests seem not to be able to differentiate between mild and severe PE. Conclusions: Current evidence suggests that autonomic dysfunction is highly prevalent in pre-eclamptic women. Among autonomic functions, cardiovascular reflexes appear to be predominantly affected, seen as reduced cardiac parasympathetic activity and elevated cardiac sympathetic activity. The diagnostic value of autonomic testing in the prediction and monitoring of autonomic failure in pre-eclamptic women remains to be determined.
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Affiliation(s)
- Dalia Yousif
- Division of Healthcare Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
| | - Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ana Isabel Penzlin
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Mido Max Hijazi
- Department of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Alexandra Pinter
- Division of Healthcare Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany.,Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Timo Siepmann
- Division of Healthcare Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany.,Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Lambert GW, Schlaich MP, Eikelis N, Lambert EA. Sympathetic activity in obesity: a brief review of methods and supportive data. Ann N Y Acad Sci 2019; 1454:56-67. [PMID: 31268175 DOI: 10.1111/nyas.14140] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/11/2019] [Accepted: 05/23/2019] [Indexed: 12/12/2022]
Abstract
The increase in the prevalence of obesity and the concomitant rise in obesity-related illness have led to substantial pressure on health care systems throughout the world. While the combination of reduced exercise, increased sedentary time, poor diet, and genetic predisposition is undoubtedly pivotal in generating obesity and increasing disease risk, a large body of work indicates that the sympathetic nervous system (SNS) contributes to obesity-related disease development and progression. In obesity, sympathetic nervous activity is regionalized, with activity in some outflows being particularly sensitive to the obese state, whereas other outflows, or responses to stimuli, may be blunted, thereby making the assessment of sympathetic nervous activation in the clinical setting difficult. Isotope dilution methods and direct nerve recording techniques have been developed and utilized in clinical research, demonstrating that in obesity there is preferential activation of the muscle vasoconstrictor and renal sympathetic outflows. With weight loss, sympathetic activity is reduced. Importantly, sympathetic nervous activity is associated with end-organ dysfunction and changes in sympathetic activation that accompany weight loss are often reflected in an improvement of end-organ function. Whether targeting the SNS directly improves obesity-related illness remains unknown, but merits further attention.
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Affiliation(s)
- Gavin W Lambert
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Nina Eikelis
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elisabeth A Lambert
- The Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Victoria, Australia.,The School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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58
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Chou Y, Huang W, Chang C, Yang CCH, Kuo TBJ, Lin S, Chiang W, Chu T. Heart rate variability as a predictor of rapid renal function deterioration in chronic kidney disease patients. Nephrology (Carlton) 2019; 24:806-813. [DOI: 10.1111/nep.13514] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Yu‐Hsiang Chou
- Renal Division, Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
- Department of Internal MedicineNational Taiwan University Hospital Jin‐Shan Branch New Taipei City Taiwan
- Graduate Institute of Physiology, College of MedicineNational Taiwan University Taipei Taiwan
| | - Wei‐Lieh Huang
- Department of PsychiatryNational Taiwan University Hospital Yunlin Branch, Yunlin County Taiwan
- Department of Psychiatry, College of MedicineNational Taiwan University Taipei Taiwan
- Graduate Institute of Clinical Medicine, College of MedicineNational Taiwan University Taipei Taiwan
| | - Chin‐Hao Chang
- Department of Medical ResearchNational Taiwan University Hospital Taipei Taiwan
| | - Cheryl C. H. Yang
- Institute of Brain Science, National Yang‐Ming University Taipei Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang‐Ming University Taipei Taiwan
- Institute of Translational and Interdisciplinary Medicine, National Central University Taoyuan Taiwan
| | - Shuei‐Liong Lin
- Renal Division, Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
- Graduate Institute of Physiology, College of MedicineNational Taiwan University Taipei Taiwan
- Department of Integrated Diagnostics &TherapeuticsNational Taiwan University Hospital Taipei Taiwan
- Research Center for Developmental Biology and Regenerative MedicineNational Taiwan University Taipei Taiwan
| | - Wen‐Chih Chiang
- Renal Division, Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
| | - Tzong‐Shinn Chu
- Renal Division, Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
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Salivary levels of alpha-amylase are associated with neurobehavioral alertness during extended wakefulness, but not simulated night-shift work. Physiol Behav 2019; 204:1-9. [DOI: 10.1016/j.physbeh.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 11/17/2022]
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Quantitative Assessment of Autonomic Regulation of the Cardiac System. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:4501502. [PMID: 31178987 PMCID: PMC6501147 DOI: 10.1155/2019/4501502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/27/2019] [Indexed: 12/16/2022]
Abstract
Autonomic neural system (ANS) regulates the circulation to provide optimal perfusion of every organ in accordance with its metabolic needs, and the quantitative assessment of autonomic regulation is crucial for personalized medicine in cardiovascular diseases. In this paper, we propose the Dystatis to quantitatively evaluate autonomic regulation of the human cardiac system, based on homeostatis and probabilistic graphic model, where homeostatis explains ANS regulation while the probability graphic model systematically defines the regulation process for quantitative assessment. The indices and measurement methods for three well-designed scenarios are also illustrated to evaluate the proposed Dystatis: (1) heart rate variability (HRV), blood pressure variability (BPV), and respiration synchronization (Synch) in resting situation; (2) chronotropic competence indices (CCI) in graded exercise testing; and (3) baroreflex sensitivity (BRS), sympathetic nerve activity (SNA), and parasympathetic nerve activity (PNA) in orthostatic testing. The previous clinical results have shown that the proposed method and indices for autonomic cardiac system regulation have great potential in prediction, diagnosis, and rehabilitation of cardiovascular diseases, hypertension, and diabetes.
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61
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Carter JR. Microneurography and sympathetic nerve activity: a decade-by-decade journey across 50 years. J Neurophysiol 2019; 121:1183-1194. [PMID: 30673363 DOI: 10.1152/jn.00570.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The technique of microneurography has advanced the field of neuroscience for the past 50 years. While there have been a number of reviews on microneurography, this paper takes an objective approach to exploring the impact of microneurography studies. Briefly, Web of Science (Thomson Reuters) was used to identify the highest citation articles over the past 50 years, and key findings are presented in a decade-by-decade highlight. This includes the establishment of microneurography in the 1960s, the acceleration of the technique by Gunnar Wallin in the 1970s, the international collaborations of the 1980s and 1990s, and finally the highest impact studies from 2000 to present. This journey through 50 years of microneurographic research related to peripheral sympathetic nerve activity includes a historical context for several of the laboratory interventions commonly used today (e.g., cold pressor test, mental stress, lower body negative pressure, isometric handgrip, etc.) and how these interventions and experimental approaches have advanced our knowledge of cardiovascular, cardiometabolic, and other human diseases and conditions.
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Affiliation(s)
- Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University , Houghton, Michigan
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Futtrup J, Nordentoft M, Elfving B, Krogh J. The association between norepinephrine and metabolism in patients with major depression. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.npbr.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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63
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Hoye NA, Wilson LC, Jardine DL, Walker RJ. Sympathetic overactivity in dialysis patients-Underappreciated and clinically consequential. Semin Dial 2018; 32:255-265. [PMID: 30461070 DOI: 10.1111/sdi.12756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence-based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidneys, has been established to be prognostic in the dialysis population for over 15 years. Despite this, tangible therapeutic interventions have, to date, been unsuccessful and the outlook for patients remains poor. This narrative review summarizes established experimental and clinical data, highlighting recent developments, and proposes why interventions to ameliorate sympathetic hyperactivity may well be beneficial for this high-risk population.
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Affiliation(s)
- Neil A Hoye
- Department of Renal Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Luke C Wilson
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - David L Jardine
- Department of Medicine, University of Otago, Christchurch, Otago, New Zealand
| | - Robert J Walker
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand
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Heart rate variability biofeedback and other psychophysiological procedures as important elements in psychotherapy. Int J Psychophysiol 2018; 131:89-95. [DOI: 10.1016/j.ijpsycho.2017.09.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022]
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65
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Begaye B, Piaggi P, Thearle MS, Haskie K, Walter M, Schlögl M, Bonfiglio S, Krakoff J, Vinales KL. Norepinephrine and T4 Are Predictors of Fat Mass Gain in Humans With Cold-Induced Brown Adipose Tissue Activation. J Clin Endocrinol Metab 2018; 103:2689-2697. [PMID: 29788444 PMCID: PMC6276720 DOI: 10.1210/jc.2018-00387] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/11/2018] [Indexed: 12/24/2022]
Abstract
CONTEXT In healthy adults with detectable cold-induced brown adipose tissue activation (CIBA), the relationships between sympathetic nervous system (SNS) or thyroid activity during energy balance (EBL) with CIBA and body composition change are undetermined. OBJECTIVE To investigate the relationships between CIBA and thermoneutral catecholamines and thyroid hormones measured during EBL and to determine if CIBA, catecholamines, or thyroid hormones predict body composition changes. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS Twelve healthy volunteers (seven male and five female) with positive CIBA [>2 standardized uptake value (g/mL)] had 24-hour energy expenditure (24hEE) assessed during EBL via whole-room indirect calorimetry while residing on a clinical research unit. Positron emission tomography/computed tomography scans were performed after exposure to 16°C for 2 hours to quantify CIBA. MAIN OUTCOME MEASURES CIBA, 24hEE during EBL, and thermoneutrality with concomitant measurement of urinary catecholamines and plasma free T3 and free T4. Body composition at baseline and 6 months by dual-energy X-ray absorptiometry. RESULTS Lower urinary norepinephrine and free T4 were associated with higher CIBA (r = -0.65, P = 0.03; and r = -0.75, P < 0.01, respectively), but CIBA was not associated with 24hEE at thermoneutrality (P = 0.77). Lower CIBA (β = -3.5 kg/standardized uptake value; P < 0.01) predicted fat mass gain, whereas higher urinary norepinephrine and free T4 predicted future fat mass gain at 6 months (β = 3.0 kg per twofold difference in norepinephrine, P = 0.03; and β = 1.2 kg per 0.1-ng/dL difference in free T4, P = 0.03, respectively). CONCLUSION Lower SNS and free thyroid measurements at baseline indicate a greater capacity for CIBA, which may be predictive against fat mass gain.
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Affiliation(s)
- Brittany Begaye
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Marie S Thearle
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | | | - Mary Walter
- Clinical Core Laboratory, National Institute of Diabetes and Digestive and
Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mathias Schlögl
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
- Department of Geriatrics and Aging Research, University Hospital Zurich,
Zurich, Switzerland
| | - Susan Bonfiglio
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
| | - Karyne L Vinales
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and
Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases,
Phoenix, Arizona
- Correspondence and Reprint Requests: Karyne L. Vinales, MD,
Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research
Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th
Street, Phoenix, Arizona 85016. E-mail:
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Shahzad T, Saleem S, Usman S, Mirza J, Islam QU, Ouahada K, Marwala T. System dynamics of active and passive postural changes: Insights from principal dynamic modes analysis of baroreflex loop. Comput Biol Med 2018; 100:27-35. [PMID: 29975851 DOI: 10.1016/j.compbiomed.2018.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
Abstract
The baroreflex being a key modulator of cardiovascular control ensures adequate blood pressure regulation under orthostatic stress which otherwise may cause severe hypotension. Contrary to conventional baroreflex sensitivity indices derived across a-priori traditional frequency bands, the present study is aimed at proposing new indices for the assessment of baroreflex drive which follows active (supine to stand-up) and passive (supine to head-up tilt) postural changes. To achieve this, a novel system identification approach of principal dynamic modes (PDM) was utilized to extract data-adaptive frequency components of closed-loop interactions between beat-to-beat interval and systolic blood pressure recorded from 10 healthy humans. We observed that the gain of low-pass global PDM of cardiac arm (:feedback reflex loop, mediated by pressure sensors to adjust heart rate in response to arterial blood pressure), and 0.2 Hz global PDM of mechanical arm (:feed-forward pathways, originating changes in arterial blood pressure in response to heart rate variations) may function as potential markers to distinguish active and passive orthostatic tests in healthy subjects.
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Affiliation(s)
- Tariq Shahzad
- Department of Electrical and Electronic Engineering Science, University of Johannesburg, South Africa.
| | - Saqib Saleem
- Department of Electrical Engineering, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan.
| | - Saeeda Usman
- Department of Electrical Engineering, COMSATS University Islamabad, Sahiwal Campus, Sahiwal, Pakistan.
| | - Jawad Mirza
- Department of Electrical Engineering, COMSATS University Islamabad, Islamabad, Pakistan.
| | - Qamar-Ul Islam
- Department of Space Science, Institute of Space Technology, Islamabad, Pakistan.
| | - Khmaies Ouahada
- Department of Electrical and Electronic Engineering Science, University of Johannesburg, South Africa.
| | - Tshilidzi Marwala
- Department of Electrical and Electronic Engineering Science, University of Johannesburg, South Africa.
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Cong X, Xu X, Xu L, Li M, Xu C, Qin Q, Huo X. Elevated biomarkers of sympatho-adrenomedullary activity linked to e-waste air pollutant exposure in preschool children. ENVIRONMENT INTERNATIONAL 2018; 115:117-126. [PMID: 29558634 DOI: 10.1016/j.envint.2018.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 02/07/2023]
Abstract
Air pollution is a risk factor for cardiovascular disease (CVD), and cardiovascular regulatory changes in childhood contribute to the development and progression of cardiovascular events at older ages. The aim of the study was to investigate the effect of air pollutant exposure on the child sympatho-adrenomedullary (SAM) system, which plays a vital role in regulating and controlling the cardiovascular system. Two plasma biomarkers (plasma epinephrine and norepinephrine) of SAM activity and heart rate were measured in preschool children (n = 228) living in Guiyu, and native (n = 104) and non-native children (n = 91) living in a reference area (Haojiang) for >1 year. Air pollution data, over the 4-months before the health examination, was also collected. Environmental PM2.5, PM10, SO2, NO2 and CO, plasma norepinephrine and heart rate of the e-waste recycling area were significantly higher than for the non-e-waste recycling area. However, there was no difference in plasma norepinephrine and heart rate between native children living in the non-e-waste recycling area and non-native children living in the non-e-waste recycling area. PM2.5, PM10, SO2 and NO2 data, over the 30-day and the 4-month average of pollution before the health examination, showed a positive association with plasma norepinephrine level. PM2.5, PM10, SO2, NO2 and CO concentrations, over the 24 h of the day of the health examination, the 3 previous 24-hour periods before the health examination, and the 24 h after the health examination, were related to increase in heart rate. At the same time, plasma norepinephrine and heart rate on children in the high air pollution level group (≤50-m radius of family-run workshops) were higher than those in the low air pollution level group. Our results suggest that air pollution exposure in e-waste recycling areas could result in an increase in heart rate and plasma norepinephrine, implying e-waste air pollutant exposure impairs the SAM system in children.
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Affiliation(s)
- Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, Guangdong, China.
| | - Long Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Minghui Li
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Cheng Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Qilin Qin
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangzhou and Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 510632, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangzhou and Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 510632, Guangdong, China.
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68
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Valenza G, Citi L, Saul JP, Barbieri R. Measures of sympathetic and parasympathetic autonomic outflow from heartbeat dynamics. J Appl Physiol (1985) 2018; 125:19-39. [PMID: 29446712 DOI: 10.1152/japplphysiol.00842.2017] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Reliable and effective noninvasive measures of sympathetic and parasympathetic peripheral outflow are of crucial importance in cardiovascular physiology. Although many techniques have been proposed to take up this long-lasting challenge, none has proposed a satisfying discrimination of the dynamics of the two separate branches. Spectral analysis of heart rate variability is the most currently used technique for such assessment. Despite its widespread use, it has been demonstrated that the subdivision in the low-frequency (LF) and high-frequency (HF) bands does not fully reflect separate influences of the sympathetic and parasympathetic branches, respectively, mainly due to their simultaneous action in the LF. Two novel heartbeat-derived autonomic measures, the sympathetic activity index (SAI) and parasympathetic activity index (PAI), are proposed to separately assess the time-varying autonomic nervous system synergic functions. Their efficacy is validated in landmark autonomic maneuvers generally employed in clinical settings. The novel measures move beyond the classical frequency domain paradigm through identification of a set of coefficients associated with a proper combination of Laguerre base functions. The resulting measures were compared with the traditional LF and HF power. A total of 236 ECG recordings were analyzed for validation, including autonomic outflow changes elicited by procedures of different nature and temporal variation, such as postural changes, lower body negative pressure, and handgrip tests. The proposed SAI-PAI measures consistently outperform traditional frequency-domain indexes in tracking expected instantaneous autonomic variations, both vagal and sympathetic, and may aid clinical decision making, showing reduced intersubject variability and physiologically plausible dynamics. NEW & NOTEWORTHY While it is possible to obtain reliable estimates of parasympathetic activity from the ECG, a satisfying method to disentangle the sympathetic component from HRV has not been proposed yet. To overcome this long-lasting limitation, we propose two novel HRV-based indexes, the sympathetic and parasympathetic activity indexes.
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Affiliation(s)
- Gaetano Valenza
- Computational Physiology and Biomedical Instruments Group, Bioengineering and Robotics Research Center E. Piaggio, and Department of Information Engineering, University of Pisa , Pisa , Italy.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital , Boston, Massachusetts
| | - Luca Citi
- School of Computer Science and Electronic Engineering, University of Essex , Colchester , United Kingdom
| | - J Philip Saul
- Department of Pediatrics, West Virginia University School of Medicine , Morgantown, West Virginia
| | - Riccardo Barbieri
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano , Italy.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital , Boston, Massachusetts
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Herzig D, Eser P, Omlin X, Riener R, Wilhelm M, Achermann P. Reproducibility of Heart Rate Variability Is Parameter and Sleep Stage Dependent. Front Physiol 2018; 8:1100. [PMID: 29367845 PMCID: PMC5767731 DOI: 10.3389/fphys.2017.01100] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022] Open
Abstract
Objective: Measurements of heart rate variability (HRV) during sleep have become increasingly popular as sleep could provide an optimal state for HRV assessments. While sleep stages have been reported to affect HRV, the effect of sleep stages on the variance of HRV parameters were hardly investigated. We aimed to assess the variance of HRV parameters during the different sleep stages. Further, we tested the accuracy of an algorithm using HRV to identify a 5-min segment within an episode of slow wave sleep (SWS, deep sleep). Methods: Polysomnographic (PSG) sleep recordings of 3 nights of 15 healthy young males were analyzed. Sleep was scored according to conventional criteria. HRV parameters of consecutive 5-min segments were analyzed within the different sleep stages. The total variance of HRV parameters was partitioned into between-subjects variance, between-nights variance, and between-segments variance and compared between the different sleep stages. Intra-class correlation coefficients of all HRV parameters were calculated for all sleep stages. To identify an SWS segment based on HRV, Pearson correlation coefficients of consecutive R-R intervals (rRR) of moving 5-min windows (20-s steps). The linear trend was removed from the rRR time series and the first segment with rRR values 0.1 units below the mean rRR for at least 10 min was identified. A 5-min segment was placed in the middle of such an identified segment and the corresponding sleep stage was used to assess the accuracy of the algorithm. Results: Good reproducibility within and across nights was found for heart rate in all sleep stages and for high frequency (HF) power in SWS. Reproducibility of low frequency (LF) power and of LF/HF was poor in all sleep stages. Of all the 5-min segments selected based on HRV data, 87% were accurately located within SWS. Conclusions: SWS, a stable state that, in contrast to waking, is unaffected by internal and external factors, is a reproducible state that allows reliable determination of heart rate, and HF power, and can satisfactorily be detected based on R-R intervals, without the need of full PSG. Sleep may not be an optimal condition to assess LF power and LF/HF power ratio.
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Affiliation(s)
- David Herzig
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
| | - Prisca Eser
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
| | - Ximena Omlin
- Sensory-Motor Systems Lab, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems Lab, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland.,Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Matthias Wilhelm
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, Zurich Center for Interdisciplinary Sleep Research and Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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70
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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71
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Laranjo S, Geraldes V, Oliveira M, Rocha I. Insights into the background of autonomic medicine. Rev Port Cardiol 2017; 36:757-771. [PMID: 29037833 DOI: 10.1016/j.repc.2017.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/12/2016] [Accepted: 01/08/2017] [Indexed: 12/27/2022] Open
Abstract
Knowledge of the physiology underlying the autonomic nervous system is pivotal for understanding autonomic dysfunction in clinical practice. Autonomic dysfunction may result from primary modifications of the autonomic nervous system or be secondary to a wide range of diseases that cause severe morbidity and mortality. Together with a detailed history and physical examination, laboratory assessment of autonomic function is essential for the analysis of various clinical conditions and the establishment of effective, personalized and precise therapeutic schemes. This review summarizes the main aspects of autonomic medicine that constitute the background of cardiovascular autonomic dysfunction.
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Affiliation(s)
- Sérgio Laranjo
- Instituto de Fisiologia da Faculdade de Medicina e Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal
| | - Vera Geraldes
- Instituto de Fisiologia da Faculdade de Medicina e Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Oliveira
- Instituto de Fisiologia da Faculdade de Medicina e Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal
| | - Isabel Rocha
- Instituto de Fisiologia da Faculdade de Medicina e Centro Cardiovascular, Universidade de Lisboa, Lisboa, Portugal.
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72
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Sympathomodulatory effects of sodium–glucose transporter-2 inhibitors in the kidneys and beyond. J Hypertens 2017; 35:1966-1967. [DOI: 10.1097/hjh.0000000000001454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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73
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Insights into the background of autonomic medicine. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2017.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nederend I, Ten Harkel ADJ, Blom NA, Berntson GG, de Geus EJC. Impedance cardiography in healthy children and children with congenital heart disease: Improving stroke volume assessment. Int J Psychophysiol 2017; 120:136-147. [PMID: 28778397 DOI: 10.1016/j.ijpsycho.2017.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/20/2017] [Accepted: 07/29/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Stroke volume (SV) and cardiac output are important measures in the clinical evaluation of cardiac patients and are also frequently used in research applications. This study was aimed to improve SV scoring derived from spot-electrode based impedance cardiography (ICG) in a pediatric population of healthy volunteers and patients with a corrected congenital heart defect. METHODS 128 healthy volunteers and 66 patients participated. First, scoring methods for ambiguous ICG signals were optimized to improve agreement of B- and X-points with aortic valve opening/closure in simultaneously recorded transthoracic echocardiography (TTE). Building on the improved scoring of B- and X-points, the Kubicek equation for SV estimation was optimized by testing the agreement with the simultaneously recorded SV by TTE. Both steps were initially done in a subset of the sample of healthy children and then validated in the remaining subset of healthy children and in a sample of patients. RESULTS SV assessment by ICG in healthy children strongly improved (intra class correlation increased from 0.26 to 0.72) after replacing baseline thorax impedance (Z0) in the Kubicek equation by an equation (7.337-6.208∗dZ/dtmax), where dZ/dtmax is the amplitude of the ICG signal at the C-point. Reliable SV assessment remained more difficult in patients compared to healthy controls. CONCLUSIONS After proper adjustment of the Kubicek equation, SV assessed by the use of spot-electrode based ICG is comparable to that obtained from TTE. This approach is highly feasible in a pediatric population and can be used in an ambulatory setting.
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Affiliation(s)
- Ineke Nederend
- Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Nico A Blom
- Department of Pediatric Cardiology, LUMC University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Gary G Berntson
- Ohio State University, Department of Psychology, 1835 Neil Avenue, Columbus OH 43210, United States.
| | - Eco J C de Geus
- Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
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75
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Chen DLT, Brown R, Liess C, Poljak A, Xu A, Zhang J, Trenell M, Jenkins A, Chisholm D, Samocha-Bonet D, Macefield VG, Greenfield JR. Muscle Sympathetic Nerve Activity Is Associated with Liver Insulin Sensitivity in Obese Non-Diabetic Men. Front Physiol 2017; 8:101. [PMID: 28293196 PMCID: PMC5328983 DOI: 10.3389/fphys.2017.00101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 02/07/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction: Muscle sympathetic nerve activity (MSNA) may play a role in insulin resistance in obesity. However, the direction and nature of the relationship between MSNA and insulin resistance in obesity remain unclear. We hypothesized that resting MSNA would correlate inversely with both muscle and liver insulin sensitivity and that it would be higher in insulin-resistant vs. insulin-sensitive subjects. Materials and methods: Forty-five non-diabetic obese subjects were studied. As no significant relationships were found in women, the data presented in on 22 men aged 48 ± 12 years. Two-step (15 and 80 mU/m2/min) hyperinsulinaemic-euglycaemic clamps were performed using deuterated glucose to determine liver and muscle insulin sensitivity. Clinical and metabolic parameters were assessed. MSNA was measured via a microelectrode inserted percutaneously into the common peroneal nerve. Results: MSNA burst frequency correlated inversely with liver insulin sensitivity (r = -0.53, P = 0.02) and positively with the hepatokines C-reactive protein (CRP) and fibroblast growth factor (FGF)-19 (r = 0.57, P = 0.006, and r = -0.47, P = 0.03, respectively). MSNA burst frequency was lower in Liversen compared to Liverres (27 ± 5 vs. 38 ± 2 bursts per minute; P = 0.03). Muscle insulin sensitivity was unrelated to MSNA. Discussion: Sympathetic neural activation is related to liver insulin sensitivity and circulating hepatokines CRP and FGF-19 in non-diabetic obese men. These results suggest a potential hepato-endocrine-autonomic axis. Future studies are needed to clarify the influence of MSNA on liver insulin sensitivity in men.
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Affiliation(s)
- Daniel L. T. Chen
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Rachael Brown
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Carsten Liess
- Philips HealthcareLuebeckertordamm, Hamburg, Germany
| | - Anne Poljak
- Bioanalytical Mass Spectrometry Facility, UNSW SydneySydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | - Jialiang Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | | | - Arthur Jenkins
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Health Science, University of WollongongWollongong, NSW, Australia
| | - Donald Chisholm
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Dorit Samocha-Bonet
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Vaughan G. Macefield
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Jerry R. Greenfield
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- Department of Endocrinology and Diabetes Center, St. Vincent's HospitalSydney, NSW, Australia
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Bronzwaer ASGT, Bogert LWJ, Westerhof BE, Piek JJ, Daemen MJAP, van Lieshout JJ. Abnormal haemodynamic postural response in patients with chronic heart failure. ESC Heart Fail 2017; 4:146-153. [PMID: 28451451 PMCID: PMC5396043 DOI: 10.1002/ehf2.12127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/17/2016] [Accepted: 11/08/2016] [Indexed: 12/12/2022] Open
Abstract
Aim The objective was to evaluate in treated heart failure (HF) patients whether multidrug therapy interferes with the cardiovascular autonomic response to postural stress. Methods and results Blood pressure (BP; Finapres), heart rate (HR), stroke volume, and total peripheral resistance (TPR) responses to standing up were measured in 33 HF patients and 10 healthy age‐matched controls. Ten hypertensive (HT) patients treated with a similar combination of drugs but without heart failure served as reference subjects to account for use of medication. Frequency domain measures of HR and BP variability were calculated as correlates of cardiovascular autonomic function. Postural hypotension was found in 16 out of 33 HF patients independently from New York Heart Association functional class. In HF patients vs. HT patients and healthy controls the haemodynamic postural response was abnormal with a large initial BP fall and a slackened reflex increase in TPR resulting in inadequate BP recovery. HR and BP variability were normal in HT patients and healthy controls but attenuated in HF patients. The magnitude of the postural HR, stroke volume, and TPR responses as well as HR and BP variability was inversely related to the New York Heart Association class. Conclusions In HF patients, the autonomic vasomotor response to postural stress is abnormal, more pronounced with increasing disease severity, and frequently associated with overt postural hypotension. These phenomena appear related to the cardiac condition rather than treatment.
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Affiliation(s)
- Anne-Sophie G T Bronzwaer
- Department of Internal Medicine, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands.,Laboratory for Clinical Cardiovascular Physiology, Centre for Heart Failure Research, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands
| | - Lysander W J Bogert
- Department of Internal Medicine, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands.,Laboratory for Clinical Cardiovascular Physiology, Centre for Heart Failure Research, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands
| | - Berend E Westerhof
- Laboratory for Clinical Cardiovascular Physiology, Centre for Heart Failure Research, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands.,Department of Pulmonary DiseasesVU University Medical CentreAmsterdamThe Netherlands
| | - Jan J Piek
- AMC Heart Center, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands
| | - Mat J A P Daemen
- Department of Pathology, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands
| | - Johannes J van Lieshout
- Department of Internal Medicine, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands.,Laboratory for Clinical Cardiovascular Physiology, Centre for Heart Failure Research, Academic Medical CentreUniversity of AmsterdamAmsterdamThe Netherlands.,MRC/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life SciencesUniversity of Nottingham Medical School, Queen's Medical CentreNottinghamUK
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77
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Cruz LGDB, Bocchi EA, Grassi G, Guimaraes GV. Neurohumoral and Endothelial Responses to Heated Water-Based Exercise in Resistant Hypertensive Patients. Circ J 2016; 81:339-345. [PMID: 28049937 DOI: 10.1253/circj.cj-16-0870] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The neurohumoral and endothelial responses to the blood pressure (BP) lowering effects of heated water-based exercise (HEx) in resistant hypertension (HT) patients remain undefined.Methods and Results:We investigated these in 44 true resistant HT patients (age 53.3±0.9 years, mean±SEM). They were randomized and allocated to 2 groups, 28 to a HEx training protocol, which consisted of callisthenic exercises and walking in a heated pool for 1 h, three times weekly for 12 weeks and 16 patients to a control group maintaining their habitual activities. Measurements made before and after 12 weeks of HEx included clinic and 24-h BP, plasma levels of nitric oxide, endothelin-1, aldosterone, renin, norepinephrine and epinephrine, as well as peak V̇O2, and endothelial function (reactive hyperemia). After 12 weeks of HEx patients showed a significant decrease in clinic and 24-h systolic and diastolic BPs. Concomitantly, nitric oxide increased significantly (from 25±8 to 75±24 μmol/L, P<0.01), while endothelin-1 (from 41±5 to 26±3 pg/mL), renin (from 35±4 to 3.4±1 ng/mL/h), and norepinephrine (from 720±54 to 306±35 pg/mL) decreased significantly (P<0.01). Plasma aldosterone also tended to decrease, although not significantly (from 101±9 to 76±4 pg/mL, P=NS). Peak V̇O2increased significantly after HEx (P<0.01), while endothelial function was unchanged. No significant change was detected in the control group. CONCLUSIONS The BP-lowering effects of HEx in resistant HT patients were accompanied by a significant reduction in the marked neurohumoral activation characterizing this clinical condition.
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Affiliation(s)
- Lais Galvani de Barros Cruz
- Laboratory of Physical Activity and Health Heart Institute, Clinical Hospital, Department of Medicine, Sao Paulo University
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Jewson JL, Lambert EA, Docking S, Storr M, Lambert GW, Gaida JE. Pain duration is associated with increased muscle sympathetic nerve activity in patients with Achilles tendinopathy. Scand J Med Sci Sports 2016; 27:1942-1949. [DOI: 10.1111/sms.12820] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 12/19/2022]
Affiliation(s)
- J. L. Jewson
- Faculty of Medicine, Nursing and Health Sciences; Monash University; Melbourne Vic. Australia
| | - E. A. Lambert
- Human Neurotransmitters Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
- Department of Physiology; Monash University; Melbourne Vic. Australia
| | - S. Docking
- Department of Physiotherapy; Monash University; Melbourne Vic. Australia
- Australian Centre for Research into Injury in Sport and its Prevention; Federation University; Ballarat Vic. Australia
| | - M. Storr
- Department of Physiotherapy; Monash University; Melbourne Vic. Australia
| | - G. W. Lambert
- Faculty of Medicine, Nursing and Health Sciences; Monash University; Melbourne Vic. Australia
- Human Neurotransmitters Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - J. E. Gaida
- Department of Physiotherapy; Monash University; Melbourne Vic. Australia
- University of Canberra Research Institute for Sport and Exercise (UC-RISE); Canberra ACT Australia
- Discipline of Physiotherapy; University of Canberra; Canberra ACT Australia
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Sympathetic neurons are a powerful driver of myocyte function in cardiovascular disease. Sci Rep 2016; 6:38898. [PMID: 27966588 PMCID: PMC5155272 DOI: 10.1038/srep38898] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 11/15/2016] [Indexed: 01/23/2023] Open
Abstract
Many therapeutic interventions in disease states of heightened cardiac sympathetic activity are targeted to the myocytes. However, emerging clinical data highlights a dominant role in disease progression by the neurons themselves. Here we describe a novel experimental model of the peripheral neuro-cardiac axis to study the neuron’s ability to drive a myocyte cAMP phenotype. We employed a co-culture of neonatal ventricular myocytes and sympathetic stellate neurons from normal (WKY) and pro-hypertensive (SHR) rats that are sympathetically hyper-responsive and measured nicotine evoked cAMP responses in the myocytes using a fourth generation FRET cAMP sensor. We demonstrated the dominant role of neurons in driving the myocyte ß-adrenergic phenotype, where SHR cultures elicited heightened myocyte cAMP responses during neural activation. Moreover, cross-culturing healthy neurons onto diseased myocytes rescued the diseased cAMP response of the myocyte. Conversely, healthy myocytes developed a diseased cAMP response if diseased neurons were introduced. Our results provide evidence for a dominant role played by the neuron in driving the adrenergic phenotype seen in cardiovascular disease. We also highlight the potential of using healthy neurons to turn down the gain of neurotransmission, akin to a smart pre-synaptic ß-blocker.
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Iyer MS, Bergman RN, Korman JE, Woolcott OO, Kabir M, Victor RG, Clegg DJ, Kolka C. Renal Denervation Reverses Hepatic Insulin Resistance Induced by High-Fat Diet. Diabetes 2016; 65:3453-3463. [PMID: 27495220 PMCID: PMC5079632 DOI: 10.2337/db16-0698] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/26/2016] [Indexed: 12/18/2022]
Abstract
Activation of the sympathetic nervous system (SNS) constitutes a putative mechanism of obesity-induced insulin resistance. Thus, we hypothesized that inhibiting the SNS by using renal denervation (RDN) will improve insulin sensitivity (SI) in a nonhypertensive obese canine model. SI was measured using euglycemic-hyperinsulinemic clamp (EGC), before (week 0 [w0]) and after 6 weeks of high-fat diet (w6-HFD) feeding and after either RDN (HFD + RDN) or sham surgery (HFD + sham). As expected, HFD induced insulin resistance in the liver (sham 2.5 ± 0.6 vs. 0.7 ± 0.6 × 10-4 dL ⋅ kg-1 ⋅ min-1 ⋅ pmol/L-1 at w0 vs. w6-HFD [P < 0.05], respectively; HFD + RDN 1.6 ± 0.3 vs. 0.5 ± 0.3 × 10-4 dL ⋅ kg-1 ⋅ min-1 ⋅ pmol/L-1 at w0 vs. w6-HFD [P < 0.001], respectively). In sham animals, this insulin resistance persisted, yet RDN completely normalized hepatic SI in HFD-fed animals (1.8 ± 0.3 × 10-4 dL ⋅ kg-1 ⋅ min-1 ⋅ pmol/L-1 at HFD + RDN [P < 0.001] vs. w6-HFD, [P not significant] vs. w0) by reducing hepatic gluconeogenic genes, including G6Pase, PEPCK, and FOXO1. The data suggest that RDN downregulated hepatic gluconeogenesis primarily by upregulating liver X receptor α through the natriuretic peptide pathway. In conclusion, bilateral RDN completely normalizes hepatic SI in obese canines. These preclinical data implicate a novel mechanistic role for the renal nerves in the regulation of insulin action specifically at the level of the liver and show that the renal nerves constitute a new therapeutic target to counteract insulin resistance.
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Affiliation(s)
- Malini S Iyer
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Richard N Bergman
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jeremy E Korman
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Orison O Woolcott
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Morvarid Kabir
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Ronald G Victor
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Deborah J Clegg
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Cathryn Kolka
- Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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Adlan AM, Paton JFR, Lip GYH, Kitas GD, Fisher JP. Increased sympathetic nerve activity and reduced cardiac baroreflex sensitivity in rheumatoid arthritis. J Physiol 2016; 595:967-981. [PMID: 27561790 PMCID: PMC5285627 DOI: 10.1113/jp272944] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/19/2016] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with an increased risk of cardiovascular mortality. Increased sympathetic nerve activity and reduced cardiac baroreflex sensitivity heighten cardiovascular risk, althogh whether such autonomic dysfunction is present in RA is not known. In the present study, we observed an increased sympathetic nerve activity and reduced cardiac baroreflex sensitivity in patients with RA compared to matched controls. Pain was positively correlated with sympathetic nerve activity and negatively correlated with cardiac baroreflex sensitivity. The pattern of autonomic dysfunction that we describe may help to explain the increased cardiovascular risk in RA, and raises the possibility that optimizing pain management may resolve autonomic dysfunction in RA. ABSTRACT Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with increased cardiovascular morbidity/mortality and an incompletely understood pathophysiology. In animal studies, central and blood borne inflammatory cytokines that can be elevated in RA evoke pathogenic increases in sympathetic activity and reductions in baroreflex sensitivity (BRS). We hypothesized that muscle sympathetic nerve activity (MSNA) was increased and BRS decreased in RA. MSNA, blood pressure and heart rate (HR) were recorded in age- and sex-matched RA-normotensive (n = 13), RA-hypertensive patients (RA-HTN; n = 17), normotensive (NC; n = 17) and hypertensive controls (HTN; n = 16). BRS was determined using the modified Oxford technique. Inflammation and pain were determined using serum high sensitivity C-reactive protein (hs-CRP) and a visual analogue scale (VAS), respectively. MSNA was elevated similarly in RA, RA-HTN and HTN patients (32 ± 9, 35 ± 14, 37 ± 8 bursts min-1 ) compared to NC (22 ± 9 bursts min-1 ; P = 0.004). Sympathetic BRS was similar between groups (P = 0.927), whereas cardiac BRS (cBRS) was reduced in RA, RA-HTN and HTN patients [5(3-8), 4 (2-7), 6 (4-9) ms mmHg-1 ] compared to NC [11 (8-15) ms mmHg-1 ; P = 0.002]. HR was independently associated with hs-CRP. Increased MSNA and reduced cBRS were associated with hs-CRP although confounded in multivariable analysis. VAS was independently associated with MSNA burst frequency, cBRS and HR. We provide the first evidence for heightened sympathetic outflow and reduced cBRS in RA that can be independent of hypertension. In RA patients, reported pain was positively correlated with MSNA and negatively correlated with cBRS. Future studies should assess whether therapies to ameliorate pain and inflammation in RA restores autonomic balance and reduces cardiovascular events.
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Affiliation(s)
- Ahmed M Adlan
- College of Life & Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Julian F R Paton
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, UK
| | - Gregory Y H Lip
- University of Birmingham Centre of Cardiovascular Sciences, City Hospital, Birmingham, UK
| | - George D Kitas
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands, UK
| | - James P Fisher
- College of Life & Environmental Sciences, University of Birmingham, Birmingham, UK
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Just TP, Cooper IR, DeLorey DS. Sympathetic Vasoconstriction in Skeletal Muscle: Adaptations to Exercise Training. Exerc Sport Sci Rev 2016; 44:137-43. [DOI: 10.1249/jes.0000000000000085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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83
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Eckberg DL, Diedrich A, Cooke WH, Biaggioni I, Buckey JC, Pawelczyk JA, Ertl AC, Cox JF, Kuusela TA, Tahvanainen KUO, Mano T, Iwase S, Baisch FJ, Levine BD, Adams-Huet B, Robertson D, Blomqvist CG. Respiratory modulation of human autonomic function: long-term neuroplasticity in space. J Physiol 2016; 594:5629-46. [PMID: 27029027 DOI: 10.1113/jp271656] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/14/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS We studied healthy astronauts before, during and after the Neurolab Space Shuttle mission with controlled breathing and apnoea, to identify autonomic changes that might contribute to postflight orthostatic intolerance. Measurements included the electrocardiogram, finger photoplethysmographic arterial pressure, respiratory carbon dioxide levels, tidal volume and peroneal nerve muscle sympathetic activity. Arterial pressure fell and then rose in space, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations rose and then fell in space, and descended to preflight levels upon return to Earth. Sympathetic burst frequencies (but not areas) were greater than preflight in space and on landing day, and astronauts' abilities to modulate both burst areas and frequencies during apnoea were sharply diminished. Spaceflight triggers long-term neuroplastic changes reflected by reciptocal sympathetic and vagal motoneurone responsiveness to breathing changes. ABSTRACT We studied six healthy astronauts five times, on Earth, in space on the first and 12th or 13th day of the 16 day Neurolab Space Shuttle mission, on landing day, and 5-6 days later. Astronauts followed a fixed protocol comprising controlled and random frequency breathing and apnoea, conceived to perturb their autonomic function and identify changes, if any, provoked by microgravity exposure. We recorded the electrocardiogram, finger photoplethysmographic arterial pressure, tidal carbon dioxide concentrations and volumes, and peroneal nerve muscle sympathetic activity on Earth (in the supine position) and in space. (Sympathetic nerve recordings were made during three sessions: preflight, late mission and landing day.) Arterial pressure changed systematically from preflight levels: pressure fell during early microgravity exposure, rose as microgravity exposure continued, and drifted back to preflight levels after return to Earth. Vagal metrics changed in opposite directions: vagal baroreflex gain and two indices of vagal fluctuations (root mean square of successive normal R-R intervals; and proportion of successive normal R-R intervals greater than 50 ms, divided by the total number of normal R-R intervals) rose significantly during early microgravity exposure, fell as microgravity exposure continued, and descended to preflight levels upon return to Earth. Sympathetic mechanisms also changed. Burst frequencies (but not areas) during fixed frequency breathing were greater than preflight in space and on landing day, but their control during apnoea was sharply altered: astronauts increased their burst frequencies from already high levels, but they could not modulate either burst areas or frequencies appropriately. Space travel provokes long-lasting sympathetic and vagal neuroplastic changes in healthy humans.
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Affiliation(s)
- Dwain L Eckberg
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - André Diedrich
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - William H Cooke
- Department of Kinesiology, Health, and Nutrition, University of Texas at San Antonio, San Antonio, TX, USA
| | - Italo Biaggioni
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Jay C Buckey
- Dartmouth Hitchcock Medical Centre, Lebanon, NH, USA
| | - James A Pawelczyk
- Department of Physiology, Pennsylvania State University, University Park and Hershey, PA, USA
| | - Andrew C Ertl
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - James F Cox
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Tom A Kuusela
- Department of Physics, Turku University, Turku, Finland
| | - Kari U O Tahvanainen
- Department of Clinical Physiology and Nuclear Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Tadaaki Mano
- Gifu University of Medical Science, 795-1 Nagamine Ichihiraga, Seki, Gifu, 501-3892, Japan
| | - Satoshi Iwase
- Department of Physiology, Aichi Medical University, Aichi, Japan
| | | | - Benjamin D Levine
- Department of Medicine, University of Texas Southwestern Medical Centre at Dallas, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Hospital, Dallas, TX, USA
| | | | - David Robertson
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - C Gunnar Blomqvist
- Department of Medicine, University of Texas Southwestern Medical Centre at Dallas, Dallas, TX, USA
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Posada-Quintero HF, Florian JP, Orjuela-Cañón ÁD, Chon KH. Highly sensitive index of sympathetic activity based on time-frequency spectral analysis of electrodermal activity. Am J Physiol Regul Integr Comp Physiol 2016; 311:R582-91. [PMID: 27440716 DOI: 10.1152/ajpregu.00180.2016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/14/2016] [Indexed: 11/22/2022]
Abstract
Time-domain indices of electrodermal activity (EDA) have been used as a marker of sympathetic tone. However, they often show high variation between subjects and low consistency, which has precluded their general use as a marker of sympathetic tone. To examine whether power spectral density analysis of EDA can provide more consistent results, we recently performed a variety of sympathetic tone-evoking experiments (43). We found significant increase in the spectral power in the frequency range of 0.045 to 0.25 Hz when sympathetic tone-evoking stimuli were induced. The sympathetic tone assessed by the power spectral density of EDA was found to have lower variation and more sensitivity for certain, but not all, stimuli compared with the time-domain analysis of EDA. We surmise that this lack of sensitivity in certain sympathetic tone-inducing conditions with time-invariant spectral analysis of EDA may lie in its inability to characterize time-varying dynamics of the sympathetic tone. To overcome the disadvantages of time-domain and time-invariant power spectral indices of EDA, we developed a highly sensitive index of sympathetic tone, based on time-frequency analysis of EDA signals. Its efficacy was tested using experiments designed to elicit sympathetic dynamics. Twelve subjects underwent four tests known to elicit sympathetic tone arousal: cold pressor, tilt table, stand test, and the Stroop task. We hypothesize that a more sensitive measure of sympathetic control can be developed using time-varying spectral analysis. Variable frequency complex demodulation, a recently developed technique for time-frequency analysis, was used to obtain spectral amplitudes associated with EDA. We found that the time-varying spectral frequency band 0.08-0.24 Hz was most responsive to stimulation. Spectral power for frequencies higher than 0.24 Hz were determined to be not related to the sympathetic dynamics because they comprised less than 5% of the total power. The mean value of time-varying spectral amplitudes in the frequency band 0.08-0.24 Hz were used as the index of sympathetic tone, termed TVSymp. TVSymp was found to be overall the most sensitive to the stimuli, as evidenced by a low coefficient of variation (0.54), and higher consistency (intra-class correlation, 0.96) and sensitivity (Youden's index > 0.75), area under the receiver operating characteristic (ROC) curve (>0.8, accuracy > 0.88) compared with time-domain and time-invariant spectral indices, including heart rate variability.
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Affiliation(s)
| | - John P Florian
- Navy Experimental Diving Unit, Panama City, Florida; and
| | | | - Ki H Chon
- University of Connecticut, Storrs, Connecticut;
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Assessment of vascular autonomic function using peripheral arterial tonometry. Heart Vessels 2016; 32:260-268. [DOI: 10.1007/s00380-016-0870-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 07/01/2016] [Indexed: 01/02/2023]
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86
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Grimaldi D, Carter JR, Van Cauter E, Leproult R. Adverse Impact of Sleep Restriction and Circadian Misalignment on Autonomic Function in Healthy Young Adults. Hypertension 2016; 68:243-50. [PMID: 27271308 PMCID: PMC4902172 DOI: 10.1161/hypertensionaha.115.06847] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/16/2016] [Indexed: 11/16/2022]
Abstract
Insufficient sleep and circadian rhythm disturbances have been each associated with adverse cardiovascular outcomes in epidemiological studies, but experimental evidence for a causal link is scarce. The present study compares the impact of circadian misalignment (CM) to circadian alignment (CA) on human autonomic function using a nonrandomized parallel group design to achieve the same total sleep time in both conditions. After baseline assessments (3 days with 10-hour bedtimes), 26 healthy young adults were assigned to sleep restriction (SR; eight 5-hour bedtimes) with either fixed nocturnal bedtimes (CA; n=13) or bedtimes delayed by 8.5 hours on 4 of the 8 days (CM; n=13). Daytime ambulatory blood pressure and heart rate (HR; CA, n=11; CM, n=10) and 24-hour urinary norepinephrine levels (CA, n=13; CM, n=13) were assessed at baseline and the end of SR. Nocturnal HR and HR variability were analyzed during sleep at baseline and during the fourth and seventh nights of SR (CA, n=8; CM, n=12). SR resulted in a significant increase in daytime HR in both groups, without changes in blood pressure. SR increased 24-hour urinary norepinephrine in the CM group (30±4 versus 21±2 μg), but not in the circadian alignment group (group×condition, P=0.005). In contrast to the lack of detectable impact of CM on daytime autonomic function, SR with CM elicited greater increases in nocturnal HR, as well as greater reductions in vagal indices of HR variability, than SR without CM (group×condition, P<0.05). In conclusion, SR and CM both result in impaired autonomic function that could lead, under chronic conditions, to enhanced cardiovascular risk.
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Affiliation(s)
- Daniela Grimaldi
- From the Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, IL (D.G., J.R.C., E.V.C., R.L.); and Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.).
| | - Jason R Carter
- From the Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, IL (D.G., J.R.C., E.V.C., R.L.); and Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.)
| | - Eve Van Cauter
- From the Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, IL (D.G., J.R.C., E.V.C., R.L.); and Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.)
| | - Rachel Leproult
- From the Sleep, Metabolism and Health Center, Department of Medicine, The University of Chicago, IL (D.G., J.R.C., E.V.C., R.L.); and Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton (J.R.C.)
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87
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Erne P, Sudano I, Resink TJ, Lüscher TF. Interventional therapy for hypertension: Back on track again? Crit Rev Clin Lab Sci 2016; 54:18-25. [PMID: 27282628 DOI: 10.1080/10408363.2016.1194367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Treatment-resistant hypertension, or resistant hypertension, is defined as blood pressure that remains above target despite concurrent use of at least three antihypertensive agents from different classes at optimal doses, one of which should be a diuretic. Important considerations in the diagnosis of treatment-resistant hypertension include the exclusion of pseudoresistance and the evaluation of potential secondary causes of hypertension and of concomitant conditions that maintain high blood pressure. The ability to diagnose true treatment-resistant hypertension is important for selection of patients who may be appropriately treated with an invasive therapy. Currently, there are three interventional approaches to treat resistant hypertension, namely: (1) reduction of the activity of the sympathetic nervous system by renal nerve ablation, (2) stimulation of baroreceptors and (3) creation of a peripheral arterial venous anastomosis. This review focuses on the rationale behind these invasive approaches and the clinical results.
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Affiliation(s)
- Paul Erne
- a Department of Biomedicine , Basel University Hospital , Basel , Switzerland and
| | - Isabella Sudano
- b Cardiology, University Heart Center, University Hospital Zurich , Zurich , Switzerland
| | - Therese J Resink
- a Department of Biomedicine , Basel University Hospital , Basel , Switzerland and
| | - Thomas F Lüscher
- b Cardiology, University Heart Center, University Hospital Zurich , Zurich , Switzerland
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88
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Zhu L, Zhao X, Zeng P, Zhu J, Yang S, Liu A, Song Y. Study on autonomic dysfunction and metabolic syndrome in Chinese patients. J Diabetes Investig 2016; 7:901-907. [PMID: 27181217 PMCID: PMC5089954 DOI: 10.1111/jdi.12524] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 02/17/2016] [Accepted: 03/22/2016] [Indexed: 01/08/2023] Open
Abstract
Aims/Introduction There is still a lack of simple methods and instruments for the early assessment of autonomic dysfunction in metabolic syndrome patients. Assessment of sudomotor function has been proposed to explore autonomic function, and could be used as an early biomarker for metabolic syndrome. In the present study, we use a quick and non‐invasive method to measure sudomotor function, and aimed to evaluate its efficacy to identify metabolic syndrome in a Chinese population. Materials and Methods Information on the 1,160 Chinese participants involved in the study, such as age, sex, blood pressure, waist circumference, body mass index, fasting plasma glucose and lipid profile, and SUDOSCAN, was recorded. During the sudomotor test, patients were asked to place their bare hands and feet on large electrodes. The test took 2 min to carry out, was painless and no participant preparation was required. Results A total of 567 participants were diagnosed with metabolic syndrome. The prevalence of metabolic syndrome correlated significantly with increasing SUDOSCAN cardiac risk score (P for trend <0.0001). Furthermore, an increase in cardiac risk score value was associated with an increase in the number of metabolic syndrome components (P for trend <0.0001). Compared with the no‐risk group (cardiac risk score <20), participants in the high‐risk group (cardiac risk score ≥30) had a 2.83‐fold increased risk of prevalent metabolic syndrome (P < 0.0001), and 1.51‐fold increased risk (P = 0.01) after adjustments. Conclusions Autonomic dysfunction is correlated to components of metabolic syndrome. The role of SUDOSCAN in the screening of at‐risk populations for metabolic syndrome has to be confirmed by further studies.
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Affiliation(s)
- Ling Zhu
- Physical Examination Center, Beijing Hospital of Ministry of Health, Beijing, China.
| | - Xiaolan Zhao
- Health Management Center of Southwest Hospital, The Third Military Medical University, Chongqing, China
| | - Ping Zeng
- The Key Laboratory of Geriatrics, Beijing Hospital of Ministry of Health, Beijing, China
| | - Jianguo Zhu
- The Key Laboratory of Geriatrics, Beijing Hospital of Ministry of Health, Beijing, China
| | - Shuwen Yang
- Physical Examination Center, Beijing Hospital of Ministry of Health, Beijing, China
| | - Annan Liu
- Physical Examination Center, Beijing Hospital of Ministry of Health, Beijing, China
| | - Yuehua Song
- Physical Examination Center, Beijing Hospital of Ministry of Health, Beijing, China
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Power Spectral Density Analysis of Electrodermal Activity for Sympathetic Function Assessment. Ann Biomed Eng 2016; 44:3124-3135. [PMID: 27059225 DOI: 10.1007/s10439-016-1606-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/02/2016] [Indexed: 10/22/2022]
Abstract
Time-domain features of electrodermal activity (EDA), the measurable changes in conductance at the skin surface, are typically used to assess overall activation of the sympathetic system. These time domain features, the skin conductance level (SCL) and the nonspecific skin conductance responses (NS.SCRs), are consistently elevated with sympathetic nervous arousal, but highly variable between subjects. A novel frequency-domain approach to quantify sympathetic function using the power spectral density (PSD) of EDA is proposed. This analysis was used to examine if some of the induced stimuli invoke the sympathetic nervous system's dynamics which can be discernible as a large spectral peak, conjectured to be present in the low frequency band. The resulting indices were compared to the power of low-frequency components of heart rate variability (HRVLF) time series, as well as to time-domain features of EDA. Twelve healthy subjects were subjected to orthostatic, physical and cognitive stress, to test these techniques. We found that the increase in the spectral powers of the EDA was largely confined to 0.045-0.15 Hz, which is in the prescribed band for HRVLF. These low frequency components are known to be, in part, influenced by the sympathetic nervous dynamics. However, we found an additional 5-10% of the spectral power in the frequency range of 0.15-0.25 Hz with all three stimuli. Thus, dynamics of the normalized sympathetic component of the EDA, termed EDASympn, are represented in the frequency band 0.045-0.25 Hz; only a small amount of spectral power is present in frequencies higher than 0.25 Hz. Our results showed that the time-domain indices (the SCL and NS.SCRs), and EDASympn, exhibited significant increases under orthostatic, physical, and cognitive stress. However, EDASympn was more responsive than the SCL and NS.SCRs to the cold pressor stimulus, while the latter two were more sensitive to the postural and Stroop tests. Additionally, EDASympn exhibited an acceptable degree of consistency and a lower coefficient of variation compared to the time-domain features. Therefore, PSD analysis of EDA is a promising technique for sympathetic function assessment.
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90
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The blood pressure-lowering effect of renal denervation is inversely related to kidney function. J Hypertens 2016; 32:2045-53; discussion 2053. [PMID: 25023158 DOI: 10.1097/hjh.0000000000000282] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES In renal denervation (RDN), a wide range in the blood pressure (BP)-lowering effect has been reported. On the basis of the current knowledge of pathophysiology, we hypothesized that the BP-lowering effect of RDN would be inversely related to kidney function. Second, we investigated whether direct and indirect variables of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) would be related as well. METHODS Sixty-seven patients from a prospective cohort of patients treated with RDN with completed 6 months follow-up were included. Data collected during routine standardized work-up before RDN were used: 24-h urine excretion of creatinine, albumin, sodium and catecholamines, plasma creatinine, renin activity and aldosterone, ambulatory BP-monitoring and a captopril challenge test. When considered well tolerated, antihypertensive drugs were stopped before these investigations. RESULTS The BP-lowering was inversely related to estimated glomerular filtration rate (eGFR) in patients who stopped antihypertensive drugs prior to testing (ß: 0.46, P = 0.013). There was a positive relation between SBP at baseline and the BP-lowering effect of RDN (ß:-0.55 mmHg per mmHg, P < 0.001). Parameters related to the rennin-angiotensin system (aldosterone, captopril test) and the sympathetic nervous system (dipping pattern and catecholamines in urine) positively related to the BP-lowering effect of RDN. CONCLUSION The present explorative study shows an inverse relation between the BP-lowering effect of RDN and eGFR. Second, we found relations between variables of the RAAS and SNS with the BP-lowering effect of RDN. The data complement current concepts on pathophysiology of sympathetic hyperactivity and hypertension and may give some insight in the wide range of the effect of RDN.
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91
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Jayasinghe SU, Lambert GW, Torres SJ, Fraser SF, Eikelis N, Turner AI. Hypothalamo-pituitary adrenal axis and sympatho-adrenal medullary system responses to psychological stress were not attenuated in women with elevated physical fitness levels. Endocrine 2016. [PMID: 26206752 DOI: 10.1007/s12020-015-0687-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
It is not clear if higher levels of cardiorespiratory fitness are associated with lower hypothalamo-pituitary adrenal (HPA) axis and sympatho-adrenal medullary (SAM) system reactivity to psychological stress in women. The association between cardio-metabolic risk markers and acute physiological responses to psychological stress in women who differ in their cardiorespiratory fitness status has also not been investigated. Women with high (n = 22) and low (n = 22) levels of fitness aged 30-50 years (in the mid-follicular phase of the menstrual cycle) were subjected to a Trier Social Stress Test (TSST) at 1500 h. Plasma concentrations of cortisol, adrenaline (Adr), noradrenaline (NA), and dopamine (DA) were measured in samples collected every 7-15 min from 1400 to 1700 h. Heart rate and blood pressure were measured at the same time points. Low-fit women had elevated serum triglyceride, cholesterol/HDL ratio, fasting glucose, and HOMA-IR levels compared with high-fit women. While cortisol, Adr, NA, HR, and blood pressure all demonstrated a significant response to the TSST, the responses of these variables did not differ significantly between high- and low-fit women in response to the TSST. Dopamine reactivity was significantly higher in the low-fit women compared with high-fit women. There was also a significant negative correlation between VO2 max and DA reactivity. These findings suggest that, for low-fit women aged 30-50 years, the response of HPA axis and SAM system to a potent acute psychological stressor is not compromised compared to that in high-fit women.
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Affiliation(s)
- Sisitha U Jayasinghe
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Susan J Torres
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Steve F Fraser
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Nina Eikelis
- Baker IDI Heart & Diabetes Institute, Melbourne, VIC, Australia
| | - Anne I Turner
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
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92
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Nair GKK, Massé S, Asta J, Sevaptisidis E, Azam MA, Lai PFH, Veluppillaim A, Magtibay K, Jackson N, Nanthakumar K. The need for and the challenges of measuring renal sympathetic nerve activity. Heart Rhythm 2016; 13:1166-1171. [PMID: 26806582 DOI: 10.1016/j.hrthm.2016.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Indexed: 12/14/2022]
Abstract
Renal denervation (RDN) was primarily developed to treat hypertension and is potentially a new method for treating arrhythmias. Because of the lack of a standardized protocol to measure renal sympathetic nerve activity, RDN is administered in a blind manner. This inability to assess efficacy at the time of treatment delivery may be a large contributor to the ambiguity of RDN outcomes reported in the hypertension literature. The advancement of RDN as a treatment of hypertension or arrhythmias will be hampered by the lack of delivery assessment, a deficiency that the cardiovascular electrophysiology community, with its expertise in recording and mapping, may have a role in addressing and overcoming. The development of endovascular recording of renal nerve action potentials may provide a useful accessory tool for RDN. Innovation in this area will be crucial as we as a community reconsider the therapeutic value of RDN.
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Affiliation(s)
| | | | - John Asta
- University Health Network, Toronto, Ontario, Canada
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93
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Modulation of the Interaction of Enteric Bacteria with Intestinal Mucosa by Stress-Related Catecholamines. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 874:143-66. [PMID: 26589217 DOI: 10.1007/978-3-319-20215-0_6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Stress associated with parturition, transport or mixing has long been correlated with enhanced faecal excretion of diarrhoeal zoonotic pathogens in animals such as Salmonella enterica and Escherichia coli. It may also predispose humans to infection and/or be associated with more severe outcomes. One possible explanation for this phenomenon is the ability of enteric bacterial pathogens to sense and respond to host stress-related catecholamines. This article reviews evidence of the ability of catecholamine hormones to modulate interactions between Gram-negative diarrhoeal pathogens and intestinal mucosa, as well as the molecular mechanisms that may be at work.
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94
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Backes TP, Horvath PJ, Kazial KA. Salivary alpha amylase and salivary cortisol response to fluid consumption in exercising athletes. Biol Sport 2015; 32:275-80. [PMID: 26681828 PMCID: PMC4672157 DOI: 10.5604/20831862.1163689] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/05/2015] [Accepted: 06/24/2015] [Indexed: 11/13/2022] Open
Abstract
The objective of the study was to examine salivary biomarker response to fluid consumption in exercising athletes. Exercise induces stress on the body and salivary alpha amylase (sAA) and salivary cortisol are useful biomarkers for activity in the sympathoadrenal medullary system and the hypothalamic pituitary adrenal axis which are involved in the stress response. Fifteen college students were given 150 ml and 500 ml of water on different days and blinded to fluid condition. The exercise protocol was identical for both fluid conditions using absolute exercise intensities ranging from moderate to high. Saliva was collected prior to exercise, post moderate and post high intensities and analyzed by Salimetrics assays. Exercise was significant for sAA with values different between pre-exercise (85 ± 10 U · ml−1) and high intensity (284 ± 30 U · ml−1) as well as between moderate intensity (204 ± 32 U · ml−1) and high intensity. There was no difference in sAA values between fluid conditions at either intensity. Exercise intensity and fluid condition were each significant for cortisol. Cortisol values were different between pre-exercise (0.30 ± 0.03 ug · dL−1) and high intensity (0.45 ± 0.05 ug · dL−1) as well as between moderate intensity (0.33 ± 0.04 ug · dL−1) and high intensity. Moderate exercise intensity cortisol was lower in the 500 ml condition (0.33 ± 0.03 ug · dL−1) compared with the 150 ml condition (0.38 ± 0.03 ug · dL−1). This altered physiological response due to fluid consumption could influence sport performance and should be considered. In addition, future sport and exercise studies should control for fluid consumption.
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Affiliation(s)
- T P Backes
- Department of Biology, State University of New York at Fredonia, Fredonia NY USA
| | - P J Horvath
- Department of Exercise & Nutrition Sciences, State University of New York at Buffalo, Buffalo, NY USA
| | - K A Kazial
- Department of Biology, State University of New York at Fredonia, Fredonia, NY USA
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95
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Greaney JL, Kenney WL, Alexander LM. Sympathetic regulation during thermal stress in human aging and disease. Auton Neurosci 2015; 196:81-90. [PMID: 26627337 DOI: 10.1016/j.autneu.2015.11.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 02/07/2023]
Abstract
Humans control their core temperature within a narrow range via precise adjustments of the autonomic nervous system. In response to changing core and/or skin temperature, several critical thermoregulatory reflex effector responses are initiated and include shivering, sweating, and changes in cutaneous blood flow. Cutaneous vasomotor adjustments, mediated by modulations in sympathetic nerve activity (SNA), aid in the maintenance of thermal homeostasis during cold and heat stress since (1) they serve as the first line of defense of body temperature and are initiated before other thermoregulatory effectors, and (2) they are on the efferent arm of non-thermoregulatory reflex systems, aiding in the maintenance of blood pressure and organ perfusion. This review article highlights the sympathetic responses of humans to thermal stress, with a specific focus on primary aging as well as impairments that occur in both heart disease and type 2 diabetes mellitus. Age- and pathology-related changes in efferent muscle and skin SNA during cold and heat stress, measured directly in humans using microneurography, are discussed.
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Affiliation(s)
- Jody L Greaney
- Department of Kinesiology, Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, United States.
| | - W Larry Kenney
- Department of Kinesiology, Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, United States
| | - Lacy M Alexander
- Department of Kinesiology, Noll Laboratory, The Pennsylvania State University, University Park, PA 16802, United States
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96
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Jayasinghe SU, Torres SJ, Fraser SF, Turner AI. Cortisol, blood pressure, and heart rate responses to food intake were independent of physical fitness levels in women. Appl Physiol Nutr Metab 2015; 40:1186-92. [PMID: 26499850 DOI: 10.1139/apnm-2015-0168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This research tested the hypothesis that women who had higher levels of physical fitness will have lower hypothalamo-pituitary-adrenal axis (cortisol) and sympatho-adrenal medullary system (blood pressure and heart rate) responses to food intake compared with women who had low levels of physical fitness. Lower fitness (n = 22; maximal oxygen consumption = 27.4 ± 1.0 mL∙kg(-1)·min(-1)) and higher fitness (n = 22; maximal oxygen consumption = 41.9 ± 1.6 mL∙kg(-1)·min(-1)) women (aged 30-50 years; in the follicular phase of the menstrual cycle) who participated in levels of physical activity that met (lower fitness = 2.7 ± 0.5 h/week) or considerably exceeded (higher fitness = 7.1 ± 1.4 h/week) physical activity guidelines made their own lunch using standardised ingredients at 1200 h. Concentrations of cortisol were measured in blood samples collected every 15 min from 1145-1400 h. Blood pressures and heart rate were also measured every 15 min between 1145 h and 1400 h. The meal consumed by the participants consisted of 20% protein, 61% carbohydrates, and 19% fat. There was a significant overall response to lunch in all of the parameters measured (time effect for all, p < 0.01). The cortisol response to lunch was not significantly different between the groups (time × treatment, p = 0.882). Overall, both groups showed the same pattern of cortisol secretion (treatment p = 0.839). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate responses (time × treatment, p = 0.726, 0.898, 0.713, and 0.620, respectively) were also similar between higher and lower fitness women. Results suggest that the physiological response to food intake in women is quite resistant to modification by elevated physical fitness levels.
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Affiliation(s)
- Sisitha U Jayasinghe
- Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia.,Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia
| | - Susan J Torres
- Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia.,Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia
| | - Steve F Fraser
- Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia.,Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia
| | - Anne I Turner
- Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia.,Centre for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria 3125, Australia
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97
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Morgan DA, Despas F, Rahmouni K. Effects of leptin on sympathetic nerve activity in conscious mice. Physiol Rep 2015; 3:3/9/e12554. [PMID: 26381017 PMCID: PMC4600394 DOI: 10.14814/phy2.12554] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The adipocyte-derived hormone, leptin, has emerged as an important regulator of regional sympathetic nerve activity (SNA) with pathophysiological implications in obesity. Genetically engineered mice are useful to understand the molecular pathways underlying the SNA responses evoked by leptin. However, so far the effect of leptin on direct SNA in mice has been studied under general anesthesia. Here, we examined the sympathetic responses evoked by leptin in conscious mice. Mice were instrumented, under ketamine/xylazine anesthesia, with renal or lumbar SNA recordings using a thin (40 gauge) bipolar platinum-iridium wire. The electrodes were exteriorized at the nape of the neck and mice were allowed (5 h) to recover from anesthesia. Interestingly, the reflex increases in renal and lumbar SNA caused by sodium nitroprusside (SNP)-induced hypotension was higher in the conscious phase versus the anesthetized state, whereas the increase in both renal and lumbar SNA evoked by leptin did not differ between anesthetized or conscious mice. Next, we assessed whether isoflurane anesthesia would yield a better outcome. Again, the SNP-induced increase in renal SNA and baroreceptor-renal SNA reflex were significantly elevated in the conscious states relative to isoflurane-anesthetized phase, but the renal SNA response induced by leptin in the conscious states were qualitatively comparable to those evoked above. Thus, despite improvement in sympathetic reflexes in conscious mice the sympathetic responses evoked by leptin mimic those induced during anesthesia.
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Affiliation(s)
- Donald A Morgan
- Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Fabien Despas
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Kamal Rahmouni
- Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
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98
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Notarius CF, Millar PJ, Floras JS. Muscle sympathetic activity in resting and exercising humans with and without heart failure. Appl Physiol Nutr Metab 2015; 40:1107-15. [PMID: 26481289 DOI: 10.1139/apnm-2015-0289] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The sympathetic nervous system is critical for coordinating the cardiovascular response to various types of physical exercise. In a number of disease states, including human heart failure with reduced ejection fraction (HFrEF), this regulation can be disturbed and adversely affect outcome. The purpose of this review is to describe sympathetic activity at rest and during exercise in both healthy humans and those with HFrEF and outline factors, which influence these responses. We focus predominately on studies that report direct measurements of efferent sympathetic nerve traffic to skeletal muscle (muscle sympathetic nerve activity; MSNA) using intraneural microneurographic recordings. Differences in MSNA discharge between subjects with and without HFrEF both at rest and during exercise and the influence of exercise training on the sympathetic response to exercise will be discussed. In contrast to healthy controls, MSNA increases during mild to moderate dynamic exercise in the presence of HFrEF. This increase may contribute to the exercise intolerance characteristic of HFrEF by limiting muscle blood flow and may be attenuated by exercise training. Future investigations are needed to clarify the neural afferent mechanisms that contribute to efferent sympathetic activation at rest and during exercise in HFrEF.
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Affiliation(s)
- Catherine F Notarius
- a University Health Network and Mount Sinai Hospital Division of Cardiology, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Philip J Millar
- b Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - John S Floras
- a University Health Network and Mount Sinai Hospital Division of Cardiology, University of Toronto, Toronto, ON M5G 2C4, Canada
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99
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Maciorkowska D, Zbroch E, Malyszko J. Circulating renalase, catecholamines, and vascular adhesion protein 1 in hypertensive patients. ACTA ACUST UNITED AC 2015; 9:855-64. [PMID: 26403854 DOI: 10.1016/j.jash.2015.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/16/2015] [Accepted: 08/04/2015] [Indexed: 01/11/2023]
Abstract
The aim of the study was to estimate and correlate circulating levels of renalase, vascular adhesion protein-1 (VAP-1), catecholamines in patients with primary hypertension. The renalase, VAP-1, and catecholamines concentration was estimated in 121 hypertensive patients. The correlation between renalase, VAP-1 levels and catecholamine concentration in blood, blood pressure control, pharmacological therapy, and medical history were taken in to consideration. The median office blood pressure was 145.5/86 mm Hg and was significantly higher than the median home blood pressure measurement value, which was 135/80 mm Hg, P < .05. Circulating renalase and VAP-1 (Me 9.57 μg/mL and Me = 326.7 ng/mL) levels were significantly higher in patients with hypertension comparing to healthy individuals (3.83 μg/mL and 248.37 ng/mL, P < .05). The correlation between renalase and noradrenalin concentration in blood was observed (r = 0.549; P < .05), also the correlation between VAP-1 and noradrenaline was noticed (r = 0.21, P = .029). Renalase level was higher in patients with coronary artery disease and correlated with decreased ejection fraction. VAP-1 concentration correlated also with left ventricular ejection fraction (r = -0.23, P = .013). Hypertensive patients with diabetes mellitus had almost statistically significant higher VAP-1 concentration compared with hypertensive patients without diabetes mellitus (Me = 403.22 ng/mL vs. Me = 326,68 ng/mL, P = .064). In multiple regression analysis, renalase was predicted by plasma dopamine and norepinephrine as also diastolic office blood pressure and left ventricle ejection fraction. Circulating renalase and VAP-1 levels are elevated in patients with poor blood pressure control. Its correlation with noradrenalin concentration need further studies to find out the role of renalase as also VAP-1 in pathogenesis and treatment of hypertension.
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Affiliation(s)
- Dominika Maciorkowska
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland.
| | - Edyta Zbroch
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
| | - Jolanta Malyszko
- Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland
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100
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Petrakova L, Doering BK, Vits S, Engler H, Rief W, Schedlowski M, Grigoleit JS. Psychosocial Stress Increases Salivary Alpha-Amylase Activity Independently from Plasma Noradrenaline Levels. PLoS One 2015; 10:e0134561. [PMID: 26247781 PMCID: PMC4527714 DOI: 10.1371/journal.pone.0134561] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 07/12/2015] [Indexed: 12/05/2022] Open
Abstract
Salivary alpha-amylase activity (sAA) and plasma noradrenaline (NA) concentrations are often considered to be surrogate markers of sympathetic activation in response to stress. However, despite accumulating evidence for a close association between sAA and noradrenaline and other indicators of sympathetic activity, reliability and generality of this relation remains unclear. We employed the Trier Social Stress Test (TSST) in order to directly compare the responses in sAA and NA to psychological stress in healthy volunteers (n = 23). The TSST significantly increased sAA and NA plasma levels with no significant differences in females and males. However, when subjects were divided according to their NA responses into low versus high responders, both groups did not significantly differ in their sAA before, during or after stress exposure. These data suggest that in response to acute psychological stress both plasma NA levels and sAA reflect sympathetic activity, however seemed to increase independently from each other.
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Affiliation(s)
- Liubov Petrakova
- Institute of Medical Psychology and Behavioral Immunobiology, University of Duisburg-Essen, Essen, Germany
| | - Bettina K. Doering
- Department of Clinical Psychology & Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Sabine Vits
- Institute of Medical Psychology and Behavioral Immunobiology, University of Duisburg-Essen, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University of Duisburg-Essen, Essen, Germany
| | - Winfried Rief
- Department of Clinical Psychology & Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University of Duisburg-Essen, Essen, Germany
| | - Jan-Sebastian Grigoleit
- Institute of Medical Psychology and Behavioral Immunobiology, University of Duisburg-Essen, Essen, Germany
- Laboratory of Neuronal Structure and Function, The Salk Institute for Biological Studies, La Jolla, California, United States of America
- * E-mail:
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