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Vasomotor sympathetic neural control is maintained during sustained upright posture in humans
Ist Teil von
The Journal of physiology, 2006-12, Vol.577 (2), p.679-687
Ort / Verlag
Oxford, UK: The Physiological Society
Erscheinungsjahr
2006
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
Vasomotor sympathetic activity plays an important role in arterial pressure maintenance via the baroreflex during acute orthostasis
in humans. If orthostasis is prolonged, blood pressure may be supported additionally by humoral factors with a possible reduction
in sympathetic baroreflex sensitivity. We tested the hypothesis that baroreflex control of muscle sympathetic nerve activity
(MSNA) decreases during prolonged upright posture. MSNA and haemodynamics were measured supine and during 45 min 60 deg upright
tilt in 13 healthy individuals. Sympathetic baroreflex sensitivity was quantified using the slope of the linear correlation
between MSNA and diastolic pressure during spontaneous breathing. It was further assessed as the relationship between MSNA
and stroke volume, with stroke volume derived from cardiac output (C 2 H 2 rebreathing) and heart rate. Total peripheral resistance was calculated from mean arterial pressure and cardiac output. We
found that MSNA increased from supine to upright (17 ± 8 ( s.d. ) versus 38 ± 12 bursts min â1 ; P < 0.01), and continued to increase to a smaller degree during sustained tilt (39 ± 11, 41 ± 12, 43 ± 13 and 46 ± 15 bursts
min â1 after 10, 20, 30 and 45 min of tilt; between treatments P < 0.01). Sympathetic baroreflex sensitivity increased from supine to upright (â292 ± 180 versus
â718 ± 362 units beat â1 mmHg â1 ; P < 0.01), but remained unchanged as tilting continued (â611 ± 342 and â521 ± 221 units beat â1 mmHg â1 after 20 and 45 min of tilt; P
= 0.49). For each subject, changes in MSNA were associated with changes in stroke volume ( r
= 0.88 ± 0.13, P < 0.05), while total peripheral resistance was related to MSNA during 45 min upright tilt ( r
= 0.82 ± 0.15, P < 0.05). These results suggest that the vasoconstriction initiated by sympathetic adrenergic nerves is maintained by ongoing
sympathetic activation during sustained (i.e. 45 min) orthostasis without obvious changes in vasomotor sympathetic neural
control.