Reflex control of sympathetic activity during simulated ventricular tachycardia in humans

Michael L. Smith, Jose A. Joglar, Stephen L. Wasmund, Mark D. Carlson, Patrick J. Welch, Mohamed H. Hamdan, Kara Quan, Richard L. Page

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background - Ventricular tachyarrhythmias present a unique set of stimuli to arterial and cardiopulmonary baroreceptors by increasing cardiac filling pressures and decreasing arterial pressure. The net effect on the control of sympathetic nerve activity (SNA) in humans is unknown. The purpose of this study was to determine the relative roles of cardiopulmonary and arterial baroreceptors in controlling SNA and arterial pressure during ventricular pacing in humans. Methods and Results - Two experiments were performed in which SNA and hemodynamic responses to ventricular pacing were compared with nitroprusside infusion (NTP) in 12 patients and studied with and without head-up tilt or phenylephrine to normalize the stimuli to either the arterial or cardiopulmonary baroreceptors in 9 patients. In experiment 1, the slope of the relation between SNA and mean arterial pressure was greater during NTP (-4.7 ± 1.4 U/mm Hg) than during ventricular pacing (-3.4 ± 1.1 U/mm Hg). Comparison of NTP doses and ventricular pacing rates that produced comparable hypotension showed that SNA increased more during NTP (P = 0.03). In experiment 2, normalization of arterial pressure during pacing resulted in SNA decreasing below baseline (P < 0.05), whereas normalization of cardiac filling pressure resulted in a greater increase in SNA than pacing alone (212 ± 35% versus 189 ± 37%, P = 0.04). Conclusions - These data demonstrate that in humans arterial baroreflex control predominates in mediating sympathoexcitation during ventricular tachyarrhythmias and that cardiopulmonary baroreceptors contribute significant inhibitory modulation.

Original languageEnglish (US)
Pages (from-to)628-634
Number of pages7
JournalCirculation
Volume100
Issue number6
StatePublished - Aug 10 1999

Fingerprint

Pressoreceptors
Nitroprusside
Ventricular Tachycardia
Reflex
Arterial Pressure
Tachycardia
Pressure
Baroreflex
Phenylephrine
Human Activities
Hypotension
Hemodynamics
Head

Keywords

  • Arrhythmia
  • Death, sudden
  • Nervous system, autonomic
  • Pacing
  • Pressure

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Smith, M. L., Joglar, J. A., Wasmund, S. L., Carlson, M. D., Welch, P. J., Hamdan, M. H., ... Page, R. L. (1999). Reflex control of sympathetic activity during simulated ventricular tachycardia in humans. Circulation, 100(6), 628-634.

Reflex control of sympathetic activity during simulated ventricular tachycardia in humans. / Smith, Michael L.; Joglar, Jose A.; Wasmund, Stephen L.; Carlson, Mark D.; Welch, Patrick J.; Hamdan, Mohamed H.; Quan, Kara; Page, Richard L.

In: Circulation, Vol. 100, No. 6, 10.08.1999, p. 628-634.

Research output: Contribution to journalArticle

Smith, ML, Joglar, JA, Wasmund, SL, Carlson, MD, Welch, PJ, Hamdan, MH, Quan, K & Page, RL 1999, 'Reflex control of sympathetic activity during simulated ventricular tachycardia in humans', Circulation, vol. 100, no. 6, pp. 628-634.
Smith ML, Joglar JA, Wasmund SL, Carlson MD, Welch PJ, Hamdan MH et al. Reflex control of sympathetic activity during simulated ventricular tachycardia in humans. Circulation. 1999 Aug 10;100(6):628-634.
Smith, Michael L. ; Joglar, Jose A. ; Wasmund, Stephen L. ; Carlson, Mark D. ; Welch, Patrick J. ; Hamdan, Mohamed H. ; Quan, Kara ; Page, Richard L. / Reflex control of sympathetic activity during simulated ventricular tachycardia in humans. In: Circulation. 1999 ; Vol. 100, No. 6. pp. 628-634.
@article{35b82f8d22c84a6b929ea213f601ee50,
title = "Reflex control of sympathetic activity during simulated ventricular tachycardia in humans",
abstract = "Background - Ventricular tachyarrhythmias present a unique set of stimuli to arterial and cardiopulmonary baroreceptors by increasing cardiac filling pressures and decreasing arterial pressure. The net effect on the control of sympathetic nerve activity (SNA) in humans is unknown. The purpose of this study was to determine the relative roles of cardiopulmonary and arterial baroreceptors in controlling SNA and arterial pressure during ventricular pacing in humans. Methods and Results - Two experiments were performed in which SNA and hemodynamic responses to ventricular pacing were compared with nitroprusside infusion (NTP) in 12 patients and studied with and without head-up tilt or phenylephrine to normalize the stimuli to either the arterial or cardiopulmonary baroreceptors in 9 patients. In experiment 1, the slope of the relation between SNA and mean arterial pressure was greater during NTP (-4.7 ± 1.4 U/mm Hg) than during ventricular pacing (-3.4 ± 1.1 U/mm Hg). Comparison of NTP doses and ventricular pacing rates that produced comparable hypotension showed that SNA increased more during NTP (P = 0.03). In experiment 2, normalization of arterial pressure during pacing resulted in SNA decreasing below baseline (P < 0.05), whereas normalization of cardiac filling pressure resulted in a greater increase in SNA than pacing alone (212 ± 35{\%} versus 189 ± 37{\%}, P = 0.04). Conclusions - These data demonstrate that in humans arterial baroreflex control predominates in mediating sympathoexcitation during ventricular tachyarrhythmias and that cardiopulmonary baroreceptors contribute significant inhibitory modulation.",
keywords = "Arrhythmia, Death, sudden, Nervous system, autonomic, Pacing, Pressure",
author = "Smith, {Michael L.} and Joglar, {Jose A.} and Wasmund, {Stephen L.} and Carlson, {Mark D.} and Welch, {Patrick J.} and Hamdan, {Mohamed H.} and Kara Quan and Page, {Richard L.}",
year = "1999",
month = "8",
day = "10",
language = "English (US)",
volume = "100",
pages = "628--634",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Reflex control of sympathetic activity during simulated ventricular tachycardia in humans

AU - Smith, Michael L.

AU - Joglar, Jose A.

AU - Wasmund, Stephen L.

AU - Carlson, Mark D.

AU - Welch, Patrick J.

AU - Hamdan, Mohamed H.

AU - Quan, Kara

AU - Page, Richard L.

PY - 1999/8/10

Y1 - 1999/8/10

N2 - Background - Ventricular tachyarrhythmias present a unique set of stimuli to arterial and cardiopulmonary baroreceptors by increasing cardiac filling pressures and decreasing arterial pressure. The net effect on the control of sympathetic nerve activity (SNA) in humans is unknown. The purpose of this study was to determine the relative roles of cardiopulmonary and arterial baroreceptors in controlling SNA and arterial pressure during ventricular pacing in humans. Methods and Results - Two experiments were performed in which SNA and hemodynamic responses to ventricular pacing were compared with nitroprusside infusion (NTP) in 12 patients and studied with and without head-up tilt or phenylephrine to normalize the stimuli to either the arterial or cardiopulmonary baroreceptors in 9 patients. In experiment 1, the slope of the relation between SNA and mean arterial pressure was greater during NTP (-4.7 ± 1.4 U/mm Hg) than during ventricular pacing (-3.4 ± 1.1 U/mm Hg). Comparison of NTP doses and ventricular pacing rates that produced comparable hypotension showed that SNA increased more during NTP (P = 0.03). In experiment 2, normalization of arterial pressure during pacing resulted in SNA decreasing below baseline (P < 0.05), whereas normalization of cardiac filling pressure resulted in a greater increase in SNA than pacing alone (212 ± 35% versus 189 ± 37%, P = 0.04). Conclusions - These data demonstrate that in humans arterial baroreflex control predominates in mediating sympathoexcitation during ventricular tachyarrhythmias and that cardiopulmonary baroreceptors contribute significant inhibitory modulation.

AB - Background - Ventricular tachyarrhythmias present a unique set of stimuli to arterial and cardiopulmonary baroreceptors by increasing cardiac filling pressures and decreasing arterial pressure. The net effect on the control of sympathetic nerve activity (SNA) in humans is unknown. The purpose of this study was to determine the relative roles of cardiopulmonary and arterial baroreceptors in controlling SNA and arterial pressure during ventricular pacing in humans. Methods and Results - Two experiments were performed in which SNA and hemodynamic responses to ventricular pacing were compared with nitroprusside infusion (NTP) in 12 patients and studied with and without head-up tilt or phenylephrine to normalize the stimuli to either the arterial or cardiopulmonary baroreceptors in 9 patients. In experiment 1, the slope of the relation between SNA and mean arterial pressure was greater during NTP (-4.7 ± 1.4 U/mm Hg) than during ventricular pacing (-3.4 ± 1.1 U/mm Hg). Comparison of NTP doses and ventricular pacing rates that produced comparable hypotension showed that SNA increased more during NTP (P = 0.03). In experiment 2, normalization of arterial pressure during pacing resulted in SNA decreasing below baseline (P < 0.05), whereas normalization of cardiac filling pressure resulted in a greater increase in SNA than pacing alone (212 ± 35% versus 189 ± 37%, P = 0.04). Conclusions - These data demonstrate that in humans arterial baroreflex control predominates in mediating sympathoexcitation during ventricular tachyarrhythmias and that cardiopulmonary baroreceptors contribute significant inhibitory modulation.

KW - Arrhythmia

KW - Death, sudden

KW - Nervous system, autonomic

KW - Pacing

KW - Pressure

UR - http://www.scopus.com/inward/record.url?scp=0033543104&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033543104&partnerID=8YFLogxK

M3 - Article

VL - 100

SP - 628

EP - 634

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 6

ER -