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Open Journal of Cardiology & Heart Diseases

Pulse Synchronized Contractions (PSCs): A Call to Action!

Allen W Mangel* and Kate Lothman

RTI Health Solutions, Research Triangle Park, USA

*Corresponding author: Allen Mangel, RTI Health Solutions, PO Box 12194, Research Triangle Park, NC 27514, USA

Submission: January 17, 2018; Published: January 29, 2018

DOI: 10.31031/OJCHD.2018.01.000508

ISSN: 2578-0204
Volume1 Issue2

Abstract

Keywords: Cardiovascular; Windkessel; PSCs

Editorial

For over a century, the prevailing view has been that the smooth muscle wall of large conduit arteries does not undergo rhythmic contractile activity in synchrony with the cardiac cycle. This behavior was described by Otto Frank and denoted the Windkessel Hypothesis [1]. Considering the wide acceptance of the Windkessel Hypothesis, potential targets for new therapeutic agents have not considered rhythmic activation during the cardiac cycle.

In contrast to the Windkessel Hypothesis, evidence has accumulated that the smooth muscle wall of large arteries undergoes rhythmic activation in synchrony with the heartbeat. This rhythmic contractile activity has been denoted pulse synchronized contractions (PSCs) [2-6]. PSCs have been demonstrated in dogs, cats, rats, and, notably, humans [2-13]. Specifically, activity has been seen in aorta, carotid, femoral, pulmonary, and brachial arteries [213]. Much attention has been paid to confirming that PSCs are not due to a movement artifact secondary to the pulse wave or cardiac contractions [2,13]. PSCs are not abolished in bled animals, in which there is no pulse wave, and when animals have a dissociation between ventricular contractile activity and right atrial activity, PSCs are coupled to atrial not ventricular rate [2].

The pacemaker for PSCs resides in the right atrium [2,13], allowing speculation that this may allow coordination between cardiac and vascular contractile activity. Generation of PSCs is through a neurogenic not myogenic mechanism [2,12,13], although the specific neural pathway has not been elucidated.

Although data in contradistinction to the Windkessel Hypothesis have been published for over 50 years [2-13] and these findings have been demonstrated in several independent laboratories, PSCs have not been accepted, and, therefore, a potential therapeutic site for the treatment of certain cardiovascular diseases has not been explored. PSCs may potentially serve a protective function limiting vessel distension with the pulse wave as the upstroke of the PSC appears to slightly precede the upstroke of the pulse wave. This specific timing of the pulse wave and PSC may serve to limit vessel distension, reducing the Laplacian forces acting on the vessel wall.

References

  1. Frank O (1899) Die Grundform des Arteriellen Pulses. Zeitschrift fur Biologie 37: 483-526.
  2. Mangel A, Fahim M, Van Breemen (1982) Control of vascular contractility by the cardiac pacemaker. Science 215(4540): 1627-1629.
  3. Mangel AW (2014) Does the aortic smooth muscle wall undergo rhythmic contractions during the cardiac cycle. Experimental & Clinical Cardiology 20(11): 6844-6851.
  4. Mangel AW (2017) A changing paradigm for understanding the behavior of the cardiovascular system. J Clin Exp Cardiol 8: 496.
  5. Mangel A, Lothman K (2017) Emergence of a new paradigm in understanding the cardiovascular system: pulse synchronized contractions. Cardiovasc Pharmacol Open access 6(5): 220.
  6. Marion SB, Mangel AW (2014) From depolarization-dependent contractions in gastrointestinal smooth muscle to aortic pulse synchronized contractions. Clin Exp Gastroenterol 7: 61-66.
  7. Ravi K, Fahim M (1987) Rhythmic contractile activity of the pulmonary artery studied in vivo in cats. J Auton Nerv Syst 18(1): 33-37.
  8. Heyman F (1955) Movements of the arterial wall connected with auricular systole seen in cases of atrioventricular heart block. Acta Med Scand 152(2): 91-96.
  9. Heyman F (1957) Comparison of intra-arterially and extra-arterially recorded pulse waves in man and dog. Acta Medica Scandinavica 157(6): 503-510.
  10. Heyman F (1959) Extra- and intra-arterial records of pulse waves and locally introduced pressure waves. Acta Medica Scandinavica 163(6): 473-475.
  11. Heyman F (1961) Pulse synchronous movements of the arterial wall peripheral to an obstruction in the circulation of the arm. Acta Medica Scand 169: 87-93.
  12. Heyman F, Stenberg K (1962) The effect of stellate ganglion block on the relationship between extra- and intra-arterially recorded brachial pulse waves in man. Acta Medica Scandinavica 171(1): 9-11.
  13. Sahibzada N, Mangel AW, Tatge JE, Dretchen KL, Franz MR, et al. (2015) Rhythmic aortic contractions induced by electrical stimulation in vivo in the rat. PLoS One 10(7): e0130255.

© 2018 Allen W Mangel, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.