Favorable effects of carotid endarterectomy on baroreflex sensitivity and cardiovascular neural modulation: a 4-month follow-up

2013 ◽  
Vol 304 (12) ◽  
pp. R1114-R1120 ◽  
Author(s):  
Laura Dalla Vecchia ◽  
Franca Barbic ◽  
Andrea Galli ◽  
Massimo Pisacreta ◽  
Rosella Gornati ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
High Frequency ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Carotid Surgery ◽  
Sympathetic Activation ◽  
Arterial Baroreflex ◽  
Baroreceptor Sensitivity ◽  
Arterial Baroreflex Sensitivity

Carotid surgery variably modifies carotid afferent innervation, thus affecting arterial baroreceptor sensitivity. Low arterial baroreflex sensitivity is a well-known independent risk factor for cardiovascular diseases. The aim of this study was to assess the 4-mo effects of carotid endarterectomy (CEA) on arterial baroreceptor sensitivity and cardiovascular autonomic profile in patients with unilateral carotid stenosis. We enrolled 20 patients (72 ± 8 yr) with unilateral >70% carotid stenosis. ECG, beat-by-beat blood pressure, and respiration were continuously recorded before and 126 ± 9 days after CEA, at rest and during a 75° head-up tilt. Both pharmacological (modified Oxford technique, BRS) and spontaneous (index α, spectral analysis) arterial baroreflex sensitivity were assessed. Cardiovascular autonomic profile was evaluated by plasma catecholamines and spectral indexes of cardiac sympathovagal modulation [low-frequency R-R interval (LFRR), low frequency-to high frequency ratio (LF/HF), high-frequency R-R interval (HFRR)] and sympathetic vasomotor control [low-frequency systolic arterial pressure (LFSAP)] obtained from heart rate and SAP variability. After CEA, both the index α and BRS were higher ( P < 0.02) at rest. SAP variance decreased both at rest and during tilt ( P < 0.02). Before surgery, tilt did not modify the autonomic profile compared with baseline. After CEA, tilt increased LF/HF and LFSAP and reduced HFRR compared with rest ( P < 0.02). Four months after CEA was performed, arterial baroreflex sensitivity was enhanced. Accordingly, the patients' autonomic profile had shifted toward reduced cardiac and vascular sympathetic activation and enhanced cardiac vagal activity. The capability to increase cardiovascular sympathetic activation in response to orthostasis was restored. Baroreceptor sensitivity improvement might play an additional role in the more favorable outcome observed in patients after carotid surgery.

Arterial baroreflex sensitivity and blood pressure variabilities before and after carotid surgery

1991 ◽  
Vol 69 (16) ◽  
pp. 763-768 ◽  
Author(s):  
M. Hirschl ◽  
M. M. Hirschl ◽  
D. Magometschnigg ◽  
B. Liebisch ◽  
O. Wagner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Baroreflex Sensitivity ◽  
Carotid Surgery ◽  
Arterial Baroreflex ◽  
Before And After ◽  
Arterial Baroreflex Sensitivity

Arterial baroreflex sensitivity assessed from phase IV of the Valsalva maneuver

1996 ◽  
Vol 78 (5) ◽  
pp. 575-579 ◽  
Author(s):  
Josef Kautzner ◽  
Juha E.K. Hartikainen ◽  
A.John Camm ◽  
Marek Malik
Keyword(s):  
Baroreflex Sensitivity ◽  
Valsalva Maneuver ◽  
Arterial Baroreflex ◽  
Arterial Baroreflex Sensitivity ◽  
Phase Iv

Attenuation by diltiazem of arterial baroreflex sensitivity in man

1984 ◽  
Vol 26 (6) ◽  
pp. 675-679 ◽  
Author(s):  
J. F. Giudicelli ◽  
A. Berdeaux ◽  
A. Edouard ◽  
F. Lhoste ◽  
C. Richer ◽  
...  
Keyword(s):  
Baroreflex Sensitivity ◽  
Arterial Baroreflex ◽  
Arterial Baroreflex Sensitivity

Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
High Frequency ◽  
Healthy Subjects ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Upright Position ◽  
Vascular Responses ◽  
Autonomic Responses ◽  
Head Up Tilt

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.

scholarly journals Methodological and computational insights on the assessment of arterial baroreflex sensitivity

2019 ◽  
Vol 104 (5) ◽  
pp. 779-780 ◽  
Author(s):  
Theodore G. Papaioannou ◽  
Romanos Fasoulis ◽  
Elias Gialafos ◽  
Dimitrios Tousoulis
Keyword(s):  
Baroreflex Sensitivity ◽  
Arterial Baroreflex ◽  
Arterial Baroreflex Sensitivity

scholarly journals Sympathetic activation is associated with increased IL-6, but not CRP in the absence of obesity: lessons from postural tachycardia syndrome and obesity

2015 ◽  
Vol 309 (12) ◽  
pp. H2098-H2107 ◽  
Author(s):  
Luis E. Okamoto ◽  
Satish R. Raj ◽  
Alfredo Gamboa ◽  
Cyndya A. Shibao ◽  
Amy C. Arnold ◽  
...  
Keyword(s):  
High Frequency ◽  
Low Frequency ◽  
Postural Tachycardia Syndrome ◽  
Sympathetic Activation ◽  
Healthy Individuals ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Postural Tachycardia ◽  
Obese Female ◽  
Sympathetic Modulation

Sympathetic activation is thought to contribute to the inflammatory process associated with obesity, which is characterized by elevated circulating C-reactive protein (hsCRP) and interleukin-6 (IL-6). To evaluate whether sympathetic activation is associated with inflammation in the absence of obesity, we studied patients with postural tachycardia syndrome (POTS), a condition characterized by increased sympathetic tone in otherwise healthy individuals. Compared with 23 lean controls, 43 lean female POTS had greater vascular sympathetic modulation (low-frequency blood pressure variability, LFSBP, 3.2 ± 0.4 vs. 5.5 ± 0.6 mmHg2, respectively, P = 0.006), lower cardiac parasympathetic modulation (high-frequency heart rate variability, 1,414 ± 398 vs. 369 ± 66 ms2, P = 0.001), and increased serum IL-6 (2.33 ± 0.49 vs. 4.15 ± 0.54 pg/ml, P = 0.011), but this was not associated with increases in hsCRP, which was low in both groups (0.69 ± 0.15 vs. 0.82 ± 0.16 mg/l, P = 0.736). To explore the contribution of adiposity to inflammation, we then compared 13 obese female POTS patients and 17 obese female controls to matched lean counterparts (13 POTS and 11 controls). Compared with lean controls, obese controls had increased LFSBP(3.3 ± 0.5 vs. 7.0 ± 1.1 mmHg2; P = 0.016), IL-6 (2.15 ± 0.58 vs. 3.92 ± 0.43 pg/ml; P = 0.030) and hsCRP (0.69 ± 0.20 vs. 3.47 ± 0.72 mg/l; P = 0.001). Obese and lean POTS had similarly high IL-6 but only obese POTS had increased hsCRP (5.76 ± 1.99 mg/l vs. 0.65 ± 0.26; P < 0.001). In conclusion, sympathetic activation in POTS is associated with increased IL-6 even in the absence of obesity. The coupling between IL-6 and CRP, however, requires increased adiposity, likely through release of IL-6 by visceral fat.

scholarly journals Sympathoexcitation and impaired arterial baroreflex sensitivity are linked to vascular inflammation in individuals with elevated resting blood pressure

2019 ◽  
Vol 7 (7) ◽  
pp. e14057 ◽  
Author(s):  
Ida T. Fonkoue ◽  
Ngoc‐Anh Le ◽  
Melanie L. Kankam ◽  
Dana DaCosta ◽  
Toure N. Jones ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Baroreflex Sensitivity ◽  
Vascular Inflammation ◽  
Arterial Baroreflex ◽  
Resting Blood Pressure ◽  
Arterial Baroreflex Sensitivity
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