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Biomedical subjects

J Tank

Publications and source records attributed to J Tank.

18 recordsLinked to original sources
PubMed2005

Osmosensitive mechanisms contribute to the water drinking-induced pressor response in humans.

BACKGROUND: Water drinking elicits a sympathetically mediated pressor response in multiple-system atrophy patients through an unknown mechanism. We reasoned that gastrointestinal distention, hyposomotic stimulation, or both contribute to the water-induced pressor response. METHODS: We compared the response to normal saline and water on blood pressure in 10 patients with probable multiple-system atrophy. Patients featured moderate to severe autonomic dysfunction. EKG and finger arterial blood pressure were recorded continuously, and 500 mL normal saline and distilled water were each given in a single-blinded fashion. Fluids were applied through a previously inserted nasogastric tube within a 5-minute period. RESULTS: Blood pressure began to increase within 10 minutes after water administration and reached a maximum after 20 minutes. Blood pressure did not change after saline administration. The blood pressure change after 20 minutes was 8 +/- 9/2 +/- 5 mmHg with water and -1 +/- 11/-1 +/- 7 mmHg with normal saline administration (p = 0.02 between interventions). Heart rate did not change with either intervention. CONCLUSION: Ingestion of water elicits a greater pressor response than the ingestion of normal saline. Thus, gastric distention is probably not the crucial mechanisms for the water-induced pressor response. Instead, the response may be mediated through osmosensitive afferent structures in the gastrointestinal tract, portal vein, and liver.

Autonomic Nervous System Diseases↗
PubMed2004

The autonomous regulation system functional reserves evaluation in 7-day head down bedrest.

The heart rate variability estimation was used for autonomous regulation diagnostic in the 7-day head down bedrest experiment (HDBR). The new device "Pneumocard" and the fix respirations test were applied. The growth of sympathetic activity of autonomous nervous system and reduction of functional reserves of regulation mechanisms were observed in the microgravity modeling by HDBR. The analysis of the individual data had shown, that at two volunteers with most significant growth of SI after the experiment the orthostatic intolerance was observed. The data received in experiment confirm a hypothesis that growth of sympathetic activity in microgravity is accompanied by reduction of regulation mechanisms functional reserves is prognostic unfavorable.

Aerospace Medicine↗
PubMed2002

[Hypotension--harmless or dangerous? The "orthostasis test" gives the answer].

Patients with non-specific symptoms that manifest when standing, are commonly seen in the doctor's office. The suspected diagnosis orthostatic dysregulation, can be established on the basis of a careful history, physical examination and a standing test. Frequent symptoms of orthostatic dysregulation are orthostatic hypotension, neurocardiogenic syncope and orthostatic intolerance. If a disorder of the autonomic nervous system is suspected, the need for further investigations is evaluated on an individual basis. The aim of such further diagnostic procedures is to differentiate between mild forms of autonomic disturbance that are unlikely to affect the patient's prognosis (mild orthostatic intolerance, neurocardiogenic syncope) and severe forms of autonomic failure, to identify the affected parts of the autonomic nervous system (partial or global autonomic failure) and, whenever necessary, to initiate appropriate treatment.

Adolescent↗
PubMed2002

A cross-system comparison of bacterial and fungal biomass in detritus pools of headwater streams.

The absolute amount of microbial biomass and relative contribution of fungi and bacteria are expected to vary among types of organic matter (OM) within a stream and will vary among streams because of differences in organic matter quality and quantity. Common types of benthic detritus [leaves, small wood, and fine benthic organic matter (FBOM)] were sampled in 9 small (1st-3rd order) streams selected to represent a range of important controlling factors such as surrounding vegetation, detritus standing stocks, and water chemistry. Direct counts of bacteria and measurements of ergosterol (a fungal sterol) were used to describe variation in bacterial and fungal biomass. There were significant differences in bacterial abundance among types of organic matter with higher densities per unit mass of organic matter on fine particles relative to either leaves or wood surfaces. In contrast, ergosterol concentrations were significantly greater on leaves and wood, confirming the predominance of fungal biomass in these larger size classes. In general, bacterial abundance per unit organic matter was less variable than fungal biomass, suggesting bacteria will be a more predictable component of stream microbial communities. For 7 of the 9 streams, the standing stock of fine benthic organic matter was large enough that habitat-weighted reach-scale bacterial biomass was equal to or greater than fungal biomass. The quantities of leaves and small wood varied among streams such that the relative contribution of reach-scale fungal biomass ranged from 10% to as much as 90% of microbial biomass. Ergosterol concentrations were positively associated with substrate C:N ratio while bacterial abundance was negatively correlated with C:N. Both these relationships are confounded by particle size, i.e., leaves and wood had higher C:N than fine benthic organic matter. There was a weak positive relationship between bacterial abundance and streamwater soluble reactive phosphorus concentration, but no apparent pattern between either bacteria or fungi and streamwater dissolved inorganic nitrogen. The variation in microbial biomass per unit organic matter and the relative abundance of different types of organic matter contributed equally to driving differences in total microbial biomass at the reach scale.

Bacteria↗
PubMed2001

Limited effect of systemic beta-blockade on sympathetic outflow.

Central beta-adrenoreceptors may augment sympathetic outflow. We tested the hypothesis that beta-blockade attenuates central sympathetic outflow by inhibiting central adrenoreceptors. We studied 18 healthy controls (4 female, 14 male; age, 26+/-6 years, body mass index, 23+/-3 kg/m(2)). ECG, brachial, and finger arterial blood pressure, muscle sympathetic nerve activity, and respiration were measured continuously before and during complete beta-blockade. Subjects received a total intravenous dose of 0.21 mg/kg of propranolol in 15 minutes. Spontaneous baroreflex slopes were calculated using the sequence technique (BRSup, BRSdown). The sympathetic baroreflex slope was determined at baseline using phenylephrine and sodium nitroprusside infusions. The subjects underwent cold pressor testing before and during beta-blockade. The R-R interval increased from 861+/-119 ms at baseline to 952+/-141 ms during beta-blockade (P<0.01). Blood pressure was 117+/-9/65+/-8 mm Hg at baseline and 117+/-10/67+/-8 mm Hg during beta-Blockade (P=NS). beta-Blockade did not affect baroreflex sensitivity (BRSup: 21+/-10 versus 28+/-11 ms/mmHg, P<0.1; BRSdown: 17+/-8 versus 20+/-8 ms/mmHg, P=NS). Muscle sympathetic nerve activity increased significantly during beta-blockade (number of bursts/100 beats: 32+/-9 versus 40+/-14, P<0.05), compared with baseline. However, the operating points of the parasympathetic and sympathetic baroreflex during beta-blockade were on the baroreflex curves obtained at baseline. beta-Blockade blunted the heart rate response to cold pressor testing; blood pressure and muscle sympathetic nerve activity responses were similar. Our study demonstrates that propranolol does not cause an acute decrease in sympathetic activity in normotensive young subjects. This, observation is not consistent with an important tonic stimulatory effect of beta-adrenoreceptors in the brain.

Adrenergic beta-Antagonists↗
PubMed2001

Autonomic nervous system function in patients with monogenic hypertension and brachydactyly: a field study in north-eastern Turkey.

Laboratory studies in patients with autosomal-dominant hypertension and brachydactyly showed increased sensitivity to sympathetic stimuli and severe abnormalities in baroreflex buffering. To further elucidate the mechanisms by which impaired baroreflex sensitivity could influence blood pressure (BP), we conducted autonomic testing under field conditions. We studied 17 hypertensive affected (13 to 48 years, BMI 22.7 +/- 6.5 kg/m(2), 160 +/- 23/98 +/- 15 mm Hg) and 12 normotensive non-affected (9 to 60 years, BMI 24.0 +/- 4.7 kg/m(2), 120 +/- 16/70 +/- 10 mm Hg) family members. Pulse intervals and finger BP were measured using the Portapres device. Valsalva ratio, the blood pressure overshoot during phase IV of the Valsalva manoeuver, the Ewing coefficient (RR30/15 ratio), and heart rate and BP variability were similar in affected and non-affected family members. Overall, baroreflex sensitivity calculated using the cross-spectral (BRSLF, BRSHF) and sequence techniques (BRS+, BRS-) was not different between the groups. However, in younger family members, BRS+ was 12 +/- 3.7 and 22 +/- 13 msec/mm Hg in affected and in non-affected family members, respectively. The decline in BRS with age and with increasing blood pressure was absent in affected family members. We conclude that autonomic reflex testing conducted under field conditions is not impaired in patients with monogenic hypertension and brachydactyly. However, noninvasive testing showed impaired baroreflex control of heart rate at a young age. The reduced BRS in young family members with moderate arterial hypertension may suggest that the impaired baroreflex function is not secondary to the hypertension but rather a primary abnormality, which aggravates the progression of hypertension.

Adolescent↗
PubMed2001

Spontaneous baroreflex sensitivity and heart rate variability are not superior to classic autonomic testing in older patients with type 2 diabetes.

BACKGROUND: Early detection of cardiac autonomic neuropathy (CAN) permits individual risk stratification. Spontaneous heart rate variability (HRV) and baroreflex sensitivity (BRS) are suggested to be superior to classic autonomic testing in that they detect CAN earlier, with greater reliability, and do not require the patient's undue attention. METHODS: To test that hypothesis, we studied 53 diabetic patients (mean age, 55 years) and 38 age-matched healthy control subjects (HC). Subjects underwent deep breathing, Valsalva maneuver, and orthostatic testing. Each abnormal test was counted as 1 point. A change in systolic blood pressure during standing of more than 10 mm Hg was graded with a single point; a decrease of more than 20 mm Hg received 2 points. A total score of zero was regarded as no CAN (noCAN), a score > or =4 as severe CAN (sCAN), and scores of 1 to 3 as mild CAN (mCAN). Spontaneous BRS was determined using the sequence technique. HRV was calculated as coefficient of variation (CV), high frequency power (HF) and low frequency power (LF). RESULTS: Mean group values for HRV and BRS were: CV = 3.9+/-1.3; 4.0+/-1.3; 2.4+/-1.1; and 1.2+/-0.4; BRS = 8+/-3; 8+/-5; 5+/-2; and 2+/-2 msec/mm Hg for HC n = 38, noCAN n = 15, mCAN n = 26, and sCAN n = 12, respectively. BRS was similar in HC and patients with noCAN. In sCAN, BRS detected only 10 of 12 patients. HRV and BRS did not improve reclassification based on discriminant analysis. CONCLUSION: BRS and HRV did not detect CAN in older diabetic patients better than classic autonomic testing.

Aged↗
PubMed2001

Genetic influences on baroreflex function in normal twins.

Blood pressure and heart rate are strongly influenced by genetic factors; however, despite the pivotal role of genetics in short-term cardiovascular regulation, little is known about the genetic contribution to baroreflex function. We assessed genetic influence on baroreflex sensitivity (BRS) in 149 twin pairs (88 monozygotic of age 33+/-13 years and BMI 23+/-4 kg/m(2) and 61 dizygotic of age 33+/-11 years and BMI 24+/-4 kg/m(2)). ECG and finger arterial blood pressures were measured continuously under resting conditions. BRS values were calculated by use of cross-spectral analysis (baroreflex slope calculated as mean value of transfer function between systolic blood pressure and the R-R interval in the low-frequency band [BRSLF] and baroreflex slope calculated as the mean value of transfer function between systolic blood pressure and R-R interval in the respiratory frequency band [BRSHF]) and the sequence technique (BRS+, BRS-). Heritability (h(2)) was estimated with a path-modeling approach. BRS values did not differ significantly between groups (monozygotic, BRSLF, 17+/-13; BRSHF, 21+/-18; BRS+, 19+/-16; and BRS-, 21+/-15, and dizygotic, BRSLF, 16+/-9; BRSHF, 20+/-14; BRS+, 18+/-10; and BRS-, 20+/-11 ms/mm Hg), and were significantly correlated (P:<0.001). When variances and covariances for monozygotic and dizygotic twins were compared, significant correlations were found for BRS in monozygotic (range, r=0.38 to 0.48) but not in dizygotic twin pairs (r=-0.03 to 0.09). Thus, BRS is heritable; the variability can be explained by genetic influences (P:<0.01; h(2) range, 0.36 to 0.44). The genetic influence on BRS remained strong after correction for BMI and blood pressure. Therefore, BRS is strongly genetically determined, probably by different genes than are resting blood pressure and BMI.

Adult↗
PubMed2001

Interaction between beta-adrenergic receptor stimulation and nitric oxide release on tissue perfusion and metabolism.

Nitric oxide (NO) may be an important modulator of sympathetic tone. We used im and sc microdialysis in humans to characterize the interaction of NO synthase inhibition and adrenoreceptor stimulation on tissue perfusion, metabolism, and norepinephrine release. Microdialysis probes were perfused with L- or D-nitro-L-arginine-methyl-ester (100 micromol/L) followed by incremental doses of isoproterenol, epinephrine, or nitroprusside. Blood flow was estimated based on the ethanol dilution technique. In muscle, the increase in blood flow with isoproterenol was abolished by L-NAME. The ethanol ratio was 0.03 +/- 0.011 with D-NAME and 0.075 +/- 0.014 with L-NAME during isoproterenol treatment (1 micromol/L). The effect was less pronounced in adipose tissue. The vasodilatory effect of nitroprusside was similar with D- and L-NAME. L-NAME augmented isoproterenol- and epinephrine-induced glycerol release. Dialysate glycerol during 1 micromol/L isoproterenol was 47 +/- 6.7 micromol/L with D-NAME and 72 +/- 15 micromol/L with L-NAME. In skeletal muscle, dialysate norepinephrine during 1 micromol/L isoproterenol treatment was 0.73 +/- 0.17 and 1.3 +/- 0.15 nmol/L with D- and L-NAME, respectively. We conclude that NO synthase inhibition attenuates beta(2)-adrenoreceptor-mediated vasodilation and enhances beta-adrenoreceptor-mediated lipolysis. These effects are in part mediated through an increase in interstitial norepinephrine concentrations. The data are consistent with the idea that in humans, NO is important in modulating and ameliorating sympathetic effects in peripheral tissues.

Adrenergic beta-Agonists↗
PubMed2000

Severely impaired baroreflex-buffering in patients with monogenic hypertension and neurovascular contact.

BACKGROUND: We identified a family with a monogenic syndrome of hypertension, brachydactyly, and neurovascular contact of the brain stem. Neurovascular contact of the ventrolateral medulla may lead to arterial hypertension by interfering with baroreflex function. METHODS AND RESULTS: In 5 patients with monogenic hypertension (18 to 34 years old), we conducted detailed autonomic function tests. Blood pressure during complete ganglionic blockade was 134+/-4.9/82+/-4.1 mm Hg and 90+/-6/49+/-2.4 mm Hg in patients and in control subjects, respectively. During ganglionic blockade, plasma vasopressin concentration increased 24-fold in control subjects and <2-fold in patients. In patients, cold pressor testing, hand-grip testing, and upright posture all increased blood pressure excessively. In contrast, muscle sympathetic nerve activity was not increased at rest or during cold pressor testing. The phenylephrine dose that increased systolic blood pressure 12.5 mm Hg was 8.0+/-2.0 microg in patients and 135+/-35 microg in control subjects before ganglionic blockade and 5.4+/-0.4 microg in patients and 13+/-4.8 microg in control subjects during ganglionic blockade. CONCLUSIONS: In patients with monogenic hypertension and neurovascular contact, basal blood pressure was increased even during sympathetic and parasympathetic nerve traffic interruption. However, sympathetic stimuli caused an excessive increase in blood pressure. This excessive response cannot be explained by increased sympathetic nerve traffic or increased vascular sensitivity. Instead, we suggest that baroreflex buffering and baroreflex-mediated vasopressin release are severely impaired.

Adolescent↗
PubMed2000

Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus.

BACKGROUND: We tested the hypothesis that a common oscillatory pattern might characterize the rhythmic discharge of muscle sympathetic nerve activity (MSNA) and the spontaneous variability of heart rate and systolic arterial pressure (SAP) during a physiological increase of sympathetic activity induced by the head-up tilt maneuver. METHODS AND RESULTS: Ten healthy subjects underwent continuous recordings of ECG, intra-arterial pressure, respiratory activity, central venous pressure, and MSNA, both in the recumbent position and during 75 degrees head-up tilt. Venous samplings for catecholamine assessment were obtained at rest and during the fifth minute of tilt. Spectrum and cross-spectrum analyses of R-R interval, SAP, and MSNA variabilities and of respiratory activity provided the low (LF, 0.1 Hz) and high frequency (HF, 0.27 Hz) rhythmic components of each signal and assessed their linear relationships. Compared with the recumbent position, tilt reduced central venous pressure, but blood pressure was unchanged. Heart rate, MSNA, and plasma epinephrine and norepinephrine levels increased, suggesting a marked enhancement of overall sympathetic activity. During tilt, LF(MSNA) increased compared with the level in the supine position; this mirrored similar changes observed in the LF components of R-R interval and SAP variabilities. The increase of LF(MSNA) was proportional to the amount of the sympathetic discharge. The coupling between LF components of MSNA and R-R interval and SAP variabilities was enhanced during tilt compared with rest. CONCLUSIONS: During the sympathetic activation induced by tilt, a similar oscillatory pattern based on an increased LF rhythmicity characterized the spontaneous variability of neural sympathetic discharge, R-R interval, and arterial pressure.

Adult↗
PubMed2000

Reference values of indices of spontaneous baroreceptor reflex sensitivity.

Spontaneous baroreceptor reflex sensitivity (BRS) is a well established method for determining baroreflex function, which can be used to assess the potential impact on survival after myocardial infarction, to detect autonomic dysfunction in diabetic patients and in human essential hypertension. The assessment of impaired spontaneous baroreflex function in individual patients contains important clinical information, but age-dependent reference values are still lacking. In the present study we evaluated spontaneous BRS in healthy human controls to determine reference values as a function of age. Two hundred and sixty-two healthy volunteers divided into six age groups (I: <20 years, f = 11, m = 9, II: 20-29 years, f = 42, m = 37, III: 30-39 years, f = 23, m = 37, IV: 40-49 years, f = 27, m = 22, V: 50-59 years, f = 19, m = 17, VI: 60-69 years, f = 5, m = 13). Electrocardiograms (ECG) and finger arterial BP were measured with each subject in the supine position (sup, 7 min) and during deep breathing (dB, 6/min, 15 cycles). BRS was assessed using the sequence technique and the alpha coefficients as obtained from a power spectrum density estimate. Due to the normal logarithmic distribution of the BRS, the limits for impaired baroreflex function at rest were defined from logarithmic data. The limits for the BRS at rest (P = .025) were calculated as (-0.0283 x age) + 2.5198 for the sequence technique. We did not find significant differences in BRS among the female and male healthy volunteers. Our analysis of the six age groups showed the expected significant decrease in BRS, which was most prominent at the transition from group III (<40 years) to group IV (<50 years). BRS at rest and during deep breathing as well as sequential and spectral BRS indices did differ significantly. The results underline the necessity of reference values to evaluate impaired baroreflex function in individual patients.

Adolescent↗
PubMed1998

Yohimbine in neurally mediated syncope. Pathophysiological implications.

In this study, we evaluated if increased sympathetic stimulation is an essential requirement for the development of neurally mediated syncope (NMS) by manipulating overall sympathetic outflow in subjects susceptible to tilt-induced syncope. Eight previously characterized patients with recurrent NMS (five females and three males; 34+/-2 yr) were recruited from the Vanderbilt Syncope Unit and eight age-matched controls underwent initial administration of clonidine (CLO) or yohimbine (YHO). This was done, prospectively, to determine doses of these agents that would increase or decrease plasma norepinephrine levels by >/= 30%. On a different day, in all subjects we determined intraarterial blood pressure, EKG and muscle sympathetic nerve activity (MSNA) both supine and during upright tilt. After this, subjects randomly received either CLO or YHO, and 3 h later another tilt was performed. After 1 wk, a similar procedure with the other drug was performed. During the two basal tilts, all the control subjects completed the study, whereas all the NMS patients developed syncope. Reduction in sympathetic tone by CLO resulted in a decreased tolerance to tilt in three out of eight controls and in all the NMS patients. In contrast, YHO not only increased basal plasma NorEpi levels and MSNA, but also prevented syncope in seven out of eight patients. In a selected population of patients, increased sympathetic activity is not a prerequisite for the development of syncope. Yohimbine-induced enhancement of sympathetic tone in patients with NMS improves orthostatic tolerance and raises the possibility that this drug may be a useful agent in the treatment of NMS.

Adult↗
PubMed1997

Impaired activation of the baroreflex loop as early sign of sympathetic damage in diabetics with normal heart rate variability at rest.

The objective of the study was to define the impairment of sympathovagal balance in patients with diabetes mellitus (DM) and coronary heart disease (CHD) compared to healthy controls (HC) showing similar heart rate variability (HRV) at supine rest. 88 DM (41 m, 47 f; age 62 +/- 1 years; BMI 27.1 +/- 1.5 kg/m2; HbA1c 7.9 +/- 0.4%), 49 CHD (27 m, 22 f; age 62 +/- 1 years; BMI 27.1 +/- 1.6 kg/m2; HbA1c 5.2 +/- 0.1%) and 16 HC (8 m, 8 f; age 59 +/- 1 years; BMI 26.4 +/- 0.5 kg/m2; HbA1c 5.0 +/- 0.1%) were investigated. Time series of heart period duration (HPD) were obtained during 2 min deep breathing (6/min), 5 min of supine rest and for 5 min at upright position using a RR memory device (BHL 6000, Baumann-Haldi Switzerland, modified ECG lead, 1 kHz). Mean HPD, coefficient of variation (CV), total power (TP) and integral power in the HF (0.15 to 0.5 Hz), MF (0.05 to 0.15 Hz) and LF (0.015 to 0.05 Hz) frequency bands as well as (MF-HF)/(MF + HF) as spectral index were calculated. As to be expected we found significantly lower values of CV, TP and HPD in DM compared to HC. The CV of HRV did not differ significantly between DM and CHD but TP and HPD of CHD patients were significantly higher in comparison to DM. Therefore, the deterioration of HRV was most pronounced in the DM group. For further analysis we calculated data of subjects with CV's in the upper quartile (> or = 3.52) of the CV at supine rest. The aim of this procedure was to compare subjects with similar high HRV at supine rest. With this method we obtained from all subjects 12 HC, 11 DM and 12 CHD. These DM had a significant decrease of CV, TP and the integral power at the HF frequency band during active orthostasis compared to HC and CHD. The spectral index increased significantly during standing in HC and CHD but was unchanged in DM. These changes were accompanied by a nearly similar increase of HRV during deep breathing. In conclusion, DM with normal reaction to deep breathing did not activate the sympathetic baroreflex loop during active orthostasis. This could be an early sign of sympathetic dysfunction in DM with normal HRV at supine rest.

Autonomic Nervous System Diseases↗
PubMed1995

Hemodynamic regulation during postural tilt assessed by heart rate- and blood-pressure variability combined with impedance cardiography.

Assessment of heart rate and heart rate variability (HRV) are used in sports medicine and space medicine to give conclusions about the functional state of the autonomic nervous system. Furthermore, reduced HRV and changed blood pressure variability (BPV) are accepted as risk factors in patients with cardiovascular diseases, metabolic syndrome and neurologic disorders. The aim of the first studies was to combine the evaluation of central hemodynamic (impedance cardiography) with HRV and BPV evaluation in the time and frequency domain (fft tracking) based on a standardized clinical test with automated protocol output. Data acquisition and -analysis was realized beat to beat (Kohto Ltd., Moscow) during forced breathing (150 s, 6 breath/min) and postural tilt (7 min, supine, transition to 55 degrees in 4 s, 7 min upright) allowing one to evaluate: orthostatic response type including impedance cardiography; activation of vagal afferences and efferences by forced breathing; vagal and sympathetic components during initial heart rate and blood pressure responses; characteristic changes of spectral balance of HRV and BPV (measured at the finger) during early regulation. First investigations on 34 normal volunteers subdivided into two age groups and on 13 patients with different diseases indicate that besides the age dependent changes (reduced HRV, reduced cardiac performance, reduced regulatory amplitudes and baroreflex sensitivity) individual response types can be described and dysfunction of different reflex loops can be detected. Consequently, the assessment of specific influences onto circulatory control by therapy, sport and rehabilitative training is possible and further studies are necessary.

Adult↗