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Biomedical subjects

N H Secher

Publications and source records attributed to N H Secher.

At least 199 records · Page 11Linked to original sources
PubMed1990

Cardiovascular and endocrine responses to haemorrhage in the pig.

Heart rate (HR), mean arterial pressure (MAP), indices of sympathetic and parasympathetic activity (plasma concentrations of adrenaline, noradrenaline and pancreatic polypeptide, PP), vasopressin (VP) and aldosterone (ALDO) were measured in six pigs during continuous bleeding resulting in hypovolaemic shock, from which five survived. Three stages of haemorrhage could be defined. Stage I. Resting MAP was 85 +/- 6 mmHg and increased to 96 +/- 5 mmHg with a blood loss of 275 (range 250-300) (10 (9-12)% of the estimated blood volume) concomitant with an increase in HR from 105 +/- 5 to 113 +/- 6 beats min-1 (P less than 0.05). Stage II. After a blood loss of 375 (300-500) ml (15 (13-16)%) MAP fell to 62 +/- 9 mmHg and HR to 95 +/- 5 beats min-1 (P less than 0.05). Stage III. A blood loss of 1113 (825-1450) ml (44 (30-52)%) resulted in a MAP of 50 +/- 4 mmHg and an increase in HR to 206 +/- 3 beats min-1 (P less than 0.05). Adrenaline increased from 0.3 +/- 0.1 to 0.8 +/- 0.3 (stage II) and 3.6 +/- 1.1 nmol l-1 (stage III) (P less than 0.05); noradrenaline from 0.4 +/- 0.1 to 1.5 +/- 0.4 (stage II) and 5.9 +/- 1.7 nmol l-1 (stage III) (P less than 0.05); PP from 6.2 +/- 1.6 to 13.3 +/- 2.3 (stage II) and 20.9 +/- 7.8 pmol l-1 (stage III) (P less than 0.05). VP changed only marginally, but ALDO increased from 496 +/- 54 to 623 +/- 76 pmol l-1 (stage III) (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1990

Atrial natriuretic peptide during head-up tilt induced hypovolaemic shock in man.

To evaluate the importance of right atrial filling pressure versus central blood volume for the plasma concentration of atrial natriuretic peptide in man, head-up tilt to 50 degrees maintained until the appearance of presyncopal symptoms was carried out in six healthy males. Head-up tilt increased thoracic electrical impedance from 35.4 +/- 0.9 (mean and SE) to 39.2 +/- 0.9 ohm, mean arterial pressure from 64.5 +/- 3.6 to 76.6 +/- 3.0 mmHg and heart rate from 51 +/- 3 to 85 +/- 4 beats min-1 (P less than 0.01). After 35 +/- 7 min presyncopal symptoms appeared, together with a decrease in mean arterial pressure to 51 +/- 4 mmHg and in heart rate to 59 +/- 7 beats min-1 (P less than 0.01). Central venous pressure (2.1 +/- 1.0 mmHg) did not change significantly, but atrial natriuretic peptide decreased from 9.4 +/- 1.6 to 4.2 +/- 1.3 pmol l-1 (P less than 0.01) and was inversely related to thoracic impedance (r = -0.65, n = 44, P less than 0.001). The results indicate that changes in the central blood volume rather than in central venous pressure determine the secretion of atrial natriuretic peptide in man.

Atrial Natriuretic Factor↗
PubMed1990

Cardiovascular and ventilatory responses to dynamic exercise during epidural anaesthesia in man.

1. In order to evaluate the importance of afferent neural feedback from the working muscles for cardiovascular and ventilatory responses to dynamic exercise, epidural anaesthesia was induced at L3-L4. Six healthy males cycled for 20 min at 57% of maximum oxygen uptake and for 8-12 min at increasing work intensities until exhaustion at 238 +/- 30 W without as well as with epidural anaesthesia. 2. Presence of afferent neural blockade was verified by cutaneous sensory analgesia below T10-T11 and attenuated post-exercise ischaemic pressor response (45 +/- 8-24 +/- 6 mmHg). Efferent sympathetic nerves appear to be intact since basal heart rate and blood pressure as well as the cardiovascular responses to a Valsalva manoeuvre and to a cold pressor test were unchanged. 3. During dynamic exercise with epidural anaesthesia, blood pressure was lower than in control experiments; however, ventilation and heart rate were not affected. 4. The results indicate that afferent neural activity from the working muscles is important for blood pressure regulation during dynamic exercise in man but may not be necessary for eliciting the ventilatory and heart rate responses.

Adult↗
PubMed1990

Heart rate and arterial blood pressure at the onset of static exercise in man with complete neural blockade.

1. We tested the 'muscle-heart reflex' hypothesis for the immediate increases in heart rate and blood pressure at the onset of static exercise in man by performing complete blockade of afferent nerves from the working muscles. Brief (5 s) maximal static hand-grip contractions were performed without performing a Valsalva-like manoeuvre and with no increase in central venous pressure both before and after combined axillary and radial blockade with lidocaine. Muscle strength was reduced to near zero. The effectiveness of the afferent neural blockade was evaluated by recording the heart rate and blood pressure responses and rating the perceived pain during a cold pressor test of the blocked and contralateral unblocked hand. 2. The cold pressor test increased blood pressure but had no effect on heart rate. Afferent neural blockade eliminated the increase in blood pressure and the perceived pain associated with the cold pressor test. Maximal hand-grip contractions resulted in immediate and similar increases in heart rate and blood pressure before and after afferent neural blockade of the arm. 3. The results of this study suggest that the immediate increases in heart rate and blood pressure at the onset of static exercise in man occur when the 'muscle-heart reflex' is inoperable.

Adult↗
PubMed1990

Cerebral blood flow during static exercise in humans.

Cerebral blood flow (CBF) was determined in humans at rest and during four consecutive unilateral static contractions of the knee extensors. Each contraction was maintained for 3 min 15 s with the subjects in a semisupine position. The contractions corresponded to 8, 16, 24, and 32% of the maximal voluntary contraction (MVC) and utilized alternate legs. CBF (measured by the 133Xe clearance technique) was expressed by a noncompartmental flow index (ISI). Heart rate and mean arterial pressure increased from resting values of 73 (55-80) beats/min and 88 (74-104) mmHg to 106 (86-138) beats/min and 124 (102-146) mmHg, respectively (P less than 0.0005), during the contraction at 32% MVC. Arterial PCO2 and central venous pressure did not change. Corrected to the average resting PCO2, CBF during control was 55 (35-73) ml.100 g-1.min-1 and remained constant during contractions. Cerebral vascular resistance increased from 1.5 (1.0-2.2) to 2.4 (1.4-3.0) mmHg. 100 g.min.ml-1 (P less than 0.025) at 32% of MVC. There was no difference in CBF between the two hemispheres at rest or during exercise. In contrast to dynamic leg exercise, static leg exercise is not associated with an increase in global CBF when measured by the 133Xe clearance technique.

Adult↗
PubMed1990

Does the decrease in heart rate prevent a detrimental decrease of the end-systolic volume during central hypovolemia in man?

Central hypovolemia occurring with epidural anesthesia was investigated by measurement of hemodynamic and endocrine variables in 10 patients. Responses fell into two categories. Four patients experienced a hypotensive bradycardic episode after seventeen +/- four minutes. In this group epidural anesthesia initially induced a tendency toward an increase in heart rate from 65 +/- 4 to 73 +/- 5 beats/min concomitantly with decreases in end-diastolic (172 +/- 22 to 138 +/- 16 mL), end-systolic (67 +/- 12 to 51 +/- 9 mL), and stroke (105 +/- 10 to 85 +/- 7 mL) volumes (radionuclide cardiography). A subsequent decrease in mean arterial pressure from 76 +/- 3 to 67 +/- 4 mmHg was associated with a decrease in venous return as reflected by the decrease in cardiac output from 6.1 +/- 0.4 to 4.7 +/- 0.7 L/min. In this situation when the venous return was critically reduced, the heart rate was 49 +/- 4 beats/min and no further reduction in end-diastolic and end-systolic volumes was observed. The observed endocrine changes were compatible with a response to central hypovolemia. In the other 6 patients the reaction to epidural anesthesia did not induce statistically significant changes in hemodynamic and endocrine variables. It is concluded (1) that the decrease in heart rate associated with central hypovolemia during epidural anesthesia seems to be elicited when the left ventricular end-systolic volume is decreased by about 25% and (2) that a further decrease in end-systolic volume during progressive central hypovolemia is avoided possibly as a direct consequence of the slowing of the heart.

Adult↗
PubMed1989

[Continuous non-invasive measurement of blood pressure].

Automatic continuous non-invasive measurement of blood pressure using the Penaz' principle (Finapres) was compared with the blood pressure records using a sphygmomanometer during anaesthesia in 29 patients without significant arteriosclerosis. There were no significant differences between values recorded using the two methods. Furthermore, the changes recorded in systolic, diastolic and mean arterial pressures were not significantly different. Also, the pulse recorded with the Penaz' principle corresponded to the heart rate recorded from ECG. Automatic continuous non-invasive measurement of blood pressure using the Penaz' principle offers a valuable aid for monitoring patients during anaesthesia.

Adult↗
PubMed1989

Cardiovascular responses to brief static contractions in man with topical nervous blockade.

1. We tested the hypothesis that afferent nerves from working muscles are important in determining the heart rate and blood pressure responses to brief maximal static exercise. 2. In twenty human subjects, the heart rate and arterial blood pressure responses to a brief maximal voluntary handgrip were studied before and after axillary nerve anaesthesia or to maximal one-leg knee extension before and after epidural anaesthesia at L3-L4. Maximal knee extension could not be accomplished without performing a 'Valsalva-like' manoeuvre, but during handgrip it was possible to avoid the use of muscles other than those directly involved in the contraction. Heart rate and blood pressure were also monitored during a Valsalva manoeuvre of similar duration to the maximal voluntary contractions (4 s). 3. During handgrip with normal breathing, axillary nerve anaesthesia reduced the heart rate response but had no effect on the blood pressure response. 4. During a Valsalva manoeuvre, blood pressure increased but heart rate remained stable as long as expiratory pressure was maintained. During one-leg knee extension, epidural anaesthesia reduced the blood pressure response; however, the reduction in blood pressure was probably due to a reduction in the simultaneously performed 'Valsalva-like' manoeuvre. 5. The results of this study suggest that afferent input from the working muscles is of importance for the heart rate responses to brief static muscle contractions. That such influence may be important for the blood pressure response remains unproven.

Adult↗
PubMed1989

Autonomic blockade and cardiovascular responses to static exercise in partially curarized man.

1. The cardiovascular responses, heart rate and mean arterial pressure, were followed in seventeen human subjects who performed static handgrip contractions for 2 min at the same absolute force (15% of the initial maximal voluntary contraction strength) before and during partial curarization. In control contractions the rate of perceived exertion was 10 exertion units, 16 units in contractions with tubocurarine which could be maintained and 20 units in contractions that could not be maintained. Control contractions increased mean arterial pressure by 6 mmHg from 89 mmHg while heart rate was unchanged from the resting value of 68 beats min-1. With tubocurarine, larger increases in mean arterial pressure of 11 mmHg and for heart rate of 8 beats min-1 were obtained during maintained contractions, and 15 mmHg and 16 beats min-1, respectively, during non-maintained contractions. 2. Atropine increased resting heart rate and blood pressure with tubocurarine to 107 beats min-1 and 98 mmHg, respectively, in seven subjects. The blood pressure response to exercise with tubocurarine was unaffected by atropine, but the heart rate increase was reduced from 15 to 4 beats min-1. 3. Propranolol reduced resting heart rate with tubocurarine to 56 beats min-1 with no effect on blood pressure in seven subjects. The cardiovascular responses to exercise with tubocurarine were unaffected by propranolol. In contrast, phentolamine reduced resting blood pressure with tubocurarine to 80 mmHg without affecting heart rate in seven subjects. Exercise responses with tubocurarine were unaffected by phentolamine. Combinations of atropine and propranolol in fourteen subjects or atropine and phentolamine in five subjects showed similar results during exercise with tubocurarine as with the sole use of the agents used to block autonomic receptors. 4. The results suggest that when partial curarization induces a disproportion between the signal from central command and that from exercising muscles, the larger signal arising from central command determines the magnitude of the cardiovascular responses. The centrally generated heart rate response is in part caused by vagal withdrawal. However, the blood pressure response cannot be attenuated by the sole use of alpha- or beta-receptor adrenergic blockade or combinations of these with atropine. This suggests that there may be greater redundancy in the autonomic control of blood pressure than in the vagal control of heart rate associated with central command during static exercise in man.

Adult↗
PubMed1989

Epidural anaesthesia and cardiovascular responses to static exercise in man.

1. In human subjects, sustained static contractions of the knee extensors were performed in one leg with the same absolute (10% of the initial maximal voluntary contraction) and relative (30% of the maximal voluntary contraction immediately prior to the static exercise) intensities before and during epidural anaesthesia. Epidural anaesthesia reduced strength to 62 +/- 8% of the control value and partially blocked sensory input from the working muscles. During contractions performed with the same relative force, the increases in mean arterial pressure and heart rate were greater during control contractions than during epidural anaesthesia. During contractions at the same absolute force, there was no significant difference in magnitude of cardiovascular responses between control contractions and contractions performed during epidural anaesthesia. 2. The metabolic role in the exercise pressor reflex was assessed by applying an arterial leg cuff 10 s before cessation of exercise and through the following 3 min of recovery. Although mean arterial pressure and heart rate decreased immediately after cessation of exercise, application of the arterial occlusion cuff resulted in higher post-exercise mean arterial pressure and heart rate values. Control and epidural mean arterial pressures during arterial occlusion were not significantly different. 3. The results of this study suggest that the reflex neural mechanism rather than the intended effort (central command) is important in determining the blood pressure and heart rate responses to static exercise in man. That is, when epidural anaesthesia diminishes sensory feedback and produces muscular weakness, central command does not determine the cardiovascular response. This conclusion, however, is opposite to that derived from experiments with partial neuromuscular blockade which demonstrated the importance of central command in determining the cardiovascular response to static exercise (Leonard, Mitchell, Mizuno, Rube, Saltin & Secher, 1985). Taken together, these two studies are complementary and support the concept that both central and reflex neural mechanisms play roles in regulating arterial blood pressure and heart rate during static exercise in man.

Adult↗
PubMed1989

Hormonal and metabolic responses to exercise in humans: effect of sensory nervous blockade.

Previous studies have indicated that motor center ("feedforward") activity is important for hormonal and metabolic responses to exercise. Now, epidural blockade at vertebrae L3-L4 was used to evaluate the importance of afferent neural feedback from working muscles. Six healthy, young males cycled for 20 min at 55 +/- 4% (mean +/- SE) of maximal oxygen uptake with, as well as without, epidural anesthesia. During anesthesia cutaneous sensory blockade was present below segment T11-12, the postexercise ischemic pressor response was attenuated from 34 +/- 9 to 14 +/- 4 mmHg, muscle strength reduced to 80 +/- 5% of control, and perceived exertion (Borg scale) was increased. At rest hormonal and metabolic parameters did not change in response to epidural anesthesia. During exercise, responses of catecholamines, insulin, glucagon, and growth hormone (GH) in plasma as well as glucose production and utilization, plasma free fatty acids, and plasma glycerol were similar in epidural and control experiments (P greater than 0.05). In contrast during submaximal exercise, plasma concentrations of adrenocorticotropin (ACTH) and beta-endorphin increased only in experiments without epidural anesthesia. The data indicate that impulses in afferent nerves from the working muscles are essential for the ACTH and beta-endorphin responses to submaximal dynamic exercise in humans. Afferent nervous activity is probably less important than efferent activity from motor centers for responses of GH, catecholamines and insulin, and, in turn, extramuscular fuel mobilization in exercise.

Adrenocorticotropic Hormone↗
PubMed1989

Histochemical characteristics of human expiratory and inspiratory intercostal muscles.

The relative occurrence of slow-twitch (ST) and fast-twitch (FTa and FTb) fibers, fiber size, and capillary supply in internal (INT) and external intercostal muscles (EXT), the costal diaphragm (DIA), and vastus lateralis muscle (VAS) was examined post-mortem in eight healthy males. The relative occurrence of ST fibers in INT [64 +/- 3% (SE)] and EXT (62 +/- 3%) was similar but higher than in DIA (49 +/- 3%) and VAS (40 +/- 6%; P less than 0.05). The occurrence of FTa fibers in expiratory INT (35 +/- 3%) was higher than in inspiratory INT and EXT (17 +/- 1%; P less than 0.05) but similar to DIA (28 +/- 6%) and VAS (32 +/- 2%). Accordingly, expiratory INT had fewer FTb fibers (1 +/- 1%) than the others (P less than 0.05). Expiratory INT had a 60% larger fiber area than inspiratory INT and EXT and DIA (P less than 0.05), but the area was similar to that of VAS. The number of capillaries per fiber was higher in expiratory INT (2.3 +/- 0.1) than in inspiratory INT and EXT (1.6 +/- 0.1), DIA (1.9 +/- 0.1), and VAS (1.8 +/- 0.2; P less than 0.05). The results suggest that the occurrence of many large capillary-rich FTa fibers in expiratory INT is bound to function (expiratory vs. inspiratory) rather than to anatomy (INT vs. EXT).

Adenosine Triphosphatases↗
PubMed1989

Cerebral blood flow during submaximal and maximal dynamic exercise in humans.

Cerebral blood flow (CBF) in humans was measured at rest and during dynamic exercise on a cycle ergometer corresponding to 56% (range 27-85) of maximal O2 uptake (VO2max). Exercise bouts were performed by 16 male and female subjects, lasted 15 min each, and were carried out in a semisupine position. CBF (133Xe clearance) was expressed as the initial slope index (ISI) and as the first compartment flow (F1). CBF at rest [ISI, 58 (range 45-73); F1, 76 (range 55-98) ml.100 g-1.min-1] increased during exercise [ISI to 79 (57-94) and F1 to 118 (75-164) ml.100 g-1.min-1, P less than 0.01]. CBF did not differ significantly between work loads from 32 (24-33) to 86% (74-96) of VO2max (n = 10). During exercise, mean arterial pressure increased from 84 (60-100) to 101 (78-124) Torr (P less than 0.01) and PCO2 remained unchanged [5.1 (4.6-5.6) vs. 5.4 (4.4-6.3) kPa, n = 6]. These results demonstrate a median increase of 31% (0-87) in CBF by ISI and a median increase of 58% (0-133) in CBF by F1 during dynamic exercise in humans.

Adult↗
PubMed1989

Effects of partial neuromuscular blockade on sympathetic nerve responses to static exercise in humans.

We used intraneural recordings of sympathetic nerve activity in conscious humans to determine if central command increases sympathetic discharge to resting skeletal muscle during static exercise. In nine healthy subjects, we measured arterial pressure, heart rate, and muscle sympathetic nerve activity with microelectrodes in the peroneal nerve of the resting leg during 1) static handgrip at 15% and 30% maximal voluntary contraction and 2) attempted handgrip during partial neuromuscular blockade produced by systemic administration of tubocurarine chloride (0.075 mg/kg i.v.). During curare, subjects reported that they used near-maximal motor effort to attempt a sustained handgrip contraction, but they generated almost no force. Without sustained contraction, the intent to exercise alone, that is, central command, caused statistically significant (p less than 0.05) increases in muscle sympathetic nerve activity as well as in arterial pressure and heart rate. However, the increases in muscle sympathetic nerve activity (+ 56 +/- 16% over control) and in mean arterial pressure (+ 12 +/- 2 mm Hg) during attempted handgrip were much smaller (p less than 0.05) than the sympathetic nerve response (+ 217 +/- 37% over control) and pressor response (+ 25 +/- 3 mm Hg) during an actual static handgrip at 30% maximal voluntary contraction. In contrast, heart rate increased as much during the attempted contraction (+ 18 +/- 2 beats/min) as during the actual contraction at 30% maximal voluntary contraction (+ 16 +/- 4 beats/min). In 11 additional subjects, the heart rate responses during curare were greatly attenuated (p less than 0.05) by atropine but were not significantly affected by propranolol.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1988

Slowing of the heart during anaphylactic shock. A report of five cases.

Five patients are reported with anaphylactic shock reactions due to i.v. administration of atracurium, methicillin, amidotrezoate (n = 2) and plasma. In these patients a fall in heart rate (HR) from 5-50 beats.min-1 was recorded during the hypotensive period. In three of the patients HR was 40 beats.min-1 or less, and in two of the patients a hypotensive bradycardiac episode spontaneously reappeared after normal HR and BP were established. Central venous pressure (CVP) fell in one patient from 0.8 to 0.6 kPa as HR and BP decreased while arterial oxygen tension remained normal. All patients were in a stable condition after treatment with volume expansion and sympathomimetic drugs. These observations indicate that anaphylactic shock is associated with a strong and sometimes persistent vagal tone to the heart in parallel with the early reaction to hypotensive hypovolaemic shock.

Aged↗
PubMed1988

Angiotensin II attenuates reflex decrease in heart rate and sympathetic activity in man.

Circulatory variables and hormone concentrations in arterial plasma were measured in six normal subjects during angiotensin II (ANG II) step-up infusion of 0.25 and 1.00 ng kg-1 X min. During the 1.00 ng kg-1 X min infusion ANG II plasma concentrations increased from 11 +/- 2 to 48 +/- 6 pg ml-1; i.e., similar to those obtained during acute hypotensive hypovolaemia in man. Mean arterial pressure increased (P less than 0.05) from a resting value of 89 +/- 3 to 97 +/- 5 mmHg. Heart rate and catecholamine concentrations did not change. Plasma aldosterone increased (P less than 0.05) from 36 +/- 4 to 77 +/- 10 pg ml-1 during the infusion. Plasma concentrations of vasopressin, adrenalin and pancreatic polypeptide did not change during the investigation. During the 0.25 and 1.00 ng kg-1 X min infusion subcutaneous blood flow decreased (P = 0.06) to 67 +/- 20 and 66 +/- 26%, respectively, of control. It is concluded that: (1) ANG II in physiological doses in man may augment the sympathetic activity on the circulatory system since compensatory decreases in heart rate or in plasma catecholamines were not observed during the increased arterial pressure; (2) ANG II does not induce a general decrease in vagal tone as plasma pancreatic polypeptide concentrations were unchanged; (3) the obtained plasma concentrations of ANG II do not stimulate the release of vasopressin to plasma; and (4) the threshold for reducing the subcutaneous blood flow is reached within relatively small increments in plasma ANG II.

Angiotensin II↗
PubMed1988

Arterial blood pressure at the onset of dynamic exercise in partially curarized man.

In six young men, heart rate and arterial mean blood pressure responses to the onset of light dynamic exercise 99 W (range 59-138) on a stationary bicycle were followed during partial neuromuscular blockade with tubocurarine. Tubocurarine was used in order to accentuate the central nervous (central command) influence on the cardiovascular variables and reduced hand-grip strength to 42% (36-47) of control. At the onset of exercise heart rate increased immediately and similarly with and without neuromuscular blockade. Mean arterial blood pressure remained constant during the first 6 s of control exercise and then increased. With tubocurarine a decrease of 9 mmHg (3-12) was seen during the first 6 s (P less than 0.01) before blood pressure increased. The similar heart rate responses seen with and without neuromuscular blockade indicate that central command has little influence on this variable at the onset of dynamic exercise. The constant blood pressure at the onset of control exercise suggests that the immediate changes in cardiac output and peripheral vascular resistance, respectively, are accurately matched. The decrease in blood pressure at the onset of exercise with tubocurarine suggests that central command stimulates vasodilatating nerves to arterioles in the working muscles.

Adult↗