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Baroreflex and chemoreflex function after bilateral carotid body tumor resection.
Henri J L M Timmers1, John M Karemaker, Wouter Wieling
1Department of General Internal Medicine (541), Department of Otorhinolaryngology, University Medical Center St Radboud, Geert Grooteplein Zuid 8, PO Box 9101, 6500 HB Nijmegen, The Netherlands. H.Timmers@aig.azn.nl
Journal of Hypertension
|March 18, 2003
Summary
Bilateral carotid body tumor resection impairs arterial baroreflex function and abolishes the normocapnic hypoxic drive, indicating peripheral chemoreflex failure. This surgery impacts cardiovascular autonomic regulation long-term.
Area of Science:
- Cardiovascular Physiology
- Autonomic Nervous System Function
- Surgical Outcomes
Background:
- Carotid bodies are crucial for cardiorespiratory reflexes.
- Surgical resection of carotid body tumors may affect autonomic function.
- Long-term consequences of bilateral carotid body tumor resection on reflex control are not fully understood.
Purpose of the Study:
- To determine the chronic effects of bilateral carotid body tumor resection on arterial baroreflex and peripheral chemoreflex.
- To investigate potential long-term autonomic dysfunction following this surgery.
Main Methods:
- Studied 8 patients post-bilateral carotid body tumor resection (median 3.4 years) and 12 healthy controls.
- Assessed baroreflex sensitivity, blood pressure, heart rate, and variability.
- Evaluated cardiovascular reflex tests and ventilatory responses to hypoxia.
Main Results:
- Patients showed significantly lower baroreflex sensitivity and Valsalva ratio compared to controls.
- Increased blood pressure variability and orthostatic hypotension were observed in some patients.
- The normocapnic ventilatory response to hypoxia was absent in all patients, indicating peripheral chemoreflex failure.
Conclusions:
- Bilateral carotid body tumor resection leads to heterogeneous arterial baroreflex dysfunction.
- Peripheral chemoreflex failure, specifically the abolition of normocapnic hypoxic drive, is a consistent outcome.
- These findings highlight significant long-term autonomic and respiratory regulatory changes after surgery.