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Relationship of Cardiac Chamber Volume to Baroreflex Activity in Normal Humans

Vascular Medicine, Cardiovascular and Endocrinology Divisions, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts 02115

Address requests for reprints to: M. A. Creager, M.D., Division of Vascular Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115.

The objectives of this study were to examine the effect of incremental lower body negative pressure (LBNP) on cardiac chamber volume and assess the relationship between cardiac chamber volume and baroreflex activation of the neu-rohormonal axis. Accordingly, echocardiographic determination of cardiac chamber volume and neurohormonal responses were studied in 14 normal subjects during incremental LBNP. LBNP –10 mm Hg decreased left atrial diameter and left ventricular systolic volume index, but did not alter heart rate, systolic or pulse pressure, or stroke volume. During LBNP –10 mm Hg, plasma norepinephrine levels increased, suggesting activation of the sympathetic nervous system. LBNP –40 mm Hg caused a significant decrease in left atrial diameter and left ventricular systolic, diastolic, and stroke volume indices. During LBNP –40 mm Hg, heart rate increased, and systolic and pulse pressure fell. With this more negative level of LBNP, norepinephine, angiotensin II, aldosterone, and arginine vasopressin concentrations and PRA all increased. The findings that left atrial diameter decreased and plasma norepinephrine concentration increased during LBNP –10 mm Hg suggest that the sympathetic nervous system is sensitive to changes in atrial receptor activity. At higher levels of LBNP (–40 mm Hg), activation of the renin-angibtensin system and release of vasopressin were associated with a fall in left ventricular diastolic volurne as well as a decrease in the pressure input to the arterial baroreceptors. Under this condition, the differential contribution of the cardiopulmonary and arterial baroreceptbrs to the regulation of the renin-angiotensin system and vasopressin release cannot be distinguished.

Received December 22, 1986.

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