scholarly journals Intravenous adenosine and dyspnea in humans

2005 ◽  
Vol 98 (1) ◽  
pp. 180-185 ◽  
Author(s):  
Nausherwan K. Burki ◽  
Wheeler J. Dale ◽  
Lu-Yuan Lee
Keyword(s):  
Heart Rate ◽  
Heart Rate Response ◽  
Ventilatory Response ◽  
Normal Subjects ◽  
Peripheral Chemoreceptor ◽  
C Fibers ◽  
Group Data ◽  
Lung Resistance ◽  
Time Latency ◽  
Stimulation Of

Intravenous adenosine for the treatment of supraventricular tachycardia is reported to cause bronchospasm and dyspnea and to increase ventilation in humans, but these effects have not been systematically studied. We therefore compared the effects of 10 mg of intravenous adenosine with placebo in 21 normal subjects under normoxic conditions and evaluated the temporal sequence of the effects of adenosine on ventilation, dyspnea, and heart rate. The study was repeated in 11 of these subjects during hyperoxia. In all subjects, adenosine resulted in the development of dyspnea, assessed by handgrip dynamometry, without any significant change ( P > 0.1) in lung resistance as measured by the interrupter technique. There were significant increases ( P < 0.05) in ventilation and heart rate in response to adenosine. The dyspneic response occurred slightly before the ventilatory or heart rate responses in every subject, but the timing of the dyspneic, ventilatory, and heart rate responses was not significantly different when the group data were analyzed (18.9 ± 5.8, 20.3 ± 5.5, and 19.7 ± 4.5 s, respectively). During hyperoxia, adenosine resulted in similar effects, with no significant differences in the magnitude of the ventilatory response; however, compared with the normoxic state, the intensity of the dyspneic response was significantly ( P < 0.05) reduced, whereas the heart rate response increased significantly ( P < 0.05). These data indicate that intravenous adenosine-induced dyspnea is not associated with bronchospasm in normal subjects. The time latency of the response indicates that the dyspnea is probably not a consequence of peripheral chemoreceptor or brain stem respiratory center stimulation, suggesting that it is most likely secondary to stimulation of receptors in the lungs, most likely vagal C fibers.

Cardiorespiratory responses following isoproterenol injection in rabbits

1979 ◽  
Vol 47 (2) ◽  
pp. 352-359 ◽  
Author(s):  
R. Winn ◽  
J. R. Hildebrandt ◽  
J. Hildebrandt
Keyword(s):  
Heart Rate ◽  
Carotid Artery ◽  
Heart Rate Response ◽  
Ventilatory Response ◽  
Vena Cava ◽  
Direct Stimulation ◽  
Carotid Bodies ◽  
Receptor Sites ◽  
The Common ◽  
Stimulation Of

Receptor sites for the ventilatory response to isoproterenol were investigated in anesthetized rabbits with bolus injections in the common carotid artery (ia) and in the vena cava (iv). The delay from injection to the increase in ventilation (TVE) was significantly shorter following ia (1.5 s) compared to iv injections (about 5 s). The delay to the increase in heart rate (THR) was significantly shorter after iv (about 4.5 s) than after ia injections (12.5 s). When isoproterenol and NaCN injections were compared, there was no difference in TVE. Following carotid body resection, the VE response to isoproterenol was greatly reduced after iv and ia injections; however, THR was unaffected. In intact animals breathing 100% O2 the VE response to isoproterenol was significantly reduced with no change in TVE or in the heart rate response. We conclude that the ventilatory increase following the injection of isoproterenol is due primarily to direct stimulation of the carotid bodies.

Propranolol and the Ventilatory Response to Hypoxia and Hypercapnia in Normal Man

1978 ◽  
Vol 55 (5) ◽  
pp. 491-497 ◽  
Author(s):  
J. M. Patrick ◽  
Janice Tutty ◽  
S. B. Pearson
Keyword(s):  
Heart Rate ◽  
Chemical Control ◽  
Heart Rate Response ◽  
Ventilatory Response ◽  
Normal Subjects ◽  
Control Of Breathing ◽  
Maximal Expiratory Flow ◽  
Progressive Exercise ◽  
Normal Man ◽  
Ventilatory Response To Hypoxia

1. The effect on respiration of a single dose of propranolol has been studied in normal subjects. 2. The degree of β-adrenoreceptor blockade was assessed in terms of the impaired heart-rate response to progressive exercise and the plasma propranolol concentration. 3. No effect of propranolol was demonstrated on either the ventilatory response to rebreathing CO2 in hyperoxia, or the response to progressive isocapnic hypoxia. Simple indices of maximal expiratory flow (FEV1.0% and PEFR) were also unchanged. 4. The absence of any effect of propranolol on the chemical control of breathing in man is discussed in relation to the conflicting literature.

Comparison of phenylephrine bolus and infusion methods in baroreflex measurements

1990 ◽  
Vol 69 (3) ◽  
pp. 962-967 ◽  
Author(s):  
J. T. Sullebarger ◽  
C. S. Liang ◽  
P. D. Woolf ◽  
A. E. Willick ◽  
J. F. Richeson
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Baroreflex Sensitivity ◽  
Heart Rate Response ◽  
Pressor Response ◽  
Plasma Catecholamines ◽  
Systolic Arterial Pressure ◽  
Normal Subjects ◽  
Vagus Nerves ◽  
Baroreflex Control

Phenylephrine (PE) bolus and infusion methods have both been used to measure baroreflex sensitivity in humans. To determine whether the two methods produce the same values of baroreceptor sensitivity, we administered intravenous PE by both bolus injection and graded infusion methods to 17 normal subjects. Baroreflex sensitivity was determined from the slope of the linear relationship between the cardiac cycle length (R-R interval) and systolic arterial pressure. Both methods produced similar peak increases in arterial pressure and reproducible results of baroreflex sensitivity in the same subjects, but baroreflex slopes measured by the infusion method (9.9 +/- 0.7 ms/mmHg) were significantly lower than those measured by the bolus method (22.5 +/- 1.8 ms/mmHg, P less than 0.0001). Pretreatment with atropine abolished the heart rate response to PE given by both methods, whereas plasma catecholamines were affected by neither method of PE administration. Naloxone pretreatment exaggerated the pressor response to PE and increased plasma beta-endorphin response to PE infusion but had no effect on baroreflex sensitivity. Thus our results indicate that 1) activation of the baroreflex by the PE bolus and infusion methods, although reproducible, is not equivalent, 2) baroreflex-induced heart rate response to a gradual increase in pressure is less than that seen with a rapid rise, 3) in both methods, heart rate response is mediated by the vagus nerves, and 4) neither the sympathetic nervous system nor the endogenous opiate system has a significant role in mediating the baroreflex control of heart rate to a hypertensive stimulus in normal subjects.

Dynamic vagosympathetic interaction augments heart rate response irrespective of stimulation patterns

1997 ◽  
Vol 272 (5) ◽  
pp. H2180-H2187 ◽  
Author(s):  
T. Kawada ◽  
M. Sugimachi ◽  
T. Shishido ◽  
H. Miyano ◽  
Y. Ikeda ◽  
...  
Keyword(s):  
Heart Rate ◽  
Transfer Function ◽  
Heart Rate Response ◽  
Rate Regulation ◽  
Heart Rate Regulation ◽  
Two Systems ◽  
Tonic Stimulation ◽  
White Noises ◽  
Dynamic Stimulation ◽  
Stimulation Of

We previously demonstrated that tonic stimulation of either the sympathetic or the vagal nervous system augmented the dynamic heart rate response to the other of the two systems. We characterized the phenomenon as bidirectional augmentation of heart rate regulation. The question remained unanswered, however, as to whether such augmentation could occur under simultaneous dynamic stimulation of the two systems. The transfer characteristics from nerve stimulation to heart rate were well described by linear systems analysis, although no attention was paid to the aphasic nature of the stimuli in relation to each R-R interval. When we stimulated the two nerves with statistically independent Gaussian white noises, gain of the transfer function increased by 63.2 +/- 47.4% relative to individual stimulation (P < 0.05). When we stimulated the two nerves with mutually reciprocal Gaussian white noises, gain of the transfer function increased by 54.9 +/- 49.1% (P < 0.05). Thus simultaneous dynamic stimulation of the sympathetic and vagal systems bidirectionally augmented heart rate regulation irrespective of the pattern of the stimulation signals.

Ventilatory response to transient hyperoxia in head injury hyperventilation

1980 ◽  
Vol 49 (1) ◽  
pp. 52-58 ◽  
Author(s):  
A. G. Leitch ◽  
J. E. McLennan ◽  
S. Balkenhol ◽  
R. L. McLaurin ◽  
R. G. Loudon
Keyword(s):  
Head Injury ◽  
Ventilatory Response ◽  
Minute Ventilation ◽  
Respiratory Control ◽  
Normal Subjects ◽  
Respiratory Alkalosis ◽  
Cerebral Injury ◽  
Peripheral Chemoreceptor ◽  
Male Patients ◽  
Almost All

We have measured breath-by-breath instantaneous minute ventilation (VIinst) before, during, and after the administration of 10 breaths of 100% oxygen to seven male patients with head injury hyperventilation. The patients were hypoxemic (PaO2 61.2 ± 6.3) and hypocapnic (PaCO2 26.6 ± 5.9) with a respiratory alkalosis (pH 7.53 ± 0.06) while breathing air. Following the oxygen VIinst fell on the average by 40 ± 12.7% from 16.06 ± 3.75 1.min-1 to a minimum of 9.73 ± 3.20 1.min-1 at 20.4 ± 2.9 s after the first breath of oxygen. In the majority of our hyperventilating patients, almost all of the resting hyperventilation could be abolished transiently by 100% oxygen. This fall in ventilation represents the peripheral chemoreceptor contribution to resting ventilation and is increased in the head injury patients in comparison with normal subjects breathing air or hypoxic gas mixtures, altitude-acclimatized subjects and patients who are hypoxic because of chronic bronchitis or interstitial lung disease. We suggest that the increased reflex hypoxic drive to ventilation found in our patients is secondary to their cerebral injury, resulting in a reduction of descending cortical inhibitory influences on the medullary respiratory control centers.

Ventilatory effects of substance P, vasoactive intestinal peptide, and nitroprusside in humans

1990 ◽  
Vol 68 (1) ◽  
pp. 295-301 ◽  
Author(s):  
D. L. Maxwell ◽  
R. W. Fuller ◽  
C. M. Dixon ◽  
F. M. Cuss ◽  
P. J. Barnes
Keyword(s):  
Substance P ◽  
Vasoactive Intestinal Peptide ◽  
Carotid Body ◽  
Animal Studies ◽  
Ventilatory Response ◽  
Hypoxic Ventilatory Response ◽  
Peripheral Chemoreceptor ◽  
Hypotensive Action ◽  
Ventilatory Effects ◽  
Stimulation Of

Animal studies suggest that the neuropeptides, substance P and vasoactive intestinal peptide (VIP), may influence carotid body chemoreceptor activity and that substance P may take part in the carotid body response to hypoxia. The effects of these peptides on resting ventilation and on ventilatory responses to hypoxia and to hypercapnia have been investigated in six normal humans. Infusions of substance P (1 pmol.kg-1.min-1) and of VIP (6 pmol.kg-1.min-1) were compared with placebo and with nitroprusside (5 micrograms.kg-1.min-1) as a control for the hypotensive action of the peptides. Both peptides caused significantly less hypotension than nitroprusside. Substance P and nitroprusside caused significantly greater increases in ventilation and in the hypoxic ventilatory response than VIP. No changes were seen in hypercapnic sensitivity. The stimulation of ventilation and the differential effects on ventilatory chemosensitivity that accompanied hypotension are consistent either with stimulation of carotid body chemoreceptor activity or with an interaction with peripheral chemoreceptor input to the respiratory center, as is seen in animals. The similar cardiovascular but different ventilatory effects of the peptides suggest that substance P may also stimulate the carotid body in a manner independent of the effect of hypotension. This is consistent with a role of substance P in the hypoxic ventilatory response in humans.

Respiratory and circulatory activities in carotid body-resected humans

1992 ◽  
Vol 73 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Y. Honda
Keyword(s):  
Carotid Body ◽  
Ventilatory Response ◽  
Dominant Role ◽  
Peripheral Resistance ◽  
Normal Subjects ◽  
Systemic Circulation ◽  
Peripheral Chemoreceptor ◽  
Single Breath ◽  
Arterial Blood ◽  
Single Breath Test

The respiratory and circulatory activities of patients who underwent carotid body resection (CBR) more than two decades ago were reviewed. No significant ventilatory response to continuous hypoxia was observed. However, in response to stimulation of peripheral chemoreceptors, transient hyperventilation occurred before hypoxemic blood arrived at the central nervous system (single-breath test), which indicated the presence of weak peripheral chemosensitivity. Because of this slight residual peripheral chemosensitivity, which was found shortly after the operation and apparently remained more or less unchanged for greater than 20 years, peripheral chemoreceptor activity, which has been reported in other animal species, does not seem to have returned. Delayed hypoxic hyperventilation reported in dogs and cats with CBR was not observed. Hypoxia significantly depressed the ventilatory response to CO2, but the delayed ventilatory depression with time that has been demonstrated in normal subjects did not occur. In our circulatory studies, hypoxia augmented the heart rate and slightly depressed the stroke volume and total peripheral resistance in the systemic circulation but induced no appreciable changes in arterial blood pressure or cardiac output. We used these results to partition the relative contributions to the overall circulatory response of carotid body stimulation, pulmonary inflation, and other modifying influences. From these calculations, it was inferred that the carotid body reflex plays a dominant role in vascular activities whereas the pulmonary inflation reflex dominates in cardiac activities in humans.

Autonomic Control of the Immediate Heart Rate Response to Lying Down

1982 ◽  
Vol 62 (1) ◽  
pp. 57-64 ◽  
Author(s):  
F. Bellavere ◽  
D. J. Ewing
Keyword(s):  
Heart Rate ◽  
Heart Rate Response ◽  
Normal Subjects ◽  
Muscular Exercise ◽  
Diabetic Patients ◽  
Normal Pattern ◽  
Sympathetic Control ◽  
The Third ◽  
Steady Level ◽  
Lying Down

1. The initial heart rate response to lying down was analysed in 18 younger (23–36 years) and 10 older (48–67 years) normal subjects, and consisted of an immediate shortening of the R—R interval reaching a maximum around the third or fourth beat after lying, followed by a lengthening beyond the resting value to reach a steady level around beats 25–30. In six diabetic patients with autonomic neuropathy, no cardiac acceleration occurred and the deceleration was markedly diminished. 2. In eight young normal subjects the pattern of response was altered by atropine, which abolished the initial shortening of the R—R interval over the first 10 beats. Thereafter slow but steady lengthening of the R—R interval occurred. With additional propranolol the later part of the response was further attenuated. Propranolol alone did not affect the normal pattern of response. 3. Six young normal subjects performed short periods of muscular exercise, lying, sitting and standing, and the heart rate patterns were compared with that after lying down. After both manoeuvres R—R interval shortened and then lengthened back to the resting level within 10–15 beats. Thereafter it remained steady after muscular exercise, but continued to lengthen after lying down. 4. In four young normal subjects, no initial R—R interval shortening occurred during fast or slow ‘passive’ tilting from the 80° head-up position to horizontal, whereas shortening was seen both with fast and slow ‘active’ lying down. 5. It is concluded that the immediate part of the heart rate response to lying down (during the first 10 beats) is under vagal control and the later part predominantly under sympathetic control. The first part of the response is probably due to a ‘muscle—heart’ reflex which occurs during the change in posture.

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