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Intracranial mesenchymal chondrosarcoma (MCS) is a rare neoplasm. The diagnosis of MCS is confirmed by the presence of a biphasic pattern on histological examination, comprising undifferentiated small round cells admixed with islands of well-differentiated hyaline cartilage; however, a differential diagnosis may be challenging in some cases. A 28-year-old woman with a 2-month history of headache was referred to our hospital. Radiologic studies showed an extra-axial lobulated mass composed of calcified and uncalcified areas occupying the left middle fossa. Surgical resection was planned, but her headache suddenly worsened before her planned hospital admission and she was admitted as an emergency. Radiologic studies showed an acute hemorrhage in the uncalcified part of the mass. The mass was resected via the left zygomatic approach after embolization of the feeder vessels. The most likely histopathological diagnosis was MCS. However, the typical bimorphic pattern was not identified in our surgical samples; each undifferentiated area and well-differentiated area was observed separately in different tissue specimens, and no islands of well-differentiated hyaline cartilage were identified within the undifferentiated areas in the same specimen. Molecular assays confirmed the presence of HEY1-NCOA2 fusion. IRF2BP2-CDX1 fusion and IDH1/2 mutations were negative. The final diagnosis of MCS was made based on the presence of HEY1-NCOA2 gene fusion. MCS should be included in the differential diagnosis when radiologic studies show an extra-axial lobulated mass with calcification. Furthermore, molecular demonstration of HEY1-NCOA2 gene fusion may help make a precise diagnosis of MCS, especially in surgical samples lacking the typical histopathological features.

In obesity and type 2 diabetes, numerous genes are differentially expressed, and microRNAs are involved in transcriptional regulation of target mRNAs, but miRNAs critically involved in the appetite control are not known. Here, we identified upregulation of miR-342-3p and its host gene Evl in brain and adipose tissues in C57BL/6 mice fed with high fat-high sucrose (HFHS) chow by RNA sequencing. Mir342 (-/-) mice fed with HFHS chow were protected from obesity and diabetes. The hypothalamic arcuate nucleus neurons co-express Mir342 and EVL. The percentage of activated NPY+pSTAT3+ neurons were reduced, while POMC+pSTAT3+ neurons increased in Mir342 (-/-) mice, and they demonstrated the reduction of food intake and amelioration of metabolic phenotypes. Snap25 was identified as a major target gene of miR-342-3p and the reduced expression of Snap25 may link to functional impairment hypothalamic neurons and excess of food intake. The inhibition of miR-342-3p may be a potential candidate for miRNA-based therapy.

Although the pulsatility of an input pressure is an important factor that determines the arterial baroreflex responses, whether the difference in the input waveforms can meaningfully affect the baroreflex function remains unknown. This study aimed to compare baroreflex responses between two distinct pressure waveforms: a forward saw wave (FSW) and a backward saw wave (BSW). In seven anesthetized rats, carotid sinus pressure was exposed to the FSW or the BSW with a mean of 120 mmHg, pulse pressure of 40 mmHg, and pulse frequency of 1 Hz. Changes in efferent sympathetic nerve activity (SNA) and arterial pressure (AP) during six consecutive saw wave trials (FSW1, BSW1, FSW2, BSW2, FSW3, and BSW3) were examined. The steady-state SNA value during FSW1 was 91.1 ± 1.9%, which was unchanged during FSW2 and FSW3 but significantly increased during BSW1 (106.6 ± 3.4%, P < 0.01), BSW2 (110.6 ± 2.5%, P < 0.01), and BSW3 (111.6 ± 2.3%, P < 0.01). The steady-state AP value during FSW1 was 98.2 ± 8.1 mmHg, which was unchanged during FSW2 and FSW3 but significantly increased during BSW1 (106.7 ± 7.4 mmHg, P < 0.01), BSW2 (105.6 ± 7.8 mmHg, P < 0.01), and BSW3 (103.8 ± 7.2 mmHg, P < 0.05). In conclusion, the FSW was more effective than the BSW in reducing mean SNA and AP. The finding could be applied to designing an artificial pulsatile pressure such as that generated by left ventricular assist devices. NEW & NOTEWORTHY This study examined whether the waveforms of an input pressure alone can affect the baroreflex function by using a forward saw wave and a backward saw wave with the same mean pressure, pulse pressure, and pulse frequency. The forward saw wave was more effective than the backward saw wave in reducing sympathetic nerve activity and arterial pressure. The finding could be applied to designing an artificial pulsatile pressure such as that generated by left ventricular assist devices.

Desipramine (DMI) is a blocker of neuronal norepinephrine (NE) uptake transporter. Although intravenous DMI has been shown to cause centrally-mediated sympathoinhibition and peripheral NE accumulation, its parasympathetic effect remains to be elucidated. We hypothesized that intravenous DMI activates the cardiac vagal nerve via an α2-adrenergic mechanism. Using a cardiac microdialysis technique, changes in myocardial interstitial acetylcholine (ACh) levels in the left ventricular free wall in response to intravenous DMI (1mg·kg-1) were examined in anesthetized rats. In rats with intact vagi (n=7), intravenous DMI increased ACh from 1.67±0.43 to 2.48±0.66nM (P

An α2A-adrenergic agonist guanfacine improves autonomic imbalance in attention-deficit hyperactivity disorder, suggesting that it may be useful to correct autonomic imbalance in chronic heart failure (CHF) patients. To investigate the effects of guanfacine on cardiac autonomic nerve activities, a microdialysis technique was applied to anesthetized rabbit heart. Acetylcholine (ACh) and norepinephrine (NE) concentrations in atrial dialysates were measured as indices of cardiac autonomic nerve activities. Guanfacine at a dose of 100 μg/kg significantly decreased heart rate and increased dialysate ACh concentration without decreasing sympathetic NE release. Guanfacine may be useful for vagal activation therapy in CHF patients.

BACKGROUND There is ongoing controversy over whether neural or peripheral factors are the predominant cause of hypertension. The closed-loop negative feedback operation of the arterial baroreflex hampers understanding of how arterial pressure (AP) is determined through the interaction between neural and peripheral factors. METHODS AND RESULTS: A novel analysis of an isolated open-loop baroreceptor preparation to examine sympathetic nervous activity (SNA) and AP responses to changes in carotid sinus pressure (CSP) in adult spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) was conducted. In the neural arc (CSP-SNA relationship), the midpoint pressure (128.9±3.8 vs. 157.9±8.1 mmHg, P

The recent development of computer technology has made it possible to simulate the hemodynamics of congenital heart diseases on a desktop computer. However, multi-scale modeling of the cardiovascular system based on computed tomographic and magnetic resonance images still requires long simulation times. The lumped parameter model is potentially beneficial for real-time bedside simulation of congenital heart diseases. In this review, we introduce the basics of the lumped parameter model (time-varying elastance chamber model combined with modified Windkessel vasculature model) and illustrate its usage in hemodynamic simulation of congenital heart diseases using examples such as hypoplastic left heart syndrome and Fontan circulation. We also discuss the advantages of the lumped parameter model and the problems for clinical use.

There are some debate as to dynamic-state applicability and cause-and-effect relationship between variables in Guyton9s circulatory equilibrium model. The work of Moller PW et al. () supports the dynamic-state applicability in the venous return property of Guyton9s model. State-space representation clearly depicts function structure of cardiovascular system; inputs to the system firstly affect internal unmeasureable properties of system (total stressed blood volume, pump function, systemic arterial resistance) and as a result measurable variables (cardiac output, venous return, RAP, LAP, systemic arterial pressure) were determined simultaneously as circulatory equilibrium. Accordingly, there is no cause-and-effect relationship among measurable variables.

A hybrid procedure combining bilateral pulmonary artery banding with ductal stenting has recently been used as stage I palliation for hypoplastic left heart syndrome. However, the advantage of the hybrid procedure over the Norwood procedure on ventricular energetics remains unclear. To clarify this, we performed a computational analysis with a combination of time-varying elastance chamber model and modified three-element Windkessel vascular model. Although mean pulmonary artery (PA) pressure, pulmonary flow, and oxygen saturation were almost equivalent with the Norwood procedure, the hybrid procedure delivered higher systolic and lower diastolic systemic arterial pressures compared to the Norwood procedure with right ventricle (RV) to PA shunt. As a result, the hybrid procedure yielded increased systolic pressure-volume area and impaired mechanical efficiency. Therefore, the hybrid procedure has probably no advantage on ventricular energetics compared to the Norwood procedure with a RV-PA shunt.

Aim To examine whether sympathetic afferent stimulation (SAS) inhibits central vagal activation induced by α2-adrenergic stimulation. Methods In anaesthetized Wistar-Kyoto rats, a cardiac microdialysis technique was applied to the left ventricle, and the effect of α2-adrenergic stimulation by medetomidine on myocardial interstitial acetylcholine (ACh) levels was examined in the absence (n = 6) or the presence (n = 6) of SAS delivered from the left stellate ganglion. The effect of electrical vagal efferent stimulation on myocardial interstitial ACh release was also examined in the absence or the presence of SAS (n = 6). Results Intravenous medetomidine (0.1 mg kg−1) significantly increased myocardial interstitial ACh levels in the absence of SAS (from 1.95 ± 0.79 to 3.36 ± 1.61 nm, P

We have reported that minute ventilation [ $$ \dot{V}_{\text{E}} $$ ] and end-tidal CO2 tension [ $$ P_{{{\text{ETCO}}_{ 2} }} $$ ] are determined by the interaction between central controller and peripheral plant properties. During exercise, the controller curve shifts upward with unchanged central chemoreflex threshold to compensate for the plant curve shift accompanying increased metabolism. This effectively stabilizes $$ P_{{{\text{ETCO}}_{ 2} }} $$ within the normal range at the expense of exercise hyperpnea. In the present study, we investigated how endurance-trained athletes reduce this exercise hyperpnea. Nine exercise-trained and seven untrained healthy males were studied. To characterize the controller, we induced hypercapnia by changing the inspiratory CO2 fraction with a background of hyperoxia and measured the linear $$ P_{{{\text{ETCO}}_{ 2} }} - \dot{V}_{\text{E}} $$ relation [ $$ \dot{V}_{\text{E}} = S\, (P_{{{\text{ETCO}}_{2} }} - {\rm B}) $$ ]. To characterize the plant, we instructed the subjects to alter $$ \dot{V}_{\text{E}} $$ voluntarily and measured the hyperbolic $$\dot{V}_{\text{E}} - P_{{{\text{ETCO}}_{ 2} }} $$ relation ( $$ P_{{{\text{ETCO}}_{ 2} }} = A/\dot{V}_{\text{E}} + C $$ ). We characterized these relations both at rest and during light exercise. Regular exercise training did not affect the characteristics of either controller or plant at rest. Exercise stimulus increased the controller gain (S) both in untrained and trained subjects. On the other hand, the $$ P_{{{\text{ETCO}}_{ 2} }} $$ -intercept (B) during exercise was greater in trained than in untrained subjects, indicating that exercise-induced upward shift of the controller property was less in trained than in untrained subjects. The results suggest that the additive exercise drive to breathe was less in trained subjects, without necessarily a change in central chemoreflex threshold. The hyperbolic plant property shifted rightward and upward during exercise as predicted by increased metabolism, with little difference between two groups. The $$ \dot{V}_{\text{E}} $$ during exercise in trained subjects was 21% lower than that in untrained subjects (P

We examined the transfer function of autonomic heart rate (HR) control in anesthetized sedentary and exercise-trained (16 wk, treadmill for 1 h, 5 times/wk at 15 m/min and 15-degree grade) rats for comparison to HR variability assessed in the conscious resting state. The transfer function from sympathetic stimulation to HR response was similar between groups (gain, 4.2 ± 1.5 vs. 4.5 ± 1.5 beats·min−1·Hz−1; natural frequency, 0.07 ± 0.01 vs. 0.08 ± 0.01 Hz; damping coefficient, 1.96 ± 0.55 vs. 1.69 ± 0.15; and lag time, 0.7 ± 0.1 vs. 0.6 ± 0.1 s; sedentary vs. exercise trained, respectively, means ± SD). The transfer gain from vagal stimulation to HR response was 6.1 ± 3.0 in the sedentary and 9.7 ± 5.1 beats·min−1·Hz−1 in the exercise-trained group ( P = 0.06). The corner frequency (0.11 ± 0.05 vs. 0.17 ± 0.09 Hz) and lag time (0.1 ± 0.1 vs. 0.2 ± 0.1 s) did not differ between groups. When the sympathetic transfer gain was averaged for very-low-frequency and low-frequency bands, no significant group effect was observed. In contrast, when the vagal transfer gain was averaged for very-low-frequency, low-frequency, and high-frequency bands, exercise training produced a significant group effect ( P < 0.05 by two-way, repeated-measures ANOVA). These findings suggest that, in the frequency domain, exercise training augments the dynamic HR response to vagal stimulation but not sympathetic stimulation, regardless of the frequency bands.

Non-technical summary The arterial baroreflex is a closed-loop, negative feedback control system that senses baroreceptor pressure and controls systemic arterial pressure (AP) to attenuate perturbations in AP. The total arc of the baroreflex consists of two subsystems: the neural (baroreceptor pressure input to sympathetic nerve activity (SNA)) and peripheral (SNA input to AP) arcs. We show that although the spontaneous baroreflex transfer function obtained by closed-loop analysis has been believed to represent the neural arc function, it is inappropriate for system identification of the neural arc but is essentially appropriate for the peripheral arc under resting condition, when compared with open-loop transfer functions that have good predictabilities of time-series output dynamics from input signals. Our results indicate that in the spontaneous baroreflex system under closed-loop conditions, the peripheral arc (feedforward) function predominates over the neural arc (feedback) function, probably because of the SNA component that is independent of the baroreceptor pressure input. Abstract Although the dynamic characteristics of the baroreflex system have been described by baroreflex transfer functions obtained from open-loop analysis, the predictability of time-series output dynamics from input signals, which should confirm the accuracy of system identification, remains to be elucidated. Moreover, despite theoretical concerns over closed-loop system identification, the accuracy and the predictability of the closed-loop spontaneous baroreflex transfer function have not been evaluated compared with the open-loop transfer function. Using urethane and α-chloralose anaesthetized, vagotomized and aortic-denervated rabbits (n= 10), we identified open-loop baroreflex transfer functions by recording renal sympathetic nerve activity (SNA) while varying the vascularly isolated intracarotid sinus pressure (CSP) according to a binary random (white-noise) sequence (operating pressure ± 20 mmHg), and using a simplified equation to calculate closed-loop-spontaneous baroreflex transfer function while matching CSP with systemic arterial pressure (AP). Our results showed that the open-loop baroreflex transfer functions for the neural and peripheral arcs predicted the time-series SNA and AP outputs from measured CSP and SNA inputs, with r2 of 0.8 ± 0.1 and 0.8 ± 0.1, respectively. In contrast, the closed-loop-spontaneous baroreflex transfer function for the neural arc was markedly different from the open-loop transfer function (enhanced gain increase and a phase lead), and did not predict the time-series SNA dynamics (r2; 0.1 ± 0.1). However, the closed-loop-spontaneous baroreflex transfer function of the peripheral arc partially matched the open-loop transfer function in gain and phase functions, and had limited but reasonable predictability of the time-series AP dynamics (r2, 0.7 ± 0.1). A numerical simulation suggested that a noise predominantly in the neural arc under resting conditions might be a possible mechanism responsible for our findings. Furthermore, the predictabilities of the neural arc transfer functions obtained in open-loop and closed-loop conditions were validated by closed-loop pharmacological (phenylephrine and nitroprusside infusions) pressure interventions. Time-series SNA responses to drug-induced AP changes predicted by the open-loop transfer function matched closely the measured responses (r2, 0.9 ± 0.1), whereas SNA responses predicted by closed-loop-spontaneous transfer function deviated greatly and were the inverse of measured responses (r, −0.8 ± 0.2). These results indicate that although the spontaneous baroreflex transfer function obtained by closed-loop analysis has been believed to represent the neural arc function, it is inappropriate for system identification of the neural arc but is essentially appropriate for the peripheral arc under resting conditions, when compared with open-loop analysis.

Although baroreceptors are known to reset to operate in a higher pressure range in spontaneously hypertensive rats (SHR), the total profile of dynamic arterial pressure (AP) regulation remains to be clarified. We estimated open-loop transfer functions of the carotid sinus baroreflex in SHR and Wistar Kyoto (WKY) rats. Mean input pressures were set at 120 (WKY120 and SHR120) and 160 mmHg (SHR160). The neural arc transfer function from carotid sinus pressure to efferent splanchnic sympathetic nerve activity (SNA) revealed derivative characteristics in both WKY and SHR. The slope of dynamic gain (in decibels per decade) between 0.1 and 1 Hz was not different between WKY120 (10.1 ± 1.0) and SHR120 (10.4 ± 1.1) but was significantly greater in SHR160 (13.2 ± 0.8, P < 0.05 with Bonferroni correction) than in SHR120. The peripheral arc transfer function from SNA to AP showed low-pass characteristics. The slope of dynamic gain (in decibels per decade) did not differ between WKY120 (−34.0 ± 1.2) and SHR120 (−31.4 ± 1.0) or between SHR120 and SHR160 (−32.8 ± 1.3). The total baroreflex showed low-pass characteristics and the dynamic gain at 0.01 Hz did not differ between WKY120 (0.91 ± 0.08) and SHR120 (0.84 ± 0.13) or between SHR120 and SHR160 (0.83 ± 0.11). In both WKY and SHR, the declining slope of dynamic gain was significantly gentler for the total baroreflex than for the peripheral arc, suggesting improved dynamic AP response in the total baroreflex. In conclusion, the dynamic characteristics of AP regulation by the carotid sinus baroreflex were well preserved in SHR despite significantly higher mean AP.

The internal thoracic artery (ITA) is harvested by either the pedicled or the skeletonized technique in coronary artery bypass grafting (CABG), with no clear advantage of one technique over the other. We compared graft flow between the pedicled and skeletonized ITA grafts while varying myocardial oxygen demand. CABG was performed to the left anterior descending artery in five anesthetized dogs using a pedicled ITA graft and the graft was subsequently skeletonized. Graft flow was measured during stepwise electrical stimulation of the stellate ganglion. The baseline graft flow before sympathetic stimulation was higher in skeletonized (27.8 ± 1.9 ml/min) than that in pedicled ITA grafts (22.6 ± 2.7 ml/min) (P < 0.05). In both ITA grafts, however, graft flow increased to a similar level during sympathetic stimulation that doubled the double product, correlating with the double product. Based on these results, we conclude that metabolic demand can override the potential difference in sympathetic vasoconstriction in both pedicled and skeletonized ITA grafts.

We estimated the transfer function of autonomic heart rate (HR) control by using random binary sympathetic or vagal nerve stimulation in anaesthetized rats. The transfer function from sympathetic stimulation to HR response approximated a second-order, low-pass filter with a lag time (gain, 4.29 ± 1.55 beats min−1 Hz−1; natural frequency, 0.07 ± 0.03 Hz; damping coefficient, 1.96 ± 0.64; and lag time, 0.73 ± 0.12 s). The transfer function from vagal stimulation to HR response approximated a first-order, low-pass filter with a lag time (gain, 8.84 ± 4.51 beats min−1 Hz−1; corner frequency, 0.12 ± 0.06 Hz; and lag time, 0.12 ± 0.08 s). These results suggest that the dynamic characteristics of HR control by the autonomic nervous system in rats are similar to those of larger mammals.

We estimated open-loop dynamic characteristics of the carotid sinus baroreflex in normal control rats and chronic heart failure (CHF) rats after myocardial infarction. First, the neural arc transfer function from carotid sinus pressure to splanchnic sympathetic nerve activity (SNA) and its corresponding step response were examined. Although the steady-state response was attenuated in CHF, the negative peak response and the time to peak did not change significantly, suggesting preserved neural arc dynamic characteristics. Next, the peripheral arc transfer function from SNA to arterial pressure (AP) and its corresponding step response were examined. The steady-state response and the initial slope were reduced in CHF, suggesting impaired end-organ responses. In a simulation study based on the dynamic and static characteristics, the percent recovery of AP was reduced progressively as the size of disturbance increased in CHF, suggesting that a reserve for AP buffering is lost in CHF despite relatively maintained baseline AP.

To directly monitor vagal acetylcholine (ACh) release into the sinoatrial node, which regulates heart rate, we implanted a microdialysis probe in the right atrium near the sinoatrial node and in the right ventricle of anesthetized rabbits, and perfused with Ringer's solution containing eserine. (1) Electrical stimulation of right or left cervical vagal nerve decreased atrial rate and increased dialysate ACh concentration in the right atrium in a frequency-dependent manner. Compared to left vagal stimulation, right vagal nerve stimulation decreased atrial rate to a greater extent at all frequencies, and increased dialysate ACh concentration to a greater extent at 10 and 20 Hz. However, dialysate ACh concentration in the right atrium correlated well with atrial rate independent of whether electrical stimulation was applied to the right or left vagal nerve (atrial rate=304-131 x log[ACh], R(2)=0.77). (2) Right or left vagal nerve stimulation at 20 Hz decreased atrial rate and increased dialysate ACh concentrations in both the right atrium (right, 17.9+/-4.0 nM; left, 7.9+/-1.4 nM) and right ventricle (right, 0.9+/-0.3 nM; left, 1.0+/-0.4 nM). However, atrial dialysate ACh concentrations were significantly higher than ventricular concentrations, while ventricular dialysate ACh concentrations were not significantly different between right and left vagal nerve stimulation. (3) The response of ACh release to right and left vagal nerve stimulation was abolished by intravenous administration of a ganglionic blocker, hexamethonium bromide. In conclusion, ACh concentration in dialysate from the right atrium, sampled by microdialysis, is a good marker of ACh release from postganglionic vagal nerves to the sinoatrial node.

To better understand the pathophysiological role of angiotensin II (ANG II) in the dynamic autonomic regulation of heart rate (HR), we examined the effects of intravenous administration of ANG II (10 μg·kg−1·h−1) on the transfer function from vagal or sympathetic nerve stimulation to HR in anesthetized rabbits with sinoaortic denervation and vagotomy. In the vagal stimulation group ( n = 7), we stimulated the right vagal nerve for 10 min using binary white noise (0–10 Hz). The transfer function from vagal stimulation to HR approximated a first-order low-pass filter with pure delay. ANG II attenuated the dynamic gain from 7.6 ± 0.9 to 5.8 ± 0.9 beats·min−1·Hz−1 (means ± SD; P < 0.01) without affecting the corner frequency or pure delay. In the sympathetic stimulation group ( n = 7), we stimulated the right postganglionic cardiac sympathetic nerve for 20 min using binary white noise (0–5 Hz). The transfer function from sympathetic stimulation to HR approximated a second-order low-pass filter with pure delay. ANG II slightly attenuated the dynamic gain from 10.8 ± 2.6 to 10.2 ± 3.1 beats·min−1·Hz−1 ( P = 0.049) without affecting the natural frequency, damping ratio, or pure delay. The disproportional suppression of the dynamic vagal and sympathetic regulation of HR would result in a relative sympathetic predominance in the presence of ANG II. The reduced high-frequency component of HR variability in patients with cardiovascular diseases, such as myocardial infarction and heart failure, may be explained in part by the peripheral effects of ANG II on the dynamic autonomic regulation of HR.

Background: Autonomic neural intervention is a promising tool for modulating the circulatory system thereby treating some cardiovascular diseases. Methods and Results: In 8 pentobarbital-anesthetized cats, it was examined whether the arterial pressure (AP) could be controlled by acupuncture-like hind-limb electrical stimulation (HES). With a 0.5-ms pulse width, HES monotonically reduced AP as the stimulus current increased from 1 to 5 mA, suggesting that the stimulus current could be a primary control variable. In contrast, the depressor effect of HES showed a nadir approximately 10 Hz in the frequency range between 1 and 100 Hz. Dynamic characteristics of the AP response to HES approximated a second-order low-pass filter with dead time (gain: -10.2 ±1.6 mmHg/mA, natural frequency: 0.040 ±0.004 Hz, damping ratio 1.80 ±0.24, dead time: 1.38 ±0.13 s, mean ± SE). Based on these dynamic characteristics, a servo-controlled HES system was developed. When a target AP value was set at 20 mmHg below the baseline AP, the time required for the AP response to reach 90% of the target level was 38 ±10 s. The steady-state error between the measured and target AP values was 1.3 ±0.1 mmHg. Conclusions: Autonomic neural intervention by acupuncture-like HES might provide an additional modality to quantitatively control the circulatory system. (Circ J 2009; 73: 851 - 859)

Although an importance of vasoconstrictor skin sympathetic nerve activity (SNA) in control of cutaneous circulation is widely recognized, the decoding rule that translate dynamic fluctuations of vasoconstrictor skin SNA into skin blood flow is not fully understood. In 10 male subjects who rested in supine position under normothermic condition, we measured skin blood flow index (by laser-Doppler flowmetry) at the dorsum pedis, and vasoconstrictor skin SNA (by microneurography) that was confirmed to innervate the same region as the flow index. We determined the transfer and coherence functions from the neural activity input to the flow and quantified the contribution and predictability from the input to output by system engineering technique. The results showed that in frequency-domain analysis, the transfer function from vasoconstrictor skin SNA to skin blood flow had low-pass filter characteristics with 3.6 ± 0.1 s of pure time delay. The coherence function was approximately 0.5 between 0.01 and 0.1 Hz and less above 0.1 Hz. In time-domain analysis, the predictability from the SNA to the skin blood flow was approximately 50%. These findings indicate that at normothermic rest, the decoding rule from vasoconstrictor skin SNA to skin blood flow of skin is characterized by low-pass filter with 3–4 s of pure time delay, and that the vasoconstrictor skin SNA contributes to a half of fluctuation of skin blood flow in the condition. The incomplete dependence of skin blood flow on vasoconstrictor skin SNA may confirm nonneural mechanisms to control cutaneous circulation even at normothermic rest.

Vagal nerve stimulation has been suggested to ameliorate left ventricular (LV) remodeling in heart failure. However, it is not known whether and to what degree vagal nerve stimulation affects matrix metalloproteinase (MMP) and tissue inhibitor of MMP (TIMP) in myocardium, which are known to play crucial roles in LV remodeling. We therefore investigated the effects of electrical stimulation of efferent vagal nerve on myocardial expression and activation of MMPs and TIMPs in a rabbit model of myocardial ischemia-reperfusion (I/R) injury. Anesthetized rabbits were subjected to 60 min of left coronary artery occlusion and 180 min of reperfusion with (I/R-VS, n = 8) or without vagal nerve stimulation (I/R, n = 7). Rabbits not subjected to coronary occlusion with (VS, n = 7) or without vagal stimulation (sham, n = 7) were used as controls. Total MMP-9 protein increased significantly after left coronary artery occlusion in I/R-VS and I/R to a similar degree compared with VS and sham values. Endogenous active MMP-9 protein level was significantly lower in I/R-VS compared with I/R. TIMP-1 mRNA expression was significantly increased in I/R-VS compared with the I/R, VS, and sham groups. TIMP-1 protein was significantly increased in I/R-VS and VS compared with the I/R and sham groups. Cardiac microdialysis technique demonstrated that topical perfusion of acetylcholine increased dialysate TIMP-1 protein level, which was suppressed by coperfusion of atropine. Immunohistochemistry demonstrated a strong expression of TIMP-1 protein in cardiomyocytes around the dialysis probe used to perfuse acetylcholine. In conclusion, in a rabbit model of myocardial I/R injury, vagal nerve stimulation induced TIMP-1 expression in cardiomyocytes and reduced active MMP-9.

Grb2-associated binder (Gab) family of scaffolding adaptor proteins coordinate signaling cascades downstream of growth factor and cytokine receptors. In the heart, among EGF family members, neuregulin-1beta (NRG-1beta, a paracrine factor produced from endothelium) induced remarkable tyrosine phosphorylation of Gab1 and Gab2 via erythroblastic leukemia viral oncogene (ErbB) receptors. We examined the role of Gab family proteins in NRG-1beta/ErbB-mediated signal in the heart by creating cardiomyocyte-specific Gab1/Gab2 double knockout mice (DKO mice). Although DKO mice were viable, they exhibited marked ventricular dilatation and reduced contractility with aging. DKO mice showed high mortality after birth because of heart failure. In addition, we noticed remarkable endocardial fibroelastosis and increase of abnormally dilated vessels in the ventricles of DKO mice. NRG-1beta induced activation of both ERK and AKT in the hearts of control mice but not in those of DKO mice. Using DNA microarray analysis, we found that stimulation with NRG-1beta upregulated expression of an endothelium-stabilizing factor, angiopoietin 1, in the hearts of control mice but not in those of DKO mice, which accounted for the pathological abnormalities in the DKO hearts. Taken together, our observations indicated that in the NRG-1beta/ErbB signaling, Gab1 and Gab2 of the myocardium are essential for both maintenance of myocardial function and stabilization of cardiac capillary and endocardial endothelium in the postnatal heart.

Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m(2), the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure.

Although an axoplasmic Ca2+ increase is associated with an exocytotic acetylcholine (ACh) release from the parasympathetic postganglionic nerve endings, the role of voltage-dependent Ca2+ channels in ACh release in the mammalian cardiac parasympathetic nerve is not clearly understood. Using a cardiac microdialysis technique, we examined the effects of Ca2+ channel antagonists on vagal nerve stimulation- and ischemia-induced myocardial interstitial ACh releases in anesthetized cats. The vagal stimulation-induced ACh release [22.4 nM (SD 10.6), n = 7] was significantly attenuated by local administration of an N-type Ca2+ channel antagonist ω-conotoxin GVIA [11.7 nM (SD 5.8), n = 7, P = 0.0054], or a P/Q-type Ca2+ channel antagonist ω-conotoxin MVIIC [3.8 nM (SD 2.3), n = 6, P = 0.0002] but not by local administration of an L-type Ca2+ channel antagonist verapamil [23.5 nM (SD 6.0), n = 5, P = 0.758]. The ischemia-induced myocardial interstitial ACh release [15.0 nM (SD 8.3), n = 8] was not attenuated by local administration of the L-, N-, or P/Q-type Ca2+ channel antagonists, by inhibition of Na+/Ca2+ exchange, or by blockade of inositol 1,4,5-trisphosphate [Ins( 1 , 4 , 5 )P3] receptor but was significantly suppressed by local administration of gadolinium [2.8 nM (SD 2.6), n = 6, P = 0.0283]. In conclusion, stimulation-induced ACh release from the cardiac postganglionic nerves depends on the N- and P/Q-type Ca2+ channels (with a dominance of P/Q-type) but probably not on the L-type Ca2+ channels in cats. In contrast, ischemia-induced ACh release depends on nonselective cation channels or cation-selective stretch activated channels but not on L-, N-, or P/Q type Ca2+ channels, Na+/Ca2+ exchange, or Ins( 1 , 4 , 5 )P3 receptor-mediated pathway.

Objectives We examined how repolarization and depolarization abnormalities contribute to the development of extrasystoles and subsequent ventricular fibrillation (VF) in a model of the Brugada syndrome. Background Repolarization and depolarization abnormalities have been considered to be mechanisms of the coved-type ST-segment elevation (Brugada-electrocardiogram [ECG]) and development of VF in the Brugada syndrome. Methods We used high-resolution (256 × 256) optical mapping techniques to study arterially perfused canine right ventricular wedges (n = 20) in baseline and in the Brugada-ECG produced by administration of terfenadine (5 μmol/l), pinacidil (2 μmol/l), and pilsicainide (5 μmol/l). We recorded spontaneous episodes of phase 2 re-entrant (P2R)-extrasystoles and subsequent self-terminating polymorphic ventricular tachycardia (PVT) or VF under the Brugada-ECG condition and analyzed the epicardial conduction velocity and action potential duration (APD) restitutions in each condition. Results Forty-one episodes of spontaneous P2R-extrasystoles in the Brugada-ECG were successfully mapped in 9 of 10 preparations, and 33 of them were originated from the maximum gradient of repolarization (GR max : 176 ± 54 ms/mm) area in the epicardium, leading to PVT (n = 12) or VF (n = 5). The epicardial GR max was not different between PVT and VF. Wave-break during the first P2R-extrasystole produced multiple wavelets in all VF cases, whereas no wave-break or wave-break followed by wave collision and termination occurred in PVT cases. Moreover, conduction velocity restitution was shifted lower and APD restitution was more variable in VF cases than in PVT cases. Conclusions Steep repolarization gradient in the epicardium but not endocardium develops P2R-extrasystoles in the Brugada-ECG condition, which might degenerate into VF by further depolarization and repolarization abnormalities.

Despite accumulating data of muscle sympathetic nerve activity (SNA) measured by human microneurography, whether neural discharges of muscle SNA correlates and coheres with those of other SNAs controlling visceral organs remains unclear. Further, how the baroreflex control of SNA affects the relations between these SNAs remains unknown. In urethane and alpha-chloralose anesthetized, vagotomized, and aortic-denervated rabbits, we recorded muscle SNA from the tibial nerve using microneurography and simultaneously recorded renal and cardiac SNAs. After isolating the carotid sinuses, we produced a baroreflex closed-loop condition by matching the isolated intracarotid sinus pressure (CSP) with systemic arterial pressure (CLOSE). We also fixed CSP at operating pressure (FIX) or altered CSP widely (WIDE: operating pressure +/- 40 mmHg). Under these conditions, we calculated time-domain and frequency-domain measures of the correlation between muscle SNA and renal or cardiac SNAs. At CLOSE, muscle SNA resampled at 1 Hz correlated with both renal (r(2) = 0.71 +/- 0.04, delay = 0.10 +/- 0.004 s) and cardiac SNAs (r(2) = 0.58 +/- 0.03, delay = 0.13 +/- 0.004 s) at optimal delays. Moreover,muscle SNA at CLOSE strongly cohered with renal and cardiac SNAs(coherence0.8) at the autospectral peak frequencies, and weakly (0.4-0.5) at the remaining frequencies. Increasing the magnitude of CSP change from FIX to CLOSE and further to WIDE resulted in corresponding increases in correlation and coherence functions at nonpeak frequencies, and the coherence functions at peak frequencies remained high (0.8). In conclusion, muscle SNA correlates and coheres approximately with renal and cardiac SNAs under closed-loop baroreflex conditions. The arterial baroreflex is capable of potently homogenizing neural discharges of these SNAs by modulating SNA at the nonpeak frequencies of SNA autospectra.

An intermittent exposure to artificial hypergravity with physical exercise by a human centrifuge may provide a countermeasure against various physiological problems after space flight. To test the effects of hypergravity with ergometric exercise on dynamic regulation of heart rate during weightlessness, we quantified autonomic cardiovascular control before and after head-down-tilt bed rest (HDBR) with and without the countermeasure. Twelve male subjects underwent a 14-day period of HDBR. Six of them were exposed to a hypergravity (+1.2 Gz acceleration at heart level) for 30 min with ergometric exercise (60 W, n=4; 40 W, n=2) as a countermeasure on day 1, 2, 3, 5, 7, 9, 11, 12, 13 and 14, during HDBR (CM group). The remaining six were not exposed to a hypergravity exercise during HDBR (control group). Blood pressure and ECG were recorded at a supine position before and after HDBR. The high frequency power of R-R interval (HFRR; 1,008+/-238 to 353+/-56 ms(2) P

Neuronal uptake is the most important mechanism by which norepinephrine (NE) is removed from the synaptic clefts at sympathetic nerve terminals. We examined the effects of neuronal NE uptake blockade on the dynamic sympathetic regulation of the arterial baroreflex because dynamic characteristics are important for understanding the system behavior in response to exogenous disturbance. We perturbed intracarotid sinus pressure (CSP) according to a binary white noise sequence in anesthetized rabbits, while recording cardiac sympathetic nerve activity (SNA), arterial pressure (AP), and heart rate (HR). Intravenous administration of desipramine (1 mg/kg) decreased the normalized gain of the neural arc transfer function from CSP to SNA relative to untreated control (1.03 ± 0.09 vs. 0.60 ± 0.08 AU/mmHg, mean ± SE, P < 0.01) but did not affect that of the peripheral arc transfer function from SNA to AP (1.10 ± 0.05 vs. 1.08 ± 0.10 mmHg/AU). The normalized gain of the transfer function from SNA to HR was unaffected (1.01 ± 0.04 vs. 1.09 ± 0.12 beats·min−1·AU−1). Desipramine decreased the natural frequency of the transfer function from SNA to AP by 28.7 ± 7.0% (0.046 ± 0.007 vs. 0.031 ± 0.002 Hz, P < 0.05) and that of the transfer function from SNA to HR by 64.4 ± 2.2% (0.071 ± 0.003 vs. 0.025 ± 0.002 Hz, P < 0.01). In conclusion, neuronal NE uptake blockade by intravenous desipramine administration reduced the total buffering capacity of the arterial baroreflex mainly through its action on the neural arc. The differential effects of neuronal NE uptake blockade on the dynamic AP and HR responses to SNA may provide clues for understanding the complex pathophysiology of cardiovascular diseases associated with neuronal NE uptake deficiency.

Space-flight and its ground-based simulation model, 6° head-down bed rest (HDBR), cause cardiovascular deconditioning in humans. Because sympathetic vasoconstriction plays a very important role in circulation, we examined whether HDBR impairs α-adrenergic vascular responsiveness to sympathetic nerve activity. We subjected eight healthy volunteers to 14 days of HDBR and before and after HDBR measured calf muscle sympathetic nerve activity (MSNA; microneurography) and calf blood flow (venous occlusion plethysmography) during sympathoexcitatory stimulation (rhythmic handgrip exercise). HDBR did not change the increase in total MSNA ( P = 0.97) or the decrease in calf vascular conductance ( P = 0.32) during exercise, but it did augment the increase in calf vascular resistance ( P = 0.0011). HDBR augmented the transduction gain from total MSNA into calf vascular resistance, assessed as the least squares linear regression slope of vascular resistance on total MSNA (0.05 ± 0.02 before HDBR, 0.20 ± 0.06 U·min-1·burst-1after HDBR, P = 0.0075), but did not change the transduction gain into calf vascular conductance ( P = 0.41). Our data indicate that α-adrenergic vascular responsiveness to sympathetic nerve activity is preserved in the supine position after HDBR in humans.

Although orthostatic hypotension is a common clinical syndrome after spaceflight and its ground-based simulation model, 6 degrees head-down bed rest (HDBR), the pathophysiology remains unclear. The authors' hypothesis that a decrease in sympathetic nerve activity is the major pathophysiology underlying orthostatic hypotension after HDBR was tested in a study involving 14-day HDBR in 22 healthy subjects who showed no orthostatic hypotension during 15-min 60 degrees head-up tilt test (HUT) at baseline. After HDBR, 10 of 22 subjects demonstrated orthostatic hypotension during 60 degrees HUT. In subjects with orthostatic hypotension, total activity of muscle sympathetic nerve activity (MSNA) increased less during the first minute of 60 degrees HUT after HDBR (314% of resting supine activity) than before HDBR (523% of resting supine activity, P < 0.05) despite HDBR-induced reduction in plasma volume (13% of plasma volume before HDBR). The postural increase in total MSNA continued during several more minutes of 60 degrees HUT while arterial pressure was maintained. Thereafter, however, total MSNA was paradoxically suppressed by 104% of the resting supine level at the last minute of HUT (P < 0.05 vs. earlier 60 degrees HUT periods). The suppression of total MSNA was accompanied by a 22 +/- 4-mmHg decrease in mean blood pressure (systolic blood pressure

The strength of sympathetic vasoconstrictor nerve traffic to the skin has an important role in human thermoregulation since it controls heat loss from the skin by constricting or dilating cutaneous blood vessels. This study sought to clarify the time relationship between a reduction of the vasoconstrictor activity induced by elevating the ambient temperature (Ta), and subsequent change of core temperature (Tty). For this purpose, we recorded peroneal skin sympathetic nerve activity (SSNA), laser Doppler skin blood flow, skin and core (tympanic) temperatures in 11 subjects while increasing Ta from 15 to 30 degrees C during approximately 30 min. We observed a significant suppression of SSNA 7.7 min after Ta rise with marked interindividual variations. Tty displayed an increase with a peak after 8.2 min followed by a successive decrease, which became significant 14 min after the Ta rise. The rate of decrease of vasoconstrictor SSNA correlated both with the rate of decrease of Tty (P0.01) and the magnitude of the Tty decrease (P0.0005). A cross-correlogram between SSNA and Tty showed a peak at 7 min (r=0.52). We conclude that a Ta rise-induced reduction of skin vasoconstrictor nerve traffic leads to a core temperature decrease after 7-8 min.

Although large conductance Ca(2+)-activated K(+) (BK) channels play an important role in determining vascular tone, their role in the efferent cardiac vagal system remains to be elucidated. In anesthetized rabbits (n=9), acetylcholine (ACh) was measured at the right atrium near the sinoatrial node by a cardiac microdialysis technique, and the ACh release in response to electrical stimulation of the cervical preganglionic vagal nerves was examined. Local administration of a BK channel blocker iberiotoxin (2 microM) through a dialysis fiber increased the stimulation-induced ACh release from 7.6+/-2.7 to 9.0+/-3.2 nM (P0.05). Addition of intravenous administration of iberiotoxin (0.11 mg/body) did not increase the stimulation-induced ACh release further (10.8+/-4.4 nM). These results indicate that the BK channels play an inhibitory role in the vagal ACh release to the sinoatrial node.

Astronauts usually work under much mental stress. However, it is unclear how and whether or not an exposure to microgravity affects physiological response to mental stress in humans. To examine effects of microgravity on vasomotor sympathetic and peripheral vasodilator responses to mental stress, we performed 10 min of mental arithmetic (MA) before and after 14 days of 6° head-down bed rest (HDBR), a ground-based simulation of spaceflight. Total muscle sympathetic nerve activity (MSNA, measured by microneurography) slightly increased during MA before HDBR, and this increase was augmented after HDBR. Calf blood flow (measured by venous occlusion plethysmography) increased and calf vascular resistance (calculated by dividing mean blood pressure by calf blood flow) decreased during MA before HDBR, but these responses were abolished after HDBR. Increases in heart rate and mean blood pressure during MA were not different between before and after HDBR. These findings suggest that HDBR augmented vasomotor sympathoexcitation but attenuated vasodilatation in the calf muscle in response to mental stress.

Aims Cilnidipine is a unique Ca 2 + channel blocker that inhibits both L-type and N-type Ca 2 + channels. The present study aimed to assess the effects of intravenous cilnidipine on sympathetic outflow and sympathetic arterial pressure (AP) and heart rate (HR) regulations. Main methods Carotid sinus baroreceptor regions were isolated from the systemic circulation in anesthetized and vagotomized Wistar Kyoto rats. Changes in efferent sympathetic nerve activity (SNA), AP and HR in response to a stepwise input of carotid sinus pressure were examined before and during intravenous cilnidipine administration (30 μg/kg bolus + 100 μg kg − 1 h − 1 infusion, n = 6). Key findings Cilnidipine significantly reduced the AP response range (from 68.0 ± 10.2 to 34.6 ± 4.1 mmHg, P = 0.007) but did not affect the SNA response range (from 90.4 ± 10.3 to 84.7 ± 9.5%, P = 0.297) or the HR response range (from 50.4 ± 10.1 to 48.1 ± 6.2 beats/min, P = 0.719). Significance Cilnidipine, at a depressor dose used in the present study, does not acutely suppress sympathetic outflow from the central nervous system. Also, it spared the sympathetic HR response, suggesting that N-type Ca 2 + channel blocking action at the cardiac sympathetic nerve endings may be a modest one.

Aim To elucidate the abnormality of vagal control in spontaneously hypertensive rats (SHR) by measuring left ventricular myocardial interstitial acetylcholine (ACh) release in response to α2-adrenergic stimulation as an index of in vivo vagal nerve activity. Methods A cardiac microdialysis technique was applied to the rat left ventricle in vivo, and the effect of α2-adrenergic stimulation by medetomidine or electrical vagal nerve stimulation on myocardial interstitial ACh levels was examined in normotensive Wistar–Kyoto rats (WKY) and SHR under anaesthetized conditions. Results Intravenous medetomidine (0.1 mg kg−1) significantly increased the ACh levels in WKY (from 2.4 ± 0.6 to 4.2 ± 1.3 nmol L−1, P

When the Norwood procedure is conducted for the hypoplastic left heart syndrome using a non-valved right ventricle (RV) to pulmonary artery (PA) shunt, diastolic regurgitation from PA to RV may have an adverse effect on postoperative hemodynamics. In this study, we examined the impact of the diastolic regurgitation on ventricular energetics by computational analysis using a combination of a time-varying elastance chamber model and a modified three-element Windkessel vascular model. This study revealed that use of the valved or non-valved RV-PA shunt eliminated pulmonary over-circulation which was observed when using the systemic to pulmonary artery shunt (modified Blalock-Taussig shunt). Although the valved RV-PA shunt improved pulmonary blood supply and consequently increased pulmonary artery flow and oxygen saturation compared to the non-valved RV-PA shunt, the non-valved RV-PA shunt improved ventricular energetics in spite of the presence of PA to RV regurgitation.

The carotid sinus baroreflex is one of the most important negative feedback systems to stabilize arterial pressure. Although static characteristics of the carotid sinus baroreflex can be assessed by using a stepwise input protocol under baroreflex open-loop conditions, the step duration has been determined empirically. In the present study, we examined the effects of different time windows (5-10, 15-20, 25-30, 35-40, 45-50, and 55-60 s) on the static characteristics estimated by using a 60-s stepwise input protocol in 10 anesthetized rats. Based on the results, we compared the static characteristics between actual 60-s and 20-s stepwise input protocols. Most of the parameters of the static characteristics did not differ significantly between the 60-s and 20-s stepwise input protocols, suggesting that the open-loop baroreflex static characteristics can be estimated by using a stepwise input with the step duration as short as 20 s in normal rats.

In our extended Guyton's model, the ability of heart to pump blood is characterized by a cardiac output curve and the ability of vasculature to pool blood by a venous return surface. These intersect in a three-dimensional coordinate system at the operating right atrial pressure, left atrial pressure, and cardiac output. The baseline cardiac output curve and venous return surface and their changes after volume change would predict new hemodynamics. The invasive methods needed to precisely characterize cardiac output curve and venous return surface led us to aim at estimating cardiac output curve and venous return surface from a single hemodynamic measurement. Using the average values for two logarithmic function parameters, and for two slopes of a surface, we were able to estimate cardiac output curve and venous return surface. The estimated curve and surface predicted new hemodynamics after volume change precisely.

Although central ghrelin has cardioprotective effect through inhibiting sympathetic nerve activity, the effects of central ghrelin on cardiac vagal nerve remain unknown. We investigated the effects of centrally administered ghrelin on cardiac autonomic nerve activities using microdialysis technique. A microdialysis probe was implanted in the right atrial wall adjacent to the sinoatrial node of an anesthetized rabbit and was perfused with Ringer's solution containing a cholinesterase inhibitor, eserine. After injection of ghrelin (1 nmol) into the right lateral cerebral ventricle, norepinephrine (NE) and acetylcholine (ACh) concentrations in the dialysate samples were measured as indices of NE and ACh release from nerve endings to the sinoatrial node using high-performance liquid chromatography. Heart rate was 270±4 bpm at baseline and decreased gradually after ghrelin injection to 234±9 bpm (P0.01) at 60-80 min, followed by gradual recovery. Dialysate ACh concentration was 5.5±0.8 nM at baseline and increased gradually after ghrelin injection to 8.8±1.2 nM (P0.01) at 60-80 min; the concentration started to decrease gradually from 100 to 120 min after injection reaching 5.6±0.8 nM at 160-180 min. Central ghrelin did not change mean arterial pressure or dialysate NE concentration. The elevated dialysate ACh concentration declined rapidly after transection of cervical vagal nerves. These results indicate that centrally administered ghrelin activates cardiac vagal nerve.

One and a half ventricle repair (1.5VR) is a surgical option for hypoplastic right ventricle (RV). The benefits of this procedure compared to biventricular repair (2VR) or Fontan operation remain unsettled. To compare postoperative hemodynamics, we performed a theoretical analysis using a computational model based on lumped-parameter state-variable equations. We varied the RV stiffness constant (B RV) to simulate the various RV hypoplasia, and estimated hemodynamics for a given B RV. With B RV 150%, cardiac output became larger in 1.5VR than in 2VR. With B RV > 250%, RV end-diastolic volume was almost the same between 1.5VR and 2VR, and a rapid increase in atrial pressure precluded the use of 1.5VR. These results indicate that the beneficial effect of 1.5VR depends on the RV stiffness constant. Determination of management strategy should not only be based on the morphologic parameters but also on the physiological properties of RV.

The ultimate goal of disease treatment is to control the biological system beyond the native regulation to combat pathological process. To maximize the advantage of drugs, we attempted to pharmacologically control the biological system at will, e.g., control multiple hemodynamic variables with multiple cardiovascular drugs. A comprehensive physiological cardiovascular model enabled us to evaluate cardiovascular properties (pump function, vascular resistance, and blood volume) and the feedback control of these properties. In 12 dogs, with dobutamine (5+/-3 mug.kg(-1).min(-1)), nitroprusside (4+/-2 mug.kg(-1).min(-1)), dextran (2+/-2 ml.kg(-1)), and furosemide (10 mg in one, 20 mg in one), rapid, sufficient and stable control of pump function, vascular resistance and blood volume resulted in similarly quick and stable control of blood pressure, cardiac output and left atrial pressure in 5+/-7, 7+/-5, and 12+/-10 minutes, respectively. These variables remained stable for 60 minutes (RMS 4+/-3 mmHg, 5+/-2 ml.min(-1).kg(-1), 0.8+/-0.6 mmHg, respectively).

Comprehensive understanding of hemodynamics remains a challenge even for expert cardiologists, partially due to a lack of an appropriate macroscopic model. We attempted to amend three major problems of Guyton's conceptual model (unknown left atrial pressure, unilateral heart damage, blood redistribution) and developed a comprehensive macroscopic model of hemodynamics that provides quantitative information. We incorporated a third axis of left atrial pressure, resulting in a 3D coordinate system. Pump functions of left and right heart are expressed by an integrated cardiac output curve, and the capacitive function of total vasculature by a venous return surface. The equations for both the cardiac output curve and venous return surface would facilitate precise diagnosis (especially evaluation of blood volume) and choice of appropriate treatments, including application to autopilot systems.

Although an acute arterial pressure (AP) elevation induced by intravenous angiotensin II (ANG II) does not inhibit sympathetic nerve activity (SNA) compared to an equivalent AP elevation induced by phenylephrine, there are conflicting reports as to how circulating ANG II affects the baroreflex control of SNA. Because most studies have estimated the baroreflex function under closed-loop conditions, differences in the rate of input pressure change and the magnitude of pulsatility may have biased the estimation results. We examined the effects of intravenous ANG II (10 microg kg(-1) h(-1)) on the open-loop system characteristics of the carotid sinus baroreflex in anesthetized and vagotomized rats. Carotid sinus pressure (CSP) was raised from 60 to 180 mmHg in increments of 20 mmHg every minute, and steady-state responses in systemic AP, splanchnic SNA and heart rate (HR) were analyzed using a four-parameter logistic function. ANG II significantly increased the minimum values of AP (67.6 +/- 4.6 vs. 101.4 +/- 10.9 mmHg, P0.01), SNA (33.3 +/- 5.4 vs. 56.5 +/- 11.5%, P0.05) and HR (391.1 +/- 13.7 vs. 417.4 +/- 11.5 beats/min, P0.01). ANG II, however, did not attenuate the response range for AP (56.2 +/- 7.2 vs. 49.7 +/- 6.2 mmHg), SNA (69.6 +/- 5.7 vs. 78.9 +/- 9.1%) or HR (41.7 +/- 5.1 vs. 51.2 +/- 3.8 beats/min). The maximum gain was not affected for AP (1.57 +/- 0.28 vs. 1.20 +/- 0.25), SNA (1.94 +/- 0.34 vs. 2.04 +/- 0.42%/mmHg) or HR (1.11 +/- 0.12 vs. 1.28 +/- 0.19 beats min(-1) mmHg(-1)). It is concluded that high levels of circulating ANG II did not attenuate the response range of open-loop carotid sinus baroreflex control for AP, SNA or HR in anesthetized and vagotomized rats.

To examine endogenous acetylcholine (ACh) release in the rabbit left ventricle during acute ischemia, ischemic preconditioning and electrical vagal stimulation.We measured myocardial interstitial ACh levels in the rabbit left ventricle using a cardiac microdialysis technique. In Protocol 1 (n=6), the left circumflex coronary artery (LCX) was occluded for 30min and reperfused for 30min. In Protocol 2 (n=5), the LCX was temporarily occluded for 5min. Ten minutes later, the LCX was occluded for 30min and reperfused for 30min. In Protocol 3 (n=5), bilateral efferent vagal nerves were stimulated at 20Hz and 40Hz (10V, 1-ms pulse duration).In Protocol 1, a 30-min coronary occlusion increased the ACh level from 0.39+/-0.15 to 7.0+/-2.2nM (mean+/-SE, P0.01). In Protocol 2, a 5-min coronary occlusion increased the ACh level from 0.33+/-0.07 to 0.75+/-0.11nM (P0.05). The ACh level returned to 0.48+/-0.10nM during the interval. After that, a 30-min coronary occlusion increased the ACh level to 2.4+/-0.49nM (P0.01). In Protocol 3, vagal stimulation at 20Hz and 40Hz increased the ACh level from 0.29+/-0.06 to 1.23+/-0.48 (P0.05) and 2.44+/-1.13nM (P0.01), respectively.Acute ischemia significantly increased the ACh levels in the rabbit left ventricle, which appeared to exceed the vagal stimulation-induced ACh release. Brief ischemia as short as 5min can also increase the ACh level, suggesting that endogenous ACh release can be a trigger for ischemic preconditioning.

We assessed in vivo interstitial norepinephrine (NE) levels at the sinoatrial node in rabbits, using microdialysis technique. A dialysis probe was implanted adjacent to the sinoatrial node of an anesthetized rabbit and dialysate was sampled during sympathetic nerve stimulation. Atrial dialysate NE concentration correlated well with heart rate. Desipramine significantly increased dialysate NE concentrations both before and during sympathetic nerve stimulation compared with the absence of desipramine. However, desipramine did not affect the relation between heart rate and dialysate NE concentration. These results suggest that atrial dialysate NE level reflects the relative change of NE concentration in the synaptic cleft. Microdialysis is a powerful tool to assess in vivo interstitial NE levels at the sinoatrial node.

Many earlier human studies have reported that increasing the tilt angle of head-up tilt (HUT) results in greater muscle sympathetic nerve activity (MSNA) response, indicating the amplitude dependence of sympathetic activation in response to orthostatic stress. However, little is known about whether and how the inclining speed of HUT influences the MSNA response to HUT, independent of the magnitude of HUT. Twelve healthy subjects participated in passive 30 degrees HUT tests at inclining speeds of 1 degrees (control), 0.1 degrees (slow), and 0.0167 degrees (very slow) per second. We recorded MSNA (tibial nerve) by microneurography and assessed nonstationary time-dependent changes of R-R interval variability using a complex demodulation technique. MSNA averaged over every 10 degrees tilt angle increased during inclination from 0 degrees to 30 degrees , with smaller increases in the slow and very slow tests than in the control test. Although a 3-min MSNA overshoot after reaching 30 degrees HUT was observed in the control test, no overshoot was detected in the slow and very slow tests. In contrast with MSNA, increases in heart rate during the inclination and after reaching 30 degrees were similar in these tests, probably because when compared with the control test, greater increases in plasma epinephrine counteracted smaller autonomic responses in the very slow test. These results indicate that slower HUT results in lower activation of MSNA, suggesting that HUT-induced sympathetic activation depends partially on the speed of inclination during HUT in humans.

Presynaptic α2-adrenergic receptors are known to exert feedback inhibition on norepinephrine release from the sympathetic nerve terminals. To elucidate the dynamic characteristics of the inhibition, we stimulated the right cardiac sympathetic nerve according to a binary white noise signal while measuring heart rate (HR) in anesthetized rabbits ( n = 6). We estimated the transfer function from cardiac sympathetic nerve stimulation to HR and the corresponding step response of HR, with and without the blockade of presynaptic inhibition by yohimbine (1 mg/kg followed by 0.1 mg·kg−1·h−1 iv). We also examined the effect of the α2-adrenergic receptor agonist clonidine (0.3 and 1.5 mg·kg−1·h−1 iv) in different rabbits ( n = 5). Yohimbine increased the maximum step response (from 7.2 ± 0.8 to 12.2 ± 1.7 beats/min, means ± SE, P < 0.05) without significantly affecting the initial slope (0.93 ± 0.23 vs. 0.94 ± 0.22 beats·min−1·s−1). Higher dose but not lower dose clonidine significantly decreased the maximum step response (from 6.3 ± 0.8 to 6.8 ± 1.0 and 2.8 ± 0.5 beats/min, P < 0.05) and also reduced the initial slope (from 0.56 ± 0.07 to 0.51 ± 0.04 and 0.22 ± 0.06 beats·min−1·s−1, P < 0.05). Our findings indicate that presynaptic α2-adrenergic autoinhibition limits the maximum response without significantly compromising the rapidity of effector response. In contrast, pharmacologic augmentation of the presynaptic inhibition not only attenuates the maximum response but also results in a sluggish effector response.

Although muscarinic K(+) (K(ACh)) channels contribute to a rapid heart rate (HR) response to vagal stimulation, whether background sympathetic tone affects the HR control via the K(ACh)channels remains to be elucidated. In seven anesthetized rabbits with sinoaortic denervation and vagotomy, we estimated the dynamic transfer function of the HR response by using random binary vagal stimulation (0-10 Hz). Tertiapin, a selective K(ACh) channel blocker, decreased the dynamic gain (to 2.3+/- 0.9 beats.min(-1).Hz(-1), from 4.6+/- 1.1, P < 0.01, mean+/- SD) and the corner frequency (to 0.05+/- 0.01 Hz, from 0.26+/- 0.04, P < 0.01). Under 5 Hz tonic cardiac sympathetic stimulation (CSS), tertiapin decreased the dynamic gain (to 3.6+/- 1.0 beats.min(-1).Hz(-1), from 7.3+/- 1.1, P < 0.01) and the corner frequency (to 0.06+/- 0.02 Hz, from 0.23+/- 0.06, P < 0.01). Two-way analysis of variance indicated significant interaction between the tertiapin and CSS effects on the dynamic gain. In contrast, no significant interactions were observed between the tertiapin and CSS effects on the corner frequency and the lag time. In conclusion, although a cyclic AMP-dependent mechanism has been well established, an accentuated antagonism also occurred in the direct effect of ACh via the K(ACh) channels. The rapidity of the HR response obtained by the K(ACh) channel pathway was robust during the accentuated antagonism.