Altered Baroreflex-Mediated Cardiovascular Responses to Acute Hypotension in Heart Failure Patients Compared to Healthy Adults

Patients with heart failure (HF) exhibit baroreflex dysfunction, which is associated with increased morbidity and mortality. Orthostatic hypotension, a decrease in blood pressure (BP) upon standing, is a condition that often occurs in HF, and may be linked with altered baroreflex responsiveness in this population. However, data on baroreflex-mediated cardiovascular responses to acute hypotension in HF patients are limited. Therefore, 8 HF patients (7 men; mean±SEM 65±3y; ejection fraction 30.5±3.1%) and 7 healthy control (CON) adults (6 men; 65±2y) underwent 7.5 minutes of unilateral lower-limb ischemia via inflation of a thigh cuff on one leg to non-pharmacologically induce acute hypotension upon cuff deflation. Beat-to-beat systolic BP, diastolic BP, and mean arterial BP (MAP; photoplethysmographic finger cuff) and heart rate (HR; electrocardiogram) were recorded continuously before, during, and after cuff inflation. Statistical analysis involved independent-samples t-tests. Baseline values were not different between groups (systolic BP: 128±8 vs. 128±4mmHg; diastolic BP: 73±3 vs. 82±5mmHg; MAP: 90±3 vs. 97±4mmHg; HR: 62±2 vs. 56±2b.min-1 for HF and CON, respectively; P\u3e0.05). The magnitude of the induced decrease in MAP was similar in both groups (HF -11±1 vs. CON -12±2mmHg; P\u3e0.05). However, the time-to-peak MAP decrease was significantly longer in HF compared to CON (HF 11±2 vs. CON 6±1s; PP\u3e0.05). However, the time-to-peak HR increase was longer in HF compared to CON (HF 9±1 vs. CON 6±1s; PP\u3e0.05). However, the time-to-peak HR increase was longer in HF compared to CON (HF 9±1 vs. CON 6±1s;

Sympathetic responses to Valsava's manoeuvre following bed rest

Activité sympathique intramusculaire, pression sanguine, tolérance orthostatique et inclinaison tête haute. Effets d'une période de 14 jours en position couchée tête en bas (HDBR) sur la régulation du système nerveux autonome au cours d'une manoeuvre de Valsava. Valeur prédictive de cette procédure sur le contrôle de la pression sanguine au cours d'un séance d'inclinaison de la table vers le haut à 60°. Etude dans le cadre de la recherche sur les effets des vols spatiaux habités chez les spationautes et astronautes

CARDIOVASCULAR RESPONSE TO EXERCISE CARDIOVASCULAR RESPONSE TO EXERCISE

T his article is intended for instructors who teach cardiovascular physiology. In our physiology course exercise physiology is used as a tool to review and integrate cardiovascular and respiratory physiology. It is assumed that the students already have mastered the fundamentals of cardiovascular and respiratory physiology. Because this paper is part of a cardiovascular refresher course, I have deleted much of the respiratory physiology. The objectives of this presentation are for the student to 1) understand the relationship between maximal oxygen consumption and endurance during sustained exercise and be able to define ''maximal oxygen consumption''; 2) understand the determinants of maximal oxygen consumption; 3) understand the effects of dynamic exercise on the cardiovascular system and mechanisms for these effects; 4) understand the relationships between exercise intensity and major cardiorespiratory parameters, including heart rate, cardiac output, blood flow distribution, left ventricular stroke volume, arterial pressures, total peripheral resistance, and arterial and venous blood oxygen content; 5) be able to compare and contrast the cardiovascular effects of dynamic and isometric exercise in man and the mechanisms responsible for the major differences; and 6) be able to apply knowledge of the cardiovascular effects of exercise to understanding causes of cardiovascular symptoms in disease and in diagnosis of disease states. This material contains many areas that stimulate discussion with students and allow exploration of concepts that are challenging for the student. This give and take between teachers and student is difficult to summarize in an article of this sort. Therefore, subjects that in my experience often stimulate questions and discussion with the students are indicated in the text