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Titolo:
AUGMENTED PERIPHERAL CHEMOSENSITIVITY AS A POTENTIAL INPUT TO BAROREFLEX IMPAIRMENT AND AUTONOMIC IMBALANCE IN CHRONIC HEART-FAILURE
Autore:
PONIKOWSKI P; CHUA TP; PIEPOLI M; ONDUSOVA D; WEBBPEPLOE K; HARRINGTON D; ANKER SD; VOLTERRANI M; COLOMBO R; MAZZUERO G; GIORDANO A; COATS AJS;
Indirizzi:
NATL HEART & LUNG INST,IMPERIAL COLL SCH MED,DEPT CARDIAC MED,DOVEHOUSE ST LONDON SW3 6LY ENGLAND NATL HEART & LUNG INST,IMPERIAL COLL SCH MED,DEPT CARDIAC MED LONDON SW3 6LY ENGLAND
Titolo Testata:
Circulation
fascicolo: 8, volume: 96, anno: 1997,
pagine: 2586 - 2594
SICI:
0009-7322(1997)96:8<2586:APCAAP>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
SYMPATHETIC-NERVE ACTIVITY; LEFT-VENTRICULAR DYSFUNCTION; POWER SPECTRAL-ANALYSIS; PACED CANINE MODEL; RATE-VARIABILITY; BLOOD-PRESSURE; VENTILATORY RESPONSES; CAROTID BARORECEPTORS; CHEMORECEPTOR REFLEX; NORMAL HUMANS;
Keywords:
HEART FAILURE; AUTONOMIC FUNCTION; CHEMORECEPTORS; BARORECEPTORS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
54
Recensione:
Indirizzi per estratti:
Citazione:
P. Ponikowski et al., "AUGMENTED PERIPHERAL CHEMOSENSITIVITY AS A POTENTIAL INPUT TO BAROREFLEX IMPAIRMENT AND AUTONOMIC IMBALANCE IN CHRONIC HEART-FAILURE", Circulation, 96(8), 1997, pp. 2586-2594

Abstract

Background The precise mechanisms responsible for the sympathetic overactivity and blunted baroreflex control in chronic heart failure (CHF) remain obscure. Augmented peripheral chemosensitivity has recently been demonstrated in CHF, We evaluated the relation between peripheral chemoreflex sensitivity and autonomic activity in patients with CHF. Methods and Results We studied in 26 stable patients with CHF the peripheral chemosensitivity (ventilatory response to hypoxia using transient inhalations of pure nitrogen), autonomic balance (spectral analysis of heart rate variability [HRV]), and baroreflex sensitivity (bolus phenylephrine method and alpha index). To determine whether transient inactivation of peripheral chemoreceptors might influence autonomic balance, 12 patients underwent a second study during which they breathed 100% O-2. Peripheral chemosensitivity correlated inversely with HRV power within the low-frequency band (0.04 to 0.15 Hz) (r=-.52, P=.006) and inversely with baroreflex sensitivity (r=-.60, P=.005). When the patients were divided into two groups according to the chemosensitivity of age-matched normal controls (above and below mean+2 SDs of chemosensitivity of control subjects), those above the normal range revealed more impaired autonomic balance, ie, lower baroreflex sensitivity (1.4+/-1.3 versus 5.0+/-1.5 ms/mm Hg, P<.0001) and depressed values of low-frequency power (2.5+/-1.8 versus 4.1+/-0.8 ln ms(2), P<.005) compared with those with normal chemosensitivity. Transient hyperoxia did not alter heart rate or systolic pressure but resulted in an increase in HRV and an improvement in baroreflex sensitivity. Conclusions A link between increased peripheral chemosensitivity and impaired autonomic control, including baroreflex inhibition, is demonstrated. The clinical importance of this phenomenon warrants further investigation.

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Documento generato il 11/07/20 alle ore 06:26:17