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(Hypertension. 2000;35:76.)
© 2000 American Heart Association, Inc.

Scientific Contributions

Dissociation Between Neural and Vascular Responses to Sympathetic Stimulation

Contribution of Local Adrenergic Receptor Function

Giris Jacob; Fernando Costa; John Shannon; David Robertson; Italo Biaggioni

From the Clinical Research Center, Department of Medicine, Pharmacology, and Neurology, Vanderbilt University Medical Center, Nashville, Tenn, and the Jacob Recanati Autonomic Dysfunction Center (G.J.), Department of Internal Medicine C, Rambam Medical Center, Haifa, Israel.

Correspondence to Italo Biaggioni, MD, AA3228 MCN, Vanderbilt University, Nashville, TN 37232-2195. E-mail italo.biaggioni{at}mcmail.vanderbilt.edu

Abstract—Sympathetic activation produced by various stimuli, eg, mental stress or handgrip, evokes regional vascular responses that are often nonhomogeneous. This phenomenon is believed to be the consequence of the recruitment of differential central neural pathways or of a sympathetically mediated vasodilation. The purpose of this study was to determine whether a similar heterogeneous response occurs with cold pressor stimulation and to test the hypothesis that local differences in adrenergic receptor function could be in part responsible for this diversity. In 8 healthy subjects, local norepinephrine spillover and blood flow were measured in arms and legs at baseline and during sympathetic stimulation induced by baroreflex mechanisms (nitroprusside infusion) or cold pressor stimulation. At baseline, legs had higher vascular resistance (27±5 versus 17±2 U, P=0.05) despite lower norepinephrine spillover (0.28±0.04 versus 0.4±0.05 mg · min^-1 · dL^-1, P=0.03). Norepinephrine spillover increased similarly in both arms and legs during nitroprusside infusion and cold pressor stimulation. On the other hand, during cold stimulation, vascular resistance increased in arms but not in legs (20±9% versus -7±4%, P=0.03). Increasing doses of isoproterenol and phenylephrine were infused intra-arterially in arms and legs to estimate ß-mediated vasodilation and -induced vasoconstriction, respectively. ß-Mediated vasodilation was significantly lower in legs compared with arms. Thus, we report a dissociation between norepinephrine spillover and vascular responses to cold stress in lower limbs characterized by a paradoxical decrease in local resistance despite increases in sympathetic activity. The differences observed in adrenergic receptor responses cannot explain this phenomenon.

Key Words: autonomic nervous system • norepinephrine • receptors, adrenergic • vasodilation

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