Circulation, Vol 77, 279-288, Copyright © 1988 by American Heart Association
JS Sanders, DW Ferguson and AL Mark
Arterial baroreceptors in the carotid sinus (CBR) and aortic arch (ABR)
regions exert important control over heart rate and peripheral vascular
responses to changes in arterial pressure. The relative roles of these two
baroreflex pathways on control of sympathetic nerve activity during
sustained elevation of arterial pressure in man is unknown. We therefore
studied the relative contributions of the carotid versus the aortic
baroreflexes on the control of muscle sympathetic nerve activity (MSNA)
during elevation of arterial pressure in normal human subjects. In eight
normal men (group I), we measured MSNA (microneurography) during sustained
elevation of arterial pressure produced by intravenous infusion of
phenylephrine (PE) alone (combined ABR and CBR activation) versus during PE
infusion with superimposed application of sustained external neck pressure
(NP). NP was applied during sustained PE infusion to eliminate the increase
in transmural carotid sinus pressure and thus remove CBR activation,
thereby causing ABR stimulation alone. Mean arterial pressure was measured
directly, central venous pressure was held constant during PE infusion, and
MSNA was measured as total activity (burst frequency X amplitude) and
expressed as units. Infusion of PE (ABR and CBR activation) increased mean
arterial pressure from 87.2 +/- 2.8 to 94.9 +/- 2.9 mm Hg (+/- SE, p less
than .001). This was accompanied by a decrease in heart rate from 65.8 +/-
3.4 to 56.1 +/- 3.3 beats/min (p less than .001) and a decrease in MSNA
from 236.2 +/- 47.5 to 84.5 +/- 19.3 units (p less than .001). During
infusion of PE with superimposed NP (ABR activation alone), mean arterial
pressure increased further to 101.2 +/- 2.9 mm Hg (p less than .001 versus
control or PE alone), and heart rate returned to control levels of 62.9 +/-
2.0 beats/min (p = NS vs control; p less than .01 PE vs PE plus NP), but
MSNA remained reduced at 48.6 +/- 9.2 units (p less than .01 vs control; p
= NS vs PE alone). Thus, combined activation of ABR and CBR resulted in a
65 +/- 5% attenution of MSNA, while activation of ABR alone resulted in a
73 +/- 7% attenuation of MSNA. In a separate series of experiments in seven
subjects (group II) we used sustained external neck suction alone to
activate the CBR (leaving the ABR either unchanged or minimally
deactivated) and studied the MSNA responses to this CBR
activation.(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Arterial baroreflex control of sympathetic nerve activity during elevation of blood pressure in normal man: dominance of aortic baroreflexes
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242.
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