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Biomedical subjects

L Gregorini

Publications and source records attributed to L Gregorini.

At least 55 records · Page 3Linked to original sources

Blood pressure variability in man: its relation to high blood pressure, age and baroreflex sensitivity.

1. Intra-arterial blood pressure and heart rate were recorded for 24 h in ambulant hospitalized patients of variable age who had normal blood pressure or essential hypertension. Mean 24 h values, standard deviations and variation coefficient were obtained as the averages of values separately analysed for 48 consecutive half-hour periods. 2. In older subjects standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation aations and variation coefficient were obtained as the averages of values separately analysed for 48 consecurive half-hour periods. 2. In older subjects standard deviation and variation coefficient for mean arterial pressure were greater than in younger subjects with similar pressure values, whereas standard deviation and variation coefficient for heart rate were smaller. 3. In hypertensive subjects standard deviation for mean arterial pressure was greater than in normotensive subjects of similar ages, but this was not the case for variation coefficient, which was slightly smaller in the former than in the latter group. Normotensive and hypertensive subjects showed no difference in standard deviation and variation coefficient for heart rate. 4. In both normotensive and hypertensive subjects standard deviation and even more so variation coefficient were slightly or not related to arterial baroreflex sensitivity as measured by various methods (phenylephrine, neck suction etc.). 5. It is concluded that blood pressure variability increases and heart rate variability decreases with age, but that changes in variability are not so obvious in hypertension. Also, differences in variability among subjects are only marginally explained by differences in baroreflex function.

Adult↗

Plasma catecholamines and blood pressure responses to the carotid baroreceptor reflex in essential hypertension.

1. Slight decreases and increases in carotid baroreceptor activity were induced in subjects with essential hypertension by slight alterations in carotid transmural pressure (variable pressure neck-chamber technique) in order to obtain limited increases and reductions in sympathetic adrenergic activity. 2. When sympathetic activity was reflexly increased there was a rise in arterial pressure but no significant increase in plasma catecholamines. Likewise when sympathetic activity was reflexly reduced there was a fall in arterial pressure but no significant reduction in plasma catecholamines. 3. Plasma noradrenaline and adrenaline significantly and markedly increased in the same subjects when sympathetic activity was increased by activation of both arterial and low pressure baroreceptor reflexes with tilting. 4. It is suggested that measurements of catecholamines in systemic plasma may reveal marked degrees of sympathetic activation but may not be a sensitive index of more moderate changes in sympathetic tone.

Adult↗

Baroreceptor control of atrioventricular conduction in man.

Although human baroreflexes are known to exert a powerful physiological control on heart rate, little information exists on the physiological control they exert on the atrioventricular conduction system. In 11 normotensive subjects with normal atrioventricular conduction, we altered baroreceptor activity by injection of pressor and depressor drugs (phenylephrine and trinitroglycerin) and recorded mean arterial pressure (MAP, catheter measurements), R-R interval, and pre-His and post-His intervals (A-H and H-V, His bundle recording). With the subjects in sinus rhythm, increasing MAP by 21+/- 1 mm Hg caused a marked lengthening (250 +/- 28 msec), and decreasing MAP by 17 +/- 2 mm Hg a marked shortening (142 +/- 16 msec) of the R-R interval. There was little change in the A-H interval and no change at all in the H-V interval. However, when the R-R interval was kept constant in these subjects by atrial pacing, a similar increase and decrease in MAP caused, respectively, a marked lengthening (49 +/- 6 msec) and shortening (19 +/- 3 msec) of the A-H interval, although the H-V interval remained unaffected. Thus physiological ranges of baroreceptor activation have a marked influence on the atrioventricular node but apparently not on the ventricular portion of the atrioventricular conduction system. This influence is unmasked when pacing prevents the baroreceptor influence on the sinoatrial node.

Adult↗

Baroreceptor reflexes in human hypertension.

We studied the control of arterial pressure by the carotid sinus baroreceptors in 35 hypertensive humans, using a variable pressure neck chamber to alter carotid sinus transmural pressure in a graded fashion. The results were compared with those obtained from 11 normotensives. As in normotensives, reduction in carotid transmural pressure caused a linearly related pressor response and vice versa. However, whereas in normotensives the pressure response was greater than the depressor, the reverse was the case in hypertensives. Furthermore, the pressor response decreased and the depressor response increased progressively with an increase in severity of the hypertension. Thus while in normotensives the carotid baroreflex is more effective in protecting against hypotension, in hypertensives the antihypertensive function of the reflex is favored. Similar differences between hypertensives and normotensives were found with respect to the carotid baroreceptor control of heart rate. In eight hypertensives, reflex changes in heart rate also were studied by injection of phenylephrine and trinitroglycerine to vary not only carotid baroreceptor activity, but also activity of extracarotid baroreceptors. The results were compared with results of similar studies on eight normotensives. These comparisons suggest that, whereas the carotid baroreceptor reflex remains active in hypertension, reflexes stemming from extracarotid baroreceptor areas are much diminished.

Adult↗

Circulatory reflexes from carotid and extracarotid baroreceptor areas in man.

The carotid sinus baroreceptor reflex was studied in 11 normotensive subjects, using a variable pressure neck chamber and correcting for imperfect pressure transmission to the carotid sinus. Decreased carotid baroreceptor stimulation caused a sustaineded rise in arterial pressure, and increased carotid baroreceptor stimulation caused a sustain fall. The responses were in linear relation to the stimulus, and, after reaching the steady state, greater for the reduced than for the increased baroreceptor stimulation. Thus the carotid sinus baroreceptor reflex of the normotensive man is an effective antihypotensive and antihypertensive feedback system, though the former function may have more sensitivity. The increased and decreased baroreceptor stimulation by the neck chamber also caused bradycardia and tachycardia which were modest in magnitude and often transient. In eight subjects the reflex changes in heart rate induced by the neck chamber were compared with those induced by altering transmural pressure not merely at the carotid sinus but throughout the arterial tree (injection of phenylephrine and trinitroglycerin). The slopes of these relations were 3 times as great in the latter circumstance. Thus the carotid baroreceptors play a lesser role in heart rate control than do extracarotid baroreceptors.

Adult↗

Carotid baroreceptor reflex in normotensive and hypertensive subjects.

1. A graded decrease and increase in carotid baroreceptor activity (induced by a varying pressure in a neck chamber) caused a linearly related increase and decrease in arterial blood pressure. This occurred in both normotensive and hypertensive subjects. 2. Decrease of carotid baroreceptor activity caused a greater increase of blood pressure in normotensive than in hypertensive subjects. Increasing the activity caused changes of similar magnitude in the two groups. 3. Decrease of baroreceptor activity also caused an increase in heart rate although increasing the activity of the reflex had little effect on heart rate, particularly in normotensive subjects. Thus the carotid baroreceptor effect on blood pressure does not always reflect that on heart rate and inference of one reflex response from measurement of the other may be in error.

Blood Pressure↗