López-Galán E, Andreu-Heredia A, Carrazana-Escalona R, Querts MO, García NJC, Lazo-Herrera LA, Muñoz-Bustos GA, Albarrán-Torres FA, Sánchez-Hechavarría ME

Language: Spanish
References: 28
Page: 164-172
PDF size: 659.90 Kb.

ABSTRACT

Introduction: Reactive hyperemia is a technique where rapid and exaggerated reperfusion is applied to an organ or tissue when circulation is restored after a period of total arterial occlusion.
Objective: To analyze the role of occlusion time on dynamic changes in autonom-ic activation during reactive hyperemia.
Method: Healthy individuals (n=30) aged 18 to 25 years old participated in this study. Vascular reactivity was assessed by measuring the dynamic changes in finger pulse volume amplitude and pulse transit time relative to the RR intervals in the test (occluded arm) and control arm (contralateral non-occluded arm) during one, three and five minutes of occlusion using two separate photoplethysmograph-ic sensors. Heart rate variability was calculated from the simultaneously acquired electrocardiogram signal to monitor the dynamic changes in cardiac autonomic nervous system activity. The variables analysis of all signals was displayed every one second in the average response graphics.
Results: Time-varying analysis of the vascular and autonomic response during reactive hyperemia demonstrated the presence of a characteristic response pat-tern with an increase in the sympathetic index and a decrease in the parasympa-thetic index between the eight and ten seconds, an increase in heart rate at 20 seconds and a progressive increase in pulse volume amplitude during the first 60 seconds after occlusion; regardless of the time of occlusion. In addition, there was a decrease in pulse transit time relative to RR intervals, followed by an increase; regardless of occlusion time.
Conclusions: Early cardiovascular sympathetic activation during reactive hyper-emia is independent from occlusion time, suggesting a reflex cardiovascular auto-nomic response involved in the generation of the physiological phenomenon of reactive hyperemia.

REFERENCES

1. Leeson P, Thorne S, Donald A, Mullen M, Clark-son P, Deanfield J. Non-invasive measurement of endothelial function: effect on brachial artery di-latation of graded endothelial dependent and independent stimuli. Heart. 1997;78(1):22-7. [

2. DOI]

3. Jasperse JL, Shoemaker JK, Gray EJ, Clifford PS. Positional differences in reactive hyperemia pro-vide insight into initial phase of exercise hypere-mia. J Appl Physiol (1985). 2015;119(5):569-75. [DOI]

4. Rosenberry R, Nelson MD. Reactive hyperemia: a review of methods, mechanisms, and considera-tions. Am J Physiol Regul Integr Comp Physiol. 2020;318(3):605-18. [DOI]

5. Mohiaddin RH, Gatehouse eD, Moon JC, Youssuf-fidin M, Yang GZ, Firmin DN, et al. Assessment of reactive hyperaemia using real time zonal echo-planar flow imaging. J Cardiovasc Magn Reson. 2002;4(2):283-7. [DOI]

6. Sidhu JS, Newey VR, Nassiri DK, Kaski JC. A rap-id and reproducible on line automated technique to determine endothelial function. Heart. 2002; 88(3):289-92. [DOI]

7. Reriani M, Sara JD, Flammer AJ, Gulati R, Li J, Rihal C, et al. Coronary endothelial function test-ing provides superior discrimination compared with standard clinical risk scoring in prediction of cardiovascular events. Coron Artery Dis. 2016; 27(3):213-20. [DOI]

8. Lenkey Z, Illyés M, Böcskei R, Husznai R, Sársze-gi Z, Meiszterics Z, et al. Comparison of arterial stiffness parameters in patients with coronary ar-tery disease and diabetes mellitus using Arterio-graph. Physiol Res. 2014;63(4):429-37. [DOI]

9. Zahedi E, Jaafar R, Ali MA, Mohamed AL, Maskon O. Finger photoplethysmogram pulse amplitude changes induced by flow-mediated dilation. Phys-iol Meas. 2008;29(5):625-37. [DOI]

10. Onkelinx S, Cornelissen V, Goetschalckx K, Thomaes T, Verhamme P, Vanhees L. Reproduc-ibility of different methods to measure the endo-thelial function. Vasc Med. 2012;17(2):79-84. [DOI]

11. Kandhai-Ragunath JJ, Jørstad HT, de Man FH, Peters RJ, von Birgelen C. Approaches for non-in-vasive assessment of endothelial function: focus on peripheral arterial tonometry. Neth Heart J. 2013;21(5):214-8. [DOI]

12. Tomiyama H, Yoshida M, Higashi Y, Takase B, Furumoto T, Kario K, et al. Autonomic nervous activation triggered during induction of reactive hyperemia exerts a greater influence on the measured reactive hyperemia index by peripher-al arterial tonometry than on flow-mediated vas-odilatation of the brachial artery in patients with hypertension. Hypertens Res. 2014;37(10):914-8. [DOI]

13. Hijmering ML, Stroes ES, Olijhoek J, Hutten BA, Blankestijn PJ, Rabelink TJ. Sympathetic activa-tion markedly reduces endothelium-dependent, flow-mediated vasodilation. J Am Coll Cardiol. 2002;39(4):683-8. [DOI]

14. Padilla J, Young CN, Simmons GH, Deo SH, New-comer SC, Sullivan JP, et al. Increased muscle sympathetic nerve activity acutely alters conduit artery shear rate patterns. Am J Physiol Heart Circ Physiol. 2010;298(4):H1128-35. [DOI]

15. Yoshida M, Tomiyama H, Shiina K, Odaira M, Yamashina A. The difference of the influence of autonomic nervous activation caused by reactive hyperemia on two different endothelial function tests. Europ Heart J. 2013;34(Suppl 1):1436. [DOI]

16. Bade G, Chandran DS, Kumar Jaryal A, Talwar A, Deepak KK. Contribution of systemic vascular re-activity to variability in pulse volume amplitude response during reactive hyperemia. Eur J Appl Physiol. 2019;119(3):753-60. [DOI]

17. Thijssen DH, Atkinson CL, Ono K, Sprung VS, Spence AL, Pugh CJ, et al. Sympathetic nervous system activation, arterial shear rate, and flow-mediated dilation. J Appl Physiol (1985). 2014; 116(10):1300-7. [DOI]

18. Spranger MD, Kaur J, Sala-Mercado JA, Machado TM, Krishnan AC, Alvarez A, et al. Attenuated muscle metaboreflex-induced pressor response during postexercise muscle ischemia in renovas-cular hypertension. Am J Physiol Regul Integr Comp Physiol. 2015;308(7):R650-8. [DOI]

19. Cuadra Sanz M, Rossi E, Delisle Rodríguez D, Mántaras MC, Perrone MS, Fainstein D, et al. Sis-tema para el registro simultáneo de la onda de pulso y el electrocardiograma orientado al estu-dio de la regulación autonómica. En: 4th Int In Conf FIE’08 [Internet]; 2008 [citado 21 Feb 2021]. Disponible en: https://bit. ly/3UcGlwt

20. Manikandan MS, Soman KP. A novel method for detecting R-peaks in electrocardiogram (ECG) signal. Biomed Signal Process Control. 2012;7(2): 118-28. [DOI]

21. Thijssen DH, Black MA, Pyke KE, Padilla J, Atkin-son G, Harris RA, et al. Assessment of flow-medi-ated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2011;300(1):2-12. [DOI]

22. Carrazana-Escalona R, Ricardo-Ferro BT, Fernán-dez-de la Vara Prieto R, Sánchez-Hechavarría ME. Algoritmo para la detección de puntos clínicos de interés de la onda de pulso arterial. Rev Cuba In-form Méd [Internet]. 2018 [citado 23 Feb 2021]; 10(1):40-8. Disponible en:

23. http://revinformatica. sld. cu/index. php/rcim/article/view/259/pdf_72

24. Boushel R. Muscle metaboreflex control of the circulation during exercise. Acta Physiol (Oxf). 2010;199(4):367-83. [DOI]

25. Shaffer F, McCraty R, Zerr CL. A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability. Front

26. Psychol [Internet]. 2014 [citado 23 feb 2021];5: 1040. Disponible en:

27. https://doi. org/10. 3389/fpsyg. 2014. 01040

28. Selvaraj N, Jaryal AK, Santhosh J, Anand S, Deep-ak KK. Monitoring of reactive hyperemia using photoplethysmographic pulse amplitude and transit time. J Clin Monit Comput. 2009;23(5):315-22. [DOI]