The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Rose Anne Kenny - One of the best experts on this subject based on the ideXlab platform.
-
Carotid Sinus Syndrome—Clinical Characteristics in Elderly Patients
2016Co-Authors: Rose Anne Kenny, Gary TraynorAbstract:Carotid Sinus massage was carried out on 130 consecutive patients referred for investigation of dizziness, syncope or unexplained falls. Carotid Sinus syndrome was diagnosed in 33 for whom no other cause of symptoms was identified. Right-sided hypersensitivity was more frequent than left-sided. Thirty per cent identified a prodrome before syncope and 30 % had retrograde amnesia for the event. In 52%, symptoms were precipitated by head movement and in 48 % by vagal stimuli. Seven described 'drop attacks ' but symptoms were reproduced with Carotid Sinus massage during head-up tilt. Injuries, including fractured neck of femur, were sustained by the majority. Carotid Sinus massage should be performed routinely on all elderly patients who have symptoms of unexplained dizziness, falls or syncope. Cardiac pacing relieves syncopal symptoms in those with a predominant cardio-inhibitory response and recurrent syncope
-
cardioinhibitory Carotid Sinus syndrome a mathematical model
International Conference of the IEEE Engineering in Medicine and Biology Society, 2015Co-Authors: Ciaran Finucane, Rose Anne Kenny, Gerard BoyleAbstract:Carotid Sinus massage (CSM) is a simple clinical test for stimulating the Carotid Sinus reflex. During CSM, firm longitudinal massage is applied at the point of maximal pulsation over the Carotid bifurcation resulting in relative bradycardia. CSM is used to diagnose Cardioinhibitory Carotid Sinus Syndrome (CICSS). CICSS is an age-related disorder, characterized by profound symptomatic cardioinhibition (> 3 seconds pause) following CSM. CICSS prevalence increases with age and is responsible for 1 to 20% of all pacemaker implantations per year. Treatment options for CSS are limited and much debate still remains around its underlying etiology. In this paper we present a first computer simulation of Carotid Sinus massage (CSM) in older adults and demonstrate its ability to simulate normal heart rate responses to CSM. Importantly we demonstrate that our mathematical model requires inclusion of model elements to simulate autonomic control of perinodal T-cell activity in order to replicate the profound cardioinhibitory response observed in CICSS. Our model findings implicate CSS as a candidate biomarker of biological aging and frailty.
-
Carotid Sinus hypersensitivity in asymptomatic older persons implications for diagnosis of syncope and falls
JAMA Internal Medicine, 2006Co-Authors: Simon Kerr, Mark S Pearce, Carol Brayne, Richard J Davis, Rose Anne KennyAbstract:Background Carotid Sinus hypersensitivity is the most commonly reported cause of falls and syncope in older persons. Recent guidelines recommend 5 to 10 seconds of Carotid Sinus massage in supine and upright positions with beat-to-beat monitoring. The aim of this study was to determine the prevalence of Carotid Sinus hypersensitivity in (1) an unselected community sample of older people and (2) a subsample with no history of syncope, dizziness, or falls using recently standardized diagnostic criteria. Methods One thousand individuals older than 65 years were randomly sampled from a single general practice register; 272 participants underwent supine and upright Carotid Sinus massage with continuous heart rate and phasic blood pressure monitoring. Carotid Sinus hypersensitivity was defined as asystole of 3 seconds or greater and/or a drop in systolic blood pressure of 50 mm Hg or greater. Results Carotid Sinus hypersensitivity was present in 107 individuals (39%); 24% had asystole of 3 seconds or greater during Carotid Sinus massage; and 16% had symptoms (including syncope) with Carotid Sinus hypersensitivity. Age (odds ratio, 1.05; 95% confidence interval, 1.00-1.09) and male sex (odds ratio, 1.71; 95% confidence intervals, 1.04-2.82) were the only predictors of Carotid Sinus hypersensitivity. In 80 previously asymptomatic individuals, Carotid Sinus hypersensitivity was present in 28 (35%) and accompanied by symptoms in 10. The 95th percentile for Carotid Sinus massage response was 7.3 seconds' asystole and a 77–mm Hg drop in systolic blood pressure. Conclusions Carotid Sinus hypersensitivity is common in older persons, even those with no history of syncope, dizziness, or falls. The finding of a hypersensitive response should not necessarily preclude further investigation for other causes of syncope.
-
2 bradyarrhythmias sick Sinus syndrome Carotid Sinus syndrome
Europace, 2005Co-Authors: Rose Anne Kenny, Clive Ballard, Ruth Pearce, J Hampton, Simon Kerr, M WiddringtonAbstract:Objectives To determine the prevalence of Carotid Sinus hypersensitivity (CSH) and define heart rate (HR) and blood pressure (BP) responses to Carotid Sinus massage (CSM) in (a) an unselected community sample of older people and (b) a sub-sample with no prior history of syncope, dizziness or falls. Methods One thousand subjects were randomly sampled from a general practice database of 1517 patients over 65 years and stratified for age and gender. Consenting participants underwent detailed clinical assessment prior to supine and upright Carotid Sinus massage CSM with continuous heart rate and phasic blood pressure monitoring. CSH was defined as asystole in excess of 3 seconds and / or a drop in SBP of greater than 50mmHg. Results 272 participants had CSM. CSH was present in 107 (39%); 27% had asystole >3 seconds during CSM; 16% had symptoms (including syncope) with CSH. Previous history of syncope falls or dizziness was not predictive of CSH. Age (OR 1.05 95%CI 1.00, 1.09) and male sex (OR 1.71; 95%CI 1.04, 2.82) were the only independent predictors of CSH. In a previously asymptomatic sub-sample of 80 participants, CSH was present in 28 (35%). The 95th percentile for response was 7.3 seconds' asystole and 77mmHg drop in systolic blood pressure (7.1 seconds and 74mmHg when supine; 5.6 seconds and 76mmHg when erect). Conclusion CSH is common in older persons, even those with no prior history of syncope, dizziness, or falls. Derived normal thresholds for heart rate and blood pressure responses are larger than previously reported in symptomatic groups. When present, CSH cannot be assumed to be the attributable cause in those presenting with syncope and further work is required to determine the factors which transform CSH into a symptomatic state.
-
amnesia for loss of consciousness in Carotid Sinus syndrome implications for presentation with falls
Journal of the American College of Cardiology, 2005Co-Authors: Steve W Parry, Nick I Steen, Mary Baptist, Rose Anne KennyAbstract:OBJECTIVES The goal of this study was to compare the clinical characteristics of patients with Carotid Sinus syndrome who presented with falls with those who presented with syncope. BACKGROUND Carotid Sinus syndrome presents with both falls and syncope. The reasons for this differential presentation are unknown, but amnesia for loss of consciousness may be the underlying cause. METHODS Two groups of 34 consecutive patients with Carotid Sinus syndrome as the sole cause of falls and syncope were recruited. Cognitive function and clinical characteristics were compared between the two groups. RESULTS Syncopal subjects with Carotid Sinus syndrome were more likely to be older males (18 [53%] vs. 7 [21%] years; p = 0.006) with a longer duration of symptoms (27.9 vs. 13.3 months; p = 0.009) and more soft tissue injuries (19 [56%] vs. 9 [26%]; p = 0.03). Duration of asystole during Carotid Sinus massage was similar in both groups (5.1 vs. 5.4 s; p = 0.42), but witnessed amnesia for loss of consciousness was more frequent in fallers than those with syncope (21 [95%] vs. 4 [12%]; p < 0.001). Clinical characteristics and cognitive function were otherwise similar in both groups. CONCLUSIONS Patients with Carotid Sinus syndrome have similar rates of witnessed loss of consciousness during laboratory testing regardless of symptoms. However, those presenting with falls are far less likely to perceive any disturbance of consciousness than those with syncope, showing for the first time the manner in which such patients manifest symptoms. Cognitive impairment does not explain the amnesia for loss of consciousness seen in fallers with Carotid Sinus syndrome.
Steve W Parry - One of the best experts on this subject based on the ideXlab platform.
-
should we ever pace for Carotid Sinus syndrome
Frontiers in Cardiovascular Medicine, 2020Co-Authors: Steve W ParryAbstract:Carotid Sinus syndrome has been associated with transient loss of consciousness for millennia, and while steeped in cardiovascular lore, there is little in the way of solid evidence to guide its main treatment modality, permanent cardiac pacing. This article reviews the history of the condition in the context of its contemporary understanding before examining three key concepts in the consideration of what constitutes a manageable disease: first, is there a pathophysiologic rationale for the disease (in this case Carotid Sinus syndrome)? Second, is there a good diagnostic test that will identify it reliably? And finally, is there a convincingly evidence-based treatment for the disease? Relevant literature is reviewed, and recommendations made in how we view pacing in the context of this intriguingly opaque condition.
-
cardiac iodine 123 meta iodo benzylguanidine uptake in Carotid Sinus hypersensitivity
PLOS ONE, 2015Co-Authors: Maw Pin Tan, Alan Murray, Terry Hawkins, Simon Kerr, Thomas Chadwick, Steve W ParryAbstract:Background Carotid Sinus syndrome is the association of Carotid Sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with Carotid Sinus syndrome, asymptomatic Carotid Sinus hypersensitivity and controls without Carotid Sinus hypersensitivity.
-
the history of diagnosing Carotid Sinus hypersensitivity why are the current criteria too sensitive
Europace, 2011Co-Authors: C T P Krediet, Steve W Parry, Michele Brignole, David L Jardine, David G Benditt, Wouter WielingAbstract:The Carotid Sinus syndrome and Carotid Sinus hypersensitivity (CSH) are closely related disorders. The first is characterized by syncope triggered by manipulation of the Carotid Sinus in daily life (e.g. shaving). According to the current European Society of Cardiology guidelines, CSH is diagnosed when Carotid Sinus massage elicits ≥3 s asystole, a fall in systolic blood pressure of ≥50 mmHg, or both, with symptoms. The question is, however, whether symptoms can be expected when these criteria are met. Although they are widely accepted, we will show that their basis is primarily in arbitrary clinical observations and that in the original publications the link between classification and clinical symptoms was often dubious. The current criteria for CSH are thus too sensitive, explaining the reported high prevalence of CSH in the general older population. The review will conclude with suggesting a stricter set of criteria for CSH that should be evaluated in future studies.
-
results of Carotid Sinus massage in a tertiary referral unit is Carotid Sinus syndrome still relevant
Age and Ageing, 2009Co-Authors: Maw Pin Tan, Alan Murray, Thomas Chadwick, Julia L Newton, Pam Reeve, Steve W ParryAbstract:BACKGROUND Carotid Sinus hypersensitivity (CSH) is associated with syncope, drop attacks and unexplained falls in older people. However, a recent study has also reported a prevalence of 35% in asymptomatic community-dwelling older people. OBJECTIVE we conducted a retrospective observational study to investigate the haemodynamic and symptom responses of a large cohort of patients undergoing Carotid Sinus massage (CSM). METHODS the electronically stored haemodynamic data of 302 consecutive patients, aged 71 +/- 11 years, investigated with CSM for unexplained falls and syncope was analysed. Bilateral sequential CSM was performed in the supine and upright positions with continuous electrocardiogram (ECG) and non-invasive beat-to-beat blood pressure monitoring (Taskforce, CN Systems, Austria). CSH (CSH) was defined by maximal R-R interval > or =3 s (cardioinhibitory) and/or a systolic blood pressure drop of > or =50 mmHg (vasodepressor). RESULTS a total of 74/302 (25%) subjects had CSH, 37 (50%) of which were cardioinhibitory (CI) and 37 (50%) were vasodepressor (VD) subtypes. Subjects with positive CSM were significantly older (75.2 vs 70.2 years, P < 0.001), and more likely to be male (32% vs 19%, P < 0.01). CSH was diagnosed with right-sided CSM alone in 45 (61%) subjects and erect CSM only in 36 (49%) subjects. Symptom reproduction was more likely with the CI than the VD subtypes (82% vs 28%; P < 0.001). CONCLUSION CSH was diagnosed in 25% of patients investigated with CSM at our specialist unit, lower than the prevalence of 39% reported for community-dwelling older individuals. This discrepancy may be explained by selection bias and demographic differences, but raises the possibility of CSH being an age-related epiphenomenon rather than a causal mechanism for syncope, drop attacks and unexplained falls. Our observations have important implications for clinical practice and the development of future research strategies.
-
the relationship between Carotid Sinus hypersensitivity orthostatic hypotension and vasovagal syncope a case control study
Europace, 2008Co-Authors: Steve W Parry, Maw Pin Tan, Thomas Chadwick, Julia L NewtonAbstract:Aims Previous uncontrolled studies reported an overlap between Carotid Sinus hypersensitivity (CSH), vasovagal syncope (VVS), and orthostatic hypotension (OH). We conducted a case–control study evaluating this relationship in a large patient cohort. Methods and results The electronically stored continuous electrocardiograph and blood pressure (BP) measurements for active stand and head-up tilt-table (HUT) tests of 302 consecutive patients investigated with Carotid Sinus massage (CSM) were analysed. Carotid Sinus hypersensitivity was defined as ≥3 s asystole and/or systolic BP (SBP) drop of ≥50 mmHg during CSM. Orthostatic hypotension was defined as BP reductions of ≥20 mmHg systolic or of ≥10 mmHg diastolic, whereas VVS was diagnosed with a positive HUT test. There was no significant difference in the number of subjects with OH (57 vs. 55%; P = 0.778) or HUT-positive VVS (45 vs. 47%; P = 0.828) between cases with CSH and controls without CSH. Carotid Sinus hypersensitivity subjects had significantly larger SBP reduction ( P = 0.039) and longer time to nadir ( P = 0.007) during active stand, and trends to vasodepressor ( P = 0.071) and dysautonomic responses to HUT ( P = 0.151). Conclusion Carotid Sinus hypersensitivity, OH, and VVS are common conditions affecting patients with syncope and falls which are likely to co-exist in such individuals. The differences in haemodynamic response patterns to active stand and HUT in CSH subjects could be the result of an age-associated delay in sympathetic responses.
Maw Pin Tan - One of the best experts on this subject based on the ideXlab platform.
-
RESEARCH ARTICLE Cardiac Iodine-123-Meta-Iodo- Benzylguanidine Uptake in Carotid Sinus
2016Co-Authors: Maw Pin Tan, Alan Murray, Terry Hawkins, Thomas J. Chadwick, Simon R. J. KerrAbstract:Background Carotid Sinus syndrome is the association of Carotid Sinus hypersensitivity with syncope, un-explained falls and drop attacks in generally older people. We evaluated cardiac sympathet-ic innervation in this disorder in individuals with Carotid Sinus syndrome, asymptomatic Carotid Sinus hypersensitivity and controls without Carotid Sinus hypersensitivity. Methods Consecutive patients diagnosed with Carotid Sinus syndrome at a specialist falls and synco-pe unit were recruited. Asymptomatic Carotid Sinus hypersensitivity and non-Carotid Sinus hypersensitivity control participants recruited from a community-dwelling cohort. Cardiac sympathetic innervation was determined using Iodine-123-metaiodobenzylguanidine (123-I-MIBG) scanning. Heart to mediastinal uptake ratio (H:M) were determined for early and late uptake on planar scintigraphy at 20 minutes and 3 hours following intravenous injection of 123-I-MIBG. Result
-
cardiac iodine 123 meta iodo benzylguanidine uptake in Carotid Sinus hypersensitivity
PLOS ONE, 2015Co-Authors: Maw Pin Tan, Alan Murray, Terry Hawkins, Simon Kerr, Thomas Chadwick, Steve W ParryAbstract:Background Carotid Sinus syndrome is the association of Carotid Sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with Carotid Sinus syndrome, asymptomatic Carotid Sinus hypersensitivity and controls without Carotid Sinus hypersensitivity.
-
results of Carotid Sinus massage in a tertiary referral unit is Carotid Sinus syndrome still relevant
Age and Ageing, 2009Co-Authors: Maw Pin Tan, Alan Murray, Thomas Chadwick, Julia L Newton, Pam Reeve, Steve W ParryAbstract:BACKGROUND Carotid Sinus hypersensitivity (CSH) is associated with syncope, drop attacks and unexplained falls in older people. However, a recent study has also reported a prevalence of 35% in asymptomatic community-dwelling older people. OBJECTIVE we conducted a retrospective observational study to investigate the haemodynamic and symptom responses of a large cohort of patients undergoing Carotid Sinus massage (CSM). METHODS the electronically stored haemodynamic data of 302 consecutive patients, aged 71 +/- 11 years, investigated with CSM for unexplained falls and syncope was analysed. Bilateral sequential CSM was performed in the supine and upright positions with continuous electrocardiogram (ECG) and non-invasive beat-to-beat blood pressure monitoring (Taskforce, CN Systems, Austria). CSH (CSH) was defined by maximal R-R interval > or =3 s (cardioinhibitory) and/or a systolic blood pressure drop of > or =50 mmHg (vasodepressor). RESULTS a total of 74/302 (25%) subjects had CSH, 37 (50%) of which were cardioinhibitory (CI) and 37 (50%) were vasodepressor (VD) subtypes. Subjects with positive CSM were significantly older (75.2 vs 70.2 years, P < 0.001), and more likely to be male (32% vs 19%, P < 0.01). CSH was diagnosed with right-sided CSM alone in 45 (61%) subjects and erect CSM only in 36 (49%) subjects. Symptom reproduction was more likely with the CI than the VD subtypes (82% vs 28%; P < 0.001). CONCLUSION CSH was diagnosed in 25% of patients investigated with CSM at our specialist unit, lower than the prevalence of 39% reported for community-dwelling older individuals. This discrepancy may be explained by selection bias and demographic differences, but raises the possibility of CSH being an age-related epiphenomenon rather than a causal mechanism for syncope, drop attacks and unexplained falls. Our observations have important implications for clinical practice and the development of future research strategies.
-
the relationship between Carotid Sinus hypersensitivity orthostatic hypotension and vasovagal syncope a case control study
Europace, 2008Co-Authors: Steve W Parry, Maw Pin Tan, Thomas Chadwick, Julia L NewtonAbstract:Aims Previous uncontrolled studies reported an overlap between Carotid Sinus hypersensitivity (CSH), vasovagal syncope (VVS), and orthostatic hypotension (OH). We conducted a case–control study evaluating this relationship in a large patient cohort. Methods and results The electronically stored continuous electrocardiograph and blood pressure (BP) measurements for active stand and head-up tilt-table (HUT) tests of 302 consecutive patients investigated with Carotid Sinus massage (CSM) were analysed. Carotid Sinus hypersensitivity was defined as ≥3 s asystole and/or systolic BP (SBP) drop of ≥50 mmHg during CSM. Orthostatic hypotension was defined as BP reductions of ≥20 mmHg systolic or of ≥10 mmHg diastolic, whereas VVS was diagnosed with a positive HUT test. There was no significant difference in the number of subjects with OH (57 vs. 55%; P = 0.778) or HUT-positive VVS (45 vs. 47%; P = 0.828) between cases with CSH and controls without CSH. Carotid Sinus hypersensitivity subjects had significantly larger SBP reduction ( P = 0.039) and longer time to nadir ( P = 0.007) during active stand, and trends to vasodepressor ( P = 0.071) and dysautonomic responses to HUT ( P = 0.151). Conclusion Carotid Sinus hypersensitivity, OH, and VVS are common conditions affecting patients with syncope and falls which are likely to co-exist in such individuals. The differences in haemodynamic response patterns to active stand and HUT in CSH subjects could be the result of an age-associated delay in sympathetic responses.
Hongfang Jin - One of the best experts on this subject based on the ideXlab platform.
-
endogenous hydrogen sulfide enhances Carotid Sinus baroreceptor sensitivity by activating the transient receptor potential cation channel subfamily v member 1 trpv1 channel
Journal of the American Heart Association, 2017Co-Authors: Ying Liao, Yaqian Huang, Selena Y Chen, Yan Sun, Chufan Sun, Chaoshu Tang, Hongfang JinAbstract:Background We aimed to investigate the regulatory effects of hydrogen sulfide (H 2 S) on Carotid Sinus baroreceptor sensitivity and its mechanisms. Methods and Results Male Wistar‐Kyoto rats and spontaneously hypertensive rats (SHRs) were used in the experiment and were given an H 2 S donor or a cystathionine‐β‐synthase inhibitor, hydroxylamine, for 8 weeks. Systolic blood pressure and the cystathionine‐β‐synthase/H 2 S pathway in Carotid Sinus were detected. Carotid Sinus baroreceptor sensitivity and the functional curve of the Carotid baroreceptor were analyzed using the isolated Carotid Sinus perfusion technique. Effects of H 2 S on transient receptor potential cation channel subfamily V member 1 (TRPV1) expression and S‐sulfhydration were detected. In SHRs, systolic blood pressure was markedly increased, but the cystathionine‐β‐synthase/H 2 S pathway in the Carotid Sinus was downregulated in comparison to that of Wistar‐Kyoto rats. Carotid Sinus baroreceptor sensitivity in SHRs was reduced, demonstrated by the right and upward shift of the functional curve of the Carotid baroreceptor. Meanwhile, the downregulation of TRPV1 protein was demonstrated in the Carotid Sinus; however, H 2 S reduced systolic blood pressure but enhanced Carotid Sinus baroreceptor sensitivity in SHRs, along with TRPV1 upregulation in the Carotid Sinus. In contrast, hydroxylamine significantly increased the systolic blood pressure of Wistar‐Kyoto rats, along with decreased Carotid Sinus baroreceptor sensitivity and reduced TRPV1 protein expression in the Carotid Sinus. Furthermore, H 2 S‐induced enhancement of Carotid Sinus baroreceptor sensitivity of SHRs could be amplified by capsaicin but reduced by capsazepine. Moreover, H 2 S facilitated S‐sulfhydration of TRPV1 protein in the Carotid Sinus of SHRs and Wistar‐Kyoto rats. Conclusions H 2 S regulated blood pressure via an increase in TRPV1 protein expression and its activity to enhance Carotid Sinus baroreceptor sensitivity.
Jin Hongfang - One of the best experts on this subject based on the ideXlab platform.
-
Endogenous Hydrogen Sulfide Enhances Carotid Sinus Baroreceptor Sensitivity by Activating the Transient Receptor Potential Cation Channel Subfamily V Member 1 (TRPV1) Channel
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2017Co-Authors: Yu Wen, Liao Ying, Huang Yaqian, Chen, Selena Y., Sun Yan, Sun Chufan, Wu Yuming, Tang Chaoshu, Du Junbao, Jin HongfangAbstract:Background-We aimed to investigate the regulatory effects of hydrogen sulfide (H2S) on Carotid Sinus baroreceptor sensitivity and its mechanisms. Methods and Results-Male Wistar-Kyoto rats and spontaneously hypertensive rats (SHRs) were used in the experiment and were given an H2S donor or a cystathionine-beta-synthase inhibitor, hydroxylamine, for 8 weeks. Systolic blood pressure and the cystathionine-beta-synthase/H2S pathway in Carotid Sinus were detected. Carotid Sinus baroreceptor sensitivity and the functional curve of the Carotid baroreceptor were analyzed using the isolated Carotid Sinus perfusion technique. Effects of H2S on transient receptor potential cation channel subfamily V member 1 (TRPV1) expression and S-sulfhydration were detected. In SHRs, systolic blood pressure was markedly increased, but the cystathionine-beta therefore-synthase/H2S pathway in the Carotid Sinus was downregulated in comparison to that of Wistar-Kyoto rats. Carotid Sinus baroreceptor sensitivity in SHRs was reduced, demonstrated by the right and upward shift of the functional curve of the Carotid baroreceptor. Meanwhile, the downregulation of TRPV1 protein was demonstrated in the Carotid Sinus; however, H2S reduced systolic blood pressure but enhanced Carotid Sinus baroreceptor sensitivity in SHRs, along with TRPV1 upregulation in the Carotid Sinus. In contrast, hydroxylamine significantly increased the systolic blood pressure of Wistar-Kyoto rats, along with decreased Carotid Sinus baroreceptor sensitivity and reduced TRPV1 protein expression in the Carotid Sinus. Furthermore, H2S-induced enhancement of Carotid Sinus baroreceptor sensitivity of SHRs could be amplified by capsaicin but reduced by capsazepine. Moreover, H2S facilitated S-sulfhydration of TRPV1 protein in the Carotid Sinus of SHRs and Wistar-Kyoto rats. Conclusions-H2S regulated blood pressure via an increase in TRPV1 protein expression and its activity to enhance Carotid Sinus baroreceptor sensitivity.National Natural Science Foundation of China [81500325, 81100181]; Major Basic Research Development Program of China [2013CB933801]; National Youth Top-Notch Talent Support ProgramSCI(E)ARTICLE5