The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.
Augmented Peripheral Chemosensitivity as a Potential Input to Baroreflex Impairment and Autonomic Imbalance in Chronic Heart Failure
Abstract
Background The precise mechanisms responsible for the sympathetic overactivity and blunted baroreflex control in chronic heart failure (CHF) remain obscure. Augmented peripheral chemosensitivity has recently been demonstrated in CHF. We evaluated the relation between peripheral chemoreflex sensitivity and autonomic activity in patients with CHF. Methods and Results We studied in 26 stable patients with CHF the peripheral chemosensitivity (ventilatory response to hypoxia using transient inhalations of pure nitrogen), autonomic balance (spectral analysis of heart rate variability [HRV]), and baroreflex sensitivity (bolus phenylephrine method and α index). To determine whether transient inactivation of peripheral chemoreceptors might influence autonomic balance, 12 patients underwent a second study during which they breathed 100% O 2. Peripheral chemosensitivity correlated inversely with HRV power within the low-frequency band (0.04 to 0.15 Hz) (r=−.52,P=.006) and inversely with baroreflex sensitivity (r=−.60,P=.005). When the patients were divided into two groups according to the chemosensitivity of age-matched normal controls (above and below mean+2 SDs of chemosensitivity of control subjects), those above the normal range revealed more impaired autonomic balance, ie, lower baroreflex sensitivity (1.4±1.3 versus 5.0±1.5 ms/mm Hg,P<.0001) and depressed values of low-frequency power (2.5±1.8 versus 4.1±0.8 ln ms 2,P<.005) compared with those with normal chemosensitivity. Transient hyperoxia did not alter heart rate or systolic pressure but resulted in an increase in HRV and an improvement in baroreflex sensitivity. Conclusions A link between increased peripheral chemosensitivity and impaired autonomic control, including baroreflex inhibition, is demonstrated. The clinical importance of this phenomenon warrants further investigation.
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Cites
Cardiovascular neural regulation explored in the frequency domain.
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Plasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart Failure
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Cited by
Dimopoulos, K., Okonko, D. O., Diller, G.-P., Broberg, C. S., Salukhe, T. V., Babu-Narayan, S. V., Li, W., Uebing, A., Bayne, S., Wensel, R., et al. (2006) · Circulation · doi:10.1161/circulationaha.105.594218 · Cited by 313
Self-citationSlow Breathing Increases Arterial Baroreflex Sensitivity in Patients With Chronic Heart Failure
Bernardi, L., Porta, C., Spicuzza, L., Bellwon, J., Spadacini, G., Frey, A. W., Yeung, L. Y. C., Sanderson, J. E., Pedretti, R., & Tramarin, R. (2002) · Circulation · doi:10.1161/hc0202.103311 · Cited by 274
Bernardi, L., Gabutti, A., Porta, C., & Spicuzza, L. (2001) · Journal of Hypertension · doi:10.1097/00004872-200112000-00016 · Cited by 243
Role of Volume Redistribution in the Congestion of Heart Failure
Fudim, M., Hernandez, A. F., & Felker, G. M. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.006817 · Cited by 199
Autonomic dysfunction in the ICU patient
Schmidt, H. B., Werdan, K., & Müller-Werdan, U. (2001) · Current Opinion in Critical Care · doi:10.1097/00075198-200110000-00002 · Cited by 138
Metadata
- Authors
- Ponikowski, P., Chua, T. P., Piepoli, M., Ondusova, D., Webb-Peploe, K., Harrington, D., Anker, S. D., Volterrani, M., Colombo, R., Mazzuero, G., Giordano, A., & Coats, A. J. S.
- Venue
- Circulation
- Published
- 1997-10-21
- Volume
- 96
- Issue
- 8
- Pages
- 2586-2594
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2002606850
- Cited by
- 271
- References
- 48
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- closed
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- Ponikowski, P., Chua, T. P., Piepoli, M., Ondusova, D., Webb-Peploe, K., Harrington, D., Anker, S. D., Volterrani, M., Colombo, R., Mazzuero, G., Giordano, A., & Coats, A. J. S. (1997). Augmented Peripheral Chemosensitivity as a Potential Input to Baroreflex Impairment and Autonomic Imbalance in Chronic Heart Failure. Circulation. https://doi.org/10.1161/01.cir.96.8.2586
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