title: Differential reflex control of forearm and calf resistance vessels by chemosensitive cardiac afferent activation.
abstract: The aim of this study was to determine whether chemosensitive ventricular afferent activation in humans evokes a diffuse pattern of reflex vasodilation involving the skeletal muscle circulation of all the extremities or a highly specified pattern of vasodilation that is limited to the rather small vascular bed of the forearm. In 10 patients with innervated ventricles and 7 patients with denervated ventricles resulting from heart transplantation, we performed simultaneous plethysmographic recordings of blood flow in the forearm and calf during chemosensitive ventricular afferent activation with intracoronary Renografin. In patients with innervated ventricles, intracoronary Renografin evoked directionally opposite vascular responses in the forearm and calf: forearm resistance decreased from 50 +/- 11 to 31 +/- 8 units, whereas calf resistance increased from 42 +/- 7 to 59 +/- 9 units (P < 0.05, calf vs. forearm). Forearm vasodilation was eliminated after heart transplantation, indicating that this is a reflex response caused by ventricular afferents. In contrast, calf vasoconstriction was well preserved despite ventricular deafferentation, indicating that this response is caused by mechanisms other than ventricular afferent activation, possibly the sinoaortic baroreceptors. Taken together, these findings document a remarkable degree of specificity in the effects of cardiac afferent activation on the reflex regulation of regional vasomotor tone in humans.
authors.affiliation: Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9034.
authors.forename: T N
authors.initials: TN
authors.lastname: Jacobsen
authors.forename: R A
authors.initials: RA
authors.lastname: Lange
authors.forename: M T
authors.initials: MT
authors.lastname: Olivari
authors.forename: C W
authors.initials: CW
authors.lastname: Yancy
authors.forename: V P
authors.initials: VP
authors.lastname: Horn
authors.forename: W S
authors.initials: WS
authors.lastname: Ring
authors.forename: B J
authors.initials: BJ
authors.lastname: Baldwin
authors.forename: R A
authors.initials: RA
authors.lastname: Cooley
authors.forename: R G
authors.initials: RG
authors.lastname: Victor
mesh_terms: D000328:Adult; D000368:Aged; D002628:Chemoreceptor Cells / Q000187:drug effects / Q000502:physiology*; D017023:Coronary Angiography; D003331:Coronary Vessels; D003974:Diatrizoate Meglumine / Q000494:pharmacology; D005260:Female; D005542:Forearm / Q000098:blood supply* / Q000502:physiology; D006321:Heart / Q000187:drug effects / Q000294:innervation / Q000502:physiology*; D006339:Heart Rate / Q000187:drug effects; D006352:Heart Ventricles / Q000294:innervation; D006801:Humans; D007275:Injections, Intravenous; D007866:Leg / Q000098:blood supply* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009121:Muscle Denervation; D009475:Neurons, Afferent / Q000187:drug effects / Q000502:physiology*; D010991:Plethysmography; D012018:Reflex / Q000187:drug effects / Q000502:physiology*; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology*; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D016276:Ventricular Function
chemical_list: D003974:Diatrizoate Meglumine