P-42 Arterial Baroreflex Control of Single-Unit Muscle Sympathetic Nerve Activity in Chronic Heart Failure with Atrial Fibrillation

Arterial baroreflex control of muscle sympathetic nerve activity (ABRMSNA) is impaired in chronic systolic heart failure (CHF). The purpose of the study was to test the hypothesis that exercise training would improve the gain and reduce the time delay of ABRMSNA in CHF patients. Twenty-six CHF patients, New York Heart Association Functional Class II-III, EF ≤ 40%, peak V̇o2 ≤ 20 ml·kg−1·min−1 were divided into two groups: untrained (UT, n = 13, 57 ± 3 years) and exercise trained (ET, n = 13, 49 ± 3 years). Muscle sympathetic nerve activity (MSNA) was directly recorded by microneurography technique. Arterial pressure was measured on a beat-to-beat basis. Time series of MSNA and systolic arterial pressure were analyzed by autoregressive spectral analysis. The gain and time delay of ABRMSNA was obtained by bivariate autoregressive analysis. Exercise training was performed on a cycle ergometer at moderate intensity, three 60-min sessions per week for 16 wk. Baseline MSNA, gain and time delay of ABRMSNA, and low frequency of MSNA (LFMSNA) to high-frequency ratio (HFMSNA) (LFMSNA/HFMSNA) were similar between groups. ET significantly decreased MSNA. MSNA was unchanged in the UT patients. The gain and time delay of ABRMSNA were unchanged in the ET patients. In contrast, the gain of ABRMSNA was significantly reduced [3.5 ± 0.7 vs. 1.8 ± 0.2, arbitrary units (au)/mmHg, P = 0.04] and the time delay of ABRMSNA was significantly increased (4.6 ± 0.8 vs. 7.9 ± 1.0 s, P = 0.05) in the UT patients. LFMSNA-to-HFMSNA ratio tended to be lower in the ET patients ( P < 0.08). Exercise training prevents the deterioration of ABRMSNA in CHF patients.

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Abstract 17981: Decreased Oscillatory Pattern of Sympathetic Nerve Activity is Associated With Arterial Baroreflex Dysfunction in Chronic Heart Failure Patients

Circulation ◽

10.1161/circ.132.suppl_3.17981 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Edgar Toschi-Dias ◽

Raphaela V Groehs ◽

Ligia M Antunes-Correa ◽

Patrícia F Trevizan ◽

Denise M Lobo ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Sympathetic Nerve ◽

Sympathetic Nerve Activity ◽

Muscle Sympathetic Nerve Activity ◽

Inverse Association ◽

Arterial Baroreflex ◽

Nerve Activity ◽

Oscillatory Pattern

Background: Sympathetic activation and arterial baroreflex (ABR) dysfunction typify chronic heart failure (CHF). In addition, decreased oscillatory pattern of muscle sympathetic nerve activity (MSNA, LF MSNA /HF MSNA ) seems to contribute to sympathetic exacerbation in patients with CHF. Unknown is whether the LF MSNA /HF MSNA is associated with ABR dysfunction in CHF patients. To answer this question, we investigated the association between gain, latency and coupling of ABR function and LF MSNA /HF MSNA in CHF patients. Methods and Results: Forty-three CHF patients, Functional Class II to III, NYHA, ejection fraction ≤40% were allocated into two groups according to the level of LF MSNA /HF MSNA index: 1) Higher LF MSNA /HF MSNA (n=21, 52±2 years) and 2) Lower LF MSNA /HF MSNA (n=22, 54±1 years). Blood pressure (BP, oscillometric beat-to-beat basis) and MSNA (microneurography technique) were recorded during 10 min at rest. Spectral and cross-spectral analyses of BP and MSNA variabilities were conducted to assess the LF MSNA /HF MSNA and the gain, latency and coupling between BP and MSNA of ABR function. Etiology, ejection fraction, gain and latency of ABR function were similar between groups. However, the patients with lower LF MSNA /HF MSNA had increased MSNA bursts frequency (53±2vs. 39±3 bursts/min, P<0.01) and total activity (180±15 vs. 126±17 a.u, P=0.03) compared to the patients with higher LF MSNA /HF MSNA . In contrast, the patients with lower LF MSNA /HF MSNA had reduced coupling of ABR function (69±3 vs. 80±2 %, P<0.01). Further analysis showed a significant association between the coupling of ABR function and LF MSNA /HF MSNA (R=0.36, P=0.02). Conclusions: There is an inverse association between the LF MSNA /HF MSNA index and sympathetic nerve activity. In addition, there is a direct association between the LF MSNA /HF MSNA index and the coupling of ABR, which suggests that the ABR dysfunction explains, at least in part, the augmented sympathetic nerve activity in CHF patients.

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