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At least 19 recordsLinked to original sources
PubMed1986

Mechanical effects of vasoactive drugs on carotid sinus.

Carotid sinus diameter (CSD) is influenced by changes in sympathetic tone and vasoactive agents. This study was designed to determine which mechanical properties of the carotid sinus region were influenced by infusing vasoconstrictors (epinephrine, 4.56 X 10(-6) M, and phenylephrine, 9.85 X 10(-5) M) and a vasodilator (nitroprusside, 1.68 X 10(-4) M). CSD, carotid sinus length (CSL), pressure (CSP), and compliance (CSC), and arterial pressure were all recorded simultaneously from the isolated constant-flow-perfused carotid sinus region of 11 anesthetized dogs (35 mg/kg pentobarbital sodium) before and after drug perfusion. CSC was measured by a method previously described in which 13 microliters of perfusate is injected into the segment in a step-like manner and the resultant step change in pressure recorded. The compliance of the vessel segment is read on-line after a calibration procedure. CSD and CSL were measured using sonomicrometer length gauges positioned across and along the length of the carotid sinus segment. At a CSP of 99.9 +/- 0.6 (SE) mmHg, CSD, CSL, and CSC were 8.50 +/- 0.44 mm, 9.44 +/- 0.84 mm, and 0.46 +/- 0.05 microliter/mmHg, respectively. Decreasing CSP to 50 mmHg significantly reduced CSD and CSL and increased CSC. Increasing CSP to 150 mmHg produced opposite results. Vasoconstrictor drug infusion significantly decreased and vasodilator drug infusion significantly increased both CSD and CSL, producing parallel shifts in the CSP-CSD and -CSL curves toward and away from the pressure axis. The shift to new pressure-volume curves resulted in no change in CSC in response to the vasoactive agents.

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PubMed1988

Association between immediate termination of supraventricular tachycardia by carotid sinus pressure and carotid sinus hypersensitivity.

An association between rapid reversion of supraventricular tachycardia by carotid sinus stimulation and carotid sinus reflex hypersensitivity during sinus rhythm is described in a 55-year-old patient. The findings indicate that a high level of vagal tone facilitates vagal maneuvers in terminating some supraventricular tachyarrhythmias. The briskness of the response during tachycardia may also be a marker for underlying carotid sinus hypersensitivity.

Carotid Sinus↗
PubMed1979

Carotid sinus syndrome: treatment by carotid sinus denervation.

Hypersensitive carotid sinus is a rare cause of spontaneous syncopal attacks. It must be differentiated from the other more common causes, such as intrinsic cardiac disease, vasovagal responses, postural hypotension and cerebrovascular insufficiency, although it may accompany these conditions. The definition of carotid sinus syncope is syncope elicited by stimulation of a hypersensitive carotid sinus. Nineteen patients with carotid sinus syncope were treated by carotid sinus denervation. Ages ranged from 48 to 83 with a mean of 65.5 years. Symptoms of marked dizziness or syncope were reproduced by gentle compression over the carotid bifurcation, while ECG monitoring revealed bradycardia or transient asystole. Seventeen patients had carotid arteriograms, eleven of which were normal. One patient had stenosis of the external carotid artery, while five had stenosis of the internal carotid. The right carotid sinus was involved in ten patients, the left in three and both sides in six. All patients underwent unilateral or bilateral carotid sinus denervation. Five patients with internal carotid stenosis had concomitant carotid endarterectomy. Complete relief of symptoms or marked improvement was noted in all but one patient. Postoperative follow-up ranged up to 15 years. Carotid sinus denervation is a simple, effective method of treating this disorder.

Aged↗
PubMed1976

Interplay among carotid sinus, cardiopulmonary, and carotid body reflexes in dogs.

Interactions among vascular reflexes evoked from carotid sinuses, carotid bodies, and cardiopulmonary region were examined in anesthetized, atropinized, and respired dogs with aortic nerves cut. The carotid sinuses were perfused at 220, 150, and 40-50 mmHg; the chemoreceptors were stimulated by perfusion with hypoxic hypercapnic blood. Cardiopulmonary vasomotor inhibition was interrupted by vagal cold block. Measurements were made of arterial blood pressure and of kidney and hindlimb vascular resistance. At sinus pressures less than 170-160 mmHg, cardiopulmonary vasomotor inhibition increased with increase in blood volume. At high sinus pressure, interruption of this augmented cardiopulmonary inhibition was as ineffective in changing vascular resistance as interruption of the lesser inhibition present during normovolemia. Chemoreceptor stimulation increased the response to vagal block at intermediate but not at high or low sinus pressure. The studies demonstrate the dominant role of the carotid sinus reflex when the three systems interact and the ineffectiveness of chemoreceptor stimulation when carotid or cardiopulmonary inhibition is maximal.

Animals↗
PubMed1995

Long-term follow-up of the reproducibility of carotid sinus hypersensitivity in patients with carotid sinus syndrome.

The reproducibility of carotid sinus hypersensitivity to carotid sinus massage was studied in the long-term follow-up of 8 patients with carotid sinus syndrome. A cardioinhibitory response was induced in 7 patients, while a vasodepressor response was found in the remaining patient. The 7 patients were treated with dual-chamber pacemaker implantation and the remaining patient was treated with propranolol. All of the patients remained asymptomatic during a follow-up period of 48 +/- 11 months. Carotid sinus massage during the follow-up period in patients with a cardioinhibitory response revealed asystolic intervals of 3 s or longer in 4 patients and in 3 patients at the second and third follow-up examinations, respectively, although there were no significant differences in the ventricular asystolic intervals between before, and 34 +/- 11 months and 48 +/- 11 months after treatment. However, each patient showed a wide variation in asystolic intervals. The differences in asystolic intervals between prior to treatment (first) and the third test were significantly greater than those between the first and the second test (2.4 +/- 1.2 s vs 0.7 +/- 0.6 s; p < 0.05). The one patient with a vasodepressor response had a decreased systolic blood pressure greater than 50 mmHg by carotid sinus massage at all three occasions. In conclusion, most patients with carotid sinus syndrome showed abnormal and variable responses to carotid sinus massage during long-term follow-up period although there was no recurrence of symptoms after treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2000

Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential.

OBJECTIVE: To assess the diagnostic value of supine and upright carotid sinus massage in elderly patients. DESIGN: Prospective controlled cohort study. SETTING: Three inner city accident and emergency departments and a dedicated syncope facility. PATIENTS: 1375 consecutive patients aged > 55 years presenting with unexplained syncope and drop attacks; 25 healthy controls. INTERVENTIONS: Bilateral supine carotid sinus massage, repeated in the 70 degrees head up tilt position if the initial supine test was not diagnostic of cardioinhibitory and mixed carotid sinus hypersensitivity. MAIN OUTCOME MEASURES: Diagnosis of cardioinhibitory or mixed carotid sinus hypersensitivity; clinical characteristics of supine v upright positive groups. RESULTS: 226 patients were excluded for contraindications to carotid sinus massage. Of 1149 patients undergoing massage, 223 (19%) had cardioinhibitory or mixed carotid sinus hypersensitivity; 70 (31%) of these had a positive response to massage with head up tilt following negative supine massage (95% confidence interval, 25.3% to 37.5%). None of the healthy controls showed carotid sinus hypersensitivity on erect or supine massage. The initially positive supine test had 74% specificity and 100% sensitivity; these were both 100% for the upright positive test. The clinical characteristics of the supine v upright positive subgroups were similar. CONCLUSIONS: The diagnosis of carotid sinus hypersensitivity amenable to treatment by pacing may be missed in one third of cases if only supine massage is performed. Massage should be done routinely in the head up tilt position if the initial supine test is negative.

Aged↗
PubMed1981

The responses in renal nerves to stimulation of atrial receptors, carotid sinus baroreceptors and carotid chemoreceptors.

The reflex reduction in activity in renal sympathetic nerves in response to distension of small balloons in the pulmonary vein-atrial junctions was studied in dogs anaesthetized with chloralose; the carotid sinuses were isolated and perfused with blood. In the first group of dogs, the response to distension of the balloons was studied at different levels of carotid sinus pressure. In thirteen preparations of renal nerves in eight dogs the response was not significantly influenced when the mean carotid sinus pressure was changed from 9.5 kPa to 17.5 kPa, despite marked changes in control frequencies of activity in the nerves. In the second group of dogs, the response to distension of the balloons was studied when the carotid sinuses were perfused alternately with arterial and venous blood. In six preparations of renal nerves in five dogs the response was not significantly influenced when the blood perfusing the carotid sinuses was changed, despite marked changes in control frequencies of activity in the nerves. In a third group of dogs, the reflex reduction in activity in renal nerves in response to a step increase in pressure in one carotid sinus was examined at different levels of pressure in the contralateral carotid sinus. In six preparations of renal nerves in five dogs the response to an increase in pressure in one carotid sinus was significantly reduced when the mean pressure in the contralateral sinus was changed from 8.7 kPa to 17.1 kPa. It is concluded that there is no interaction between the projections of atrial receptors and carotid sinus baroreceptors or carotid chemoreceptors in their convergence on the same efferent renal neurones.

Animals↗