Central and Peripheral Haemodynamic Responses to High Carbohydrate and High Fat Meals in Human Cardiac Transplant Recipients

1996 ◽  
Vol 90 (6) ◽  
pp. 473-483 ◽  
Author(s):  
M. T. Kearney ◽  
A. J. Cowley ◽  
T. A. Stubbs ◽  
A. J. Perry ◽  
I. A. MacDonald
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Cardiac Transplant ◽  
Transplant Recipients ◽  
High Fat ◽  
Maximal Increase ◽  
Cardiac Denervation ◽  
Output Response ◽  
High Carbohydrate ◽  
Fat Meal

1. Patients with autonomic dysfunction and elderly people with an age-related decline in autonomic function can suffer from a fall in blood pressure after eating. While the cardiovascular changes after eating and the effect of meal composition on these changes are well established, the underlying mechanisms are less clear. 2. This study assessed the cardiac, circulatory and humoral responses to ingestion of isoenergetic (2.5 MJ) high carbohydrate and high fat meals in nine orthotopic cardiac transplant recipients, who before transplantation had significant circulatory, metabolic and autonomic abnormalities and after transplantation had complete or partial extrinsic cardiac denervation, and compared them to the responses seen in nine healthy age-matched control subjects. 3. All variables were measured non-invasively. Cardiac transplant recipients, despite cardiac denervation, showed a normal heart rate response to high carbohydrate and high fat meals (maximal increase at 30 min postprandially +7.8 ± 1.1 and +6.3 ± 1.4 beats/min respectively), a normal cardiac output response to the high carbohydrate meal (maximal increase at 30 min +1.16 ± 0.25 l/min), but a significantly attenuated cardiac output response to the high fat meal. Cardiac transplant recipients had attenuated superior mesenteric artery blood flow responses after both meals (P < 0.05) and an attenuated calf vascular resistance response after the high fat meal (P < 0.01). Throughout the study after both meals, cardiac transplant recipients maintained blood pressure. 4. This study demonstrates that cardiac transplant recipients, despite partial or complete cardiac denervation, have a normal chronotropic response to food and a normal cardiac output response to a high carbohydrate meal. The attenuated cardiac output response to a high fat meal did not compromise blood pressure, due at least in part to decreased splanchnic vasodilatation.

Cardiovascular responses to a high-fat and a high-carbohydrate meal in healthy elderly subjects

1993 ◽  
Vol 84 (3) ◽  
pp. 263-270 ◽  
Author(s):  
M. B. Sidery ◽  
A. J. Cowley ◽  
I. A. MacDonald
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Confidence Interval ◽  
Elderly Subjects ◽  
High Fat ◽  
High Carbohydrate ◽  
Fat Meal ◽  
Carbohydrate Meal

1. The cardiovascular responses to high-fat and high-carbohydrate meals (2.5 MJ) were compared in healthy, non-obese elderly subjects (mean age 68 years, range 63–74 years). 2. Measurements of cardiac output, blood pressure, heart rate, calf blood flow and superior mesenteric artery blood flow were made before and for 60 min after the two meals. 3. Systolic blood pressure only fell after the high-carbohydrate meal, reaching a nadir 13 mmHg below baseline values (95% confidence interval of the change, −2 to −25 mmHg). Diastolic blood pressure fell by 8 mmHg at 30 min after the high-carbohydrate meal (95% confidence interval of the change, −1 to −15 mmHg) and by 5 mmHg 45 min after the high-fat meal (95% confidence interval of the change, −1 to −8 mmHg). 4. Superior mesenteric artery blood flow rose by 70% after the high-carbohydrate meal (95% confidence interval of the change, +105 to +297 ml/min) and by 42% after the high-fat meal (95% confidence interval of the change, +35 to +256 ml/min, P <0.0001, analysis of variance). Calf blood flow reached a nadir 30 min after the high-carbohydrate meal (95% confidence interval of the change, −0.14 to −0.96ml min−1 100 ml−1) and 15min after the high-fat meal (95% confidence interval of the change, −0.1 to −0.92ml min−1 100ml−1P <0.01). There was no significant change in heart rate or cardiac output over the experimental period. 5. In elderly subjects the gut hyperaemia associated with food ingestion is not accompanied by concomitant increases in cardiac output and heart rate. This failure of cardiovascular adjustment to the vascular demands by the gut is likely to contribute to the fall in blood pressure seen in these healthy elderly subjects.

scholarly journals Abnormal diurnal variation of blood pressure, cardiac output, and vascular resistance in cardiac transplant recipients.

Circulation ◽  
1994 ◽  
Vol 90 (6) ◽  
pp. 2797-2803 ◽  
Author(s):  
R N Idema ◽  
A H van den Meiracker ◽  
A H Balk ◽  
E Bos ◽  
M A Schalekamp ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Diurnal Variation ◽  
Vascular Resistance ◽  
Cardiac Transplant ◽  
Transplant Recipients

Blood Pressure, Heart Rate and Neuroendocrine Responses to a High Carbohydrate and a High Fat Meal in Healthy Young Subjects

1990 ◽  
Vol 79 (5) ◽  
pp. 517-522 ◽  
Author(s):  
D. Heseltine ◽  
J. F. Potter ◽  
G. Hartley ◽  
I. A. MacDonald ◽  
O. F. W. James
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Plasma Insulin ◽  
The Elderly ◽  
High Fat ◽  
High Carbohydrate ◽  
Neuroendocrine Responses ◽  
Young Subjects ◽  
Fat Meal ◽  
Carbohydrate Meal

1. The responses of blood pressure, heart rate, autonomic function and plasma insulin to a high carbohydrate and a high fat meal of equivalent energy value were studied in nine young volunteers. 2. Neither meal produced a significant change in supine or erect blood pressure. The high carbohydrate meal, however, resulted in an overall rise in both supine (6 beats/min) and erect (6 beats/min; P < 0.05) heart rate, no such changes being seen after the high fat meal. 3. Plasma noradrenaline levels increased by a maximum of 126% at 90 min (0.98 to 2.22 nmol/l) after the high carbohydrate meal but were virtually unchanged after the high fat meal (P < 0.01). Parasympathetic function showed no between-meal differences. Plasma insulin and glucose levels were significantly higher after the high carbohydrate meal than after the high fat meal. No postprandial difference in packed cell volume was found between meal types. 4. We conclude that, in young subjects, the postprandial blood pressure after a high carbohydrate meal is maintained by an increase in heart rate associated with increased sympathetic nervous system activity. These changes are at variance with the blood pressure and heart rate responses seen in the elderly after a high carbohydrate meal. A high fat meal has no significant cardiovascular or neuroendocrine effects in the young or old. The nutrient composition of meals has to be taken into account when studying the postprandial cardiovascular and neuroendocrine responses in the young.

scholarly journals Postprandial lipaemia does not affect resting haemodynamic responses but does influence cardiovascular reactivity to dynamic exercise

2010 ◽  
Vol 104 (6) ◽  
pp. 863-871 ◽  
Author(s):  
Victoria G. Rontoyanni ◽  
Philip J. Chowienczyk ◽  
Thomas A. B. Sanders
Keyword(s):  
Cardiac Output ◽  
Cardiovascular Reactivity ◽  
Dynamic Exercise ◽  
Crossover Design ◽  
High Fat ◽  
Postprandial Lipaemia ◽  
Post Exercise ◽  
High Carbohydrate ◽  
The Difference ◽  
Fat Meal

Postprandial lipaemia impairs endothelial function, possibly by changes in oxidative stress, but whether this affects cardiac output and/or systemic vascular resistance (SVR) at rest and in response to dynamic exercise remains uncertain. The present study set out to investigate the effects of a high-fat meal (HFM) v. a low-fat, high-carbohydrate meal (HCM) on cardiac output and SVR. A HFM (50 g fat) and an isoenergetic HCM (5 g fat) were randomly fed to thirty healthy adults using a crossover design. Cardiac output, heart rate and blood pressure (BP) were measured, and stroke volume and SVR were calculated over a 3 h rest following the meal, during exercise 3 h postprandially and for 45 min post-exercise. Blood samples were collected at fasting, 3 h postprandially and immediately post-exercise. Plasma TAG increased by 63·8 % 3 h following the HFM, and NEFA fell by 94·1 % 3 h after the HCM. There was a 9·8 % rise in plasma 8-isoprostane-F2α concentration following the HFM, and a 6·2 % fall following the HCM. Cardiac output increased postprandially, but the difference between meals at rest or exercise was not statistically significant. The HFM resulted in a 3·2 mmHg (95 % CI 0·7, 5·7) smaller increase in exercise mean arterial BP compared with the HCM due to a greater fall in exercise SVR. Postprandial lipaemia induced by a HFM does not affect cardiac output and/or SVR at rest, but it blunts the increase in BP during exercise.

Effect of a Physiological Insulin Infusion on the Cardiovascular Responses to a High Fat Meal: Evidence Supporting a Role for Insulin in Modulating Postprandial Cardiovascular Homoeostasis in Man

1996 ◽  
Vol 91 (4) ◽  
pp. 415-423 ◽  
Author(s):  
M. T. Kearney ◽  
A. J. Cowley ◽  
T. A. Stubbs ◽  
I. A. MacDonald
Keyword(s):  
Blood Pressure ◽  
Skeletal Muscle ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Mesenteric Artery ◽  
Insulin Infusion ◽  
High Fat ◽  
High Carbohydrate ◽  
Meal Ingestion ◽  
Fat Meal

1. While the haemodynamic adjustments occurring after meal ingestion and the different effects of meals of different composition on these changes are well established, the mechanisms underlying these changes are less clear. Insulin, which has been shown to be both a positive inotrope and to stimulate vasodilatation in the skeletal muscle vascular bed, may account for the different cardiac and regional haemodynamic responses to high fat and high carbohydrate meals. 2. This study assessed the effect of an insulin infusion reproducing the plasma insulin profile seen after a high carbohydrate meal on the cardiovascular and regional haemodynamic response to a high fat meal. All measurements were carried out non-invasively in nine healthy lean subjects (mean age 24.5 ± 1.3 years). 3. The high fat meal resulted in increases in cardiac output (0.7 ± 0.321/min, P < 0.001), heart rate (7.8 ± 2.1 beats/min, P < 0.001) and insulin (25.1 ± 4.2 m-units/l, P < 0.001), and a decline in systemic vascular resistance (−1.9 ± 0.9 units, P < 0.05) and superior mesenteric artery vascular resistance (− 45 ± 9 units, P < 0.01). After the high fat meal alone, calf vascular resistance and blood pressure did not change. After the high fat meal accompanied by insulin (peak insulin 86.1 ± 10.1 m-units/l) there were greater cardiac responses [(P < 0.001); cardiac output, 1.17 ± 0.361/min, and heart rate, 13.4 ± 2.1 beats-/min], and a larger fall in systemic vascular resistance and superior mesenteric artery vascular resistance. Unlike the high fat meal alone, the high fat meal with insulin was accompanied by a fall in calf vascular resistance (8.3 ± 3.3 units) and blood pressure (3.8 ± 1.6 mmHg). 4. The results of this study support a role for insulin in modulating postprandial cardiovascular homoeostasis; in particular, by its depressor action on skeletal muscle vasculature, insulin may in part contribute to the fall in blood pressure seen in the elderly, who have an inadequate cardiac response to the fall in systemic vascular resistance occurring after meal ingestion.

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