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T Mano

Publications and source records attributed to T Mano.

At least 145 records · Page 8Linked to original sources

Age-related changes in baroreflex control of heart rate and sympathetic nerve activity in healthy humans.

To determine how the baroreflex control of sympathetic nerve activity is affected by aging, muscle sympathetic nerve activity (MSNA) from the tibial nerve was monitored using microneurography, and heart rate and blood pressure were recorded during the pressor or depressor responses to intravenous injections of phenylephrine or nitroglycerin in 39 healthy humans, aged 16 to 56 years. Although the baroreflex slope for heart rate showed attenuation with aging, the baroreflex slope for MSNA was not affected by aging. These data suggest preservation of the baroreflex control of sympathetic nerve activity despite attenuation of the baroreflex control of parasympathetic nerve activity by aging in humans.

Adolescent↗

Effect of metoclopramide on muscle sympathetic nerve activity in humans.

The aim of this study was to determine the effect of metoclopramide on the sympathetic nervous system. Muscle sympathetic nerve activity was increased in two stages after metoclopramide injection. The initial increase in sympathetic nerve activity may result from the unloading of arterial baroreceptors because there was a negative correlation between mean blood pressure and muscle sympathetic nerve activity. The later increase in muscle sympathetic nerve activity may be attributed to the central activation of the sympathetic nervous system because there was a positive correlation between mean blood pressure and muscle sympathetic nerve activity. These results suggest that metoclopramide activates the sympathetic nervous system by two different mechanisms.

Adrenergic Fibers↗

Possible mechanism of anhidrosis in a symptomatic female carrier of Fabry's disease: an assessment by skin sympathetic nerve activity and sympathetic skin response.

Fabry's disease, X-linked alpha-galactosidase deficiency, features a variety of autonomic abnormalities including anhidrosis. In this study, we measured the skin sympathetic nerve activity (SSNA), skin potential and sweat rate in a symptomatic female carrier to investigate the underlying pathophysiology of anhidrosis. The basal activity and responsiveness of SSNA were both fairly well preserved, although slightly reduced compared with the control levels. However, sweating was completely absent, despite the normal skin potential change in response to SSNA bursts. These results suggest that anhidrosis in Fabry's disease is a result of sweat gland dysfunction as well as abnormal SSNA.

Adult↗

Influence of preload, afterload, and contractility on myocardial ultrasonic tissue characterization with integrated backscatter.

Influence of hemodynamic changes in preload, afterload and contractility on myocardial integrated backscatter (IB) was studied in 26 adult mongrel dogs by measuring myocardial IB calibrated with the backscatter from the blood during volume infusion (preload alteration), during aortic constriction (afterload alteration), and during dobutamine or propranolol infusion (contractility alteration). Changes in preload, afterload or contractility did not significantly affect the calibrated myocardial IB either in the septum or in the posterior wall. Changes in preload and afterload did not affect the magnitude of cyclic variation in IB. However, dobutamine produced a significant increase in the magnitude of cyclic variation in IB and propranolol significantly decreased the magnitude of cyclic variation in IB. These data indicated that the calibrated myocardial IB is independent of preload, afterload and contractility, and that the magnitude of cyclic variation in IB is influenced by contractility. We may estimate static (related to histological changes such as fibrosis, edema, necrosis, and so on) and dynamic (related to myocardial contraction such as sarcomere length, muscle fiber orientation, and so on) properties of the myocardium more precisely using myocardial IB calibrated with the backscatter from the blood in addition to the magnitude of cyclic variation in IB.

Adrenergic beta-Agonists↗

Analysis of transmural trend of myocardial integrated ultrasonic backscatter in patients with old myocardial infarction.

Changes in myocardial integrated backscatter (IB) reflect myocardial viability in patients with myocardial infarction. IB may be obtained separately in the subendocardial and subepicardial layers to establish a transmural trend. The purpose of this study is to examine the possibilities that the measurement of the transmural trend in myocardial IB may provide a new estimate of transmurality of infarction in patients with old myocardial infarction. A calibrated myocardial IB and its transmural trend were measured both in the septum and posterior wall in 21 normal subjects, 24 patients with anteroseptal old myocardial infarction (13 patients with Q-wave myocardial infarction and 11 patients with non-Q-wave myocardial infarction). The transmural trend in myocardial IB was assessed by measuring the acoustic parameter separately in the right and left ventricular halves of the septum, and in the endocardial and epicardial halves of the posterior wall. The magnitude of cyclic variation of IB (a difference between minimum and maximum peaks) was lower, and calibrated myocardial IB (the maximum value of myocardial IB at end diastole calibrated with the power of Doppler signals from the blood along the same ultrasound beam) was higher in patients with anteroseptal old myocardial infarction in the septum, compared with normal subjects. Among patients with myocardial infarction, the difference in these IB parameters between the right and left ventricular halves of the septum was found only in patients with non-Q-wave myocardial infarction. The transmural trend of myocardial IB was likely to reflect the transmurality of myocardial infarction. Therefore, our data give another insight into the assessment of transmural inhomogeneity of myocardial fibrosis or viability in patients with myocardial infarction.

Aged↗

MR findings and neurologic manifestations in Lowe oculocerebrorenal syndrome.

Two patients with oculocerebrorenal syndrome are described. Both had abnormal findings on electroencephalography and developed seizure episodes. Although Patient 2 manifested abnormal electroencephalographic findings at the age of 6 years, he did not develop seizures until the age of 9 years. Phenytoin was effective for controlling seizures in both patients. On magnetic resonance examination, there were two different types of lesions. The first lesion manifested high intensity on both T2- and proton density-weighted images, suggesting gliosis or demyelination. The second lesion manifested definitely low signals on both T1- and proton density-weighted images, implying a cystic lesion. However, these lesions on magnetic resonance examination were not correlated with the severity of clinical manifestations.

Adolescent↗

A new method of quantifying human muscle sympathetic nerve activity for frequency domain analysis.

We present a new method for quantitative analysis of muscle sympathetic nerve activity (MSNA), expressed as muscle sympathetic burst area (MSBA). This technique is likely to be useful for inter-individual comparisons and for frequency domain analysis of MSNA. After standardization of MSNA so that the burst of highest amplitude in the integrated MSNA trace was 1000 units, MSNA was assessed by measuring the area of each burst in the integrated MSNA trace, with baroreflex latency of about 1.3 sec while triggered by consecutive R-waves of the ECG. We examined the relationship between MSBA and burst rate (burst number/min) or plasma norepinephrine levels at rest in 50 healthy subjects, aged 23-82 years. MSBA showed positive correlations with burst rate (r = 0.91, n = 50) and plasma levels of norepinephrine (r = 0.64, n = 22). During head-up tilting in 6 subjects, MSBA showed linear correlations with sine values of tilt angles and with plasma norepinephrine levels. These results suggest that MSBA is a useful index of MSNA for evaluating both intra-individual and inter-individual variations of MSNA.

Adult↗

Ultrasonic myocardial tissue characterization in patients with dilated cardiomyopathy: value in noninvasive assessment of myocardial fibrosis.

Dilated cardiomyopathy (DCM) is usually diagnosed from the left ventricular functional viewpoint by the detection of dilated ventricular cavity and depressed myocardial contractility. Although histologic analysis of the myocardium no doubt provides clinically important information, it is possible only with microscopic examination of biopsy specimen of the myocardium. The objective of this particular study is to clarify the comparative values of the measures of ultrasonic tissue characterization, that is, calibrated myocardial integrated backscatter (IB) and the magnitude of cyclic variation in IB, with conventional echocardiographic parameters in assessing histologic condition of the myocardium. The magnitude of cyclic variation in IB and myocardial IB at end-diastole calibrate with the power of Doppler signals from the blood were measured in addition to conventional echocardiographic parameters in 14 patients with DCM. Calibrated myocardial IB was higher in patients with more fibrosis in the biopsy specimen of the heart tissue, whereas the magnitude of variation in IB or conventional echocardiographic parameters did not significantly correlate with a histologic estimate of myocardial fibrosis. Calibrated myocardial IB provides information about the myocardial fibrosis that cannot be assessable with conventional echocardiographic parameters. Calibrated myocardial IB and the magnitude of cyclic variation of IB are likely to reflect somewhat different acoustic properties of the myocardium.

Adult↗

Endothelial dysfunction in the early stage of atherosclerosis precedes appearance of intimal lesions assessable with intravascular ultrasound.

The objective of this study was to clarify whether morphologic evaluation of the in vivo artery with intravascular ultrasound provides as sensitive a marker as endothelial dysfunction or microscopic histologic assessment. Endothelial dysfunction assessed with the changes in the vessel diameter during acetylcholine infusion has been used as a more sensitive marker of atherosclerosis than the angiographic estimates of morphologic structure of the vessel. Recent advent of intravascular ultrasound has provided such high-resolution images of the vessels that morphologic changes in the vessel structure are sensitively and accurately detected. Twenty-two rabbits were divided into three groups: six rabbits fed a cholesterol-rich diet for 2 weeks as the hypercholesterolemia group, eight rabbits fed with the diet for 8 weeks as the atherosclerosis group, and eight rabbits fed a normal diet as the normal group. After evaluating the atherosclerotic lesions by intravascular ultrasound, the cross-sectional area was measured in the baseline and during the infusion of acetylcholine (0.05, 0.5, and 5 micrograms/kg/min) and nitroglycerin (5 micrograms/kg/min). No atherosclerotic lesions were detectable with intravascular ultrasound in any rabbit despite the presence of microscopic intimal lesions in the vessels in the rabbits of the atherosclerosis group. The cross-sectional area increased during acetylcholine infusion in the rabbits of the normal and the hypercholesterolemia groups. In contrast, in the rabbits of the atherosclerosis group, the cross-sectional area did not significantly increase during acetylcholine infusion at the rate of 0.5 microgram/kg/min and even tended to decrease at the rate of 5 micrograms/kg/min (-3.8% +/- 3.7%, P < 0.05 vs the normal group). Dilating responses to nitroglycerin infusion were similar among all three groups. In conclusion, impairment of the endothelium-dependent vasodilating response assessed with intravascular ultrasound in the in vivo vessel precedes the appearance of echographic atherosclerotic findings. Thus intravascular ultrasound, if used in combination with drug intervention to assess endothelial function, would provide even more accurate assessment of the vessels than conventional intravascular ultrasound alone.

Acetylcholine↗

Myocardial integrated ultrasonic backscatter in patients with old myocardial infarction: comparison with radionuclide evaluation.

The purpose of our study was to clarify whether the abnormalities in integrated backscatter may be used to assess myocardial viability in patients with old myocardial infarction by comparing these integrated backscatter parameters with conventional radionuclide and echocardiographic estimates of myocardial viability. Two myocardial integrated backscatter parameters, the magnitude of cyclic variation in integrated backscatter and the myocardial integrated backscatter calibrated with the power of Doppler signals from the blood along the same ultrasound beam (calibrated myocardial integrated backscatter), were measured in 21 normal persons and 33 patients with old anteroseptal myocardial infarction. Calibrated myocardial integrated backscatter was higher and the magnitude of cyclic variation in integrated backscatter was lower in the infarct septum compared with the septum of normal subjects. Percent thallium uptake, as assessed in scintigraphic images taken at rest or after reinjection, correlated well with the calibrated myocardial integrated backscatter (r = -0.72, p < 0.01) and more weakly but significantly with the magnitude of cyclic variation in integrated backscatter (r = 0.55, p < 0.05) in 16 of 33 patients. The measurement of calibrated myocardial integrated backscatter, in addition to the magnitude of cyclic variation of integrated backscatter, may likely be valuable in the noninvasive assessment of myocardial viability.

Adult↗

Role of basal release of nitric oxide in the presence of acute left ventricular dysfunction: comparative study with normal condition.

The basal release of nitric oxide (NO) plays an important role in the regulation of vascular circulation in the presence of acute left ventricular dysfunction. It is not clear, however, whether the role is as important in the presence of acute left ventricular dysfunction as it is in the normal condition. In addition, the effects of flow rate on the role of basal NO have not been clarified in the presence of acute left ventricular dysfunction. This in vivo study was attempted to compare the contribution of the basal release of NO to the regulation of vascular circulation and the effects of a mechanically reduced basal flow rate on the contribution of basally released NO between the normal condition and acute left ventricular dysfunction. In eight anesthetized dogs, the responses of femoral artery blood flow to NG-monomethyl-L-arginine (L-NMMA, 10(-5)M) were observed with and without a reduction in basal flow. The same observation was performed after the production of acute left ventricular dysfunction by coronary microembolization. Without the reduction in basal flow, the L-NMMA-induced decrease in femoral artery flow was significantly larger in acute left ventricular dysfunction than in the normal condition (-40 +/- 12% vs-17 +/- 6%, P < .01). Under the reduction in basal flow, there was no significant change in flow during the infusion of L-NMMA in the normal condition and only a small decrease in acute left ventricular dysfunction. There was no significant difference in the L-NMMA-induced changes in flow between these conditions. The contribution of basally released NO to the regulation of vascular circulation is larger in the presence of acute left ventricular dysfunction than in the normal condition; however, the role of basal NO is reduced with a decrease in basal flow rate.

Acetylcholine↗

Ageing reduces sympatho-suppressive response to head-out water immersion in humans.

Muscle sympathetic nerve activity (MSNA) is suppressed during thermoneutral head-out water immersion (HOI) in humans. In this study, the effects of ageing on the suppressive response of MSNA to HOI were determined. MSNA was recorded microneurographically from the tibial nerve in 16 healthy men, 10 of whom were aged 19-30 years (young group) and six aged 45-67 years (older group). MSNA was suppressed in all the subjects during HOI. The suppressive response was significantly less prominent in the older group than in the young group. A significant negative correlation between age and the suppressive response of MSNA induced by HOI (r = -0.53, P < 0.05) was found. We conclude that suppressive response of sympathetic nerve activity to HOI is reduced with age.

Adult↗

Stellate ganglion block is associated with increased tibial nerve muscle sympathetic activity in humans.

BACKGROUND: Left stellate ganglion block has been shown to increase heart rate and blood pressure, possible because of blockage of afferent vagal fibers from arterial baroreceptors in the aortic arch. Because efferent muscle sympathetic nerve activity (MSNA) is influenced by the arterial baroreflex, the hypothesis that left stellate ganglion block increases efferent MSNA recorded from the tibial nerve of humans was tested. METHODS: Twenty healthy male volunteers were sequentially assigned to one of three groups: stellate ganglion block (n = 10), in which 7 ml 1% mepivacaine was injected into the left stellate ganglion; placebo (n = 5), in which 7 ml of saline was injected into the left stellate ganglion; and intramuscular injection (n = 5), in which 7 ml mepivacaine was injected into the left deltoid muscle. Direct intraneural microneurographic recording with a tungsten microelectrode was used to record MSNA in the left tibial nerve. MSNA, heart rate, and blood pressure were recorded before and after injection in all groups. An additional five volunteers were studied with transthoracic echocardiography to examine the effect of stellate ganglion block on preload changes. RESULTS: Tibial nerve MSNA increased after mepivacaine injection to the left stellate ganglion but was unchanged after saline injection to the left stellate ganglion or mepivacaine injection into the deltoid muscle. Heart rate increased significantly after the left stellate ganglion block but did not change significantly after saline injection to the left stellate ganglion or after mepivacaine injection to the deltoid muscle. Systemic blood pressure did not change significantly in all groups. Left ventricular end-diastolic area and left ventricular end-diastolic circumference did not change after stellate ganglion block. CONCLUSIONS: Tibial nerve MSNA increased during left stellate ganglion block with mepivacaine.

Adult↗

Adrenergic vascular control.

The gravity-dependency and age-dependency of noradrenergic vasoconstrictor outflow to skeletal muscle (muscle sympathetic nerve activity; MSNA) in humans was analyzed by applying microneurography technique. The basal level of MSNA in the horizontally supine position increased with aging without significant changes in arterial baroreflex sensitivity. MSNA responded to +Gz load by head-up tilt and to simulated microgravity by thermoneutral head-out immersion with increasing and decreasing the activity, respectively. These gravity related responses of MSNA were age-dependent, being reduced by aging. Simultaneously monitored hemodynamic responses to +Gz load and to simulated microgravity were also age-dependent, being reduced by aging. The gravity-dependent and also age-dependent changes in the noradrenergic vasoconstrictor outflow to muscle seem to be related to the mechanisms controlling the gravity-dependent fluid shift in the human body.

Adolescent↗

Atrial natriuretic hormone inhibits angiotensin II-stimulated sympathetic nerve activity in humans.

We examined the effect of intravenous infusion of atrial natriuretic hormone (ANH) on the response of muscle sympathetic nerve activity (MSNA) to infused angiotensin II (ANG II) in humans. Infusion of saline alone or ANH (10 ng.kg-1.min-1) alone produced no significant change in MSNA, whereas the infusion of ANG II (5 ng.kg-1.min-1) alone caused a decrease in MSNA. Because elevations in arterial pressure (AP) and central venous pressure (CVP) also occurred due to ANG II, such elevations in AP and CVP could inhibit MSNA via baroreflexes. Then, the effect of ANG II on AP and CVP was inhibited by the simultaneous infusion of nitroprusside (N). Infusion of ANG II (5 ng.kg-1.min-1) produced significant increases in MSNA when ANG II was infused along with N. However, the simultaneously infused ANH (10 ng.kg-1.min-1) abolished the increases in MSNA induced by ANG II when the elevation in AP and CVP was inhibited by N. Thus ANH inhibits ANG II-induced sympathetic activation in humans. The results suggest that ANH may modulate sympathetic nerve activity at least in part by antagonizing the action of ANG II.

Adult↗

Delayed and diminished pressor response to muscle sympathetic nerve activity in the elderly.

We studied the effects of aging on alpha-receptor-mediated vasoconstrictive responses to sympathetic nerve activity in 16 healthy aged [75.8 +/- 2.7 (SE) yr] and young men (33.8 +/- 2.0 yr). Muscle sympathetic nerve activity (MSNA), heart rate, and blood pressure were analyzed during slow respiration (0.1 Hz). Peak amplitude and phase were calculated from a cosine function fitted with 0.1 Hz by using the least squares method. The latency of the pressor response to MSNA, defined as lag time from the peak of MSNA to diastolic blood pressure, was significantly longer in the aged than the young group (7.1 +/- 0.3 vs. 5.4 +/- 0.4 s; P < 0.01). The extent of pressor response to MSNA, defined as diastolic blood pressure rise in response to increase in total MSNA, was significantly lower in the aged than the young group (0.038 +/- 0.006 vs. 0.099 +/- 0.024 mmHg/unit, P < 0.001). These results suggest that alpha-receptor-mediated vasoconstrictive responses to MSNA may be attenuated in the elderly.

Adult↗

One-minute wave in body fluid volume change enhanced by postural sway during upright standing.

To analyze how the 1-min oscillation in postural sway and 1-min wave in body fluid volume change contribute to human circulatory homeostasis, several levels of body circumference, foot pressure center, electromyograms, and volumes of the leg, abdomen, and thorax were measured during upright standing for 40 min in 20 healthy young men. Spectral analyses of these parameters revealed that a 1-min rhythm is found in all parameters and that the 1-min wave in body fluid volume changes in the lower leg, which occur in fluid pooling caused by gravity, propagate upward. Muscle pumping in the lower leg triggered by the postural sway was found to increase the power of this 1-min wave. A quantitative analysis of body circumferences disclosed that the 1-min wave in body fluid volume change compensates for gravitational downward fluid shift, with the volume of 6.3 +/- 5.0 ml/cycle at the heart level. We concluded that a coupling mechanism between the 1-min oscillation in postural sway and the upward propagation of 1-min wave in body fluid volume change contributes to maintain systemic blood pressure during upright standing in humans.

Adolescent↗

Coronary back flow pressure is elevated in association with increased left ventricular end-diastolic pressure in humans.

To clarify the effect of left ventricular (LV) diastolic pressure on the coronary pressure-flow relation in humans, the instantaneous diastolic coronary pressure-Doppler flow velocity relation was analyzed at rest and during papaverine-induced maximal vasodilation in 15 patients with angiographically normal coronary arteries. The values for slope (alpha PF) and zero-flow pressure intercept (Pzf index) of the instantaneous diastolic coronary pressure-flow velocity relation were obtained by a linear regression analysis. Although alpha PF did not correlate with LV end-diastolic pressure (EDP), the Pzf index correlated positively with LVEDP both at rest and during maximal vasodilation (r = 0.64, P < 0.05 and r = 0.58, P < 0.05, respectively). Thus, the back pressure to coronary inflow, as indicated by the Pzf index, may be elevated in patients with increased LVEDP, resulting in the rightward shift of the maximally dilated coronary pressure-flow relation and decreased maximal coronary flow and reserve at any given perfusion pressure.

Adult↗