Antidiuretic hormone response to volume depletion in diabetic patients with cardiac autonomic dysfunction

1985 ◽  
Vol 68 (5) ◽  
pp. 545-552 ◽  
Author(s):  
André Grimaldi ◽  
Wojciech Pruszczynski ◽  
Francis Thervet ◽  
Raymond Ardaillou
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Antidiuretic Hormone ◽  
Autonomic Dysfunction ◽  
Heart Rate Response ◽  
Plasma Aldosterone ◽  
Valsalva Manoeuvre ◽  
Diabetic Patients ◽  
Volume Depletion ◽  
Cardiac Autonomic Dysfunction

1. Thirty-three insulin-dependent diabetic patients were separated into two groups from the results of three different tests for cardiac vagal neuropathy: heart rate response to deep breathing, Valsalva manoeuvre and heart rate response to postural change. Seventeen patients were considered as without ('intact’ patients) and 16 as with ('denervated’ patients) cardiac autonomic dysfunction. One patient with a transplanted heart was also studied. 2. Plasma antidiuretic hormone (ADH), plasma aldosterone and plasma renin activity (PRA) were measured immediately before and 60 min after intravenous administration of frusemide and passage from lying to standing. The kinetics of hormonal responses were analysed more precisely (five blood collections) in six patients of each group who were studied again. Heart rate and blood pressure were recorded before each blood collection. 3. Volume depletion estimated from the rise in plasma protein (+ 11.9 and + 12.2% in ‘denervated’ and ‘intact’ patients respectively) and heart rate response (+ 10.6 and + 14.7%) were similar in both groups. Mean blood pressure was unchanged in the ‘intact’ patients whereas it fell in the ‘denervated’ patients (−13.5%). PRA (+ 161.5 and + 231.2% in ‘denervated’ and ‘intact’ patients respectively) and plasma aldosterone (+ 318.2 and 279%) increased in both groups whereas plasma ADH was stimulated only in ‘intact’ patients (+ 55.3%). The failure of ADH to respond significantly to the volume stimulus in ‘denervated’ patients was confirmed by the results of the time-course study. Plasma ADH remained at the same levels in ‘denervated’ patients whereas it increased significantly (+ 82.4%) in ‘intact’ patients. There was no ADH response in the transplanted patient. 4. These results suggest that, in humans, cardiac receptors and vagal pathways play a role in ADH response to volume depletion.

Cardiac autonomic dysfunction in obese subjects

1989 ◽  
Vol 76 (6) ◽  
pp. 567-572 ◽  
Author(s):  
Marco ROSSI ◽  
Giuliano Marti ◽  
Luigi Ricordi ◽  
Gabriele Fornasari ◽  
Giorgio Finardi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Heart Rate ◽  
Autonomic Dysfunction ◽  
Cross Correlation ◽  
Heart Rate Response ◽  
Valsalva Manoeuvre ◽  
Deep Breathing ◽  
Cardiac Autonomic Dysfunction ◽  
Obese Subjects

1. The prevalence of cardiac autonomic alterations was evaluated in 23 obese subjects with body mass index 37.2 ± 3.03 kg/m2 (mean ± sd), compared with 78 controls with body mass index 22.5 ± 2.6 kg/m2 (P < 0.001). 2. Cardiac autonomic function was assessed by four standard tests (heart rate response to deep breathing and to the Valsalva manoeuvre, systolic blood pressure fall after standing and diastolic pressure rise during handgrip) and by the cross-correlation test, a new method of computerized analysis of respiratory sinus arrhythmia based on spectral analysis of electrocardiographic and respiratory signals. 3. Considering tests indicative of parasympathetic function, only the heart rate response to the deep breathing and the cross-correlation test were significantly lower in the obese than in the control group [deep breathing = 13.95 ± 8.65 beats/min (mean ± sd) vs 24.5 ± 7.65, P < 0.001; cross-correlation 4.28 ± 0.74 units vs 5.14 ± 0.63, P < 0.001]. Deep breathing and/or cross-correlation were abnormal in 10 (43.5%) obese subjects (deep breathing: seven subjects, cross-correlation: eight subjects). No significant difference between groups was found for the response to the Valsalva manoeuvre: the Valsalva ratio was 1.69 ± 0.45 in obese subjects and 1.88 ± 0.33 in controls (P = NS). The Valsalva ratio was abnormal in three obese subjects. 4. No significant differences were found between groups for tests indicative of sympathetic function. The rise in diastolic blood pressure after handgrip was 12.6 ± 6.2 mmHg (1.67 ± 0.82 kPa) in obese subjects and 18.2 ± 4.9 mmHg (2.42 ± 0.65 kPa) in controls (P = NS), and the fall in systolic blood pressure after standing was −6.8 ± 8.6 mmHg (−0.90 ± 1.14 kPa) in obese subjects and −6.9 ± 10.4 mmHg (−0.91 ± 1.38 kPa) in controls (P = NS). The handgrip test was abnormal in four obese subjects, while no obese subject had an abnormal blood pressure response to standing. 5. Our findings suggest a high incidence of cardiac autonomic dysfunction in obese subjects. Since cardiac autonomic alterations have been shown to be involved in the mechanisms of cardiac sudden death, our data suggest a possible role of autonomic dysfunction in the increased risk for sudden death in obesity.

scholarly journals Chemical Sympathectomy Restores Baroreceptor-Heart Rate Reflex and Heart Rate Variability in Rats With Chronic Nitric Oxide Deficiency

2015 ◽  
pp. 459-466 ◽  
Author(s):  
M. CHASWAL ◽  
S. DAS ◽  
J. PRASAD ◽  
A. KATYAL ◽  
M. FAHIM
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Frequency Domain ◽  
Autonomic Dysfunction ◽  
Sympathetic Innervation ◽  
Chemical Sympathectomy ◽  
Principal Mechanism ◽  
Cardiac Autonomic Dysfunction

Nitric oxide (NO) plays a crucial role not only in regulation of blood pressure but also in maintenance of cardiac autonomic tone and its deficiency induced hypertension is accompanied by cardiac autonomic dysfunction. However, underlying mechanisms are not clearly defined. We hypothesized that sympathetic activation mediates hemodynamic and cardiac autonomic changes consequent to deficient NO synthesis. We used chemical sympathectomy by 6-hydroxydopamine to examine the influence of sympathetic innervation on baroreflex sensitivity (BRS) and heart rate variability (HRV) of chronic NG-nitro-L-arginine methyl ester (L-NAME) treated adult Wistar rats. BRS was determined from heart rate responses to changes in systolic arterial pressure achieved by intravenous administration of phenylephrine and sodium nitroprusside. Time and frequency domain measures of HRV were calculated from 5-min electrocardiogram recordings. Chronic L-NAME administration (50 mg/kg per day for 7 days orally through gavage) in control rats produced significant elevation of blood pressure, tachycardia, attenuation of BRS for bradycardia and tachycardia reflex and fall in time as well as frequency domain parameters of HRV. Sympathectomy completely abolished the pressor as well as tachycardic effect of chronic L-NAME. In addition, BRS and HRV improved after removal of sympathetic influence in chronic L-NAME treated rats. These results support the concept that an exaggerated sympathetic activity is the principal mechanism of chronic L NAME hypertension and associated autonomic dysfunction.

Juvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis

2016 ◽  
Vol 46 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Magda M. Maia ◽  
Bruno Gualano ◽  
Ana L. Sá-Pinto ◽  
Adriana M.E. Sallum ◽  
Rosa M.R. Pereira ◽  
...  
Keyword(s):  
Heart Rate ◽  
Autonomic Dysfunction ◽  
Fibromyalgia Syndrome ◽  
Heart Rate Response ◽  
Juvenile Fibromyalgia ◽  
Cardiac Autonomic Dysfunction

Short- and long-term reproducibility of autonomic measures in supine and standing positions

2004 ◽  
Vol 106 (1) ◽  
pp. 61-66 ◽  
Author(s):  
M. A. KOWALEWSKI ◽  
M. URBAN
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Response ◽  
Blood Pressure Response ◽  
Body Position ◽  
Valsalva Manoeuvre ◽  
Deep Breathing ◽  
Autonomic Nervous ◽  
Short And Long Term

Autonomic nervous tests and heart rate variability (HRV) have been used to assess cardiac autonomic function and to evaluate long-term prognosis. The aim of this study was to evaluate the short- and long-term reproducibility of HRV parameters and autonomic nervous tests according to body position (supine or standing). The study group consisted of 26 healthy subjects. Autonomic nervous tests and HRV were performed twice during the day and the results were averaged. The protocol was then repeated 3 days after each examination and also after 6 and 24 months. Autonomic nervous tests included deep breathing, Valsalva manoeuvre and isometric muscle exercise (handgrip), as well as blood pressure and heart rate in response to standing. ECG recordings were taken for 10 min during spontaneous breathing for HRV analysis. We found that the reproducibility of some parameters of the autonomic nervous test were independent of body position [E/I ratio (heart rate response to deep breathing)], whereas other parameters were dependent on body position (Valsalva manoeuvre and blood pressure response to sustained handgrip). In addition, within-day measurements of those parameters varied from non-reproducible (Valsalva ratio, handgrip and blood pressure response to standing) to moderately reproducible [E/I ratio and 30/15 ratio (heart rate response to standing)]. Among the HRV parameters, we found that total power (TP), low (LF)- and high (HF)-frequency were reproducible not only for measurements made within the same day, but also during short- and long-term observations, and only the LF/HF ratio was dependent on body position. We conclude that only a few autonomic nervous tests are reproducible in the short- and long-term. Because HRV parameters obtained during spontaneous respiration showed high reproducibility for measurements made within the same day as well as in the short- and long-term, they should be used instead of autonomic nervous tests when long-term observations are carried out in a healthy population.

Cardiac Autonomic Dysfunction in Offspring of Hypertensive Parents During Exercise

2017 ◽  
Vol 38 (14) ◽  
pp. 1105-1110 ◽  
Author(s):  
Leonardo Almeida ◽  
Tiago Peçanha ◽  
Pedro Mira ◽  
Livia Souza ◽  
Lílian da Silva ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Autonomic Dysfunction ◽  
Voluntary Contraction ◽  
P Value ◽  
Autonomic Modulation ◽  
Isometric Handgrip ◽  
Exercise Protocol ◽  
Cardiac Autonomic Modulation ◽  
Cardiac Autonomic Dysfunction

AbstractOffspring of hypertensive parents present autonomic dysfunction at rest and during physiological maneuvers. However, the cardiac autonomic modulation during exercise remains unknown. This study tested whether the cardiac autonomic modulation would be reduced in offspring of hypertensive parents during exercise. Fourteen offspring of hypertensive and 14 offspring of normotensive individuals were evaluated. The groups were matched by age (24.5±1.0 vs. 26.6±1.5 years; p=0.25) and BMI (22.8±0.6 vs. 24.2±1.0 kg/m2; p=0.30). Blood pressure and heart rate were assessed simultaneously during 3 min at baseline followed by 3-min isometric handgrip at 30% of maximal voluntary contraction. Cardiac autonomic modulation was evaluated using heart rate variability. Primary variables were subjected to two-way ANOVA (group vs. time). P value<0.05 was considered statistically significant. Blood pressure and heart rate were similar between groups during exercise protocol. In contrast, offspring of hypertensive subjects showed a reduction of SDNN (Basal=34.8±3.5 vs. 45.2±3.7 ms; Exercise=30.8±3.3 vs. 41.5±3.9 ms; p group=0.01), RMSSD (Basal=37.1±3.7 vs. 52.0±6.0 ms; Exercise=28.6±3.4 vs. 41.9±5.3 ms; p group=0.02) and pNN50 (Basal=15.7±4.0 vs. 29.5±5.5%; Exercise=7.7±2.4 vs. 18.0±4.3%; p group=0.03) during the exercise protocol in comparison with offspring of normotensive parents. We concluded that normotensive offspring of hypertensive parents exhibit impaired cardiac autonomic modulation during exercise.

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