American journal of physiology. Heart and circulatory physiology最新文献

{"title":"Plasma levels of sTREM2 in chronic heart failure: predictors and prognostic relevance.","authors":"Jan Traub, Niklas Beyersdorf, Roxanne Sell, Stefan Frantz, Stefan Störk, Guido Stoll, Anna Frey","doi":"10.1152/ajpheart.00728.2024","DOIUrl":"10.1152/ajpheart.00728.2024","url":null,"abstract":"<p><p>Triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane protein expressed on myeloid cells, including macrophages and microglia, and is involved in modulating inflammation and lipid metabolism. Elevated plasma levels of soluble TREM2 (sTREM2) have been associated with heart failure (HF) and neurodegenerative diseases, such as Alzheimer's disease (AD). This post hoc analysis explored the association of plasma sTREM2 with cognition and mortality in the Cognition.Matters-HF cohort of 148 patients with chronic HF. Plasma sTREM2 levels were measured using a bead-based immunoassay, and the cohort was split into high and low sTREM2 groups based on a median concentration of 16.6 ng/mL. Higher sTREM2 levels were associated with worse cognitive performance, particularly in working memory (<i>T</i> = -2.67, <i>P</i> = 0.009) and visual/verbal memory (<i>T</i> = -2.16, <i>P</i> = 0.032), but not with cardiac function. In univariate Cox regression, a higher plasma sTREM2 concentration was linked to increased mortality (HR = 1.28, 95% CI 1.05-1.57, <i>P</i> = 0.015), although this association did not remain significant after adjusting for age and heart failure severity (adjusted HR = 0.95, 95% CI 0.70-1.28, <i>P</i> = 0.720). These findings suggest that plasma sTREM2 reflects cognitive impairment more than cardiac dysfunction in HF, highlighting its potential as a biomarker for neuroinflammation in patients with HF.<b>NEW & NOTEWORTHY</b> This study establishes a significant association between elevated plasma sTREM2 levels and cognitive impairment in chronic patients with heart failure (HF), particularly in working memory and attention. Although higher sTREM2 levels correlated with worse survival in unadjusted analyses, they did not emerge as independent predictors of mortality once adjustments had been made for age and heart failure severity. These findings suggest that plasma sTREM2 may serve as a valuable biomarker for detecting HF-related mild cognitive impairment.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H594-H602"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational arsenite exposure alters maternal postpartum heart size and induces Ca²⁺-handling dysregulation in cardiomyocytes.","authors":"Nicole Taube, Morgan Steiner, Obialunanma V Ebenebe-Kasonde, Raihan Kabir, Haley Garbus-Grant, Sarah-Marie Alam El Din, Emily Illingworth, Nadan Wang, Brian L Lin, Mark J Kohr","doi":"10.1152/ajpheart.00266.2024","DOIUrl":"10.1152/ajpheart.00266.2024","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of mortality in the United States. Studies suggest a role for environmental exposures in the etiology of cardiovascular disease, including exposure to arsenic through drinking water. Arsenic exposure during pregnancy has been shown to have effects on offspring, but few studies have examined impacts on maternal cardiovascular health. Although our prior work documented the detrimental effect of arsenic on the maternal heart during pregnancy, our current study examines the effect of gestational arsenic exposure on the maternal heart postpartum. Timed-pregnant wild-type (C57BL/6J) mice were exposed to 0, 100, or 1,000 µg/L sodium arsenite (NaAsO₂) via drinking water from <i>embryonic day 2.5</i> until parturition. Postpartum heart structure and function was assessed via transthoracic echocardiography and gravimetric measurement. Hypertrophic markers were probed via qRT-PCR and Western blot. Isolated cardiomyocyte Ca²⁺-handling and contraction were also assessed, along with the expression of with Ca²⁺-handling and contractile proteins. Interestingly, we found that exposure to either 100 or 1,000 µg/L sodium arsenite increased postpartum heart size at <i>postpartum day 12</i> vs. nonexposed postpartum controls. At the cellular level, we found altered cardiomyocyte Ca²⁺-handling and contraction, along with expression changes of key contractile proteins, including α-actin and cardiac myosin binding protein C (cMyBP-c). Together, these findings suggest that gestational arsenic exposure impacts the postpartum maternal heart, possibly inducing long-term cardiovascular changes. Furthermore, these findings highlight the importance of reducing arsenic exposure during pregnancy, and the need for more research on the impact of arsenic on maternal heart health and adverse pregnancy events.<b>NEW & NOTEWORTHY</b> Gestational exposure to sodium arsenite at environmentally relevant doses (100 and 1,000 µg/L) increases postpartum heart size, and induces dysregulated Ca²⁺ homeostasis and impaired shortening in isolated cardiomyocytes. This is the first study to demonstrate that gestational arsenic exposure impacts postpartum heart structure and function beyond the exposure period.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H460-H471"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of kinin B1 receptor alleviates SARS-CoV-2-induced long-lasting cardiovascular complications.","authors":"Drew Theobald, Lisandra E de Castro Braz, Shaw M Akula, Jeffrey B Eells, Srinivas Sriramula","doi":"10.1152/ajpheart.00861.2024","DOIUrl":"10.1152/ajpheart.00861.2024","url":null,"abstract":"<p><p>Long COVID has been associated with significant cardiovascular complications, including fibrosis, functional impairment, and chronic inflammatory and immune responses. However, the underlying mechanisms driving these cardiac pathologies following COVID-19 infection remain understudied. Previously, we characterized a mouse model of long COVID and observed enhanced expression of kinin B1 receptor (B1R) in the infected animals. Here, we investigated the role of B1R in mediating long-COVID-induced cardiac pathologies. K18-hACE2 transgenic mice were infected intranasally with SARS-CoV-2 and evaluated at 28 days postinfection (dpi) to model long COVID and the effects of pharmacological blockade of B1R were evaluated. Persistent upregulation of B1R expression was accompanied by apoptosis, disrupted cardiomyocyte architecture, fibrosis, impaired gap junction integrity, and sustained inflammation and immune cell infiltration. B1R blockade restored gap junction integrity, reduced fibrosis and apoptosis, and mitigated inflammation and immune activation. Together, these data indicate that B1R plays a critical role in long-COVID-induced cardiac remodeling and damage, highlighting its potential as a target for treating long-lasting cardiovascular complications following SARS-CoV-2 infection.<b>NEW & NOTEWORTHY</b> We are the first to report that elevated B1R expression may drive the long-lasting cardiovascular effects associated with recovery from COVID-19 infection. We have also collected novel evidence showing that blockade of B1R can reduce the cardiac complications associated with long COVID and may serve as a novel therapeutic target to mitigate SARS-CoV-2-induced long-term cardiac damage in affected individuals.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H711-H718"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term hemodynamic responses and reverse remodeling after pharmacotherapy in HFpEF versus HFrEF: a systematic review and meta-analysis.","authors":"Arno A van de Bovenkamp, Soufiane Nassiri, Adrianus J Bakermans, George L Burchell, Frances S de Man, Ramon B van Loon, M Louis Handoko","doi":"10.1152/ajpheart.00544.2024","DOIUrl":"10.1152/ajpheart.00544.2024","url":null,"abstract":"<p><p>The acute response to therapeutic afterload reduction differs between heart failure with preserved (HFpEF) versus reduced ejection fraction (HFrEF), with larger left ventricular (LV) stroke work augmentation in HFrEF compared with HFpEF. This may (partially) explain the neutral effect of HFrEF-medication in HFpEF. It is unclear whether such differences in hemodynamic response persist and/or differentially trigger reverse remodeling in the case of long-term afterload reduction. A systematic search was performed, identifying 21 clinical trials investigating renin-angiotensin-aldosterone system (RAAS) inhibitors, β-blockers, and sodium-glucose cotransport 2 inhibitors that report data on afterload reduction, stroke volume, and reverse remodeling in HFpEF and/or HFrEF. In both HFpEF and HFrEF, meta-analyses revealed limited long-term change in systolic/diastolic blood pressure (-5.6/-3.2 and -4.6/-1.4 mmHg, respectively) and LV afterload reduction (arterial elastance: -0.039 and -0.055 mmHg/mL, respectively). Long-term treatment did not result in an increase in stroke volume, with the exception of β-blockers in HFrEF. Indexed LV mass decreased slightly in both HFpEF and HFrEF (-2.8 and -2.3 g/m², respectively). In HFrEF, treatment reduced LV end-diastolic and end-systolic volume (-8 and -6 mL, respectively), whereas in HFpEF there was no relevant change. Contrary to acute heart failure studies, long-term afterload reduction had little effect on blood pressure and stroke volume augmentation in both HFpEF and HFrEF. However, reverse remodeling was clearly present in HFrEF but was essentially absent in HFpEF.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H419-H432"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and functional remodeling for elite cyclists during exercise; pressure-volume loops and hemodynamic forces analysis.","authors":"Alessio Pellegrino, Loira Toncelli, Simone Vanni, Alessandra Modesti, Gianni Pedrizzetti, Pietro Amedeo Modesti","doi":"10.1152/ajpheart.00882.2024","DOIUrl":"10.1152/ajpheart.00882.2024","url":null,"abstract":"<p><p>The study was designed to investigate the pattern of intraventricular hemodynamic forces (HDFs) and myocardial performance during exercise in elite cyclists (ECs). Transthoracic stress echocardiography was performed on 19 ECs and 13 age-matched sedentary controls (SCs) at three incremental exercise intensities based on heart rate reserve (HRR). Left ventricular (LV) HDFs were computed from echocardiography long-axis datasets using a novel technique based on endocardial boundary tracking, both in apex-base and latero-septal directions. Pressure volume (PV) loops were noninvasively investigated using the single-beat approach. Differences between groups were investigated using mixed model analysis. At PV loops, EC showed a steeper increase in stroke work compared with SC, without acute changes in ventricular capacity (EDVI₂₀). Contractility, measured as ventricular elastance (E_es), increased during exercise with no difference between groups (<i>P</i> = 0.625). At rest, EC had significantly lower heart rates and generated lower HDF than SC. However, during exercise, the pressure gradient developed by EC in systole, and therefore systolic HDF, was significantly higher than that developed by SC (<i>P</i> < 0.009), also showing a greater elastic rebound in late systole compared with SC (<i>P</i> < 0.032). Importantly, during early diastolic filling, EC showed lower HDF deceleration than SC (<i>P</i> < 0.043), indicating a facilitated relaxation of the left ventricle. Analysis of the HDF pattern during exercise shows the functional changes that occur in EC, characterized by increased HDF generation in systole, and facilitated relaxation in early diastole. This is the first time LV structural and functional remodeling is reported for elite cyclists during exercise.<b>NEW & NOTEWORTHY</b> Analysis of the hemodynamic forces shows that the functional changes that occur in elite cyclists during exercise are characterized by increased hemodynamic forces generation in systole, and facilitated relaxation in early diastole.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H393-H400"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allostatic load and cardiometabolic health in a young adult South African population: the African-PREDICT study.","authors":"A Wentzel, W Smith, E Jansen van Vuren, R Kruger, Y Breet, E Wonkam-Tingang, N A Hanchard, S T Chung","doi":"10.1152/ajpheart.00845.2024","DOIUrl":"10.1152/ajpheart.00845.2024","url":null,"abstract":"<p><p>Sustained stress, assessed as a high allostatic load score (ALS), is an independent cardiovascular disease (CVD) risk factor in older adults but its associations in young people are undefined. Since neurological maturation impacts stress adaptation and CVD risk, we assessed the relationship of ALS with CVD profile by using a tiered approach stratified by age [emerging adults (EA) aged 20-24 yr vs. young adults (YA) aged 25-30 yr] and ALS (high vs. low). In 1,054 healthy participants of the African Prospective Study on Early Detection and Identification of Cardiovascular Disease and Hypertension (African-PREDICT), we determined: <i>1</i>) ALS in EA versus YA; <i>2</i>) the relationship between ALS and cardiovascular (CV) health, and <i>3</i>) the odds of high ALS > 4 to identify masked hypertension (HT) and prediabetes as cardiometabolic outcomes. A nine-component, four-domain ALS was compiled: neuroendocrine [dehydroepiandrosterone (DHEA), cortisol], inflammatory [interleukin-6 (IL-6), C-reactive protein (CRP)], cardiovascular [systolic blood pressure (SBP) and diastolic blood pressure (DBP)], and metabolic [total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), body mass index (BMI)]. Retinal vessel caliber, pulse wave velocity (PWV), and cardiac structure and function were assessed. Median ALS was 3 (range: 1-9). A high-ALS > 4 was more common in YA versus EA (47 vs. 35%, <i>P</i> = 0.032). Higher ALS associated with narrower retinal arteries (<i>P</i> < 0.01), greater PWV (<i>P ≤</i> 0.01), lower diastolic function (<i>P</i> < 0.01), and left ventricular (LV) function (<i>P</i> < 0.01). High-ALS increased the odds of having masked hypertension, prediabetes, narrower retinal arteries, higher LV mass, poorer diastolic and ventricular functions (all <i>P</i> ≤ 0.01), in EA and YA independent of traditional CVD risk factors. The composite ALS identified early-stress dysregulation in cardiometabolic health and higher odds for masked hypertension and prediabetes in young adults. Cumulative stress may be a modifiable, independent cardiometabolic risk factor in younger populations that needs further investigation.<b>NEW & NOTEWORTHY</b> This is the first study to assess the effect of stress, as a composite allostatic load score, on micro-, macrovascular, and central cardiac features in healthy emerging and young adults, independent of traditional cardiovascular risk markers. It exemplifies independent stress-induced changes throughout the cardiovascular tree, which may increase the risk of cardiometabolic complications, masked hypertension, and prediabetes. Sustained stress may be a key etiological factor in cardiometabolic disease development in a young population.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H581-H593"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal cardiovascular research and education should be prioritized in the United States.","authors":"Helen E Collins","doi":"10.1152/ajpheart.00751.2024","DOIUrl":"10.1152/ajpheart.00751.2024","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H433-H440"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AIM2 targeting of nuclear DNA leakage in dendritic cells exacerbates vasculitis in a murine model of Kawasaki disease.","authors":"Chintogtokh Baatarjav, Takanori Komada, Yoshitaka Gunji, Satoko Komori, Hidetoshi Aizawa, Noriko Nagi-Miura, Tadayoshi Karasawa, Masafumi Takahashi","doi":"10.1152/ajpheart.00901.2024","DOIUrl":"10.1152/ajpheart.00901.2024","url":null,"abstract":"<p><p>Kawasaki disease (KD) is an acute vasculitis that mostly affects children and is characterized by inflammation of medium-sized arteries, particularly the coronary arteries. The absent in melanoma 2 (AIM2) inflammasome senses cytosolic dsDNA and regulates IL-1β-driven inflammation. We investigated the role of AIM2 in <i>Candida albicans</i> water-soluble fraction (CAWS)-induced vasculitis in a murine model mimicking KD. <i>Aim2</i>^-/- mice exhibited reduced vasculitis, inflammatory cell infiltration, and vascular fibrosis in the aorta and coronary arteries. In addition, dsDNA damage was detected in Dectin-2⁺ cells infiltrating vasculitis areas. In vitro experiments showed that CAWS induced dsDNA damage in Dectin-2⁺ bone marrow-derived dendritic cells (BMDCs) isolated from wild-type (WT) and <i>Aim2</i>^-/- mice. Furthermore, CAWS induces nuclear membrane deformation and DNA leakage into the cytosol, leading to AIM2 inflammasome activation and subsequent IL-1β production in WT BMDC. These findings suggest that AIM2 inflammasome activation in dendritic cells, triggered by dsDNA damage and leakage, contributes to the development of CAWS-induced vasculitis, and provides important insights into the inflammatory mechanisms underlying KD.<b>NEW & NOTEWORTHY</b> The AIM2 inflammasome in dendritic cells is a significant component of the murine model of Kawasaki disease-like vasculitis induced by CAWS injection. The AIM2 deficiency reduces vasculitis via reduced inflammatory cell infiltration and vascular fibrosis in CAWS-induced vasculitis. CAWS induces the damage and leakage of nuclear DNA in dendritic cells, which triggers AIM2 inflammasome activation, leading to an IL-1β-driven inflammatory response.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H509-H517"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive echocardiographic protocol for pigs with emphasis on diastolic function: advantages over MRI assessment.","authors":"Nadia Martinez Naya, Thomas E Sharp, Manuela G Sgai, Jose M C Capcha, Lina A Shehadeh","doi":"10.1152/ajpheart.00858.2024","DOIUrl":"10.1152/ajpheart.00858.2024","url":null,"abstract":"<p><p>Swine are increasingly used in cardiovascular research due to their anatomical and physiological similarities to humans, particularly for studying diastolic dysfunction. Although MRI offers excellent structural imaging, echocardiography provides superior real-time assessment of diastolic parameters. To address the lack of standardized methods and reduce variability across studies, we present a comprehensive guide for performing echocardiography in Yorkshire pigs, detailing anatomical considerations, equipment requirements, and technical approaches. We describe systematic approaches for obtaining and optimizing right parasternal long- and short-axis views, apical four-chamber, and subcostal imaging windows, with specific attention to anatomical variations from human cardiac orientation and standard clinical transducer positioning. These tomographic views enable a comprehensive assessment of systolic and diastolic function, including ventricular volumes, wall thicknesses, chamber dimensions, ejection fraction, and Doppler measurements of blood flow and tissue velocities. This standardized methodology for echocardiographic images acquisition enhances data reliability in cardiovascular pig models, improving the interpretation of preclinical study results and strengthening translational research outcomes. The protocol also provides consistency for veterinary applications, making echocardiography a preferred modality for longitudinal studies in this valuable translational model.<b>NEW & NOTEWORTHY</b> Anatomical positioning: porcine heart is more central and caudal than human heart; apical views are obtained at sixth to seventh intercostal space; right parasternal views are most reliable in pigs. Technical requirements are as follows: standardized sedation protocol is essential; specialized veterinary procedure table; and integrated electrocardiogram (ECG) monitoring for timing. Clinical value: excellent translational model for cardiovascular research; regular protocol adjustment based on animal size.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H401-H414"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High variability in the reproducibility of key hemodynamic responses to head-up tilt.","authors":"Heidi Bouquin, Lauri J Suojanen, Jenni K Koskela, Essi Pietilä, Manoj Kumar Choudhary, Jukka T Mustonen, Ilkka H Pörsti","doi":"10.1152/ajpheart.00796.2024","DOIUrl":"10.1152/ajpheart.00796.2024","url":null,"abstract":"<p><p>Increased blood pressure upon standing is considered a cardiovascular risk factor. We investigated the reproducibility of changes in aortic blood pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance during three passive head-up tilts (HUT) in 223 participants without cardiovascular medications (mean age 46 yr, BMI 28 kg/m², 54% male). The median time gap between the first and the second HUT was 9 wk and the second and the third HUT was 4 wk. We utilized whole body impedance cardiography and radial artery tonometry as methods. The participants were divided into quartiles of the changes in each hemodynamic variable during the first HUT, and the reproducibility of these changes was tested during successive HUTs. During the first HUT, significant differences were present in all between-quartile comparisons (<i>n</i> = 6) of all variables. The differences persisted as follows: reduction of stroke volume in six out of six (6/6) between-quartile comparisons (<i>P</i> < 0.001), decrease in cardiac output (<i>P</i> < 0.001) and increase in heart rate in 5/6 comparisons (<i>P</i> < 0.001), change in systemic vascular resistance in 3/6 comparisons (<i>P</i> < 0.001), change in aortic systolic blood pressure in 1/6 comparisons (<i>P</i> = 0.043), and change in aortic diastolic blood pressure in none (<i>P</i> = 0.266). To conclude, the reproducibility of upright posture-induced changes is high for stroke volume, cardiac output, and heart rate, moderate for systemic vascular resistance, and modest for aortic blood pressure. Although an increase in blood pressure during upright posture may be a cardiovascular risk factor, this effect may be attributed to other underlying hemodynamic variables that exhibit more reproducible posture-related changes.<b>NEW & NOTEWORTHY</b> We examined the reproducibility of hemodynamic responses to three passive head-up tilts. The associated changes in stroke volume, cardiac output, and heart rate were highly reproducible. Systemic vascular resistance showed moderate reproducibility, whereas blood pressure changes during upright posture were modestly reproducible. If an exaggerated blood pressure response to upright posture is a cardiovascular risk factor, it is likely attributed to other hemodynamic variables that exhibit more reproducible posture-related changes.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H387-H392"},"PeriodicalIF":4.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}