Document Detail


Vagal Heart Rate Control in Patients with Atrial Fibrillation: Impact of Tonic Activation of Peripheral Chemosensory Function in Heart Failure.
MedLine Citation:
PMID:  22826079     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Heart failure (HF) and atrial fibrillation (AF), emerging as two epidemics of the twenty-first century, are commonly associated with each other. Both have been mechanistically linked to changes in cardiac vagal control. The importance of peripheral chemosensors, located in the carotid body, has not been elucidated so far. We therefore investigated whether tonic activation of excitatory chemoreceptor afferents contributes to the altered vagal control in HF patients with a history of AF. In 18 patients (72 ±9 year, 7 male) with sinus rhythm and a history of AF (n=9, without any evidence of structural heart disease, AF group; n=9 with structural heart disease and clinical presentation of HF, AFHF group) we investigated the impact of chemosensory deactivation (by breathing 100% oxygen) on heart rate, blood pressure, cardiac output, total peripheral resistance, oxygen saturation and breathing rate. Ten healthy individuals served as a control group. In addition, we performed a deep breathing test demonstrating an impaired heart rate variation in patients with and without HF as compared with controls (expiration/inspiration difference: 23.9±6.9 vs. 6.9±6.1 bpm, and 23.9±6.9 vs. 7.8±4.8 bpm; p<0.05). In both control and AF groups, heart rate decreased during chemoreceptor deactivation (control: -4.8±3.4%; AF: -5.1±3.0%; p<0.05), whereas heart rate did not change in AFHF patients. This resulted in impaired cardiac chemoreflex sensitivity in AFHF patients (1.9±1.6 vs. 0.5±1.2 ms/mmHg; p<0.05). In conclusion, our data suggest that tonic activation of excitatory chemoreceptor afferents contributes to a low vagal tone in heart failure patients with a history of AF (Clinical Trials NCT01262508).
Authors:
T Drexel; C Eickholt; J Mühlsteff; A Ritz; M Siekiera; K Kirmanoglou; V Schulze; D-I Shin; J Balzer; T Rassaf; M Kelm; C Meyer
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Advances in experimental medicine and biology     Volume:  755     ISSN:  0065-2598     ISO Abbreviation:  -     Publication Date:  2013  
Date Detail:
Created Date:  2012-7-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0121103     Medline TA:  Adv Exp Med Biol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  287-297     Citation Subset:  -    
Affiliation:
Division of Cardiology, Pulmonology and Vascular Medicine, Department of Medicine, University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
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