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Biomedical subjects

Jacques Regnard

Publications and source records attributed to Jacques Regnard.

7 recordsLinked to original sources

Six-month cardiovascular changes in cyclosporine-treated recipients of corneal grafts: serial baroreflex responses.

Loss of autonomic cardiovascular homoeostasis is often suspected in hypertension that has developed after organ transplantation. We serially assessed autonomic cardiovascular control in eight patients in generally good condition who needed cyclosporine (CyA) treatment because of high risk of rejection in corneal transplantation. To this aim, we investigated the patients, before and while they were receiving CyA, for 1 week and at 1, 3 and 6 months. For each period, spontaneous baroreflex, blood pressure, heart rate and variability were assessed, as well as neuro-hormonal indicators, while the patients were in both supine and 60 degrees upright positions. After 1 week of treatment, patients showed increases in systolic, diastolic and pulse blood pressures (P<0.05) that were concomitant with a transient decrease in plasma noradrenaline (P<0.05), which, thereafter, resumed the range of baseline values for 6 months. After patients had received CyA treatment for 1 month, the total power of systolic blood pressure variability and its low-frequency component remained higher than before treatment (P<0.05). At 3 and 6 months, heart rate was decreased (P<0.001) when high-frequency power of RR variability and plasma atrial natriuretic peptide were increased (P<0.05). As plasma noradrenaline never exceeded the baseline range, the hypertensive effect of CyA was not likely to have resulted from sympathetic activation. Rather, the increase in systolic blood pressure variability, its low-frequency component and the pattern of pulse pressure changes, pointed to a direct vascular effect of CyA. The maintenance of a normal cardiac baroreflex function during 6 months of CyA treatment might be pivotal to the adaptive responses towards direct CyA effects.

Adult↗

Decrease in heart rate variability with overtraining: assessment by the Poincaré plot analysis.

Numerous symptoms have been associated with the overtraining syndrome (OT), including changes in autonomic function. Heart rate variability (HRV) provides non-invasive data about the autonomic regulation of heart rate in real-life conditions. The aims of the study were to: (i) characterize the HRV profile of seven athletes (OA) diagnosed as suffering of OT, compared with eight healthy sedentary (C) and eight trained (T) subjects during supine rest and 60 degrees upright, and (ii) compare the traditional time- and frequency-domain analysis assessment of HRV with the non-linear Poincaré plot analysis. In the latter each R-R interval is plotted as a function of the previous one, and the standard deviations of the instantaneous (SD1) and long-term R-R interval variability are calculated. Total power was higher in T than in C and OA both in supine (1158 +/- 1137, 6092 +/- 3554 and 2970 +/- 2947 ms2 for C, T and OA, respectively) and in upright (640 +/- 499, 1814 +/- 806 and 1092 +/- 712 ms2 for C, T and OA, respectively; P<0.05) positions. In supine position, indicators of parasympathetic activity to the sinus node were higher in T compared with C and OA (high-frequency power: 419.1 +/- 381.2, 1105.3 +/- 781.4 and 463.7 +/- 715.8 ms2 for C, T and OA, respectively; P<0.05; SD1: 29.5 +/- 18.5, 75.2 +/- 17.2 and 37.6 +/- 27.5 for C, T and OA, respectively; P<0.05). OA had a marked predominance of sympathetic activity regardless of the position (LF/HF were 0.47 +/- 0.35, 0.47 +/- 0.50 and 3.96 +/- 5.71 in supine position for C, T and OA, respectively, and 2.09 +/- 2.17, 7.22 +/- 6.82 and 12.04 +/- 10.36 in upright position for C, T and OA, respectively). The changes in HRV indexes induced by the upright posture were greater in T than in OA. The shape of the Poincaré plots allowed the distinction between the three groups, with wide and narrow shapes in T and OA, respectively, compared with C. As Poincaré plot parameters are easy to compute and associated with the 'width' of the scatter gram, they corroborate the traditional time- and frequency-domain analysis. We suggest that they could be used to indicate fatigue and/or prevent OT.

Adolescent↗

Comparison of various techniques used to estimate spontaneous baroreflex sensitivity (the EuroBaVar study).

This study compared spontaneous baroreflex sensitivity (BRS) estimates obtained from an identical set of data by 11 European centers using different methods and procedures. Noninvasive blood pressure (BP) and ECG recordings were obtained in 21 subjects, including 2 subjects with established baroreflex failure. Twenty-one estimates of BRS were obtained by methods including the two main techniques of BRS estimates, i.e., the spectral analysis (11 procedures) and the sequence method (7 procedures) but also one trigonometric regressive spectral analysis method (TRS), one exogenous model with autoregressive input method (X-AR), and one Z method. With subjects in a supine position, BRS estimates obtained with calculations of alpha-coefficient or gain of the transfer function in both the low-frequency band or high-frequency band, TRS, and sequence methods gave strongly related results. Conversely, weighted gain, X-AR, and Z exhibited lower agreement with all the other techniques. In addition, the use of mean BP instead of systolic BP in the sequence method decreased the relationships with the other estimates. Some procedures were unable to provide results when BRS estimates were expected to be very low in data sets (in patients with established baroreflex failure). The failure to provide BRS values was due to setting of algorithmic parameters too strictly. The discrepancies between procedures show that the choice of parameters and data handling should be considered before BRS estimation. These data are available on the web site (http://www.cbi.polimi.it/glossary/eurobavar.html) to allow the comparison of new techniques with this set of results.

Adult↗

Quantitative Poincaré plot analysis of heart rate variability: effect of endurance training.

The aim of the study was to evaluate the effectiveness of the Poincaré plot analysis of heart rate variability (HRV) in observing endurance training-induced changes. Four 10-min manoeuvres were performed (supine lying, standing, steady state exercising and subsequent recovery) by eight control subjects before and after a short-term endurance training and by eight subjects trained for at least 3 years. HRV was assessed by traditional time- and frequency-domain indexes, in parallel with the Poincaré plot analysis. In the latter each R-R interval is plotted as a function of the previous one, and the standard deviations of the instantaneous and long-term R-R interval variability are calculated. In our subjects, the Poincaré scatter grams became gradually narrower from supine to exercising, with progressive parasympathetic withdrawal. Short- and long-term endurance training led to higher aerobic power ( p<0.05) and ventilatory threshold shifted towards higher power output ( p<0.05). All HRV evaluation methods showed that HRV values were higher after training both during supine lying and standing ( p<0.05). The Poincaré scatter grams were wider in the trained state. Standard deviations of the Poincaré plot were significantly correlated with the main parameters of the time- and frequency-domain analyses, especially concerning the parasympathetic indicators. These results suggested that Poincaré plot parameters as well as the "width" of the scatter gram could be considered as surrogates of time- and frequency-domain analysis to assess training-induced changes in HRV.

Adult↗

Human bone marrow angiogenesis: in vitro modulation by substance P and neurokinin A.

We have previously described a culture system for human bone marrow endothelial cells that organize into capillary tubes associated to pericytes. In the present work, we used this model to assess the angiogenic properties of tachykinins, which have been demonstrated to be involved in neuro-immuno-haematopoietic interactions. The substance P (SP) and neurokinin A (NKA) were similarly potent at increasing in vitro angiogenesis, via NK1 and NK2 receptors respectively. These mediators were not produced by cells in culture, suggesting that in vivo they may be released by nerve fibres in the bone marrow. Therefore, we looked for in situ innervation of the human bone marrow, unknown to date, using immunohistochemistry techniques. As in rodents, arterioles were largely innervated, associated with between one and 10 nerve fibres. Capillary innervation was more restrictive as a unique thin nerve fibre was found in the vicinity of only 6% of these vessels. Finally, no nerve fibres were observed in the vicinity of sinus walls. In conclusion, both in vitro results and the anatomical display of nerve fibres suggest a role in human bone marrow for the vasoactive neuropeptides SP and NKA, which were secreted into a perivascular location. These neural mediators might modulate blood flow in the bone marrow both in the short term by adjusting vascular tone and in the long term by inducing angiogenesis.

Angiogenesis Inducing Agents↗