Increased sympathetic nerve activity and reduced cardiac baroreflex sensitivity in rheumatoid arthritis

Adlan, Ahmed; Paton, Julian F. R.; Lip, Gregory Y.H.; Kitas, George D.; Fisher, James

doi:10.1113/jp272944

Cited by 57 publications

(71 citation statements)

References 71 publications

(147 reference statements)

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“…; Adlan et al . ). Infusion of these agents results in a fall and subsequent rise in arterial BP that activates and deactivates the arterial baroreceptors.…”

Section: Methodsmentioning

confidence: 97%

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Acute hydrocortisone administration reduces cardiovagal baroreflex sensitivity and heart rate variability in young men

Adlan

Zanten

Lip

et al. 2018

The Journal of Physiology

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Key points A surge in cortisol during acute physiological and pathophysiological stress may precipitate ventricular arrhythmia and myocardial infarction.Reduced cardiovagal baroreflex sensitivity and heart rate variability are observed during acute stress and are associated with an increased risk of acute cardiac events.In the present study, healthy young men received either a single iv bolus of saline (placebo) or hydrocortisone, 1 week apart, in accordance with a randomized, placebo‐controlled, cross‐over study design.Hydrocortisone acutely increased heart rate and blood pressure and reduced cardiovagal baroreflex sensitivity and heart rate variability in young men.These findings suggest that, by reducing cardiovagal baroreflex sensitivity and heart rate variability, acute surges in cortisol facilitate a pro‐arrhythmic milieu and provide an important mechanistic link between stress and acute cardiac events AbstractSurges in cortisol concentration during acute stress may increase cardiovascular risk. To better understand the interactions between cortisol and the autonomic nervous system, we determined the acute effects of hydrocortisone administration on cardiovagal baroreflex sensitivity (BRS), heart rate variability (HRV) and cardiovascular reactivity. In a randomized, placebo‐controlled, single‐blinded cross‐over study, 10 healthy males received either a single iv bolus of saline (placebo) or 200 mg of hydrocortisone, 1 week apart. Heart rate (HR), blood pressure (BP) and limb blood flow were monitored 3 h later, at rest and during the sequential infusion of sodium nitroprusside and phenylephrine (modified Oxford Technique), a cold pressor test and a mental arithmetic stress task. HRV was assessed using the square root of the mean of the sum of the squares of differences between successive R‐R intervals (rMSSD). Hydrocortisone markedly increased serum cortisol 3 h following infusion and also compared to placebo. In addition, hydrocortisone elevated resting HR (+7 ± 4 beats min−1; P < 0.001) and systolic BP (+5 ± 5 mmHg; P = 0.008); lowered cardiovagal BRS [geometric mean (95% confidence interval) 15.6 (11.1–22.1) ms/mmHg vs. 26.2 (17.4––39.5) ms/mmHg, P = 0.011] and HRV (rMSSD 59 ± 29 ms vs. 84 ± 38 ms, P = 0.004) and increased leg vasoconstrictor responses to cold pressor test (Δ leg vascular conductance −45 ± 20% vs. −23 ± 26%; P = 0.023). In young men, an acute cortisol surge is accompanied by increases in HR and BP, as well as reductions in cardiovagal BRS and HRV, potentially providing a pro‐arrhythmic milieu that may precipitate ventricular arrhythmia or myocardial infarction and increase cardiovascular risk.

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“…; Adlan et al . ). Infusion of these agents results in a fall and subsequent rise in arterial BP that activates and deactivates the arterial baroreceptors.…”

Section: Methodsmentioning

confidence: 97%

“…; Adlan et al . ); the ‘sequence technique’ ( G SEQ ) (Parati et al . ); and low frequency transfer function gain ( G LFTF ) (deBoer et al .…”

Section: Methodsmentioning

confidence: 99%

Acute hydrocortisone administration reduces cardiovagal baroreflex sensitivity and heart rate variability in young men

Adlan

Zanten

Lip

et al. 2018

The Journal of Physiology

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“…Multiunit recordings of MSNA were obtained (FE185 NeuroAmp EX; ADInstruments) from the peroneal nerve using tungsten microelectrodes (FHC, Bowdoin, ME, USA; Adlan et al . ). A reference electrode was inserted s.c .…”

Section: Methodsmentioning

confidence: 97%

Carotid chemoreceptor control of muscle sympathetic nerve activity in hypobaric hypoxia

Fisher

Flück

Hilty

et al. 2017

Experimental Physiology

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Edited by: Paul Fadel New Findings r What is the central question of this study?High-altitude hypoxia increases muscle sympathetic nerve activity (MSNA), but whether intravenous infusion of dopamine, to blunt the responsiveness of the carotid chemoreceptors, reduces MSNA at high altitude is not known. r What is the main finding and its importance?Muscle sympathetic nerve activity was elevated after 15-17 days of high-altitude hypoxia (3454 m) compared with values at 'sea level' (432 m). However, intravenous dopamine infusion to blunt the responsiveness of the carotid chemoreceptors did not significantly decrease MSNA either at sea level or at high altitude, suggesting that high-altitude sympathoexcitation arises via a different mechanism.High-altitude hypoxia causes pronounced sympathoexcitation, but the underlying mechanisms remain unclear. We tested the hypothesis that i.v. infusion of dopamine to attenuate carotid chemoreceptor responsiveness would reduce muscle sympathetic nerve activity (MSNA) at high altitude. Nine healthy individuals [mean (SD); 26 (4) years of age] were studied at 'sea level' (SL; Zurich) and at high altitude (ALT; 3454 m; 15-17 days after arrival), both while breathing the ambient air and during an acute incremental hypoxia test (eight 3 min stages; partial pressure of end-tidal O 2 90-45 mmHg). Intravenous infusions of dopamine (3 µg kg −1 min −1 ) and placebo (saline) were administered on both study days, according to a single-blind randomized cross-over design. Sojourn to high altitude decreased the partial pressure of end-tidal O 2 (to ß60 mmHg) and increased minute ventilation [V E ; mean ± SEM, SL versus ALT: saline, 8.6 ± 0.5 versus 11.3 ± 0.6 l min −1 ; dopamine, 8.2 ± 0.5 versus 10.6 ± 0.8 l min −1 ; P < 0.05] and MSNA burst frequency by ß80% [SL versus ALT: saline, 16 ± 3 versus 28 ± 4 bursts min −1 ; dopamine, 16 ± 4 versus 31 ± 4 bursts min −1 ; P < 0.05) when breathing the ambient air, but were not different with dopamine. Increases in MSNA burst frequency andV E during the acute incremental hypoxia test were greater at ALT than SL (P < 0.05). Dopamine did not affect the magnitude of the MSNA burst frequency response to acute incremental hypoxia at either SL or ALT. However,V E was lower with dopamine than saline administration throughout the acute incremental hypoxia test at ALT. These data indicate that i.v. infusion of low-dose dopamine to blunt the responsiveness of the carotid chemoreceptors does not significantly decrease MSNA at high altitude.

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“…Among them, impairment in autonomic cardiovascular regulation, otherwise known as cardiovascular autonomic dysfunction, has received growing attention over recent years (Adlan et al . ).…”

Section: Neural–immune Imbalance As Integral Components Of the Cardiomentioning

confidence: 97%

“…Alternatively, it is possible to suggest that macrophage activation and the consequential increase in centrally and/or peripherally driven inflammation may contribute to an increased excitability of the premotor sympathetic neurons and to inhibition of cardiac vagal preganglionic neurons in the medulla, culminating in an increased sympathetic outflow to the heart and vasculature, and decreased parasympathetic outflow to the heart (Adlan et al . ).…”

Section: Neural–immune Imbalance As Integral Components Of the Cardiomentioning

confidence: 97%

Inflammation and cardiovascular autonomic dysfunction in rheumatoid arthritis: a bidirectional pathway leading to cardiovascular disease

Peçanha

Andrade-Lima

2017

The Journal of Physiology

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Increased sympathetic nerve activity and reduced cardiac baroreflex sensitivity in rheumatoid arthritis

Cited by 57 publications

References 71 publications

Acute hydrocortisone administration reduces cardiovagal baroreflex sensitivity and heart rate variability in young men

Acute hydrocortisone administration reduces cardiovagal baroreflex sensitivity and heart rate variability in young men

Carotid chemoreceptor control of muscle sympathetic nerve activity in hypobaric hypoxia

Inflammation and cardiovascular autonomic dysfunction in rheumatoid arthritis: a bidirectional pathway leading to cardiovascular disease

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