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1 School of Human Movement and Exercise Science
2 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia 6009
3
Cardiac Transplant Unit, Royal Perth Hospital, Perth, Australia 6000
We compared haemodynamic and peripheral vasomotor responses to lower body negative pressure (LBNP) in cardiac transplant recipients who had undergone bicaval anastomoses, involving right atrial deafferentation (–RA), and the conventional procedure in which some atrial baroreceptor afferents remain intact (+RA). We measured mean forearm blood flow (FBF) responses using Doppler/ultrasound during three randomised trials involving 0 (baseline), –20 and –40 mmHg LBNP in 15 transplant recipients (9 –RA, 6 +RA) and in eight healthy matched controls. A significant effect of LBNP on FBF existed between control and transplant groups (P < 0.05; two-way ANOVA). Mild LBNP (–20 mmHg), significantly decreased FBF by 29.7 ± 10.0% relative to baseline in +RA subjects (P < 0.05), whereas the 17.7 ± 10.3% decrease in –RA subjects was not significant. In response to –40 mmHg LBNP, FBF significantly decreased in control (42.4 ± 4.6%, P < 0.05) and +RA subjects (33.3 ± 11.4%, P < 0.05) with no significant change in the –RA group. The response of systolic blood pressure (SBP) to –40 mmHg significantly differed between groups (P < 0.05): –RA subjects decreased significantly (P < 0.05) whilst the decrease in SBP in +RA subjects did not achieve significance and control subjects exhibited an increase. The heart rate increase from baseline to –40 mmHg was significantly attenuated in –RA relative to controls and the +RA group (P < 0.05). The present study demonstrates that atrial deafferentation impairs reflex vasomotor control of the circulation in response to low- and high-level LBNP, indicating that atrial deafferentation may contribute to abnormal arterial pressure regulation.
(Received 11 June 2004;
accepted after revision 23 August 2004;
first published online 26 August 2004)
Corresponding author D. J. Green: School of Human Movement and Exercise Science, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. Email: brevis{at}cyllene.uwa.edu.au
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