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Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope

Furlan, R. and Heusser, K. and Minonzio, M. and Shiffer, D. and Cairo, B. and Tank, J. and Jordan, J. and Diedrich, A. and Gauger, P. and Zamuner, Roberto, A. and Dipaola, F. and Porta, A. and Barbic, F. (2019) Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope. Journal of Clinical Medicine, 8 (1434). Multidisciplinary Digital Publishing Institute (MDPI). DOI: 10.3390/jcm8091434 ISSN 2077-0383

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Official URL: https://www.mdpi.com/2077-0383/8/9/1434

Abstract

We hypothesized that sympathetic baroreflex mediated uncoupling between neural sympathetic discharge pattern and arterial pressure (AP) fluctuations at 0.1 Hz during baroreceptor unloading might promote orthostatic pre-syncope. Ten volunteers (32 ± 6 years) underwent electrocardiogram, beat-to-beat AP, respiratory activity and muscle sympathetic nerve activity (MSNA) recordings while supine (REST) and during 80° head-up tilt (HUT) followed by −10 mmHg stepwise increase of lower body negative pressure until pre-syncope. Cardiac and sympathetic baroreflex sensitivity were quantified. Spectrum analysis of systolic and diastolic AP (SAP and DAP) and calibrated MSNA (cMSNA) variability assessed the low frequency fluctuations (LF, ~0.1 Hz) of SAP, DAP and cMSNA variability. The squared coherence function (K2) quantified the coupling between cMSNA and DAP in the LF band. Analyses were performed while supine, during asymptomatic HUT (T1) and at pre-syncope onset (T2). During T2 we found that: (1) sympathetic baroreceptor modulation was virtually abolished compared to T1; (2) a progressive decrease in AP was accompanied by a persistent but chaotic sympathetic firing; (3) coupling between cMSNA and AP series at 0.1 Hz was reduced compared to T1. A negligible sympathetic baroreceptor modulation during pre-syncope might disrupt sympathetic discharge pattern impairing the capability of vessels to constrict and promote pre-syncope.

Item URL in elib:https://elib.dlr.de/129779/
Document Type:Article
Title:Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope
Authors:
AuthorsInstitution or Email of AuthorsAuthors ORCID iD
Furlan, R.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyUNSPECIFIED
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Minonzio, M.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyUNSPECIFIED
Shiffer, D.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyUNSPECIFIED
Cairo, B.Department of Biomedical Sciences for Health, University of Milan, Milan, ItalyUNSPECIFIED
Tank, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Diedrich, A.Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TNUNSPECIFIED
Gauger, P.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.UNSPECIFIED
Zamuner, Roberto, A.Departamento de Kinesiología, Universidad Católica del Maule, 3530000 Talca, Maule, ChileUNSPECIFIED
Dipaola, F.Department of Internal Medicine, Humanitas Clinical and Research Center, IRCCS, Humanitas University,UNSPECIFIED
Porta, A.Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyUNSPECIFIED
Barbic, F.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyUNSPECIFIED
Date:10 September 2019
Journal or Publication Title:Journal of Clinical Medicine
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In SCOPUS:No
In ISI Web of Science:Yes
Volume:8
DOI :10.3390/jcm8091434
Publisher:Multidisciplinary Digital Publishing Institute (MDPI)
ISSN:2077-0383
Status:Published
Keywords:syncope; vasovagal; baroreceptors; muscle sympathetic nerve activity; power spectrum analysis; heart rate variability; blood pressure variability; MSNA variability
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 - Forschung unter Weltraumbedingungen
DLR - Research theme (Project):R - Vorhaben Systemphysiologie
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:29 Oct 2019 13:35
Last Modified:14 Dec 2019 04:25

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