Contribution of Muscle Afferents to the Hemodynamic, Autonomic, and Ventilatory Responses to Exercise in Patients With Chronic Heart Failure

Circulation ◽  
1996 ◽  
Vol 93 (5) ◽  
pp. 940-952 ◽  
Author(s):  
Massimo Piepoli ◽  
Andrew L. Clark ◽  
Maurizio Volterrani ◽  
Stamatis Adamopoulos ◽  
Peter Sleight ◽  
...  
2020 ◽  
Vol 27 (17) ◽  
pp. 1862-1872
Author(s):  
Luca Angius ◽  
Antonio Crisafulli

Exercise intolerance and early fatiguability are hallmark symptoms of chronic heart failure. While the malfunction of the heart is certainly the leading cause of chronic heart failure, the patho-physiological mechanisms of exercise intolerance in these patients are more complex, multifactorial and only partially understood. Some evidence points towards a potential role of an exaggerated afferent feedback from group III/IV muscle afferents in the genesis of these symptoms. Overactivity of feedback from these muscle afferents may cause exercise intolerance with a double action: by inducing cardiovascular dysregulation, by reducing motor output and by facilitating the development of central and peripheral fatigue during exercise. Importantly, physical inactivity appears to affect the progression of the syndrome negatively, while physical training can partially counteract this condition. In the present review, the role played by group III/IV afferent feedback in cardiovascular regulation during exercise and exercise-induced muscle fatigue of healthy people and their potential role in inducing exercise intolerance in chronic heart failure patients will be summarised.


2010 ◽  
Vol 588 (24) ◽  
pp. 5033-5047 ◽  
Author(s):  
Han-Jun Wang ◽  
Yu-Long Li ◽  
Lie Gao ◽  
Irving H. Zucker ◽  
Wei Wang

2012 ◽  
Vol 302 (11) ◽  
pp. R1260-R1270 ◽  
Author(s):  
Han-Jun Wang ◽  
Yu-Long Li ◽  
Irving H. Zucker ◽  
Wei Wang

An exaggerated exercise pressor reflex (EPR) contributes to exercise intolerance and excessive sympathoexcitation in the chronic heart failure (CHF) state, which is prevented by exercise training (ExT) at an early stage in the development of CHF. We hypothesized that ExT has a beneficial effect on the exaggerated EPR by improving the dysfunction of muscle afferents in CHF. We recorded the discharge of mechanically sensitive ( group III) and metabolically sensitive ( group IV) afferents in response to static contraction, passive stretch, and hindlimb intra-arterial injection of capsaicin in sham+sedentary (Sed), sham+ExT, CHF+Sed, and CHF+ExT rats. Compared with sham+Sed rats, CHF+Sed rats exhibited greater responses of group III afferents to contraction and stretch, whereas the responses of group IV afferents to contraction and capsaicin were blunted. ExT prevented the sensitization of group III responses to contraction or stretch and partially prevented the blunted group IV responses to contraction or capsaicin in CHF rats. Furthermore, we investigated whether purinergic 2X (P2X) and transient receptor potential vanilloid 1 (TRPV1) receptors mediate the altered sensitivity of muscle afferents by ExT in CHF. We found that the upregulated P2X and downregulated TRPV1 receptors in L4/5 dorsal root ganglia of CHF rats were normalized by ExT. Hindlimb intra-arterial infusion of a P2X antagonist attenuated the group III response to contraction or stretch in CHF rats to a greater extent than in sham rats, which was normalized by ExT. These findings suggest that ExT improves the abnormal sensitization of muscle afferents in CHF at least, in part, via restoring the dysfunction of P2X and TRPV1 receptors.


2005 ◽  
Vol 7 (4) ◽  
pp. 612-617 ◽  
Author(s):  
Klaus K.A. Witte ◽  
Simon Thackray ◽  
Nikolay P. Nikitin ◽  
John G.F. Cleland ◽  
Andrew L. Clark

2014 ◽  
Vol 174 (2) ◽  
pp. 368-375 ◽  
Author(s):  
Markus Amann ◽  
Massimo Venturelli ◽  
Stephen J. Ives ◽  
David E. Morgan ◽  
Benjamin Gmelch ◽  
...  

1998 ◽  
Vol 66 (1) ◽  
pp. 59-63 ◽  
Author(s):  
William Armour ◽  
Andrew L. Clark ◽  
Gerald P. McCann ◽  
W.Stewart Hillis

2011 ◽  
Vol 25 (S1) ◽  
Author(s):  
Han‐Jun Wang ◽  
Yu‐Long Li ◽  
Lie Gao ◽  
Irving H. Zucker ◽  
Wei Wang

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