Journal article
Parasympathetic hyperresponsiveness and bradyarrhythmias during apnoea in hypertension
Clinical autonomic research, Vol.2(3), pp.171-176
06/1992
DOI: 10.1007/BF01818958
PMID: 1498563
Abstract
VOLUNTARY end-expiratory apnoea in a 23-year-old asymptomatic mild hypertensive patient consistently elicited bradyarrhythmias (complete heart block and sinus pause) and sympathetic activation to muscle blood vessels, indicating simultaneous sympathetic and parasympathetic activation during apnoea. The sympathetic bradyarrhythmic response to apnoea was potentiated by hypoxia and eliminated by atropine. Baroreflex activation also attenuated the bradycardic response to apnoea.
A 43-year-old hypertensive patient with sleep apnoea also exhibited bradyarrhythmias (sinus arrest for up to 10 s) and a fall in perfusion pressure to <50 mmHg during episodes of sleep apnoea. These cardiovascular changes were associated with a reduction in oxygen saturation to levels as low as 35%. Neither patient was on any medication.
Simultaneous sympathetic and parasympathetic activation during episodes of apnoea may predispose to cardiovascular catastrophe. These chemoreflex mediated autonomic changes are inhibited by baroreflex activation. We propose that patients with impaired baroreflexes (patients with hypertension or heart failure and premature infants) may be especially susceptible to excessive autonomic responses to chemoreflex stimulation during periods of apnoea. In these patient groups, brady-arrhythmias, hypoxia, hypoperfusion and sympathetic activation during apnoea may predispose to sudden death.
Details
- Title: Subtitle
- Parasympathetic hyperresponsiveness and bradyarrhythmias during apnoea in hypertension
- Creators
- Virend Kristen SomersMark Eric DykenAllyn Lewis MarkFrancois Mitry Abboud
- Resource Type
- Journal article
- Publication Details
- Clinical autonomic research, Vol.2(3), pp.171-176
- DOI
- 10.1007/BF01818958
- PMID
- 1498563
- ISSN
- 0959-9851
- eISSN
- 1619-1560
- Language
- English
- Date published
- 06/1992
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984020733502771
Metrics
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