Department of Kinesiology, University of Guelph-Humber, Toronto, Ontario, Canada.
Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.
J Am Heart Assoc. 2018 Jan 29;7(3):e007971. doi: 10.1161/JAHA.117.007971.
Whether the sympathetic nervous system can directly alter central aortic stiffness remains controversial, mainly because of the difficulty in experimentally augmenting peripheral vasoconstrictor activity without changing blood pressure.
To address this limitation, we utilized low-level cardiopulmonary baroreflex loading and unloading shown previously to alter sympathetic outflow without evoking parallel hemodynamic modulation. Blood pressure and carotid-femoral aortic pulse wave velocity (cf-PWV) were measured in 32 healthy participants (24±2 years; women: n=15) before and during 12-minute applications of low-level lower body negative pressure; -7 mm Hg) and lower body positive pressure; +7 mm Hg), applied in a random order. Fibular nerve microneurography was used to collect muscle sympathetic nerve activity (MSNA) in a subset (n=8) to confirm peripheral sympathetic responses. During lower body negative pressure, heart rate, blood pressure, stroke volume, cardiac output, and total peripheral resistance were not statistically different (all >0.05); MSNA burst frequency (+15%; =0.007), total MSNA (+44%; =0.006), and cf-PWV (∆+0.3±0.2 m/s; <0.001) increased. In total, 28 (88%) of participants observed an increase in cf-PWV greater than the baseline typical error of measurement. During lower body positive pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance were not statistically different (all >0.05), though blood pressure increased (<0.05) and pulse pressure decreased (=0.01); MSNA burst frequency (-4%; =0.37), total MSNA (-7%; =0.89), and cf-PWV (∆0.0±0.2 m/s; =0.68) were not statistically different.
These findings provide evidence that acute elevations in peripheral sympathetic activity can increase central aortic PWV in young participants independent of a change in distending or pulsatile blood pressure or heart rate.
交感神经系统是否可以直接改变中心主动脉僵硬度仍存在争议,主要是因为在不改变血压的情况下,很难增强外周血管收缩活性。
为了解决这个限制,我们利用低水平心肺压力反射加载和卸载,先前的研究表明,这种方法可以改变交感神经输出,而不会引起平行的血流动力学调节。在 32 名健康参与者(24±2 岁;女性:n=15)中,在 12 分钟的低水平下体负压(-7mmHg)和下体正压(+7mmHg)应用前后,测量血压和颈股主动脉脉搏波速度(cf-PWV)。在随机顺序下应用。腓肠神经微神经记录术用于收集部分(n=8)的肌肉交感神经活动(MSNA),以确认外周交感反应。在下体负压期间,心率、血压、每搏量、心输出量和总外周阻力没有统计学差异(均>0.05);MSNA 爆发频率(+15%;=0.007)、总 MSNA(+44%;=0.006)和 cf-PWV(∆+0.3±0.2m/s;<0.001)增加。总共 28(88%)名参与者观察到 cf-PWV 增加大于基线典型测量误差。在下体正压期间,心率、每搏量、心输出量和总外周阻力没有统计学差异(均>0.05),尽管血压升高(<0.05)和脉压降低(=0.01);MSNA 爆发频率(-4%;=0.37)、总 MSNA(-7%;=0.89)和 cf-PWV(∆0.0±0.2m/s;=0.68)没有统计学差异。
这些发现提供了证据,表明急性增加外周交感神经活性可以增加年轻参与者的中心主动脉 PWV,而不改变扩张或脉动血压或心率。