Greatly Enhanced Pressor Response to Antidiuretic Hormone in Patients with Impaired Cardiovascular Reflexes Due to Idiopathic Orthostatic Hypotension

Möhring, Jan; Glänzer, K; Ja, Maciel Júnior; Düsing, Rainer; Hj, Kramer; Arbogast, R; Koch‐Weser, Jan

doi:10.1097/00005344-198007000-00004

Cited by 150 publications

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“…Additionally, in decapitated animals, this factor of displacement for vasopressin was 8,000 for doses that caused a 50-mmHg rise in systemic arterial pressure 33 . Consistent with these experimental findings is the observation that the dose-response curves for vasopressin in patients with idiopathic orthostatic hypotension (Shy-Drager's syndrome) were markedly displaced to the left when compared to those of normal subjects 34,35 . Similar findings have also been reported in brain-dead patients 36 .…”

Section: -A) Heart Rate (Hr) B) Cardiac Index (Ci) C) Mean Arterialsupporting

confidence: 61%

Infusão intravenosa de vasopressina causa efeitos cardiovasculares adversos dose-dependentes em cães anestesiados

Martins¹,

Sabha²,

Paganelli³

et al. 2010

Arq. Bras. Cardiol.

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Section: -A) Heart Rate (Hr) B) Cardiac Index (Ci) C) Mean Arterialsupporting

confidence: 61%

Infusão intravenosa de vasopressina causa efeitos cardiovasculares adversos dose-dependentes em cães anestesiados

Martins¹,

Sabha²,

Paganelli³

et al. 2010

Arq. Bras. Cardiol.

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“…The response to these drugs is strongly influenced by the ability of the baroreflex to compensate for the change in vascular tone, a so-called baroreflex blood pressure buffering. In patients with damage to the afferent arc (baroreflex failure) 32 or the efferent baroreflex arc either because of neuronal degeneration (autonomic failure) [33][34][35][36] or ganglionic blockade, [37][38][39] RMSSD indicates square root of mean squared differences of successive R-R intervals; LF RRI , R-R variability in LF range; HF RRI , R-R variability in HF range; LF RRI /HF RRI , ratio between R-R variability in the LF and HF range; LF SBP , systolic blood pressure variability in the LF range; cross-spectral BRS-LF, baroreflex heart rate sensitivity determined by cross-spectral analysis in the LF range; cross-spectral BRS-HF, baroreflex heart rate sensitivity determined by crossspectral analysis in the HF range; BRS-up, baroreflex heart rate sensitivity determined by the sequence technique for increasing systolic blood pressure; BRS-down, baroreflex heart rate sensitivity determined by the sequence technique for decreasing systolic blood pressure; pharmacological BRS RRI and BRS MSNA, heart rate and sympathetic BRS determined with nitroprusside and phenylephrine infusion. *PϽ0.05; †PϽ0.01.…”

Section: Discussionmentioning

confidence: 99%

Baroreflex Regulation of Heart Rate and Sympathetic Vasomotor Tone in Women and Men

et al. 2005

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Abstract-Gender has been reported to influence baroreflex heart rate regulation and baroreflex blood pressure buffering.We tested the hypothesis that gender influences baroreflex regulation of heart rate and sympathetic vasomotor tone. We recruited 32 normal-weight healthy subjects (17 men and 15 women). ECGs for heart rate, brachial and finger blood pressure, and muscle sympathetic nerve activity (MSNA) were measured. Baroreflex heart rate and MSNA regulation were assessed using incremental phenylephrine and nitroprusside infusions. Baseline blood pressure was similar in men and women. MSNA was 21Ϯ2.5 bursts/min in women and 19Ϯ2.8 bursts/min in men (NS). The gain of the baroreflex MSNA curves was similar in women and men (Ϫ1.9Ϯ0.2 bursts/min per mm Hg in men and Ϫ2.0Ϯ0.3 bursts/min per mm Hg in women). Baroreflex gain for heart rate regulation was 17Ϯ3.2 ms/mm Hg in women and 19Ϯ1.9 ms/mm Hg in men (NS). We conclude that baroreflex gains for heart rate and sympathetic MSNA regulation are similar in women and men. However, the probability for congruence between men and women in terms of the MSNA baroreflex curves was 0.06% for burst rate, 0.4% for burst incidence, and 0.01% for burst area. In women, the MSNA baroreflex curve may be shifted to slightly lower blood pressure such that at a given blood pressure MSNA tends to be lower. Key Words: autonomic nervous system Ⅲ baroreflex Ⅲ gender Ⅲ nervous system, sympathetic T he autonomic nervous system influences blood pressure and heart rate through adjustments in parasympathetic and sympathetic activity. Parasympathetic and sympathetic activities are tightly regulated through baroreflex mechanisms. Therefore, baroreflexes have a pivotal role in shortterm cardiovascular regulation and buffer-excessive blood pressure swings. 1,2 Among numerous other variables, baroreflexes are also involved in long-term blood pressure maintenance. [3][4][5] Even when overall blood pressure regulation is functioning properly, the balance between baroreflex regulation of heart rate and vascular tone may be perturbed. Imbalance between sympathetic activation of the heart and the vasculature has been described in heart failure patients, 6 postural tachycardia syndrome patients, 7,8 and in healthy subjects treated with norepinephrine transporter inhibitors. 9,10 Factors influencing baroreflex function may have an important bearing on human cardiovascular disease. Gender may be such a variable. Previous studies suggest that baroreflex blood pressure buffering is less effective in women than in men. 11 The balance between baroreflex-mediated heart rate and muscle sympathetic nerve activity (MSNA) changes may also be influenced by gender. The idea is supported by the observation that resting sympathetic vasomotor tone tends to be decreased in women, 12,13 whereas resting heart rate is increased. 14 -16 Furthermore, with standing, women showed an exaggerated heart rate and an attenuated sympathetic vasomotor response. 17 Moreover, previous studies suggested that baroreflex heart rate regulati...

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“…Vasopressin has specific effects on baroreflex mechanisms that tend to buffer its pressor actions (22,23), and vasopressin infusion causes a greater decrease in lumbar (24) and renal (25) sympathetic nerve activity than equipressor doses of phenylephrine. Vasopressin sensitivity is increased in baroreceptor denervated animals (26) and in patients with impaired baroreflexes due to autonomic neuropathy (27). The markedly attenuated baroreceptor reflex described in heart failure (28) may similarly increase sensitivity to vasopressin.…”

Section: Discussionmentioning

confidence: 99%

Vasoconstrictor role for vasopressin in experimental heart failure in the rabbit.

Arnolda¹,

McGrath²,

Cocks³

et al. 1986

J. Clin. Invest.

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Vasopressin's role as a vasoconstrictor in chronic heart failure was examined in rabbits with adriamycin cardiomyopathic congestive heart failure. Chronic adriamycin treatment resulted in a decrease in cardiac output (829±38-610±36 ml/mi, P < 0.005) and blood pressure (83±2-76±3 mmHg, P < 0.01), and an increase in peripheral resistance (8,377±381-10,170±657 dyn-s-cm-, P < 0.05). Plasma renin activity (4.7±0.6-10.9±2.8 ng angiotensin I/ml * h) and norepinephrine (0.7±0.1-13±0.2 pmol/mL P < 0.05) increased while plasma vasopressin levels did not change. Vasopressin infusion, however, produced significantly greater increases in peripheral resistance in animals with heart failure than in controls. Moreover, a specific vasopressin vascular antagonist reduced blood pressure (7±3%) and peripheral resistance (14±4%) and increased cardiac output (10±3%) in animals with heart failure but had no cardiovascular effects in normal rabbits. These results suggest that vascular sensitivity to vasopressin is increased in heart failure, and that it contributes significantly to the increased afterload in heart failure despite normal plasma levels. In this model of severe, chronic heart failure the sympathetic, renin-angiotensin, and vasopressin systems all appear to be activated.

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Greatly Enhanced Pressor Response to Antidiuretic Hormone in Patients with Impaired Cardiovascular Reflexes Due to Idiopathic Orthostatic Hypotension

Cited by 150 publications

References 0 publications

Infusão intravenosa de vasopressina causa efeitos cardiovasculares adversos dose-dependentes em cães anestesiados

Infusão intravenosa de vasopressina causa efeitos cardiovasculares adversos dose-dependentes em cães anestesiados

Baroreflex Regulation of Heart Rate and Sympathetic Vasomotor Tone in Women and Men

Vasoconstrictor role for vasopressin in experimental heart failure in the rabbit.

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