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Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Aug 2022Heart failure (HF) is the endstage of multiple cardiovascular diseases.Impaired autonomic regulation and sympathetic-parasympathetic imbalance are considered key factors... (Review)
Review
Heart failure (HF) is the endstage of multiple cardiovascular diseases.Impaired autonomic regulation and sympathetic-parasympathetic imbalance are considered key factors in HF progression.Baroreflex activation therapy (BAT),a novel device-based therapy which stimulates the carotid sinuses and regulates autonomic function,has demonstrated good efficacy in treating HF and improving prognosis.This review summarized the results of the latest relevant studies to provide support for further study of BAT.
Topics: Baroreflex; Heart Failure; Humans
PubMed: 36065707
DOI: 10.3881/j.issn.1000-503X.13998 -
Hypertension Research : Official... Aug 2018Hypertension has strong adverse effects on cardiovascular diseases, and increased blood pressure (BP) variability (BPV) is closely associated with the development of... (Review)
Review
Hypertension has strong adverse effects on cardiovascular diseases, and increased blood pressure (BP) variability (BPV) is closely associated with the development of hypertensive organ injuries and the occurrence of cardiovascular diseases. Similar to other forms of BPV, short-term beat-to-beat BPV has also been established as a risk factor for cardiovascular diseases. Baroreflex failure is the major mechanism involved in the pathophysiology of short-term beat-to-beat BPV. Previous clinical and animal studies have demonstrated that baroreflex failure disrupted beat-to-beat BPV and hypertensive organ damage. Moreover, short-term beat-to-beat BPV was an independent determinant of vascular elasticity. Although, the clinical measurement tools and therapeutics for beat-to-beat BPV are not sufficient, we should consider that large beat-to-beat BPV is an important risk factor for cardiovascular diseases in patients with hypertension.
Topics: Baroreflex; Blood Pressure; Heart Rate; Humans; Hypertension
PubMed: 29880837
DOI: 10.1038/s41440-018-0056-y -
The Journal of Physiological Sciences :... Nov 2019This brief review summarizes the current knowledge on sex differences in baroreflex function, with a major focus on studies in humans. It has been demonstrated that... (Review)
Review
This brief review summarizes the current knowledge on sex differences in baroreflex function, with a major focus on studies in humans. It has been demonstrated that healthy women have blunted cardiovagal baroreflx sensitivity during a rapid (i.e., within seconds) hypertensive stimulus, but baroreflex sensitivity is similar between the sexes during a hypotensive stimulus. Normal aging decreases cardiovagal baroreflex sensitivity and the rate of decline is similar in men and women. Cardiovagal baroreflex sensitivity is reduced in pathological conditions such as hypertension and type II diabetes, and the reduction is greater in female patients than male patients. There is no clear sex difference in sympathetic baroreflex sensitivity among young individuals, however, with women of more advanced age, sympathetic baroreflex sensitivity decreases, which appears to be associated with greater arterial stiffness compared with similarly aged men. The blunted sympathetic baroreflex sensitivity in older women may predispose them to an increased prevalence of hypertension and cardiovascular disease.
Topics: Aging; Baroreflex; Cardiovascular Diseases; Female; Humans; Male; Sex Factors; Sympathetic Nervous System
PubMed: 31721084
DOI: 10.1007/s12576-019-00727-z -
European Journal of Heart Failure Sep 2022
Topics: Baroreflex; Blood Pressure; Electric Stimulation Therapy; Heart Failure; Heart Rate; Humans
PubMed: 35851979
DOI: 10.1002/ejhf.2627 -
Journal of Cardiovascular... Sep 1995Baroreflex sensitivity (BRS) has rapidly gained considerable attention as a result of multiple experimental and clinical reports on its prognostic value after a... (Review)
Review
Baroreflex sensitivity (BRS) has rapidly gained considerable attention as a result of multiple experimental and clinical reports on its prognostic value after a myocardial infarction. This article reviews the several aspects related to the use and significance of BRS. The methodology of baroreflex testing in man is described. The complex pathophysiology underlying BRS and the hypotheses proposed to explain its frequent reduction after a myocardial infarction are discussed. The section on experimental data also provides a rationale to understand the relation between increased vagal activity and reduced propensity for ventricular fibrillation. The article focuses largely on the clinical studies relating BRS and risk of cardiac mortality and also discusses the several attempts to modify this marker of reflex vagal activation.
Topics: Animals; Baroreflex; Coronary Disease; Humans; Prognosis
PubMed: 8556196
DOI: 10.1111/j.1540-8167.1995.tb00452.x -
Future Cardiology May 2020Endovascular baroreflex amplification is an alternative treatment strategy for patients with resistant hypertension. In endovascular baroreflex, the carotid baroreflex... (Review)
Review
Endovascular baroreflex amplification is an alternative treatment strategy for patients with resistant hypertension. In endovascular baroreflex, the carotid baroreflex is activated by a MobiusHD device (MD) which has been implanted in the internal carotid artery. This review will discuss the MD technology and mechanism of action and promising results in the first-in-human prospective study involving the use of the MD in patients with resistant hypertension.
Topics: Antihypertensive Agents; Baroreflex; Blood Pressure; Humans; Hypertension
PubMed: 32048879
DOI: 10.2217/fca-2020-0003 -
Duodecim; Laaketieteellinen... 2016Baroreceptors are sensory nerve endings in the carotid sinuses and the aortic arch. Notably, a dysfunction in the autonomic nervous system (sympathetic hyperactivity)... (Review)
Review
Baroreceptors are sensory nerve endings in the carotid sinuses and the aortic arch. Notably, a dysfunction in the autonomic nervous system (sympathetic hyperactivity) has been shown to be part of the pathophysiology of chronic hypertension. Baroreflex activation therapy is an invasive treatment modality to decrease blood pressure by stimulating baroreceptors in the wall of the carotid sinus. Preliminary results of baroreflex activation therapy in resistant hypertension and systolic heart failure have been promising. If its effect can be proven in controlled studies, it may serve as an important new tool in the treatment of patients with resistant hypertension at a high risk of cardiovascular complications.
Topics: Baroreflex; Carotid Sinus; Drug Resistance; Electric Stimulation Therapy; Humans; Hypertension
PubMed: 29190040
DOI: No ID Found -
Physiology (Bethesda, Md.) Mar 2015Because of resetting, a role for baroreflexes in long-term control of arterial pressure has been commonly dismissed in the past. However, in recent years, this... (Review)
Review
Because of resetting, a role for baroreflexes in long-term control of arterial pressure has been commonly dismissed in the past. However, in recent years, this perspective has changed. Novel approaches for determining chronic neurohormonal and cardiovascular responses to natural variations in baroreceptor activity and to electrical stimulation of the carotid baroreflex indicate incomplete resetting and sustained responses that lead to long-term alterations in sympathetic activity and arterial pressure.
Topics: Animals; Antihypertensive Agents; Arterial Pressure; Baroreflex; Cardiovascular System; Homeostasis; Humans; Hypertension; Mechanotransduction, Cellular; Models, Cardiovascular; Obesity; Pressoreceptors; Renin-Angiotensin System; Time Factors
PubMed: 25729060
DOI: 10.1152/physiol.00035.2014 -
Acta Physiologica (Oxford, England) Jun 2014The arterial baroreflex is critical to both short- and long-term regulation of blood pressure. However, human baroreflex research has been largely limited to the... (Review)
Review
The arterial baroreflex is critical to both short- and long-term regulation of blood pressure. However, human baroreflex research has been largely limited to the association between blood pressure and cardiac period (or heart rate) or indices of vascular sympathetic function. Over the past decade, emerging techniques based on carotid ultrasound imaging have allowed new means of understanding and measuring the baroreflex. In this review, we describe the assessment of the mechanical and neural components of the baroreflex through the use of carotid ultrasound imaging. The mechanical component refers to the change in carotid artery diameter in response to changes in arterial pressure, and the neural component refers to the change in R-R interval (cardiac baroreflex) or muscle sympathetic nerve activity (sympathetic baroreflex) in response to this barosensory vessel stretch. The key analytical concepts and techniques are discussed, with a focus on the assessment of baroreflex sensitivity via the modified Oxford method. We illustrate how the application of carotid ultrasound imaging has contributed to a greater understanding of baroreflex physiology in humans, covering topics such as ageing and diurnal variation, and physiological challenges including exercise, postural changes and mental stress.
Topics: Baroreflex; Carotid Arteries; Humans; Ultrasonography
PubMed: 24739079
DOI: 10.1111/apha.12302 -
American Journal of Physiology.... Oct 2002The arterial baroreflex contributes importantly to the short-term regulation of blood pressure and cardiovascular variability. A number of factors (including reflex,... (Review)
Review
The arterial baroreflex contributes importantly to the short-term regulation of blood pressure and cardiovascular variability. A number of factors (including reflex, humoral, behavioral, and environmental) may influence gain and effectiveness of the baroreflex, as well as cardiovascular variability. Many central neural structures are also involved in the regulation of the cardiovascular system and contribute to the integrity of the baroreflex. Consequently, brain injuries or ischemia may induce baroreflex impairment and deranged cardiovascular variability. Baroreflex dysfunction and deranged cardiovascular variability are also common findings in cardiovascular disease. A blunted baroreflex gain and impaired heart rate variability are predictive of poor outcome in patients with heart failure and myocardial infarction and may represent an early index of autonomic activation in left ventricular dysfunction. The mechanisms mediating these relationships are not well understood and may in part be the result of cardiac structural changes and/or altered central neural processing of baroreflex signals.
Topics: Animals; Arteries; Baroreflex; Brain; Cardiovascular Diseases; Cardiovascular Physiological Phenomena; Humans
PubMed: 12228049
DOI: 10.1152/ajpregu.00051.2002