Previous evidence has shown that sympathetic nerve responses to insular cortical (IC) stimulation are mediated by synapses within the lateral hypothalamic area (LHA) and ventrolateral medulla. The present study determined the receptor(s) involved at the synapse in the LHA associated with stimulation-evoked IC sympathetic responses. Twenty-seven male Wistar rats were instrumented for renal nerve activity, arterial pressure, and heart rate recording. The right IC was stimulated with a bipolar electrode (200-1,000 microA, 2 ms, 0.8 Hz) resulting in sympathetic nerve responses. Antagonists were then pressure injected into the ipsilateral LHA (300-500 nl). Kynurenate (250 mM) injections resulted in 51 +/- 8% (range 0-100%) block of IC-stimulated sympathetic nerve responses. Similarly, the N-methyl-D-aspartic acid (NMDA)-receptor antagonist DL-2-amino-5-phosphonopentanoic acid (200 microM) resulted in an inhibition (82 +/- 8%; range 51-100%) of IC-stimulated sympathetic responses. Injection of the non-NMDA antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (200 microM) had no effect on IC sympathetic responses. Injection of antagonists to GABA, acetylcholine, and adrenergic receptors was also without effect. No antagonist injections had any effects on baseline sympathetic nerve discharge, arterial pressure, or heart rate. These results suggest that the IC autonomic efferents projecting to the LHA utilize NMDA glutamatergic receptors.
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http://dx.doi.org/10.1152/ajpheart.1998.275.2.H689 | DOI Listing |
Patients presenting with severe acute cardiogenic pulmonary edema with hypoxia commonly require intubation until heart failure treatments take effect. A new term describing similar condition is called sympathetic crashing acute pulmonary edema (SCAPE). It is also called Flash pulmonary edema.
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