RESUMO
BACKGROUND: Sympathetic activity causes changes in electrocardiogram (ECG) during cold exposure and the changes have been studied mostly during hypothermia and less during mild acute nonshivering cold exposure. Cold-induced sympathetic activity also activates brown adipose tissue (BAT) and increases arterial blood pressure (BP) and plasma catecholamine levels. We examined changes in ECG parameters during acute nonshivering cold exposure and their associations with markers of sympathetic activity during cold exposure: brachial blood pressure (BP), plasma catecholamine levels, and BAT activity measured by positron emission tomography (PET). METHODS AND RESULTS: Healthy subjects (M/F = 13/24, aged 20-55 years) were imaged with [15 O]H2 O (perfusion, N = 37) and [18 F]FTHA to measure plasma nonesterified fatty acid uptake (NEFA uptake, N = 37) during 2-h nonshivering cold exposure. 12-lead ECG (N = 37), plasma catecholamine levels (N = 17), and brachial BP (N = 31) were measured at rest in room temperature (RT) and re-measured after a 2-h nonshivering cold exposure. There were significant differences between RT and cold exposure in P axis (35.6 ± 26.4 vs. 50.8 ± 22.7 degrees, p = 0.005), PR interval (177.7 ± 24.6 ms vs.163.0 ± 28.7 ms, p = 0.001), QRS axis (42.1 ± 31.3 vs. 56.9 ± 24.1, p = 0.003), and QT (411.7 ± 25.5 ms vs. 434.5 ± 39.3 ms, p = 0.001). There was no significant change in HR, QRS duration, QTc, JTc, and T axis during cold exposure. Systolic BP (127.2 ± 15.7 vs. 131.8 ± 17.9 mmHg, p = 0.008), diastolic BP (81.7 ± 12.0 vs. 85.4 ± 13.0 mmHg, p = 0.02), and plasma noradrenaline level increased during cold exposure (1.97 ± 0.61 vs. 5.07 ± 1.32 µmol/L, p = 0.001). Cold-induced changes in ECG parameters did not correlate with changes in BAT activity, brachial BP, plasma catecholamines, or skin temperature. CONCLUSIONS: During short-term nonshivering cold exposure, there were increases in P axis, PR interval, QRS axis, and QT compared to RT in healthy adults. Cold-induced changes in ECG parameters did not correlate with BAT activity, brachial BP, or plasma catecholamine levels which were used as markers of cold-induced sympathetic activity.
Assuntos
Tecido Adiposo Marrom/inervação , Pressão Arterial , Artéria Braquial/inervação , Catecolaminas/sangue , Temperatura Baixa , Eletrocardiografia , Voluntários Saudáveis , Frequência Cardíaca , Sistema Nervoso Simpático/fisiologia , Adaptação Fisiológica , Tecido Adiposo Marrom/diagnóstico por imagem , Tecido Adiposo Marrom/metabolismo , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Sistema Nervoso Simpático/metabolismo , Fatores de Tempo , Adulto JovemRESUMO
Prolonged sitting, which is known to impair peripheral vascular function, often occurs in spaces (e.g., offices) with mild hypercapnic atmospheres. However, the effects of prolonged sitting in hypercapnic conditions on vascular function are unknown. Therefore, the purpose of this study was to investigate the effects of prolonged sitting in mild hypercapnic conditions on vascular and autonomic function in humans. Twelve healthy young adults participated in two experimental visits that consisted of sitting for 2.5 h in a control condition [normal atmospheric conditions sitting (PSIT)] or a mild hypercapnic condition (HCAP; CO2 = 1,500 ppm). During each visit, heart rate variability (HRV), blood pressure (BP), pulse wave velocity (PWV), augmentation index (AIx), brachial and popliteal artery flow-mediated dilation (FMD), and near-infrared spectroscopy (NIRS) were assessed before and after prolonged sitting. Sitting significantly decreased AIx in both groups (P < 0.05). Brachial and popliteal FMD were reduced with sitting (P < 0.05), and the reduction in popliteal FMD was amplified by HCAP (P < 0.05). Baseline microvascular oxygenation was decreased following sitting in both groups (P < 0.05). However, microvascular reoxygenation upon cuff release was slower only in HCAP (P < 0.05). HRV, HR, BP, and PWV did not significantly change with sitting in either group (P > 0.05). We conclude that prolonged sitting attenuated both brachial and popliteal endothelial function and was associated with perturbed microcirculation. Additionally, mild hypercapnic conditions further impaired peripheral endothelial and microvascular function. Together, these findings suggest that prolonged sitting is accompanied by a host of deleterious effects on the vasculature, which are exacerbated by mild hypercapnia.NEW & NOTEWORTHY The results of this study reveal that prolonged sitting attenuates endothelial function and microvascular function. Additionally, prolonged sitting with mild hypercapnia, which is similar to everyday environments, further exacerbates peripheral endothelial function and microvascular function.
Assuntos
Artéria Braquial/inervação , Hemodinâmica , Hipercapnia/fisiopatologia , Artéria Poplítea/inervação , Postura Sentada , Sistema Nervoso Simpático/fisiopatologia , Adulto , Pressão Arterial , Artéria Braquial/diagnóstico por imagem , Feminino , Frequência Cardíaca , Hemoglobinas/metabolismo , Humanos , Hipercapnia/sangue , Hipercapnia/diagnóstico por imagem , Masculino , Microcirculação , Oxiemoglobinas/metabolismo , Artéria Poplítea/diagnóstico por imagem , Fatores de Tempo , Rigidez Vascular , Adulto JovemRESUMO
Our objective was to define the positions of the nerves around the brachial artery and, secondarily, to assess the risk of intraneural injection during dual guided axillary block. Sixty ultrasound-guided axillary blocks were performed. The locations of the musculocutaneous, median, ulnar, and radial nerves relative to the brachial artery were determined. The position of the ulnar nerve was defined in relation to that of the brachial vein, and the position of the musculocutaneous nerve in relation to the coracobrachialis muscle. The locations were confirmed by neurostimulation and injection of local anesthetic was avoided when the current intensities were below 0.3 mA. The incidences of intraneural injection and postblock neurological injury were recorded. The median nerve was located in the upper external quadrant in 89% of cases and the ulnar nerve in the upper internal quadrant (95%), superficial (19%), or deep (81%) to the brachial vein. The radial nerve was located in the lower internal quadrant in 97% of cases, and the musculocutaneous nerve in the lower external quadrant in 85%. Its disposition differed depending on its proximity to the artery (106 ± 26°) or whether it was inside the coracobrachialis muscle (119 ± 15°; P = 0.023). Three intraneural injections were observed (0.5%, one in the median and two in the radial nerves) and no patient had postblock neuropathy. Our study evidences slight anatomical variability among the neural structures in the axillary region and confirms the safety of the axillary technique with double monitoring, using ultrasound to monitor the approach of the needle to the nerve and nerve stimulation at currents > 0.3 mA to reduce the incidence of intraneural injection. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. 2018.
Assuntos
Artéria Braquial/inervação , Plexo Braquial/anatomia & histologia , Adulto , Artéria Braquial/diagnóstico por imagem , Bloqueio do Plexo Braquial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , UltrassonografiaRESUMO
To study how changes in baroreceptor afferent activity affect patterns of sympathetic neural activation, we manipulated arterial blood pressure with intravenous nitroprusside (NTP) and phenylephrine (PE) and measured action potential (AP) patterns with wavelet-based methodology. We hypothesized that 1) baroreflex unloading (NTP) would increase firing of low-threshold axons and recruitment of latent axons and 2) baroreflex loading (PE) would decrease firing of low-threshold axons. Heart rate (HR, ECG), arterial blood pressure (BP, brachial catheter), and muscle sympathetic nerve activity (MSNA, microneurography of peroneal nerve) were measured at baseline and during steady-state systemic, intravenous NTP (0.5-1.2 µg·kg-1·min-1, n = 13) or PE (0.2-1.0 µg·kg-1·min-1, n = 9) infusion. BP decreased and HR and integrated MSNA increased with NTP ( P < 0.01). AP incidence (326 ± 66 to 579 ± 129 APs/100 heartbeats) and AP content per integrated burst (8 ± 1 to 11 ± 2 APs/burst) increased with NTP ( P < 0.05). The firing probability of low-threshold axons increased with NTP, and recruitment of high-threshold axons was observed (22 ± 3 to 24 ± 3 max cluster number, 9 ± 1 to 11 ± 1 clusters/burst; P < 0.05). BP increased and HR and integrated MSNA decreased with PE ( P < 0.05). PE decreased AP incidence (406 ± 128 to 166 ± 42 APs/100 heartbeats) and resulted in fewer unique clusters (15 ± 2 to 9 ± 1 max cluster number, P < 0.05); components of an integrated burst (APs or clusters per burst) were not altered ( P > 0.05). These data support a hierarchical pattern of sympathetic neural activation during manipulation of baroreceptor afferent activity, with rate coding of active neurons playing the predominant role and recruitment/derecruitment of higher-threshold units occurring with steady-state hypotensive stress. NEW & NOTEWORTHY To study how changes in baroreceptor afferent activity affect patterns of sympathetic neural activation, we manipulated arterial blood pressure with intravenous nitroprusside and phenylephrine and measured sympathetic outflow with wavelet-based methodology. Baroreflex unloading increased sympathetic activity by increasing firing probability of low-threshold axons (rate coding) and recruiting new populations of high-threshold axons. Baroreflex loading decreased sympathetic activity by decreasing the firing probability of larger axons (derecruitment); however, the components of an integrated burst were unaffected.
Assuntos
Barorreflexo , Artéria Braquial/fisiologia , Sistema Nervoso Simpático/fisiologia , Potenciais de Ação , Adulto , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/inervação , Feminino , Frequência Cardíaca , Humanos , Masculino , Nitroprussiato/farmacologia , Nervo Fibular/fisiologia , Fenilefrina/farmacologia , Pressorreceptores/fisiologia , Sistema Nervoso Simpático/efeitos dos fármacos , Vasoconstritores/farmacologia , Vasodilatadores/farmacologiaRESUMO
The octopus arm contains a tridimensional array of muscles with a massive sensory-motor system. We herein provide the first evidence for the existence of serotonin (5-HT) in the octopus arm nervous system and investigated its distribution using immunohistochemistry. 5-HT-like immunoreactive (5-HT-lir) nerve cell bodies were exclusively localized in the cellular layer of the axial nerve cord. Those cell bodies emitted 5-HT-lir nerve fibers in the direction of the sucker, the intramuscular nerves cords, the ganglion of the sucker, and the intrinsic musculature. Others 5-HT-lir nerve fibers were observed in various tissues, including the cerebrobrachial tract, the skin, and the blood vessels. 5-HT was detected by high-performance liquid chromatography in various regions of the octopus arm at levels matching the density of 5-HT-lir staining. The absence of 5-HT-lir interconnections between the cerebrobrachial tract and the other components of the axial nerve cord suggests that two types of 5-HT-lir innervation exist in the arm. One type, which originates from the brain, may innervate the periphery through the cerebrobrachial tract. Another type, which originates in the cellular layer of the axial nerve cord, may form an intrinsic network in the arm. In addition, 5-HT-lir fibers likely emitted from the neuropil of the axial nerve cord were found to project into cells showing staining for peripheral choline acetyltransferase, a marker of sensory cells of the sucker. Taken together, these observations suggest that intrinsic 5-HT-lir innervation may participate in the sensory transmission in the octopus arm.
Assuntos
Extremidades/anatomia & histologia , Fibras Nervosas/metabolismo , Neurônios/metabolismo , Serotonina/metabolismo , Animais , Artéria Braquial/inervação , Colina O-Acetiltransferase/metabolismo , Cromatografia Líquida de Alta Pressão , Técnicas Eletroquímicas , Extremidades/fisiologia , OctopodiformesRESUMO
BACKGROUND: Impairments in macrovascular, microvascular and autonomic function are present in asymptomatic youths with clustered cardiovascular disease risk factors. This study determines the within-day reliability and between-day reliability of a single protocol to non-invasively assess these outcomes in adolescents. METHODS: Forty 12- to 15-year-old adolescents (20 boys) visited the laboratory in a fasted state on two occasions, approximately 1 week apart. One hour after a standardized cereal breakfast, macrovascular function was determined via flow-mediated dilation (FMD). Heart rate variability (root mean square of successive R-R intervals; RMSSD) was determined from the ECG-gated ultrasound images acquired during the FMD protocol prior to cuff occlusion. Microvascular function was simultaneously quantified as the peak (PRH) and total (TRH) hyperaemic response to occlusion in the cutaneous circulation of the forearm via laser Doppler imaging. To address within-day reliability, a subset of twenty adolescents (10 boys) repeated these measures 90 min afterwards on one occasion. RESULTS: The within-day typical error and between-day typical error expressed as a coefficient of variation of these outcomes are as follows: ratio-scaled FMD, 5·1% and 10·6%; allometrically scaled FMD, 4·4% and 9·4%; PRH, 11% and 13·3%; TRH, 29·9% and 23·1%; and RMSSD, 17·6% and 17·6%. The within- and between-day test-retest correlation coefficients for these outcomes were all significant (r > 0·54 for all). CONCLUSION: Macrovascular, microvascular and autonomic functions can be simultaneously and non-invasively determined in adolescents using a single protocol with an appropriate degree of reproducibility. Determining these outcomes may provide greater understanding of the progression of cardiovascular disease and aid early intervention.
Assuntos
Sistema Nervoso Autônomo/fisiologia , Artéria Braquial/diagnóstico por imagem , Técnicas de Imagem de Sincronização Cardíaca , Eletrocardiografia , Endotélio Vascular/diagnóstico por imagem , Frequência Cardíaca , Microvasos/diagnóstico por imagem , Ultrassonografia Doppler , Vasodilatação , Adolescente , Artéria Braquial/inervação , Criança , Endotélio Vascular/inervação , Feminino , Humanos , Masculino , Microvasos/inervação , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
Transient reduction in vascular function following systemic large muscle group exercise has previously been reported in humans. The mechanisms responsible are currently unknown. We hypothesised that sympathetic nervous system activation, induced by cycle ergometer exercise, would contribute to post-exercise reductions in flow-mediated dilatation (FMD). Ten healthy male subjects (28 ± 5 years) undertook two 30 min sessions of cycle exercise at 75% HR(max). Prior to exercise, individuals ingested either a placebo or an α1-adrenoreceptor blocker (prazosin; 0.05 mg kg(-1)). Central haemodynamics, brachial artery shear rate (SR) and blood flow profiles were assessed throughout each exercise bout and in response to brachial artery FMD, measured prior to, immediately after and 60 min after exercise. Cycle exercise increased both mean and antegrade SR (P < 0.001) with retrograde SR also elevated under both conditions (P < 0.001). Pre-exercise FMD was similar on both occasions, and was significantly reduced (27%) immediately following exercise in the placebo condition (t-test, P = 0.03). In contrast, FMD increased (37%) immediately following exercise in the prazosin condition (t-test, P = 0.004, interaction effect P = 0.01). Post-exercise FMD remained different between conditions after correction for baseline diameters preceding cuff deflation and also post-deflation SR. No differences in FMD or other variables were evident 60 min following recovery. Our results indicate that sympathetic vasoconstriction competes with endothelium-dependent dilator activity to determine post-exercise arterial function. These findings have implications for understanding the chronic impacts of interventions, such as exercise training, which affect both sympathetic activity and arterial shear stress.
Assuntos
Exercício Físico , Fluxo Sanguíneo Regional , Sistema Nervoso Simpático/fisiologia , Vasodilatação , Agonistas alfa-Adrenérgicos/farmacologia , Adulto , Artéria Braquial/inervação , Artéria Braquial/fisiologia , Hemodinâmica , Humanos , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Prazosina/farmacologia , Sistema Nervoso Simpático/efeitos dos fármacosRESUMO
NEW FINDINGS: What is the central question of this study? This study addresses the following two central questions. (i) What is the impact of vascular deconditioning after spinal cord injury (SCI) on shear rate patterns and endothelial function? (ii) What is the impact of acutely altered shear rate on endothelial function in both SCI and able-bodied control subjects? What is the main finding and its importance? Two main findings in the present study were as follows: (i) reduced superficial femoral artery endothelial function in the SCI group; and (ii) acutely altered shear rate decreased endothelial function in both SCI and able-bodied control subjects. These findings may shed some light on future interventions taking into account these regulatory mechanisms. Spinal cord injury (SCI) induces vascular deconditioning below the level of the lesion and disrupts sympathetic innervation of blood vessels. It is unclear how these changes affect shear rate (SR) profiles and endothelial function when compared with able-bodied (AB) persons. Recent evidence suggests that periods of increased retrograde SR are associated with acute decreases in endothelial function, but is unknown how modified SR patterns influence sublesional vasculature in SCI. The present study examined the acute and chronic effects of altered SR patterns and oscillatory shear index on endothelial function via relative flow-mediated dilatation (FMD%) in both the brachial and superficial femoral arteries (BA and SFA, respectively) of eight individuals with SCI and eight matched AB control subjects. Baseline BA SR patterns and FMD% were similar between groups, while SFA anterograde SR was higher (P < 0.01) and FMD% lower (P = 0.04) in SCI versus AB subjects. Shear rate patterns were then acutely altered through the BA and SFA using a subsystolic cuff-inflation model. Bilateral FMD assessments were conducted before and after 30 min of unilateral inflation of a forearm or thigh blood pressure cuff to 75 mmHg. Cuff inflation resulted in concomitant increases in both anterograde (P < 0.05) and retrograde SR (P < 0.05), as well as acute decreases in FMD% (P < 0.05) in the BA and SFA in both groups. These results highlight that brief manipulation of SR patterns can acutely impair FMD% in conditions of both normal and altered sympathetic innervation and arterial remodelling. This information is crucial when designing strategies to combat impaired vascular function in both healthy and clinical populations.
Assuntos
Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Artéria Femoral/fisiopatologia , Extremidade Inferior/irrigação sanguínea , Traumatismos da Medula Espinal/fisiopatologia , Extremidade Superior/irrigação sanguínea , Vasodilatação , Adaptação Fisiológica , Adulto , Velocidade do Fluxo Sanguíneo , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/inervação , Estudos de Casos e Controles , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/inervação , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Traumatismos da Medula Espinal/diagnóstico , Estresse Mecânico , Fatores de Tempo , Ultrassonografia Doppler de PulsoRESUMO
The autonomic nervous system plays a central role in both acute and chronic blood pressure regulation in humans. The activity of the sympathetic branch of the autonomic nervous system is positively associated with peripheral resistance, an important determinant of mean arterial pressure in men. In contrast, there is no association between sympathetic nerve activity and peripheral resistance in women before menopause, yet a positive association after menopause. We hypothesized that autonomic support of blood pressure is higher after menopause in women. We examined the effect of ganglionic blockade on arterial blood pressure and how this relates to baseline muscle sympathetic nerve activity in 12 young (25±1 years) and 12 older postmenopausal (61±2 years) women. The women were studied before and during autonomic blockade using trimethaphan camsylate. At baseline, muscle sympathetic nerve activity burst frequency and burst incidence were higher in the older women (33±3 versus 15±1 bursts/min; 57±5 versus 25±2 bursts/100 heartbeats, respectively; P<0.05). Muscle sympathetic nerve activity bursts were abolished by trimethaphan within minutes. Older women had a greater decrease in mean arterial pressure (-29±2 versus -9±2 mm Hg; P<0.01) and total peripheral resistance (-10±1 versus -5±1 mm Hg/L per minute; P<0.01) during trimethaphan. Baseline muscle sympathetic nerve activity was associated with the decrease in mean arterial pressure during trimethaphan (r=-0.74; P<0.05). In summary, our results suggest that autonomic support of blood pressure is greater in older women compared with young women and that elevated sympathetic nerve activity in older women contributes importantly to the increased incidence of hypertension after menopause.
Assuntos
Envelhecimento/fisiologia , Pressão Sanguínea/fisiologia , Hipertensão/fisiopatologia , Sistema Nervoso Simpático/fisiologia , Resistência Vascular/fisiologia , Adulto , Pressão Sanguínea/efeitos dos fármacos , Artéria Braquial/inervação , Artéria Braquial/fisiologia , Feminino , Bloqueadores Ganglionares/administração & dosagem , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Nervo Fibular/fisiologia , Sistema Nervoso Simpático/efeitos dos fármacos , Trimetafano/administração & dosagem , Resistência Vascular/efeitos dos fármacos , Vasodilatadores/administração & dosagem , Adulto JovemRESUMO
BACKGROUND: Sildenafil, a selective phosphodiesterase-type-5 (PDE-5) inhibitor, produces vasodilation that improves erectile dysfunction and pulmonary hypertension. Sildenafil could also cause baroreflex sympathetic activation that would enhance vascular tone and oppose direct vasodilation. We tested the hypothesis that sildenafil administration increases sympathetically mediated vascular tone in healthy middle-aged men. METHODS: We randomized 9 healthy, middle-aged, male volunteers (mean age 45±2 years) in a double-blind, crossover fashion to receive a single oral dose of sildenafil 100mg or placebo on 2 separate study days. Hemodynamics and forearm blood flow responses were measured at baseline, at 30 and 45 minutes after study drug administration, and then during intra-arterial infusions of vasoactive drugs. After sildenafil and placebo administration, intrabrachial medications were infused to test forearm alpha receptor sensitivity (norepinephrine), cyclic-AMP-mediated vasodilation (isoproterenol), and sympathetically mediated vascular tone (phentolamine) (adenosine was a control vasodilator). Blood samples were taken before and 60 minutes after study drug administration and at the end of the intrabrachial infusions for measurement of plasma norepinephrine concentrations. RESULTS: Forearm vascular responses to norepinephrine, isoproterenol, and adenosine were not different after placebo and sildenafil administration. Percentage reduction in forearm vascular resistance during phentolamine was significantly lower after sildenafil than placebo (-73% ± 3% vs -63% ± 3%; P = 0.0002). Sildenafil significantly increased plasma norepinephrine compared with placebo 60 minutes after study drug administration and at the end of the study session (P = 0.02). CONCLUSIONS: Sildenafil increased sympathetically mediated vascular tone in middle-aged healthy men. Alpha-adrenergic-mediated vasoconstriction may offset vasodilation during PDE-5 inhibition and may explain the significant hypotension observed in patients taking alpha-blockers with sildenafil.
Assuntos
Hipertensão/tratamento farmacológico , Piperazinas/administração & dosagem , Sulfonas/administração & dosagem , Sistema Nervoso Simpático/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/inervação , Artéria Braquial/fisiopatologia , Estudos Cross-Over , Método Duplo-Cego , Seguimentos , Antebraço/irrigação sanguínea , Humanos , Hipertensão/fisiopatologia , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Inibidores da Fosfodiesterase 5/administração & dosagem , Purinas/administração & dosagem , Valores de Referência , Citrato de Sildenafila , Sistema Nervoso Simpático/fisiopatologia , Vasodilatação/fisiologiaRESUMO
Although vascular function is lower in the morning than afternoon, previous studies have not assessed the influence of prior sleep on this diurnal variation. The authors employed a semiconstant routine protocol to study the contribution of prior nocturnal sleep to the previously observed impairment in vascular function in the morning. Brachial artery vascular function was assessed using the flow-mediated dilation technique (FMD) in 9 healthy, physically active males (mean ± SD: 27 ± 9 yrs of age), at 08:00 and 16:00 h following, respectively, 3.29 ± .37 and 3.24 ± .57 h prior sleep estimated using actimetry. Heart rate and systolic and diastolic blood pressures were also measured. The data of the experimental sleep condition were compared with the data of the "normal" diurnal sleep condition, in which FMD measurements were obtained from 21 healthy individuals who slept only during the night, as usual, before the morning test session. The morning-afternoon difference in FMD was 1 ± 4% in the experimental sleep condition compared with 3 ± 4% in the normal sleep condition (p = .04). This difference was explained by FMD being 3 ± 3% lower in afternoon following the prior experimental sleep (p = .01). These data suggest that FMD is more dependent on the influence of supine sleep than the endogenous circadian timekeeper, in agreement with our previous finding that diurnal variation in FMD is influenced by exercise. These findings also raise the possibility of a lower homeostatic "set point" for vascular function following a period of sleep and in the absence of perturbing hemodynamic fluctuation.
Assuntos
Vasos Sanguíneos/fisiologia , Ritmo Circadiano/fisiologia , Sono/fisiologia , Adolescente , Adulto , Vasos Sanguíneos/diagnóstico por imagem , Vasos Sanguíneos/inervação , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/inervação , Artéria Braquial/fisiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Endotélio Vascular/fisiologia , Humanos , Masculino , Modelos Cardiovasculares , Ultrassonografia , Vasodilatação/fisiologia , Sistema Vasomotor/fisiologia , Adulto JovemRESUMO
Brachial Plexus is formed by the union of the anterior rami of cervical 5, 6, 7, 8 and thoracic 1 nerves. These nerves unite and divide to form the key nerves innervating the upper limb. Variations in the course of these nerves are clinically important to anesthetists, neurologists and orthopedicians. We report bilateral variations in the arterial and neural structures in the upper limb of a 65 year old cadaver. The muscles of the arm on one side were innervated by the median nerve with absence ofmusculocutaneous. While on the other side the musculocutaneous nerve contributed to the formation of the median nerve. There was a presence of high bifurcation of brachial artery on both sides. Knowledge of such variations in the innervations of muscles and the arterial supply of the limbs are important to remember before performing any reconstructive procedures or interventions on the limb.
Assuntos
Artéria Braquial/anormalidades , Nervo Mediano/anormalidades , Nervo Musculocutâneo/anormalidades , Idoso , Artéria Braquial/inervação , Humanos , MasculinoRESUMO
64 patients operated on the reason of complex regional hand pain syndrome were examined with the use of laser spectral Doppler flowmetry and thermography. 33 patients had thoracoscopic Th3 ganglion clipation; 16 patients had brachial artery and vein perivascular sympathectomy; 15 patients periarterial sympathectomy on the level of brachial artery. Desympathisation (microcirculatory hemodynamic improvement and trophotropic microcirculation regulatory changes) was mostly apparent after thoracoscopic clipation and perivascular desympatisation in comparison with isolated periarterial sympatectomy.
Assuntos
Mãos , Distrofia Simpática Reflexa , Simpatectomia , Sistema Vasomotor/cirurgia , Idoso , Artéria Braquial/inervação , Testes Respiratórios , Feminino , Mãos/irrigação sanguínea , Mãos/inervação , Humanos , Fluxometria por Laser-Doppler , Masculino , Microcirculação , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Período Pós-Operatório , Distrofia Simpática Reflexa/diagnóstico , Distrofia Simpática Reflexa/fisiopatologia , Distrofia Simpática Reflexa/cirurgia , Pele/irrigação sanguínea , Pele/inervação , Temperatura Cutânea , Simpatectomia/efeitos adversos , Simpatectomia/métodos , Termografia , Toracoscopia , Resultado do Tratamento , Sistema Vasomotor/fisiopatologia , Veias/inervaçãoRESUMO
Intermittent arm ischemia before percutaneous coronary intervention induces remote ischemic preconditioning (RIPC) and attenuates myocardial injury in patients with myocardial infarction. Several studies have shown that intermittent arm ischemia increases coronary flow and is related to autonomic nerve system. The aim of this study was to determine whether intermittent arm ischemia induces vasodilatation of other arteries and to assess changes in the autonomic nerve system during intermittent arm ischemia in humans. We measured change in the right brachial artery diameter during intermittent left arm ischemia through three cycles of 5-min inflation (200 mmHg) and 5-min deflation of a blood-pressure cuff using a 10-MHz linear array transducer probe in 20 healthy volunteers. We simultaneously performed power spectral analysis of heart rate. Ischemia-reperfusion of the left arm significantly dilated the right brachial artery time-dependently, resulting in a 3.2 ± 0.4% increase after the 3rd cycle. In the power spectral analysis of heart rate, the high-frequency domain (HF), which is a marker of parasympathetic activity, was significantly higher after the 3rd cycle of ischemia-reperfusion than baseline HF (P = 0.02). Intermittent arm ischemia was accompanied by vasodilatation of another artery and enhancement of parasympathetic activity. Those effects may play an important role in the mechanism of RIPC.
Assuntos
Braço/irrigação sanguínea , Sistema Nervoso Autônomo/fisiologia , Artéria Braquial/inervação , Artéria Braquial/fisiopatologia , Vasodilatação/fisiologia , Adulto , Pressão Sanguínea/fisiologia , Circulação Coronária/fisiologia , Eletrocardiografia/métodos , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Traumatismo por Reperfusão/fisiopatologia , Adulto JovemRESUMO
Sex differences exist in autonomic control of the cardiovascular system. This study was designed to directly test sex or female menstrual phase-related differences in α-adrenergic control of blood flow during exercise. We hypothesized that women would exhibit reduced α-adrenergic vasoconstriction compared with men during exercise; in addition, women would constrict less during the early luteal than the early follicular phase of the female menses. Young men (n = 10) were studied once and women (n = 9) studied twice, once during the early follicular phase and once during the early luteal phase of female menses. We measured forearm blood flow (FBF; Doppler ultrasound of the brachial artery) during rest and steady-state dynamic exercise (15 and 30% of maximal voluntary contraction, 20 contractions/min). A brachial artery catheter was inserted for the local administration of α-adrenergic agonists [phenylephrine (PE; α(1)) or clonidine (CL; α(2))]. Blood flow responses to exercise [forearm vascular conductance (FVC)] were similar between all groups. At rest, infusion of PE or CL decreased FVC in all groups (40-60% reduction). Vasoconstriction to PE was abolished in all groups at 15 and 30% exercise intensity. Vasoconstriction to CL was reduced at 15% and abolished at 30% intensity in all groups; women had less CL-induced constriction during the early luteal than early follicular phase (P < 0.017, 15% intensity). These results indicate that vasodilator responses to forearm exercise are comparable between men and women and are achieved through similar paths of α-adrenergic vascular control at moderate intensities; this control may differ at low intensities specific to the female menstrual phase.
Assuntos
Artéria Braquial/inervação , Exercício Físico , Antebraço/irrigação sanguínea , Ciclo Menstrual , Receptores Adrenérgicos alfa/metabolismo , Sistema Nervoso Simpático/metabolismo , Vasoconstrição , Vasodilatação , Agonistas alfa-Adrenérgicos/administração & dosagem , Adulto , Velocidade do Fluxo Sanguíneo , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/efeitos dos fármacos , Feminino , Fase Folicular , Humanos , Infusões Intra-Arteriais , Fase Luteal , Masculino , Receptores Adrenérgicos alfa/efeitos dos fármacos , Fluxo Sanguíneo Regional , Fatores Sexuais , Sistema Nervoso Simpático/efeitos dos fármacos , Ultrassonografia , Vasoconstrição/efeitos dos fármacos , Vasoconstritores/administração & dosagem , Vasodilatação/efeitos dos fármacos , Vasodilatadores/administração & dosagem , Adulto JovemRESUMO
Branchial artery vasoreactivity and nerve density were measured in teleosts of different phylogenetic relatedness from cold (-1.86 degrees to +1 degrees C) and temperate ( approximately 13 degrees C) environments. Polar Notothenia coriiceps and temperate Paranotothenia angustata are closely related Southern Hemisphere nototheniids, and polar Boreogadus saida and temperate Myoxocephalus scorpius are Northern Hemisphere species that are phylogenetically distant from each other and the nototheniids. Rainbow trout Oncorhynchus mykiss was used as a temperate comparison of different activity patterns. Cumulative dose-response curves for efferent branchial arteries (EBAs) revealed a lack of alpha-adrenergic (noradrenaline [NOR]) vasoactivity in M. scorpius and a lack of cholinergic (carbachol [CARB]) vasoactivity in B. saida, while responses in N. coriiceps and P. angustata were irregular. Oncorhynchus mykiss vessels were responsive to both constrictors, suggesting either receptor absence or spatial heterogeneity among species. The sensitivity (pEC(50)) of NOR or 5-hydroxytryptamine (5-HT) vasoconstriction showed little interspecific variation, while maximal tension varied among species for NOR but not 5-HT. Acute cooling did not affect agonist-independent vascular contraction induced by KCl or in response to NOR or 5-HT. The CARB sensitivity of EBAs increased with cooling in P. angustata alone. Each species possessed a unique pattern of innervation on both branchial arteries, distal and proximal to their respective aortas, that partially differentiated between nototheniids and nonnototheniids. We conclude there is little evidence for cold adaptation of branchial artery contractility, and mechanisms of vascular control likely reflect phylogeny rather than thermal history.
Assuntos
Adaptação Fisiológica/fisiologia , Artéria Braquial/fisiologia , Meio Ambiente , Peixes/fisiologia , Tono Muscular/fisiologia , Antagonistas Adrenérgicos beta/farmacologia , Animais , Regiões Antárticas , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/inervação , Carbacol/farmacologia , Agonistas Colinérgicos/farmacologia , Relação Dose-Resposta a Droga , Peixes/genética , Microscopia Confocal , Tono Muscular/efeitos dos fármacos , Miografia , Norepinefrina/farmacologia , Filogenia , Serotonina/farmacologia , Sotalol/farmacologia , Temperatura , Vasoconstritores/farmacologiaRESUMO
During Doppler ultrasound assessment of blood flow, a wall filter is used to reduce or eliminate high-amplitude, low-velocity signals from the vessel wall and the surrounding tissue. This study investigated the impact of a range of wall filters (22 Hz, 75 Hz, 128 Hz, and 252 Hz) on the accuracy of forearm blood flow monitoring during the sympathoexcitatory application of lower body negative pressure, when peripheral blood flow may decrease substantially. The 252 Hz filter eliminated diastolic flow in 4 of 10 participants. In the remaining participants, the 252 Hz filter minimized the sensitivity of the pulsatility index. The interpretation of physiological responses could ultimately be compromised by using filters beyond 128 Hz.
Assuntos
Artéria Braquial/diagnóstico por imagem , Antebraço/irrigação sanguínea , Ultrassonografia Doppler de Pulso/instrumentação , Adolescente , Adulto , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Artéria Braquial/inervação , Desenho de Equipamento , Feminino , Humanos , Pressão Negativa da Região Corporal Inferior , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Valor Preditivo dos Testes , Fluxo Pulsátil , Fluxo Sanguíneo Regional , Resistência Vascular , Sistema Vasomotor/fisiologia , Adulto JovemRESUMO
The purpose of this investigation was to assess the interactive influence of sympathetic activation and supplemental nitric oxide (NO) on brachial artery distensibility vs. its diameter. It was hypothesized that 1) sympathetic activation and NO competitively impact muscular conduit artery (brachial artery) mechanics, and 2) neurogenic constrictor input affects conduit vessel stiffness independently of outright changes in conduit vessel diastolic diameter. Lower body negative pressure (LBNP) and a cold pressor stress (CPT) were used to study the changes in conduit vessel mechanics when the increased sympathetic outflow occurred with and without changes in heart rate (LBNP -40 vs. -15 mmHg) and blood pressure (CPT vs. LBNP). These maneuvers were performed in the absence and presence of nitroglycerin. Neither LBNP nor CPT altered brachial artery diastolic diameter; however, distensibility was reduced by 25 to 54% in each reflex (all P < 0.05). This impact of sympathetic activation on brachial artery distensibility was not altered by nitroglycerin supplementation (21-54%; P < 0.05), although baseline diameter was increased by the exogenous NO (P < 0.05). The results indicate that sympathetic excitation can reduce the distensibility of the brachial artery independently of concurrent changes in diastolic diameter, heart rate, and blood pressure. However, exogenous NO did not minimize or reverse brachial stiffening during sympathetic activation. Therefore, sympathetic outflow appears to impact the stiffness of this conduit vessel rather than its diastolic diameter or, by inference, its local resistance to flow.
Assuntos
Artéria Braquial/fisiologia , Hemodinâmica/fisiologia , Óxido Nítrico/fisiologia , Reflexo/fisiologia , Adulto , Fenômenos Biomecânicos , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Artéria Braquial/anatomia & histologia , Artéria Braquial/inervação , Débito Cardíaco/efeitos dos fármacos , Débito Cardíaco/fisiologia , Temperatura Baixa , Feminino , Antebraço/irrigação sanguínea , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Hemodinâmica/efeitos dos fármacos , Humanos , Pressão Negativa da Região Corporal Inferior , Masculino , Doadores de Óxido Nítrico/farmacologia , Nitroglicerina/farmacologia , Nociceptores/fisiologia , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fluxo Sanguíneo Regional/fisiologia , Volume Sistólico/efeitos dos fármacos , Volume Sistólico/fisiologia , Sistema Nervoso Simpático/fisiologiaRESUMO
Obesity increases the risk of hypertension and its cardiovascular complications. This has been partly attributed to increased sympathetic nerve activity, as assessed by microneurography and catecholamine assays. However, increased vasoconstriction in response to obesity-induced sympathoactivation has not been unequivocally demonstrated in obese subjects without hypertension. We evaluated sympathetic alpha-adrenergic vascular tone in the forearm by brachial arterial infusion of the alpha-adrenoreceptor antagonist phentolamine (120 microg/min) in normotensive obese (daytime ambulatory arterial pressure: 123+/-1/77+/-1 mm Hg; body mass index: 35+/-1 kg/m(2)) and lean (daytime ambulatory arterial pressure: 123+/-2/77+/-2 mm Hg; body mass index: 22+/-1 kg/m(2)) subjects (n=25 per group) matched by blood pressure, age, and gender. Microneurographic sympathetic nerve activity to skeletal muscle was significantly higher in obese subjects (30+/-3 versus 22+/-1 bursts per minute; P=0.02). Surprisingly, complete alpha-adrenergic receptor blockade by phentolamine (at concentrations sufficient to completely inhibit norepinephrine and phenylephrine-induced vasoconstriction) caused equivalent vasodilatation in obese (-57+/-2%) and lean subjects (-57+/-3%; P=0.9). In conclusion, sympathetic vascular tone in the forearm circulation is not increased in obese normotensive subjects despite increased sympathetic outflow. Vasodilator factors or mechanisms occurring in obese normotensive subjects could oppose the vasoconstrictor actions of increased sympathoactivation. Our findings may help to explain why some obese subjects are protected from the development of hypertension.
Assuntos
Artéria Braquial/inervação , Obesidade/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Vasoconstrição/fisiologia , Antagonistas Adrenérgicos alfa/administração & dosagem , Adulto , Pressão Sanguínea/fisiologia , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/fisiopatologia , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Fentolamina/administração & dosagem , Índice de Gravidade de Doença , Sistema Nervoso Simpático/efeitos dos fármacos , Vasoconstrição/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Vasodilatação/fisiologiaRESUMO
RATIONALE: Although various factors influence peripheral circulation in chronic obstructive pulmonary disease (COPD) patients, little is known about the vasomotor changes in these subjects. OBJECTIVES: The present study was designed to assess alterations in the brachial circulation of COPD patients. METHODS: Twenty-five COPD patients and 25 healthy subjects were studied. Brachial artery (BA) blood flow and indices of BA stiffness were investigated by two-dimensional ultrasonography and pulsed Doppler. Cardiac dimensions, left ventricular (LV) function and cardiac output were assessed by pulsed Doppler echocardiography. MAIN RESULTS: A significant increase in LV mass was observed in the COPD group despite normal arterial pressure. Total arterial compliance and BA compliance were significantly decreased in COPD patients in comparison with healthy subjects. Heart rate was increased in COPD patients and was inversely correlated with PaO(2) and forced expiratory volume in the first second (FEV(1)). A decrease in LV preload was expressed by a reduction in LV diastolic diameters and LV stroke volume. Patients with severe COPD have a lower BA surface area than patients with moderate COPD. FEV(1) and PaO(2) were significantly related to BA compliance. CONCLUSION: In COPD patients, significant alterations in the peripheral circulation were observed. Moreover, the magnitude of changes in the peripheral circulation was related to the severity of COPD.