(Circulation. 2000;101:886.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Oscillatory Patterns in Sympathetic Neural Discharge and Cardiovascular Variables During Orthostatic Stimulus
From Centro Ricerche Cardiovascolari, CNR, Medicina Interna II, Ospedale L. Sacco, and Centro LITA di Vialba, Università degli Studi di Milano, Milan, Italy (R.F., A.P., A.M.); the Division of Clinical Pharmacology, Department of Medicine (F.C., D.R.), and the Department of Biomedical Engeneering (L.B., R.S.), Vanderbilt University, Nashville, Tenn; Clinic Bavaria Kreischa, Kreischa, Germany (J.T.); and the Division of Clinical Pharmacology, Dupont Pharmaceuticals Co, Wilmington, Del (R.M.-G.).
Correspondence to Dr Raffaello Furlan, Unità Sincopi e Disturbi della Postura, Medicina Interna II, Ospedale L. Sacco, Università di Milano, Via G.B. Grassi 74, 20157 Milano, Italy. E-mail raffaellof{at}fisiopat.sacco.unimi.it
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° 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, LFMSNA 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 LFMSNA 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.
Key Words: nervous system, autonomic • catecholamines • spectrum analysis • tilt-table test
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