Burgoyne S, Georgakopoulos D, Belenkie I, Tyberg JV. Systemic vascular effects of acute electrical baroreflex stimulation. Am J Physiol Heart Circ Physiol 307: H236 -H241, 2014. First published May 9, 2014; doi:10.1152/ajpheart.00422.2013.-We intended to determine if acute baroreflex activation therapy (BAT) increases venous capacitance and aortic conductance. BAT is effective in resistant hypertension, but its effect on the systemic vasculature is poorly understood. Left ventricular (LV) and aortic pressures and subdiaphragmatic aortic and caval flows (ultrasonic) were measured in six anesthetized dogs. Changes in abdominal blood volume (V abdominal) were estimated as the integrated difference in abdominal aortic inflow and caval outflow. An electrode was implanted on the right carotid sinus. Data were measured during control and BAT. Next, sodium nitroprusside (SNP) was infused and BAT was subsequently added. Finally, angiotensin II (ANG II) was infused, and three increased BAT currents were added. We found that BAT decreased mean aortic pressure (P Ao) by 22.5 Ϯ 1.3 mmHg (P Ͻ 0.001) and increased aortic conductance by 16.2 Ϯ 4.9% (P Ͻ 0.01) and V abdominal at a rate of 2.2 Ϯ 0.6 ml·kg Ϫ1 ·min Ϫ1 (P Ͻ 0.01). SNP decreased PAo by 17.4 Ϯ 0.7 mmHg (P Ͻ 0.001) and increased V abdominal at a rate of 2.2 Ϯ 0.7 ml·kg Ϫ1 ·min Ϫ1 (P Ͻ 0.05). During the SNP infusion, BAT decreased P Ao further, by 26.0 Ϯ 2.1 mmHg (P Ͻ 0.001). ANG II increased PAo by 40.4 Ϯ 3.5 mmHg (P ϭ 0.001). When an increased BAT current was added, P Ao decreased to baseline (P Ͻ 0.01) while aortic conductance increased from 62.3 Ϯ 5.2% to 80.2 Ϯ 3.3% (P Ͻ 0.05) of control. V abdominal increased at a rate of 1.8 Ϯ 0.9 ml·kg Ϫ1 ·min
Ϫ1(P Ͻ 0.01), reversing the ANG II effects. In conclusion, BAT increases arterial conductance, decreases P Ao, and increases venous capacitance even in the presence of powerful vasoactive drugs. Increasing venous capacitance may be an important effect of BAT in hypertension.baroreceptors; venous capacitance; aortic conductance ELECTRICAL BARORECEPTOR activation therapy (BAT) can be achieved with an implantable medical device (CVRx Inc.) and has been used to treat resistant hypertension (27). There is also potential for this approach to be useful in heart failure (11). While the effects of BAT on cardiac function (i.e., heart rate, contractility, and cardiac output) have been established (11), the effects on the peripheral circulation (i.e., arterial conductance and venous capacitance) have not been defined. Control of venous capacitance is important in the maintenance of cardiovascular homeostasis and cardiac output (35). Modulation of venous capacitance by sympathetic outflow has been demonstrated with studies during electrical stimulation, including splanchnic and hepatic nerves (5, 7), changes in carotid artery pressure (31), and pharmacological manipulation of sympathetic activity (23). The control of vascular capacitance by the carotid baroreflex has been well-investigated and demonstrated (30). While the effects of ...