A principal causa de mortalidade nos pacientes com doença renal crônica é a doença cardiovascular. A alta prevalência de hipertensão arterial nestes pacientes e sua relação com riscos cardiovasculares são indiscutíveis. A doença renal crônica é caracterizada pela hiperatividade simpática, o que contribui para gênese ou agravo da hipertensão arterial. O exercício aeróbico reduz a pressão arterial e a atividade nervosa simpática em diversas populações, mas seus efeitos não são claros em pacientes com doença renal crônica. O objetivo deste estudo foi avaliar nestes pacientes as respostas hemodinâmicas e neurais ao exercício estático com handgrip após uma sessão de exercício aeróbio. Nove pacientes, portadores de doença renal crônica no estágio III (52±8 anos) e doze indivíduos saudáveis (50±5 anos), em ordem aleatória, realizaram uma sessão de exercício aeróbio em ciclo ergômetro (45 minutos a 50% do Vo2pico) e uma sessão de repouso (repouso sentado por 45 minutos). Após as sessões, foram registradas no período basal e durante o exercício estático com handgrip (3 minutos a 30% da contração voluntária máxima): atividade nervosa simpática periférica (microneurografia), pressão arterial, freqüência cardíaca (método oscilométrico Dixtal no membro inferior), fluxo sangüíneo do antebraço (pletismografia) e calculada a resistência vascular periférica. O teste t-studant foi usado para análise de dados no basal e, no período de exercício estático, o ANOVA de dois fatores. Valores de P<0,05 foram considerados estatisticamente significantes. O exercício físico reduziu a pressão arterial sistólica (162±15 152±23 mm Hg), a pressão arterial diastólica (91±11 vs. 85±14 mm Hg), a atividade nervosa simpática (38±4 31±4 impulsos/min) e a resistência vascular periférica (59±29 41±28 unidades) e aumentou o fluxo sanguíneo do antebraço (2,1±0,8 3,2±1,3 ml(min.100ml)) e a freqüência cardíaca (62±9 67±9 bpm) dos pacientes com doença renal crônica. Durante o exercício estático houve atenuação do metabolorreflexo na sessão exercício, de maneira que a atividade simpática, os níveis pressóricos e a resistência vascular periférica foram reduzidos. Não houve alterações significativas na proteinúria pós-exercício aeróbio. Portanto, o exercício físico aeróbio reduziu os níveis tensionais, a atividade nervosa simpática e a resistência vascular periférica. Estas respostas foram observadas agudamente, mas podemos pressupor que estes efeitos também sejam observados com o treinamento físico / Cardiovascular disease is the major cause of death in chronic kidney disease patients. The high prevalence of hypertension in these patients and its relation with cardiovascular risks are been established. The chronic kidney disease is characterized by a sympathetic overactivity and might contribute to the pathogenesis and worsening of arterial hypertension. The aerobic exercise reduces the blood pressure and sympathetic nerve activity in several populations, but its effects are not fully understood in chronic kidney disease patients. The aim of this study was to evaluate the hemodynamic and neural responses to static handgrip exercise after one session of aerobic exercise in these patients. Nine chronic kidney disease stage III patients (50±8 years old) and twelve healthy volunteers (50±5 years old), in random order, realized an aerobic exercise session on cycle ergometer (45 minutes at 50% of Vo2peak) and a rest session (45 minutes of seated rest). After the sessions, during basal period and static handgrip exercise (3 minutes at 30% of maximal voluntary contraction force) were registered: muscle sympathetic nerve activity (microneurography), blood pressure and heart rate (by the oscilometric method Dixtal in lower limb), forearm blood flow (pletismography) and peripheral vascular resistance was calculated. For data analysis in the basal period, a t-student test was used and a two way ANOVA during handgrip exercise period. Values of P<0,05 were considered to be statistically significant. The aerobic exercise reduced systolic blood pressure (162±15 152±23 mm Hg), diastolic blood pressure (91±11 vs. 85±14 mm Hg), sympathetic nerve activity (38±4 31±4 bursts/min) and peripheral vascular resistance (59±29 41±28 U), and increased the forearm blood flow (2,1±0,8 3,2±1,3 ml(min.100ml)) and the heart rate (62±9 67±9 bpm) in this population. In the exercise session, during the static handgrip exercise, the metabolorreflex was attenuated and blood pressure, sympathetic nerve activity and peripheral vascular resistance were reduced. There were no significant differences in the pos-exercise proteinuria. These responses were observed after a single bout of aerobic exercise, but these effects might be observed in the physical training too

Doctor of Philosophy / Department of Anatomy and Physiology / Michael J. Kenney / It is well established that normal aging is associated with progressive increases in efferent sympathetic nerve discharge (SND). Type II diabetes, obesity, heart failure, and hypertension are pathologies that have been attributed to both the processes of aging and sympathetic dysfunction, exemplifying the importance of understanding central regulation of SND during aging. However, the central mechanisms mediating altered SND with advancing age remain unclear. The rostral ventral lateral medulla (RVLM) is a brainstem region critically involved in setting the basal level of sympathetic outflow and cardiovascular function. Indeed, the RVLM is the only presympathetic region that when bilaterally inactivated results in profound reductions in both SND and arterial pressure. Glutamatergic influences in RVLM activity are powerfully inhibited by tonic GABAergic neural inputs originating from the caudal ventral lateral medulla (CVLM); effects that are mediated by GABAA receptors located on presympathetic neuronal cell bodies within the RVLM. In the present study we proposed that reductions in GABA[subscript A] receptor subunit gene expression may reflect withdrawal of GABAergic tone in the RVLM thereby contributing to the basal sympathetic activation that occurs with advancing age. Therefore, the objective of the current study was to identify age-related changes in the constitutive expression of genes related to GABAergic and muscarinic, nicotinic and dopaminergic receptor systems due to their reported involvement in modulating GABA[subscript A] receptor function, in the RVLM of adult young (3-5 mo. old), middle-aged (12 mo. old), weight stable presenescent (24-25 mo. old) and senescent (>24 mo. old) Fischer 344 (F344) rats using a commercially available real-time PCR array. Real-time analysis revealed nonuniform and age-associated changes in the RVLM GABA, muscarinic, nicotinic and dopaminergic neurotransmitter gene expression profile between young and middle-aged F344 rats. Heterogeneous expression of genes related to these neurotransmitters was also observed between presenescent and senescent F344 rats. Our results suggest that potential changes in neurotransmitter synthesis and degradation, uptake, transport, signaling and receptor subunit composition may account for the sympathoexcitatory state that is commonly observed in the aged.

Dados da literatura mostram que a inervação simpática possui papel apenas na síntese e secreção das proteínas da saliva. Neste trabalho mostramos que após o tratamento crônico com reserpina, uma droga simpatolítica, houve alteração na síntese de diferentes proteínas em glândulas submandibulares e parótidas relacionadas com vários processos biológicos e a posterior administração de agonistas de adrenoceptores reverteu esses efeitos. Além disso, na glândula parótida, a estimulação da inervação simpática é importante para o processo de exocitose das proteínas secretadas. Esses resultados sugerem que a inervação simpática possui um importante papel para a funcionalidade das glândulas salivares de camundongos, isto é, mantendo estas glândulas em constante estado de ativação, regulando a síntese de diferentes proteínas dessas glândulas ou promovendo a exocitose de proteínas da saliva. Além disso, os resultados mostram que a inervação simpática atua de maneira diferente nas glândulas submandibulares e parótidas de camundongos. / Data in literature show that sympathetic outflow has a role only in stimulating synthesis and secretion of the saliva proteins in mammals. We show that after chronic treatment with reserpine, a sympatholytic drug, there were changes in the synthesis of different proteins in submandibular and parotid glands associated with various biological processes and subsequent administration of adrenoceptor agonists reversed these effects. Furthermore, in the parotid gland, stimulation of the sympathetic outflow is important to the process of exocytosis of secretory proteins. These results suggest that sympathetic outflow plays an important role for the functionality of the mouse salivary glands, namely, keeping these glands in a constant activated stage, regulating the synthesis of different proteins in these glands or promoting the exocytosis of saliva proteins. Furthermore, these results show that the sympathetic outflow acts differently in the mouse.

INTRODUÇÃO: O infarto agudo do miocárdio está associado à hiperativação simpática e diminuição do fluxo sanguíneo muscular (FSM). Por outro lado, tem sido documentado que o treinamento físico promove importantes adaptações autonômicas e vasculares no indivíduo. O objetivo deste estudo foi testar a hipótese de que o treinamento físico diminuiria a atividade nervosa simpática muscular (ANSM) e aumentaria o FSM em repouso e durante o exercício físico em pacientes com Síndrome Isquêmica Miocárdica Instável (SIMI). MÉTODOS: Foram incluídos no estudo, 63 pacientes internados na Unidade Clínica de Coronariopatia Aguda diagnosticados com SIMI. Um mês após o evento isquêmico, 51 pacientes continuaram o seguimento e foram alocados, consecutivamente, em 2 grupos: treinamento físico (SIMI-TF, n=25, 54±1 anos), e sedentário (SIMI-Sed, n=26, 52±2 anos). Ao final do estudo, 14 pacientes do grupo SIMI-TF e 20 pacientes do grupo SIMI-Sed finalizaram o protocolo experimental. Esses pacientes foram comparados a um grupo controle saudável (n=13, 49±1anos). A ANSM foi medida pela técnica de microneurografia. O FSM foi avaliado por pletismografia de oclusão venosa, a pressão arterial (PA) foi medida pelo método oscilométrico indireto e a frequência cardíaca pelo eletrocardiograma. Todas as avaliações foram realizadas no basal, durante a fase de internação hospitalar e, no basal e durante 3 minutos de exercício físico de preensão de mãos (30% da contração voluntária máxima) no período de seguimento do estudo (1º., 3º.e 7º. mês após o evento isquêmico). O treinamento físico foi realizado em cicloergômetro, 3 vezes por semana, durante 6 meses. RESULTADOS: Durante a fase de internação hospitalar, a ANSM basal foi significativamente maior (65±2 vs. 32±2 disparos/100batimentos, p<0,001) e a condutância vascular no antebraço (CVA= FSM/PAmédia) foi significativamente menor (1,91±0,1 vs. 2,99±0,38 unidades, p<0,001) no grupo SIMI em relação ao grupo Controle. Comportamento semelhante foi observado 1 mês após o evento isquêmico, a ANSM continuou aumentada (64±3 vs. 62±4 vs. 32±2 disparos/100batimentos, p<0,001, respectivamente) e a CVA diminuída (1,73±0,1 vs. 1,72±0,1 vs. 2,99±0,4 unidades, p<0,001, respectivamente) nos grupos SIMI-Sed e SIMI-TF em relação ao grupo Controle. Durante o exercício de preensão de mãos, os níveis de ANSM foram maiores (71±4 e 69±4 vs. 43±3 disparos/100batimentos, p<0,001, respectivamente) e a CVA foi menor (1,60±0,1 e 1,59±0,2 vs. 3,53±0,47 unidades, p<0,001, respectivamente), nos grupos SIMI-Sed e SIMI-TF em relação ao grupo Controle. Após o treinamento físico, a ANSM basal diminuiu no grupo SIMITF (62±4 vs. 40±3 disparos/100batimentos, p=0,02), atingindo níveis semelhantes ao grupo Controle (40±3 vs. 32±2 disparos/100batimentos, p=0,24, respectivamente). Durante o exercício físico, a ANSM diminuiu no grupo SIMI-TF (72±5 vs. 60±5 disparos/100batimentos, p<0,001). Porém, a CVA não foi significativamente modificada tanto no basal como durante o exercício no grupo SIMI-TF. Nenhuma alteração significativa foi observada na ANSM e CVA do grupo SIMI-Sed, tanto em repouso como durante o exercício. CONCLUSÕES: Em pacientes com SIMI, o treinamento físico normalizou a ANSM basal e diminuiu seus níveis durante o exercício, porém, não modificou o FSM. Como a ativação simpática está relacionada com pior prognóstico, nossos resultados ressaltam a importância clínica do treinamento físico em pacientes após SIMI / Introduction: The myocardial infarction is associated with sympathetic hiperactivation and reduced forearm blood flow (FBF). On the other hand, the exercise training leads to important autonomic and vascular adaptations. The purpose of this study was to test the hypothesis that exercise training would decrease the muscle sympathetic nerve activity (MSNA) and would increase the FBF at rest and during exercise in patients with acute coronary syndrome (ACS). Methods: Sixty-three patients admitted to the coronary intensive care unit with ACS were studied. One month after ischemic event, 51 patients continued the follow-up study and were allocated consecutively in two groups: exercise training (ACS-ET, n=25, 54±1 years) and sedentary (ACSSed, n=26, 52±2 years). At the end of the study, 14 patients in the group ACS-ET and 20 patients in the group ACS-Sed concluded the experimental protocol. These patients were compared to a control group of healthy subjects (n=13, 49±1 years). The MSNA was measured by microneurography technique. The FBF was measured by venous occlusion plethysmography, the blood pressure (BP) was measured by indirect oscillometric method and the heart rate was measured by electrocardiogram. All measurements were done at rest condition during inpatient phase and at rest condition and during 3 minutes of handgrip exercise (30% of maximum voluntary contraction) during outpatient follow-up (1st, 3rd and 7th months after the ischemic event). The exercise training was performed on a cycle ergometer 3 times per week for 6 months. RESULTS: During inpatient phase, the MSNA at rest was significantly higher (65±2 vs. 32±2 bursts/100heart beats, p<0.001) and forearm vascular conductance (FVC=FBF/mean BP) was significantly lower (1.91±0.1 vs. 2.99±0.38 units, p<0.001) in ACS group when compared to control group. One month after the ischemic event, the MSNA remained significantly higher (64±3 vs. 62±4 vs. 32±2 bursts/100 heart beats, p<0,001) and the FVC continue significantly lower (1.73±0.1 vs. 1.72±0.1 vs. 2.99±0.4 units, p<0,001) in the ACS-Sed and ACS-ET groups when compared to the control group. During handgrip exercise, the MSNA levels were significantly higher (71±4 and 69±4 vs. 43±3 bursts/100heart beats, p <0.001, respectively) and FVC levels were significantly lower (1.60±0.1 and 1.59± 0.2 vs. 3.53 ± 0.47 units, p <0.001, respectively) in the ACS-Sed and ACS-ET groups when compared to the control group, respectively. After exercise training, the MSNA at rest decreased significantly in the group ACS-ET (62±4 vs. 40±3 bursts/100 heart beats, p=0.02), reaching similar levels to those found in the control group (40±3. vs. 32±2 burts/100 heart beats, p= 0.24, respectively). During handgrip exercise the MSNA decreased significantly in ACS-ET group (72±5 vs. 60±5 bursts/100 heart beats, p <0.001). However, the FVC was not significantly changed at rest and during exercise in ACS-ET group. No significant change was observed in MSNA and FVC in ACS-Sed group at rest and during exercise. CONCLUSIONS: In patients with ACS, the exercise training normalized the MSNA at rest and decreased their levels during exercise, but no change was observed in the FVC. Since sympathetic activation is related to poor prognosis, our results highlight the clinical importance of ET in patients with ACS

This study investigated whether acute myocardial ischemia of the anterior left ventricular wall induced an increase in cardiac sympathetic efferent nerve activity and thereby affected regional myocardial blood flow and contractile function.

α2-Adrenergic receptor (AR) subtype mRNA (α2a, α2b, α2c) neuronal localization in human spinal cord has not been described. We therefore performed in situ hybridization to identify cell bodies at four levels of human spinal cord (cervical, thoracic, lumbar, sacral) containing α2AR subtype specific mRNA. α2AR mRNA is present in gray matter only (ventral > dorsal; sacral > cervical > thoracic = lumbar). In addition to α2AR mRNA in cell bodies in thoracic and lumbar intermediolateral (sympathetic) and sacral intermediate (parasympathetic) cell columns (lamina VII), all levels in dorsal horn laminae I, II, V, and ventral horn lamina IX, we demonstrate α2AR mRNA in dorsal horn laminae III and IV, and dorsal nucleus of Clarke, where α2ARs have not been described. Previously unreported heterogeneity in α2AR subtype distribution (α2a and α2bAR mRNA present, α2cAR mRNA virtually absent) is found at all sites of α2AR mRNA expression in human spinal cord, including locations known to mediate effects of α2AR agonist drugs on nociception, autonomic function and motor tone. Cervical spinal cord demonstrates a predominance of α2a mRNA signal, while thoracic, lumbar, and sacral spinal cord demonstrate an increasing predominance of α2bAR mRNA. If confirmed at a protein level, these findings have profound implications for therapeutic strategies in managing human pain.

The goal of this study was to build on the historic use of the avian model of development and also to further the knowledge of autonomic nervous system (ANS) regulation of cardiovascular function in vertebrates. Vasoactive drugs sodium nitroprusside, a vasodilator and phenylephrine, a vasoconstrictor were used to study the correlation of cardiovascular function relationship with nerve activity, both sympathetic and parasympathetic (vagal). Additionally, ANG II was used to assess its effects on vagal inhibition. The present study shows that pharmacologically-induced hypertension is associated with a fall in mSNA, indicating that the capacity for sympathetic autonomic cardiovascular regulation is established by late incubation however, late-stage embryonic chickens did not show a significant increase in mSNA during hypotension. The hypotensive response of the embryo was not accompanied by the expected inhibition of vagal discharge; however a slight but insignificant reduction in vagal discharge was noted. When vagal efferent output was isolated, a significant drop in vagal efferent activity was noted in response to hypotension. The present study showed late-stage embryonic chickens lack a vagal response to hypertension in both efferent and sensory limbs. In this study, vagal discharge was reduced from baseline levels in response to Ang II. Collectively, the present study indicates that the lack of a decreased heart rate, in response to increases in Pm caused by Ang II, is due to a central inhibitory action of Ang II on the vagus. Data from the present study suggests that although autonomic interaction with the cardiovascular system in present in late-stage chicken embryos, it is still underdeveloped and possesses a limited capacity.

No description available.

Research has indicated that the frontal and temporal lobes are involved in the mediation of heart rate and blood pressure. However, whereas these regions of the brain have been identified in the mediation of heart rate and blood pressure, the specific cerebral processes involved in determining the direction and magnitude of change in heart rate and blood pressure has not been adequately addressed. The present paper proposes that changes in the magnitude of cerebral activation between the left and right frontal and temporal lobes is partly that which determines the direction and magnitude of changes in heart rate and blood pressure. The present investigation sought to test part of this proposition, namely, that increasing magnitude of cerebral activity within the right anterior temporal region generates increasing levels of sympathetic control of heart rate and blood pressure and that the right lateral frontal region acts to inhibit sympathetic activity. A total of 45 right handed men, with no history of significant head injury, were exposed to 55 dB, 75 dB, and 90 dB white noise presentations. Right frontal lobe functioning was assessed by performance on the Ruff Figural Fluency Test (RFFT), with the participants scoring in the lower one-third classified as Low Fluency. Those scoring in the upper one-third were classified as High Fluency. Quantitative electroencephalography, measured at 19 electrodes sites arranged according to the International 10/20 System, as well as heart rate and blood pressure responses to white noise presentation were measured. Although the results failed to support any of the hypotheses concerning the effects of varying intensity of white noise on cardiovascular activity, partial support was found for the hypotheses that varying intensity of white noise would generate differential changes in high beta magnitude between the Low and High Fluency groups. The results are discussed in terms of support for the model being tested. Alternative explanations of the findings are also provided that demonstrate correspondence between the QEEG and cardiovascular data. Finally, limitations of the model and the methods of the present investigation are discussed and suggestions for improvement are provided. / Ph. D.

Ce travail avait pour but de déterminer, chez le rat vigil, le rôle de l’innervation sympathique dans le contrôle de l’hémodynamique cérébrale 1/ au cours d’une période d’activité normale d’environ 4 heures, et 2/ lors d’une augmentation aiguë de la pression artérielle (PA) induite par un stress émotionnel (jet d’air). Les débits sanguins dans les artères carotides internes (DSCa) ont été mesurés grâce à des sondes Doppler chroniquement implantées, chez des rats intacts ou ayant subi l’exérèse unilatérale du ganglion cervical supérieur. Le stress induit une élévation brusque et importante de la PA qui s’accompagne d’une hyperémie et d’une vasodilatation beaucoup plus marquées du côté dénervé que du côté innervé. Dans les conditions de base, l’analyse spectrale révèle une augmentation de la variabilité du DSCa du côté dénervé. La cohérence entre les deux DSCa, qui fournit un index de corrélation linéaire dans le domaine fréquentiel, a été calculée avant (cohérence ordinaire) et après élimination mathématique de l’influence de la PA (cohérence partielle). Les cohérences ordinaire et partielle sont diminuées par la sympathectomie unilatérale dans une bande de fréquences comprises entre 0,01 et 0,1 Hz. Ceci suggère un rôle modulateur important de l’innervation sympathique vis-à-vis de ces fluctuations lentes des DSCa. Ces résultats montrent que chez le rat vigil, l’innervation sympathique exerce un rôle protecteur de la circulation cérébrale face aux augmentations de PA au cours du stress émotionnel. Par ailleurs, cette innervation module des fluctuations spontanées lentes du débit sanguin cérébral qui ne sont pas directement reliées aux fluctuations de la PA. / The goal of the present work was to determine, in conscious rats, the role of the sympathetic innervation in the control of cerebral hemodynamics 1/ during a baseline period lasting ~4 h, and 2/ during an acute increase in blood pressure (BP) evoked by an emotional stressor (jet of air). Blood flows in internal carotid arteries (CaBF) were recorded with Doppler flow probes chronically implanted in intact rats and in rats that underwent unilateral excision of the superior cervical ganglion. Stress induced a large and brisk increase in BP which was accompanied by hyperemia and vasodilatation that were much stronger on the denervated than on the intact side. Spectral analysis demonstrated an overall enhancement of CaBF variability on the denervated side. Coherence between the two CaBFs, which provides an index of linear correlation in the frequency domain, was computed before (ordinary coherence) and after (partial coherence) mathematically eliminating the influence of BP. Both ordinary and partial coherences were lowered by unilateral sympathectomy in the 0.01-0.1 Hz frequency range, which suggests an important modulatory role for sympathetic innervation with respect to these slow CaBF fluctuations. These results indicate that in the conscious rat, sympathetic innervation plays a protective role of the cerebral circulation in the face of stress-induced increases in BP. On the other hand, this innervation modulates slow, spontaneous fluctuations of cerebral blood flow which are not directly related to BP fluctuations.