Sympathetic Nerve Traffic Responses to Surgical Removal of Pheochromocytoma
Pheochromocytoma is usually characterized by a marked increase in peripheral catecholamine secretion. Whether this is accompanied by an alteration in central sympathetic drive has not been clarified. In 6 patients with adrenal pheochromocytoma (mean±SEM age, 49.3±7.2 years), we measured systolic and...
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| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 1999-09, Vol.34 (3), p.461-465 |
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| creator | Grassi, Guido Seravalle, Gino Turri, Carlo Mancia, Giuseppe |
| description | Pheochromocytoma is usually characterized by a marked increase in peripheral catecholamine secretion. Whether this is accompanied by an alteration in central sympathetic drive has not been clarified. In 6 patients with adrenal pheochromocytoma (mean±SEM age, 49.3±7.2 years), we measured systolic and diastolic blood pressure (photoplethysmographic device), heart rate (ECG), venous plasma catecholamines (high-performance liquid chromatography), and postganglionic muscle sympathetic nerve activity (microneurography) before and 78.3±13 days after surgical removal of the tumor. In each experimental session, measurements were performed during (1) a 60-minute resting period to compare several values of sympathetic nerve traffic at similar blood pressures before and after surgery and (2) voluntary end-expiratory apnea, ie, a maneuver inducing sympathetic activation. Tumor removal significantly (P |
| doi_str_mv | 10.1161/01.hyp.34.3.461 |
| format | Article |
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Whether this is accompanied by an alteration in central sympathetic drive has not been clarified. In 6 patients with adrenal pheochromocytoma (mean±SEM age, 49.3±7.2 years), we measured systolic and diastolic blood pressure (photoplethysmographic device), heart rate (ECG), venous plasma catecholamines (high-performance liquid chromatography), and postganglionic muscle sympathetic nerve activity (microneurography) before and 78.3±13 days after surgical removal of the tumor. In each experimental session, measurements were performed during (1) a 60-minute resting period to compare several values of sympathetic nerve traffic at similar blood pressures before and after surgery and (2) voluntary end-expiratory apnea, ie, a maneuver inducing sympathetic activation. Tumor removal significantly (P<0.05 at least) reduced plasma catecholamines, blood pressure, and heart rate. In contrast, muscle sympathetic nerve activity was significantly (P<0.01) increased, both when quantified as bursts per minute (from 28.1±5.7 to 54.3±7.5) and as bursts per 100 heartbeats (from 33.4±5.6 to 65.1±6.5). This was also the case when data were evaluated in periods of 2 experimental sessions characterized by similar diastolic blood pressure values. The apnea maneuver induced sympathetic nerve traffic responses that were significantly (P<0.05) greater after surgery than before surgery. These data provide the first direct evidence that in pheochromocytoma central sympathetic outflow is markedly reduced and that this reduction cannot be ascribed to a reflex inhibitory response to elevated blood pressures. It is likely that this sympathoinhibition is rather due to a central depression of sympathetic outflow induced by high circulating catecholamines.</description><identifier>ISSN: 0194-911X</identifier><identifier>EISSN: 1524-4563</identifier><identifier>DOI: 10.1161/01.hyp.34.3.461</identifier><identifier>PMID: 10489394</identifier><identifier>CODEN: HPRTDN</identifier><language>eng</language><publisher>Philadelphia, PA: American Heart Association, Inc</publisher><subject>Adrenal Gland Neoplasms - metabolism ; Adrenal Gland Neoplasms - physiopathology ; Adrenal Gland Neoplasms - surgery ; Biological and medical sciences ; Blood Pressure ; Catecholamines - blood ; Female ; Heart Rate ; Hemodynamics ; Humans ; Male ; Medical sciences ; Middle Aged ; Muscles - innervation ; Pheochromocytoma - metabolism ; Pheochromocytoma - physiopathology ; Pheochromocytoma - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of endocrine glands ; Sympathetic Nervous System - physiopathology</subject><ispartof>Hypertension (Dallas, Tex. 1979), 1999-09, Vol.34 (3), p.461-465</ispartof><rights>1999 American Heart Association, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5158-b3aaa56f86ffc9b72e7fd6617716fe7db3eb614b8891e4e753440dbd2de559893</citedby><cites>FETCH-LOGICAL-c5158-b3aaa56f86ffc9b72e7fd6617716fe7db3eb614b8891e4e753440dbd2de559893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1981504$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10489394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grassi, Guido</creatorcontrib><creatorcontrib>Seravalle, Gino</creatorcontrib><creatorcontrib>Turri, Carlo</creatorcontrib><creatorcontrib>Mancia, Giuseppe</creatorcontrib><title>Sympathetic Nerve Traffic Responses to Surgical Removal of Pheochromocytoma</title><title>Hypertension (Dallas, Tex. 1979)</title><addtitle>Hypertension</addtitle><description>Pheochromocytoma is usually characterized by a marked increase in peripheral catecholamine secretion. Whether this is accompanied by an alteration in central sympathetic drive has not been clarified. In 6 patients with adrenal pheochromocytoma (mean±SEM age, 49.3±7.2 years), we measured systolic and diastolic blood pressure (photoplethysmographic device), heart rate (ECG), venous plasma catecholamines (high-performance liquid chromatography), and postganglionic muscle sympathetic nerve activity (microneurography) before and 78.3±13 days after surgical removal of the tumor. In each experimental session, measurements were performed during (1) a 60-minute resting period to compare several values of sympathetic nerve traffic at similar blood pressures before and after surgery and (2) voluntary end-expiratory apnea, ie, a maneuver inducing sympathetic activation. Tumor removal significantly (P<0.05 at least) reduced plasma catecholamines, blood pressure, and heart rate. In contrast, muscle sympathetic nerve activity was significantly (P<0.01) increased, both when quantified as bursts per minute (from 28.1±5.7 to 54.3±7.5) and as bursts per 100 heartbeats (from 33.4±5.6 to 65.1±6.5). This was also the case when data were evaluated in periods of 2 experimental sessions characterized by similar diastolic blood pressure values. The apnea maneuver induced sympathetic nerve traffic responses that were significantly (P<0.05) greater after surgery than before surgery. These data provide the first direct evidence that in pheochromocytoma central sympathetic outflow is markedly reduced and that this reduction cannot be ascribed to a reflex inhibitory response to elevated blood pressures. It is likely that this sympathoinhibition is rather due to a central depression of sympathetic outflow induced by high circulating catecholamines.</description><subject>Adrenal Gland Neoplasms - metabolism</subject><subject>Adrenal Gland Neoplasms - physiopathology</subject><subject>Adrenal Gland Neoplasms - surgery</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Catecholamines - blood</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscles - innervation</subject><subject>Pheochromocytoma - metabolism</subject><subject>Pheochromocytoma - physiopathology</subject><subject>Pheochromocytoma - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of endocrine glands</subject><subject>Sympathetic Nervous System - physiopathology</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkM1rFEEQxRtRzBo9e5M5iLeZdG1_HyWoCQkaTAQ9NT091c7ozPbYPZOw_70ddkELiuIVv3oUj5DXQBsACWcUmn4_N4w3rOESnpANiC2vuZDsKdlQMLw2AN9PyIucf1EKnHP1nJwA5dowwzfk6nY_zW7pcRl89RnTPVZ3yYVQ1FfMc9xlzNUSq9s1_Ry8G8t2ivdlxlDd9Bh9n-IU_X6Jk3tJngU3Znx1nKfk28cPd-cX9fWXT5fn769rL0DoumXOOSGDliF406otqtBJCUqBDKi6lmErgbdaG0COSjDOadd22w6FMOXvU_Lu4Dun-GfFvNhpyB7H0e0wrtkqSpkSWhfw7AD6FHNOGOychsmlvQVqH_OzFOzFjxvLuGW25Fcu3hyt13bC7j_-EFgB3h4Bl0scIbmdH_I_zmgQ9BHjB-whjgum_HtcHzDZHt249JaW4lupazDGUFNUXRo0-ws2bYi0</recordid><startdate>199909</startdate><enddate>199909</enddate><creator>Grassi, Guido</creator><creator>Seravalle, Gino</creator><creator>Turri, Carlo</creator><creator>Mancia, Giuseppe</creator><general>American Heart Association, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199909</creationdate><title>Sympathetic Nerve Traffic Responses to Surgical Removal of Pheochromocytoma</title><author>Grassi, Guido ; Seravalle, Gino ; Turri, Carlo ; Mancia, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5158-b3aaa56f86ffc9b72e7fd6617716fe7db3eb614b8891e4e753440dbd2de559893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adrenal Gland Neoplasms - metabolism</topic><topic>Adrenal Gland Neoplasms - physiopathology</topic><topic>Adrenal Gland Neoplasms - surgery</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Catecholamines - blood</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Muscles - innervation</topic><topic>Pheochromocytoma - metabolism</topic><topic>Pheochromocytoma - physiopathology</topic><topic>Pheochromocytoma - surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of endocrine glands</topic><topic>Sympathetic Nervous System - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grassi, Guido</creatorcontrib><creatorcontrib>Seravalle, Gino</creatorcontrib><creatorcontrib>Turri, Carlo</creatorcontrib><creatorcontrib>Mancia, Giuseppe</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grassi, Guido</au><au>Seravalle, Gino</au><au>Turri, Carlo</au><au>Mancia, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sympathetic Nerve Traffic Responses to Surgical Removal of Pheochromocytoma</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>1999-09</date><risdate>1999</risdate><volume>34</volume><issue>3</issue><spage>461</spage><epage>465</epage><pages>461-465</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><coden>HPRTDN</coden><abstract>Pheochromocytoma is usually characterized by a marked increase in peripheral catecholamine secretion. Whether this is accompanied by an alteration in central sympathetic drive has not been clarified. In 6 patients with adrenal pheochromocytoma (mean±SEM age, 49.3±7.2 years), we measured systolic and diastolic blood pressure (photoplethysmographic device), heart rate (ECG), venous plasma catecholamines (high-performance liquid chromatography), and postganglionic muscle sympathetic nerve activity (microneurography) before and 78.3±13 days after surgical removal of the tumor. In each experimental session, measurements were performed during (1) a 60-minute resting period to compare several values of sympathetic nerve traffic at similar blood pressures before and after surgery and (2) voluntary end-expiratory apnea, ie, a maneuver inducing sympathetic activation. Tumor removal significantly (P<0.05 at least) reduced plasma catecholamines, blood pressure, and heart rate. In contrast, muscle sympathetic nerve activity was significantly (P<0.01) increased, both when quantified as bursts per minute (from 28.1±5.7 to 54.3±7.5) and as bursts per 100 heartbeats (from 33.4±5.6 to 65.1±6.5). This was also the case when data were evaluated in periods of 2 experimental sessions characterized by similar diastolic blood pressure values. The apnea maneuver induced sympathetic nerve traffic responses that were significantly (P<0.05) greater after surgery than before surgery. These data provide the first direct evidence that in pheochromocytoma central sympathetic outflow is markedly reduced and that this reduction cannot be ascribed to a reflex inhibitory response to elevated blood pressures. It is likely that this sympathoinhibition is rather due to a central depression of sympathetic outflow induced by high circulating catecholamines.</abstract><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>10489394</pmid><doi>10.1161/01.hyp.34.3.461</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adrenal Gland Neoplasms - metabolism Adrenal Gland Neoplasms - physiopathology Adrenal Gland Neoplasms - surgery Biological and medical sciences Blood Pressure Catecholamines - blood Female Heart Rate Hemodynamics Humans Male Medical sciences Middle Aged Muscles - innervation Pheochromocytoma - metabolism Pheochromocytoma - physiopathology Pheochromocytoma - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of endocrine glands Sympathetic Nervous System - physiopathology |
| title | Sympathetic Nerve Traffic Responses to Surgical Removal of Pheochromocytoma |
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