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Hoiland RL, Caldwell HG, Carr JMJR, Howe CA, Stacey BS, Dawkins T, Wakeham DJ, Tremblay JC, Tymko MM, Patrician A, Smith KJ, Sekhon MS, MacLeod DB, Green DJ, Bailey DM, Ainslie PN. Nitric oxide contributes to cerebrovascular shear-mediated dilatation but not steady-state cerebrovascular reactivity to carbon dioxide. J Physiol 2021; 600:1385-1403. [PMID: 34904229 DOI: 10.1113/jp282427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/07/2021] [Indexed: 12/15/2022] Open
Abstract
Cerebrovascular CO2 reactivity (CVR) is often considered a bioassay of cerebrovascular endothelial function. We recently introduced a test of cerebral shear-mediated dilatation (cSMD) that may better reflect endothelial function. We aimed to determine the nitric oxide (NO)-dependency of CVR and cSMD. Eleven volunteers underwent a steady-state CVR test and transient CO2 test of cSMD during intravenous infusion of the NO synthase inhibitor NG -monomethyl-l-arginine (l-NMMA) or volume-matched saline (placebo; single-blinded and counter-balanced). We measured cerebral blood flow (CBF; duplex ultrasound), intra-arterial blood pressure and P aC O 2 . Paired arterial and jugular venous blood sampling allowed for the determination of trans-cerebral NO2 - exchange (ozone-based chemiluminescence). l-NMMA reduced arterial NO2 - by ∼25% versus saline (74.3 ± 39.9 vs. 98.1 ± 34.2 nM; P = 0.03). The steady-state CVR (20.1 ± 11.6 nM/min at baseline vs. 3.2 ± 16.7 nM/min at +9 mmHg P aC O 2 ; P = 0.017) and transient cSMD tests (3.4 ± 5.9 nM/min at baseline vs. -1.8 ± 8.2 nM/min at 120 s post-CO2 ; P = 0.044) shifted trans-cerebral NO2 - exchange towards a greater net release (a negative value indicates release). Although this trans-cerebral NO2 - release was abolished by l-NMMA, CVR did not differ between the saline and l-NMMA trials (57.2 ± 14.6 vs. 54.1 ± 12.1 ml/min/mmHg; P = 0.49), nor did l-NMMA impact peak internal carotid artery dilatation during the steady-state CVR test (6.2 ± 4.5 vs. 6.2 ± 5.0% dilatation; P = 0.960). However, l-NMMA reduced cSMD by ∼37% compared to saline (2.91 ± 1.38 vs. 4.65 ± 2.50%; P = 0.009). Our findings indicate that NO is not an obligatory regulator of steady-state CVR. Further, our novel transient CO2 test of cSMD is largely NO-dependent and provides an in vivo bioassay of NO-mediated cerebrovascular function in humans. KEY POINTS: Emerging evidence indicates that a transient CO2 stimulus elicits shear-mediated dilatation of the internal carotid artery, termed cerebral shear-mediated dilatation. Whether or not cerebrovascular reactivity to a steady-state CO2 stimulus is NO-dependent remains unclear in humans. During both a steady-state cerebrovascular reactivity test and a transient CO2 test of cerebral shear-mediated dilatation, trans-cerebral nitrite exchange shifted towards a net release indicating cerebrovascular NO production; this response was not evident following intravenous infusion of the non-selective NO synthase inhibitor NG -monomethyl-l-arginine. NO synthase blockade did not alter cerebrovascular reactivity in the steady-state CO2 test; however, cerebral shear-mediated dilatation following a transient CO2 stimulus was reduced by ∼37% following intravenous infusion of NG -monomethyl-l-arginine. NO is not obligatory for cerebrovascular reactivity to CO2 , but is a key contributor to cerebral shear-mediated dilatation.
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Affiliation(s)
- Ryan L Hoiland
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Hannah G Caldwell
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jay M J R Carr
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Connor A Howe
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Benjamin S Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Tony Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Denis J Wakeham
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Joshua C Tremblay
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Michael M Tymko
- Neurovascular Health Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Alexander Patrician
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Kurt J Smith
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA.,Cerebrovascular Health, Exercise, and Environmental Research Science (CHEERS) Laboratory, School of Exercise Science, Physical and Health Education, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - David B MacLeod
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), University of Western Australia, Nedlands, Western Australia, Australia
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Philip N Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Averyanova IV. Cardiohemodynamics and gas analysis rearrangements in response to re-breathing in young males of Russia’s Fareast. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to examine the changes occurred in the heart rate variability, cardiovascular system and gas analysis in response to the test with return breathing in young Caucasian and Native men residing in Magadan region and Chukotka Autonomous District. Methods — Total 345 young men were examined; of them 65 were Native people from Chukotka Autonomous District (ChAD) and 35 Natives from Magadan Region (MR) as well as Caucasians (48 from ChAD and 197 from MR, respectively). Results — Studies have shown that in response to the hypoxic-hypercapnic effect, there were changes in the cardiovascular system, heart rate and gas analysis, with a number of differences depending on ethnicity and the region of residence. Region-related features of cardiohemodynamics were manifested by a more pronounced increase in the systolic blood pressure and heart rate in response to the re-breathing test in the two ethnic groups living in ChAD, which was observed against the background of higher values of the difference “baseline-test” in carbon dioxide levels in the exhaled air. Ethnic differences in our studies were seen due to the pronounced increase in response to the test for the activity of the parasympathetic link of the autonomic nervous system (increased TP and HF), at the background of a decrease in VLF observed only among Caucasians, which was associated with the lowest oxygen concentration in the exhaled air at the peak of the test. It was found that the significant differences in gas analysis identified at rest and at the peak of the test as well as rearrangements of the heart rate and cardiovascular system characteristics in response to the re-breathing in the young subjects residing in different regions of northeast Russia and belonging to different ethnic groups can serve as informative criteria reflecting the region caused ethnic characteristics of the organism. Conclusion — It was found, the most visible and informative parameters for the differences in dynamics of the studied systems demonstrated by the subjects of the two ethnic groups in the two observed regions of the Far East in response to a hypoxic-hypercapnic test with return breathing have been the spectral characteristics of the heart rate (TP, HF, VLF) and gas analysis with the calculation of the difference between the baseline and the peak values (difference in the CO2 and O2 concentration of the test-baseline).
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Hoiland RL, Fisher JA, Ainslie PN. Regulation of the Cerebral Circulation by Arterial Carbon Dioxide. Compr Physiol 2019; 9:1101-1154. [DOI: 10.1002/cphy.c180021] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Sobiech T, Buchner T, Krzesiński P, Gielerak G. Cardiorespiratory coupling in young healthy subjects. Physiol Meas 2017; 38:2186-2202. [PMID: 29076810 DOI: 10.1088/1361-6579/aa9693] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To quantify the presence of cardiorespiratory interaction in a group of 41 healthy subjects performing a subset of the Ewing test battery. APPROACH We measure the empirical distribution of the cardiorespiratory coupling time (RI), defined as the time from inspiration onset to R peaks in the ECG. The study protocol is a subset of the Ewing test battery. The respiratory function was measured with a thoracic belt and heart rate was obtained from a two channel ECG measurement. Both series of fiducial points were determined using custom software. Additionally, we determine the presence of cardiorespiratory coupling (CRC) and cardiorespiratory interaction (CRI) using Shannon entropy, synchrograms and coordigrams. MAIN RESULTS We observe that the RI distribution is asymmetric and nonuniform. These features are a manifestation of the causal relation between heart action and respiration. The preceding R peak strongly affects a position of inspiration onset. From the asymmetry of the RI distribution we conclude that this relation is stronger than the relation between inspiration onset and the following R peak. We use a suitable choice of surrogate data to prove that the result cannot be falsified. We observe a dual structure of the RI histograms, which may be related to the respiratory rhythmogenesis. We compare the sensitivity of RI histograms with other measures of CRI and CRC. In 46% of subjects, CRC appears in at least one stage of the examination, most often in resting states. In states of increased stress-orthostasis or physical (exercise)-the strength of coupling is visibly diminished. The nonuniform structure of the RI histogram is more sensitive to the presence of CRI than synchrograms or coordigrams are, as is well visible in the group averages. We also refer to the question of the most proper mathematical description of cardiorespiratory dynamics (phase domain or time domain). Finally, we formulate the hypothesis that the arterial blood pressure is a common driver of cardiac and respiratory rhythms. SIGNIFICANCE Analysis of the asymmetry of RI histograms is an interesting and sensitive method to study cardiorespiratory interaction and autonomic balance, in order to assess physical and mental health. The dual structure of the RI histograms which we have observed suggests the possible presence of a twofold mechanism for respiratory rhythmogenesis, as proposed by Galletly and Larsen.
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Affiliation(s)
- Tomasz Sobiech
- Cardiovascular Physics Group, Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
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Hoiland RL, Smith KJ, Carter HH, Lewis NC, Tymko MM, Wildfong KW, Bain AR, Green DJ, Ainslie PN. Shear-mediated dilation of the internal carotid artery occurs independent of hypercapnia. Am J Physiol Heart Circ Physiol 2017; 313:H24-H31. [DOI: 10.1152/ajpheart.00119.2017] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/03/2017] [Accepted: 04/03/2017] [Indexed: 12/29/2022]
Abstract
Evidence for shear stress as a regulator of carotid artery dilation in response to increased arterial CO2 was recently demonstrated in humans during sustained elevations in CO2 (hypercapnia); however, the relative contributions of CO2 and shear stress to this response remains unclear. We examined the hypothesis that, after a 30-s transient increase in arterial CO2 tension and consequent increase in internal carotid artery shear stress, internal carotid artery diameter would increase, indicating shear-mediated dilation, in the absence of concurrent hypercapnia. In 27 healthy participants, partial pressures of end-tidal O2 and CO2, ventilation (pneumotachography), blood pressure (finger photoplethysmography), heart rate (electrocardiogram), internal carotid artery flow, diameter, and shear stress (high-resolution duplex ultrasound), and middle cerebral artery blood velocity (transcranial Doppler) were measured during 4-min steady-state and transient 30-s hypercapnic tests (both +9 mmHg CO2). Internal carotid artery dilation was lower in the transient compared with steady-state hypercapnia (3.3 ± 1.9 vs. 5.3 ± 2.9%, respectively, P < 0.03). Increases in internal carotid artery shear stress preceded increases in diameter in both transient (time: 16.8 ± 13.2 vs. 59.4 ± 60.3 s, P < 0.01) and steady-state (time: 18.2 ± 14.2 vs. 110.3 ± 79.6 s, P < 0.01) tests. Internal carotid artery dilation was positively correlated with shear rate area under the curve in the transient ( r2 = 0.44, P < 0.01) but not steady-state ( r2 = 0.02, P = 0.53) trial. Collectively, these results suggest that hypercapnia induces shear-mediated dilation of the internal carotid artery in humans. This study further promotes the application and development of hypercapnia as a clinical strategy for the assessment of cerebrovascular vasodilatory function and health in humans. NEW & NOTEWORTHY Shear stress dilates the internal carotid artery in humans. This vasodilatory response occurs independent of other physiological factors, as demonstrated by our transient CO2 test, and is strongly correlated to shear area under the curve. Assessing carotid shear-mediated dilation may provide a future avenue for assessing cerebrovascular health and the risk of cerebrovascular events.
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Affiliation(s)
- Ryan L. Hoiland
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
| | - Kurt J. Smith
- School of Sport Science, Exercise, and Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Howard H. Carter
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Nia C.S. Lewis
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
| | - Michael M. Tymko
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
| | - Kevin W. Wildfong
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
| | - Anthony R. Bain
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado; and
| | - Daniel J. Green
- School of Sport Science, Exercise, and Health, The University of Western Australia, Crawley, Western Australia, Australia
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Philip N. Ainslie
- Centre for Heart, Lung, and Vascular Health, University of British Columbia Okanagan Campus, School of Health and Exercise Sciences, Kelowna, British Columbia, Canada
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Tearney CC, Barter LS, Pypendop BH. Cardiovascular effects of equipotent doses of isoflurane alone and isoflurane plus fentanyl in New Zealand White rabbits (Oryctolagus cuniculus). Am J Vet Res 2016; 76:591-8. [PMID: 26111088 DOI: 10.2460/ajvr.76.7.591] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine effects of equipotent concentrations of fentanyl and isoflurane, compared with isoflurane alone, on cardiovascular variables in New Zealand White rabbits (Oryctolagus cuniculus). ANIMALS 6 adult female New Zealand White rabbits. PROCEDURES Rabbits were anesthetized with isoflurane, and lungs were mechanically ventilated. The minimum alveolar concentration (MAC) of isoflurane alone (baseline) and with fentanyl administered IV to achieve 3 targeted plasma concentrations was determined for each rabbit by means of an electrical stimulus. Cardiovascular variables were measured in a separate experiment at 1.3X isoflurane MAC and equipotent doses of isoflurane plus fentanyl at the same 3 targeted plasma concentrations. Blood samples were collected for measurement of blood gas variables and plasma fentanyl concentrations. Treatment effects were evaluated by repeated-measures ANOVA followed by 2-tailed paired t tests with sequentially rejective Bonferroni correction. RESULTS Mean ± SD MAC of isoflurane was 1.95 ± 0.27%. Mean measured plasma fentanyl concentrations of 4.97, 8.93, and 17.19 ng/mL reduced isoflurane MAC by 17%, 37%, and 56%, respectively. Mean measured plasma fentanyl concentrations during cardiovascular measurements were 5.49, 10.26, and 18.40 ng/mL. Compared with baseline measurements, heart rate was significantly lower at all 3 plasma fentanyl concentrations, mean arterial blood pressure and systemic vascular resistance were significantly higher at mean fentanyl concentrations of 10.26 and 18.40 ng/mL, and cardiac output was significantly higher at 18.40 ng of fentanyl/mL. CONCLUSIONS AND CLINICAL RELEVANCE Administration of fentanyl in isoflurane-anesthetized rabbits resulted in improved mean arterial blood pressure and cardiac output, compared with isoflurane alone. This balanced anesthesia technique may prove useful in the management of clinical cases in this species.
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Delliaux S, Ichinose M, Watanabe K, Fujii N, Nishiyasu T. Cardiovascular responses to forearm muscle metaboreflex activation during hypercapnia in humans. Am J Physiol Regul Integr Comp Physiol 2015; 309:R43-50. [PMID: 25904685 DOI: 10.1152/ajpregu.00402.2014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 04/16/2015] [Indexed: 12/27/2022]
Abstract
We characterized the cardiovascular responses to forearm muscle metaboreflex activation during hypercapnia. Ten healthy males participated under three experimental conditions: 1) hypercapnia (HCA, PetCO2 : +10 mmHg, by inhalation of a CO2-enriched gas mixture); 2) muscle metaboreflex activation (MMA, by 5 min of local circulatory occlusion after 1 min of 50% maximum voluntary contraction isometric handgrip under normocapnia); and 3) HCA+MMA. We measured mean arterial pressure (MAP), heart rate (HR), and cardiac output (CO); calculated stroke volume (SV), and total peripheral resistance (TPR); and evaluated myocardial oxygen consumption (MV̇o2) and cardiac work (CW) noninvasively. MAP increased in the three experimental conditions but HCA+MMA led to the highest MAP, CO, and HR. Moreover, HCA+MMA increased SV and was associated with the highest MV̇o2 and CW. HCA and MMA exhibited inhibitory interactions with MAP, HR, TPR, MV̇o2, and CW, increases of which were smaller during HCA+MMA than the sum of the increases during HCA and MMA alone (MAP: +28 ± 2 vs. +34 ± 2 mmHg, P < 0.001; HR: +15 ± 2 vs. +22 ± 3 bpm, P < 0.01; TPR: +1.1 ± 1.4 vs. +3.0 ± 1.5 mmHg·l·min(-1), P < 0.05; MV̇o2: +50.25 ± 4.74 vs. +59.48 ± 5.37 mmHg·min(-1)·10(-2), P < 0.01; CW: +59.10 ± 7.52 vs. +63.67 ± 7.71 ml mmHg·min(-1)·10(-4), P < 0.05). Oppositely, HCA and MMA interactions were linearly additive for CO (+2.3 ± 0.4 l/min) and SV (+13 ± 4 ml). We showed that muscle metaboreflex and hypercapnia interact in healthy humans, reducing vasoconstriction but enhancing SV.
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Affiliation(s)
- Stephane Delliaux
- Aix-Marseille University, MD, DS-ACI, UMR 2, Marseille, France; APHM, Hôpital Nord, Pôle cardiovasculaire et thoracique, Laboratoire de Physiologie Respiratoire-Explorations à l'Exercice, Marseille, France; Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Pôle cardiovasculaire et thoracique, Laboratoire de Physiologie Respiratoire-Explorations à l'Exercice, Marseille, France; Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masashi Ichinose
- School of Business and Administration, Meiji University, Tokyo, Japan; Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
| | - Kazuhito Watanabe
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
| | - Naoto Fujii
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeshi Nishiyasu
- Laboratory of Physiology-Circulation, Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; and
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Gosliga JM, Barter LS. Cardiovascular effects of dopamine hydrochloride and phenylephrine hydrochloride in healthy isoflurane-anesthetized New Zealand White rabbits (Oryctolagus cuniculus). Am J Vet Res 2015; 76:116-21. [DOI: 10.2460/ajvr.76.2.116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Duffin J, Mateika JH. Cross-Talk opposing view: peripheral and central chemoreflexes have additive effects on ventilation in humans. J Physiol 2014; 591:4351-3. [PMID: 24037126 DOI: 10.1113/jphysiol.2013.256800] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Barter LS, Epstein SE. Cardiopulmonary effects of three concentrations of isoflurane with or without mechanical ventilation and supramaximal noxious stimulation in New Zealand white rabbits. Am J Vet Res 2013; 74:1274-80. [DOI: 10.2460/ajvr.74.10.1274] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sabino JPJ, Oliveira MD, Giusti H, Glass ML, Salgado HC, Fazan R. Hemodynamic and ventilatory response to different levels of hypoxia and hypercapnia in carotid body-denervated rats. Clinics (Sao Paulo) 2013; 68:395-9. [PMID: 23644862 PMCID: PMC3611878 DOI: 10.6061/clinics/2013(03)oa18] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 11/25/2012] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Chemoreceptors play an important role in the autonomic modulation of circulatory and ventilatory responses to changes in arterial O(2) and/or CO(2). However, studies evaluating hemodynamic responses to hypoxia and hypercapnia in rats have shown inconsistent results. Our aim was to evaluate hemodynamic and respiratory responses to different levels of hypoxia and hypercapnia in conscious intact or carotid body-denervated rats. METHODS Male Wistar rats were submitted to bilateral ligature of carotid body arteries (or sham-operation) and received catheters into the left femoral artery and vein. After two days, each animal was placed into a plethysmographic chamber and, after baseline measurements of respiratory parameters and arterial pressure, each animal was subjected to three levels of hypoxia (15, 10 and 6% O(2)) and hypercapnia (10% CO(2)). RESULTS The results indicated that 15% O(2) decreased the mean arterial pressure and increased the heart rate (HR) in both intact (n = 8) and carotid body-denervated (n = 7) rats. In contrast, 10% O(2) did not change the mean arterial pressure but still increased the HR in intact rats, and it decreased the mean arterial pressure and increased the heart rate in carotid body-denervated rats. Furthermore, 6% O(2) increased the mean arterial pressure and decreased the HR in intact rats, but it decreased the mean arterial pressure and did not change the HR in carotid body-denervated rats. The 3 levels of hypoxia increased pulmonary ventilation in both groups, with attenuated responses in carotid body-denervated rats. Hypercapnia with 10% CO(2) increased the mean arterial pressure and decreased HR similarly in both groups. Hypercapnia also increased pulmonary ventilation in both groups to the same extent. CONCLUSION This study demonstrates that the hemodynamic and ventilatory responses varied according to the level of hypoxia. Nevertheless, the hemodynamic and ventilatory responses to hypercapnia did not depend on the activation of the peripheral carotid chemoreceptors.
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Affiliation(s)
- João Paulo J Sabino
- Department of Physiology, School of Medicine of Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
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Armstrong HF, Gonzalez-Costello J, Jorde UP, Ginsburg ME, Layton AM, Thomashow BM, Bartels MN. The effect of lung volume reduction surgery on chronotropic incompetence. Respir Med 2012; 106:1389-95. [PMID: 22770683 DOI: 10.1016/j.rmed.2012.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/04/2012] [Accepted: 06/10/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronotropic incompetence (CI) is a marker of poor prognosis in patients with COPD. Treatments that improve pulmonary function and exercise capacity may affect CI. Objectives are to evaluate CI before and after lung volume reduction surgery (LVRS) and determine if changes in CI are associated with changes in pulmonary function and exercise capacity. METHODS We performed a retrospective review of 75 patients who underwent LVRS and who had complete cardiopulmonary exercise testing and concurrent pulmonary function tests two months before and about 6 months after surgery. Additionally we evaluated 28 control patients that were randomized to medical treatment as part of the National Emphysema Treatment Trial at our center. We studied CI using the percent of predicted heart rate reserve=(heart rate peak-heart rate rest)/((208-0.7×age)-heart rate rest)×100, before and after surgery and compared it to the control group. RESULTS Mean percent of predicted heart rate reserve improved from 41% to 50% (p-value <0.001) after LVRS, while the control group did not change. The mean forced vital capacity and expiratory volume in 1s, peak oxygen consumption, carbon dioxide production, ventilation, tidal volume and maximal workload all improved in the surgery group, while the controls did not improve. CONCLUSIONS CI improves after LVRS in a population of patients with COPD. CI improvements are associated with the increases in pulmonary function and exercise capacity. This improvement is seen in a domain of known cardiopulmonary impairment prior to surgery that improves as a positive response to the therapy of LVRS.
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Affiliation(s)
- Hilary F Armstrong
- Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, NY, NY 10032, USA.
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Baroreceptor sensitivity after Valsalva maneuver in women with chronic obstructive pulmonary disease. Clin Auton Res 2012; 22:185-9. [DOI: 10.1007/s10286-012-0161-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 03/26/2012] [Indexed: 11/25/2022]
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Tjen-A-Looi SC, Hsiao AF, Longhurst JC. Central and peripheral mechanisms underlying gastric distention inhibitory reflex responses in hypercapnic-acidotic rats. Am J Physiol Heart Circ Physiol 2011; 300:H1003-12. [PMID: 21217073 PMCID: PMC3064299 DOI: 10.1152/ajpheart.01131.2010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 12/30/2010] [Indexed: 11/22/2022]
Abstract
We have observed that in chloralose-anesthetized animals, gastric distension (GD) typically increases blood pressure (BP) under normoxic normocapnic conditions. However, we recently noted repeatable decreases in BP and heart rate (HR) in hypercapnic-acidotic rats in response to GD. The neural pathways, central processing, and autonomic effector mechanisms involved in this cardiovascular reflex response are unknown. We hypothesized that GD-induced decrease in BP and HR reflex responses are mediated during both withdrawal of sympathetic tone and increased parasympathetic activity, involving the rostral (rVLM) and caudal ventrolateral medulla (cVLM) and the nucleus ambiguus (NA). Rats anesthetized with ketamine and xylazine or α-chloralose were ventilated and monitored for HR and BP changes. The extent of cardiovascular inhibition was related to the extent of hypercapnia and acidosis. Repeated GD with both anesthetics induced consistent falls in BP and HR. The hemodynamic inhibitory response was reduced after blockade of the celiac ganglia or the intraabdominal vagal nerves with lidocaine, suggesting that the decreased BP and HR responses were mediated by both sympathetic and parasympathetic afferents. Blockade of the NA decreased the bradycardia response. Microinjection of kainic acid into the cVLM reduced the inhibitory BP response, whereas depolarization blockade of the rVLM decreased both BP and HR inhibitory responses. Blockade of GABA(A) receptors in the rVLM also reduced the BP and HR reflex responses. Atropine methyl bromide completely blocked the reflex bradycardia, and atenolol blocked the negative chronotropic response. Finally, α(1)-adrenergic blockade with prazosin reversed the depressor. Thus, in the setting of hypercapnic-acidosis, a sympathoinhibitory cardiovascular response is mediated, in part, by splanchnic nerves and is processed through the rVLM and cVLM. Additionally, a vagal excitatory reflex, which involves the NA, facilitates the GD-induced decreases in BP and HR responses. Efferent chronotropic responses involve both increased parasympathetic and reduced sympathetic activity, whereas the decrease in BP is mediated by reduced α-adrenergic tone.
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Affiliation(s)
- Stephanie C Tjen-A-Looi
- Susan Samueli Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, Irvine, California 92697-4075, USA.
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Gates GJ, Bartels MN, Downey JA, De Meersman RE. The effect of chemoreceptor stimulation upon muscle sympathetic nerve activity. Respir Physiol Neurobiol 2009; 167:268-72. [DOI: 10.1016/j.resp.2009.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Revised: 05/14/2009] [Accepted: 05/20/2009] [Indexed: 11/28/2022]
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