Sympathetic Neural Control at Rest and During the Cold Pressor Test in Patients With Heart Failure With Preserved Ejection Fraction

• DOI: 10.1161/hypertensionaha.123.21918
• Publication Date: 2024-02-22T10:04:53Z
• Authors: Ryosuke Takeda; Sarah L. Hissen; John D. Akins; Takuro Washio; Christopher M. He...; James P. MacNamara; Satyam Sarma; Benjamin D. Levine; Paul J. Fadel; Qi Fu
• Keywords: Microneurography; Cold pressor test; Supine position; Sympathetic nervous system

Background: We tested the hypothesis that patients with heart failure preserved ejection fraction (HFpEF) would have greater muscle sympathetic nerve activity (MSNA) at rest and reactivity during a cold pressor test compared non–heart controls. Further, given importance of baroreflex modulation MSNA in control blood pressure (BP), we hypothesized HFpEF exhibit reduced sensitivity. METHODS: Twenty-eight 44 matched controls (mean±SD: 71±8 versus 70±7 years; 9 men/19 women 16 men/28 women) were studied. BP, rate, (microneurography) measured 6 to 10 minutes supine 2-minute test. Spontaneous sensitivity was assessed rest. Results: Patients had higher resting burst frequency (39±14 31±12 bursts/min; P =0.020) lower (−2.83±0.76 −3.57±1.19 bursts/100 heartbeats/mm Hg; =0.019) than controls, but incidence not different between groups (56±19 50±20 heartbeats; =0.179). During test, increases indices did differ ( =0.135–0.998), smaller increase diastolic BP (Δ4±6 Δ14±11 mm <0.001) Conclusions: Despite augmented frequency, significantly groups, HFpEF. Furthermore, attenuated responses These data suggest that, physiological stress, is intact, peripheral pathway for vasoconstriction may be impaired