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The efficacy of electrical baroreflex activation therapy is independent of peripheral chemoreceptor modulation

Heusser, K. and Thöne, A. and Lipp, A. and Menne, J. and Beige, J. and Reuter, H. and Hoffmann, F. and Halbach, M. and Eckert, S. and Wallbach, M. and Koziolek, M. and Haarmann, H. and Joyner, M. and Paton, J.F.R. and Diedrich, A. and Haller, H. and Jordan, J. and Tank, J. (2018) The efficacy of electrical baroreflex activation therapy is independent of peripheral chemoreceptor modulation. In: FASEB JOURNAL, 32 (S1), 884.6-884.6. Experimental Biology Meeting 2018, 21.-25. April 2018, San Diego. doi: 10.1096/fasebj.2018.32.1_supplement.884.6.

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Official URL: https://doi.org/10.1096/fasebj.2018.32.1_supplement.884.6

Abstract

Introduction Baroreflex activation through electrical carotid sinus stimulation has been developed for the treatment of patients with arterial hypertension not sufficiently responding to pharmacological therapy. Previous studies suggested that peripheral chemoreflex afferents located in proximity to carotid baroreceptors are tonically active in hypertensive patients and may inhibit baroreflex responses. Therefore, we hypothesized that peripheral chemoreflex activation attenuates the efficacy of electrical carotid sinus stimulation. Methods We screened 35 patients with an implanted electrical carotid sinus stimulator. Of those, 11 patients exhibited a consistent acute depressor response and were included in the study (7 men/4 women, age: 67±8 years, BMI: 31.6±5.2 kg/m2, 6±2 antihypertensive drug classes). We assessed responses to electrical baroreflex stimulation during normoxia, isocapnic hypoxia (SpO2: 79.0±1.5%), and hyperoxia (40% end‐tidal O2 fraction) by recording ECG, blood pressure (SBP), ventilation, SpO2, end‐tidal CO2 and O2 fractions, and muscle sympathetic nerve activity (MSNA). Results During normoxia, baroreflex activation reduced SBP from 164±27 to 151±25 mmHg (means±SD, p<0.001), HR from 64±13 to 61±13 bpm (p=0.002), and MSNA from 42±12 to 36±12 bursts/min (p=0.004). Hypoxia increased SBP 8±12 mmHg (p=0.057), HR 10±6 bpm (p<0.001), MSNA 7±7 bursts/min (p=0.031), and ventilation 10±7 l/min (p=0. 002). However, responses to electrical carotid sinus stimulation did not differ between hypoxic and hyperoxic conditions; SBP: −15±7 vs −14±8 mmHg (p=0.938), HR: −2±3 vs −2±2 bpm (p=0.701), and MSNA: −6±4 vs −4±3 bursts/min (p=0.531). Conclusion The main finding of our study is that moderate peripheral chemoreflex activation does not attenuate acute responses to electrical baroreflex activation therapy (BAT) in patients with resistant hypertension. These patients provide insight in human baroreflex physiology and baroreflex‐chemoreflex interactions that could not be gained otherwise.

Item URL in elib:https://elib.dlr.de/126087/
Document Type:Conference or Workshop Item (Poster)
Title:The efficacy of electrical baroreflex activation therapy is independent of peripheral chemoreceptor modulation
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Thöne, A.Clinical Research Center, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Lipp, A.Department of Neurology, Charité University-Medicine Berlin, Berlin, GermanyUNSPECIFIED
Menne, J.Department of Nephrology and Hypertension, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Beige, J.Department of Nephrology and KfH Renal Unit, Hospital St. Georg Leipzig, Leipzig, GermanyUNSPECIFIED
Reuter, H.University Hypertension Center, University of Cologne, Cologne, Germany, Department of Internal Medicine and Cardiology, Evangelisches Klinikum Köln, vDepartment III of Internal Medicine, Cardiac Center, University Hospital of Cologne, Cologne, GermanyUNSPECIFIED
Hoffmann, F.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.;Department of Cardiology, Pneumology, and Angiology, Heart Center of the University of Cologne, GermanyUNSPECIFIED
Halbach, M.Department of Cardiology, Pneumology, and Angiology, Heart Center of the University of Cologne, Cologne, GermanyUNSPECIFIED
Eckert, S.Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital, Ruhr University Bochum, Bad Oeynhausen, GermanyUNSPECIFIED
Wallbach, M.Department of Nephrology & Rheumatology, University Medical Center Göttingen, Göttingen, GermanyUNSPECIFIED
Koziolek, M.Department of Nephrology & Rheumatology, University Medical Center Göttingen, Göttingen, GermanyUNSPECIFIED
Haarmann, H.Clinic for Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, GermanyUNSPECIFIED
Joyner, M.Department of Anesthesiology, Mayo Clinic, Rochester, Rochester, MNUNSPECIFIED
Paton, J.F.R.School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United KingdomUNSPECIFIED
Diedrich, A.Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TennesseeUNSPECIFIED
Haller, H.Department of Nephrology and Hypertension, Hannover Medical School, Hannover, GermanyUNSPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany and Lehrstuhl für Luft- und Raumfahrtmedizin, Universität zu Köln; Jens.Jordan (at) dlr.dehttps://orcid.org/0000-0003-4518-0706
Tank, J.Cardiovascular Aerospace Medicine Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Jens.Tank (at) dlr.dehttps://orcid.org/0000-0002-5672-1187
Date:April 2018
Journal or Publication Title:FASEB JOURNAL
Refereed publication:Yes
Open Access:No
Gold Open Access:No
In SCOPUS:No
In ISI Web of Science:Yes
Volume:32
DOI :10.1096/fasebj.2018.32.1_supplement.884.6
Page Range:884.6-884.6
Status:Published
Keywords:Baroreflex; Chemoreceptor Modulation
Event Title:Experimental Biology Meeting 2018
Event Location:San Diego
Event Type:international Conference
Event Dates:21.-25. April 2018
Organizer:Federation of American Societies of Experimental Biology (FASEB)
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - Vorhaben Systemphysiologie (old)
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Deposited By: Schrage, Larissa
Deposited On:11 Jan 2021 14:40
Last Modified:11 Jan 2021 14:40

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