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单剂量阿米洛利是否会影响健康年轻成年人的自发性动脉压力反射敏感性和血压变异性?

Does a single oral administration of amiloride affect spontaneous arterial baroreflex sensitivity and blood pressure variability in healthy young adults?

机构信息

Human Neurovascular Control Laboratory, Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States.

Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.

出版信息

J Neurophysiol. 2024 Sep 1;132(3):922-928. doi: 10.1152/jn.00264.2024. Epub 2024 Aug 7.

Abstract

Preclinical models indicate that amiloride (AMD) reduces baroreflex sensitivity and perturbs homeostatic blood pressure (BP) regulation. However, it remains unclear whether these findings translate to humans. This study investigated whether oral administration of AMD reduces spontaneous cardiac and sympathetic baroreflex sensitivity and perturbs BP regulation in healthy young humans. Heart rate (HR; electrocardiography), beat-to-beat BP (photoplethysmography), and muscle sympathetic activity (MSNA, microneurography) were continuously measured in 10 young subjects (4 females) during rest across two randomized experimental visits: ) after 3 h of oral administration of placebo (PLA, 10 mg of methylcellulose within a gelatin capsule) and ) after 3 h of oral administration of AMD (10 mg). Visits were separated for at least 48 h. We calculated the standard deviation and other indices of BP variability. Spontaneous cardiac baroreflex was assessed via the sequence technique and cardiac autonomic modulation through time- and frequency-domain HR variability. The sensitivity (gain) of the sympathetic baroreflex was determined via weighted linear regression analysis between MSNA and diastolic BP. AMD did not affect HR, BP, and MSNA compared with PLA. Indexes of cardiac autonomic modulation (time- and frequency-domain HR variability) and BP variability were also unchanged after AMD ingestion. Likewise, AMD did not modify the gain of both spontaneous cardiac and sympathetic arterial baroreflex. A single oral dose of AMD does not affect spontaneous arterial baroreflex sensitivity and BP variability in healthy young adults. Preclinical models indicate that amiloride (AMD), a nonselective antagonist of the acid-sensing ion channels (ASICs), impairs baroreflex sensitivity and perturbs blood pressure regulation. We translated these findings into humans, investigating the impact of acute oral ingestion of AMD on blood pressure variability and spontaneous cardiac and sympathetic baroreflex sensitivity in healthy young humans. In contrast to preclinical evidence, AMD does not impair spontaneous arterial baroreflex sensitivity and blood pressure variability in healthy young adults.

摘要

临床前模型表明,阿米洛利(AMD)降低了压力感受反射敏感性并扰乱了稳态血压(BP)调节。然而,这些发现是否适用于人类尚不清楚。本研究旨在探讨口服 AMD 是否会降低健康年轻人群的自主心脏和交感神经压力感受反射敏感性,并扰乱血压调节。在两次随机实验访问中,在 10 名年轻受试者(4 名女性)的休息期间,使用心电图(ECG)测量心率(HR)、逐拍血压(光体积描记法)和肌肉交感神经活动(微神经记录法)。在口服安慰剂(PLA,明胶胶囊内 10 毫克甲基纤维素)后 3 小时和口服 AMD(10 毫克)后 3 小时进行了两次连续测量。两次访问至少间隔 48 小时。我们计算了血压变异性的标准差和其他指标。通过序列技术评估自主心脏压力感受反射,通过 HR 变异性的时频域分析评估心脏自主神经调制。通过 MSNA 和舒张压之间的加权线性回归分析确定交感神经压力感受反射的敏感性(增益)。与 PLA 相比,AMD 对 HR、BP 和 MSNA 没有影响。AMD 摄入后,心脏自主神经调制(时频域 HR 变异性)和 BP 变异性的指标也没有变化。同样,AMD 也没有改变自主心脏和交感动脉压力感受反射的增益。单次口服 AMD 剂量不会影响健康年轻成年人的自主动脉压力感受反射敏感性和血压变异性。临床前模型表明,阿米洛利(AMD)是酸感应离子通道(ASICs)的非选择性拮抗剂,会损害压力感受反射敏感性并扰乱血压调节。我们将这些发现转化为人类,研究了急性口服 AMD 对健康年轻人群血压变异性和自主心脏及交感神经压力感受反射敏感性的影响。与临床前证据相反,AMD 不会损害健康年轻成年人的自主动脉压力感受反射敏感性和血压变异性。

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