(Hypertension. 1995;26:1111-1116.)
© 1995 American Heart Association, Inc.
Articles |
From the Laboratory of Cardiovascular Physiology, Department of Physiology, Biosciences Institute, University of Rio Grande do Sul (M.C.I.) and the Hypertension Unit (E.D.M., F.I., M.P., E.M.K.) and Bioengineering Division (I.A.C.), Heart Institute, School of Medicine, University of São Paulo, Brazil.
Correspondence to Eduardo M. Krieger, MD, PhD, Hypertension Unit, Heart Institute, Faculty of Medicine, University of São Paulo, Brazil, Av Dr Enéas de Carvalho Aguiar 44, São Paulo, SP 05403 000, Brazil.
| Abstract |
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Key Words: sympathetic nervous system blood pressure baroreflex
| Introduction |
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| Methods |
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SAD
SAD was performed as described previously by our
laboratory.4 Briefly, under ether anesthesia a
3-cm midline incision was made, and sternocleidomastoid muscles were
reflected laterally, exposing the neurovascular sheath. The common
carotid arteries and the vagal trunk were isolated, and the aortic
depressor fibers either traveling with the sympathetic nerve or as an
isolated aortic nerve were cut. The communicating branch of the aortic
fibers was also resected. The third contingent of aortic baroreceptor
fibers traveling with the inferior laryngeal nerve was
interrupted by resection of the superior laryngeal nerve after the
carotid bifurcation was exposed extensively for carotid stripping. To
complete SAD, the sinus nerve as well as all carotid branches and the
carotid body were resected.
Instrumentation
Arterial and venous cannulas were implanted in
normal control rats and SADa and SADc rats 1 day before
cardiovascular and nerve monitoring, and all animals
were treated with a single injection of penicillin G benzatine
(benzethacil 60 000 U). While the rat was under ether
anesthesia, polyethylene-tipped Tygon cannulas filled
with heparin in normal saline were inserted into the abdominal aorta
and inferior vena cava through the left femoral artery and
vein, respectively. The free ends of the cannulas were tunneled
subcutaneously and exteriorized at the top of the skull. On the day of
the experiment a thin bipolar platinum electrode was placed around a
branch of the left renal nerve and insulated with silicone rubber
(Wacker Sil-Gel 604) while the rat was under ether
anesthesia. Electrode implantation was performed during the
same experimental period in the SADa group and 20 days after
denervation in SADc group. Measurements were performed 4 to 6 hours
after completion of surgery to allow the rat to recover from
anesthesia. For completion of the experiments, each rat was
placed in the cage in which it had been housed since the previous day
(25x15x10-cm Plexiglas cage with a grid floor). The electrode cable
and the arterial cannula were attached to special
extensions during the recording period, allowing the rat
complete freedom of movement within the cage.
Cardiovascular and Nerve Monitoring
AP was recorded in conscious rats by connecting the
arterial cannula to a pressure transducer (Statham P23 Db)
and a pressure amplifier (model 8805C, Hewlett Packard). The signal
from the nerve electrode was recorded after being amplified
(Tektronix 5A22N differential amplifier) and filtered (bandpass filter,
100 Hz to 2 kHz). Both AP and the original neurogram were monitored
with a storage oscilloscope (Tektronix 5111) and stored on a tape
recorder (model 7754A, Hewlett Packard) during a control period of
3 minutes. RSNA and HR responses to changes in AP induced to test
baroreflex sensitivity were recorded after control
recordings. Further processing was performed using a data
acquisition system assembled on a microcomputer (PC AT 386) equipped
with an analog-to-digital converter board (10 bits, CAD 10/26,
Lynx). An electronic circuit was built for preprocessing the neurogram
before digital conversion. This circuit allows subtraction of a desired
voltage from the input signal, amplification, full-wave
rectification and integration with an analog output provided for
oscilloscope monitoring after each stage. At the end of the experiment
a dose of phenylephrine was administered to produce a
sudden and marked increase in MAP, which inhibited and decreased neural
activity to a minimum considered to be the baseline bioelectrical or
near-noise signal for subtraction from the original neurogram
before integration. Noise subtraction is performed manually with the
use of a high-resolution potentiometer followed by amplification
with a variable gain to produce a maximum spike amplitude of 10 V.
The neurogram is full-wave rectified to preserve all information
contained in the negative and positive components of the electrical
signal. For this application integration was performed in two modes:
the neurogram was integrated over the pressure pulse interval (as shown
in the tracings of Fig 2) and voltage reset mode. In the latter
integration is determined by the voltage across the capacitor of the
integrator rather than by time or event periodicity. In this
application every time this voltage level equals 10 V the capacitor is
allowed to discharge and produces a barlike signal of constant
amplitude with a frequency of occurrence proportional to the density of
the input signal. AP and integrated sympathetic activity were filtered
and digitized (120 Hz). Systolic and diastolic AP
and MAP, HR, and RSNA were determined on a beat-to-beat basis
using a specially written software with additional processing performed
with a commercial software (EXCEL 5.0, Microsoft). HR was
determined to be one over the interval between two successive peaks of
the pressure wave. RSNA was expressed by the number of bars per cardiac
cycle.11 12 13 To compare different groups of rats, RSNA
values were expressed in bars per cycle or as a percentage of the
maximal (100%) and minimal (0%) nerve activity during 1000 cardiac
cycles as described by Lundin et al.12 Briefly, to
normalize for the varying quality of the multifiber recording,
values of maximal and minimal nerve activity (100% and 0%) were
determined from the 3% of the recorded cardiac cycles that showed
the highest and the lowest activity levels. The average "zero nerve
activity" was arbitrarily calculated from these 3% out of 1000
cycles recorded because at least 3% of all cardiac cycles in these
rats appeared to lack nerve spikes. The 3% of all cardiac cycles with
the highest activity was used as the maximal activity.
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Spontaneous and Reflex Baroreceptor Testing
The resting spontaneous relation between AP and RSNA was
quantified by averaging RSNA in each pressure class (2 mm Hg) from
higher to lower values of systolic pressure obtained during the
recording period as described elsewhere.13
Briefly, with the use of the recorded 1000 cardiac cycles, we
sorted systolic AP values from highest to lowest in classes of
2 mm Hg. The corresponding RSNAs obtained at each pressure class were
averaged and are presented in Fig 3. The correlation between AP
and RSNA was expressed by fitting a regression line through the points
relating averaged RSNA and increasing systolic pressure values
of each class. The reflex control of RSNA and HR were evaluated by at
least three pressure responses (from 3 to 40 mm Hg) to
phenylephrine (0.25 to 4 µg/mL) and sodium nitroprusside
(6 to 25 µg/mL) injections. Peak increase or decrease of MAP after
every dose of phenylephrine or nitroprusside injection was
correlated with peak reflex change of RSNA or HR. The baroreflex
sensitivity was analyzed by the regression line obtained by
best-fit points relating changes in RSNA (in bars per cycle) or HR
(in bpm) and MAP (in millimeters of mercury). The basal nerve activity
was obtained by averaging the RSNA in the first 40 cycles immediately
before drug injection.
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Statistical Analysis
Data are reported as mean±SEM. The results were compared by use
of repeated-measures ANOVA. The post hoc test used was the
Newman-Keuls test. P
.05 was considered significant.
| Results |
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Original AP tracings, the renal neurogram, and RSNA integrated over the AP pulse interval are shown in Fig 2 to illustrate the differences between control, SADa, and SADc rats. SADc rats showed normalization of RSNA with a higher proportion of silent cycles and consequently with a lower 1:1 synchronization between RSNA and cardiac cycles.
Hypertension and increased AP variability (analyzed by standard deviation of MAP) was detected in SADa rats, whereas in SADc rats the MAP normalized but the increased AP variability persisted (from 6±3 in controls to 13±2 and 15±2, respectively, in SADa and SADc rats). The variability of RSNA expressed by a coefficient relating standard deviation and the average RSNA in 1000 cardiac cycles showed decreased variability in SADa rats (0.22±0.07) and normal variability in SADc rats compared with controls (0.88±0.24 versus 0.77±0.66 in controls).
Spontaneous and Reflex Changes in RSNA
The spontaneous relation between systolic pressure and
RSNA is illustrated in Fig 3. The great variability
observed in the values of RSNA in different systolic pressure
classes in normal rats decreases significantly after SAD. The inverse
correlation between systolic pressure and average RSNA in each
class of systolic pressure (every 2-mm Hg variation) observed
in intact rats disappeared in SADa rats (-0.02±0.01% per mm Hg
versus -1.90±0.3% per mm Hg in controls) and SADc rats
(-0.32±0.05% per mm Hg).
In response to nitroprusside and phenylephrine SAD rats had an impaired sensitivity for baroreflex control of HR. When the blood pressure increased, the baroreflex bradycardia in SAD rats decreased (from -2.51±0.16 bpm per mm Hg in controls to -0.15±0.01 and -0.60±0.2 bpm per mm Hg in SADa and SADc rats, respectively). The tachycardiac responses to blood pressure reduction were attenuated (from -2.86±0.4 bpm per mm Hg in controls to -0.18±0.02 and -0.7±0.2 bpm per mm Hg in SADa and SADc rats, respectively).
The RSNA responses to blood pressure increases were similarly reduced from -0.9±0.17 bars per cycle in controls to -0.13±0.02 and -0.25±0.1 bars per cycle in SADa and SADc rats, respectively. The RSNA reflex responses to blood pressure decreases decreased from -0.98±0.2 bars per cycle in controls to -0.08±0.03 and -0.37±0.1 bars per cycle in SADa and SADc rats, respectively.
| Discussion |
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Indirect hemodynamic,10 21 22 neural,11 and biochemical8 9 evidence has indicated that hypertension in the early phase of SAD in rats is produced by sympathetic hyperactivity. In the present study direct recording of RSNA showed a 100% increase in activity within the first 6 hours after SAD, which is higher than the 30% increase detected after 24 hours.23 These data indicate that the increased sympathetic activity after SAD progressively diminishes or that the different results obtained by Barres et al23 may be attributed to methodological differences. It is well known that the evaluation of nervous activity by spike counting as used by Barres et al may be inadequate when summation phenomena are present.19 Indeed, after 20 days of SAD RSNA was normal. Normalization of the sympathetic activity in SADc has been indicated by normalization of HR24 and biochemical measurements9 as well as by the reversal of hypertension.7 Our hypothesis is that AP and RSNA in SAD are determined by simultaneous elimination of chemoreceptors (hypotensive influence) and baroreceptors (hypertensive influence). In early SAD the effect of baroreceptor denervation with a consequent increase in sympathetic activity and AP is predominant.7 11 Later in the chronic stage normalization of RSNA and AP reflect a balance between opposite effects of baroreceptor and chemoreceptor denervation. Also, the interplay of other reflexes (cardiopulmonary, for instance) probably works to reverse the hypertension.7 25
In distinction to the normalization of hyperactivity of RSNA in SADc impairment of baroreflexes is still demonstrable as shown in the present experiments as well as by others.23 24 The tendency of the depressed baroreflex to improve in SADc rats was observed Barres et al,23 who showed improvement of bradycardiac and sympathoinhibition 14 days after SAD in rats. These data suggest that reflex mechanisms other than the arterial baroreflex could be active. One possibility is that cardiopulmonary reflexes could play a role in these responses because they are relatively insensitive to the moment-to-moment changes in AP seen after SAD.26 Another possibility is that the intake of sodium was reduced in SADc rats, since it was demonstrated that blood pressure is salt sensitive in SAD rats27 and that the increase of dietary sodium may increase the gain of baroreflex control of RSNA in Wistar-Kyoto rats.28
The most consistent cardiovascular alteration produced by SADa or SADc is the great increase in AP lability. Previous studies have described similar high variability in dogs,29 cats,30 and rats.23 25 Usually, the lability of AP in SAD animals is characterized by an increased standard deviation of AP obtained from computerized recordings.24 25 The main determinant of the increased AP lability in SAD rats was attributed to sympathetic hyperactivity because variability decreases after the attenuation of the hyperactivity in SADc rats.25 On the other hand the blockade of sympathetic neural transmission reduced AP lability by 75% in SAD rats.31 In the present experiments the higher lability of AP in SADa and SADc rats was accompanied by decreased RSNA variability in SADa rats and normal RSNA variability in SADc rats.
The normalization of RSNA variability with the maintenance of AP fluctuations in SADc rats and of impairment of baroreflex control suggests that the RSNA variability in SADc rats represents fluctuations in sympathetic outflow of central origin. Indeed, the spontaneous relation between systolic pressure and averaged RSNA showed an inverse correlation in control rats that was lost in SADa and SADc rats, indicating that after SAD the AP values are not directly correlated with RSNA. We observed in healthy control rats a cardiac-related discharge pattern or a good synchronization between pulse pressure and bursts of RSNA in distinction to SAD rats in which greater time intervals separated sequential bursts of synchronized activity. It may be an indication that the impairment of baroreflex control of sympathetic outflow may not be the only factor responsible for the increased AP lability in SAD rats. The absence of the beat-to-beat synchronization of the sympathetic activity seems to be important to the generation of increased AP lability in SAD rats.32 Indeed, after ganglion blockade in intact rats31 and after the increase in sympathetic activity in SAD rats,11 an increase in AP lability is observed. The common factor under both circumstances is that the baroreflex control of synchronization of sympathetic activity is lost. In this regard studies of Gebber and Barman33 showed that sympathetic discharges generated by brain stem neurons in a 2 to 6 cycles per second rhythm are still observed after baroreceptor denervation. In animals with intact baroreceptor nerves, however, the 2 to 6 cycles per second rhythm is entrained in a 1:1 relation to the cardiac cycle.
In summary our findings demonstrate that in SADc rats hypertension and the hyperactivity of RSNA observed in SADa rats are diminished whereas the baroreflex control of HR and RSNA is still impaired. Carotid sinus denervation resulting in a diminution of sympathetic drive by the chemoreceptors may play a role not only in decreasing RSNA34 but also in reducing AP.25 Finally, increased lability of AP may be due to the absence of a straight beat-to-beat synchronization between AP and sympathetic nerve activity normally provided by the baroreceptors.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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Received June 20, 1995; first decision September 16, 1995; accepted October 12, 1995.
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