Whereas sleep is generally thought to be a relatively quiescent state, there is growing experimental and clinical evidence that significant perturbations in coronary hemodynamic and cardiac electrophysiologic function occur during rapid eye movement (REM) sleep and transitions from slow wave sleep. We found in canines that intensely phasic REM produces major surges in heart rate which are accompanied by a reduction in coronary flow in the stenosed coronary circulation. During transitions from slow wave sleep, there are abrupt pauses in heart rhythm which last up to 8 seconds. These observations may provide insights into the poorly understood clinical phenomena of nocturnal angina and cardiac standstill associated with sleep apnea. We plan to elucidate the neural mechanisms involved in these sleep-induced changes in heart rhythm and to quantify their impact during acute myocardial ischemia. We will employ our newly developed signal processing techniques which permit simultaneous tracking of rapid changes in autonomic nervous system activity and cardiac vulnerability by complex demodulation of heart rate variability and T-wave alternans (Science 252:437, 1991).
Our specific aims are: l. To characterize the dynamic changes in autonomic nervous system activity and cardiac vulnerability during sleep by complex demodulation of heart rate variability and T-wave alternans in normal animals prior to and following pharmacologic and surgical denervation. 2. To define the influence of sleep state on the autonomic response and vulnerability to ventricular fibrillation during acute myocardial ischemia and reperfusion in neurally intact and denervated animals. The methods include sleep state determination based on EEG, EMG, EOG, hippocampal and lateral geniculate electrical activity, spectral analysis of electrocortical activity, and coronary hemodynamic and cardiac electrophysiologic function. The ultimate goal will be to shed light on the mechanisms involved in the genesis of life-threatening arrhythmias in individuals with coronary disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL050078-01A2
Application #
3369111
Study Section
Respiratory and Applied Physiology Study Section (RAP)
Project Start
1994-05-19
Project End
1994-08-31
Budget Start
1994-05-19
Budget End
1994-08-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Georgetown University
Department
Type
Schools of Dentistry
DUNS #
049515844
City
Washington
State
DC
Country
United States
Zip Code
20057
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Verrier, R L; Mittleman, M A (2000) The impact of emotions on the heart. Prog Brain Res 122:369-80
Rowe, K; Moreno, R; Lau, T R et al. (1999) Heart rate surges during REM sleep are associated with theta rhythm and PGO activity in cats. Am J Physiol 277:R843-9
Verrier, R L; Lau, T R; Wallooppillai, U et al. (1998) Primary vagally mediated decelerations in heart rate during tonic rapid eye movement sleep in cats. Am J Physiol 274:R1136-41
Lavery, C E; Mittleman, M A; Cohen, M C et al. (1997) Nonuniform nighttime distribution of acute cardiac events: a possible effect of sleep states. Circulation 96:3321-7
Verrier, R L; Mittelman, M A (1997) Cardiovascular consequences of anger and other stress states. Baillieres Clin Neurol 6:245-59
Verrier, R L; Muller, J E; Hobson, J A (1996) Sleep, dreams, and sudden death: the case for sleep as an autonomic stress test for the heart. Cardiovasc Res 31:181-211
Verrier, R L; Mittleman, M A (1996) Life-threatening cardiovascular consequences of anger in patients with coronary heart disease. Cardiol Clin 14:289-307
Kovach, J A; Gottdiener, J S; Verrier, R L (1995) Vagal modulation of epicardial coronary artery size in dogs. A two-dimensional intravascular ultrasound study. Circulation 92:2291-8
Nearing, B D; Oesterle, S N; Verrier, R L (1994) Quantification of ischaemia induced vulnerability by precordial T wave alternans analysis in dog and human. Cardiovasc Res 28:1440-9