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Advances in Physiology Education Jun 2022While the effects of changing heart rate and systemic vascular resistance have been generally understood and appreciated, the effects of changes in left ventricular... (Review)
Review
While the effects of changing heart rate and systemic vascular resistance have been generally understood and appreciated, the effects of changes in left ventricular contractility on end-systolic volume may have been less understood and appreciated and the effects of changes in venous capacitance on end-diastolic volume may have been unknown to many readers. Herein, we have provided a brief review for the medical student and beginning graduate student highlighting these sometimes-complex relationships.
Topics: Blood Pressure; Heart Rate; Heart Ventricles; Humans; Pressoreceptors; Vascular Resistance
PubMed: 35201919
DOI: 10.1152/advan.00160.2021 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Nov 2021With the continuous updating of head and neck surgery concepts and techniques, more and more head and neck surgeries are developing in the direction of... (Review)
Review
With the continuous updating of head and neck surgery concepts and techniques, more and more head and neck surgeries are developing in the direction of refinement.however, the more complete the surgery, the greater the possibility of subsequent nerve exposure and injury. Even a slight perturbation of the nerve may cause serious complications, such as pressure receptor failure.It is necessary to review the mechanisms and the characteristics of baroreceptor failure syndrome after head and neck tumor surgery.
Topics: Head; Head and Neck Neoplasms; Humans; Neck; Postoperative Complications; Pressoreceptors
PubMed: 34886615
DOI: 10.13201/j.issn.2096-7993.2021.11.020 -
Trends in Cardiovascular Medicine Oct 2020Atrial fibrillation (AF) is a rapidly growing clinical problem in routine practice, both for cardiologists as well as general practitioners. Current therapies aimed at... (Review)
Review
Atrial fibrillation (AF) is a rapidly growing clinical problem in routine practice, both for cardiologists as well as general practitioners. Current therapies aimed at the management of AF include anti-arrhythmic drug therapy and catheter ablation. These therapies have a number of limitations and risks, and have disappointing long-term efficacy in maintaining sinus rhythm and improving hard clinical outcomes. Because of this, there is growing interest in pursuing alternative management strategies in patients with AF. This review seeks to highlight emerging AF therapies, with a specific focus on several modalities aimed at modulation of the autonomic nervous system. These therapies have shown promise in early pre-clinical and clinical trials, and represent exciting alternatives to standard AF treatment.
Topics: Animals; Atrial Fibrillation; Autonomic Nervous System; Baroreflex; Heart Atria; Heart Rate; Humans; Kidney; Magnetic Field Therapy; Pressoreceptors; Recovery of Function; Renal Artery; Sympathectomy; Treatment Outcome; Vagus Nerve Stimulation
PubMed: 31708408
DOI: 10.1016/j.tcm.2019.10.009 -
Neuroscience Bulletin Feb 2019Clinical trials and animal experimental studies have demonstrated an association of arterial baroreflex impairment with the prognosis and mortality of cardiovascular... (Review)
Review
Clinical trials and animal experimental studies have demonstrated an association of arterial baroreflex impairment with the prognosis and mortality of cardiovascular diseases and diabetes. As a primary part of the arterial baroreflex arc, the pressure sensitivity of arterial baroreceptors is blunted and involved in arterial baroreflex dysfunction in cardiovascular diseases and diabetes. Changes in the arterial vascular walls, mechanosensitive ion channels, and voltage-gated ion channels contribute to the attenuation of arterial baroreceptor sensitivity. Some endogenous substances (such as angiotensin II and superoxide anion) can modulate these morphological and functional alterations through intracellular signaling pathways in impaired arterial baroreceptors. Arterial baroreceptors can be considered as a potential therapeutic target to improve the prognosis of patients with cardiovascular diseases and diabetes.
Topics: Animals; Baroreflex; Blood Pressure; Cardiovascular Diseases; Diabetes Mellitus; Humans; Ion Channels; Pressoreceptors
PubMed: 30146675
DOI: 10.1007/s12264-018-0274-y -
Reviews in Cardiovascular Medicine Sep 2018The search of alternative methods for improving clinical management and outcomes of individuals affected by resistant hypertension has become a true health priority. In... (Review)
Review
The search of alternative methods for improving clinical management and outcomes of individuals affected by resistant hypertension has become a true health priority. In this review, we aimed at providing a timely overview and evidence synthesis on baroreflex activation therapy (BAT) and endovascular baroreflex amplification (EBA), two device-based therapies which rely on the principle of lowering blood pressure by stimulating the carotid baroreflex to decrease the sympathetic and enhance the parasympathetic activity. In resistant forms of arterial hypertension, accruing evidence has confirmed the capacity of these techniques to improve blood pressure control and to reduce the amount of anti-hypertensive therapy at cost of few side effects. Future results from ongoing randomized sham-controlled trials are eagerly awaited to best define the efficacy, safety and durability of effects in the long term before such an invasive approach may be considered as a suitable option in daily clinical practice.
Topics: Animals; Antihypertensive Agents; Baroreflex; Blood Pressure; Drug Resistance; Electric Stimulation Therapy; Humans; Hypertension; Implantable Neurostimulators; Pressoreceptors; Treatment Outcome
PubMed: 31054557
DOI: 10.31083/j.rcm.2018.03.3185 -
Der Anaesthesist Sep 2015Baroreceptor stimulators are novel implantable devices that activate the carotid baroreceptor reflex. This results in a decrease in activity of the sympathetic nervous... (Review)
Review
Baroreceptor stimulators are novel implantable devices that activate the carotid baroreceptor reflex. This results in a decrease in activity of the sympathetic nervous system and inhibition of the renin-angiotensin-aldosterone system. In patients with drug-resistant hypertension, permanent electrical activation of the baroreceptor reflex results in blood pressure reduction and cardiac remodeling. For correct intraoperative electrode placement at the carotid bifurcation, the baroreceptor reflex needs to be activated several times. Many common anesthetic agents, such as inhalation anesthetics and propofol dampen or inhibit the baroreceptor reflex and complicate or even prevent successful placement. Therefore, a specific anesthesia and pharmacological management is necessary to ensure successful implantation of baroreceptor reflex stimulators.
Topics: Anesthesia; Baroreflex; Electric Stimulation Therapy; Electrodes, Implanted; Humans; Pressoreceptors; Prosthesis Implantation
PubMed: 26275386
DOI: 10.1007/s00101-015-0061-3 -
The Canadian Journal of Cardiology May 2020The sympathetic nervous system plays a pivotal role in the long-term regulation of arterial blood pressure through the ability of the central nervous system to integrate... (Review)
Review
The sympathetic nervous system plays a pivotal role in the long-term regulation of arterial blood pressure through the ability of the central nervous system to integrate neurohumoral signals and differentially regulate sympathetic neural input to specific end organs. Part 1 of this review will discuss neural mechanisms of salt-sensitive hypertension, obesity-induced hypertension, and the ability of prior experiences to sensitize autonomic networks. Part 2 of this review focuses on new therapeutic advances to treat resistant hypertension including renal denervation and carotid baroactivation. Both advances lower arterial blood pressure by reducing sympathetic outflow. We discuss potential mechanisms and areas of future investigation to target the sympathetic nervous system.
Topics: Animals; Autonomic Pathways; Baroreflex; Humans; Hypertension; Kidney; Obesity; Pressoreceptors; Sodium, Dietary; Sympathectomy; Sympathetic Nervous System
PubMed: 32389344
DOI: 10.1016/j.cjca.2020.03.003 -
Wiener Medizinische Wochenschrift (1946) Dec 2014The Barostim neo ™ system is a novel implantable device that activates the carotid baroreflex. It decreases the sympathetic activity and inhibits the renin system,...
The Barostim neo ™ system is a novel implantable device that activates the carotid baroreflex. It decreases the sympathetic activity and inhibits the renin system, which results in reduced blood pressure and heart rate. In patients with resistant hypertension, electrically activation of the baroreflex leads to an average decrease in systolic blood pressure of 38, 36, 40 and 53 mmHg at 1, 2, 3 and 4 years, respectively. Additionally, cardiac remodelling with reduced left ventricular mass and posterior wall thickness has been observed in long-term studies. In a limited number of patients with heart failure, baroreflex activation therapy leads to a decrease in muscle sympathetic nerve activity and to improved quality of life and functional capacities. The implantation procedure is safe and associated with risks comparable with those of other active implantable devices. Barostim neo is currently available in several European countries.
Topics: Baroreflex; Blood Pressure; Carotid Sinus; Electric Stimulation Therapy; Electrodes, Implanted; Equipment Design; Heart Failure; Heart Rate; Humans; Hypertension; Pressoreceptors; Software; Sympathetic Nervous System; Telemetry
PubMed: 25411011
DOI: 10.1007/s10354-014-0329-2 -
JACC. Heart Failure Oct 2015Heart failure (HF) represents a significant and expanding public health burden associated with increasing prevalence and exponential growth in related health care costs.... (Review)
Review
Heart failure (HF) represents a significant and expanding public health burden associated with increasing prevalence and exponential growth in related health care costs. Contemporary advances in both pharmacological and nonpharmacological therapies have often been restricted in application and benefit. Given the critical role of the autonomic nervous system (ANS) in maintaining cardiovascular homeostasis in the failing heart, there has been increasing interest in the role of ANS modulation as a therapeutic modality in HF. In this review, we highlight the anatomy of the ANS and its role in the pathophysiology of HF, as well as metrics of its assessment. Given the limitations associated with pharmacological ANS modulation, including lack of specificity and medication intolerance, we focus in this review on contemporary nonpharmacological ANS modulation therapies. For each therapy-vagal nerve stimulation, carotid baroreceptor stimulation, spinal cord stimulation, and renal denervation-we review the rationale for modulation, pre-clinical and clinical assessments, as well as procedural considerations and limitations. We conclude by commenting on novel technologies and strategies for ANS modulation on the horizon.
Topics: Acute Disease; Autonomic Nervous System; Baroreflex; Carotid Sinus; Chronic Disease; Complementary Therapies; Electric Stimulation Therapy; Female; Forecasting; Heart; Heart Failure; Humans; Male; Pressoreceptors; Risk Assessment; Spinal Cord Stimulation; Sympathectomy; Treatment Outcome; Vagus Nerve Stimulation
PubMed: 26364257
DOI: 10.1016/j.jchf.2015.05.008