Tension and Distensibility of Carotid Sinus Wall, Pressoceptors and Blood Pressure Regulation

Heymans, C; Delaunois, A. L.; Heuvel-Heymans, G. Van Den

doi:10.1161/01.res.1.1.3

Cited by 19 publications

(8 citation statements)

References 4 publications

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“…It is likely that reconstruction of the aortic lumen at operation increases the effective outlet chamber area and reduces the tension within the chamber. The work of Heymans (31) has indicated that tension and resistance to stretch of the arterial wall at the location of the carotid sinus pressor-receptors are fundamental factors in regulating and modifying systemic arterial pressure. In a review of the carotid sinus mechanism, Pickering (41) cites the studies of Koch et al which demonstrate that when the carotid sinus and depressor nerves are sectioned in rabbits the animals develop hypertension.…”

Section: Discussionmentioning

confidence: 99%

Immediate and Remote Effects of Resection on the Hypertension in Coarctation of the Aorta

March¹,

Hultgren²,

Gerbode³

1960

Heart

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Twenty-five years ago Sir Thomas Lewis summarized the state of knowledge regarding this important congenital lesion (34)* and thought that "new records of cases can have little value unless they reveal new features of interest and importance to the study of the condition." Yet hardly more than a decade later the first patients with coarctation of the aorta were to be successfully operated upon in Sweden (11) and the United States (23). A new era of progress in the treatment and understanding of the pathological physiology of this lesion began. By 1953 Gross had operated on 270 patients (24), and more recently it has been possible to collect data on 1601 patients surgically treated by 36 surgeons (52). It is apparent that operative intervention for coarctation of the aorta has become widely practised. Its broad acceptance appears to be justified not only by the demonstration that the classical pulse abnormalities can be largely reversed (5a, b), but also by the reasonable safety of the procedure and by the subjective improvement of patients (7,8, 24).The cure of the characteristic hypertension has been included among the benefits of surgical treatment in reports from a number of clinics (6,10,20, 24,27,35). Indeed a fall in blood pressure does usually follow successful intervention, but most communications have described the condition shortly after the operative procedure, and the criteria for evaluation of the blood pressure response are usually referred to an arbitrary or ideal value. With few exceptions (6, 9, 59) systematic observations at remote intervals after treatment have not been made, and in one of these (9) the conclusions appear to be at variance with the more numerous and optimistic results reported just after operation. In this latter work alone were the data given careful statistical treatment.Obviously this question is of prognostic importance since the complications of hypertension are the cause of a quarter of the deaths in coarctation (24), and since in untreated cases there is a progressive increase in systolic pressure during the first two decades of life (6). Moreover, the issue is of interest from the theoretical point of view since the mechanism of most forms of hypertension is poorly understood, and that of coarctation has evoked considerable disagreement. The classical view that it is caused by the mechanical obstruction (3, 4,34) has been challenged on a number of grounds by those who hold that it is caused by an interference with the renal arterial flow producing a generalized increase in peripheral resistance (38,44,45). Finally, there has been speculation about the mechanism and significance of the abdominal pain and the paradoxical rise of blood pressure that not infrequently follow resection of the coarctation (2,43, 47). These considerations suggested that an immediate and long-term study of the effect of operation on coarctation hypertension would be desirable. MATERIALS AND METHODSIn the ten years, [1948][1949][1950][1951][1952][1953][1954][1955][1956][1957][1958] 80 patients ...

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Section: Discussionmentioning

confidence: 99%

Immediate and Remote Effects of Resection on the Hypertension in Coarctation of the Aorta

March¹,

Hultgren²,

Gerbode³

1960

Heart

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“…Since the hypotension is a direct effect of the drugs, these alterations were unaffected by pretreatment with atropine or bilateral vagal section. The tachycardia results from activation of the systemic arterial baroreflexes and involves withdrawal of vagal tone and augmentation of P-adrenergic tone (Heymans et al, 1953).…”

Section: Group IImentioning

confidence: 99%

Mechanisms of reflex bradycardia and hypotension by metabolites of arachidonic acid in the cat

Hintze

Kaley

Panzenbeck

1984

British J Pharmacology

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1 In the cat, intravenous injections of arachidonic acid or prostaglandin (PG)F2, caused significant reductions in mean arterial pressure and heart rate which were eliminated or significantly lessened, respectively, by previous administration of indomethacin. The bradycardia to intravenous prostacyclin (PGI2) was unaffected by indomethacin. 2 In cats with bilateral ligation of the carotid arteries to eliminate competition between systemic baroreflexes and cardiopulmonary reflexes, PGI2, PGFu and arachidonic acid caused significantly greater hypotension and bradycardia than in cats with intact carotid baroreflexes. 3 The bradycardia to PGO2, PGF2cx and arachidonic acid was eliminated by bilateral vagal section or atropine. 4 PGE1, PGE2 and nitroprusside caused dose-related falls in mean arterial pressure and a small tachycardia. 5 In a small group of cats (7 of 67) nitroprusside also caused a reduction in heart rate which was eliminated by indomethacin.6 We conclude that the reflex bradycardia to PGFu, like that to arachidonic acid is, at least in part, the result of the stimulation of synthesis of another prostaglandin, most likely PGI2.

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“…Conceivably, therefore, as the function of elastic tissue has been consi dered to be that of controlling the rate of change in the form of a structure [Hass, 1939;Ayer, 1964;Rodbard, 1970], then its preponderance at the baroreceptor area modulates the distension of the intimomedial layer in systole and its prompt resump tion of normal morphology in diastole. In this way the arterial wall maintains a smoothly graded and intermittend deforma tion to which the baroreceptor nerves have been shown to be more responsive [Ead et al, 1952;Heymans et al, 1953;Gero and Gerova, 1967] The Connective Tissue/Nerve Relationships Previous ultrastructural studies of the mammalian carotid sinus wall have shown that the terminal sensory endings are located mainly in the media-adventitial bor der and deep adventitia where they are closely related to the connective tissue ele ments and the adventitial smooth muscle cells [Rees, 1967[Rees, , 1968Chiba, 1972;Bock and Gorgas, 1976;Knoche and Addicks, 1976;Knoche et al, 1980]. The receptor nerve terminals located in the outer media are normally sandwiched between two par allel elastic lamellae [Knoche et al, 1980], while those situated at the media-adventitial border are frequently applied to the adven titial surface of the external elastic lamina [Rees, 1967], The receptors located in the deep adventitia are generally related to the isolated adventitial smooth muscle cells and the elastic fibres found in this region [Rees, 1967;Knoche et al, 1980], Receptors located within the outer adventitia are mostly surrounded by bundles of collagen fibres taking a multidirectional course [Rees, 1967;Chiba, 1972;Knoche and Addicks, 1976;Knoche ex al., 1980], The problems faced in this study when obtaining and processing material for elec tron microscopy from a large animal makes it relatively difficult to determine the pat terns of distribution of the sensory nerves in the presumptive carotid baroreceptor area.…”

Section: Correlation O F Elastic Structure and Sensory Innervationmentioning

confidence: 99%

Observations on the Structure and Innervation of the Presumptive Carotid Sinus Area in the Giraffe (<i>Giraffa camelopardalis</i>)

Kimani

Mungai²

1983

Cells Tissues Organs

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The tunica media of the giraffe carotid artery is characterised by a predominantly muscular structure, except for a small area at the origins of the occipital and the vestigal internal carotid arteries. The latter has a preponderantly elastic structure and corresponds in extent to the parts of the carotid arterial wall innervated by a branch of the glossopharyngeal nerve. Sensory nerve terminals, characterised by an abundance of mitochondria, are found in the deeper parts of the adventitia bordering the elastic zone. It is concluded that the elastic zone at the cranial portion of the carotid arterial system in the giraffe constitutes the equivalent of a carotid sinus. It is further suggested that the preponderance of elastic tissue in this area is a morphological adaptation of the arterial wall to a baroreceptor function. Pertinent to this suggestion is the demonstration of a close structural relationship between the sensory nerve endings and the elastic fibres.

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Tension and Distensibility of Carotid Sinus Wall, Pressoceptors and Blood Pressure Regulation

Cited by 19 publications

References 4 publications

Immediate and Remote Effects of Resection on the Hypertension in Coarctation of the Aorta

Immediate and Remote Effects of Resection on the Hypertension in Coarctation of the Aorta

Mechanisms of reflex bradycardia and hypotension by metabolites of arachidonic acid in the cat

Observations on the Structure and Innervation of the Presumptive Carotid Sinus Area in the Giraffe (<i>Giraffa camelopardalis</i>)

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