Effects of oral pirenzepine on heart rate variability and baroreceptor reflex sensitivity after acute myocardial infarction

Pedretti, Roberto F.E.; Colombo, Enrica; Braga, Simona Sarzi; Ballardini, Luigi; Carù, B

doi:10.1016/0735-1097(94)00468-6

Cited by 20 publications

(7 citation statements)

References 26 publications

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“…Pirenzepine, a muscarinic blocker, has been previously shown to posses paradoxical vagomymetic effect in small doses, due to its predominant action on presynaptic M1 receptors. 6,7 In our study, pirenzepine given intravenously in small dose significantly increases cycle length, increases TS, and decreases TO, which is a likely effect of increased vagal tone.…”

Section: Discussionsupporting

confidence: 51%

Effects of Atropine and Pirenzepine on Heart Rate Turbulence

Vukajlović

Guettler

Mirić

et al. 2006

Noninvasive Electrocardiol

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Section: Discussionsupporting

confidence: 51%

Effects of Atropine and Pirenzepine on Heart Rate Turbulence

Vukajlović

Guettler

Mirić

et al. 2006

Noninvasive Electrocardiol

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“…Indeed, catecholamine release proved to modulate cell responsiveness to excitatory and inhibitory inputs as suggested in a neural network model by Servan-Schreiber and colleagues (39). In this context, we speculate that the repetition of mechanical stimulation of the feet every 48 -72 h, combined with a pharmacological strategy aimed at further reducing vascular sympathetic drive at rest by increasing parasympathetic activity and baroreceptor gain with clonidine, pirenzepine, or scopolamine (33), may over time stabilize the gait and (34, 42) cardiovascular autonomic improvements in patients with PD.…”

Section: Discussionmentioning

confidence: 56%

Effects of mechanical stimulation of the feet on gait and cardiovascular autonomic control in Parkinson's disease

Barbic

Galli

Vecchia

et al. 2014

Journal of Applied Physiology

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Motor impairment in Parkinson's disease (PD) is partly due to defective central processing of lower limb afferents. Concomitant alterations in cardiovascular autonomic control leading to orthostatic hypotension may worsen motor ability. We evaluated whether mechanical activation of feet sensory afferents could improve gait and modify the response of cardiovascular autonomic control to stressors in 16 patients (age 66 ± 2 yr) with idiopathic PD (Hoehn & Yhar scale 2-3) on their usual therapy. Eight subjects (group A) were randomized to undergo skin pressure (0.58 ± 0.04 kg/mm(2)) stimulation at the hallux tip and first metatarsal joint (effective stimulation; ES) of both feet. Eight remaining patients (group B) underwent sham stimulation (SS) followed by ES. Three-dimensional movement analysis provided quantitative indexes of movement disability before (baseline) and 24 h after ES and SS. Spectral analysis of heart rate and blood pressure variability provided markers of cardiac sympatho-vagal (LF/HF) and vascular sympathetic (LFSAP) modulations. Markers were measured at rest and during 75° head-up tilt, before and 24 h after ES and SS. After ES, step length and gait velocity increased, upright rotation velocity was enhanced, and step number was decreased. After ES, LFSAP declined. The increase in LF/HF and LFSAP induced by tilt was greater than before feet stimulation. No changes in gait and autonomic parameters were observed after SS. Twenty-four hours after ES, patients with PD showed improved gait and increased cardiac and vascular sympathetic modulation during upright position compared with baseline. Conversely, SS was ineffective on both movement and autonomic parameters, indicating a site specificity effect of the stimulation.

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“…The vagomimetic action of pirenzepine in the canine acutely ischaemic heart supports the possibility that this intervention may be helpful for chronic autonomic modulation . In patients with a recent myocardial infarction, oral pirenzepine has been shown to be equally effective compared with transdermal scopolamine in significantly increasing indices of cardiac vagal activity, demonstrating therapeutic potential in preventing malignant ventricular arrhythmias after infarction …”

mentioning

confidence: 86%