Augmented peripheral chemosensitivity as a potential input to baroreflex impairment and autonomic imbalance in chronic heart failure

Piotr Ponikowski, Tuan Peng Chua, Massimo Piepoli, Daniela Ondusova, Katharine Webb-Peploe, Derek Harrington, Stefan D. Anker, Maurizio Volterrani, Roberto Colombo, Giorgio Mazzuero, Amerigo Giordano, Andrew J S Coats

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The precise mechanisms responsible for the sympathetic overactivity and blunted baroreflex control in chronic heart failure (CHF) remain obscure. Augmented peripheral chemosensitivity has recently been demonstrated in CHF. We evaluated the relation between peripheral chemoreflex sensitivity and autonomic activity in patients with CHF. Methods and Results: We studied in 26 stable patients with CHF the peripheral chemosensitivity (ventilatory response to hypoxia using transient inhalations of pure nitrogen), autonomic balance (spectral analysis of heart rate variability [HRV]), and baroreflex sensitivity (bolus phenylephrine method and α index). To determine whether transient inactivation of peripheral chemoreceptors might influence autonomic balance, 12 patients underwent a second study during which they breathed 100% O2. Peripheral chemosensitivity correlated inversely with HRV power within the low-frequency band (0.04 to 0.15 Hz) (r=- 52, P=.006) and inversely with baroreflex sensitivity (r=-.60, P=.005). When the patients were divided into two groups according to the chemosensitivity of age-matched normal controls (above and below mean+2 SDs of chemosensitivity of control subjects), those above the normal range revealed more impaired autonomic balance, ie, lower baroreflex sensitivity (1.4 ± 1.3 versus 5.0 ± 1.5 ms/mm Hg, P2, P

Original languageEnglish
Pages (from-to)2586-2594
Number of pages9
JournalCirculation
Volume96
Issue number8
Publication statusPublished - Oct 21 1997

Keywords

  • Autonomic function
  • Baroreceptors
  • Chemoreceptors
  • Heart failure

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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