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Gondim ML, Rocha HNM, Mira PAC, Nobrega ACL, Prodel E. Effects of alpha-adrenergic receptor blockade on coronary circulation in postmenopausal women. Eur J Appl Physiol 2023; 123:2779-2790. [PMID: 37368136 DOI: 10.1007/s00421-023-05267-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
We sought to investigate the effect of the α1-adrenergic receptor blockade during handgrip exercise (Grip), isolated metaboreflex activation (Metabo), and cold pressor test (CPT) on coronary circulation in young (YW) and postmenopausal women (PMW). Ten YW and 9 PMW underwent two protocols: (1) 3 min of baseline followed by 3 min of CPT and (2) 3 min of rest, 3 min of Grip followed by 3 min of Metabo. Protocols were carried out under control conditions and α1-adrenergic receptor blockade (oral prazosin 0.03 mg·kg-1). Coronary blood velocity (CBV) and vascular conductance (CCI) were lower in PMW. Grip increased CBV only in YW (YW: Δ18.0 ± 21.1% vs. PMW: Δ4.2 ± 10.1%; p < 0.05), and the blockade did not change the CBV response to Grip in YW and PMW. During the Metabo, CBV returned to resting levels in YW and was unchanged from rest in PMW, before (YW:Δ1.7 ± 8.7% vs. PMW: Δ- 1.5 ± 8.6) and under the blockade (YW: Δ4.5 ± 14.8% vs. PMW: Δ9.1 ± 29.5%). CPT did not change CBV in both groups (YW: Δ3.9 ± 8.0 vs. PMW: Δ- 4.1 ± 6.2%), following the α1-blockade, CPT increased CBV only in YW (YW: Δ11.2 ± 12.8% vs. PMW: Δ2.2 ± 7.1%; p < 0.05 for group and condition). CCI decreased during Grip, Metabo, and CPT in YW and PMW, while the blockade prevented that decrease only in YW. The α1-adrenergic receptor plays a role in the control of coronary circulation in young women, evoking stronger vasoconstriction during CPT than Grip and Metabo in YW. PMW have impaired vasomotor control in the coronary circulation, which seems not to be caused by the α1-adrenergic receptor.
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Affiliation(s)
- Maitê L Gondim
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Helena N M Rocha
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
- Laboratory of Integrative Cardiometabology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Pedro A C Mira
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Antonio C L Nobrega
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Eliza Prodel
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.
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Prodel E, Cavalvanti T, Divino B, Rocha HNM, Nobrega ACL. Sympathetic control of the coronary circulation during trigeminal nerve stimulation in humans. Eur J Appl Physiol 2023; 123:2063-2071. [PMID: 37179503 DOI: 10.1007/s00421-023-05208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE We sought to investigate the sympathetic mechanism controlling coronary circulation during trigeminal nerve stimulation in healthy women. METHODS The protocol consisted of 3 min of trigeminal nerve stimulation (TGS) with cold stimuli to the face, in two conditions: (1) control and β-blockade (oral propranolol), and (2) control and α-blockade (oral prazosin). RESULTS Thirty-one healthy young subjects (women: n = 13; men: n = 18) participated in the study. By design, TGS decreased heart rate (HR), and increased blood pressure (BP) and cardiac output (CO). Before the β-blockade coronary blood velocity (CBV-Δ1.4 ± 1.3 cm s-1) increased along with the decrease of coronary vascular conductance index (CVCi-Δ-0.04 ± 0.04 cm s-1 mmHg-1) during TGS and the β-blockade abolished the CBV increase and a further decrease of CVCi was observed with TGS (Δ-0.06 ± 0.07 cm s-1 mmHg-1). During the α-blockade condition before the blockade, the CBV increased (Δ0.93 ± 1.48 cm s-1) along with the decrease of CVCi (Δ-0.05 ± 1.12 cm s-1 mmHg-1) during TGS, after the α-blockade CBV (Δ0.98 ± cm s-1) and CVCi (Δ-0.03 ± 0.06 cm s-1 mmHg-1) response to TGS did not change. CONCLUSION Coronary circulation increases during sympathetic stimulation even with a decrease in heart rate.
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Affiliation(s)
- Eliza Prodel
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Alameda Barros Terra S/N, Niteroi, Rio de Janeiro, Brazil.
- National Institute for Science & Technology-INCT (In)Activity & Exercise, Rio de Janeiro, Brazil.
| | - Thiago Cavalvanti
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Alameda Barros Terra S/N, Niteroi, Rio de Janeiro, Brazil
- National Institute for Science & Technology-INCT (In)Activity & Exercise, Rio de Janeiro, Brazil
| | - Beatriz Divino
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Alameda Barros Terra S/N, Niteroi, Rio de Janeiro, Brazil
- National Institute for Science & Technology-INCT (In)Activity & Exercise, Rio de Janeiro, Brazil
| | - Helena N M Rocha
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Alameda Barros Terra S/N, Niteroi, Rio de Janeiro, Brazil
- National Institute for Science & Technology-INCT (In)Activity & Exercise, Rio de Janeiro, Brazil
| | - Antonio C L Nobrega
- Laboratory of Exercise Science, Department of Physiology and Pharmacology, Fluminense Federal University, Alameda Barros Terra S/N, Niteroi, Rio de Janeiro, Brazil
- National Institute for Science & Technology-INCT (In)Activity & Exercise, Rio de Janeiro, Brazil
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Boulet LM, Atwater TL, Brown CV, Shafer BM, Vermeulen TD, Cotton PC, Day TA, Foster GE. Sex differences in the coronary vascular response to combined chemoreflex and metaboreflex stimulation in healthy humans. Exp Physiol 2021; 107:16-28. [PMID: 34788486 DOI: 10.1113/ep090034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/08/2021] [Indexed: 12/18/2022]
Abstract
NEW FINDINGS What is the central question of this study? Coronary blood flow in healthy humans is controlled by both local metabolic signalling and adrenergic activity: does the integration of these signals during acute hypoxia and adrenergic activation differ between sexes? What are the main findings and its importance? Both males and females exhibit an increase in coronary blood velocity in response to acute hypoxia, a response that is constrained by adrenergic stimulation in males but not females. These findings suggest that coronary blood flow control differs between males and females. ABSTRACT Coronary hyperaemia is mediated through multiple signalling pathways, including local metabolic messengers and adrenergic stimulation. This study aimed to determine whether the coronary vascular response to adrenergic stressors is different between sexes in normoxia and hypoxia. Young, healthy participants (n = 32; 16F) underwent three randomized trials of isometric handgrip exercise followed by post-exercise circulatory occlusion (PECO) to activate the muscle metaboreflex. End-tidal P O 2 was controlled at (1) normoxic levels throughout the trial, (2) 50 mmHg for the duration of the trial (hypoxia trial), or (3) 50 mmHg only during PECO (mixed trial). Mean left anterior descending coronary artery velocity (LADVmean ; transthoracic Doppler echocardiography), heart rate and blood pressure were assessed at baseline and during PECO. In normoxia, there was no change in LADVmean or cardiac workload induced by PECO in males and females. Acute hypoxia increased baseline LADVmean to a greater extent in males compared with females (P < 0.05), despite a similar increase in cardiac workload. The change in LADVmean induced by PECO was similar between sexes in normoxia (P = 0.31), greater in males during the mixed trial (male: 12.8 (7.7) cm/s vs. female: 8.1 (6.3) cm/s; P = 0.02) and reduced in males but not females in acute hypoxia (male: -4.8 (4.5) cm/s vs. female: 0.8 (6.2) cm/s; P = 0.006). In summary, sex differences in the coronary vasodilatory response to hypoxia were observed, and metaboreflex activation during hypoxia caused a paradoxical reduction in coronary blood velocity in males but not females.
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Affiliation(s)
- Lindsey M Boulet
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Taylor L Atwater
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Courtney V Brown
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Brooke M Shafer
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Tyler D Vermeulen
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Paul C Cotton
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
| | - Trevor A Day
- Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada
| | - Glen E Foster
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, British Columbia, Kelowna, Canada
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Vargas Pelaez AF, Gao Z, Ahmad TA, Leuenberger UA, Proctor DN, Maman SR, Muller MD. Effect of adrenergic agonists on coronary blood flow: a laboratory study in healthy volunteers. Physiol Rep 2016; 4:4/10/e12806. [PMID: 27225628 PMCID: PMC4886172 DOI: 10.14814/phy2.12806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 04/30/2016] [Indexed: 12/20/2022] Open
Abstract
Myocardial oxygen supply and demand mismatch is fundamental to the pathophysiology of ischemia and infarction. The sympathetic nervous system, through α‐adrenergic receptors and β‐adrenergic receptors, influences both myocardial oxygen supply and demand. In animal models, mechanistic studies have established that adrenergic receptors contribute to coronary vascular tone. The purpose of this laboratory study was to noninvasively quantify coronary responses to adrenergic receptor stimulation in humans. Fourteen healthy volunteers (11 men and 3 women) performed isometric handgrip exercise to fatigue followed by intravenous infusion of isoproterenol. A subset of individuals also received infusions of phenylephrine (n = 6), terbutaline (n = 10), and epinephrine (n = 4); all dosages were based on fat‐free mass and were infused slowly to achieve steady‐state. The left anterior descending coronary artery was visualized using Doppler echocardiography. Beat‐by‐beat heart rate (HR), blood pressure (BP), peak diastolic coronary velocity (CBVpeak), and coronary velocity time integral were calculated. Data are presented as M ± SD. Isometric handgrip elicited significant increases in BP, HR, and CBVpeak (from 23.3 ± 5.3 to 34.5 ± 9.9 cm/sec). Isoproterenol raised HR and CBVpeak (from 22.6 ± 4.8 to 43.9 ± 12.4 cm/sec). Terbutaline and epinephrine evoked coronary hyperemia whereas phenylephrine did not significantly alter CBVpeak. Different indices of coronary hyperemia (changes in CBVpeak and velocity time integral) were significantly correlated (R = 0.803). The current data indicate that coronary hyperemia occurs in healthy humans in response to isometric handgrip exercise and low‐dose, steady‐state infusions of isoproterenol, terbutaline, and epinephrine. The contribution of β1 versus β2 receptors to coronary hyperemia remains to be determined. In this echocardiographic study, we demonstrate that coronary blood flow increases when β‐adrenergic receptors are stimulated (i.e., during exercise and different intravenous infusions). Our infusion paradigms and beat‐by‐beat imaging methodologies can be used in future studies to evaluate age‐, sex‐, and disease‐ differences in adrenergic control of coronary blood flow.
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Affiliation(s)
- Alvaro F Vargas Pelaez
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Zhaohui Gao
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Tariq A Ahmad
- Division of General Internal Medicine, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Urs A Leuenberger
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - David N Proctor
- Department of Kinesiology, Noll Laboratory, The Pennsylvania State University, University Park, Pennsylvania
| | - Stephan R Maman
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Matthew D Muller
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
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Ross AJ, Gao Z, Pollock JP, Leuenberger UA, Sinoway LI, Muller MD. β-Adrenergic receptor blockade impairs coronary exercise hyperemia in young men but not older men. Am J Physiol Heart Circ Physiol 2014; 307:H1497-503. [PMID: 25239806 DOI: 10.1152/ajpheart.00584.2014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Patients with coronary artery disease have attenuated coronary vasodilator responses to physiological stress, which is partially attributed to a β-adrenergic receptor (β-AR)-mediated mechanisms. Whether β-ARs contribute to impaired coronary vasodilation seen with healthy aging is unknown. The purpose of this study was to investigate the role of β-ARs in coronary exercise hyperemia in healthy humans. Six young men (26 ± 1 yr) and seven older men (67 ± 4 yr) performed isometric handgrip exercise at 30% maximal voluntary contraction for 2 min after receiving intravenous propranolol, a β-AR antagonist, and no treatment. Isoproterenol, a β-AR agonist, was infused to confirm the β-AR blockade. Blood pressure and heart rate were monitored continuously, and coronary blood flow velocity (CBV, left anterior descending artery) was measured by transthoracic Doppler echocardiography. Older men had an attenuated ΔCBV to isometric exercise (3.8 ± 1.3 vs. 9.7 ± 2.1 cm/s, P = 0.02) compared with young men. Propranolol decreased the ΔCBV at peak handgrip exercise in young men (9.7 ± 2.1 vs. 2.7 ± 0.9 cm/s, P = 0.008). However, propranolol had no effect on ΔCBV in older men (3.8 ± 1.3 vs. 4.2 ± 1.9 cm/s, P = 0.9). Older men also had attenuated coronary hyperemia to low-dose isoproterenol. These data indicate that β-AR control of coronary blood flow is impaired in healthy older men.
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Affiliation(s)
- Amanda J Ross
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Zhaohui Gao
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Jonathan P Pollock
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Urs A Leuenberger
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Lawrence I Sinoway
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Matthew D Muller
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
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Muller MD, Gao Z, McQuillan PM, Leuenberger UA, Sinoway LI. Coronary responses to cold air inhalation following afferent and efferent blockade. Am J Physiol Heart Circ Physiol 2014; 307:H228-35. [PMID: 24816257 DOI: 10.1152/ajpheart.00174.2014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cardiac ischemia and angina pectoris are commonly experienced during exertion in a cold environment. In the current study we tested the hypotheses that oropharyngeal afferent blockade (i.e., local anesthesia of the upper airway with lidocaine) as well as systemic β-adrenergic receptor blockade (i.e., intravenous propranolol) would improve the balance between myocardial oxygen supply and demand in response to the combined stimulus of cold air inhalation (-15 to -30°C) and isometric handgrip exercise (Cold + Grip). Young healthy subjects underwent Cold + Grip following lidocaine, propranolol, and control (no drug). Heart rate, blood pressure, and coronary blood flow velocity (CBV, from Doppler echocardiography) were continuously measured. Rate-pressure product (RPP) was calculated, and changes from baseline were compared between treatments. The change in RPP at the end of Cold + Grip was not different between lidocaine (2,441 ± 376) and control conditions (3,159 ± 626); CBV responses were also not different between treatments. With propranolol, heart rate (8 ± 1 vs. 14 ± 3 beats/min) and RPP responses to Cold + Grip were significantly attenuated. However, at peak exercise propranolol also resulted in a smaller ΔCBV (1.4 ± 0.8 vs. 5.3 ± 1.4 cm/s, P = 0.035), such that the relationship between coronary flow and cardiac metabolism was impaired under propranolol (0.43 ± 0.37 vs. 2.1 ± 0.63 arbitrary units). These data suggest that cold air breathing and isometric exercise significantly influence efferent control of coronary blood flow. Additionally, β-adrenergic vasodilation may play a significant role in coronary regulation during exercise.
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Affiliation(s)
- Matthew D Muller
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Zhaohui Gao
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Patrick M McQuillan
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Urs A Leuenberger
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
| | - Lawrence I Sinoway
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, Pennsylvania
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