Supine exercise restores arterial blood pressure and skin blood flow despite dehydration and hyperthermia.
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We determined whether the deleterious effects of dehydration and hyperthermia on cardiovascular function during upright exercise were attenuated by elevating central blood volume with supine exercise. Seven trained men [maximal oxygen consumption (VO(2 max)) 4.7 +/- 0. 4 l/min (mean +/- SE)] cycled for 30 min in the heat (35 degrees C) in the upright and in the supine positions (VO(2) 2.93 +/- 0.27 l/min) while maintaining euhydration by fluid ingestion or while being dehydrated by 5% of body weight after 2 h of upright exercise. When subjects were euhydrated, esophageal temperature (T(es)) was 37. 8-38.0 degrees C in both body postures. Dehydration caused equal hyperthermia during both upright and supine exercise (T(es) = 38. 7-38.8 degrees C). During upright exercise, dehydration lowered stroke volume (SV), cardiac output, mean arterial pressure (MAP), and cutaneous vascular conductance and increased heart rate and plasma catecholamines [30 +/- 6 ml, 3.0 +/- 0.7 l/min, 6 +/- 2 mmHg, 22 +/- 8%, 14 +/- 2 beats/min, and 50-96%, respectively; all P < 0. 05]. In contrast, during supine exercise, dehydration did not cause significant alterations in MAP, cutaneous vascular conductance, or plasma catecholamines. Furthermore, supine versus upright exercise attenuated the increases in heart rate (7 +/- 2 vs. 9 +/- 1%) and the reductions in SV (13 +/- 4 vs. 21 +/- 3%) and cardiac output (8 +/- 3 vs. 14 +/- 3%) (all P < 0.05). These results suggest that the decline in cutaneous vascular conductance and the increase in plasma norepinephrine concentration, independent of hyperthermia, are associated with a reduction in central blood volume and a lower arterial blood pressure. (+info)
Lateral cerebellar hemispheres actively support sensory acquisition and discrimination rather than motor control.
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This study examined a new hypothesis proposing that the lateral cerebellum is not activated by motor control per se, as widely assumed, but is engaged during the acquisition and discrimination of tactile sensory information. This proposal derives from neurobiological studies of these regions of the rat cerebellum. Magnetic resonance imaging of the lateral cerebellar output nucleus (dentate) of humans during passive and active sensory tasks confirmed four a priori implications of this hypothesis. Dentate nuclei responded to cutaneous stimuli, even when there were no accompanying overt finger movements. Finger movements not associated with tactile sensory discrimination produced no dentate activation. Sensory discrimination with the fingers induced an increase in dentate activation, with or without finger movements. Finally, dentate activity was greatest when there was the most opportunity to modulate the acquisition of the sensory tactile data: when the discrimination involved the active repositioning of tactile sensory surface of the fingers. Furthermore, activity in cerebellar cortex was strongly correlated with observed dentate activity. This distinct four-way pattern of effects strongly challenges other cerebellar theories. However, contrary to appearances, neither our hypothesis nor findings conflict with behavioral effects of cerebellar damage, neurophysiological data on animals performing motor tasks, or cerebellar contribution to nonmotor, perceptual, and cognitive tasks. (+info)
Comparisons between hemodynamics, during and after bathing, and prognosis in patients with myocardial infarction.
(19/807)
The purpose of this study was to establish the safest way to bathe patients with myocardial infarction (MI) through measuring the hemodynamics during and after bathing. Seventy patients with MI were bathed supine in a Hubbard tank filled with 42 degrees C tap water for 5 min. The subjects were divided into 2 groups depending on their hemodynamic values 10 min after bathing: pulmonary capillary wedge pressure unchanged even after bathing (group A), and decreased pressure after bathing (group B). The left ventricular ejection fraction of group B was significantly higher than that of group A: 53.6% vs. 39.7%, respectively (p<0.01). The physical work capacity of group B was significantly higher at 5.6 METs, than that of group A with 4.5 METs (p<0.05). During the average of their 37-month follow-up period, there were 3 cardiac events in group B and 6 in group A. There were 2 cardiac events during bathing, both of which occurred in group A. When patients with MI take a bath, it is essential to closely monitor them, especially to those patients with lower cardiac function, because they have a higher possibility of a cardiac event. (+info)
Arterial pressure in humans during weightlessness induced by parabolic flights.
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Results from our laboratory have indicated that, compared with those of the 1-G supine (Sup) position, left atrial diameter (LAD) and transmural central venous pressure increase in humans during weightlessness (0 G) induced by parabolic flights (R. Videbaek and P. Norsk. J. Appl. Physiol. 83: 1862-1866, 1997). Therefore, because cardiopulmonary low-pressure receptors are stimulated during 0 G, the hypothesis was tested that mean arterial pressure (MAP) in humans decreases during 0 G to values below those of the 1-G Sup condition. When the subjects were Sup, 0 G induced a decrease in MAP from 93 +/- 4 to 88 +/- 4 mmHg (P < 0.001), and LAD increased from 30 +/- 1 to 33 +/- 1 mm (P < 0.001). In the seated position, MAP also decreased from 93 +/- 6 to 87 +/- 5 mmHg (P < 0.01) and LAD increased from 28 +/- 1 to 32 +/- 1 mm (P < 0.001). During 1-G conditions with subjects in the horizontal left lateral position, LAD increased compared with that of Sup (P < 0.001) with no further effects of 0 G. In conclusion, MAP decreases during short-term weightlessness to below that of 1-G Sup simultaneously with an increase in LAD. Therefore, distension of the heart and associated central vessels during 0 G might induce the hypotensive effects through peripheral vasodilatation. Furthermore, the left lateral position in humans could constitute a simulation model of weightlessness. (+info)
Origins of heart rate variability: relationship of heart rate burst morphology to work duration and load.
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We are developing a lexicon of specific heart period changes, or lexons, that recur frequently and whose physiological meaning can be read into ambulatory electrocardiogram (ECG). The transient, reversible "burst" of tachycardia induced by exercise initiation can also be seen on ambulatory ECG. We hypothesized that burst morphology depended on the work that preceded it and on baroreceptor activation. Ten subjects with mean age 38 yr (range 17-69 yr) underwent two protocols of semisupine cycling in which load and duration were varied. Burst duration increased with longer cycling times (median values of 18.0, 25.5, and 23.7 s with 1, 3, and 5 s of cycling, respectively; P = 0.033). Burst shape as assessed by heart period exponential decay constant and burst magnitude did not change. To assess the impact of workload, subjects cycled for 5 s at loads of 0, 25, 50, and 75 W. No significant differences were seen in burst duration, burst magnitude, or burst shape. Tachycardia preceded hypotension by 4.6 +/- 2.2 s, which is inconsistent with baroreceptor involvement in the onset of burst tachycardia. Because burst morphology is a nearly quantal response to the initiation of exercise, the presence of a burst on an ambulatory ECG implies the onset of exercise. (+info)
Spectral analysis of arterial blood pressure and cerebral blood flow velocity during supine rest and orthostasis.
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This study evaluates the effect of orthostasis on the low frequency (LF, 0.04 to 0.15 Hz) fluctuations in the blood flow velocity of the middle cerebral artery (MCAFV) in relation to its arterial blood pressure (ABP) equivalent to further define and quantify this relationship in cerebrovascular regulation. Spectral analysis was performed on 22 healthy subjects during supine rest and head-up tilt. The power in the LF range can be used to quantify the LF fluctuations, and four types of LF power data could be obtained for each individual: LF power of supine MCAFV, LF power of supine ABP, LF power of tilt MCAFV, and LF power of tilt ABP. By comparing LF power of MCAFV with LF power of ABP, two power ratios could be generated to describe the flow-pressure relationship during supine rest and head-up tilt, respectively, supine power ratio (LF power of supine MCAFV/ LF power of supine ABP) and tilt power ratio (LF power of tilt MCAFV/ LF power of tilt ABP). In addition, an index for dynamic autoregulation in response to orthostasis can be calculated from these two power ratios (tilt power ratio/supine power ratio). The authors found that this index was dependent on the extent of orthostatic MCAFV changes, and the dependency could be mathematically expressed (r = 0.61, P = .0001), suggesting its involvement in cerebrovascular regulation. Moreover, these data further support the previous observation that the LF fluctuations of MCAFV might result from modulation of its ABP equivalent, and the modulation effect could be quantified as the power ratio (LF power of MCAFV/ LF power of ABP). These observations could be an important step toward further insight into cerebrovascular regulation, which warrants more research in the future. (+info)
Progress in reducing risky infant sleeping positions--13 states, 1996-1997.
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Sudden infant death syndrome (SIDS) is one of the leading causes of postneonatal mortality in the United States. To reduce the risk for SIDS, the American Academy of Pediatrics (AAP) recommends that all healthy babies be placed to sleep on their backs. In 1994, a national "Back-to-Sleep" education campaign was begun to encourage health-care providers and the public to adopt a back or side sleeping position for all infants. To assess the response to these recommendations, CDC analyzed population-based data on infant sleeping positions during 1996 and 1997 from 13 states participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). This report summarizes the results of that analysis and indicates that from 1996 to 1997 placement of infants in the stomach sleeping position declined significantly in four states and placement of infants in the back sleeping position increased significantly in nine states. However, the percentage of infants placed on their stomachs continued to differ by state, maternal demographics, and type of insurance coverage. (+info)
Return of autonomic nervous activity after delivery: role of aortocaval compression.
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We have compared measures of heart rate variability (HRV) in 15 women in late pregnancy before and 3 months after delivery and in 20 non-pregnant controls, to study the effect of aortocaval compression on autonomic nervous activity. Normalized high-frequency power was used as an index of vagal activity and the low-/high-frequency power ratio as index of sympathovagal balance. We found that the decrease in vagal activity and increase in sympathovagal balance before delivery returned to normal 3 months after delivery. Percentage changes in vagal activity and sympathovagal balance 3 months after delivery in the left lateral decubitus position were least among three recumbent positions. The relief of aortocaval compression as a result of delivery of the fetus may be the main cause of return of autonomic nervous activity 3 months after delivery. Postpartum hormonal changes may also contribute to return of autonomic nervous activity after delivery. (+info)