DOCSLIB.ORG

Cardiovascular Reflex Refleks Cardiovascular

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cardiovascular Reflex Refleks Cardiovascular Ikhlas Muhammad Jenie, Refleks Cardiovascular ............ Cardiovascular reflex Refleks Cardiovascular Ikhlas Muhammad Jenie Bagian Fisiologi Fakultas Kedokteran Universitas Muhammadiyah Yogyakarta Abstrak Tekanan darah dan frekuensi denyut jantung merupakan parameter kardiovaskular. Pengukurannya dalam praktek kedokteran klinis telah menjadi suatu hal yang wajar dilakukan, sedangkan kepentingannya telah banyak diketahui. Pada dasarnya, parameter kardiovaskular tersebut merupakan hasil dari refleks. Tulisan ini memaparkan dasar refleks kardiovaskular ditinjau dari pengaturan melalui saraf, tidak ditinjau dari pengaturan oleh secara mekanis dan maupun faktor lokal. Refleks kardiovaskular yang dibahas meliputi barorefleks, refleks kardiopulmonar, khemorefleks, refleks kardiovaskular yang disebabkan oleh stimulasi eksteroreseptor, serta interaksi antarrefleks kardiovaskular tersebut. Kata kunci : refleks kardiovaskular, barorefleks, tekanan darah, frekuensi denyut jantung Abstract It is familiar to measure cardiovascular parameters, such as blood pressure and pulse rate, in health care practice. The importance of such measure in clinical practice is out of question. Those cardiovascular parameters, basically, are products of reflex. In this paper, we would like to describe the basic tenets of cardiovascular reflex limited to that governed by autonomic nervous system, but not to that exerted by mechanical and local factors. The cardiovascular reflexes to be discussed are arterial baroreflex, cardiopulmonary baroreflex, cardiovascular reflex of stimulation of peripheral chemoreceptors, cardiovascular reflex associated to stimulation of exteroceptors, and interaction among those reflexes. Keywords: cardiovascular reflex, baroreflex, blood pressure, heart rate Introduction excitation, b) an afferent neuron transmitting Reflex implies all process develops impulses from the receptor to the central in an organism in response to stimulation of nervous system, c) a nerve centre with an the receptors with indispensable participation efferent neuron, d) an efferent nerve fibres 1 of the central nervous system1. Reflex is extending to certain working organs . produced by the activity of certain structures Endocrinal glands can involve either of the nervous system called reflex arc, as intermediary link or the effector organ. which can be represented as follows: The role of endocrinal gland as the receptor Æ afferent nerve fibres Æ central intermediary link in the reflex arc can be shown as follows: receptor Æ afferent nerve nervous system Æ efferent nerve fibres Æ effector. Thus, reflex arc of any reflex must fibres Æ central nervous system Æ efferent include: a) a receptor, a nervous structure nerve fibres Æ endocrinal gland that able to transform energy coming from discharges the hormone into the blood Æ specific stimulus into a process of nervous effector. Thus, stimulation of any receptors 43 Mutiara Medika Vol. 7 No. 1: 43-50, Januari 2007 may produce a reflex excitation of the nerves entrance of the superior and inferior vena that innervates a certain endocrinal gland, cava and pulmonary veins (veno-atrial which can alter the passage of the hormone stretch receptors), on the wall of left of the given gland into the blood. The ventricles, and in the pulmonary circulation hormone released by the endocrinal gland (together known as cardiopulmonary will modify the activity of certain effector baroreceptors), are sensitive to changes in organs1. the blood volume that represented by The nature of the reflex depends on changes in the central venous pressure, the two aspects: 1) the state of any structure intra-ventricular pressure, and the along the reflex arc, 2) the nature and pulmonary artery pressure, respectively3. strength of the stimulus over the receptor1. There are also numerous baroreceptors in Cardiovascular parameters, such as the vessels of tissues and organs, which blood pressure, heart rate, cardiac output, continuously maintain tone of blood vessels, total peripheral resistance, basically, are responsible for redistribution of the blood products of reflex. Those parameters are among different organs1. Baroreceptors in actually cardiovascular responses to stimuli. blood vessels of skeletal muscle are Here, we would like to describe the stimulated by local pressure and active basic tenets of cardiovascular reflex limited muscle tension2. to that governed by autonomic nervous Peripheral chemoreceptors, which system, but not to that exerted by mechanical located in the carotid bodies and aortic and local factors. bodies3, and in small vessels of tissues and organs1, are sensitive to a rise of the partial + Discussion pressure of CO2, concentration of H ions The reflex arc in the cardiovascular and K--+ ions in the arterial blood, and a system decline in the partial pressure of arterial O2. 1. Receptors In the blood vessels of skeletal muscle, they There are two kinds of receptors: are known as metaboloreceptors that + interoceptors and exteroceptors. activated by an increase in K ions, H2PO4 Interoceptors are receptors located within ions and H+ ions during hard muscular works the effector organs, which can be stimulated or exercise2. by agents arising within the organism itself, Exteroceptors are located outside although some time can be stimulated also the cardiovascular system, such as: a) by external agents. In the cardiovascular receptors of the skin and mucous system, interoceptors lie in the heart and membranes of the mouth cavity, upper blood vessels. Two kinds of interoceptors respiratory tracts, cornea (tactile, thermal, here are mechanoreceptors and and pain receptors), b) receptors receiving chemoreceptors, which sensitive to the action of special chemical substances, mechanical and chemical stimulus, namely taste and olfactory receptors, c) respectively1. auditory nerves, d) visual receptors, which Mechanoreceptors in the stimulated by agents from external cardiovascular system are known as environment but can be associated to certain baroreceptors since they respond to cardiovascular response (conditional stretching usually caused by changes in reflexes)1. pressure (baro = pressure). High blood baroreceptors, which located in the 2 Afferent nerve fibers adventitial layer of the carotid sinus and a. The glossopharyngeal nerve (the IXth aortic arch (thus they are known also as cranial nerve) arterial baroreceptors), are sensitive to Through with the impulses from changes in arterial blood pressure2. Low baroreceptors in the carotid sinus and pressure baroreceptors, which lies on the chemoreceptors in the carotid bodies walls of the right and left atria near the ascend to cardiovascular centre2. 44 Ikhlas Muhammad Jenie, Refleks Cardiovascular ............ b. The vagus nerve (the Xth cranial nerve) consequence, heart rate will be increased Through with the impulses from (positively chronotropic effect) and baroreceptors in the aortic arch, veno- contractility of the cardiac muscle will be atrial stretch receptors, the stretch strengthened (positively inotropic effect). receptors in the pulmonary artery, and Sympathetic tone to most vessels will be chemoreceptors in the aortic bodies is increased to cause vasoconstriction except transmitted to cardiovascular centre2. in the skeletal muscle, cardiac muscle, liver, c. The cardiac sympathetic nerves and brain. CAC will also stimulate adrenal Through with the impulses from the medulla to release circulating epinephrine stretch receptors in the left ventricle is in the blood4. travelled to cardiovascular centre2. c. Cardiac-inhibitory centre (CIC) d. Small myelinated (group III) and small CIC is the nucleus ambiguus of the unmyelinated nerve fibres (group IV) vagus nerve. When NTS is stimulated, CIC They carry excitatory input from will be activated, and then will increase vagal skeletal muscle2. tone causing a decrease in heart rate. When NTS is inhibited by impulses from peripheral 3. Cardiovascular centre receptors or the higher centres, CIC will be The location of cardiovascular centre depressed to inhibit the vagal tone. In turn, is in the medulla oblongata. It consists of: heart rate will be increased (vagal a. Sensory centre withdrawal) 4. It is the nucleus tractus solitarius (NTS), As we note, it exists the influence from which located on the dorsomedial part of the higher nervous centre such as hypothalamus medulla, is the site of the synapse for the and cerebral cortex to the cardiovascular cardiovascular afferents from the centre. Many parts of hypothalamus and baroreceptors, cardio-pulmonary receptors, cerebral cortex can inhibit or excite CAC5. arterial chemoreceptors, pulmonary stretch Under normal condition, cerebral cortex receptors, and muscle receptors as well as inhibits cardiovascular reflexes exerted by from the higher centres, namely the interoceptors. Direct stimulation of the hypothalamus, limbic system, and cerebral cerebral cortex leads to a decrease in the cortex. NTS evaluates and processes reflex reaction caused by stimulation of the sensory information, which its output is interoceptors. If the influence of cerebral relayed to hypothalamus and cerebellum as cortex to the cardiovascular center is blocked, well as to various parts of the medulla, e.g. stimulation of interoceptors causes greater to cardiac-acceleratory centre and cardiac- changes in cardiovascular reflexes1. inhibitory centre2. b. Cardiac-acceleratorycentre (CAC) 4. Efferent nerve fibres It has intrinsic activity. However, when The heart receives endings of NTS is stimulated
Load more

Recommended publications
  • Market Analysis of Clinical Cardiology 2020
    Interventional Cardiology Journal 2019 Market Analysis ISSN 2471-8157 Vol.5 No.3 Market Analysis of Clinical Cardiology 2020 Emily Professor of Epidemiology and Public Health at Australian National University Australian Capital Territory, Australia, E-mail: [email protected] Hilaris Conferences heartily invites you to the Clinical Target Audience Cardiology in San Fransisco, USA during October 26-27, 2020, • Directors of Hypertension or related Programs or to uncover your research ideas and work on heart heath, Associations cardiac diagnosis, and cardiac surgery comes under Clinical • Heads, Deans and Professors of Hypertension or Cardiology Cardiology research. Cardiology is a medical specialty and a departments branch of internal medicine concerned with treatment of • Scientists and Researchers organizers disorders of the heart and the blood vessels. Hilaris • Doctors Conferences is assuring Clinical Cardiology 2020 will provide • Medical Colleges you that international platform to explore your recent paper in • Writers front of renowned keynote speakers, delegates, CEOs, • Healthcare professionals Professors and Doctors. We are waiting to have you in San • Founders and Employees of the related companies Fransisco. • Clinical investigators • Hospitals and Health Services Market Analysis • Pharmaceutical companies • Training institutions Cardiovascular disease is the major cause of death across • Support organizers the globe. It estimated that for 17.3 million deaths in 2015 and • Data Management Companies is further anticipated to claim 23.6 million lives in 2030 • Cardiologists training and education (according to estimation by the World Health Organization). • Nurse and nursing education institutions The International Diabetes Federation has estimating that approximately 415 million people were diabetic in 2015 while the number is expected to increase 642 million worldwide by Related Companies/Industries 2040.
    [Show full text]
  • The Ottawa Cardiovascular Centre Is Pleased Concept and Capacity
    502-1355 Bank Street, Ottawa, ON K1H 8K7 T 613-738-1584 F 613-738-9097 E [email protected] The Ottawa Cardiovascular Centre is pleased to announce the expansion of our clinic in terms of concept and capacity RAPID ACCESS • SHORT WAIT LISTS • EXPANDED SERVICES We have hired two Physician Assistants to extend and enhance our services. We have added a second pediatric cardiologist. In addition, we now offer: EXPANDED NON-INVASIVE SERVICES: Nuclear Cardiology Imaging expanded with 2 state of the art CZT solid state cameras Echocardiography expanded with addition for rapid acquisition/lower radiation of 4 state of the art GE Vivid E 90 systems • Treadmill or persantine stress myocardial • No wait times perfusion imaging • Echo contrast enhances difficult imaging RAPID REFERRAL CLINIC: • Treadmill and bicycle stress Atrial fibrillation/anticoagulation, chest pain, echocardiography palpitation/syncope, shortness of breath, • Adult and pediatric echocardiography post ER visit Arrhythmia Detection: Real time wireless RESIDUAL RISK CLINIC: prospective monitoring for immediate Optimization of diabetes, dyslipidemia, arrhythmia detection and notification hypertension, post revascularization, • 2 day holter monitoring vascular risk reduction, LV function/HF • 3 day holter: retrospective quantitative CardioOncology, adult congenital HD, analysis (on site hook-up and mail out first responders/sports – ischaemic Mini Holter) risk assessment Please note that e-Referral is now available via the OCEAN e-Referral Healthmap 502-1355 Bank Street, Ottawa,
    [Show full text]
  • TRPA1 Is Essential for the Vascular Response to Environmental Cold Exposure
    ARTICLE Received 18 Aug 2014 | Accepted 3 Nov 2014 | Published 11 Dec 2014 DOI: 10.1038/ncomms6732 OPEN TRPA1 is essential for the vascular response to environmental cold exposure Aisah A. Aubdool1, Rabea Graepel1, Xenia Kodji1, Khadija M. Alawi1, Jennifer V. Bodkin1, Salil Srivastava1, Clive Gentry2, Richard Heads1, Andrew D. Grant2, Elizabeth S. Fernandes1, Stuart Bevan2 & Susan D. Brain1 The cold-induced vascular response, consisting of vasoconstriction followed by vaso- dilatation, is critical for protecting the cutaneous tissues against cold injury. Whilst this physiological reflex response is historic knowledge, the mechanisms involved are unclear. Here by using a murine model of local environmental cold exposure, we show that TRPA1 acts as a primary vascular cold sensor, as determined through TRPA1 pharmacological antagonism or gene deletion. The initial cold-induced vasoconstriction is mediated via TRPA1-dependent superoxide production that stimulates a2C-adrenoceptors and Rho-kinase-mediated MLC phosphorylation, downstream of TRPA1 activation. The subsequent restorative blood flow component is also dependent on TRPA1 activation being mediated by sensory nerve-derived dilator neuropeptides CGRP and substance P, and also nNOS-derived NO. The results allow a new understanding of the importance of TRPA1 in cold exposure and provide impetus for further research into developing therapeutic agents aimed at the local protection of the skin in disease and adverse climates. 1 BHF Cardiovascular Centre of Excellence and Centre of Integrative Biomedicine, Cardiovascular Division, King’s College London, London SE1 9NH, UK. 2 Wolfson Centre for Age Related Diseases, King’s College London, London SE1 1UL, UK. Correspondence and requests for materials should be addressed to S.D.B.
    [Show full text]
  • Cardiovascular Disease Prevention and Control Translating Evidence
    Cardiovascular disease prevention and control Translating evidence into action 3 WHO Library Cataloguing-in-Publication Data Cardiovascular disease prevention and control: translating evidence into action. 1.Cardiovascular diseases - prevention and control 2.Cerebrovascular accident - prevention and control 3.Rheumatic heart disease - prevention and control 4.Risk reduction behavior I.World Health Organization. ISBN 92 4 159325 3 (NLM classification: WG 120) © World Health Organization 2005 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for per- mission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatso- ever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • Endogenously Released Adenosine Causes Pulmonary Vasodilation During the Acute Phase of Pulmonary Embolization in Dogs☆
    IJC Heart & Vasculature 24 (2019) 100396 Contents lists available at ScienceDirect IJC Heart & Vasculature journal homepage: http://www.journals.elsevier.com/ijc-heart-and-vasculature Endogenously released adenosine causes pulmonary vasodilation during the acute phase of pulmonary embolization in dogs☆ Hiroko Takahama a,b,c, Hiroshi Asanuma d, Osamu Tsukamoto e,ShinItoa, Masafumi Kitakaze a,⁎ a Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, Japan b Department of Cell Biology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, Japan c Department of Molecular Imaging in Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan d Department of Internal Medicine, Meiji University of Integrative Medicine, Hiyoshicho, Nantan, Kyoto, Japan e Department of Medical Biochemistry, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan article info abstract Article history: Background: Endogenous adenosine levels increase under stress in various organs. Exogenously administered Received 31 March 2019 adenosine is a well-known pulmonary vasodilator. However, the physiology and therapeutic potential of endog- Received in revised form 25 May 2019 enous adenosine during alteration in pulmonary hemodynamics such as pulmonary embolism is not elucidated. Accepted 24 June 2019 We hypothesized that the adenosine level increases following an acute elevation of pulmonary resistance, Available online 10 July 2019 resulting in pulmonary vasodilation. Methods: We induced acute pulmonary embolization by injecting plastic beads in anesthetized dogs. Plasma Keywords: adenosine levels, defined as the product of plasma adenosine concentration and simultaneous cardiac output, Adenosine Pulmonary embolization were assessed from blood samples from the superior vena cava, main pulmonary artery (MPA), and ascending Hemodynamics aorta 1 and 10 min following injection.
    [Show full text]
  • Regulation of Blood Pressure
    REGULATION OF BLOOD PRESSURE Prof. Sultan Ayoub Meo MBBS, Ph.D (Pak), M Med Ed (Dundee), FRCP (London), FRCP (Dublin), FRCP (Glasgow), FRCP (Edinburgh) Professor and Consultant, Department of Physiology, College of Medicine, King Saud University, Riyadh, KSA LECTURE OBJECTIVES ▪ Factors regulating arterial blood pressure ▪ Explain how they influence arterial blood pressure. ▪ Physiological importance of regulating arterial blood pressure ▪ Discuss short term, intermediate and long-term regulation of blood pressure; nervous, hormonal and renal regulation of arterial blood pressure. REGULATION OF BLOOD PRESSURE REGULATION OF BLOOD PRESSURE SHORT TERM REGULATION OF BLOOD PRESSURE Rapidly acting within seconds to minutes 1. Baroreceptors Reflex Mechanism 2. Chemoreceptors Mechanism 3. CNS Ischemic Response Mechanism 4. Atrial Stretch Volume Receptors 1. THE BARORECEPTORS Changes in MAP are detected by baroreceptors (pressure receptors) in the carotid and aortic arteries. Carotid baroreceptors are located in the carotid sinus, both sides of the neck. Aortic baroreceptors are located in the aortic arch. These receptors provide information to the cardiovascular centres in the medulla oblongata about the degree of stretch with pressure changes. 1. THE BARORECEPTORS Guyton and Hall, pp 174 1. THE BARORECEPTORS ❑ At normal arterial pressure the baroreceptors are active. ❑ Increased blood pressure increases their rate of activity, while decreased pressure decreases the rate of firing (activity). ❑ They play an important role in maintaining relatively constant blood flow to vital organs such as brain during rapid changes in pressure such as standing up after lying down. That is why they are called “pressure buffers”. 1. THE BARORECEPTORS 1. THE BARORECEPTORS ↑ MAP Baroreceptors ↑ Parasympathetic ↓ Sympathetic (vagal) activity activity ↓ HR ↓ SV ↓ TPR ↓ MAP 1.
    [Show full text]
  • Modelling and Control of the Human Cardiovascular System
    Research Collection Master Thesis Modelling and control of the human cardiovascular system Author(s): Gisler, Stefan Publication Date: 2011 Permanent Link: https://doi.org/10.3929/ethz-a-007207574 Rights / License: In Copyright - Non-Commercial Use Permitted This page was generated automatically upon download from the ETH Zurich Research Collection. For more information please consult the Terms of use. ETH Library Master Thesis Modelling and control of the human cardiovascular system Stefan Gisler Advisers Martin Wieser and Dr. Heike Vallery and Prof. Dr. Robert Riener Sensory Motor Systems Lab (SMS) Swiss Federal Institute of Technology Zurich (ETH) Submission: April 2011 Contents 1 Introduction 1 2 Human cardiovascular system 5 2.1 Hemodynamic system . 5 2.2 Blood pressure regulation . 7 2.3 Orthostatic reaction and muscle pump . 9 2.4 Cardiovascular pathology . 10 2.5 Literature review . 11 2.5.1 Cardiovascular responses to passive tilting . 11 2.5.2 Cardiovascular modelling . 13 3 Cardiovascular model 15 3.1 Hemodynamic system . 16 3.2 Blood pressure regulation . 18 3.3 Influence of gravity . 21 3.4 Influence of stepping . 22 3.5 Model simulations . 24 3.5.1 Fast tilt-up and tilt-down . 24 3.5.2 Stepping . 25 3.5.3 Quasi-static . 26 3.6 Model validation . 33 4 Control design 37 4.1 Model predictive control (MPC) design . 37 4.2 Simulation . 46 5 Methods 49 5.1 Healthy subjects . 49 5.1.1 Implementation . 49 5.1.2 Blood pressure recording . 49 5.1.3 Experimental design . 50 i 5.2 Patients . 53 5.2.1 Implementation .
    [Show full text]
  • Characteristics, Aetiological Spectrum and Management of Valvular Heart
    +Model ACVD-954; No. of Pages 8 ARTICLE IN PRESS Archives of Cardiovascular Disease (2017) xxx, xxx—xxx Available online at ScienceDirect www.sciencedirect.com CLINICAL RESEARCH Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre Les particularités, le profil étiologique et la prise en charge des valvulopathies acquises dans un centre cardiovasculaire en Tunisie a,∗ b a Faten Triki , Jihen Jdidi , Dorra Abid , a a Nada Tabbabi , Selma Charfeddine , a a a Sahar Ben Kahla , Mourad Hentati , Leila Abid , a Samir Kammoun a Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia b Department of Epidemiology, Hédi Chaker Hospital, University of Sfax, Sfax, Tunisia Received 21 March 2016; accepted 1st August 2016 KEYWORDS Summary Valvular heart Background. — Valvular heart diseases occur frequently in Tunisia, but no precise statistics are disease; available. Cardiac surgery; Aim. — To analyse the characteristics of patients with abnormal valvular structure and function, Heart valve; and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in Rheumatic heart a single cardiovascular centre in Tunisia. disease Methods. — This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology depart- ment between January 2010 and December 2013. Data on baseline characteristics, potential aetiology, treatment strategies and discharge outcomes were collected from medical records. Results. — There were 959 patients with a significant valvular heart disease (mean age 53 ± 17 years; female/male ratio 0.57). Valvular heart disease was native in 77% of patients.
    [Show full text]
  • The Circulatory System
    CHAPTER 6: THE CIRCULATORY SYSTEM THE CIRCULATORY SYSTEM and the LYMPHATIC SYSTEM Most of the cells in the human body are not in direct contact with the external environment, so rely on the circulatory system to act as a transport service for them. Two fluids move through the circulatory system: blood and lymph. The blood, heart, and blood vessels form the Cardiovascular System. The lymph, lymph nodes and lymph vessels form the Lymphatic System. The Cardiovascular System and the Lymphatic System collectively make up the Circulatory System. 1. Vertebrates have a closed circulatory system, meaning the blood is repeatedly cycled throughout the body inside a system of pipes. 2. It was in 1628, when the English Dr. William Harvey showed that blood circulated throughout the body in one- way vessels. According to him, blood was pumped out of the heart and into the tissues through one type of vessel and back to the heart through another type of vessel. The blood, in other words, moved in a closed cycle through the body. 3. Blood is the body’s internal transportation system. Pumped by the heart, blood travels through a network of blood vessels, carrying nutrients (O2, glucose) and hormones to the cells and removing waste products (CO2. urea) from the 1012 (= 100 trillion) cells of our bodies.. THE HEART 1. The central organ of the cardiovascular system is the heart. This is a hollow, muscular organ that contracts at regular intervals, forcing blood through the circulatory system. 2. The heart is cone-shaped, about the size of a fist, and is located in the centre of the thorax, between the lungs, directly behind the sternum (breastbone).
    [Show full text]
  • Sleep Apnoea and Systemic Hypertension
    Thorax: first published as 10.1136/thx.44.12.984 on 1 December 1989. Downloaded from Thorax 1989;44:984-989 Review Sleep apnoea and systemic hypertension Gross obstructive sleep apnoea has two clear pitfalls and problems with these experimental and consequences, recurrent sleep disruption (with epidemiological data, which call for careful scrutiny daytime sleepiness) and repeated noctural hypox- before health screening programmes start to label aemia. The importance of the hypoxaemia is debated snoring as more than an auditory nuisance. but when it is severe, or perhaps in the presence of This review divides the lines of argument and ischaemic heart disease, it may trigger off serious evidence into five parts: (1) How does obstructive sleep arrhythmias.' When associated with even quite mild apnoea raise systemic blood pressure acutely? (2) Does lower airways obstruction, obstructive sleep apnoea obstructive sleep apnoea really raise diurnal systemic may lead to diurnal hypoxaemia and hypercapnia23 blood pressure in the long term and increase cardio- with all the well known sequelae of fluid retention, vascular complications? (3) What is the evidence that pulmonary hypertension, and right ventricular hyper- an important proportion of patients with essential trophy (cor pulmonale).4 Why profound intermittent hypertension have appreciable sleep apnoea? (4) What hypoxaemia may apparently be harmless is not clear, is the epidemiological evidence that snoring is an but the key may be in its short duration and the independent risk factor for systemic hypertension and recovery of arterial oxygen tension (Pao2) between cardiovascular events? (5) What evidence do we need episodes ofapnoea. For example, this pulsatile hypox- to establish whether snoring and sleep apnoea are aemia does not lead to raised erythropoietin concen- important and underdiagnosed causes of essential trations,5 which explains the rarity ofpolycythaemia in hypertension or cardiovascular events? copyright.
    [Show full text]
  • Challenging a Proposed Role for TRPC5 in Aortic Baroreceptor Pressure-Sensing
    DOI: 10.1038/s41467-017-02703-w OPEN Correspondence: Challenging a proposed role for TRPC5 in aortic baroreceptor pressure-sensing Pratish Thakore1,2, Susan D. Brain1 & David J. Beech3 Nature Communications 9: 1245 doi:10.1038/s41467-017-02703-w (2018) Lau et al.1 have suggested a role for TRPC5 in the control of We have corresponded with Professor Xiaoqiang Yao of Lau et al.1 blood pressure where they suggest TRPC5 has a pivotal role in to try to resolve these discrepancies. Professor Yao has informed us, baroreflex regulation. after re-calculation of his data, that there was an analytical error. 1234567890():,; As part of this work it was specified that TRPC5 Correcting for this mistake, their results now also show no change in knockout (KO) mice gifted from Professor David Clapham’s baseline blood pressure between WT and TRPC5 KO mice. laboratory have elevated mean arterial pressure; WT (wildtype) Although disturbance of a mechanical force-sensing 113 ± 7 mmHg vs. KO 158 ± 26 mmHg (n = 12, p < 0.05, Fig. 8 mechanism in baroreceptors might not necessarily affect blood in the original paper1). In addition, the representative traces pressure, Lau et al.1 reported an effect that they defined as severe from one WT and one KO mouse showed no change in diurnal and suggested that it was explained by a TRPC5 mechanical variation in blood pressure or heart rate, which is unusual (Fig. 8 force-sensing mechanism in the baroreceptors. On the basis of in ref. 1). Furthermore, there was no indication of what the understanding that they have now changed their position on time periods correlated to the light and dark phases.
    [Show full text]
  • A Simplified, Langendorff-Free Method for Concomitant Isolation of Viable Cardiac Myocytes and Nonmyocytes from the Adult Mouse Heart
    New Methods in Cardiovascular Biology A Simplified, Langendorff-Free Method for Concomitant Isolation of Viable Cardiac Myocytes and Nonmyocytes From the Adult Mouse Heart Matthew Ackers-Johnson, Peter Yiqing Li, Andrew P. Holmes, Sian-Marie O’Brien, Davor Pavlovic, Roger S. Foo Rationale: Cardiovascular disease represents a global pandemic. The advent of and recent advances in mouse genomics, epigenomics, and transgenics offer ever-greater potential for powerful avenues of research. However, progress is often constrained by unique complexities associated with the isolation of viable myocytes from the adult mouse heart. Current protocols rely on retrograde aortic perfusion using specialized Langendorff apparatus, which poses considerable logistical and technical barriers to researchers and demands extensive training investment. Objective: To identify and optimize a convenient, alternative approach, allowing the robust isolation and culture of Downloaded from adult mouse cardiac myocytes using only common surgical and laboratory equipment. Methods and Results: Cardiac myocytes were isolated with yields comparable to those in published Langendorff- based methods, using direct needle perfusion of the LV ex vivo and without requirement for heparin injection. Isolated myocytes can be cultured antibiotic free, with retained organized contractile and mitochondrial morphology, transcriptional signatures, calcium handling, responses to hypoxia, neurohormonal stimulation, and electric pacing, http://circres.ahajournals.org/ and are amenable to patch clamp and adenoviral gene transfer techniques. Furthermore, the methodology permits concurrent isolation, separation, and coculture of myocyte and nonmyocyte cardiac populations. Conclusions: We present a novel, simplified method, demonstrating concomitant isolation of viable cardiac myocytes and nonmyocytes from the same adult mouse heart. We anticipate that this new approach will expand and accelerate innovative research in the field of cardiac biology.
    [Show full text]