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Combined Treatment with KV Channel Inhibitor 4-Aminopyridine and either γ-Cystathionine Lyase Inhibitor β-Cyanoalanine or Epinephrine Restores Blood Pressure, and Improves Survival in the Wistar Rat Model of Anaphylactic Shock. BIOLOGY 2022; 11:biology11101455. [PMID: 36290359 PMCID: PMC9598754 DOI: 10.3390/biology11101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Simple Summary Allergic diseases are presenting a constant increase all over the world and caused by such different substances as food, drugs, and pollens. Anaphylactic shock is the more severe complication of allergy which can induce death if the treatment is not administered immediately. Some patients do not respond to the recommended treatment, intra venous or intramuscular epinephrine. The pathophysiology of anaphylactic shock is still under investigation. The mediators released after the activation of mast cells and basophiles act on endothelial cells and smooth muscle cells, inducing the vasodilation responsible for hypotension and shock. Nitric oxide and hydrogen sulphide are both intracellular mediators that induce vasodilation. The role of potassium voltage dependent channels is suspected. We aimed to demonstrate the ability of a blocker of potassium voltage dependent channels, 4-aminopyridine, alone or in combination with inhibitors of cystathionine γ-lyase to restore blood pressure and improve survival in an ovalbumin rat anaphylactic shock model. The blockade of potassium voltage dependent channels alone or combined with inhibitors of cystathionine γ-lyase, dl-propargylglycine, or β-cyanoalanine restored blood pressure and improved survival. These findings suggest possible investigative treatment pathways for research concerning epinephrine-refractory anaphylactic shock in patients. Abstract The mechanism of anaphylactic shock (AS) remains incompletely understood. The potassium channel blocker 4-aminopyridine (4-AP), the inhibitors of cystathionine γ-lyase (ICSE), dl-propargylglycine (DPG) or β-cyanoalanine (BCA), and the nitric oxide (NO) synthase produce vasoconstriction and could be an alternative for the treatment of AS. The aim of this study was to demonstrate the ability of L-NAME, ICSE alone or in combination with 4-AP to restore blood pressure (BP) and improve survival in ovalbumin (OVA) rats AS. Experimental groups included non-sensitized Wistar rats (n = 6); AS (n = 6); AS (n = 10 per group) treated i.v. with 4-AP (AS+4-AP), epinephrine (AS+EPI), AS+DPG, AS+BCA, or with L-NAME (AS+L-NAME); or AS treated with drug combinations 4-AP+DPG, 4-AP+BCA, 4-AP+L-NAME, or 4-AP+EPI. AS was induced by i.v. OVA (1 mg). Treatments were administered i.v. one minute after AS induction. Mean arterial BP (MAP), heart rate (HR), and survival were monitored for 60 min. Plasma levels of histamine, prostaglandin E2 (PGE2) and F2 (PGF2α), leukotriene B4 and C4, angiotensin II, vasopressin, oxidative stress markers, pH, HCO3, PaO2, PaCO2, and K+ were measured. OVA induced severe hypotension and all AS rats died. Moreover, 4-AP, 4-AP+EPI, or 4-AP+BCA normalized both MAP and HR and increased survival. All sensitized rats treated with 4-AP alone or with 4-AP+BCA survived. The time-integrated MAP “area under the curve” was significantly higher after combined 4-AP treatment with ICSE. Metabolic acidosis was not rescued and NO, ICSE, and Kv inhibitors differentially alter oxidative stress and plasma levels of anaphylactic mediators. The AS-induced reduction of serum angiotensin II levels was prevented by 4-AP treatment alone or in combination with other drugs. Further, 4-AP treatment combined with EPI or with BCA also increased serum PGF2α, whereas only the 4-AP+EPI combination increased serum LTB4. Serum vasopressin and angiotensin II levels were increased by 4-AP treatment alone or in combination with other drugs. Moreover, 4-AP alone and in combination with inhibition of cystathionine γ-lyase or EPI normalizes BP, increases serum vasoconstrictor levels, and improves survival in the Wistar rat model of AS. These findings suggest possible investigative treatment pathways for research into epinephrine-refractory anaphylactic shock in patients.
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de Oliveira GL, Marques AH, da Fonseca VF, Pozzolo BA, Panacioni F, Santos TC, Guedes AA, Mocelin AG, Bertin RL, Ulbrich AZ. Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing. Sci Rep 2020; 10:11196. [PMID: 32641857 PMCID: PMC7343795 DOI: 10.1038/s41598-020-68155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/18/2020] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to investigate whether the use of handrail support during maximal exercise treadmill testing (ETT) would interfere in cardiac autonomic modulation kinetics when compared to not using handrail support. The hypothesis of overestimation in cardiac autonomic dynamics when the ETT is performed using handrail was tested. Thirty-five undergraduates (21.08 ± 2.98 years old) of both sexes, volunteered to undertake two ETT under the Ellestad protocol, in non-consecutive days. The first test (T1) was performed with handrail support and, after 7 days, the second test was performed (T2) without the support. Autonomic function was measured by heart rate variability (HRV) during both tests and resting. Estimated value of peak oxygen uptake (VO2) was 22.4% (p < 0.0001) higher in T1 when compared to T2. Overall, parasympathetic pathway was deactivated earlier in T2 than in T1, with NNxx measures variating in T1 from 10.74 ± 14.59 (ms) and in T2 from 3.48 ± 3.79 (ms). In stage two, mean values of HF in T2 corresponded to 32% of values in T1. Stage three presented a difference of 60% (p < 0.014) in LF between means reached in T1 and T2. Lastly, the association of LF and VO2 persisted longer in T1 stages than in T2 and was verified in early stages (S2 and S3) of both ETTs. Our findings suggest that parasympathetic influences on HR were slightly prolonged during ETT when subjects hold onto the treadmill.
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Affiliation(s)
- Giovanna Lima de Oliveira
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Adriana Hernandez Marques
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Vanessa Ferrari da Fonseca
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Beatriz Augusta Pozzolo
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Fernanda Panacioni
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Taís Capucho Santos
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Amanda Archeleiga Guedes
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Aurenzo Gonçalves Mocelin
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil
| | - Renata Labronici Bertin
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil.,Department of Nutrition, Center for Health Sciences, Federal University of Parana (UFPR), Curitiba, PR, Brazil
| | - Anderson Zampier Ulbrich
- Research Group of Exercise Medicine (MedEx), Federal University of Parana (UFPR), Padre Camargo Street, 280 - Alto da Gloria, Curitiba, PR, 80060-240, Brazil. .,Department of Integrative Medicine, Center for Health Sciences, Federal University of Parana (UFPR), Curitiba, PR, Brazil.
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Wiener A, Goldstein P, Alkoby O, Doenyas K, Okon‐Singer H. Blood pressure reaction to negative stimuli: Insights from continuous recording and analysis. Psychophysiology 2020; 57:e13525. [PMID: 31922263 PMCID: PMC7078923 DOI: 10.1111/psyp.13525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 12/15/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022]
Abstract
Individuals with a tendency toward abnormally enhanced cardiovascular responses to stress are at greater risk of developing essential hypertension later in life. Accurate profiling of continuous blood pressure (BP) reactions in healthy populations is crucial for understanding normal and abnormal emotional reaction patterns. To this end, we examined the continuous time course of BP reactions to aversive pictures among healthy participants. In two experiments, we showed participants negative and neutral pictures while simultaneously measuring their continuous BP and heart rate (HR) reactions. In this study, BP reactions were analyzed continuously, in contrast to previous studies, in which BP responses were averaged across blocks. To compare time points along a temporal continuum, we applied a multi-level B-spline model, which is innovative in the context of BP analysis. Additionally, HR was similarly analyzed in order to examine its correlation with BP. Both experiments revealed a similar pattern of BP reactivity and association with HR. In line with previous studies, a decline in BP and HR levels was found in response to negative pictures compared to neutral pictures. In addition, in both conditions, we found an unexpected elevation of BP toward the end of the stimuli exposure period. These findings may be explained by the recruitment of attention resources in the presence of negative stimuli, which is alleviated toward the end of the stimulation. This study highlights the importance of continuous measurement and analysis for characterizing the time course of BP reactivity to emotional stimuli.
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Affiliation(s)
- Avigail Wiener
- Department of PsychologyUniversity of HaifaHaifaIsrael
- The Integrated Brain and Behavior Research Center (IBBR)University of HaifaHaifaIsrael
| | - Pavel Goldstein
- Department of Psychology and Neuroscience and the Institute for Cognitive ScienceUniversity of Colorado BoulderBoulderColorado USA
- School of Public HealthUniversity of HaifaHaifaIsrael
| | - Oren Alkoby
- Department of PsychologyUniversity of HaifaHaifaIsrael
- The Integrated Brain and Behavior Research Center (IBBR)University of HaifaHaifaIsrael
| | - Keren Doenyas
- Department of Nephrology and HypertensionAssaf Harofeh Medical Center, Sackler School of MedicineTel‐Aviv UniversityTel‐AvivIsrael
- Sagol Center for Hyperbaric Medicine and ResearchAssaf Harofeh Medical CenterTel‐Aviv UniversityTel‐AvivIsrael
| | - Hadas Okon‐Singer
- Department of PsychologyUniversity of HaifaHaifaIsrael
- The Integrated Brain and Behavior Research Center (IBBR)University of HaifaHaifaIsrael
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Fu Q, Ogoh S. Sex differences in baroreflex function in health and disease. J Physiol Sci 2019; 69:851-859. [PMID: 31721084 PMCID: PMC10717578 DOI: 10.1007/s12576-019-00727-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/29/2019] [Indexed: 01/16/2023]
Abstract
This brief review summarizes the current knowledge on sex differences in baroreflex function, with a major focus on studies in humans. It has been demonstrated that healthy women have blunted cardiovagal baroreflx sensitivity during a rapid (i.e., within seconds) hypertensive stimulus, but baroreflex sensitivity is similar between the sexes during a hypotensive stimulus. Normal aging decreases cardiovagal baroreflex sensitivity and the rate of decline is similar in men and women. Cardiovagal baroreflex sensitivity is reduced in pathological conditions such as hypertension and type II diabetes, and the reduction is greater in female patients than male patients. There is no clear sex difference in sympathetic baroreflex sensitivity among young individuals, however, with women of more advanced age, sympathetic baroreflex sensitivity decreases, which appears to be associated with greater arterial stiffness compared with similarly aged men. The blunted sympathetic baroreflex sensitivity in older women may predispose them to an increased prevalence of hypertension and cardiovascular disease.
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Affiliation(s)
- Qi Fu
- Women's Heart Health Laboratory, Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX, 75231, USA.
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Tokyo, Japan
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Sharman JE, Boutouyrie P, Perier MC, Thomas F, Guibout C, Khettab H, Pannier B, Laurent S, Jouven X, Empana JP. Impaired baroreflex sensitivity, carotid stiffness, and exaggerated exercise blood pressure: a community-based analysis from the Paris Prospective Study III. Eur Heart J 2019; 39:599-606. [PMID: 29281076 DOI: 10.1093/eurheartj/ehx714] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/06/2017] [Indexed: 11/12/2022] Open
Abstract
Aims People with exaggerated exercise blood pressure (BP) have adverse cardiovascular outcomes. Mechanisms are unknown but could be explained through impaired neural baroreflex sensitivity (BRS) and/or large artery stiffness. This study aimed to determine the associations of carotid BRS and carotid stiffness with exaggerated exercise BP. Methods and results Blood pressure was recorded at rest and following an exercise step-test among 8976 adults aged 50 to 75 years from the Paris Prospective Study III. Resting carotid BRS (low frequency gain, from carotid distension rate, and heart rate) and stiffness were measured by high-precision echotracking. A systolic BP threshold of ≥ 150 mmHg defined exaggerated exercise BP and ≥140/90 mmHg defined resting hypertension (±antihypertensive treatment). Participants with exaggerated exercise BP had significantly lower BRS [median (Q1; Q3) 0.10 (0.06; 0.16) vs. 0.12 (0.08; 0.19) (ms2/mm) 2×108; P < 0.001] but higher stiffness [mean ± standard deviation (SD); 7.34 ± 1.37 vs. 6.76 ± 1.25 m/s; P < 0.001) compared to those with non-exaggerated exercise BP. However, only lower BRS (per 1SD decrement) was associated with exaggerated exercise BP among people without hypertension at rest {specifically among those with optimal BP; odds ratio (OR) 1.16 [95% confidence intervals (95% CI) 1.01; 1.33], P = 0.04 and high-normal BP; OR, 1.19 (95% CI 1.07; 1.32), P = 0.001} after adjustment for age, sex, body mass index, smoking, alcohol, total cholesterol, high-density lipoprotein cholesterol, resting heart rate, and antihypertensive medications. Conclusion Impaired BRS, but not carotid stiffness, is independently associated with exaggerated exercise BP even among those with well controlled resting BP. This indicates a potential pathway from depressed neural baroreflex function to abnormal exercise BP and clinical outcomes.
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Affiliation(s)
- James E Sharman
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000 Australia
| | - Pierre Boutouyrie
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France.,Pharmacology Departments, APHP, Georges Pompidou European Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Marie-Cécile Perier
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France
| | - Frédérique Thomas
- Preventive and Clinical Investigation Center, 6 rue Laperouse, 75016 Paris, France
| | - Catherine Guibout
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France
| | - Hakim Khettab
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Pharmacology Departments, APHP, Georges Pompidou European Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Bruno Pannier
- Preventive and Clinical Investigation Center, 6 rue Laperouse, 75016 Paris, France
| | - Stéphane Laurent
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France.,Pharmacology Departments, APHP, Georges Pompidou European Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Xavier Jouven
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France.,Georges Pompidou European Hospital Cardiology Departments, APHP, 20 rue Leblanc, 75015 Paris, France
| | - Jean-Philippe Empana
- Department of Epidemiology, INSERM, U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 12 rue de l'école de médecine, 75006 Paris, France
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Abstract
Perivascular adipose tissue (PVAT) is no longer recognised as simply a structural support for the vasculature, and we now know that PVAT releases vasoactive factors which modulate vascular function. Since the discovery of this function in 1991, PVAT research is rapidly growing and the importance of PVAT function in disease is becoming increasingly clear. Obesity is associated with a plethora of vascular conditions; therefore, the study of adipocytes and their effects on the vasculature is vital. PVAT contains an adrenergic system including nerves, adrenoceptors and transporters. In obesity, the autonomic nervous system is dysfunctional; therefore, sympathetic innervation of PVAT may be the key mechanistic link between increased adiposity and vascular disease. In addition, not all obese people develop vascular disease, but a common feature amongst those that do appears to be the inflammatory cell population in PVAT. This review will discuss what is known about sympathetic innervation of PVAT, and the links between nerve activation and inflammation in obesity. In addition, we will examine the therapeutic potential of exercise in sympathetic stimulation of adipose tissue.
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Affiliation(s)
- Sophie N Saxton
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, Core Technology Facility (3rd floor), 46 Grafton Street, M13 9NT, Manchester, UK.
| | - Sarah B Withers
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, Core Technology Facility (3rd floor), 46 Grafton Street, M13 9NT, Manchester, UK
- School of Environment and Life Sciences, University of Salford, Manchester, UK
| | - Anthony M Heagerty
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, Core Technology Facility (3rd floor), 46 Grafton Street, M13 9NT, Manchester, UK
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Ogoh S, Marais M, Lericollais R, Denise P, Raven PB, Normand H. Interaction between graviception and carotid baroreflex function in humans during parabolic flight-induced microgravity. J Appl Physiol (1985) 2018; 125:634-641. [PMID: 29745800 DOI: 10.1152/japplphysiol.00198.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The aim of the present study was to assess carotid baroreflex (CBR) function during acute changes in otolithic activity in humans. To address this question, we designed a set of experiments to identify the modulatory effects of microgravity on CBR function at a tilt angle of -2°, which was identified to minimize changes in central blood volume during parabolic flight. During parabolic flight at 0 and 1 g, CBR function curves were modeled from the heart rate (HR) and mean arterial pressure (MAP) responses to rapid pulse trains of neck pressure and neck suction ranging from +40 to -80 Torr; CBR control of HR (carotid-HR) and MAP (carotid-MAP) function curves, respectively. The maximal gain of both carotid-HR and carotid-MAP baroreflex function curves were augmented during microgravity compared with 1 g (carotid-HR, -0.53 to -0.80 beats·min-1·mmHg-1, P < 0.05; carotid-MAP, -0.24 to -0.30 mmHg/mmHg, P < 0.05). These findings suggest that parabolic flight-induced acute change of otolithic activity may modify CBR function and identifies that the vestibular system contributes to blood pressure regulation under fluctuations in gravitational forces. NEW & NOTEWORTHY The effect of acute changes in vestibular activity on arterial baroreflex function remains unclear. In the present study, we assessed carotid baroreflex function without changes in central blood volume during parabolic flight, which causes acute changes in otolithic activity. The sensitivity of both carotid heart rate and carotid mean arterial pressure baroreflex function was augmented in microgravity compared with 1 g, suggesting that the vestibular system contributes to blood pressure regulation in humans on Earth.
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Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University , Saitama , Japan
| | - Michaël Marais
- Normandie University , France.,UNICAEN, COMETE, Caen , France.,INSERM, U 1075 COMETE, Caen , France
| | - Romain Lericollais
- Normandie University , France.,UNICAEN, COMETE, Caen , France.,INSERM, U 1075 COMETE, Caen , France.,CHU de Caen, Department of Clinical Physiology , Caen , France
| | - Pierre Denise
- Normandie University , France.,UNICAEN, COMETE, Caen , France.,INSERM, U 1075 COMETE, Caen , France.,CHU de Caen, Department of Clinical Physiology , Caen , France
| | - Peter B Raven
- Department of Integrative Physiology, University of North Texas, Health Science Center , Fort Worth, Texas
| | - Hervé Normand
- Normandie University , France.,UNICAEN, COMETE, Caen , France.,INSERM, U 1075 COMETE, Caen , France.,CHU de Caen, Department of Clinical Physiology , Caen , France
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Limberg JK, Guo W, Joyner MJ, Charkoudian N, Curry TB. Early blood pressure response to isometric exercise is attenuated in obese individuals who have undergone bariatric surgery. J Appl Physiol (1985) 2018; 124:960-969. [PMID: 29357508 PMCID: PMC5972465 DOI: 10.1152/japplphysiol.00918.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/28/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022] Open
Abstract
Blood pressure (BP) reactivity is predictive of the development of cardiovascular disease. We hypothesized that the BP response at the onset of isometric handgrip exercise would occur earlier and to a lesser degree in individuals who underwent bariatric surgery compared with obese adults and that the reliance on total peripheral resistance (TPR) would be attenuated. Twenty-six individuals (7 nonobese, 11 obese, 8 postbariatric surgery) completed isometric handgrip exercise (40% maximum voluntary contraction) to exhaustion. Heart rate (HR, ECG) and arterial BP (brachial catheter) were measured continuously. Stroke volume was estimated from the pressure waveform, and cardiac output (CO) and TPR were calculated. Peak change, time to peak, and rate of rise in BP were assessed during the first 30 s of exercise. Obese adults exhibited a slower rise in BP and higher peak BP at exercise onset compared with nonobese controls ( P < 0.05). Peak BP and the rate of rise were not different between individuals who underwent bariatric surgery and nonobese controls ( P > 0.05). Nonobese controls exhibited an exercise-mediated increase in CO, whereas obese adults increased TPR ( P < 0.05). The increases in CO and TPR were less apparent in individuals who underwent bariatric surgery ( P > 0.05). In contrast to obese adults, individuals who underwent bariatric surgery exhibit a rapid rise in BP at exercise onset. This rapid increase in BP is associated with a fall in TPR and results in lower peak BP at the onset of isometric exercise. These data suggest that bariatric surgery improves BP reactivity via changes in the time course of hemodynamic responses. NEW & NOTEWORTHY Bariatric surgery has been shown to reduce the blood pressure (BP) response to isometric handgrip exercise. By examining the time course of the BP response to exercise, we found, in contrast to obese adults, individuals who underwent bariatric surgery exhibit a rapid rise in BP at exercise onset, which is associated with a fall in total peripheral resistance and results in lower peak BP at the onset of isometric exercise. These data suggest that bariatric surgery improves BP reactivity via reflex autonomic adjustments.
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Affiliation(s)
- Jacqueline K Limberg
- Department of Anesthesiology, Mayo Clinic , Rochester, Minnesota
- Department of Physiology, Mayo Clinic , Rochester, Minnesota
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri
| | - Winston Guo
- Department of Anesthesiology, Mayo Clinic , Rochester, Minnesota
| | - Michael J Joyner
- Department of Anesthesiology, Mayo Clinic , Rochester, Minnesota
- Department of Physiology, Mayo Clinic , Rochester, Minnesota
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine , Natick, Massachusetts
| | - Timothy B Curry
- Department of Anesthesiology, Mayo Clinic , Rochester, Minnesota
- Department of Physiology, Mayo Clinic , Rochester, Minnesota
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Bringard A, Adami A, Fagoni N, Fontolliet T, Lador F, Moia C, Tam E, Ferretti G. Dynamics of the RR-interval versus blood pressure relationship at exercise onset in humans. Eur J Appl Physiol 2017; 117:619-630. [PMID: 28238048 DOI: 10.1007/s00421-017-3564-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The dynamics of the postulated phenomenon of exercise baroreflex resetting is poorly understood, but can be investigated using closed-loop procedures. To shed light on some mechanisms and temporal relationships participating in the resetting process, we studied the time course of the relationship between the R-R interval (RRi) and arterial pressure with a closed-loop approach. METHODS On ten young volunteers at rest and during light exercise in supine and upright position, we continuously determined, on single-beat basis, RRi (electrocardiography), and arterial pressure (non-invasive finger pressure cuff). From pulse pressure profiles, we determined cardiac output (CO) by Modelflow, computed mean arterial pressure (MAP), and calculated total peripheral resistance (TPR). RESULTS At exercise start, RRi was lower than in quiet rest. As exercise started, MAP fell to a minimum (MAPm) of 72.8 ± 9.6 mmHg upright and 73.9 ± 6.2 supine, while RRi dropped. The initial RRi versus MAP relationship was linear, with flatter slope than resting baroreflex sensitivity, in both postures. TPR fell and CO increased. After MAPm, RRi and MAP varied in opposite direction toward exercise steady state, with further CO increase. CONCLUSION These results suggest that, initially, the MAP fall was corrected by a RRi reduction along a baroreflex curve, with lower sensitivity than at rest, but eventually in the same pressure range as at rest. After attainment of MAPm, a second phase started, where the postulated baroreflex resetting might have occurred. In conclusion, the change in baroreflex sensitivity and the resetting process are distinct phenomena, under different control systems.
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Affiliation(s)
- Aurélien Bringard
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, CH-1211, Genève 4, Switzerland.,Département des Neurosciences Fondamentales, Université de Genève, 1 rue Michel Servet, CH-1211, Genève 4, Switzerland
| | - Alessandra Adami
- Département des Neurosciences Fondamentales, Université de Genève, 1 rue Michel Servet, CH-1211, Genève 4, Switzerland.,Division of Respiratory and Critical Care Physiology and Medicine, Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W Carson St, Torrance, CA, 90502, USA
| | - Nazzareno Fagoni
- Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Timothée Fontolliet
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, CH-1211, Genève 4, Switzerland.,Département des Neurosciences Fondamentales, Université de Genève, 1 rue Michel Servet, CH-1211, Genève 4, Switzerland
| | - Frédéric Lador
- Service de Pneumologie, Programme Hypertension Pulmonaire, Département des Spécialités de Médecine, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, CH-1211, Genève, Switzerland
| | - Christian Moia
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, CH-1211, Genève 4, Switzerland.,Département des Neurosciences Fondamentales, Université de Genève, 1 rue Michel Servet, CH-1211, Genève 4, Switzerland
| | - Enrico Tam
- Dipartimento di Scienze Neurologiche, Biomediche e del Movimento, Università di Verona, Via Felice Casorati 43, 37131, Verona, Italy
| | - Guido Ferretti
- Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, CH-1211, Genève 4, Switzerland. .,Département des Neurosciences Fondamentales, Université de Genève, 1 rue Michel Servet, CH-1211, Genève 4, Switzerland. .,Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Viale Europa 11, 25123, Brescia, Italy.
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10
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Katayama K, Ishida K, Saito M, Koike T, Hirasawa A, Ogoh S. Enhanced muscle pump during mild dynamic leg exercise inhibits sympathetic vasomotor outflow. Physiol Rep 2014; 2:2/7/e12070. [PMID: 25347854 PMCID: PMC4187562 DOI: 10.14814/phy2.12070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Muscle sympathetic nerve activity (MSNA) is not increased during leg cycling at light and mild intensities, despite activation of central command and the exercise pressor reflex. We determined whether increasing central blood volume and loading the cardiopulmonary baroreceptors modulate sympathetic vasomotor outflow during leg cycling. To this end, we changed the pedaling frequency to enhance skeletal muscle pump. Subjects performed two leg cycle exercises at differential pedal rates of 60 and 80 rpm (60EX and 80EX trials) for two conditions (with and without MSNA measurement). In each trial, subjects completed leg cycling with a differential workload to maintain constant oxygen consumption (VO2). MSNA was recorded via microneurography at the right median nerve of the elbow. Without MSNA measurement, thoracic impedance, stroke volume (SV), and cardiac output (CO) were measured non‐invasively using impedance cardiography. Heart rate and VO2 during exercise did not differ between the 60EX and 80EX trials. Changes in thoracic impedance, SV, and CO during the 80EX trial were greater than during the 60EX trial. MSNA during the 60EX trial was unchanged compared with that at rest (25.8 ± 3.1 [rest] to 28.3 ± 3.4 [exercise] bursts/min), whereas a significant decrease in MSNA was observed during the 80EX trial (25.8 ± 2.8 [rest] to 19.7 ± 2.0 [exercise] bursts/min). These results suggest that a muscle pump‐induced increase in central blood volume, and thereby loading of cardiopulmonary baroreceptors, could inhibit sympathetic vasomotor outflow during mild dynamic leg exercise, despite activation of central command and the exercise pressor reflex. Muscle sympathetic nerve activity during leg cycling was reduced when central blood volume was manipulated by increasing the pedaling frequency. This result suggest that sympathetic vasomotor outflow is strongly affected by loading of cardiopulmonary baroreceptors at light and mild dynamic leg exercise to maintain arterial blood pressure.
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Affiliation(s)
- Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Mitsuru Saito
- Faculty of Psychological and Physical Science, Aichigakuin University, Nisshin, Japan
| | - Teruhiko Koike
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Ai Hirasawa
- Department of Biomedical Engineering, Toyo University, Kawagoe, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe, Japan
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11
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Laughlin MH, Davis MJ, Secher NH, van Lieshout JJ, Arce-Esquivel AA, Simmons GH, Bender SB, Padilla J, Bache RJ, Merkus D, Duncker DJ. Peripheral circulation. Compr Physiol 2013; 2:321-447. [PMID: 23728977 DOI: 10.1002/cphy.c100048] [Citation(s) in RCA: 174] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Blood flow (BF) increases with increasing exercise intensity in skeletal, respiratory, and cardiac muscle. In humans during maximal exercise intensities, 85% to 90% of total cardiac output is distributed to skeletal and cardiac muscle. During exercise BF increases modestly and heterogeneously to brain and decreases in gastrointestinal, reproductive, and renal tissues and shows little to no change in skin. If the duration of exercise is sufficient to increase body/core temperature, skin BF is also increased in humans. Because blood pressure changes little during exercise, changes in distribution of BF with incremental exercise result from changes in vascular conductance. These changes in distribution of BF throughout the body contribute to decreases in mixed venous oxygen content, serve to supply adequate oxygen to the active skeletal muscles, and support metabolism of other tissues while maintaining homeostasis. This review discusses the response of the peripheral circulation of humans to acute and chronic dynamic exercise and mechanisms responsible for these responses. This is accomplished in the context of leading the reader on a tour through the peripheral circulation during dynamic exercise. During this tour, we consider what is known about how each vascular bed controls BF during exercise and how these control mechanisms are modified by chronic physical activity/exercise training. The tour ends by comparing responses of the systemic circulation to those of the pulmonary circulation relative to the effects of exercise on the regional distribution of BF and mechanisms responsible for control of resistance/conductance in the systemic and pulmonary circulations.
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Affiliation(s)
- M Harold Laughlin
- Department of Medical Pharmacology and Physiology, and the Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, USA.
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12
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Pires W, Wanner SP, Lima MRM, Fonseca IAT, Fumega U, Haibara AS, Coimbra CC, Lima NRV. Physical exercise performance in temperate and warm environments is decreased by an impaired arterial baroreflex. PLoS One 2013; 8:e72005. [PMID: 23951278 PMCID: PMC3737155 DOI: 10.1371/journal.pone.0072005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 07/10/2013] [Indexed: 11/18/2022] Open
Abstract
The present study aimed to investigate whether running performance in different environments is dependent on intact arterial baroreceptor reflexes. We also assessed the exercise-induced cardiovascular and thermoregulatory responses in animals lacking arterial baroafferent signals. To accomplish these goals, male Wistar rats were subjected to sinoaortic denervation (SAD) or sham surgery (SHAM) and had a catheter implanted into the ascending aorta to record arterial pressure and a telemetry sensor implanted in the abdominal cavity to record core temperature. After recovering from these surgeries, the animals were subjected to constant- or incremental-speed exercises performed until the voluntary interruption of effort under temperate (25° C) and warm (35° C) conditions. During the constant-speed exercises, the running time until the rats were fatigued was shorter in SAD rats in both environments. Although the core temperature was not significantly different between the groups, tail skin temperature was higher in SAD rats under temperate conditions. The denervated rats also displayed exaggerated increases in blood pressure and double product compared with the SHAM rats; in particular, in the warm environment, these exaggerated cardiovascular responses in the SAD rats persisted until they were fatigued. These SAD-mediated changes occurred in parallel with increased variability in the very low and low components of the systolic arterial pressure power spectrum. The running performance was also affected by SAD during the incremental-speed exercises, with the maximal speed attained being decreased by approximately 20% in both environments. Furthermore, at the maximal power output tolerated during the incremental exercises, the mean arterial pressure, heart rate and double product were exaggerated in the SAD relative to SHAM rats. In conclusion, the chronic absence of the arterial baroafferents accelerates exercise fatigue in temperate and warm environments. Our findings also suggest that an augmented cardiovascular strain accounted for the early interruption of exercise in the SAD rats.
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Affiliation(s)
- Washington Pires
- Exercise Physiology Laboratory, Department of Physical Education, School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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13
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Fu Q, Levine BD. Exercise and the autonomic nervous system. HANDBOOK OF CLINICAL NEUROLOGY 2013; 117:147-60. [DOI: 10.1016/b978-0-444-53491-0.00013-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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14
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Regulation of blood pressure by the arterial baroreflex and autonomic nervous system. HANDBOOK OF CLINICAL NEUROLOGY 2013; 117:89-102. [DOI: 10.1016/b978-0-444-53491-0.00008-0] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Phillips AA, Krassioukov AV, Ainslie PN, Warburton DE. Baroreflex Function after Spinal Cord Injury. J Neurotrauma 2012; 29:2431-45. [DOI: 10.1089/neu.2012.2507] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Aaron A. Phillips
- Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, British Columbia, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
| | - Andrei V. Krassioukov
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, British Columbia, Canada
| | - Philip N. Ainslie
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Darren E.R. Warburton
- Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, British Columbia, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
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16
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Cortelli P, Lombardi C, Montagna P, Parati G. Baroreflex modulation during sleep and in obstructive sleep apnea syndrome. Auton Neurosci 2012; 169:7-11. [PMID: 22465134 DOI: 10.1016/j.autneu.2012.02.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 01/19/2012] [Accepted: 02/29/2012] [Indexed: 12/15/2022]
Abstract
This review focuses on the complex integration between cardiovascular reflexes and central autonomic influences controlling physiological sleep-dependent changes in arterial blood pressure and heart rate. A brief introduction on the anatomic and functional organization of the arterial baroreflex and the methods available to assess its function in humans is followed by an analysis of the functional interaction between autonomic nervous system and sleep mechanisms at the highest levels of brain organization. An insight into these interactions is important to shed light on the physiopathology of the most frequent complications of obstructive sleep apnea syndrome, such as sustained arterial hypertension, and excessive daytime sleepiness.
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Affiliation(s)
- P Cortelli
- IRCSS Istituto delle Scienze Neurologiche di Bologna, Dipartimento di Scienze Neurologiche, Alma Mater Studiorum - Università di Bologna, Italy
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17
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Abstract
Regular physical activity (endurance training, ET) has a strong positive link with cardiovascular health. The aim of this review is to draw together the current knowledge on gene expression in different cell types comprising the vessels of the circulatory system, with special emphasis on the endothelium, and how these gene products interact to influence vascular health. The effect beneficial effects of ET on the endothelium are believed to result from increased vascular shear stress during ET bouts. A number of mechanosensory mechanisms have been elucidated that may contribute to the effects of ET on vascular function, but there are questions regarding interactions among molecular pathways. For instance, increases in flow brought on by ET can reduce circulating levels of viscosity and haemostatic and inflammatory variables that may interact with increased shear stress, releasing vasoactive substances such as nitric oxide and prostacyclin, decreasing permeability to plasma lipoproteins as well as the adhesion of leucocytes. At this time the optimal rate-of-flow and rate-of-change in flow for determining whether anti-atherogenic or pro-atherogenic processes proceed remain unknown. In addition, the impact of haemodynamic variables differs with vessel size and tissue type in which arteries are located. While the hurdles to understanding the mechanism responsible for ET-induced alterations in vascular cell gene expression are significant, they in no way undermine the established benefits of regular physical activity to the cardiovascular system and to general overall health. This review summarizes current understanding of control of vascular cell gene expression by exercise and how these processes lead to improved cardiovascular health.
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Affiliation(s)
- J J Whyte
- Department of Biomedical Sciences, University of Missouri-Columbia, Columbia, MO 65211, USA
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