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Carotid baroreflex responsiveness to head-up tilt-induced central hypovolaemia: effect of aerobic fitness

Shigehiko Ogoh*, Stefanos Volianitis†, Peter Nissen†, D. Walter Wray*, Niels H. Secher† and Peter B. Raven*

This investigation examined the interaction between carotid baroreflex (CBR) responsiveness during head-up tilt (HUT)-induced central hypovolaemia and aerobic fitness. Seven average fit (AF) individuals, with a mean maximal oxygen uptake (_O2max) of 49 ± 1 (ml O₂) kg^-1min^-1, and seven high fit (HF) individuals, with a _O2max of 61 ± 1 (ml O₂) kg^-1 min^-1, voluntarily participated in the investigation. After 10-15 min supine, each subject was exposed to nine levels of progressively increasing HUT by 10 deg increments from -20 deg to +60 deg. During the final 3 min of each stage of HUT, the CBR responsiveness was measured using a rapid pulse (500 ms) train of neck pressure (NP) and neck suction (NS) ranging from +40 to -80 Torr. The maximal gain of the carotid-HR (G_max-HR) and carotid-MAP (G_max-MAP) baroreflex function curves was identified as measures of CBR responsiveness. During HUT-induced decreases in thoracic admittance, an index of central blood volume (CBV), the G_max-HR and G_max-MAP of the AF subjects increased more than the G_max-HR and G_max-MAP of the HF subjects (P < 0.05). The data demonstrate that the increase in the CBR responsiveness during a tilt-induced progressive unloading of the cardiopulmonary baroreceptors was attenuated in endurance-trained subjects. These findings provide an explanation for the predisposition to orthostatic hypotension and intolerance in well-trained athletes.

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