Emerging excitatory role of cardiovascular sympathetic afferents in pathophysiological conditions

Alberto Malliani, Nicola Montano

Research output: Contribution to journalArticle

Abstract

There is sound experimental evidence that cardiovascular sympathetic afferent fibers mediate cardiovascular reflexes largely excitatory in nature with positive-feedback characteristics. This afferent neural channel is likely to normally participate in the neural regulation of cardiovascular function. The hypothesis, which is the core of this article, is that in some pathophysiological conditions, sympathetic overactivity may be partly due to an emerging excitatory reflex action of cardiovascular sympathetic afferents. In fact, the early phase of congestive heart failure can be characterized by an increase in arterial pressure and heart rate and/or by a diastolic dysfunction, leaving unchanged the cardiac output; in these conditions, in which no baroreceptor deactivation should occur, it is possible that cardiovascular sympathetic afferents with sensory endings in the thoracic low-pressure areas, highly responsive to volume loading, are responsible for mediating the reflex sympathetic excitation. Similarly, during acute myocardial infarction, ventricular sympathetic afferents are likely to mediate a reflex sympathetic overactivity, which is known to facilitate sudden death. Finally, numerous reports have described in essential arterial hypertension an increased sympathetic activity that may be due, at least in part, to the reinforcing action of sympathosympathetic reflexes. Thus, in pathophysiological conditions, cardiovascular sympathetic afferents would mediate a reflex sympathetic overactivity independently of baroreceptive mechanisms, and such an absence of a homeostatic purpose would provide a better rationale for some beneficial effects of therapeutic correction.

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalHypertension
Volume39
Issue number1
DOIs
Publication statusPublished - 2002

Fingerprint

Reflex
Adrenergic Fibers
Pressoreceptors
Therapeutic Uses
Sudden Death
Cardiac Output
Arterial Pressure
Thorax
Heart Failure
Heart Rate
Myocardial Infarction
Pressure

Keywords

  • Heart failure
  • Heart rate
  • Hypertension, arterial
  • Ischemia
  • Lung
  • Reflex

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Emerging excitatory role of cardiovascular sympathetic afferents in pathophysiological conditions. / Malliani, Alberto; Montano, Nicola.

In: Hypertension, Vol. 39, No. 1, 2002, p. 63-68.

Research output: Contribution to journalArticle

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