Buckley MM, Johns EJ. Impact of L-NAME on the cardiopulmonary reflex in cardiac hypertrophy. Am J Physiol Regul Integr Comp Physiol 301: R1549 -R1556, 2011. First published August 24, 2011 doi:10.1152/ajpregu.00307.2011There is evidence that in cardiac failure, there is defective baroreceptor reflex control of sympathetic nerve activity. Often, cardiac failure is preceded by a state of cardiac hypertrophy in which there may be enhanced performance of the heart. This study investigated whether in two different models of cardiac hypertrophy, there was an increased contribution of nitric oxide (NO) to the low-pressure baroreceptor regulation of renal sympathetic nerve activity (RSNA) and nerve-dependent excretory function. Administration of a volume load, 0.25% body wt/min saline for 30 min, in normal rats decreased RSNA by 40% and increased urine flow by some 9-fold. Following nitro-L-arginine methyl ester (L-NAME) administration, 10 g·kg Ϫ1 ·min Ϫ1 for 60 min, which had no effect on blood pressure, heart rate, or RSNA, the volume loadinduced renal sympathoinhibitory and excretory responses were markedly enhanced. In cardiac hypertrophy states induced by 2 wk of isoprenaline/caffeine or 1 wk thyroxine administration, the volume challenge failed to suppress RSNA, and there were blunted increases in urine flow in the innervated kidneys, but following L-NAME infusion, the volume load decreased RSNA by 30 -40% and increased urine flow by some 20-fold in the innervated kidneys, roughly to the same extent as observed in normal rats. These findings suggest that the blunted renal sympathoinhibition and nerve-dependent diuresis to the volume load in cardiac hypertrophy are related to a heightened production or activity of NO within either the afferent or central arms of the reflex. renal sympathetic nerve activity; urine flow; nitric oxide CARDIAC HYPERTROPHY, DEFINED as an increase in the size and/or thickness of the ventricles in the heart, frequently progresses into heart failure (2) and is an independent predictor of cardiovascular morbidity and mortality (5,14). The development of cardiac hypertrophy is associated with an increased workload and an activation of the sympathetic nervous system, which drives the heart to ensure an adequate cardiac output and, if prolonged, may progress into cardiac failure. In the kidney, the raised sympathetic outflow will cause an enhanced sodium retention and raised circulatory volume, which will also contribute to the increased load on the heart (10).The reflex control of the cardiovascular system and blood pressure depends not only on arterial baroreceptors, but also on receptors located in the cardiopulmonary region. It is generally recognized that increasing circulatory volume leads to a fall in renal sympathetic nerve activity (RSNA), and vice versa, and has been termed the cardiopulmonary reflex. Interestingly, in two models of cardiac hypertrophy induced by isoprenaline/ caffeine or thyroxine exposure, it was found that the reflex renal sympathoinhibition in response to an ac...