Peripheral chemoreceptors sustain central chemoreflex potentiation and cardiorespiratory abnormalities in high-output heart failure

外周化学感受器维持中枢化学反射增强和高输出量心力衰竭的心肺功能异常

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Abstract

Central chemoreflex activation worsens cardiorespiratory dysfunction in high-output heart failure (HO-HF). Recently, interdependence between both peripheral and central chemoreceptors has been linked to alterations in cardiorespiratory regulation. Whether central chemoreflex potentiation in HO-HF requires sensory inputs from peripheral chemoreceptors remains completely unknown. Accordingly, we hypothesized that peripheral-central chemoreceptor interaction promotes cardiorespiratory dysfunction in non-ischemic HO-HF. We used male Sprague-Dawley rats to investigate the role of carotid bodies (CBs), the main peripheral chemoreceptors, on autonomic, respiratory, and cardiac function alterations during the progression of HO-HF. CB denervation (CBD) was used to eliminate CB inputs in HO-HF rats. The effect of CBD on HO-HF related cardiac, autonomic, and ventilatory function was measured using echocardiography, pressure-volume loop analysis, electrocardiography, plethysmography, and telemetry. HO-HF rats exhibited enhanced central chemoreflex drive, irregular breathing, autonomic imbalance, cardiac electrophysiological abnormalities, cardiac diastolic dysfunction, and cardiac hypertrophy. Remarkably, CBD completely normalized central chemoreflex function in HO-HF rats, restored ventilatory stability, reduced apnea-hypopnea incidence, improved heart rate variability, shortened QRS and PR intervals, attenuated collagen deposition, and ameliorated diastolic dysfunction. Additionally, CBD also corrected respiratory-cardiovascular coupling abnormalities in HO-HF rats. These findings demonstrate that an intact and functional CB is necessary for the development of cardiorespiratory disturbances in non-ischemic HO-HF. Targeting CB-central chemoreceptor interdependence may represent a novel therapeutic approach for non-ischemic HO-HF.

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