Tethering role of the autonomic nervous system on cardioventilatory coupling

•Positive pressure ventilation with changes of volemia affect the autonomic control of hemodynamics and the preload of left cardiac chambers.•Correction of hypovolemia increases the vagal outflow leaving unchanged the sympathetic modulation and enhances the baroreflex sensitivity.•Cardioventilatory...

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Published inRespiratory physiology & neurobiology Vol. 279; p. 103466
Main Authors Colombo, Riccardo, Wu, Maddalena Alessandra, Perotti, Andrea, Saia, Laura, Fossali, Tommaso, Ottolina, Davide, Borghi, Beatrice, Castelli, Antonio, Rech, Roberto, Cogliati, Chiara, Catena, Emanuele
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LanguageEnglish
Published Netherlands Elsevier B.V 01.08.2020
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Abstract •Positive pressure ventilation with changes of volemia affect the autonomic control of hemodynamics and the preload of left cardiac chambers.•Correction of hypovolemia increases the vagal outflow leaving unchanged the sympathetic modulation and enhances the baroreflex sensitivity.•Cardioventilatory coupling is affected by both volemia and ventilatory mode mainly in the respiratory driven frequencies. Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Correction of hypovolemia, raising cardiac preload, produced an increase in high-frequency spectral power density of heart rate, left low-frequency spectral power density unchanged but enhanced baroreflex sensitivity. Cardioventilatory coupling was affected by both central blood volume and ventilatory mode and was mainly entrained by the respiratory oscillation. In conclusion, the autonomic nervous system and baroreflex have a significant role in compensating the hemodynamic perturbation due to changes of volemia and ventilatory-induced fluctuations of venous return. They exert an integrative function on the adaptive pattern of cardioventilatory coupling.
AbstractList Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Correction of hypovolemia, raising cardiac preload, produced an increase in high-frequency spectral power density of heart rate, left low-frequency spectral power density unchanged but enhanced baroreflex sensitivity. Cardioventilatory coupling was affected by both central blood volume and ventilatory mode and was mainly entrained by the respiratory oscillation. In conclusion, the autonomic nervous system and baroreflex have a significant role in compensating the hemodynamic perturbation due to changes of volemia and ventilatory-induced fluctuations of venous return. They exert an integrative function on the adaptive pattern of cardioventilatory coupling.Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Correction of hypovolemia, raising cardiac preload, produced an increase in high-frequency spectral power density of heart rate, left low-frequency spectral power density unchanged but enhanced baroreflex sensitivity. Cardioventilatory coupling was affected by both central blood volume and ventilatory mode and was mainly entrained by the respiratory oscillation. In conclusion, the autonomic nervous system and baroreflex have a significant role in compensating the hemodynamic perturbation due to changes of volemia and ventilatory-induced fluctuations of venous return. They exert an integrative function on the adaptive pattern of cardioventilatory coupling.
•Positive pressure ventilation with changes of volemia affect the autonomic control of hemodynamics and the preload of left cardiac chambers.•Correction of hypovolemia increases the vagal outflow leaving unchanged the sympathetic modulation and enhances the baroreflex sensitivity.•Cardioventilatory coupling is affected by both volemia and ventilatory mode mainly in the respiratory driven frequencies. Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Correction of hypovolemia, raising cardiac preload, produced an increase in high-frequency spectral power density of heart rate, left low-frequency spectral power density unchanged but enhanced baroreflex sensitivity. Cardioventilatory coupling was affected by both central blood volume and ventilatory mode and was mainly entrained by the respiratory oscillation. In conclusion, the autonomic nervous system and baroreflex have a significant role in compensating the hemodynamic perturbation due to changes of volemia and ventilatory-induced fluctuations of venous return. They exert an integrative function on the adaptive pattern of cardioventilatory coupling.
Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and resulting cardioventilatory coupling is poorly understood even in healthy humans. We explored heart rate variability, baroreflex activity, and their interaction in an experimental protocol involving twelve mildly hypovolemic healthy subjects during spontaneous breathing and noninvasive positive-pressure ventilation. In seven subjects, an echocardiographic assessment was also performed. Correction of hypovolemia, raising cardiac preload, produced an increase in high-frequency spectral power density of heart rate, left low-frequency spectral power density unchanged but enhanced baroreflex sensitivity. Cardioventilatory coupling was affected by both central blood volume and ventilatory mode and was mainly entrained by the respiratory oscillation. In conclusion, the autonomic nervous system and baroreflex have a significant role in compensating the hemodynamic perturbation due to changes of volemia and ventilatory-induced fluctuations of venous return. They exert an integrative function on the adaptive pattern of cardioventilatory coupling.
ArticleNumber 103466
Author Colombo, Riccardo
Saia, Laura
Castelli, Antonio
Cogliati, Chiara
Borghi, Beatrice
Fossali, Tommaso
Ottolina, Davide
Rech, Roberto
Catena, Emanuele
Wu, Maddalena Alessandra
Perotti, Andrea
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  givenname: Maddalena Alessandra
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  organization: Department of Internal Medicine, ASST Fatebenefratelli Sacco, “Luigi Sacco” Hospital – Polo Universitario - University of Milan, Via G.B. Grassi 74, 20157 Milan, Italy
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  givenname: Andrea
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  givenname: Davide
  surname: Ottolina
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  givenname: Beatrice
  surname: Borghi
  fullname: Borghi, Beatrice
  organization: Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital – Polo Universitario, University of Milan, Milan, Italy
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  givenname: Roberto
  surname: Rech
  fullname: Rech, Roberto
  organization: Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital – Polo Universitario, University of Milan, Milan, Italy
– sequence: 10
  givenname: Chiara
  surname: Cogliati
  fullname: Cogliati, Chiara
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  givenname: Emanuele
  surname: Catena
  fullname: Catena, Emanuele
  organization: Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital – Polo Universitario, University of Milan, Milan, Italy
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Keywords Cardioventilatory coupling
Ventilation
Autonomic nervous system
Hypovolemia
Baroreflex
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Snippet •Positive pressure ventilation with changes of volemia affect the autonomic control of hemodynamics and the preload of left cardiac chambers.•Correction of...
Hypovolemia and intermittent positive pressure ventilation are conditions that frequently characterize the state of critical illness, but their interaction and...
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SubjectTerms Autonomic nervous system
Baroreflex
Cardioventilatory coupling
Hypovolemia
Ventilation
Title Tethering role of the autonomic nervous system on cardioventilatory coupling
URI https://www.clinicalkey.com/#!/content/1-s2.0-S1569904820301245
https://dx.doi.org/10.1016/j.resp.2020.103466
https://www.ncbi.nlm.nih.gov/pubmed/32454241
https://www.proquest.com/docview/2407312008
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