scholarly journals Disturbed Cardiorespiratory Adaptation in Preeclampsia: Return to Normal Stress Regulation Shortly after Delivery?

2019 ◽  
Vol 20 (13) ◽  
pp. 3149 ◽  
Author(s):  
Lackner ◽  
Papousek ◽  
Schmid-Zalaudek ◽  
Cervar-Zivkovic ◽  
Kolovetsiou-Kreiner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Physiological Stress ◽  
Cardiovascular Responses ◽  
Stressful Events ◽  
Severe Preeclampsia ◽  
Stroke Index ◽  
Increased Risk

Women with pregnancies complicated by preeclampsia appear to be at increased risk of metabolic and vascular diseases in later life. Previous research has also indicated disturbed cardiorespiratory adaptation during pregnancy. The aim of this study was to follow up on the physiological stress response in preeclampsia several weeks postpartum. A standardized laboratory test was used to illustrate potential deviations in the physiological stress responding to mildly stressful events of the kind and intensity in which they regularly occur in further everyday life after pregnancy. Fifteen to seventeen weeks postpartum, 35 women previously affected by preeclampsia (19 mild, 16 severe preeclampsia), 38 women after uncomplicated pregnancies, and 51 age-matched healthy controls were exposed to a self-relevant stressor in a standardized stress-reactivity protocol. Reactivity of blood pressure, heart rate, stroke index, and systemic vascular resistance index as well as baroreceptor sensitivity were analyzed. In addition, the mutual adjustment of blood pressure, heart rate, and respiration, partitioned for influences of the sympathetic and the parasympathetic branches of the autonomic nervous system, were quantified by determining their phase synchronization. Findings indicated moderately elevated blood pressure levels in the nonpathological range, reduced stroke volume, and elevated systemic vascular resistance in women previously affected by preeclampsia. Despite these moderate abnormalities, at the time of testing, women with previous preeclampsia did not differ from the other groups in their physiological response patterns to acute stress. Furthermore, no differences between early, preterm, and term preeclampsia or mild and severe preeclampsia were observed at the time of testing. The findings suggest that the overall cardiovascular responses to moderate stressors return to normal in women who experience a pregnancy with preeclampsia a few weeks after delivery, while the operating point of the arterial baroreflex is readjusted to a higher pressure. Yet, their regulation mechanisms may remain different.

Gender differences in cardiovascular responses to the cold hand pressor test and facial cooling

1994 ◽  
Vol 72 (10) ◽  
pp. 1193-1199 ◽  
Author(s):  
R. D. Kilgour ◽  
J. Carvalho
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Cardiovascular Responses ◽  
Pressor Test ◽  
Arterial Blood ◽  
Facial Cooling

To test the hypothesis that changes in systemic vascular resistance (SVR) contribute to the differences in arterial blood pressure responses between men and women to local cold pressor tests, nine normotensive men (25.9 ± 5.9 years old) and women (24.4 ± 5.9 years old) performed the cold hand pressor test (CPT; 6 min in 5 °C water) in the supine position. A subgroup of men (n = 5) and women (n = 5) from the CPT were exposed to 6 min of facial cooling (FC) by circulating cold water (5 °C) through a perfusion mask. Using standard auscultatory techniques, pre-experimental systolic and diastolic blood pressures were found to be significantly higher (p ≤ 0.05) in males than females. During the initial 2 min of CPT and FC, both males and females experienced similar relative increases in pressure. Thereafter, only the males maintained an elevated pressor response, whereas the females progressively declined. The gender-related trends in blood pressure can be explained by differences in SVR, with the males exhibiting significantly greater changes in SVR than females during min 4–6 in CPT. Heart rate increased (p ≤ 0.05) in both groups, with the greater rise occurring in females at each minute of CPT. Throughout FC, the changes in SVR were similar between groups, with the exception of the 6-min value being greater than baseline in men but not women. No differences in heart rate or cardiac output were observed between groups during FC. In general, the results indicate that men respond with greater and more prolonged peripheral adjustments (e.g., rise in SVR), whereas females are more like "cardiac" responders, with greater increases in heart rate and an attenuated blood pressure response to CPT.Key words: cold pressor test, facial cooling, gender, systemic vascular resistance, heart rate.

Cardiovascular reflex responses in Bangladeshi and European subjects

1991 ◽  
Vol 80 (1) ◽  
pp. 39-45 ◽  
Author(s):  
M. A. Rahman ◽  
I. Farquhar ◽  
T. Bennett
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Vascular Resistance ◽  
Cardiovascular Responses ◽  
Mean Blood Pressure ◽  
Valsalva Manoeuvre ◽  
Deep Breathing ◽  
Reflex Responses ◽  
Forearm Vascular Resistance

1. Cardiovascular responses to three different interventions, namely the Valsalva manoeuvre, deep breathing and a cold stimulus on the face, were studied in two ethnic groups (European and Bangladeshi) that have been shown to differ in the prevalence of hypertensive-vascular disease. The data obtained consisted of systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate measured by using a beat-by-beat non-invasive blood pressure monitor (the Finapres), forearm blood flow determined by venous occlusion plethysmography, and calculated forearm vascular resistance. 2. The resting haemodynamic status was similar in European and Bangladeshi subjects. However, Bangladeshi subjects showed a greater increase in heart rate, but only after 20 s into the Valsalva manoeuvre, and greater overshoots in mean blood pressure after the manoeuvre than the European subjects. Furthermore, after cold face stimulation the fall in forearm vascular resistance to baseline levels was delayed in Bangladeshi subjects relative to that in the European subjects. 3. There were no inter-group differences in the reflex bradycardia relative to mean blood pressure or in the cardiac baroreflex sensitivity estimated from systolic blood pressure and pulse interval after the Valsalva manoeuvre. In addition, values for the mean difference between maximum and minimum pulse intervals during deep breathing did not differ in Bangladeshi and European subjects. 4. These findings together suggest that, although cardiac vagal reflex responses appear similar in the two groups, sympatho-adrenal influences on the heart and vasculature may be greater in Bangladeshi subjects than in European subjects.

scholarly journals Hemodynamic Changes Associated with Spinal Anesthesia for Cesarean Delivery in Severe Preeclampsia

2008 ◽  
Vol 108 (5) ◽  
pp. 802-811 ◽  
Author(s):  
Robert A. Dyer ◽  
Jenna L. Piercy ◽  
Anthony R. Reed ◽  
Carl J. Lombard ◽  
Leann K. Schoeman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Stroke Volume ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Severe Preeclampsia

Background Hemodynamic responses to spinal anesthesia (SA) for cesarean delivery in patients with severe preeclampsia are poorly understood. This study used a beat-by-beat monitor of cardiac output (CO) to characterize the response to SA. The hypothesis was that CO would decrease from baseline values by less than 20%. Methods Fifteen patients with severe preeclampsia consented to an observational study. The monitor employed used pulse wave form analysis to estimate nominal stroke volume. Calibration was by lithium dilution. CO and systemic vascular resistance were derived from the measured stroke volume, heart rate, and mean arterial pressure. In addition, the hemodynamic effects of phenylephrine, the response to delivery and oxytocin, and hemodynamics during recovery from SA were recorded. Hemodynamic values were averaged for defined time intervals before, during, and after SA. Results Cardiac output remained stable from induction of SA until the time of request for analgesia. Mean arterial pressure and systemic vascular resistance decreased significantly from the time of adoption of the supine position until the end of surgery. After oxytocin administration, systemic vascular resistance decreased and heart rate and CO increased. Phenylephrine, 50 mug, increased mean arterial pressure to above target values and did not significantly change CO. At the time of recovery from SA, there were no clinically relevant changes from baseline hemodynamic values. Conclusions Spinal anesthesia in severe preeclampsia was associated with clinically insignificant changes in CO. Phenylephrine restored mean arterial pressure but did not increase maternal CO. Oxytocin caused transient marked hypotension, tachycardia, and increases in CO.

scholarly journals Analysis of cardiovascular responses to the H2S donors Na2S and NaHS in the rat

2015 ◽  
Vol 309 (4) ◽  
pp. H605-H614 ◽  
Author(s):  
Daniel Yoo ◽  
Ryan C. Jupiter ◽  
Edward A. Pankey ◽  
Vishwaradh G. Reddy ◽  
Justin A. Edward ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Potassium Channels ◽  
Arterial Pressure ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Vascular Tissue ◽  
Sinus Node ◽  
Cardiovascular Responses ◽  
Systemic Arterial Pressure

Hydrogen sulfide (H2S) is an endogenous gaseous molecule formed from L-cysteine in vascular tissue. In the present study, cardiovascular responses to the H2S donors Na2S and NaHS were investigated in the anesthetized rat. The intravenous injections of Na2S and NaHS 0.03–0.5 mg/kg produced dose-related decreases in systemic arterial pressure and heart rate, and at higher doses decreases in cardiac output, pulmonary arterial pressure, and systemic vascular resistance. H2S infusion studies show that decreases in systemic arterial pressure, heart rate, cardiac output, and systemic vascular resistance are well-maintained, and responses to Na2S are reversible. Decreases in heart rate were not blocked by atropine, suggesting that the bradycardia was independent of parasympathetic activation and was mediated by an effect on the sinus node. The decreases in systemic arterial pressure were not attenuated by hexamethonium, glybenclamide, Nw-nitro-l-arginine methyl ester hydrochloride, sodium meclofenamate, ODQ, miconazole, 5-hydroxydecanoate, or tetraethylammonium, suggesting that ATP-sensitive potassium channels, nitric oxide, arachidonic acid metabolites, cyclic GMP, p450 epoxygenase metabolites, or large conductance calcium-activated potassium channels are not involved in mediating hypotensive responses to the H2S donors in the rat and that responses are not centrally mediated. The present data indicate that decreases in systemic arterial pressure in response to the H2S donors can be mediated by decreases in vascular resistance and cardiac output and that the donors have an effect on the sinus node independent of the parasympathetic system. The present data indicate that the mechanism of the peripherally mediated hypotensive response to the H2S donors is uncertain in the intact rat.

Endogenous substance P modulates human cardiovascular regulation at rest and during orthostatic load

2007 ◽  
Vol 102 (6) ◽  
pp. 2092-2097 ◽  
Author(s):  
Matthew V. Dzurik ◽  
André Diedrich ◽  
Bonnie Black ◽  
Sachin Y. Paranjape ◽  
Satish R. Raj ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Substance P ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Muscle Sympathetic Nerve Activity ◽  
Cardiovascular Regulation ◽  
Postural Adjustment ◽  
Compensatory Mechanisms ◽  
Double Blind

Substance P (SP) is a peptide neurotransmitter identified in many central and peripheral neural pathways. Its precise role in human physiology has been difficult to elucidate. We used the selective neurokinin 1 (NK1) antagonist aprepitant as a pharmacological probe to determine the role of endogenous SP in human cardiovascular regulation. We performed a randomized, double-blind, placebo-controlled, crossover trial in healthy subjects. Blockade of endogenous NK1 receptors reduced resting muscle sympathetic activity 38% ( P = 0.002), reduced systemic vascular resistance by 25% ( P = 0.021), and increased cardiac index by 47% ( P = 0.006). This constellation of changes did not, however, alter either blood pressure or heart rate in the supine position. NK1 antagonism also raised orthostatic heart rate change by 38% ( P = 0.023), although during the incremental postural adjustment on the tilt table neither heart rate nor blood pressure was altered significantly. Despite a mildly attenuated vagal baroreflex with SP blockade, the depressor and pressor responses to nitroprusside and phenylephrine did not differ compared with placebo, suggesting other compensatory mechanisms. NK1 blockade manifests as a decrease in muscle sympathetic nerve activity and systemic vascular resistance. Our study suggests SP exerts a tonic enhancement of sympathetic outflow to some cardiovascular structures via its modulation of the NK1 receptor. Most likely, this ubiquitous neurotransmitter exerts effects at multiple sites that, in the aggregate, are relatively well compensated under many circumstances but may emerge with perturbations. This study is consistent with a role for SP afferents in supporting peripheral vascular resistance.

scholarly journals Blood pressure control during exercise in the Atlantic cod, Gadus morhua

1986 ◽  
Vol 126 (1) ◽  
pp. 225-236 ◽  
Author(s):  
M. Axelsson ◽  
S. Nilsson
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Atlantic Cod ◽  
Plasma Concentrations ◽  
Blood Samples ◽  
Blood Pressures ◽  
Mixed Venous

Atlantic cod were subjected to 12–15 min swimming exercise at 2/3 body lengths s-1 in a Blazka-type swim tunnel. Pre- and postbranchial blood pressures, cardiac output (ventral aortic blood flow) and heart rate were continuously recorded, and blood samples for measurement of arterial and mixed venous oxygen tension were taken before and at the end of the exercise period. In a second group of fish, subjected to similar exercise regimes, blood samples were taken for analysis of the plasma concentrations of catecholamines. Pre- and postbranchial blood pressures and cardiac output increase during exercise, while the mixed venous oxygen tension decreases. The effect on cardiac output is due to an increase of both heart rate and stroke volume. There are no significant changes in either systemic or branchial vascular resistances, or in the plasma concentrations of catecholamines. Injection of the adrenergic neurone-blocking drug bretylium produces a decrease in postbranchial blood pressure in resting cod, due to a decrease in the systemic vascular resistance. Exercising cod treated with bretylium have a significantly lower pre- and postbranchial blood pressure than exercising control cod. This is due mainly to a dramatic reduction in the systemic vascular resistance. The alpha-adrenoceptor antagonist phentolamine does not further affect the blood pressure in cod treated with bretylium. It is concluded that the exercise hypertension observed in cod depends on the effect of adrenergic vasomotor fibres maintaining the systemic vascular resistance, and also on the increase in cardiac output. An adrenergic innervation of the heart may play some role in the control of cardiac performance both at rest and during exercise, but the main cardioregulatory mechanism is likely to be non-adrenergic, most probably including cardiac control via variation of the cholinergic vagal cardioinhibitory tonus.

Cardiovascular Responses to the Intracarotid Injections of Ionic Contrast Media and Iohexol in the Dog

1986 ◽  
Vol 27 (6) ◽  
pp. 729-733 ◽  
Author(s):  
K. Hayakawa ◽  
T. W. Morris ◽  
R. W. Katzberg ◽  
H. W. Fischer
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Nervous System ◽  
Contrast Media ◽  
Vascular Resistance ◽  
Isotonic Saline ◽  
Cardiovascular Responses ◽  
Systemic Blood Pressure ◽  
Ionic Contrast ◽  
S Period

Hypotension and bradycardia are the most significant cardiovascular responses resulting from intracarotid injections of hypertonic contrast media (CM). We have assessed both local and systemic vascular responses to the selective intracarotid injections of ionic and non-ionic CM in twelve pentobarbital anesthetized dogs. Alterations in blood pressure, heart rate, and femoral, renal and carotid blood flows were monitored following right common carotid artery injections of ionic contrast media (282–288 mg I/ml), isotonic saline, and iohexol (300 mg I/ml). Ionic CM led to early (0 to 10 s) decreases in blood pressure, heart rate and femoral vascular resistance. Isotonic saline induced no significant early changes in these same parameters while iohexol caused a decrease in heart rate. Our observations suggest that the early (0 to 10 s) decreases in femoral vascular resistance, heart rate and pressure that occur with the intracarotid injection of hypertonic CM are mediated via the autonomic nervous system and initiated from a site in the carotid circulation. During the 15 to 40 s period when the CM has reached the systemic circulation, iohexol produced smaller effects on systemic blood pressure and peripheral vascular resistances than did the ionic CM. During this 15 to 40 s period there were decreased vascular resistances in the carotid and renal vascular beds that probably result from local effects of the CM, however, the femoral resistance was actually increased. This later increase in femoral resistance probably represents the results of increased sympathetic nervous system activity working to offset the decrease in renal and carotid resistances and thus maintain pressure at baseline values. The vascular resistance changes observed demonstrate a complexity of responses to CM not previously appreciated.

Central and regional hemodynamic effects during infusion of Big endothelin-1 in healthy humans

1996 ◽  
Vol 80 (6) ◽  
pp. 1921-1927 ◽  
Author(s):  
G. Ahlborg ◽  
A. Ottosson-Seeberger ◽  
A. Hemsen ◽  
J. M. Lundberg
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Systemic Vascular Resistance ◽  
Arterial Blood Pressure ◽  
Vascular Resistance ◽  
Mean Arterial Blood Pressure ◽  
Endothelin 1 ◽  
Healthy Humans ◽  
Arterial Blood

Big endothelin-1 (Big ET-1) was given intravenously to six healthy men to study uptakes and vascular effects. Blood samples were taken from systemic and pulmonary arterial and internal jugular and deep forearm venous catheters. Arterial Big ET-1-like immunoreactivity (Big ET-1-LI) increased from 5.43 +/- 0.60 to 756 +/- 27 pmol/l, and ET-1-LI increased from 4.67 +/- 0.08 to 6.67 +/- 0.52 pmol/l (P < 0.001). Skeletal muscle fractional extraction of Big ET-1-LI was 15 +/- 4%. ET-1-LI release did not increase in the studied vascular beds. Heart rate fell by 17% (P < 0.001), cardiac output fell by 26% (P < 0.001), and stroke volume fell by 11% (P < 0.05). Mean arterial blood pressure increased 18%, systemic vascular resistance increased 65%, and pulmonary vascular resistance increased 57% (P < 0.01-0.001). Pulmonary blood pressures, forearm blood flow, arterial pH, arterial PCO2, and systemic arterial-internal jugular venous O2 difference remained unchanged. No specific Big ET-1 receptors were found in human pulmonary membranes. The half-maximal inhibitory concentration for the receptor antagonist bosentan was 181 nM. In summary, circulating Big ET-1 elicits greater increases in mean arterial blood pressure and systemic vascular resistance and decreases in heart rate and cardiac output compared with an equimolar ET-1 infusion (26).

Baroreflex function in endurance- and static exercise-trained men

1988 ◽  
Vol 64 (2) ◽  
pp. 585-591 ◽  
Author(s):  
M. L. Smith ◽  
H. M. Graitzer ◽  
D. L. Hudson ◽  
P. B. Raven
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Vascular Resistance ◽  
Forearm Blood Flow ◽  
Lower Body Negative Pressure ◽  
Correlation Coefficients ◽  
Cardiovascular Responses ◽  
Cross Sectional ◽  
Baroreflex Function

The effect of exercise training mode on reflex cardiovascular control was studied in a cross-sectional design. We examined the cardiovascular responses to progressive incremental phenylephrine (PE) infusion to maximal rates of 120 micrograms/min and the delta heart rate/delta blood pressure responses to lower body negative pressure (LBNP) to -50 Torr in 30 men who were either endurance exercise trained (ET), untrained (UT), or weight trained (WT). During PE infusion, measures of blood pressures, forearm blood flow, heart rate and cardiac output, and calculations of forearm vascular resistance, stroke volume, and peripheral vascular resistance were made at each infusion rate when steady-state blood pressure was attained. No significant differences (P less than 0.05) in forearm blood flow or resistance were observed between the groups at any dose of PE, suggesting that the vasoconstrictor response was similar among the groups. Regression analyses of heart rate against mean blood pressure during the PE infusion were performed to evaluate baroreflex function. A linear model was used and correlation coefficients ranging from 0.82 to 0.96 were obtained (P less than 0.05). The slope of the line of best fit for the ET subjects (-0.57) was significantly less (P less than 0.05) than the slopes obtained for either the UT (-0.91) or WT (-0.88) subjects. In addition, the delta heart rate/delta blood pressure measurements obtained during LBNP reflected a similarly significant attenuation of reflex chronotropic control in the ET subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemodynamic response to converting enzyme inhibition at rest and exercise in humans

1982 ◽  
Vol 53 (3) ◽  
pp. 576-581 ◽  
Author(s):  
R. Fagard ◽  
P. Lijnen ◽  
L. Vanhees ◽  
A. Amery
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Uptake ◽  
Arterial Pressure ◽  
Plasma Renin Activity ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Plasma Renin ◽  
Peak Oxygen Uptake ◽  
Converting Enzyme

The response of the systemic circulation to acute inhibition of the converting enzyme with 25 mg of oral Captopril (Squibb) was studied in six normal sodium-replete male volunteers at rest and during exercise, together with its effects on exercise capacity for graded uninterrupted exercise. In recumbent subjects at rest Captopril did not affect arterial pressure or heart rate, and plasma renin activity rose 2.5-fold (P less than 0.05). In subjects in the sitting position, at rest and during exercise until exhaustion, Captopril reduced mean brachial intra-arterial pressure by an average of 7 Torr in comparison to placebo (P less than 0.001). Captopril's hypotensive effect was caused by a reduction of systemic vascular resistance (P less than 0.01), without changes of cardiac output (measured by CO2 rebreathing), heart rate, or stroke volume. Plasma renin activity was significantly higher during Captopril (P less than 0.001). Peak oxygen uptake and exercise duration were the same after administration of Captopril or placebo. The data demonstrate that the renin-angiotensin system is not involved in the homeostasis of blood pressure in supine sodium-replete humans, but has a modest role in blood pressure regulation when posture is changed from supine to upright. The orthostatic effect of Captopril is maintained during upright exercise. Furthermore the reduction of systemic vascular resistance by Captopril does not affect peak oxygen uptake.

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