Skip to main content
SpringerLink
Log in

Assessment of sympathetic cardiovascular influences in man: Haemodynamic and humoral markers versus microneurography

  • Review Paper
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

Evaluation of sympathetic cardiovascular influences has important physiological, pathophysiological and clinical implications. This paper reviews some of the methods employed to measure these influences in man, along with their advantages and disadvantages. The most useful methods appear to be the measurement of plasma noradrenaline (particularly when modified to calculate spillover rate of noradrenaline) and direct recording of sympathetic nerve traffic. With the former, despite the technological advances in measurement, certain methodological problems remain, such as the separation of noradrenaline secretion from clearance. With the latter technique peripheral muscle and skin sympathetic activity can be measured separately but the question of regional vascular variability has still to be resolved. A combination of these two methods may represent the ideal approach. This review considers the complex problems associated with attempts to precisely quantify sympathetic cardiovascular influences in man.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mancia G, Ferrari AU, Zanchetti A. Reflex control of the circulation in experimental and human hypertension. In: Zanchetti A, Tarazi R, eds.Handbook of Hypertension, vol. 8. Amsterdam: Elsevier, 1986; 47–68.

    Google Scholar 

  2. Chalmers JP, West MJ. The nervous system in the pathogenesis of essential hypertension. In: Robertson JIS, ed.Handbook of Hypertension, vol 1. Amsterdam: Elsevier, 1983; 64–96.

    Google Scholar 

  3. Cohn JN, Levine TB, Olivari MT, Garber U, Lura D, Francis GS, Simon AB, Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure.N Engl J Med 1984;311: 819–823.

    PubMed  Google Scholar 

  4. Karlsberg RP, Cryer PE, Roberts R. Serial plasma catecholamines response early in the course of clinical acute myocardial infarction: relationship to infarct extent and mortality.Am Heart J 1981;102: 24–29.

    PubMed  Google Scholar 

  5. Vallbo AB, Hagbarth KE, Torebjork HE, Wallin BG. Somatosensory, proprioceptive, and sympathetic activity in human peripheral nerves.Physiol Rev 1979;59: 919–957.

    PubMed  Google Scholar 

  6. Mancia G, Zanchetti A. Hypothalamic control of autonomic functions. In: Morgane PJ, Panksepp J, eds.Handbook of the Hypothalamus. New York: Dekker, 1981; 147–202.

    Google Scholar 

  7. Brod J, Fencl V, Hejl Z, Jirka J. Circulatory changes underlying blood pressure elevation during acute emotional stress in normotensive and hypertensive subjects.Clin Sci 1959;18: 269–279.

    PubMed  Google Scholar 

  8. Parati G, Pomidossi G, Ramirez A, Cesana B, Mancia G. Variability of the haemodynamic responses to laboratory tests employed in assessment of neural cardiovascular regulation in man.Clin Sci 1985;69: 533–540.

    PubMed  Google Scholar 

  9. Parati G, Pomidossi G, Casadei R, Ravogli A, Groppelli A, Cesana B, Mancia G. Comparison of the cardiovascular effects of different laboratory stressors and their relationship with blood pressure variability.J Hypertens 1988;6: 481–488.

    PubMed  Google Scholar 

  10. Folkow B. Physiological aspects of primary hypertension.Physiol Rev 1982;62: 347–503.

    PubMed  Google Scholar 

  11. Mancia G, Zanchetti A. Blood pressure variability. In: Zanchetti A, Tarazi R, eds.Handbook of Hypertension, vol 7. Amsterdam: Elsevier, 1986; 125–152.

    Google Scholar 

  12. Akselrod S, Gordon D, Madwed JB, Snidnam NC, Shannon DC, Cohen RJ. Hemodynamic regulation: investigation by spectral analysis.Am J Physiol 1985;249: H867-H875.

    PubMed  Google Scholar 

  13. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E, Turiel M, Baselli G, Cerutti S, Malliani A. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and in conscious dog.Circ Res 1986;59: 178–193.

    PubMed  Google Scholar 

  14. Furlan R, Guzzetti S, Crivellaro W, Dazzi S, Tinelli M, Baselli G, Cerutti S, Lombardi F, Pagani M, Malliani A. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects.Circulation 1990;81: 537–547.

    Google Scholar 

  15. Parati G, Castiglioni P, Di Rienzo M, Omboni S, Pedotti A, Mancia G. Sequential spectral analysis of 24-hour blood pressure and pulse interval in humans.Hypertension 1990;16: 414–424.

    PubMed  Google Scholar 

  16. Rosenthal S, Birch H, Osikowska B, Sever PS. Changes in plasma norepinephrine concentration following sympathetic stimulation by gradual tilting.Cardiovasc Res 1978;12: 144–147.

    PubMed  Google Scholar 

  17. Watson DS, Hamilton CA, Reid JL, Little WA. Changes in plasma norepinephrine, blood pressure and heart rate during physical activity in hypertensive man.Hypertension 1979;1: 341–346.

    PubMed  Google Scholar 

  18. Mailing TJB, Dollery CT, Hamilton CA. Clonidine and sympathetic activity during sleep.Clin Sci 1979;57: 509–514.

    PubMed  Google Scholar 

  19. Osikowska B, Sever PS. Alterations in plasma noradrenaline concentration in response to postural changes in normal subjects, in patients with autonomic failure and in essential hypertension.Br J Clin Pharmacol 1976;3: 963–964.

    Google Scholar 

  20. Thomas JA, Marks BH. Plasma norepinephrine in congestive heart failure.Am J Cardiol 1978;41: 233–243.

    PubMed  Google Scholar 

  21. Hjemdahl P. Inter-laboratory comparison of plasma catecholamine determinations using several different assays.Acta Physiol Scand 1984;121 (suppl 527): 43–54.

    Google Scholar 

  22. Folkow B, Di Bona GF, Hjemdahl P, Thoren PH, Wallin GB. Measurements of plasma norepinephrine concentrations in human primary hypertension. A word of caution on their applicability for assessing neurogenic contributions.Hypertension 1983;5: 399–403.

    PubMed  Google Scholar 

  23. Mancia G, Ferrari A, Gregorini L, Leonetti G, Parati G, Picotti GB, Ravazzani C, Zanchetti A. Plasma catecholamines do not invariably reflect sympathetically induced changes in blood pressure in man.Clin Sci 1983;65: 227–235.

    PubMed  Google Scholar 

  24. Esler M. Assessment of sympathetic nervous function in humans from noradrenaline plasma kinetics.Clin Sci 1982;62: 247–254.

    PubMed  Google Scholar 

  25. Esler M, Jennings G, Lambert G, Meredith I, Horne M, Eisenhofer G. Overflow of catecholamine neurotransmitters to the circulation: source, fate and functions.Physiol Rev 1990;4: 963–986.

    Google Scholar 

  26. Esler MD, Hasking GJ, Willet IR, Leonard PW, Jennings GL. Noradrenaline release and sympathetic nervous system activity.J Hypertens 1985;3: 117–129.

    PubMed  Google Scholar 

  27. Goldstein DS, Brush JE, Eisenhofer G, Stull R, Esler M.In vivo measurement of neuronal uptake of norepinephrine in the human heart.Circulation 1988;78: 41–48.

    PubMed  Google Scholar 

  28. Hagbarth KE, Vallbo AB. Pulse and respiratory grouping of sympathetic impulses in human muscle nerves.Acta Physiol Scand 1968;74: 96–108.

    PubMed  Google Scholar 

  29. Yamada Y, Miyajima E, Tochikubo O, Hatsukawa T, Ishii M. Age-related changes in muscle sympathetic nerve activity in essential hypertension.Hypertension 1989;13: 870–877.

    PubMed  Google Scholar 

  30. Leimbach WN, Wallin GB, Victor RG, Aylward PE, Sundlof G, Mark AL. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure.Circulation 1986;76: 913–919.

    Google Scholar 

  31. Anderson EA, Sinkey CA, Clary M, Kempf J, Mark AL. Survey of symptoms experienced after microneurographic recording.Acta Physiol Scand 1989;136 (S 584): 3.

    Google Scholar 

  32. Wallin BG, Delius W, Hagbarth KE. Comparison of sympathetic nerve activity in normotensive and hypertensive subjects.Circ Res 1973;33: 9–21.

    PubMed  Google Scholar 

  33. Wallin BG. Intraneural recording and autonomic function in man. In: Bannister R, ed.Autonomic Failure. A textbook of clinical disorders of the autonomic nervous system. Oxford: Oxford University Press, 1983; 36–51.

    Google Scholar 

  34. Wallin BG, Eckberg DL. Sympathetic transients caused by abrupt alterations of carotid baroreceptor activity in humans.Am J Physiol 1982;242: H185-H190.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cattedra di Semeiotica Medica and Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy

    Giuseppe Mancia MD & Guido Grassi MD

  2. Centro di Fisiologia Clinica e Ipertensione, Ospedale Maggiore, Via F. Sforza 35, 20122, Milano, Italy

    Giuseppe Mancia MD & Guido Grassi MD

  3. Centro Auxologico Italiano, Milano, Italy

    Giuseppe Mancia MD & Guido Grassi MD

Authors
  1. Giuseppe Mancia MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guido Grassi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mancia, G., Grassi, G. Assessment of sympathetic cardiovascular influences in man: Haemodynamic and humoral markers versus microneurography. Clinical Autonomic Research 1, 245–249 (1991). https://doi.org/10.1007/BF01824995

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01824995

Key words

Search

Navigation