Association of Sympathovagal Imbalance With Cardiovascular Risks in Young Prehypertensives

Pal, Gopal K.; Chandrasekaran, Adithan; Ananthanarayanan, Palghat Hariharan; Pal, Pravati; Nanda, Nivedita; Thiyagarajan, Durgadevi; Syamsunderkiran, Avupati N.; Lalitha, Venugopal; Dutta, Tarun Kumar

doi:10.1016/j.amjcard.2013.07.040

Cited by 52 publications

(44 citation statements)

References 30 publications

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“…The autonomic imbalance is closely related to increased cardiovascular risk. The increased sympathetic and decreased parasympathetic tone leads to decreased baroreflex gain (75). Thus, the increase in the baroreflex gain in TLR9 KO mice may reflect an increased vagal tone in these mice.…”

Section: Discussionmentioning

confidence: 98%

Toll-like receptor 9 plays a key role in the autonomic cardiac and baroreflex control of arterial pressure

Rodrigues

Silva

Hott

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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The crosstalk between the immune and the autonomic nervous system may impact the cardiovascular function. Toll-like receptors are components of the innate immune system and play developmental and physiological roles. Toll-like receptor 9 (TLR9) is involved in the pathogenesis of cardiovascular diseases, such as hypertension and heart failure. Since such diseases are commonly accompanied by autonomic imbalance and lower baroreflex sensitivity, we hypothesized that TLR9 modulates cardiac autonomic and baroreflex control of arterial pressure (AP). Toll-like receptor 9 knockout (TLR9 KO) and wild-type (WT) mice were implanted with catheters into carotid artery and jugular vein and allowed to recover for 3 days. After basal recording of AP, mice received methyl-atropine or propranolol. AP and pulse interval (PI) variability were evaluated in the time and frequency domain (spectral analysis), as well as by multiscale entropy. Spontaneous baroreflex was studied by sequence technique. Behavioral and cardiovascular responses to fear-conditioning stress were also evaluated. AP was similar between groups, but TLR9 KO mice exhibited lower basal heart rate (HR). AP variability was not different, but PI variability was increased in TLR9 KO mice. The total entropy was higher in TLR9 KO mice. Moreover, baroreflex function was found higher in TLR9 KO mice. Atropine-induced tachycardia was increased in TLR9 KO mice, whereas the propranolol-induced bradycardia was similar to WT mice. TLR9 KO mice exhibit increased behavioral and decreased tachycardia responses to fear-conditioning stress. In conclusion, our findings suggest that TLR9 may negatively modulate cardiac vagal tone and baroreflex in mice.

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Section: Discussionmentioning

confidence: 98%

Toll-like receptor 9 plays a key role in the autonomic cardiac and baroreflex control of arterial pressure

Rodrigues

Silva

Hott

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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show abstract

“…37 The triad of inflammation, oxidative stress, and impaired baroreflex sensitivity is well recognized in the chronic development of cardiometabolic disease. 38 In conscious rats, loss of baroreflex function impedes attenuation of peripheral ( joint) inflammation, mediated by sympathetic neural drive. 39 Thus, acute inflammation superimposed on a lack of established baroreflex 'reserve' may further detrimentally impair the neural anti-inflammatory armamentarium, which consequently jeopardizes metabolic homeostasis.…”

Section: Discussionmentioning

confidence: 99%

Baroreflex impairment and morbidity after major surgery

Toner

Jenkins

Ackland

2016

British Journal of Anaesthesia

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Background: Baroreflex dysfunction is a common feature of established cardiometabolic diseases that are most frequently associated with the development of critical illness. Laboratory models show that baroreflex dysfunction impairs cardiac contractility and cardiovascular performance, thereby increasing the risk of morbidity after trauma and sepsis. We hypothesized that baroreflex dysfunction contributes to excess postoperative morbidity after major surgery as a consequence of the inability to achieve adequate perioperative tissue oxygen delivery. Methods: In a randomized controlled trial of goal-directed haemodynamic therapy (GDT) in higher-risk surgical patients, baroreflex function was assessed using the spontaneous baroreflex sensitivity (BRS) method via an arterial line placed before surgery, using a validated sequence method technique (one beat lag). The BRS was calculated during the 6 h postoperative GDT intervention. Analyses of BRS were done by investigators blinded to clinical outcomes. The primary outcome was the association between postoperative baroreflex dysfunction (BRS <6 mm Hg s −1 , a negative prognostic threshold in cardiovascular

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“…The autonomic nervous system (through sympathetic and parasympathetic efferent nerves) regulates and integrates many functions in the human body – including cardiovascular activities – and the disruption in this regulation is associated with higher prevalence of adverse cardiovascular outcomes [17]. Consistent with this idea, obese adults exhibits an increase in sympathetic and a decrease in vagal activities, which has been linked to abnormal cardiovascular parameters [11].…”

Section: Introductionmentioning

confidence: 99%

Acute cyclooxygenase inhibition and baroreflex sensitivity in lean and obese adults

et al. 2016

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Purpose Obese adults exhibit increased levels of inflammation which may negatively affect blood pressure regulation. Based on existing literature, we hypothesized: 1) baroreflex sensitivity would be lower in obese adults when compared to lean adults, 2) acute ibuprofen (IBU, a cyclooxygenase inhibitor and nonsteroidal anti-inflammatory agent) administration would increase baroreflex sensitivity in obese adults, with no effect in lean adults. Methods Seven lean (4M, 3F) and six obese (5M, 1F) adults completed two visits randomized to control (CON) or IBU (800 mg oral). On each visit, blood pressure (intra-arterial catheter), heart rate (ECG), and muscle sympathetic nerve activity (MSNA, microneurography) were measured continuously. Sympathetic and cardiac baroreflex sensitivity were assessed using the modified Oxford technique. Results Measures of systemic inflammation [C-Reactive protein (CRP) and Interleukin-6 (IL-6)] were higher in obese adults when compared to lean adults, and tended to decrease with IBU (IL-6: p<0.05; CRP: p=0.14). Cardiac baroreflex sensitivity was lower in obese adults (14±2 vs 24±2 ms/mmHg, p=0.02), whereas sympathetic baroreflex sensitivity was higher in obese adults (−3.6±0.5 vs −2.1±0.5 bursts/100 beats/mmHg, p=0.03) when compared to lean. There was no effect of IBU on cardiac or sympathetic baroreflex sensitivity in either group (p-value range 0.20 – 0.71). Conclusion Despite obese individuals exhibiting higher levels of systemic inflammation and lower cardiac baroreflex sensitivity when compared to lean adults, an acute dose of IBU has no effect on cardiac or sympathetic baroreflex sensitivity.

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Association of Sympathovagal Imbalance With Cardiovascular Risks in Young Prehypertensives

Cited by 52 publications

References 30 publications

Toll-like receptor 9 plays a key role in the autonomic cardiac and baroreflex control of arterial pressure

Toll-like receptor 9 plays a key role in the autonomic cardiac and baroreflex control of arterial pressure

Baroreflex impairment and morbidity after major surgery

Acute cyclooxygenase inhibition and baroreflex sensitivity in lean and obese adults

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