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Matsukawa K, Iwamoto GA, Mitchell JH, Mizuno M, Kim HK, Williamson JW, Smith SA. Exaggerated renal sympathetic nerve and pressor responses during spontaneously occurring motor activity in hypertensive rats. Am J Physiol Regul Integr Comp Physiol 2023; 324:R497-R512. [PMID: 36779670 DOI: 10.1152/ajpregu.00271.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Stimulation of the mesencephalic locomotor region elicits exaggerated sympathetic nerve and pressor responses in spontaneously hypertensive rats (SHR) as compared with normotensive Wistar-Kyoto rats (WKY). This suggests that central command or its influence on vasomotor centers is augmented in hypertension. The decerebrate animal model possesses an ability to evoke intermittent bouts of spontaneously occurring motor activity (SpMA) and generates cardiovascular responses associated with the SpMA. It remains unknown whether the changes in sympathetic nerve activity and hemodynamics during SpMA are altered by hypertension. To test the hypothesis that the responses in renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) during SpMA are exaggerated with hypertension, this study aimed to compare the responses in decerebrate, paralyzed SHR, WKY, and normotensive Sprague-Dawley (SD) rats. In all strains, an abrupt increase in RSNA occurred in synchronization with tibial motor discharge (an index of motor activity) and was followed by rises in MAP and heart rate. The centrally evoked increase in RSNA and MAP during SpMA was much greater (306 ± 110%) in SHR than WKY (187 ± 146%) and SD (165 ± 44%). Although resting baroreflex-mediated changes in RSNA were not different across strains, mechanically or pharmacologically induced elevations in MAP attenuated or abolished the RSNA increase during SpMA in WKY and SD but had no effect in SHR. It is likely that the exaggerated sympathetic nerve and pressor responses during SpMA in SHR are induced along a central command pathway independent of the arterial baroreflex and/or result from central command-induced inhibition of the baroreflex.
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Affiliation(s)
- Kanji Matsukawa
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Integrative Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Gary A Iwamoto
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jere H Mitchell
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Masaki Mizuno
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Han-Kyul Kim
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jon W Williamson
- Department of Health Care Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Scott A Smith
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
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Katayama K, Ogoh S. Response to Letter to Editor - Comments on: Sympathetic vasomotor outflow during low-intensity leg cycling in healthy older males. Exp Physiol 2023; 108:320-322. [PMID: 36634155 PMCID: PMC10103846 DOI: 10.1113/ep091030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Keisho Katayama
- Research Center of HealthPhysical Fitness and SportsGraduate School of MedicineNagoya UniversityNagoyaJapan
| | - Shigehiko Ogoh
- Department of Biomedical EngineeringToyo UniversityKawagoeJapan
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Ishii K, Idesako M, Asahara R, Liang N, Matsukawa K. Central command suppresses pressor-evoked bradycardia at the onset of voluntary standing up in conscious cats. Exp Physiol 2023; 108:28-37. [PMID: 36404613 PMCID: PMC10103771 DOI: 10.1113/ep090718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Standing up can cause hypotension and tachycardia. Accumulated evidence poses the simple question, does the cardiac baroreflex operate at the onset of standing up? If the cardiac baroreflex is suppressed, what mechanism is responsible for baroreflex inhibition? What is the main finding and its importance? In cats, we found blunting of cardiac baroreflex sensitivity in the pressor range at the onset of voluntary hindlimb standing, but not of passive hindlimb standing. This finding suggests that central command suppresses pressor-evoked bradycardia at the onset of standing up, probably in advance, to prevent or buffer orthostatic hypotension. ABSTRACT It remains unclear whether cardiac baroreflex function is preserved or suppressed at the onset of standing up. To answer the question and, if cardiac baroreflex is suppressed, to investigate the mechanism responsible for the suppression, we compared the sensitivity of the arterial cardiac baroreflex at the onset of voluntary and passive hindlimb standing in conscious cats. Cardiac baroreflex sensitivity was estimated from the maximal slope of the baroreflex curve between the responses of systolic arterial blood pressure and heart rate to a brief occlusion of the abdominal aorta. The systolic arterial blood pressure response to standing up without aortic occlusion was greater in the voluntary case than in the passive case. Cardiac baroreflex sensitivity was clearly decreased at the onset of voluntary standing up compared with rest (P = 0.005) and the onset of passive standing up (P = 0.007). The cardiac baroreflex sensitivity at the onset of passive standing up was similar to that at rest (P = 0.909). The findings suggest that central command would transmit a modulatory signal to the cardiac baroreflex system during the voluntary initiation of standing up. Furthermore, the present data tempt speculation on a close relationship between central inhibition of the cardiac baroreflex and the centrally induced tachycardiac response to standing up.
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Affiliation(s)
- Kei Ishii
- Human Informatics and Interaction Research InstituteNational Institute of Advanced Industrial Science and TechnologyTsukubaIbarakiJapan
- Department of Integrative PhysiologyGraduate School of Biomedical and Health SciencesHiroshima UniversityMinami‐kuHiroshimaJapan
| | - Mitsuhiro Idesako
- Department of Integrative PhysiologyGraduate School of Biomedical and Health SciencesHiroshima UniversityMinami‐kuHiroshimaJapan
| | - Ryota Asahara
- Human Informatics and Interaction Research InstituteNational Institute of Advanced Industrial Science and TechnologyTsukubaIbarakiJapan
- Department of Integrative PhysiologyGraduate School of Biomedical and Health SciencesHiroshima UniversityMinami‐kuHiroshimaJapan
| | - Nan Liang
- Department of Integrative PhysiologyGraduate School of Biomedical and Health SciencesHiroshima UniversityMinami‐kuHiroshimaJapan
- Cognitive Motor Neuroscience, Human Health SciencesGraduate School of MedicineKyoto UniversitySakyo‐kuKyotoJapan
| | - Kanji Matsukawa
- Department of Integrative PhysiologyGraduate School of Biomedical and Health SciencesHiroshima UniversityMinami‐kuHiroshimaJapan
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Ishii K, Idesako M, Asahara R, Liang N, Matsukawa K. Central modulation of cardiac baroreflex moment-to-moment sensitivity during treadmill exercise in conscious cats. Physiol Rep 2022; 10:e15371. [PMID: 35757967 PMCID: PMC9234745 DOI: 10.14814/phy2.15371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 11/24/2022] Open
Abstract
It remains undetermined whether the cardiac component of the entire arterial baroreflex is blunted even at the onset of low-intensity exercise. We sought to examine the moment-to-moment sensitivity of the cardiac baroreflex during walking at different speeds and the presumed mechanisms responsible for baroreflex modulation in conscious cats. Arterial baroreflex sensitivity for heart rate was estimated from the baroreflex ratio between changes in systolic arterial blood pressure and heart rate and from the slope of the baroreflex curve between the cardiovascular responses to brief occlusion of the abdominal aorta. Treadmill walking was performed for 1 min at three levels of speed (low: 20-30 m/min, moderate: 40 m/min, and high: 50-60 m/min) or for 3 min at the stepwise change of speed (low to high to low transition). Cardiac baroreflex sensitivity was blunted at the onset of walking, irrespective of speed. Thereafter, the blunted cardiac baroreflex sensitivity was restored around 15 s of walking at any speed, while the blunting occurred again at 45 s of high-speed walking. The inhibition of cardiac baroreflex sensitivity also occurred (1) during the speed transition from low to high and (2) at 45 s of high-speed exercise of the stepwise exercise. The blunted cardiac baroreflex sensitivity was restored immediately to the resting level during the speed transition from high to low, despite sustained pressor and tachycardiac responses. Therefore, moment-to-moment modulation of the cardiac baroreflex during exercise would occur in association with motor intention (i.e., exercise onset) and effort (i.e., treadmill speed).
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Affiliation(s)
- Kei Ishii
- Human Informatics and Interaction Research InstituteNational Institute of Advanced Industrial Science and TechnologyIbarakiJapan
- Department of Integrative Physiology, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Mitsuhiro Idesako
- Department of Integrative Physiology, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Ryota Asahara
- Human Informatics and Interaction Research InstituteNational Institute of Advanced Industrial Science and TechnologyIbarakiJapan
- Department of Integrative Physiology, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Nan Liang
- Department of Integrative Physiology, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
- Cognitive Motor Neuroscience, Human Health SciencesGraduate School of Medicine, Kyoto UniversityKyotoJapan
| | - Kanji Matsukawa
- Department of Integrative Physiology, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Ogoh S, Saito S, Watanabe H, Katayama K. Cerebral blood velocity and arterial pressure at the onset of exercise: potential influence of the cardiopulmonary baroreflex. Clin Auton Res 2022; 32:143-146. [PMID: 35129712 DOI: 10.1007/s10286-022-00855-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/01/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan.
- Neurovascular Research Laboratory, University of South Wales, Pontypridd, UK.
| | - Shotaro Saito
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Hironori Watanabe
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Keisho Katayama
- Physical Fitness, and Sports, Graduate School of Medicine, Research Center of Health, Nagoya University, Nagoya, Japan
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Teixeira AL, Fernandes IA, Millar PJ, Vianna LC. GABA A receptor activation modulates the muscle sympathetic nerve activity responses at the onset of static exercise in humans. J Appl Physiol (1985) 2021; 131:1138-1147. [PMID: 34410847 DOI: 10.1152/japplphysiol.00423.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Exercise is a well-known sympathoexcitatory stimulus. However, muscle sympathetic nerve activity (MSNA) can decrease during the onset of muscle contraction. Yet, the underlying mechanisms and neurotransmitters involved in the sympathetic responses at the onset of exercise remain unknown. Herein, we tested the hypothesis that GABAA receptors may contribute to the MSNA responses at the onset of static handgrip in humans. Thirteen young, healthy individuals (4 females) performed 30 s of ischemic static handgrip at 30% of maximum volitional contraction before and following oral administration of either placebo or diazepam (10 mg), a benzodiazepine that enhances GABAA activity. MSNA (microneurography), beat-to-beat blood pressure (finger photopletysmography), heart rate (electrocardiogram), and stroke volume (ModelFlow) were continuously measured. Cardiac output (CO = stroke volume × heart rate) and total vascular conductance (TVC = CO/mean blood pressure) were subsequently calculated. At rest, MSNA was reduced while hemodynamic variables were unchanged after diazepam administration. Before diazepam, static handgrip elicited a significant decrease in MSNA burst frequency (Δ-7 ± 2 bursts/min, P < 0.01 vs. baseline) and MSNA burst incidence (Δ-16 ± 2 bursts/100 heart beats, P < 0.01 vs. baseline); however, these responses were attenuated following diazepam administration (Δ-1 ± 2 bursts/min and Δ-7 ± 2 bursts/100 heart beats, respectively; P < 0.01 vs. before diazepam). Diazepam did not affect the increases in heart rate, blood pressure, CO, and TVC at the exercise onset. Importantly, the placebo had no effect on any variable at rest or exercise onset. These findings suggest that GABAA receptor activation modulates the MSNA responses at the onset of static exercise in young, healthy humans.NEW & NOTEWORTHY In this study, we found that the reduction in muscle sympathetic nerve activity at the onset of static handgrip exercise was blunted following GABAA receptor activation with oral administration of diazepam in young, healthy individuals. The present findings provide novel insight into neural circuitry mechanisms controlling muscle sympathetic outflow during exercise in humans.
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Affiliation(s)
- André L Teixeira
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.,NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Igor A Fernandes
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Lauro C Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
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Suarez-Roca H, Mamoun N, Sigurdson MI, Maixner W. Baroreceptor Modulation of the Cardiovascular System, Pain, Consciousness, and Cognition. Compr Physiol 2021; 11:1373-1423. [PMID: 33577130 DOI: 10.1002/cphy.c190038] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain cardiovascular homeostasis by coordinating the responses to external and internal environmental stressors. While it is well known that carotid and cardiopulmonary baroreceptors modulate sympathetic vasomotor and parasympathetic cardiac neural autonomic drive, to avoid excessive fluctuations in vascular tone and maintain intravascular volume, there is increasing recognition that baroreceptors also modulate a wide range of non-cardiovascular physiological responses via projections from the nucleus of the solitary tract to regions of the central nervous system, including the spinal cord. These projections regulate pain perception, sleep, consciousness, and cognition. In this article, we summarize the physiology of baroreceptor pathways and responses to baroreceptor activation with an emphasis on the mechanisms influencing cardiovascular function, pain perception, consciousness, and cognition. Understanding baroreceptor-mediated effects on cardiac and extra-cardiac autonomic activities will further our understanding of the pathophysiology of multiple common clinical conditions, such as chronic pain, disorders of consciousness (e.g., abnormalities in sleep-wake), and cognitive impairment, which may result in the identification and implementation of novel treatment modalities. © 2021 American Physiological Society. Compr Physiol 11:1373-1423, 2021.
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Affiliation(s)
- Heberto Suarez-Roca
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University, Durham, North Carolina, USA
| | - Negmeldeen Mamoun
- Department of Anesthesiology, Division of Cardiothoracic Anesthesia and Critical Care Medicine, Duke University, Durham, North Carolina, USA
| | - Martin I Sigurdson
- Department of Anesthesiology and Critical Care Medicine, Landspitali, University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - William Maixner
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University, Durham, North Carolina, USA
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AlShahrani AN, Al‐Asoom LI, Alsunni AA, Elbahai NS, Yar T. Assessment of baroreceptor reflex sensitivity in young obese Saudi males at rest and in response to physiological challenges. Physiol Rep 2020; 8:e14625. [PMID: 33190394 PMCID: PMC7666776 DOI: 10.14814/phy2.14625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022] Open
Abstract
Autonomic imbalance in overweight/obese persons could lead to an increased risk of cardiovascular complications including hypertension and arrhythmias. Baroreceptor reflex sensitivity is a sensitive indicator to detect an altered sympathovagal balance in overweight/obese individuals. This study investigated the effects of overweight/obesity on baroreceptor sensitivity in young Saudi males at rest and in response to physiological challenges. SUBJECTS AND METHODS In this cross-sectional study, spontaneous baroreceptor sensitivity at rest and in response to deep breathing, isometric hand grip exercise and moderate intensity isotonic exercise were recorded in 20 normal weight and 20 overweight/obese subjects. Finger arterial blood pressure signal, recorded through Finometer, was used to calculate baroreceptor sensitivity through cross-correlation method. The baroreceptor sensitivity data were log transformed before application of parametric tests. RESULTS The spontaneous baroreceptor sensitivity was similar in both groups at baseline, but exhibited a significant increase during deep breathing only in normal weight (p < .001). Immediately after the isotonic exercise the baroreceptor sensitivity was significantly lower than baseline in both normal weight and overweight/obese and remained significantly lower in overweight/obese individuals compared to normal weight (p < .05) throughout the recovery period. There was a significant rise in baroreceptor sensitivity after isometric exercise in overweight/obese group only (p = .001). Pearson's correlation showed a significant negative correlation of baroreceptor sensitivity with body mass index during deep breathing (r = -.472, p = .004) and in post-isotonic exercise recovery period (r = -.414, p = .013). CONCLUSION A significantly reduced baroreceptor sensitivity response to deep breathing, reduced baroreceptor sensitivity recovery after isotonic exercise, and an exaggerated shoot up after isometric exercise in overweight/obese suggests an altered sympathovagal balance. Baroreceptor sensitivity measurements in response to physiological challenges, deep breathing, and isotonic exercise, may be more sensitive investigations for detection of early attenuation of cardiac autonomic function. This would enable timely intervention thereby delaying complications and improving the quality of life.
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Affiliation(s)
- Abdullah N. AlShahrani
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Lubna I. Al‐Asoom
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Ahmed A. Alsunni
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Nabil S. Elbahai
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Talay Yar
- Department of PhysiologyCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
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Barbosa TC, Vianna LC, Hashimoto T, Petersen LG, Olesen ND, Tsukamoto H, Sørensen H, Ogoh S, Nóbrega ACL, Secher NH. Carotid baroreflex function at the onset of cycling in men. Am J Physiol Regul Integr Comp Physiol 2016; 311:R870-R878. [DOI: 10.1152/ajpregu.00173.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/24/2016] [Indexed: 01/06/2023]
Abstract
Arterial baroreflex function is important for blood pressure control during exercise, but its contribution to cardiovascular adjustments at the onset of cycling exercise remains unclear. Fifteen healthy male subjects (24 ± 1 yr) performed 45-s trials of low- and moderate-intensity cycling, with carotid baroreceptor stimulation by neck suction at −60 Torr applied 0–5, 10–15, and 30–35 s after the onset of exercise. Cardiovascular responses to neck suction during cycling were compared with those obtained at rest. An attenuated reflex decrease in heart rate following neck suction was detected during moderate-intensity exercise, compared with the response at rest ( P < 0.05). Furthermore, compared with the reflex decrease in blood pressure elicited at rest, neck suction elicited an augmented decrease in blood pressure at 0–5 and 10–15 s during low-intensity exercise and in all periods during moderate-intensity exercise ( P < 0.05). The reflex depressor response at the onset of cycling was primarily mediated by an increase in the total vascular conductance. These findings evidence altered carotid baroreflex function during the first 35 s of cycling compared with rest, with attenuated bradycardic response, and augmented depressor response to carotid baroreceptor stimulation.
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Affiliation(s)
- Thales C. Barbosa
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Lauro C. Vianna
- Faculty of Physical Education, University of Brasilia, Brasilia, Brazil
| | - Takeshi Hashimoto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kyoto, Japan
| | - Lonnie G. Petersen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Niels D. Olesen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
- Department of Neuroscience and Pharmacology, University of Copenhagen; and
| | - Hayato Tsukamoto
- Graduate School of Sport and Health Science, Ritsumeikan University, Kyoto, Japan
| | - Henrik Sørensen
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe-Shi, Japan
| | - Antonio C. L. Nóbrega
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Niels H. Secher
- The Copenhagen Muscle Research Centre, Department of Anesthesia, University of Copenhagen, Copenhagen, Denmark
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Matsukawa K, Ishii K, Asahara R, Idesako M. Central command does not suppress baroreflex control of cardiac sympathetic nerve activity at the onset of spontaneous motor activity in the decerebrate cat. J Appl Physiol (1985) 2016; 121:932-943. [PMID: 27539494 DOI: 10.1152/japplphysiol.00299.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/11/2016] [Indexed: 11/22/2022] Open
Abstract
Our laboratory has reported that central command blunts the sensitivity of the aortic baroreceptor-heart rate (HR) reflex at the onset of voluntary static exercise in animals. We have examined whether baroreflex control of cardiac sympathetic nerve activity (CSNA) and/or cardiovagal baroreflex sensitivity are altered at the onset of spontaneously occurring motor behavior, which was monitored with tibial nerve activity in paralyzed, decerebrate cats. CSNA exhibited a peak increase (126 ± 17%) immediately after exercise onset, followed by increases in HR and mean arterial pressure (MAP). With development of the pressor response, CSNA and HR decreased near baseline, although spontaneous motor activity was not terminated. Atropine methyl nitrate (0.1-0.2 mg/kg iv) with little central influence delayed the initial increase in HR but did not alter the response magnitudes of HR and CSNA, while atropine augmented the pressor response. The baroreflex-induced decreases in CSNA and HR elicited by brief occlusion of the abdominal aorta were challenged at the onset of spontaneous motor activity. Spontaneous motor activity blunted the baroreflex reduction in HR by aortic occlusion but did not alter the baroreflex inhibition of CSNA. Similarly, atropine abolished the baroreflex reduction in HR but did not influence the baroreflex inhibition of CSNA. Thus it is likely that central command increases CSNA and decreases cardiac vagal outflow at the onset of spontaneous motor activity while preserving baroreflex control of CSNA. Accordingly, central command must attenuate cardiovagal baroreflex sensitivity against an excess rise in MAP as estimated from the effect of muscarinic blockade.
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Affiliation(s)
- Kanji Matsukawa
- Department of Integrative Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kei Ishii
- Department of Integrative Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryota Asahara
- Department of Integrative Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuhiro Idesako
- Department of Integrative Physiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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11
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Carotid haemodynamics during sympathetic nervous system stimulation via handgrip and cold pressor testing in young healthy subjects: A feasibility study. Artery Res 2014. [DOI: 10.1016/j.artres.2014.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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12
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Central command differentially affects aortic and carotid sinus baroreflexes at the onset of spontaneous motor activity. Auton Neurosci 2013; 179:75-83. [DOI: 10.1016/j.autneu.2013.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/24/2013] [Accepted: 07/29/2013] [Indexed: 11/22/2022]
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13
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Eckberg DL, Cooke WH, Diedrich A, Levine BD, Pawelczyk JA, Buckey JC, Ertl AC, Biaggioni I, Cox JF, Robertson D, Baisch FJ, Blomqvist CG, Kuusela TA, Tahvanainen KUO. Human baroreflex rhythms persist during handgrip and muscle ischaemia. Acta Physiol (Oxf) 2013; 209:114-23. [PMID: 23809494 PMCID: PMC3875341 DOI: 10.1111/apha.12143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 05/20/2013] [Accepted: 06/20/2013] [Indexed: 12/20/2022]
Abstract
AIM To determine whether physiological, rhythmic fluctuations of vagal baroreflex gain persist during exercise, post-exercise ischaemia and recovery. METHODS We studied responses of six supine healthy men and one woman to a stereotyped protocol comprising rest, handgrip exercise at 40% maximum capacity to exhaustion, post-exercise forearm ischaemia and recovery. We measured electrocardiographic R-R intervals, photoplethysmographic finger arterial pressures and peroneal nerve muscle sympathetic activity. We derived vagal baroreflex gains from a sliding (25-s window moved by 2-s steps) systolic pressure-R-R interval transfer function at 0.04-0.15 Hz. RESULTS Vagal baroreflex gain oscillated at low, nearly constant frequencies throughout the protocol (at approx. 0.06 Hz - a period of about 18 s); however, during exercise, most oscillations were at low-gain levels, and during ischaemia and recovery, most oscillations were at high-gain levels. CONCLUSIONS Vagal baroreflex rhythms are not abolished by exercise, and they are not overwhelmed after exercise during ischaemia and recovery.
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Affiliation(s)
- D. L. Eckberg
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center and Medical College of Virginia at Virginia Commonwealth University, Richmond, VA, USA
| | - W. H. Cooke
- Health and Kinesiology, University of Texas at San Antonio, San Antonio, TX, USA
| | - A. Diedrich
- Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN, USA
| | - B. D. Levine
- Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - J. A. Pawelczyk
- The Pennsylvania State University, University Park and Hershey, PA, USA
| | - J. C. Buckey
- Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - A. C. Ertl
- Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN, USA
| | - I. Biaggioni
- Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN, USA
| | - J. F. Cox
- Departments of Medicine and Physiology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center and Medical College of Virginia at Virginia Commonwealth University, Richmond, VA, USA
| | - D. Robertson
- Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University, Nashville, TN, USA
| | - F. J. Baisch
- DLR-Institute for Aerospace Medicine, Cologne, Germany
| | - C. G. Blomqvist
- Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA
| | - T. A. Kuusela
- Department of Physics, Turku University, Turku, Finland
| | - K. U. O. Tahvanainen
- Department of Clinical Physiology and Nuclear Medicine, South Karelia Central Hospital, Lappeenranta, Finland
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14
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Ichinose M, Maeda S, Kondo N, Nishiyasu T. Blood pressure regulation II: what happens when one system must serve two masters--oxygen delivery and pressure regulation? Eur J Appl Physiol 2013; 114:451-65. [PMID: 23846841 DOI: 10.1007/s00421-013-2691-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 07/02/2013] [Indexed: 11/30/2022]
Abstract
During high-intensity dynamic exercise, O2 delivery to active skeletal muscles is enhanced through marked increases in both cardiac output and skeletal muscle blood flow. When the musculature is vigorously engaged in exercise, the human heart lacks the pumping capacity to meet the blood flow demands of both the skeletal muscles and other organs such as the brain. Vasoconstriction must therefore be induced through activation of sympathetic nervous activity to maintain blood flow to the brain and to produce the added driving pressure needed to increase flow to the skeletal muscles. In this review, we first briefly summarize the local vascular and neural control mechanisms operating during high-intensity exercise. This is followed by a review of the major neural mechanisms regulating blood pressure during high-intensity exercise, focusing mainly on the integrated activities of the arterial baroreflex and muscle metaboreflex. In high cardiac output situations, such as during high-intensity dynamic exercise, small changes in total peripheral resistance can induce large changes in blood pressure, which means that rapid and fine regulation is necessary to avoid unacceptable drops in blood pressure. To accomplish this rapid regulation, arterial baroreflex function may be modulated in various ways through activation of the muscle metaboreflex and/or other neural mechanisms. Moreover, this modulation of the arterial baroreflex may change over the time course of an exercise bout, or to accommodate changes in exercise intensity. Within this model, integration of arterial baroreflex modulation with other neural mechanisms plays an important role in cardiovascular control during high-intensity exercise.
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Affiliation(s)
- Masashi Ichinose
- Human Integrative Physiology Laboratory, School of Business Administration, Meiji University, Tokyo, Japan
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15
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Masuki S, Sumiyoshi E, Koshimizu TA, Qian J, Higuchi K, Tsujimoto G, Nose H. Voluntary locomotion linked with cerebral activation is mediated by vasopressin V1a receptors in free-moving mice. J Physiol 2013; 591:3651-65. [PMID: 23671158 DOI: 10.1113/jphysiol.2013.251876] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We previously reported that cerebral activation suppressed baroreflex control of heart rate (HR) at the onset of voluntary locomotion. In the present study, we examined whether vasopressin V1a receptors in the brain were involved in these responses by using free-moving V1a receptor knockout (KO, n = 8), wild-type mice locally infused with a V1a receptor antagonist into the nucleus tractus solitarii (BLK, n = 8) and control mice (CNT, n = 8). Baroreflex sensitivity (HR/MAP) was determined from HR response (HR) to a spontaneous change in mean arterial pressure (MAP) every 4 s during the total resting period, which was ∼8.7 h, of the 12 h measuring period in the three groups. HR/MAP was determined during the periods when the cross-correlation function (R(t)) between HR and MAP was significant (P < 0.05). Cerebral activity was determined from the power density ratio of to δ wave band (/δ) on the electroencephalogram every 4 s. Spontaneous changes in /δ were significantly correlated with R(t) during 62 ± 3% of the total resting period in CNT (P < 0.05), but only 38 ± 4% in KO and 47 ± 2% in BLK (vs. CNT, both P < 0.001). When R(t) and HR/MAP were divided into six bins according to the level of /δ, both were positively correlated with /δ in CNT (both P < 0.001), while neither was correlated in KO or BLK (all P > 0.05). Moreover, the probability that mice started to move after an increase in /δ was 24 ± 4% in KO and 24 ± 6% in BLK, markedly lower than 61 ± 5% in CNT (both P < 0.001), with no suppression of the baroreflex control of HR. Thus, central V1a receptors might play an important role in suppressing baroreflex control of HR during cerebral activation at the onset of voluntary locomotion.
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Affiliation(s)
- Shizue Masuki
- Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto 390-8621, Japan.
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16
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Matsukawa K, Ishii K, Kadowaki A, Liang N, Ishida T. Differential effect of central command on aortic and carotid sinus baroreceptor-heart rate reflexes at the onset of spontaneous, fictive motor activity. Am J Physiol Heart Circ Physiol 2012; 303:H464-74. [PMID: 22730386 DOI: 10.1152/ajpheart.01133.2011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Our laboratory has reported that central command blunts the sensitivity of the aortic baroreceptor-heart rate (HR) reflex at the onset of voluntary static exercise in conscious cats and spontaneous contraction in decerebrate cats. The purpose of this study was to examine whether central command attenuates the sensitivity of the carotid sinus baroreceptor-HR reflex at the onset of spontaneous, fictive motor activity in paralyzed, decerebrate cats. We confirmed that aortic nerve (AN)-stimulation-induced bradycardia was markedly blunted to 26 ± 4.4% of the control (21 ± 1.3 beats/min) at the onset of spontaneous motor activity. Although the baroreflex bradycardia by electrical stimulation of the carotid sinus nerve (CSN) was suppressed (P < 0.05) to 86 ± 5.6% of the control (38 ± 1.2 beats/min), the inhibitory effect of spontaneous motor activity was much weaker (P < 0.05) with CSN stimulation than with AN stimulation. The baroreflex bradycardia elicited by brief occlusion of the abdominal aorta was blunted to 36% of the control (36 ± 1.6 beats/min) during spontaneous motor activity, suggesting that central command is able to inhibit the cardiomotor sensitivity of arterial baroreflexes as the net effect. Mechanical stretch of the triceps surae muscle never affected the baroreflex bradycardia elicited by AN or CSN stimulation and by aortic occlusion, suggesting that muscle mechanoreflex did not modify the cardiomotor sensitivity of aortic and carotid sinus baroreflex. Since the inhibitory effect of central command on the carotid baroreflex pathway, associated with spontaneous motor activity, was much weaker compared with the aortic baroreflex pathway, it is concluded that central command does not force a generalized modulation on the whole pathways of arterial baroreflexes but provides selective inhibition for the cardiomotor component of the aortic baroreflex.
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Affiliation(s)
- Kanji Matsukawa
- Department of Physiology, Graduate School of Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan.
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17
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Fadel PJ, Raven PB. Human investigations into the arterial and cardiopulmonary baroreflexes during exercise. Exp Physiol 2011; 97:39-50. [PMID: 22002871 DOI: 10.1113/expphysiol.2011.057554] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
After considerable debate and key experimental evidence, the importance of the arterial baroreflex in contributing to and maintaining the appropriate neural cardiovascular adjustments to exercise is now well accepted. Indeed, the arterial baroreflex resets during exercise in an intensity-dependent manner to continue to regulate blood pressure as effectively as at rest. Studies have indicated that the exercise resetting of the arterial baroreflex is mediated by both the feedforward mechanism of central command and the feedback mechanism associated with skeletal muscle afferents (the exercise pressor reflex). Another perhaps less appreciated neural mechanism involved in evoking and maintaining neural cardiovascular responses to exercise is the cardiopulmonary baroreflex. The limited information available regarding the cardiopulmonary baroreflex during exercise provides evidence for a role in mediating sympathetic nerve activity and blood pressure responses. In addition, recent investigations have demonstrated an interaction between cardiopulmonary baroreceptors and the arterial baroreflex during dynamic exercise, which contributes to the magnitude of exercise-induced increases in blood pressure as well as the resetting of the arterial baroreflex. Furthermore, neural inputs from the cardiopulmonary baroreceptors appear to play an important role in establishing the operating point of the arterial baroreflex. This symposium review highlights recent studies in these important areas indicating that the interactions of four neural mechanisms (central command, the exercise pressor reflex, the arterial baroreflex and cardiopulmonary baroreflex) are integral in mediating the neural cardiovascular adjustments to exercise.
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Affiliation(s)
- Paul J Fadel
- Department of Medical Pharmacology and Physiology, MA415 Medical Sciences Building, University of Missouri, Columbia, MO 65212, USA.
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18
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Matsukawa K. Central command: control of cardiac sympathetic and vagal efferent nerve activity and the arterial baroreflex during spontaneous motor behaviour in animals. Exp Physiol 2011; 97:20-8. [PMID: 21984731 DOI: 10.1113/expphysiol.2011.057661] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Feedforward control by higher brain centres (termed central command) plays a role in the autonomic regulation of the cardiovascular system during exercise. Over the past 20 years, workers in our laboratory have used the precollicular-premammillary decerebrate animal model to identify the neural circuitry involved in the CNS control of cardiac autonomic outflow and arterial baroreflex function. Contrary to the traditional idea that vagal withdrawal at the onset of exercise causes the increase in heart rate, central command did not decrease cardiac vagal efferent nerve activity but did allow cardiac sympathetic efferent nerve activity to produce cardiac acceleration. In addition, central command-evoked inhibition of the aortic baroreceptor-heart rate reflex blunted the baroreflex-mediated bradycardia elicited by aortic nerve stimulation, further increasing the heart rate at the onset of exercise. Spontaneous motor activity and associated cardiovascular responses disappeared in animals decerebrated at the midcollicular level. These findings indicate that the brain region including the caudal diencephalon and extending to the rostral mesencephalon may play a role in generating central command. Bicuculline microinjected into the midbrain ventral tegmental area of decerebrate rats produced a long-lasting repetitive activation of renal sympathetic nerve activity that was synchronized with the motor nerve discharge. When lidocaine was microinjected into the ventral tegmental area, the spontaneous motor activity and associated cardiovascular responses ceased. From these findings, we conclude that cerebral cortical outputs trigger activation of neural circuits within the caudal brain, including the ventral tegmental area, which causes central command to augment cardiac sympathetic outflow at the onset of exercise in decerebrate animal models.
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Affiliation(s)
- Kanji Matsukawa
- Department of Physiology, Graduate School of Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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19
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Murphy MN, Mizuno M, Mitchell JH, Smith SA. Cardiovascular regulation by skeletal muscle reflexes in health and disease. Am J Physiol Heart Circ Physiol 2011; 301:H1191-204. [PMID: 21841019 PMCID: PMC3197431 DOI: 10.1152/ajpheart.00208.2011] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 08/02/2011] [Indexed: 02/07/2023]
Abstract
Heart rate and blood pressure are elevated at the onset and throughout the duration of dynamic or static exercise. These neurally mediated cardiovascular adjustments to physical activity are regulated, in part, by a peripheral reflex originating in contracting skeletal muscle termed the exercise pressor reflex. Mechanically sensitive and metabolically sensitive receptors activating the exercise pressor reflex are located on the unencapsulated nerve terminals of group III and group IV afferent sensory neurons, respectively. Mechanoreceptors are stimulated by the physical distortion of their receptive fields during muscle contraction and can be sensitized by the production of metabolites generated by working skeletal myocytes. The chemical by-products of muscle contraction also stimulate metaboreceptors. Once activated, group III and IV sensory impulses are transmitted to cardiovascular control centers within the brain stem where they are integrated and processed. Activation of the reflex results in an increase in efferent sympathetic nerve activity and a withdrawal of parasympathetic nerve activity. These actions result in the precise alterations in cardiovascular hemodynamics requisite to meet the metabolic demands of working skeletal muscle. Coordinated activity by this reflex is altered after the development of cardiovascular disease, generating exaggerated increases in sympathetic nerve activity, blood pressure, heart rate, and vascular resistance. The basic components and operational characteristics of the reflex, the techniques used in human and animals to study the reflex, and the emerging evidence describing the dysfunction of the reflex with the advent of cardiovascular disease are highlighted in this review.
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Affiliation(s)
- Megan N Murphy
- Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9174, USA
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20
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Increased cardiovascular reactivity to the cold pressor test is not associated with increased reactivity to isometric handgrip exercise. Eur J Appl Physiol 2009; 108:837-43. [DOI: 10.1007/s00421-009-1299-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2009] [Indexed: 01/24/2023]
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21
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Cooper VL, Hainsworth R. Carotid baroreflex testing using the neck collar device. Clin Auton Res 2009; 19:102-12. [PMID: 19229465 DOI: 10.1007/s10286-009-0518-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 11/14/2008] [Indexed: 12/11/2022]
Abstract
A neck chamber device for stimulation of carotid sinus baroreceptors by changing carotid transmural pressure was first described in 1957 by Ernsting and Parry and, with several modifications, has been extensively used in a number of physiological and clinical studies. This article outlines the evolution of neck chamber devices and describes some of the advantages and limitations of the technique. We also describe the responses in healthy subjects and the changes observed in patients with some disorders affecting the autonomic nervous system.
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Affiliation(s)
- Victoria L Cooper
- Room C332, Clinical Sciences Building, Salford Royal Hospital, Stott Lane, Salford, M6 8HD, UK
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22
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Ogoh S, Fisher JP, Raven PB, Fadel PJ. Arterial baroreflex control of muscle sympathetic nerve activity in the transition from rest to steady-state dynamic exercise in humans. Am J Physiol Heart Circ Physiol 2007; 293:H2202-9. [PMID: 17675569 DOI: 10.1152/ajpheart.00708.2007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We sought to investigate arterial baroreflex (ABR) control of muscle sympathetic nerve activity (MSNA) in the transition from rest to steady-state dynamic exercise. This was accomplished by assessing the relationship between spontaneous variations in diastolic blood pressure (DBP) and MSNA at rest and during the time course of reaching steady-state arm cycling at 50% peak oxygen uptake (V̇o2peak). Specifically, DBP-MSNA relations were examined in eight subjects (25 ± 1 yr) at the start of unloaded arm cycling and then during the initial and a later period of arm cycling once the 50% V̇o2peak work rate was achieved. Heart rate and arterial blood pressure were progressively increased throughout exercise. Although resting MSNA [16 ± 2 burst/min; 181 ± 36 arbitrary units (au) total activity] was unchanged during unloaded cycling, MSNA burst frequency and total activity were significantly elevated during the initial (27 ± 4 burst/min; 367 ± 76 au; P < 0.05) and later (36 ± 7 burst/min; 444 ± 91 au; P < 0.05) periods of exercise. The relationships between DBP and burst incidence, burst strength, and total MSNA were progressively shifted rightward from unloaded to the initial to the later period of 50% V̇o2peak arm cycling without any changes in the slopes of the linear regressions (i.e., ABR sensitivity). Thus a continuous and dynamic resetting of the ABR control of MSNA occurred during the transition from rest to steady-state dynamic exercise. These findings indicate that the ABR control of MSNA was well maintained throughout dynamic exercise in humans, progressively being reset to operate around the exercise-induced elevations in blood pressure and MSNA without any changes in reflex sensitivity.
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Affiliation(s)
- Shigehiko Ogoh
- Dept. of Integrative Physiology, Univ. of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA.
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