Baker, Sarah E.

Background Central hypovolemia elicited by hemorrhage triggers sympathetically‐mediated baroreflex responses to maintain organ perfusion through peripheral vasoconstriction; humans with low tolerance (LT) to central hypovolemia have a diminished vasoconstrictor response during progressive reductions in central volume. Using the lower body negative pressure (LBNP) hemorrhage model, we tested the hypothesis that humans with LT to central hypovolemia would display attenuated resting beat‐to‐beat neuro‐hemodynamic transduction of muscle sympathetic nerve activity (MSNA) compared to those with high tolerance (HT). Methods MSNA (microneurography, peroneal nerve) and diastolic arterial pressure (DAP; finger photoplethysmography) were recorded in 33 human subjects (23 men, 10 women, age: 31 ± 9 years, BMI: 26 ± 4 kg/m 2 ) who subsequently underwent LBNP to tolerance (onset of pre‐syncopal symptoms) – Figure 1. Consistent with previous studies, subjects were classified as LT if they experienced pre‐syncopal symptoms prior to completing LBNP of −60 mm Hg, or as HT if they experienced pre‐syncopal symptoms after completing LBNP of −60 mm Hg. We performed linear regression analysis on data of binned MSNA burst areas against DAP; the slope of this regression represents transduction. Results Of the 33 subjects, 8 exhibited LT (time to pre‐syncope for LT: 17 ± 2 min and HT: 27 ± 5 min) Contrary to our hypothesis, resting beat‐to‐beat neuro‐hemodynamic transduction was not different between LT and HT subjects (median 0.09 IQR 0.03 – 0.16 mmHg (%s) − 1 vs. median 0.12 IQR 0.06 – 0.16 mmHg (%s) − 1 , respectively, p = 0.44) and was not related to time to pre‐syncope ( p = 0.70). Conclusion Tolerance to simulated blood loss is not related to resting sympathetic neuro‐hemodynamic transduction. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Objective Inadequate sleep is associated with an increased risk of hypertension. Exaggerated blood pressure (BP) reactivity to psychological stress is predictive of the development of hypertension. Following 24‐hours of total sleep deprivation, individuals exhibit an exaggerated BP response to mental stress (MS). The mechanisms contributing to this response and the generalizability to more prolonged exposure to restricted sleep are not clear. Thus we sought to examine the early hemodynamic response to MS in individuals before and during prolonged sleep restriction. We hypothesized the early rise in BP during MS would occur more slowly and would achieve a higher peak following 9 nights of restricted sleep when compared to control. We further hypothesized the contribution of total peripheral resistance (TPR) to the rise in BP would be greater following restricted sleep when compared to control. Methods Individuals completed two visits randomized to control sleep or experimental sleep restriction. Ten young (23±1 yrs) healthy, non‐obese (24±1 kg/m 2 ) men and women (5M/5F) completed the restriction visit and seven of the same individuals (23±1 yrs; 5M/2F; 24±1 kg/m 2 ) completed the control visit. Each visit consisted of 4 days of acclimation (9 hours of sleep per night) followed by 9 days of control (9 hours/night) or restricted (4 hours/night) sleep. For the purpose of this investigation, individuals were studied on days 2 and 13. Beat‐by‐beat heart rate (HR, electrocardiography) and BP (finger plethysmography) were measured continuously during 2 min of quiet rest followed by 5 min of mental arithmetic. Stroke volume (SV) was estimated from the pressure waveform and cardiac output (CO) and TPR were calculated. Peak change, time to peak, and rate of rise in BP were assessed during the initiation of mental stress (first 30‐s). Results BP increased during MS ( P <0.05) and the early peak BP did not differ between conditions ( P =0.35–0.84). However, following prolonged experimental sleep restriction, individuals achieved peak systolic BP earlier (Time to peak: 19±4 vs 9±3 s, P =0.04) and the rate of rise in diastolic BP at the onset of MS was significantly greater (0.7± 0.3 vs 2.3±0.7 mmHg/s, P =0.01) when compared to the acclimation period. No differences in time to peak BP or rate of rise at the onset of MS were observed on the control visit ( P =0.16–0.97). The peak change in SV (0.5±1.4 vs 6.3±2.1, P =0.03) and CO (1.1±0.2 vs 1.7±0.2 L/min, p=0.01) at the onset of MS were greater following prolonged sleep restriction when compared to the acclimation period. No differences in the change in SV or CO were observed on the control visit ( P =0.39–0.41) and no differences in the change in TPR were observed on either visit ( P =0.36–0.86). Conclusions Prolonged (9‐day) experimental sleep restriction (4 hours/night) results in a faster increase in BP in response to mental arithmetic. This rapid increase in BP at the onset of MS is achieved primarily via a greater increase in SV and CO when compared to the acclimation period. These data highlight an important role for CO in the BP response to stress in sleep restricted individuals and provide important insight into potential mechanisms which may contribute to the development of hypertension following inadequate sleep. Support or Funding Information NIH HL130339, NIH HL114676, NIH HL114024, NIH HL083947, APS UGSRF This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Objective Patients with sleep apnea exhibit impairments in reflex responses to decreasing, but not increasing, arterial blood pressures (BP). Attenuated BP control may contribute to the increased risk of developing hypertension observed in patients with sleep apnea; however the mechanisms involved are not completely understood. Therefore, we aimed to examine the differential effect of acute intermittent hypoxia (IH) on baroreflex sensitivity during decreasing compared to increasing BP. We hypothesized acute IH would attenuate baroreflex sensitivity to decreasing, but not increasing, BP. Methods Heart rate (HR, electrocardiography), BP (brachial arterial catheter), and muscle sympathetic nerve activity (MSNA, microneurography of the peroneal nerve) were assessed in 14 healthy adults (8M/6F; 32±1 yrs, 26±1 kg/m 2 ). Baroreflex sensitivity was evaluated during decreasing and increasing BP using the modified Oxford technique before and after 30‐min of IH [25‐s hypoxic (0.10 F i O 2 ) exposures alternating with 120‐s room air breathing]. Data were analyzed from the depressor (nitroprusside) and pressor (phenylephrine) phases of the modified Oxford for measures of cardiovagal and sympathetic baroreflex sensitivity, as well as the T50 (diastolic BP with a 50% likelihood of an MSNA burst). Results IH resulted in 15 events where oxygen saturation was reduced (S p O 2 : 98±1% vs 92±2%, p<0.01). Resting normoxic ventilation, carotid chemosensitivity to hypoxia, and MSNA were increased following IH (all p<0.05). HR, systolic BP, diastolic BP, and the T50 were not altered following 30‐min of IH (p‐value range 0.08 to 0.90). Diastolic BP was greater than T50 at baseline (Decreasing BP: p=0.046); however, after IH, diastolic BP was no longer significantly different than the T50 (p=0.52). Cardiovagal baroreflex sensitivity to decreasing and increasing BP differed at baseline (14.0±1.7 vs 22.0±3.3 ms/mmHg, p=0.02) and following IH (11.3±1.1 vs 19.1±2.0 ms/mmHg, p<0.01). Cardiovagal baroreflex sensitivity to decreasing BP tended to be lower following IH (p=0.09). Sympathetic baroreflex sensitivity to decreasing and increasing BP did not differ at baseline (−2.1±0.3 vs −2.5±0.3 %/mmHg; p=0.28) or following IH (−2.6±0.6 vs −3.0±0.4 %/mmHg, p=0.55) and was unaffected by IH (p‐value range 0.20–0.40). Conclusions Acute IH has a differential effect on baroreflex sensitivity. Specifically, cardiovagal baroreflex sensitivity to decreasing, but not increasing, BP tends to be lower following IH. In contrast, sympathetic baroreflex sensitivity is unaffected by IH. Prior to IH, diastolic BP is greater than the T50, thus promoting lower MSNA. Despite no change in baroreflex sensitivity after IH, diastolic BP is no longer significantly different than the T50 – consistent with higher MSNA following IH. Support or Funding Information NIH HL130339, Mayo Clinic Center for Biomedical Discovery This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Objective We examined the contribution of the arterial baroreflex to sympathetic discharge patterns in humans by systematically manipulating the reflex using intravenous nitroprusside and phenylephrine. We hypothesized nitroprusside would increase firing of low‐threshold axons, with no effect on recruitment of latent axons and/or synaptic delays. We further hypothesized phenylephrine would decrease firing of low‐threshold axons, with no effect on synaptic delays. Methods Heart rate (HR, ECG), arterial blood pressure (BP, brachial arterial catheter), and multi‐unit muscle sympathetic nerve activity (MSNA, microneurography of the peroneal nerve) were measured in 13 male subjects (30±2 yrs, 25±1 kg/m 2 ) at baseline and during systemic intravenous infusion of nitroprusside (0.4–1.7 μg/kg/min) and phenylephrine (0.2–1.0 μg/kg/min), administered separately. Action potential (AP) patterns were studied from the filtered raw signal using wavelet‐based methodology. Results Compared to baseline, BP decreased and HR and multi‐unit MSNA (41±5 to 53±4 bursts/100 heart beats) increased with nitroprusside (all P <0.01). Nitroprusside increased AP incidence (326±66 to 579±129 AP/100 heart beats) and AP content per integrated burst (8±1 to 11±2 AP/burst) (all P <0.01). The firing probability of low‐threshold axons increased with nitroprusside, and recruitment of previously latent, high‐threshold axons was observed (22±3 to 24±3 max clusters, 9±1 to 11±1 clusters/burst; all P <0.05). Compared to baseline, BP increased and HR and multi‐unit MSNA (41±3 to 21±3 bursts/100 heart beats) decreased with phenylephrine (all P <0.01). Phenylephrine decreased AP discharge rate (406±128 to 166±42 AP/100 heart beats) and resulted in fewer unique clusters (15±2 to 9±1 max clusters, all P <0.05); however, components of an integrated burst were not altered (9±2 vs 8±1 AP/burst; 5±1 vs 4±1 clusters/burst, P >0.05). AP cluster latency decreased with cluster size under both conditions ( P <0.01), but this relationship was not altered with nitroprusside ( P =0.42) or phenylephrine ( P =0.39). Conclusions Baroreflex unloading with systemic nitroprusside increases sympathetic neuronal discharge rate by increasing the firing probability of low‐threshold axons, in addition to recruitment of previously latent, high‐threshold axons. In contrast, baroreflex loading with systemic phenylephrine decreases neuronal discharge rate, including decreased firing probability of high‐threshold axons; however, the components of an integrated burst (AP and clusters per burst) and synaptic delays are unaffected. These data support a hierarchical pattern of sympathetic neural recruitment/de‐recruitment and suggest acute modification of synaptic delays are not influenced by the baroreflex. Support or Funding Information NIH HL083947, NIH HL130339 This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Action potentials (APs) of varying sizes and firing probabilities, that are synchronized into bursts of efferent traffic, characterize recordings of muscle sympathetic nerve activity (MSNA). Recent evidence points to ordered recruitment of these APs but the sites of this control remain unknown. This study investigated the role of the paravertebral ganglia in sympathetic AP emission patterns using pharmacological blockade of ganglionic N N ‐nicotinic receptors via trimethaphan camsylate (TM; n = 7 females, 37 ±5 years, 112 ±2/70 ±3 mmHg, 22 ±1 kg/m 2 ). Heart rate (HR; ECG), blood pressure (BP; arterial catheter) and MSNA (microneurography) were recorded during baseline, TM infusion (1–7 mg/min) and Valsalva's manoeuvre. MSNA APs were detected from the filtered raw signal using a wavelet deconstruction approach and were binned in clusters (Scott's rule) based on peak‐to‐peak amplitude (K‐means). In the final minute of MSNA burst detection during TM, HR increased (57 ±11 to 66 ±12 bpm) and mean BP decreased (97 ±7 to 90 ±7 mmHg) (both P < 0.01 compared to baseline). Relative to baseline, TM elicited a progressive reduction in total sympathetic outflow (833 ±458 to 157 ±120 AU/min), characterized by fewer integrated bursts (30 ±14 to 9 ±8 bursts/100 beats) with decaying amplitude (49 ±3 to 31 ±3 AU) (all P < 0.01). Underlying TM‐mediated attenuations in integrated MSNA were reductions in AP incidence (186 ±101 to 29 ±31 AP/100beats) and AP content per integrated burst (7 ±2 to 3 ±1 APs/burst) (all P < 0.01). Compared to baseline, the total number of active AP clusters was reduced with TM (14 ±3 to 9 ±3 AP clusters), resulting in fewer unique clusters per burst (4 ±1 to 3 ±1 AP clusters/burst) (both P < 0.01). Relative to baseline, most participants demonstrated a reduction in the within‐burst firing probability of all AP clusters, with the largest two to six AP clusters ceasing to fire in the last minute before integrated bursting activity was abolished. Following cessation of integrated MSNA bursts, the smallest 6 ±2 sympathetic AP clusters (range: 4 – 8 AP clusters) persisted to fire in an asynchronous pattern (49 ±41 AP/100beats) in all participants. Valsalva's Maneuver did not increase the incidence of these persistent small APs (60 ±42 AP/100beats, P = 0.52), or instigate any larger APs (previously active at baseline) in six of seven participants (6 ±1 total AP clusters, P = 0.30). These data suggest: 1) the paravertebral ganglia may contribute to the heterogeneity in the firing probabilities of varying sized postganglionic sympathetic APs active under baseline conditions, and 2) the presence of non‐synchronized sympathetic APs that express resistance to blockade with trimethaphan. Support or Funding Information Supported by the Natural Sciences and Engineering Research Council (NSERC) of Canada, Discovery Grant #217916‐2013. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

Asthma, chronic obstructive pulmonary disease, and other respiratory disorders often occur concurrently with heart failure (HF). HF patients with respiratory disease can improve lung function and, therefore, quality of life with β‐agonists. Beta‐agonist use remains controversial as it has been linked with increased mortality risk; however, recent studies that account for co‐morbidities find no association between β‐agonist use and mortality. Previous studies exploring the cardiovascular effect of β‐agonist use in HF are primarily retrospective and focus on heart rate (HR). We have previously demonstrated altered cardiovascular function in response to albuterol in healthy subjects. In the present study we sought to comprehensively assess the cardiovascular effects of albuterol sulfate using cardiac output (Q), stroke volume (SV), HR, systolic, diastolic, and mean arterial blood pressure (SBP, DBP, MAP, respectively) and systemic vascular resistance (SVR). We hypothesized that cardiovascular parameters would be altered 30‐minutes following albuterol administration, and that HF patients using β‐blockers would have an attenuated response. Twenty‐two healthy and twenty‐two HF subjects were recruited (age=56±13 vs. 62±12yrs; height=175±10 vs. 176±9cm; weight=78±15 vs. 93±20; BMI=26±4 vs. 30±6; and BSA=2.08±0 vs. 1.93±0m 2 , for healthy and HF, respectively, p<0.05 for weight, BMI, and BSA). We found that HR and Q increased in healthy but not HF subjects at 30min following albuterol. Patients who were not on β‐blockers (n=4, 18%) had an increase in SV and a decrease in SVR with albuterol, while there was no change in patients who were on β‐blockers (n=14, 64%). These data suggest that HF patients have an attenuated cardiovascular response to inhaled albuterol, particularly with concurrent β‐blocker usage.

Background Fluid flux in the lungs is influenced by factors altering accumulation or removal (e.g., stimulation of epithelium sodium channels, ENaC). Purpose To determine if ENaC are necessary in the normal fluid regulation with simulated altitude exposure. Methods/Results On separate occasions, 19 healthy subjects (27 ± 5 y) received either nebulized amiloride (ENaC antagonist) or placebo (nebulized saline) during 17 h normobaric hypoxia (FIO2 = 12.5%) in a randomized, double‐blind fashion. Lung diffusing capacity for carbon monoxide (DLCO), alveolar‐capillary membrane conductance (Dm) and pulmonary capillary blood volume (Vc) were measured via a rebreathe method before and after hypoxic exposure. DLCO was not different at baseline for the amiloride vs. placebo treatments (19 ± 5 vs. 21 ± 8 mL/min/mmHg). Hypoxic exposure increased Vc but did not change Dm in both treatments (Placebo: Vc = 43 ± 22 vs. 59±23 mL p=0.011, Dm = 35 ± 10 vs. 37 ± 12 mL/min/mmHg p=0.312; Amiloride: Vc = 38 ± 17 vs. 57 ± 22 mL p<0.01, Dm = 31 ± 8 vs. 34 ± 10 mL/min/mmHg p= 0.206). Conclusion Normobaric hypoxia did not differentially affect alveolar‐capillary conductance in amiloride and placebo conditions, suggesting that ENaC do not have a role in normal lung fluid regulation during acute hypoxic exposure. HL71478

Background The baroreflex plays an integral role in blood pressure maintenance by altering heart rate and sympathetic activity in response to changes in arterial pressure. Baroreflex sensitivity (BRS) has been shown to decrease linearly during progressive exposure to central hypovolemia as induced by lower body negative pressure (LBNP), and can be used as an index of decompensation status during hemorrhage. Circulating epinephrine is significantly elevated during high stress situations such as hemorrhage; however, it is unclear whether epinephrine influences BRS during progressive exposure to central hypovolemia. Based on previous work, we hypothesized epinephrine would attenuate any reduction in spontaneous cardiac baroreflex sensitivity during LBNP. Methods Ten young (35±3 yrs), healthy (BMI 24±1 kg/m 2 ) men and women (6M/4F) underwent LBNP protocols on 2 separate days consisting of a 10‐min pre‐infusion baseline, 15‐min infusion period (randomized to saline or epinephrine, 0.1 μg/kg/min), 10‐min post‐infusion baseline, and 5 minutes of LBNP at −15, −30, −45, −60, −70, and −80 mmHg until the onset of presyncope (range= −30 to −80 mmHg). Presyncope was defined as a rapid decrease in systolic blood pressure greater than 15 mmHg, systolic blood pressure less than 80 mmHg, bradycardia, or voluntary termination due to presyncopal symptoms. Heart rate (HR; electrocardiogram) and blood pressure (BP; radial arterial catheter) were recorded continuously. Spontaneous cardiac BRS was determined using the sequence method (WinCPRS). Data are reported from both 10‐min baselines and from 1 minute at 20, 40, 60, 80, and 100 percent of each individual's total LBNP exposure time. Results We observed no significant differences in total exposure time (1475±150 vs. 1415±79s; p=0.69) or cumulative stress index (820±135 vs. 699±69 min*mmHg; p=0.37) between saline and epinephrine visits, respectively. Baroreflex sensitivity did not change during post‐infusion baselines (ΔDown‐Down =−2±1 vs. −2±2 ms/mmHg; saline vs. epinephrine, respectively; p=0.09). Baroreflex sensitivity was significantly reduced with LBNP (p<0.01 main effect of LBNP). There was no difference between the change in baroreflex sensitivity during LBNP with saline or epinephrine infusion (ΔDown‐Down =−14±4 vs. −8±4 ms/mmHg, p=0.17). Conclusions Consistent with previous work, spontaneous cardiac baroreflex sensitivity fell during LBNP. Contrary to our hypothesis, epinephrine infusion did not attenuate the fall in spontaneous cardiac baroreflex sensitivity observed during simulated blood loss. Because epinephrine did not alter the effect of LBNP on BRS, these data suggest that BRS may accurately reflect decompensation status during traumatic hemorrhage independent of elevated circulating epinephrine. Support or Funding Information US Army Medical Research and Materiel Command Contract W81XWH‐13‐2‐0038

AbstractIn the absence of effective countermeasures, human convalescent plasma has been widely used to treat severe acute respiratory syndrome coronavirus 2, the causative agent of novel coronavirus disease 19 (COVID‐19), including among patients with innate or acquired immunosuppression. However, the association between COVID‐19‐associated mortality in patients with immunosuppression and therapeutic use of convalescent plasma is unknown. We review 75 reports, including one large matched‐control registry study of 143 COVID‐19 patients with hematological malignancies, and 51 case reports and 23 case series representing 238 COVID‐19 patients with immunosuppression. We review clinical features and treatment protocols of COVID‐19 patients with immunosuppression after treatment with human convalescent plasma. We also discuss the time course and clinical features of recovery. The available data from case reports and case series provide evidence suggesting a mortality benefit and rapid clinical improvement in patients with several forms of immunosuppression following COVID‐19 convalescent plasma transfusion. The utility of convalescent plasma or other forms of antibody therapy in immune‐deficient and immune‐suppressed patients with COVID‐19 warrants further investigation.

Abstract Elite performing men continue to record faster record times in running events compared to women. These sex‐based differences in running speed and endurance in humans are expected based on sexual dimorphisms that contribute to differences in the determinants of aerobic performance. Comparatively, the sexual dimorphisms contributing to sex‐based differences in elite aerobic performance are not ubiquitous across other species that compete in running events. The purpose of this review is to offer a framework and model for ongoing discussions of the physiological determinants and ultimately limits of physical performance. The records for average running speed of champion athletes were delineated by sex for thoroughbred horses, greyhound dogs, and humans. Male and female performances within each of these species are being optimized by training, nutrition, and financial incentives, and are approaching a performance maximum. For horses and greyhounds breeding also plays a role. Analysis of athletic records shows that there is a sex‐related difference of ~10% or more in elite athletic performance for humans; however, the upper limit of performance does not appear to be different between sexes for thoroughbred horses and greyhound dogs. In the context of the nil sex differences in running performance in thoroughbreds and greyhounds, we discuss the physiological role of sexual dimorphisms on sex‐specific limits to running performance. We highlight that studies on both human and animal performance in athletic events stimulate critical physiological questions and drive novel research.