Abstract

BackgroundSympathetic hyperactivity may be related to left ventricular (LV) dysfunction and baro- and chemoreflex impairment in hypertension. However, cardiac function, regarding the association of hypertension and baroreflex dysfunction, has not been previously evaluated by transesophageal echocardiography (TEE) using intracardiac echocardiographic catheter.Methods and ResultsWe evaluated exercise tests, baroreflex sensitivity and cardiovascular autonomic control, cardiac function, and biventricular invasive pressures in rats 10 weeks after sinoaortic denervation (SAD). The rats (n = 32) were divided into 4 groups: 16 Wistar (W) with (n = 8) or without SAD (n = 8) and 16 spontaneously hypertensive rats (SHR) with (n = 8) or without SAD (SHRSAD) (n = 8). Blood pressure (BP) and heart rate (HR) did not change between the groups with or without SAD; however, compared to W, SHR groups had higher BP levels and BP variability was increased. Exercise testing showed that SHR had better functional capacity compared to SAD and SHRSAD. Echocardiography showed left ventricular (LV) concentric hypertrophy; segmental systolic and diastolic biventricular dysfunction; indirect signals of pulmonary arterial hypertension, mostly evident in SHRSAD. The end-diastolic right ventricular (RV) pressure increased in all groups compared to W, and the end-diastolic LV pressure increased in SHR and SHRSAD groups compared to W, and in SHRSAD compared to SAD.ConclusionsOur results suggest that baroreflex dysfunction impairs cardiac function, and increases pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of hypertensive cardiac disease. Moreover, TEE is a useful and feasible noninvasive technique that allows the assessment of cardiac function, particularly RV indices in this model of cardiac disease.

Highlights

  • The arterial baroreflex (ABR) system is one of the most powerful and rapidly acting mechanisms for controlling blood pressure (BP) and heart rate (HR)

  • Our results suggest that baroreflex dysfunction impairs cardiac function, and increases pulmonary artery pressure, supporting a role for baroreflex dysfunction in the pathogenesis of hypertensive cardiac disease

  • transesophageal echocardiography (TEE) is a useful and feasible noninvasive technique that allows the assessment of cardiac function, right ventricular (RV) indices in this model of cardiac disease

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Summary

Introduction

The arterial baroreflex (ABR) system is one of the most powerful and rapidly acting mechanisms for controlling blood pressure (BP) and heart rate (HR). Sympathetic hyperactivity seems to be related to baro- and chemoreflex impairment and left ventricular (LV) dysfunction. Previous studies have shown that traditional SAD may induce persistent high blood pressure variability (BPV) and mild LV hypertrophy, without an increase in mean BP [2,3]. In this model, right ventricular (RV) hypertrophy secondary to pulmonary hypertension has been shown [4]. Cardiac function, regarding the association of hypertension and baroreflex dysfunction, has not been previously evaluated by transesophageal echocardiography (TEE) using intracardiac echocardiographic catheter

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