Vasomotor Sympathetic Activity during Early Pregnancy in Humans

人类妊娠早期的血管舒缩交感神经活动

• 批准号: 7788808
• 负责人: QI FU
• 金额: $ 18.54万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7788808
• 关键词: Address; Adrenergic Agents; Affect; Age; Asians; Blood Pressure; Blood Volume; Cardiac Output; Cardiovascular Diseases; Cardiovascular system; Caucasians; Caucasoid Race; Cause of Death; Cessation of life; Characteristics; Congestive Heart Failure; Coronary; Data; Development; Exploratory/Developmental Grant; Exposure to; Failure; Fetal Death; Fright; Functional disorder; Funding; Future; Goals; Grant; Human; Hyperactive behavior; Hypertension; Hypertension induced by pregnancy; Hypoxia; Knowledge; Life; Light; Low Prevalence; Maintenance; Morbidity - disease rate; Mothers; Myocardial Ischemia; Nature; Nerve; Orthostasis; Outcome; Patients; Peripheral; Play; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Histories; Pregnant Women; Publishing; Race; Recording of previous events; Regulation; Research; Research Project Grants; Risk; Role; Staging; Sympathetic Nervous System; Syndrome; Techniques; Testing; United States; Vascular resistance; Vasomotor; Woman; adrenergic; follow-up; hemodynamics; indexing; innovation; insight; neuromechanism; neuroregulation; normotensive; novel; pressure; public health relevance; theories

DESCRIPTION (provided by applicant): Pregnancy-induced hypertension affects up to 10% of pregnant women in the United States, and the most severe form, preeclampsia, is the leading cause of maternal and fetal death or morbidity. Although the mechanisms for such complications are unclear, it has been proposed that either pregnancy-induced hypertension or preeclampsia is associated with a hyperadrenergic state, which may contribute to the pathophysiology of these conditions. Sympathetic adrenergic control plays an important role in blood pressure maintenance in humans. Sympathetic activity was found to increase in normal pregnancy and to be even greater in women with pregnancy-induced hypertension or preeclampsia in late pregnancy. However, it is completely unknown whether sympathetic hyperactivity develops early in normal pregnancy, remaining high throughout the entire gestation, or whether this sympathetic activation only occurs at term, providing the substrate for pregnancy-induced hypertension or preeclampsia. We found in 5 healthy Caucasian women that during early pregnancy, sympathetic activity was extremely high (similar to those of congestive heart failure patients), while paradoxically their blood pressure and peripheral vascular resistance were normal. This finding is counter to the prevailing wisdom regarding the neurohormonal adaptation to normal pregnancy, which suggests that sympathetic activation occurs only in late pregnancy, and to our knowledge, there are no published nerve recordings in early human pregnancy. Surprisingly, one Asian woman in early pregnancy had a much less prominent increase in sympathetic activity, raising the possibility that marked sympathetic activation may be race-dependent. These observations need to be verified in more pregnant women. Thus, the purpose of this research project is to determine whether marked sympathetic activation is a universal characteristic of early pregnancy (d 8 weeks of gestation) in humans and the role of sympathetic neural control in normal pregnancy. To this end, the specific aim of this project will test the hypothesis that vasomotor sympathetic activity increases dramatically during early pregnancy despite a normal blood pressure in healthy Caucasian but not Asian women. This objective will be accomplished by utilizing the innovative technique of microneurography. If the results obtained are the same as in our pilot data, it would radically alter the understanding of how blood pressure is regulated in pregnancy as well as provide insights into the development of gestational hypertension and its most feared outcome, preeclampsia. PUBLIC HEALTH RELEVANCE: High blood pressure occurring during pregnancy is one major cause of death or morbidity for both mothers and babies, and it has been found that an increase in sympathetic activity is related to this problem. Sympathetic activity plays an important role in keeping blood pressure stable. However, increased sympathetic activity was also found in pregnant women whose blood pressure was normal during the latter months of their pregnancies. It is completely unknown whether sympathetic hyperactivity develops early during pregnancy, remaining high throughout the entire gestation, or whether this sympathetic activation only occurs at term in humans. The primary goal of this project is to address these issues. Results obtained will provide novel insights into how blood pressure is regulated by the sympathetic nervous system during normal pregnancy, particularly during early pregnancy in humans.

描述（由申请人提供）：妊娠诱发的高血压影响美国多达10％的孕妇，而最严重的形式，先兆子痫是孕产妇和胎儿死亡或发病率的主要原因。尽管这种并发症的机制尚不清楚，但已经提出，妊娠诱导的高血压或先兆子痫与超肾上腺素能状态有关，这可能有助于这些疾病的病理生理。交感神经肾上腺素能控制在人类血压维持中起重要作用。发现同情活性在正常怀孕中会增加，并且在怀孕后期怀孕诱发的高血压或先兆子痫的女性中会增加。然而，完全未知的是同情多功能在正常妊娠的早期发展，在整个妊娠中保持较高，或者这种交感神经激活仅在任期内发生，从而为怀孕诱导的高血压或前启示性提供了底物。我们在5名健康的白种妇女中发现，在怀孕初期，交感神经活动非常高（与充血性心力衰竭患者相似），而自相矛盾的是，它们的血压和周围血管耐药性正常。这一发现与关于神经激素适应正常妊娠适应的普遍智慧相反，这表明同情激活仅在妊娠晚期发生，据我们所知，在人类早期怀孕期间没有发表的神经记录。令人惊讶的是，一名亚洲妇女在怀孕初期的交感神经活动的显着增加得多，从而提高了明显的交感神经激活可能是种族依赖性的。这些观察结果需要在更多的孕妇中得到验证。因此，该研究项目的目的是确定显着的交感神经激活是否是人类早期怀孕（妊娠8周）的普遍特征，以及交感神经控制在正常妊娠中的作用。为此，该项目的具体目的将检验以下假设：尽管健康的高加索人（但不是亚洲妇女），尽管血压正常，但在怀孕初期，血管舒适的交感神经活动仍会显着增加。该目标将通过利用微功能学的创新技术来实现。如果获得的结果与我们的试点数据相同，则它将从根本上改变对怀孕中血压调节的理解，并提供对妊娠高血压发展及其最令人恐惧的结果前脱位的见解。公共卫生相关性：怀孕期间出现的高血压是母亲和婴儿的主要死亡或发病率之一，并且发现同情活动的增加与该问题有关。交感神经活动在保持血压稳定中起着重要作用。然而，在怀孕后几个月，血压正常的孕妇也发现了同情活性的增加。完全未知的是交感神经多动症是否在怀孕期间早期发展，在整个妊娠期间保持较高，或者这种交感神经激活仅在人类中才发生。该项目的主要目标是解决这些问题。获得的结果将提供有关正常怀孕期间的交感神经系统调节血压如何调节血压的新见解，尤其是在人类怀孕初期。

项目成果

Sympathetic Action Potential Firing and Recruitment Patterns Are Abnormal in Gestational Hypertension.

妊娠高血压患者交感神经动作电位的激发和募集模式异常。

• DOI: 10.1161/hypertensionaha.122.19754
• 发表时间: 2023
• 期刊: Hypertension (Dallas, Tex. : 1979)
• 作者: Badrov,MarkB;Yoo,Jeung-Ki;Hissen,SarahL;Nelson,DavidB;Shoemaker,JKevin;Fu,Qi
• 通讯作者: Fu,Qi

Muscle Sympathetic Action Potential Firing Patterns During Normotensive and Hypertensive Pregnancy: A Longitudinal Assessment.

正常血压和高血压妊娠期间的肌肉交感神经动作电位放电模式：纵向评估。

• DOI: 10.1161/circulationaha.122.062192
• 发表时间: 2023
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Badrov,MarkB;Yoo,Jeung-Ki;Hissen,SarahL;D'Souza,AndrewW;Nelson,DavidB;Shoemaker,JKevin;Fu,Qi
• 通讯作者: Fu,Qi