Vestibulo-autonomic control in man: Short- and long-latency vestibular effects on cardiovascular function.

We examined the hypothesis that vestibular signals may exert a rapid control on the heart adjusting cardiovascular function to maintain homoestasis during changes in body posture. Short- and long-latency effects of vestibular stimulation on heart rate (HR), systolic blood pressure (SP), diastolic pressure (DP) and digital blood flow (BF) were studied in fourteen normal controls (NC) and nine labyrinthine-defective subjects (LDS) exposed to abrupt head accelerations. Subjects lay supine with their head suspended in a sling whose 'release' was triggered at delays of 170 ms and 570 ms after an R-spike of the ECG. Release caused the head to fall with an acceleration approximately 0.8 g for approximately 140 ms. Three additional NC underwent head drops at 170 ms, 370 ms, 470 ms and 570 ms to determine response latencies with precision. In NC, the short-latency response to head drops timed 170 to 470 ms after an R-spike was to shorten the time to the next R-spike in comparison to pre-drop heartbeat cycles. Drops at 570 ms delay shortened only the succeeding post-stimulus RR-interval. In LDS, head drops timed 170 ms after a heartbeat failed to shorten the ongoing cardiac cycle. For both delays only the succeeding cardiac cycle was significantly shortened. In all subjects, SP rose slightly by approximately 1-3% and BF decreased by 7-24% after 3-4 heartbeats post-drop. The results are evidence for an excitatory vestibulo-cardiac reflex in man which accelerates heart rate at a latency circa 500-600 ms. SP and BF are affected at longer latencies of several heart beats. A delayed increase of heart rate in response to postural challenge may contribute to the autonomic distress experienced by patients with vestibular loss.