Sympathetic Action Potential Firing and Recruitment Patterns Are Abnormal in Gestational Hypertension.
Sympathetic Action Potential Firing and Recruitment Patterns Are Abnormal in Gestational Hypertension.
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妊娠高血压患者交感神经动作电位的激发和募集模式异常。
DOI：
10.1161/hypertensionaha.122.19754
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Fu,Qi
中科院分区：
文献类型：
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作者：
Badrov,MarkB;Yoo,Jeung-Ki;Hissen,SarahL;Nelson,DavidB;Shoemaker,JKevin;Fu,Qi
背景我们检验了这样的假设：患有妊娠期高血压（GH）的女性在妊娠晚期表现出异常的交感神经动作电位（AP）放电模式（32-36周），包括仰卧位休息和姿势应激。（非妊娠对照[CTRL]）和32名妊娠女性参与; 14例低风险（无个人GH史）正常妊娠（LR-NP），10例高风险（个人GH史）正常妊娠（HR-NP），8例发生GH。我们测量了仰卧位休息和60°头高位倾斜时的心率、血压和肌肉交感神经活动（显微神经描记术）。交感神经AP模式进行了研究，使用小波为基础的methodology.ResultsAt休息，肌肉交感神经活动爆发频率升高，在LR-NP，HR-NP，和GH与CTRL（所有P ≤0.01）;然而，AP含量/积分爆发增加，只有在GH（20±5个尖峰/爆发），与CTRL（8±3个尖峰/爆发）、LR-NP（9±2个尖峰/爆发）和HR-NP（11±4个尖峰/爆发;均P <0.0001）相比。因此，GH的总AP放电频率高于CTRL、LR-NP和HR-NP（均P <0.0001）。在妊娠期，AP频率与收缩压（R2=46%）和舒张压（R2=20%）直接相关（均P ≤0.01）。与CTRL不同（均P <0.01），发生GH的女性不能增加短阵内AP放电（P=0.71）或招募较大AP的潜伏亚群（P=0.72）可能与天花板效应有关;然而，GH队列中直立姿势的总AP放电频率高于CTRL，LR-NP，结论GH患者在仰卧位和直立位均表现出异常的交感神经AP放电模式。
BackgroundWe tested the hypothesis that women who develop gestational hypertension (GH) display abnormal sympathetic action potential (AP) discharge patterns during late pregnancy (32–36 weeks), both at supine rest and during postural stress.MethodsThirteen nonpregnant, female controls (nonpregnant controls [CTRL]) and 32 pregnant women participated; 14 had low-risk (no personal history of GH) normal pregnancies (LR-NP), 10 had high-risk (personal history of GH) normal pregnancies (HR-NP), and 8 developed GH. We measured heart rate, blood pressure, and muscle sympathetic nerve activity (microneurography) at supine rest and 60° head-up tilt. Sympathetic AP patterns were studied using wavelet-based methodology.ResultsAt rest, muscle sympathetic nerve activity burst frequency was elevated in LR-NP, HR-NP, and GH versus CTRL (allP≤0.01); however, the AP content per integrated burst was augmented only in GH (20±5 spikes/burst), compared with CTRL (8±3 spikes/burst), LR-NP (9±2 spikes/burst) and HR-NP (11±4 spikes/burst; allP<0.0001). Thus, total AP firing frequency was greater in GH versus each of CTRL, LR-NP, and HR-NP (allP<0.0001). In pregnancy, AP frequency is related directly to systolic (R2=46%) and diastolic (R2=20%) blood pressure (bothP≤0.01). Unlike CTRL (bothP<0.01), women who developed GH were unable to increase within-burst AP firing (P=0.71) or recruit latent subpopulations of larger-sized APs (P=0.72) in response to head-up tilt, perhaps related to a ceiling-effect; however, total AP firing frequency in the upright posture was elevated in the GH cohort versus CTRL, LR-NP, and HR-NP (allP<0.05).ConclusionsWomen who develop GH display aberrant sympathetic AP firing patterns in both the supine and upright postures.