Abstract
Among the many cardiopulmonary reflexes, this review specifically examines the roles of the arterial baroreflex during the Bezold-Jarisch reflex (BJR). Activation of cardiopulmonary vagal afferent C-fibers induces hypotension, bradycardia, and apnea, which are known collectively as the BJR; myocardial ischemia and infarction might induce the BJR. Arterial baroreflex has been established as an important negative feedback system that stabilizes arterial blood pressure against exogenous pressure perturbations. Therefore, understanding the functions of the arterial baroreflex during the BJR is crucial for elucidating its pathophysiological implications. The main central pathways of the BJR and the baroreflex are outlined herein, particularly addressing the common pathway between the reflexes. Furthermore, the pathophysiological roles of the arterial baroreflex during the BJR are described along with a brief discussion of pathophysiological merits and shortcomings of the reflexes.
Highlights
Cardiorespiratory responses showing bradycardia, hypotension, and apnea through cardiopulmonary vagal afferent C fibers are known as the Bezold-Jarisch reflex (BJR)
The sympathetic outflow in the baroreflex mainly passes through the brainstem such as the nucleus tractus solitarius (NTS), the caudal ventrolateral medulla (CVLM), and the rostral ventrolateral medulla (RVLM) [27, 35]
This report reviewed the baroreflex capability during the BJR that might be induced in myocardial ischemia or infarction
Summary
Cardiorespiratory responses showing bradycardia, hypotension, and apnea through cardiopulmonary vagal afferent C fibers are known as the Bezold-Jarisch reflex (BJR). This reflex was observed initially subsequent to intravenous injection of veratrum alkaloids [1, 2]. Activation of the cardiopulmonary vagal afferent fibers during the BJR blunts efferent sympathetic nerve activity (SNA), thereby engendering hypotension and bradycardia [3,4,5]. It has been established that this reflex originates mainly in the cardiopulmonary receptors on the unmyelinated and type C vagal afferent fibers [11,12,13,14,15,16]. This paper examines 1) the interactive roles of arterial baroreflex during the BJR, including 2) the common central pathways between the reflexes and 3) the pathophysiological roles of the BJR in acute myocardial ischemia
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