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Am J Physiol Heart Circ Physiol 281: H1274-H1279, 2001;
0363-6135/01 $5.00
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Vol. 281, Issue 3, H1274-H1279, September 2001

Central volume expansion is pivotal for sustained decrease in heart rate during seated to supine posture change

Bettina Pump1, Tsutomu Kamo4, Anders Gabrielsen1, Peter Bie2, Niels Juel Christensen3, and Peter Norsk1

1 Danish Aerospace Medical Centre of Research, Rigshospitalet 7805, DK-2200 Copenhagen; 2 Department of Physiology, University of Odense, DK-5000 Odense C; 3 Department of Internal Medicine and Endocrinology, Herlev Hospital, DK-2730 Herlev, Denmark; and 4 Neurology Division, St. Marianna University, Kanagawa, 216-8511 Kawasaki, Japan

During prolonged, static carotid baroreceptor stimulation by neck suction (NS) in seated humans, heart rate (HR) decreases acutely and thereafter gradually increases. This increase has been explained by carotid baroreceptor adaptation and/or buffering by aortic reflexes. During a posture change from seated to supine (Sup) with similar carotid stimulation, however, the decrease in HR is sustained. To investigate whether this discrepancy is caused by changes in central blood volume, we compared (n = 10 subjects) the effects of 10 min of seated NS (adjusted to simulate carotid stimulation of a posture change), a posture change from seated to Sup, and the same posture change with left atrial (LA) diameter maintained unchanged by lower body negative pressure (Sup + LBNP). During Sup, the prompt decreases in HR and mean arterial pressure (MAP) were sustained. HR decreased similarly within 30 s of NS (65 ± 2 to 59 ± 2 beats/min) and Sup + LBNP (65 ± 2 to 58 ± 2 beats/min) and thereafter gradually increased to values of seated. MAP decreased similarly within 5 min during Sup + LBNP and NS (by 7 ± 1 to 9 ± 1 mmHg) and thereafter tended to increase toward values of seated subjects. Arterial pulse pressure was increased the most by Sup, less so by Sup + LBNP, and was unchanged by NS. LA diameter was only increased by Sup. In conclusion, static carotid baroreceptor stimulation per se causes the acute (<30 s) decrease in HR during a posture change from seated to Sup, whereas the central volume expansion (increased LA diameter and/or arterial pulse pressure) is pivotal to sustain this decrease. Thus the effects of central volume expansion override adaptation of the carotid baroreceptors and/or buffering of aortic reflexes.

antidiuretic hormone; baroreceptors; blood pressure; lower body negative pressure; neck suction


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