Piezopulsometric analysis of autonomic regulation of the cardiovascular system in an elderly person under stress

Author(s):  
В.П. Нестеров ◽  
А.И. Бурдыгин ◽  
К.Б. Иванов ◽  
С.В. Нестеров ◽  
С.И. Сороко

Описаны результаты применения нового метода артериальной пьезопульсометрии для неинвазивной оценки функционального состояния и физиологических механизмов автономной регуляции сердечно-сосудистой системы (ССС) у пожилого человека при острой боли, связанной с неожиданной физической травмой. Такое воздействие в первый же день вызвало негативную стресс-реакцию в мышечных эффекторах (МЭ) ССС, провоцируя аномальное усиление и ускорение сократимости миокарда ЛЖ сердца. Анализ графиков волн пульсового АД крови (ПАДК) показал, что максимальная скорость прироста ПАДК - VmaxPP, отражающая сократительную способность миокарда, выросла с 625±74 перед травмой до 2 117±173 мм рт. ст./с после травмы, исказив контур нормального графика. Причиной этого роста могло быть быстрое суммарное воздействие трансмиттеров нейроэндокринной симпатико-адреналовой системы на адренорецепторы кардиомиоцитов. Результаты спектрального анализа вариабельности параметров волн ПАДК подтвердили такую возможность. Было показано, что при стрессе норадреналин из активированных симпатических эфферентов добавляется к характерному для пожилых людей уже повышенному содержанию гуморальных катехоламинов в межклеточной среде миокарда вблизи адренорецепторов кардиомиоцитов. При этом существенно возрастает активность парасимпатических эфферентов, выделяющих ацетилхолин, ингибирующий контрактильную реакцию миокарда и тем самым выполняющий сдерживающую кардиопротекторную функцию. При исследовании механизмов автономной регуляции МЭ ССС в условиях стрессорного воздействия использовали персонализированный подход. The article describes the results of using the method of arterial piezopulsometry for non-invasive assessment of the functional state and physiological mechanisms of autonomous regulation of the cardiovascular system (CVS) in an elderly person with acute pain associated with unexpected physical trauma. On the first day, such an effect caused a negative stress reaction in the muscle effectors (ME) of the CVS, provoking an abnormal increase and acceleration of the contractility of the left ventricular myocardium. Analysis of the arterial blood pressure (PP) pulse wave graphs showed that the maximum rate of PP growth - VmaxPP, which reflects myocardial contractility, increased from 625±74 before injury to 2 117±173 mm Hg/s after injury, distorting the contour of the normal PP waveform. The reason for this growth could be the rapid cumulative effect of transmitters of the neuroendocrine sympathoadrenal system on adrenergic receptors (AR) of cardiomyocytes (CM). The results of the spectral analysis of the variability of the parameters of the PP waves confirmed this possibility. It was shown that under stress, norepinephrine from activated sympathetic efferents is added to the already increased content of humoral catecholamines in the extracellular environment of the myocardium near the AR of the CM, which is characteristic of the elderly. At the same time, the activity of parasympathetic efferents, releasing acetylcholine, which inhibits the contractile reaction of the myocardium and, thereby, performs a restraining cardioprotective function, significantly increases. A personalized approach was used for piezopulsometric study of the mechanisms of autonomous regulation of ME CVS under specific conditions of stress.

Author(s):  
Л.М. Кожевникова ◽  
И.Б. Цорин ◽  
Е.О. Ионова ◽  
В.В. Барчуков ◽  
Т.Д. Никифорова ◽  
...  

Цель исследования - изучение гендерных различий в сердечно-сосудистой системе у крыс c алкогольной кардиомиопатией. Методика. Алкогольную кардиомиопатию у крыс воспроизводили, предоставляя им в качестве единственного источника питья 10%-ный водный раствор этилового спирта в течение 24 нед. Для оценки размеров левого желудочка сердца и его инотропной функции использовали эхокардиографию. С помощью полимеразной цепной реакции «в реальном времени» определяли экспрессию ряда рецепторов и регуляторных белков в миокарде левого желудочка и грудной аорте. Результаты. Сравнительный анализ показал, что у интактных самок по сравнению с самцами размеры левого желудочка сердца значительно меньше, в то время как фракции укорочения и выброса выше. Принудительная алголизация в течение 24-х нед как у самцов, так и у самок вызывает развитие алкогольной кардиомиопатии, эхокардиографически проявляющейся увеличением размеров левого желудочка сердца и угнетением его сократительной функции. Однако у самок увеличение размеров левого желудочка выражено в значительно большей степени. В биоптатах левого желудочка сердца животных обоего пола изменения уровня экспрессии мРНК рецепторов эндогенных трансмиттеров: катехоламинов (β1- и β2-AR), ангиотензина II (AT1A-R), эндотелина-1 (ETA-R) и регуляторных белков (Eрас1, Ерас2 и CaM) при алкогольной кардиомиопатии носит однонаправленный характер. В аорте самок повышается экспрессия мРНК ключевых вазоконстрикторных рецепторов (α1-R, ETA-R, VIA-R, AT1A-R), тогда как в аорте самцов, напротив снижается. Заключение. Таким образом, как у самок, так и самцов крыс 24-недельное систематическое потребление алкоголя приводит к формированию алкогольной кардиомиопатии, однако у самок выявленные патологические изменения прогностически более неблагоприятны. Aim. To study sex-related differences of changes in the cardiovascular system in rats with alcoholic cardiomyopathy (AСMP). Methods. Alcoholic cardiomyopathy was induced in rats by offering them a 10% aqueous solution of ethyl alcohol as the only source of fluid for 24 weeks. Echocardiography was used to assess the size and inotropic function of the left ventricle. Expression of receptors and regulatory proteins in the left ventricular myocardium and thoracic aorta was determined using real-time polymerase chain reaction. Results. Comparative analysis showed that the left ventricle was much smaller in intact females than in males whereas shortening and ejection fractions of the female left ventricle were greater. Forced alcoholization for 24 weeks induced ACMP in both males and females, which was evident on echocardiogram as enlargement of the left ventricle and depression of its contractility. However, the increase in left ventricular size was considerably more pronounced in females. In biopsy samples of the left ventricle, the expression of mRNA of genes for endogenous transmitter receptors [catecholamines (β1 and β2-AR), angiotensin II (AT1-R), endothelin-1 (ETA-R) and regulatory proteins (Epac1, Epac2 and CaM) changed in the same direction in both males and females. The mRNA expression of key vasoconstrictor receptor genes (α1-R, VIA-R, ATIA-R) was increased in the female aorta but reduced in the male aorta. Conclusion. In both female and male rats, the 24-week alcohol consumption on a regular basis resulted in ACMP; however, in females, pathological changes were prognostically more adverse.


2021 ◽  
Vol 34 (3) ◽  
pp. 299-299
Author(s):  
Yu Feng ◽  
Man-li Zhou ◽  
Jian-zhang Wang ◽  
Jia-qi Zhang ◽  
Shu-le Qian ◽  
...  

Abstract Background To investigate the effects of telmisartan on the protein profiles of the left ventricular myocardium in spontaneously hypertensive rats (SHR). Methods Sixteen SHR were randomly divided into control and telmisartan treatment groups. Rats were treated with sterile water (10 ml/kg) or telmisartan (4.33 mg/kg) by gavage for 12 weeks. Wistar-Kyoto (WKY) rats treated with sterile water (10 ml/kg) as controls. At the end of 12 weeks of control or telmisartan treatment, rats were sacrificed, and hearts were collected for protein preparations, isotope labeling, and mass spectrometric analysis. Results In total, there were 23 differentially expressed proteins in the left ventricular myocardium between control and telmisartan treatment groups in SHR. Compared with the telmisartan group, the upregulated proteins in the SHR were dual-specificity mitogen-activated protein kinase kinase 3-like, transgelin, and haptoglobin subtype 2. The downregulated proteins in the SHR were as follows: von Willebrand factor (fragment), kininogen 1, small ribonucleoprotein-related protein, fibrinogen beta chain, protein mass 3 (fragment), proteasome 26s, heat shock protein 27-related protein 1, tenascin X, fibronectin subtype 2, transferrin receptor protein, platelets 1, cathepsin L1, complement factor B, isoform CRA_b, fibrinogen isomer, immunoglobulin heavy chain (γ polypeptide), and α 1 antiprotease. Conclusions Telmisartan differentially regulates myocardial protein expression in hypertensive rats including heat shock protein 27, fibrinogen, fibronectin, proteasome 26s and transgelin, as well as proteins in biochemical, metabolic, and signal transduction pathways. These changes in protein expression may contribute to the antihypertrophic effects of telmisartan in hypertension.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yankun Lyu ◽  
Vipin K. Verma ◽  
Younjee Lee ◽  
Iosif Taleb ◽  
Rachit Badolia ◽  
...  

AbstractIt is well established that the aging heart progressively remodels towards a senescent phenotype, but alterations of cellular microstructure and their differences to chronic heart failure (HF) associated remodeling remain ill-defined. Here, we show that the transverse tubular system (t-system) and proteins underlying excitation-contraction coupling in cardiomyocytes are characteristically remodeled with age. We shed light on mechanisms of this remodeling and identified similarities and differences to chronic HF. Using left ventricular myocardium from donors and HF patients with ages between 19 and 75 years, we established a library of 3D reconstructions of the t-system as well as ryanodine receptor (RyR) and junctophilin 2 (JPH2) clusters. Aging was characterized by t-system alterations and sarcolemmal dissociation of RyR clusters. This remodeling was less pronounced than in HF and accompanied by major alterations of JPH2 arrangement. Our study indicates that targeting sarcolemmal association of JPH2 might ameliorate age-associated deficiencies of heart function.


2021 ◽  
Vol 8 (2) ◽  
pp. 9
Author(s):  
Nina C. Wunderlich ◽  
Siew Yen Ho ◽  
Nir Flint ◽  
Robert J. Siegel

The morphological changes that occur in myxomatous mitral valve disease (MMVD) involve various components, ultimately leading to the impairment of mitral valve (MV) function. In this context, intrinsic mitral annular abnormalities are increasingly recognized, such as a mitral annular disjunction (MAD), a specific anatomical abnormality whereby there is a distinct separation between the mitral annulus and the left atrial wall and the basal portion of the posterolateral left ventricular myocardium. In recent years, several studies have suggested that MAD contributes to myxomatous degeneration of the mitral leaflets, and there is growing evidence that MAD is associated with ventricular arrhythmias and sudden cardiac death. In this review, the morphological characteristics of MAD and imaging tools for diagnosis will be described, and the clinical and functional aspects of the coincidence of MAD and myxomatous MVP will be discussed.


2014 ◽  
Vol 112 (11) ◽  
pp. 951-959 ◽  
Author(s):  
Morten Eriksen ◽  
Arnfinn Ilebekk ◽  
Alessandro Cataliotti ◽  
Cathrine Rein Carlson ◽  
Torstein Lyberg ◽  
...  

SummaryBradykinin (BK) receptor-2 (B2R) and β2-adrenergic receptor (β2AR) have been shown to form heterodimers in vitro. However, in vivo proofs of the functional effects of B2R-β2AR heterodimerisation are missing. Both BK and adrenergic stimulation are known inducers of tPA release. Our goal was to demonstrate the existence of B2R-β2AR heterodimerisation in myocardium and to define its functional effect on cardiac release of tPA in vivo. We further investigated the effects of a non-selective β-blocker on this receptor interplay. To investigate functional effects of B2R-β2AR heterodimerisation (i. e. BK transactivation of β2AR) in vivo, we induced serial electrical stimulation of cardiac sympathetic nerves (SS) in normal pigs that underwent concomitant BK infusion. Both SS and BK alone induced increases in cardiac tPA release. Importantly, despite B2R desensitisation, simultaneous BK infusion and SS (BK+SS) was characterised by 2.3 ± 0.3-fold enhanced tPA release compared to SS alone. When β-blockade (propranolol) was introduced prior to BK+SS, tPA release was inhibited. A persistent B2R-β2AR heterodimer was confirmed in BK-stimulated and nonstimulated left ventricular myocardium by immunoprecipitation studies and under non-reducing gel conditions. All together, these results strongly suggest BK transactivation of β2AR leading to enhanced β2AR-mediated release of tPA. Importantly, non-selective β-blockade inhibits both SS-induced release of tPA and the functional effects of B2R-β2AR heterodimerisation in vivo, which may have important clinical implications.


Medicina ◽  
2010 ◽  
Vol 46 (3) ◽  
pp. 193 ◽  
Author(s):  
Sigita Glaveckaitė ◽  
Kęstutis Ručinskas ◽  
Jelena Čelutkienė ◽  
Vytė Maneikienė ◽  
Diana Zakarkaitė ◽  
...  

Isolated noncompaction of the ventricular myocardium is defined as a rare cardiomyopathy caused by intrauterine arrest of compaction of the myocardial fibers and meshwork, an important process in myocardial development, in absence of any coexisting congenital heart lesions. A lot of controversies exist about diagnostic criteria, nomenclature, origin, pathogenesis, and prognosis of this disease. Here, we describe an adult patient with isolated left ventricular noncompaction who presented with worsening congestive heart failure and was successfully treated with heart transplantation.


Author(s):  
Wojciech Tański ◽  
Paweł Gać ◽  
Angelika Chachaj ◽  
Małgorzata Sobieszczańska ◽  
Rafał Poręba ◽  
...  

Abstract Background The aim of the study was to assess the relationship between the occurrence of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and the cardiac magnetic resonance (CMR) changes in people without clinically overt heart disease. Methods The study group consisted of 74 people (48.81 ± 11.35 years): 29 patients with RA, 23 patients with AS and 22 people from control group. Blood samples were taken to assess laboratory parameters, disease activity was determined using activity scales, and CMR was performed. Results It was shown that the factors independently related to higher left ventricular mass index are AS occurrence, human B27 leukocyte antigen occurrence, higher neutrophil gelatinase–associated lipocalin concentration (NGAL) and higher body mass index (BMI). The lower right ventricular ejection fraction is result of an independent effect of RA, AS and higher NGAL. RA presence, methotrexate use, higher rheumatoid factor titer, higher NGAL, older age and higher BMI should be considered independent risk factors for greater left ventricular myocardium water content. RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher C-reactive protein concentration can be independently associated with a higher probability of non-ischemic left ventricular myocardium injury. Larger pericardial fluid volume is result of an independent effect of higher NGAL, higher anti-cyclic citrullinated peptide antibodies titer and higher DAS28 disease activity index. Use of steroids is protective factor against larger volume of pericardial fluid. Conclusions RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR. Key Points•RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR..•The independent risk factors for higher LVEF are AS occurrence, human B27 leukocyte antigen occurrence, higher NGAL concentration and higher BMI..•RA presence, methotrexate use, higher RF, higher NGAL, older age and higher BMI are independent risk factors for higher LV T2 ratio..•RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher CRP are independently associated with a higher risk of non-ischemic LV myocardium injury..


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