Acute hyperoxia reveals tonic influence of peripheral chemoreceptors on systemic vascular resistance in heart failure patients

Stanislaw Tubek,Piotr Niewinski,Anna Langner-Hetmanczuk,Waldemar Banasiak,Bartlomiej Paleczny,Piotr Ponikowski

doi:10.1038/s41598-021-99159-2

Stanislaw Tubek, Piotr Niewinski + Show 4 more

Open Access

https://doi.org/10.1038/s41598-021-99159-2

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Journal: Scientific Reports	Publication Date: Oct 21, 2021
Citations: 7	License type: open-access

Affiliation: Wroclaw Medical University

Abstract

Peripheral chemoreceptors’ (PCh) hyperactivity increases sympathetic tone. An augmented acute ventilatory response to hypoxia, being a marker of PCh oversensitivity, was also identified as a marker of poor prognosis in HF. However, not much is known about the tonic (chronic) influence of PCh on cardio-respiratory parameters. In our study 30 HF patients and 30 healthy individuals were exposed to 100% oxygen for 1 min during which minute ventilation and hemodynamic parameters were non-invasively recorded. Systemic vascular resistance (SVR) and mean arterial pressure (MAP) responses to acute hyperoxia differed substantially between HF and control. In HF hyperoxia caused a significant drop in SVR in early stages with subsequent normalization, while increase in SVR was observed in controls. MAP increased in controls, but remained unchanged in HF. Bilateral carotid bodies excision performed in two HF subjects changed the response to hyperoxia towards the course seen in healthy individuals. These differences may be explained by the domination of early vascular reaction to hyperoxia in HF by vasodilation due to the inhibition of augmented tonic activity of PCh. Otherwise, in healthy subjects the vasoconstrictive action of oxygen remains unopposed. The magnitude of SVR change during acute hyperoxia may be used as a novel method for tonic PCh activity assessment.

Highlights

Peripheral chemoreceptors’ (PCh) hyperactivity increases sympathetic tone
The study protocol consisted of two parts: (1) assessment of the effects of acute hyperoxia on hemodynamic and respiratory parameters; (2) evaluation of individual peripheral chemosensitivity to hypoxia (HVR) using transient hypoxia method
There were no significant differences in body mass index (BMI), haemoglobin level, creatinine serum level, heart rate (HR), systemic vascular resistance (SVR) and blood oxygen saturation (SpO2) between studied groups

Summary

Introduction

Peripheral chemoreceptors’ (PCh) hyperactivity increases sympathetic tone. An augmented acute ventilatory response to hypoxia, being a marker of PCh oversensitivity, was identified as a marker of poor prognosis in HF. Bilateral carotid bodies excision performed in two HF subjects changed the response to hyperoxia towards the course seen in healthy individuals. These differences may be explained by the domination of early vascular reaction to hyperoxia in HF by vasodilation due to the inhibition of augmented tonic activity of PCh. Otherwise, in healthy subjects the vasoconstrictive action of oxygen remains unopposed. In humans with HFrEF, stimulation of PCh with hypoxia increases sympathetic tone—measured directly with muscle sympathetic nerve activity (MSNA)[5] Oversensitivity of these structures, defined as exaggerated ventilatory response to transient PCh activation with hypoxia (hypoxic ventilatory response—HVR), is a welldefined independent factor for poor prognosis in HFrEF6. PCh surgical excision significantly reduces sympathetic activity, assessed with MSNA, in pre-selected HFrEF patients[8]

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