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Broadbent J, Reichmuth J, Trozic I, Kneihsl M, Rössler A, Green DA, Rodriguez J, Hinghofer-Szalkay H, Fazekas F, Goswami N. Adrenomedullin and galanin responses to orthostasis in older persons. Eur J Clin Invest 2017; 47:812-818. [PMID: 28796366 DOI: 10.1111/eci.12803] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 08/07/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Neuroendocrine responses to orthostasis may be critical in the maintenance of mean arterial pressure in healthy individuals. A greater reduction in orthostatic tolerance with age may relate to modulation of hormonal responses such as adrenomedullin and galanin. Thus, we investigated (i) whether adrenomedullin and galanin concentrations increase during orthostatic challenge in older subjects, (ii) whether adrenomedullin and galanin concentrations are higher in older females compared with older males when seated and during orthostatic challenge, and (iii) whether postural changes in plasma concentrations of galanin are correlated with levels of adrenomedullin in either older females or males. MATERIALS AND METHODS Subjects (n = 18; 12 ♀; 55-80 years old) performed a sit-to-stand test in a 25°C sensory-minimised environment, with blood samples collected after 4 min of being seated and then when standing. Plasma adrenomedullin and galanin concentrations were determined. RESULTS Baseline plasma concentration of adrenomedullin (5·35 ± 0·74 (n = 12, females) vs. 7·40 ± 1·06 pg/mL (n = 5, males)) and galanin (64·07 ± 9·05 vs. 98·99 ± 16·90 pg/mL, respectively) did not significantly differ between genders. Furthermore, plasma adrenomedullin and galanin concentrations were not significantly affected by adoption of the upright posture in either gender and were not correlated in females or males. CONCLUSIONS Adrenomedullin and galanin concentrations were similar between genders and did not change following adoption of the standing posture. To further clarify the roles, these hormones play in orthostatic intolerance, adrenomedullin and galanin concentrations should be assessed in participants who show presyncopal symptoms during an orthostatic challenge.
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Affiliation(s)
- James Broadbent
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria.,Centre of Human & Aerospace Physiological Sciences, King's College London, London, UK
| | - Johannes Reichmuth
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Irhad Trozic
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Andreas Rössler
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - David A Green
- Centre of Human & Aerospace Physiological Sciences, King's College London, London, UK
| | - Joel Rodriguez
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria.,Centre of Human & Aerospace Physiological Sciences, King's College London, London, UK
| | - Helmut Hinghofer-Szalkay
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Nandu Goswami
- Gravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria
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O'Shea D, Lackner HK, Rössler A, Green DA, Gauger P, Mulder E, Tamma G, Hinghofer-Szalkay H, Valenti G, Goswami N. Influence of bed rest on plasma galanin and adrenomedullin at presyncope. Eur J Clin Invest 2015; 45:679-85. [PMID: 25912957 DOI: 10.1111/eci.12455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/22/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND The role of hormones in reduced orthostatic tolerance following long-term immobilization remains uncertain. We have previously shown that plasma concentrations of adrenomedullin and galanin, two peptides with vasodepressor properties, rise significantly during orthostatic challenge. We tested the hypothesis that bedrest immobilization increases the rise in adrenomedullin and galanin during orthostatic challenge leading to presyncope. MATERIALS AND METHODS We measured baseline (supine), presyncope and recovery (10 min postpresyncope, supine) levels of adrenomedullin and galanin in 8 healthy men, before and after 21 days of -6° head-down bed rest (HDBR). Presyncope was elicited using a combined head-up tilt and graded lower body negative pressure protocol. Orthostatic tolerance was defined as the time taken from the commencement of head-up tilt to the development of presyncope. RESULTS Orthostatic tolerance time after HDBR reduced by 8·36 ± 5·39 min (P = 0·0032). HDBR increased plasma adrenomedullin concentration to orthostatic challenge (P = 0·0367). Compared to pre-HDBR, a significant rise in post-HDBR presyncopal (P < 0·001) and recovery adrenomedullin concentration (P < 0·01) was demonstrated. In contrast, we observed no change in pre- and post-HDBR galanin levels to orthostatic challenge. CONCLUSIONS Bedrest immobilization appears to affect adrenomedullin levels in that greater increases in adrenomedullin occur at presyncope following bedrest immobilization. Due to its peripheral vasculature hypotensive effect, the greater levels of adrenomedullin at presyncope following bedrest immobilization may have contributed to the reduced orthostatic capacity postbedrest.
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Affiliation(s)
- Daniel O'Shea
- Gravitational Physiology and Medicine research unit, Institute of Physiology, Medical University of Graz, Graz, Austria.,Centre of Human & Aerospace Physiological Sciences, King's College London, London, UK
| | - Helmut K Lackner
- Gravitational Physiology and Medicine research unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Andreas Rössler
- Gravitational Physiology and Medicine research unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - David A Green
- Centre of Human & Aerospace Physiological Sciences, King's College London, London, UK
| | - Peter Gauger
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Edwin Mulder
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Grazia Tamma
- Department of Biosciences, Biotechnologies and Biopharmaceutics University of Bari, Bari, Italy
| | - Helmut Hinghofer-Szalkay
- Gravitational Physiology and Medicine research unit, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - Giovanna Valenti
- Department of Biosciences, Biotechnologies and Biopharmaceutics University of Bari, Bari, Italy
| | - Nandu Goswami
- Gravitational Physiology and Medicine research unit, Institute of Physiology, Medical University of Graz, Graz, Austria
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Chalkias A, Fanos V, Noto A, Castrén M, Gulati A, Svavarsdóttir H, Iacovidou N, Xanthos T. 1H NMR-metabolomics: can they be a useful tool in our understanding of cardiac arrest? Resuscitation 2014; 85:595-601. [PMID: 24513156 DOI: 10.1016/j.resuscitation.2014.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/12/2013] [Accepted: 01/26/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This review focuses on the presentation of the emerging technology of metabolomics, a promising tool for the detection of identifying the unrevealed biological pathways that lead to cardiac arrest. DATA SOURCES The electronic bases of PubMed, Scopus, and EMBASE were searched. Research terms were identified using the MESH database and were combined thereafter. Initial search terms were "cardiac arrest", "cardiopulmonary resuscitation", "post-cardiac arrest syndrome" combined with "metabolomics". RESULTS Metabolomics allow the monitoring of hundreds of metabolites from tissues or body fluids and already influence research in the field of cardiac metabolism. This approach has elucidated several pathophysiological mechanisms and identified profiles of metabolic changes that can be used to follow the disease processes occurring in the peri-arrest period. This can be achieved through leveraging the strengths of unbiased metabolome-wide scans, which include thousands of final downstream products of gene transcription, enzyme activity and metabolic products of extraneously administered substances, in order to identify a metabolomic fingerprint associated with an increased risk of cardiac arrest. CONCLUSION Although this technology is still under development, metabolomics is a promising tool for elucidating biological pathways and discovering clinical biomarkers, strengthening the efforts for optimizing both the prevention and treatment of cardiac arrest.
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Affiliation(s)
- Athanasios Chalkias
- MSc "Cardiopulmonary Resuscitation", Medical School, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU and University of Cagliari, Cagliari, Italy
| | - Antonio Noto
- Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU and University of Cagliari, Cagliari, Italy
| | - Maaret Castrén
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Section of Emergency Medicine, Södersjukhuset, Stockholm, Sweden
| | - Anil Gulati
- Midwestern University, Downers Grove, IL, USA
| | | | - Nicoletta Iacovidou
- Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; 2nd Department of Obstetrics and Gynecology, Neonatal Division, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Xanthos
- MSc "Cardiopulmonary Resuscitation", Medical School, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece
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The relationships between plasma adrenomedullin and endothelin-1 concentrations and Doppler echocardiographic indices of left ventricular function during static exercise in healthy men. J Hum Kinet 2012; 33:81-9. [PMID: 23487485 PMCID: PMC3588682 DOI: 10.2478/v10078-012-0047-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Our previous study showed a significant relationships between static exercise-induced changes in plasma adrenomedullin (ADM) and those in endothelin-1 (ET-1), noradrenaline (NA) and pre-ejection period/left ventricular ejection time ratio (PEP/LVET) in older healthy men. It is hypothesized that ADM, ET-1, NA and adrenaline (A) may function as endogenous regulators of cardiac function by modulating myocardial contractility during static exercise. The present study was undertaken to assess the relationships between exercise-induced changes in plasma ADM, ET-1, NA, A concentrations and those in ascending aortic blood flow peak velocity (PV) and mean acceleration (MA) measured by Doppler echocardiography in 24 healthy older men during two 3-min bouts of handgrip at 30% of maximal voluntary contraction, performed alternately with each hand without any break between the bouts. Plasma ADM, ET-1, NA and A as well as heart rate (HR), blood pressure (BP), PV and MA were determined. During handgrip, plasma ADM, ET-1, NA and A as well as HR, BP increased, whereas PV and MA decreased. The increases in plasma ADM correlated positively with those in ET-1, NA and diastolic BP, and correlated negatively with changes in PV (r= −0.68) and MA (r= −0.62). The increases in plasma ET-1 correlated positively with those in NA and BPs and correlated negatively with changes in PV (r= −0.67) and MA (r= −0.60). The results of this study suggest that in healthy older men the exercise-induced changes in plasma ADM, ET 1 and catecholamines are related to alterations in left ventricular contractile state and may co-operatively counteract age-related deterioration of cardiac performance in men.
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Hughson RL, Shoemaker JK, Blaber AP, Arbeille P, Greaves DK, Pereira-Junior PP, Xu D. Cardiovascular regulation during long-duration spaceflights to the International Space Station. J Appl Physiol (1985) 2012; 112:719-27. [DOI: 10.1152/japplphysiol.01196.2011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Early evidence from long-duration flights indicates general cardiovascular deconditioning, including reduced arterial baroreflex gain. The current study investigated the spontaneous baroreflex and markers of cardiovascular control in six male astronauts living for 2–6 mo on the International Space Station. Measurements were made from the finger arterial pressure waves during spontaneous breathing (SB) in the supine posture pre- and postflight and during SB and paced breathing (PB, 0.1 Hz) in a seated posture pre- and postflight, as well as early and late in the missions. There were no changes in preflight measurements of heart rate (HR), blood pressure (BP), or spontaneous baroreflex compared with in-flight measurements. There were, however, increases in the estimate of left ventricular ejection time index and a late in-flight increase in cardiac output (CO). The high-frequency component of RR interval spectral power, arterial pulse pressure, and stroke volume were reduced in-flight. Postflight there was a small increase compared with preflight in HR (60.0 ± 9.4 vs. 54.9 ± 9.6 beats/min in the seated posture, P < 0.05) and CO (5.6 ± 0.8 vs. 5.0 ± 1.0 l/min, P < 0.01). Arterial baroreflex response slope was not changed during spaceflight, while a 34% reduction from preflight in baroreflex slope during postflight PB was significant (7.1 ± 2.4 vs. 13.4 ± 6.8 ms/mmHg), but a smaller average reduction (25%) during SB (8.0 ± 2.1 vs. 13.6 ± 7.4 ms/mmHg) was not significant. Overall, these data show no change in markers of cardiovascular stability during long-duration spaceflight and only relatively small changes postflight at rest in the seated position. The current program routine of countermeasures on the International Space Station provided sufficient stimulus to maintain cardiovascular stability under resting conditions during long-duration spaceflight.
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Affiliation(s)
- R. L. Hughson
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo,
| | - J. K. Shoemaker
- School of Kinesiology and Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario,
| | - A. P. Blaber
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada; and
| | - P. Arbeille
- Unite Medecine Physiologie Spatiale, CERCOM, EFMP CHU Trousseau, Tours, France
| | - D. K. Greaves
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo,
| | | | - D. Xu
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo,
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Chalkias A, Xanthos T. Post-cardiac arrest syndrome: Mechanisms and evaluation of adrenal insufficiency. World J Crit Care Med 2012; 1:4-9. [PMID: 24701395 PMCID: PMC3956066 DOI: 10.5492/wjccm.v1.i1.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 10/18/2011] [Accepted: 12/21/2011] [Indexed: 02/06/2023] Open
Abstract
Cardiac arrest is one of the leading causes of death and represents maximal stress in humans. After restoration of spontaneous circulation, post-cardiac arrest syndrome is the predominant disorder in survivors. Besides the post-arrest brain injury, the post-resuscitation myocardial stunning, and the systemic ischemia/reperfusion response, this syndrome is characterized by adrenal insufficiency, a disorder that often remains undiagnosed. The pathophysiology of adrenal insufficiency has not been elucidated. We performed a comprehensive search of three medical databases in order to describe the major pathophysiological disturbances which are responsible for the occurrence of the disorder. Based on the available evidence, this article will help physicians to better evaluate and understand the hidden yet deadly post-cardiac arrest adrenal insufficiency.
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Affiliation(s)
- Athanasios Chalkias
- Athanasios Chalkias, Theodoros Xanthos, Department of Anatomy, Medical School, University of Athens, 11527 Athens, Greece
| | - Theodoros Xanthos
- Athanasios Chalkias, Theodoros Xanthos, Department of Anatomy, Medical School, University of Athens, 11527 Athens, Greece
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Rössler A, Fink M, Goswami N, Batzel JJ. Modeling of hyaluronan clearance with application to estimation of lymph flow. Physiol Meas 2011; 32:1213-38. [DOI: 10.1088/0967-3334/32/8/014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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