{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:17:16Z","timestamp":1791901036801,"version":"4.3.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:p>\n            Cardiac parasympathetic activity reduces susceptibility to potentially lethal ventricular arrhythmias in heart failure and ischemic heart disease. This influence is mediated in large part by antagonism of the adverse cardiac effects of sympathetic overactivity (\u201cindirect\u201d parasympathetic activity) in addition to the \u201cdirect\u201d effects of muscarinic stimulation. Nitric oxide modulates parasympathetic cardiac signaling in some animal models, but human data are lacking. We have investigated the influence of endogenous nitric oxide on cardiac responses to parasympathetic stimulation in healthy humans. In 18 volunteers, we studied chronotropic and inotropic responses to muscarinic stimulation, both before and after prestimulation with isoproterenol. Cardiac muscarinic stimulation was achieved using an intravenous bolus of the short-acting cholinesterase inhibitor, edrophonium. Responses were assessed during a background infusion of a nitric oxide synthase inhibitor (\n            <jats:italic>N<\/jats:italic>\n            <jats:sup>G<\/jats:sup>\n            -monomethyl-\n            <jats:sc>l<\/jats:sc>\n            -arginine [\n            <jats:sc>l<\/jats:sc>\n            -NMMA]), placebo (saline), or phenylephrine (vasoconstrictor control) in a single-blind, random order, crossover protocol.\n            <jats:sc>l<\/jats:sc>\n            -NMMA did not affect chronotropic responses to edrophonium alone (direct parasympathetic activity). The decrease in heart rate attributable to \u201cindirect\u201d parasympathetic activity (derived by comparison with the effect of edrophonium during concurrent adrenergic stimulation) was substantially attenuated by\n            <jats:sc>l<\/jats:sc>\n            -NMMA in comparison to both control infusions. No modification of muscarinic inotropic responses by\n            <jats:sc>l<\/jats:sc>\n            -NMMA was apparent in comparison to the vasoconstrictor control. Nitric oxide exerts a powerful facilitating influence on indirect (antiadrenergic) but not direct human cardiac parasympathetic control. Stimulation of the endogenous nitric oxide pathway might enhance parasympathetic protection against the adverse influences of cardiac sympathetic overactivity.\n          <\/jats:p>","DOI":"10.1161\/01.hyp.0000126171.46645.f9","type":"journal-article","created":{"date-parts":[[2004,3,23]],"date-time":"2004-03-23T01:54:07Z","timestamp":1080006847000},"page":"1023-1028","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Nitric Oxide and Cardiac Muscarinic Control in Humans"],"prefix":"10.1161","volume":"43","author":[{"given":"Saqib","family":"Chowdhary","sequence":"first","affiliation":[{"name":"From the Departments of Cardiovascular Medicine (S.C., A.M.M., J.N.T.) and Physiology (J.H.C.), University of Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Marsh","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Medicine (S.C., A.M.M., J.N.T.) and Physiology (J.H.C.), University of Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Coote","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Medicine (S.C., A.M.M., J.N.T.) and Physiology (J.H.C.), University of Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan N.","family":"Townend","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Medicine (S.C., A.M.M., J.N.T.) and Physiology (J.H.C.), University of Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.98.15.1510"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.103.16.2072"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198409273111303"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.68.5.2019002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1969.27.4.465"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2407"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1042\/cs0970005"},{"key":"e_1_3_2_8_2","first-page":"R403","volume":"268","year":"1995","unstructured":"Armour JA, Smith FM, Losier AM, Ellenberger HH, Hopkins DA. 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Pharmacol Rev. 1973; 25: 119\u2013155.","journal-title":"Pharmacol Rev"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.1.8281643"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.90.1.347"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.res.0000047531.75030.b5"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.273.46.30249"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.2.161"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)00973-5"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1982.52.6.1652"}],"container-title":["Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.HYP.0000126171.46645.f9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:15:15Z","timestamp":1715530515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.HYP.0000126171.46645.f9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2004,5]]}},"alternative-id":["10.1161\/01.HYP.0000126171.46645.f9"],"URL":"https:\/\/doi.org\/10.1161\/01.hyp.0000126171.46645.f9","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,5]]},"assertion":[{"value":"2004-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2004-03-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}