Document Detail


Peripheral chemoreflex activation contributes to sympathetic baroreflex impairment in chronic heart failure.
MedLine Citation:
PMID:  22241144     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Chemoreflex-mediated sympathetic activation contributes to both initiation and progression of chronic heart failure (CHF). METHOD:: To study the direct role of increased peripheral chemosensitivity in reducing sympathetic baroreflex function in CHF patients, we compared sympathetic baroreflex function, assessed by the slope of the relationship between muscle sympathetic nerve activity (MSNA) and DBP, in CHF patients with augmented (n = 18) and normal (n = 20) peripheral chemosensitivity. Using a double-blind, randomized, vehicle-controlled study, we examined the effect of chemoreflex deactivation (by breathing 100% oxygen for 15 min) on sympathetic baroreflex function in CHF patients with elevated and with normal chemosensitivity. RESULTS:: Baseline MSNA was elevated (60.6 ± 3.2 vs. 48.9 ± 3.7 bursts/min, P < 0.05) and sympathetic baroreflex function impaired (3.06 ± 0.55 vs. 5.51 ± 0.69 %bursts/mmHg, P < 0.05) in CHF patients with augmented peripheral chemosensitivity compared with controls. Administration of 100% oxygen led to a significant decrease in MSNA (from 60.5 ± 3.2 to 52.6 ± 3.2 bursts/min, P < 0.001) and increase in sympathetic baroreflex (from 2.95 ± 0.56 to 6.18 ± 0.77, P < 0.001) in CHF patients with enhanced chemoreflex sensitivity. In contrast, neither room air nor 100% oxygen changed MSNA, hemodynamics or sympathetic baroreflex function in CHF patients with normal chemosensitivity. CONCLUSION:: We report for the first time that increased peripheral chemoreflex sensitivity directly decreases sympathetic baroreflex function in CHF patients. This interaction contributes to sympathetic overactivity and blunted sympathetic baroreflex function of CHF patients and may explain how chemoreceptors contribute to the bad prognosis of CHF patients.
Authors:
Fabien Despas; Elisabeth Lambert; Angelica Vaccaro; Marc Labrunee; Nicolas Franchitto; Marine Lebrin; Michel Galinier; Jean-Michel Senard; Gavin Lambert; Murray Esler; Atul Pathak
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-11
Journal Detail:
Title:  Journal of hypertension     Volume:  -     ISSN:  1473-5598     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aInstitut National de la Sante et de la Recherche Médicale, UMR-1048, Institut des Maladies Métaboliques et Cardiovasculaires bUniversité de Toulouse III Paul Sabatier cDepartment of Clinical Pharmacology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France dHuman Neurotransmitter Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia eDepartment of Cardiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
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