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Testing individual baroreflex responses to hypoxia-induced peripheral chemoreflex stimulation

Kronsbein, H. and Gerlach, D.A. and Heusser, K. and Hoff, A. and Hoffmann, F. and Diedrich, A. and Ehmke, H. and Jordan, J. and Tank, J. (2020) Testing individual baroreflex responses to hypoxia-induced peripheral chemoreflex stimulation. Clinical Autonomic Research. Springer. DOI: 10.1007/s10286-019-00660-6. ISSN 0959-9851

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Abstract

INTRODUCTION: Baroreflexes and peripheral chemoreflexes control efferent autonomic activity making these reflexes treatment targets for arterial hypertension. The literature on their interaction is controversial, with suggestions that their individual and collective influence on blood pressure and heart rate regulation is variable. Therefore, we applied a study design that allows the elucidation of individual baroreflex-chemoreflex interactions. METHODS: We studied nine healthy young men who breathed either normal air (normoxia) or an air-nitrogen-carbon dioxide mixture with decreased oxygen content (hypoxia) for 90 min, with randomization to condition, followed by a 30-min recovery period and then exposure to the other condition for 90 min. Multiple intravenous phenylephrine bolus doses were applied per condition to determine phenylephrine pressor sensitivity as an estimate of baroreflex blood pressure buffering and cardiovagal baroreflex sensitivity (BRS). RESULTS: Hypoxia reduced arterial oxygen saturation from 98.1 ± 0.4 to 81.0 ± 0.4% (p < 0.001), raised heart rate from 62.9 ± 2.1 to 76.0 ± 3.6 bpm (p < 0.001), but did not change systolic blood pressure (p = 0.182). Of the nine subjects, six had significantly lower BRS in hypoxia (p < 0.05), two showed a significantly decreased pressor response, and three showed a significantly increased pressor response to phenylephrine in hypoxia, likely through reduced baroreflex buffering (p < 0.05). On average, hypoxia decreased BRS by 6.4 ± 0.9 ms/mmHg (19.9 ± 2.0 vs. 14.12 ± 1.6 ms/mmHg; p < 0.001) but did not change the phenylephrine pressor response (p = 0.878). CONCLUSION: We applied an approach to assess individual baroreflex-chemoreflex interactions in human subjects. A subgroup exhibited significant impairments in baroreflex blood pressure buffering and BRS with peripheral chemoreflex activation. The methodology may have utility in elucidating individual pathophysiology and in targeting treatments modulating baroreflex or chemoreflex function.

Item URL in elib:https://elib.dlr.de/134755/
Document Type:Article
Title:Testing individual baroreflex responses to hypoxia-induced peripheral chemoreflex stimulation
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Kronsbein, H.Institute of Aerospace Medicine, German Aerospace Center, Cologne, GermanyUNSPECIFIED
Gerlach, D.A.Cardiovascular Aerospace Medicine Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germanyhttps://orcid.org/0000-0001-7044-6065
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center, Cologne, GermanyUNSPECIFIED
Hoff, A.Institute of Aerospace Medicine, German Aerospace Center, 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
Diedrich, A.Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TNUNSPECIFIED
Ehmke, H.Institute of Cellular and Integrative Physiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUNSPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; 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:23 January 2020
Journal or Publication Title:Clinical Autonomic Research
Refereed publication:Yes
Open Access:Yes
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
DOI :10.1007/s10286-019-00660-6.
Publisher:Springer
ISSN:0959-9851
Status:Published
Keywords:Blood pressure; Cardiovascular; Chemoreflex; Pharmacological baroreflex; Phenylephrine
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 Apr 2020 11:05
Last Modified:29 Apr 2020 11:35

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