Preeclampsia-A State of Sympathetic Overactivity

Schobel, Hans P.; Fischer, Thorsten; Heuszer, Karsten; Geiger, Helmut; Schmieder, Roland E.

doi:10.1097/00006254-199704000-00002

Cited by 71 publications

(102 citation statements)

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“…Previous attempts to study autonomic nervous system function by means of plasma and urinary catecholamine concentrations did not give conclusive results. 23,30,31 A substantial increase in sympathetic vasoconstrictor activity has been found by Schobel et al, 1 measuring the postganglionic sympatheticnerve activity in the blood vessels of skeletal muscle. Since five of the nine pre-eclamptic patients received dihydralazine at the time of the study, we have to assume that pre-eclampsia was at a greater level of severity than in our patients.…”

Section: Discussionmentioning

confidence: 86%

“…The pathophysiological mechanism is still unknown, although some reports suggest an autonomic nervous dysfunction such as sympathetic and parasympathetic impairment. [1][2][3] Most studies have investigated autonomic nervous function by non-invasive evaluations using standard cardiovascular tests (ie, deep breathing, standing up, cold pressure tests and Valsalva manoeuvre), or by measuring the sympathetic nerve activity in the blood vessels of the skeletal muscle with intraneural microelectrodes. 1 Few studies used spectral analysis of blood pressure and heart rate variability to evaluate autonomic nervous system function in pre-eclampsia and pregnancyinduced hypertension, showing conflicting results ranging from decreased vagal control of the heart to increased sympathetic and parasympathetic control of heart rate and blood pressure.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Most studies have investigated autonomic nervous function by non-invasive evaluations using standard cardiovascular tests (ie, deep breathing, standing up, cold pressure tests and Valsalva manoeuvre), or by measuring the sympathetic nerve activity in the blood vessels of the skeletal muscle with intraneural microelectrodes. 1 Few studies used spectral analysis of blood pressure and heart rate variability to evaluate autonomic nervous system function in pre-eclampsia and pregnancyinduced hypertension, showing conflicting results ranging from decreased vagal control of the heart to increased sympathetic and parasympathetic control of heart rate and blood pressure. 2,4,5 In addition, baroreflex control has not been investigated to date in a dynamic way, by the frequency domain approach, such as cross-spectrum analysis and calculation of ␣-index, which has become a useful and non-invasive assessment of the spontaneous baroreflex gain.…”

Section: Introductionmentioning

confidence: 99%

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Baroreflex control of heart rate is impaired in pre-eclampsia

et al. 1999

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Autonomic nervous dysfunction, such as parasympathetic and sympathetic impairment, has been suggested as possible cause of pre-eclampsia, but the studies are not conclusive. Our purpose was to assess non-invasively if pre-eclampsia is associated with a decreased baroreflex function. Nine women with pre-eclampsia (PE), eight normotensive pregnant women, and seven healthy normotensive non-pregnant women were studied. Continuous finger blood pressure was recorded by a Portapres device in the left lateral recumbent position and active standing. Baroreflex gain was evaluated by

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Baroreflex control of heart rate is impaired in pre-eclampsia

et al. 1999

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“…18 Human studies on sympathetic activity during pregnancy focused mainly on muscular sympathetic nerve activity and provided conflicting results, reporting increased 7 and unaltered muscular sympathetic nerve activity levels. 19 Taking further into consideration that the sympathetic nervous system is highly localized 20 and the sympathetic neural outflow to muscles is not necessarily the same as that to the heart, it remains to be proven whether sympathetic cardiac activity is increased in normal human pregnancy and responsible for the observed changes in rate adaptation of the QT interval.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

et al. 2010

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The maternal heart significantly adapts to the circulatory needs of pregnancy, but the effect of pregnancy on ventricular repolarization is poorly understood. The aim of this study was to quantify longitudinal changes in ventricular repolarization during pregnancy. Monthly electrocardiographs (ECGs) were recorded in 32 pregnant women with normal uterine perfusion and 32 pregnant women with abnormal perfusion, starting from the 20th week of gestation until 3 days postpartum. Ventricular repolarization was assessed through various QT interval variability and heart rate adaptation measures. The pregnancy outcomes of all women with normal perfusion were normal. Among pregnancies with abnormal uterine perfusion, 15 pregnancy outcomes were normal, but 17 pregnancies developed preeclampsia and/or small-for-gestational-age infants. In pregnancies with normal perfusion, the QT c interval was unaltered, but the QT interval-heart rate hysteresis lag was shorter and the QT interval-heart rate regression residual was higher compared with those of a control group of 10 healthy non-pregnant women. Pregnancies with abnormal uterine perfusion that developed pathological outcomes showed significantly smaller QT interval-heart rate regression residuals and a trend towards shorter QT c intervals compared with pregnant women with normal perfusion. In conclusion, pregnancy has a significant effect on ventricular repolarization. Pregnancies with abnormal uterine perfusion and subsequent pathological outcomes are paralleled by changes in ventricular repolarization that precede clinical symptoms.

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“…Increased concentration of catecholamines in platelets and plasma reflects hyperactivity of the sympathetic nervous system. [2][3][4][5][6][7] Schobel et al 8 reported that postganglionic sympathetic-nerve activity of vascular smooth muscle is increased by means of intraneural microelectrodes in pre-eclamptic women. Supine hypertension (ie, positive rollover test) is observed in some cases of pre-eclampsia.…”

Section: Introductionmentioning

confidence: 99%

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

et al. 1999

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We hypothesised that long term epidural anaesthesia suppresses sympathetic overactivity in pre-eclampsia. Two equal groups of severe pre-eclamptic patients were treated either with long-term epidural anaesthesia (epidural group) or bed rest, diet control, and an antihypertensive drug (control group). After 7 days of epidural block, mean arterial blood pressures decreased, platelet count and serum total protein increased in all cases while proteinuria decreased in four cases. All patients treated with a long-term epidural therapy continued their pregnancies for more than 3 weeks after admission. The infants in the epidural group had 1-min Apgar scores above 8, a body weight of 2240 ± 310 g (mean ± s.d.) and

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Preeclampsia-A State of Sympathetic Overactivity

Cited by 71 publications

References 0 publications

Baroreflex control of heart rate is impaired in pre-eclampsia

Baroreflex control of heart rate is impaired in pre-eclampsia

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

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