Balance between cardiac output and sympathetic nerve activity in resting humans: role in arterial pressure regulation

Charkoudian, Nisha; Joyner, Michael J.; Johnson, C. P.; Eisenach, John H.; Dietz, Niki M.; Wallin, B. Gunnar

doi:10.1113/jphysiol.2005.090076

Cited by 215 publications

(272 citation statements)

References 29 publications

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“…Individuals with an upper body fat distribution pattern demonstrate a lower cardiac output and higher systemic vascular resistance compared with individuals with a lower body fat distribution pattern (Jern, 1992). These observations are consistent with recent findings by Charkoudian et al (Charkoudian et al, 2005) which suggest that there is balance between cardiac output and MSNA among healthy, normotensive individuals. Those individuals with a lower cardiac output exhibit higher levels of MSNA at rest.…”

Section: Potential Consequences Of Sympathetic Nervous System Activatsupporting

confidence: 83%

Sympathetic nervous system behavior in human obesity

Davy

Orr

2009

Neuroscience & Biobehavioral Reviews

143

121

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The sympathetic nervous system (SNS) plays an essential role in the regulation of metabolic and cardiovascular homeostasis. Low SNS activity has been suggested to be a risk factor for weight gain and obesity development. In contrast, SNS activation is characteristic of a number of metabolic and cardiovascular diseases that occur more frequently in obese individuals. Until recently, the relation between obesity and SNS behavior has been controversial because previous approaches for assessing SNS activity in humans have produced inconsistent findings. Beginning in the early 1990's, many studies using state of the art neurochemical and neurophysiological techniques have provided important insight. The purpose of the present review is to provide an overview of our current understanding of the regional specific alterations in SNS behavior in human obesity. We will discuss findings from our own laboratory which implicate visceral fat as an important depot linking obesity with skeletal muscle SNS activation. The influence of weight change on SNS behavior and the potential mechanisms and consequences of region specific SNS activation in obesity will also be considered.

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Section: Potential Consequences Of Sympathetic Nervous System Activatsupporting

confidence: 83%

Sympathetic nervous system behavior in human obesity

Davy

Orr

2009

Neuroscience & Biobehavioral Reviews

143

121

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“…Baroreceptor activation underlies repeated inhibition of muscle sympathetic nerve activity occurring during each cardiac cycle (32). Importantly, cardiac output provides a superior between-subject index of baroreceptor activation, which may be independent of systolic blood pressure differences (33). Our findings extend neuroimaging observations of central baroreflex responses (16,27) to show a direct modulation of cortical activity by afferent baroreceptor information within each cardiac cycle.…”

Section: Discussionsupporting

confidence: 73%

A cortical potential reflecting cardiac function

Gray

Taggart

Sutton

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

187

132

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Emotional trauma and psychological stress can precipitate cardiac arrhythmia and sudden death through arrhythmogenic effects of efferent sympathetic drive. Patients with preexisting heart disease are particularly at risk. Moreover, generation of proarrhythmic activity patterns within cerebral autonomic centers may be amplified by afferent feedback from a dysfunctional myocardium. An electrocortical potential reflecting afferent cardiac information has been described, reflecting individual differences in interoceptive sensitivity (awareness of one's own heartbeats). To inform our understanding of mechanisms underlying arrhythmogenesis, we extended this approach, identifying electrocortical potentials corresponding to the cortical expression of afferent information about the integrity of myocardial function during stress. We measured changes in cardiac response simultaneously with electroencephalography in patients with established ventricular dysfunction. Experimentally induced mental stress enhanced cardiovascular indices of sympathetic activity (systolic blood pressure, heart rate, ventricular ejection fraction, and skin conductance) across all patients. However, the functional response of the myocardium varied; some patients increased, whereas others decreased, cardiac output during stress. Across patients, heartbeat-evoked potential amplitude at left temporal and lateral frontal electrode locations correlated with stress-induced changes in cardiac output, consistent with an afferent cortical representation of myocardial function during stress. Moreover, the amplitude of the heartbeat-evoked potential in the left temporal region reflected the proarrhythmic status of the heart (inhomogeneity of left ventricular repolarization). These observations delineate a cortical representation of cardiac function predictive of proarrhythmic abnormalities in cardiac repolarization. Our findings highlight the dynamic interaction of heart and brain in stress-induced cardiovascular morbidity. afferent homeostatic feedback ͉ electroencephalography ͉ heart beat-evoked potential ͉ insula cortex ͉ ischemia

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“…Several studies in heart failure patients show that sympathetic hyperactivity is triggered by lower BRS 33, 34, 35. We observed that spontaneous BRS is decreased either BRS+ or BRS− in patients with RCM.…”

Section: Discussionsupporting

confidence: 49%

Cardiac and peripheral autonomic control in restrictive cardiomyopathy

et al. 2017

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AimsAutonomic dysfunction determines the advance of dilated cardiomyopathy (DCM) and is related to poor outcomes. However, this autonomic imbalance is unknown in patients with restrictive cardiomyopathy (RCM) even though they have similar symptoms and poor quality of life as DCM patients have. The aim of this study was to evaluate if autonomic and neurovascular controls were altered in RCM patients.Methods and resultsFifteen RCM patients, 10 DCM patients, and 10 healthy subjects were evaluated. Heart rate and blood pressure (BP) were recorded. Peripheral sympathetic activity [muscle sympathetic nerve activity (MSNA)] by microneurography and cardiac sympathetic activity by power spectrum analysis of heart rate variability. Spontaneous baroreflex sensitivity (BRS) was evaluated by the sequence method and forearm blood flow by venous occlusion plethysmography. Both cardiomyopathy groups had higher MSNA frequency (P < 0.001) and MSNA incidence (P < 0.001), higher cardiac sympathovagal balance (P < 0.02), reduced BRS for increase (P = 0.002) and for decrease in BP (P = 0.002), and lower forearm blood flow (P < 0.001) compared with healthy subjects. We found an inverse correlation between BRS for increase and decrease in BP and peripheral sympathetic activity (r = −0.609, P = 0.001 and r = −0.648, P < 0.001, respectively) and between BRS for increase and decrease in BP and cardiac sympathetic activity (r = −0.503, P = 0.03 and r = −0.487, P = 0.04, respectively).ConclusionsThe RCM patients had cardiac and peripheral autonomic dysfunctions associated with peripheral vasoconstriction. Nonetheless, the presence of normal ejection fraction underestimates the evolution of the disease and makes clinical treatment difficult. These alterations could lead to a similar cardiovascular risk as that observed in DCM patients.

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Balance between cardiac output and sympathetic nerve activity in resting humans: role in arterial pressure regulation

Cited by 215 publications

References 29 publications

Sympathetic nervous system behavior in human obesity

Sympathetic nervous system behavior in human obesity

A cortical potential reflecting cardiac function

Cardiac and peripheral autonomic control in restrictive cardiomyopathy

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