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Am J Physiol Heart Circ Physiol 288: H710-H715, 2005. First published October 7, 2004; doi:10.1152/ajpheart.00540.2004
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Feedback effects of circulating norepinephrine on sympathetic outflow in healthy subjects

Mikko P. Tulppo,1,2 Heikki V. Huikuri,2 Elli Tutungi,3 Derek S. Kimmerly,3 Adrian W. Gelb,3 Richard L. Hughson,4 Timo H. Mäkikallio,1,2 and J. Kevin Shoemaker3

1Merikoski Rehabilitation and Research Centre, Oulu; 2Department of Medicine, University of Oulu, Oulu, Finland; 3University of Western London, Ontario; and 4Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada

Submitted 7 June 2004 ; accepted in final form 5 October 2004

The amplitude of low-frequency (LF) oscillations of heart rate (HR) usually reflects the magnitude of sympathetic activity, but during some conditions, e.g., physical exercise, high sympathetic activity results in a paradoxical decrease of LF oscillations of HR. We tested the hypothesis that this phenomenon may result from a feedback inhibition of sympathetic outflow caused by circulating norepinephrine (NE). A physiological dose of NE (100 ng·kg–1·min–1) was infused into eight healthy subjects, and infusion was continued after {alpha}-adrenergic blockade [with phentolamine (Phe)]. Muscle sympathetic nervous activity (MSNA) from the peroneal nerve, LF (0.04–0.15 Hz) and high frequency (HF; 0.15–0.40 Hz) spectral components of HR variability, and systolic blood pressure variability were analyzed at baseline, during NE infusion, and during NE infusion after Phe administration. The NE infusion increased the mean blood pressure and decreased the average HR (P < 0.01 for both). MSNA (10 ± 2 vs. 2 ± 1 bursts/min, P < 0.01), LF oscillations of HR (43 ± 13 vs. 35 ± 13 normalized units, P < 0.05), and systolic blood pressure (3.1 ± 2.3 vs. 2.0 ± 1.1 mmHg2, P < 0.05) decreased significantly during the NE infusion. During the NE infusion after PHE, average HR and mean blood pressure returned to baseline levels. However, MSNA (4 ± 2 bursts/min), LF power of HR (33 ± 9 normalized units), and systolic blood pressure variability (1.7 ± 1.1 mmHg2) remained significantly (P < 0.05 for all) below baseline values. Baroreflex gain did not change significantly during the interventions. Elevated levels of circulating NE cause a feedback inhibition on sympathetic outflow in healthy subjects. These inhibitory effects do not seem to be mediated by pressor effects on the baroreflex loop but perhaps by a presynaptic autoregulatory feedback mechanism or some other mechanism that is not prevented by a nonselective {alpha}-adrenergic blockade.

heart rate dynamics; catecholamines; blood pressure oscillation



Address for reprint requests and other correspondence: M. P. Tulppo, Merikoski Rehabilitation and Research Centre, Kasarmintie 13, PO Box 404, FIN-90101 Oulu, Finland (E-mail: mikko.tulppo{at}merikoski.fi)







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