scholarly journals Relevance of the Carotid Body Chemoreflex in the Progression of Heart Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
David C. Andrade ◽  
Claudia Lucero ◽  
Camilo Toledo ◽  
Carlos Madrid ◽  
Noah J. Marcus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Carotid Body ◽  
Poor Prognosis ◽  
Autonomic Function ◽  
Current Knowledge ◽  
Experimental Models ◽  
Breathing Patterns ◽  
Breathing Control ◽  
Global Health Problem ◽  
Disordered Breathing

Chronic heart failure (CHF) is a global health problem affecting millions of people. Autonomic dysfunction and disordered breathing patterns are commonly observed in patients with CHF, and both are strongly related to poor prognosis and high mortality risk. Tonic activation of carotid body (CB) chemoreceptors contributes to sympathoexcitation and disordered breathing patterns in experimental models of CHF. Recent studies show that ablation of the CB chemoreceptors improves autonomic function and breathing control in CHF and improves survival. These exciting findings indicate that alterations in CB function are critical to the progression of CHF. Therefore, better understanding of the physiology of the CB chemoreflex in CHF could lead to improvements in current treatments and clinical management of patients with CHF characterized by high chemosensitivity. Accordingly, the main focus of this brief review is to summarize current knowledge of CB chemoreflex function in different experimental models of CHF and to comment on their potential translation to treatment of human CHF.

scholarly journals Carotid body denervation improves autonomic and cardiac function and attenuates disordered breathing in congestive heart failure

2014 ◽  
Vol 592 (2) ◽  
pp. 391-408 ◽  
Author(s):  
Noah J. Marcus ◽  
Rodrigo Del Rio ◽  
Evan P. Schultz ◽  
Xiao-Hong Xia ◽  
Harold D. Schultz
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Function ◽  
Carotid Body ◽  
Disordered Breathing ◽  
Carotid Body Denervation

scholarly journals Inhibition of hydrogen sulfide restores normal breathing stability and improves autonomic control during experimental heart failure

2013 ◽  
Vol 114 (9) ◽  
pp. 1141-1150 ◽  
Author(s):  
Rodrigo Del Rio ◽  
Noah J. Marcus ◽  
Harold D. Schultz
Keyword(s):  
Heart Failure ◽  
Hydrogen Sulfide ◽  
Autonomic Function ◽  
Low Frequency ◽  
Cardiac Autonomic Function ◽  
Breathing Patterns ◽  
Irreversible Inhibitor ◽  
Ventilatory Responses ◽  
Afferent Discharge ◽  
Systolic Blood Pressure Variability

Cardiovascular autonomic imbalance and breathing instability are major contributors to the progression of heart failure (CHF). Potentiation of the carotid body (CB) chemoreflex has been shown to contribute to these effects. Hydrogen sulfide (H2S) recently has been proposed to mediate CB hypoxic chemoreception. We hypothesized that H2S synthesis inhibition should decrease CB chemoreflex activation and improve breathing stability and autonomic function in CHF rats. Using the irreversible inhibitor of cystathione γ-lyase dl-propargylglycine (PAG), we tested the effects of H2S inhibition on resting breathing patterns, the hypoxic and hypercapnic ventilatory responses, and the hypoxic sensitivity of CB chemoreceptor afferents in rats with CHF. In addition, heart rate variability (HRV) and systolic blood pressure variability (SBPV) were calculated as an index of autonomic function. CHF rats, compared with sham rats, exhibited increased breath interval variability and number of apneas, enhanced CB afferent discharge and ventilatory responses to hypoxia, decreased HRV, and increased low-frequency SBPV. Remarkably, PAG treatment reduced the apnea index by 90%, reduced breath interval variability by 40–60%, and reversed the enhanced hypoxic CB afferent and chemoreflex responses observed in CHF rats. Furthermore, PAG treatment partially reversed the alterations in HRV and SBPV in CHF rats. Our results show that PAG treatment restores breathing stability and cardiac autonomic function and reduces the enhanced ventilatory and CB chemosensory responses to hypoxia in CHF rats. These results support the idea that PAG treatment could potentially represent a novel pathway to control sympathetic outflow and breathing instability in CHF.

Beyond the Apnoea–Hypopnoea Index – Prognostic Value of Other Elements of Polysomnography to Describe Sleep-disordered Breathing in Heart Failure

2009 ◽  
Vol 5 (2) ◽  
pp. 53
Author(s):  
Philip B Adamson ◽  
Keyword(s):  
Heart Failure ◽  
Standard Method ◽  
Patient Population ◽  
Prognostic Value ◽  
Sleep Disordered Breathing ◽  
Treatment Success ◽  
Multiple Components ◽  
Severity Of The Disease ◽  
Disordered Breathing

There is increasing appreciation of the prevalence of sleep-disordered breathing (SDP) in heart failure. As we examine this patient population, the difficulties of determining success in the treatment of SDB are becoming evident. The apnoea–hypopnoea index (AHI) is the standard method of measuring both the severity of the disease and treatment success, but in itself is a composite of multiple components. This article examines both current and developing measurements in the treatment of SDB.

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