Xing Daniel T, May Clive N, Booth Lindsea C, Ramchandra Rohit
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia.
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
Exp Physiol. 2014 Aug;99(8):1031-41. doi: 10.1113/expphysiol.2014.079491. Epub 2014 Jun 13.
Heart failure (HF) is associated with a large increase in cardiac sympathetic nerve activity (CSNA), which has detrimental effects on the heart and promotes arrhythmias and sudden death. There is increasing evidence that arterial chemoreceptor activation plays an important role in stimulating renal sympathetic nerve activity (RSNA) and muscle sympathetic nerve activity in HF. Given that sympathetic nerve activity to individual organs is differentially controlled, we investigated whether tonic arterial chemoreceptor activation contributes to the increased CSNA in HF. We recorded CSNA and RSNA in conscious normal sheep and in sheep with mild HF induced by rapid ventricular pacing (ejection fraction <40%). Tonic arterial chemoreceptor function was evaluated by supplementing room air with 100% intranasal oxygen (2-3 l min(-1)) for 20 min, thereby deactivating chemoreceptors. The effects of hyperoxia on resting levels and baroreflex control of heart rate, CSNA and RSNA were determined. In HF, chemoreceptor deactivation induced by hyperoxia significantly reduced CSNA [90 ± 2 versus 75 ± 5 bursts (100 heart beats)(-1), P < 0.05, n = 10; room air versus hyperoxia] and heart rate (96 ± 4 versus 85 ± 4 beats min(-1), P < 0.001, n = 12). There was no change in RSNA burst incidence [93 ± 4 versus 92 ± 4 bursts (100 heart beats)(-1), n = 7], although due to the bradycardia the RSNA burst frequency was decreased (90 ± 8 versus 77 ± 7 bursts min(-1), P < 0.001). In normal sheep, chemoreceptor deactivation reduced heart rate without a significant effect on CSNA or RSNA. In summary, deactivation of peripheral chemoreceptors during HF reduced the elevated levels of CSNA, indicating that tonic arterial chemoreceptor activation plays a critical role in stimulating the elevated CSNA in HF.
心力衰竭(HF)与心脏交感神经活动(CSNA)大幅增加有关,这对心脏有不利影响,并会引发心律失常和猝死。越来越多的证据表明,动脉化学感受器激活在刺激HF患者的肾交感神经活动(RSNA)和肌肉交感神经活动中起重要作用。鉴于对各个器官的交感神经活动是受不同控制的,我们研究了持续性动脉化学感受器激活是否导致HF患者CSNA增加。我们记录了清醒正常绵羊以及快速心室起搏诱导的轻度HF绵羊(射血分数<40%)的CSNA和RSNA。通过向室内空气中补充100%鼻内氧气(2 - 3 l min(-1))20分钟来评估持续性动脉化学感受器功能,从而使化学感受器失活。确定了高氧对静息水平以及心率、CSNA和RSNA的压力反射控制的影响。在HF患者中,高氧诱导的化学感受器失活显著降低了CSNA[90±2对75±5次爆发/(100次心跳)(-1),P<0.05,n = 10;室内空气对高氧]和心率(96±4对85±4次/分钟,P<0.001,n = 12)。RSNA爆发发生率没有变化[93±4对92±4次爆发/(100次心跳)(-1),n = 7],尽管由于心动过缓,RSNA爆发频率降低(90±8对77±7次/分钟,P<0.001)。在正常绵羊中,化学感受器失活降低了心率,但对CSNA或RSNA没有显著影响。总之,HF期间外周化学感受器失活降低了升高的CSNA水平,表明持续性动脉化学感受器激活在刺激HF患者升高的CSNA中起关键作用。