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The ergoreflex: how the skeletal muscle modulates ventilation and cardiovascular function in health and disease
Author(s) -
Aimo Alberto,
Saccaro Luigi Francesco,
Borrelli Chiara,
Fabiani Iacopo,
Gentile Francesco,
Passino Claudio,
Emdin Michele,
Piepoli Massimo Francesco,
Coats Andrew J.S.,
Giani Alberto
Publication year - 2021
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.2298
Subject(s) - medicine , cardiorespiratory fitness , heart failure , skeletal muscle , cardiology , myopathy , exercise intolerance , subclinical infection , reflex , neuromuscular disease , heart disease , physical medicine and rehabilitation , ventilation (architecture) , disease , mechanical engineering , engineering
The control of ventilation and cardiovascular function during physical activity is partially regulated by the ergoreflex, a cardiorespiratory reflex activated by physical activity. Two components of the ergoreflex have been identified: the mechanoreflex, which is activated early by muscle contraction and tendon stretch, and the metaboreflex, which responds to the accumulation of metabolites in the exercising muscles. Patients with heart failure (HF) often develop a skeletal myopathy with varying degrees of severity, from a subclinical disease to cardiac cachexia. HF‐related myopathy has been associated with increased ergoreflex sensitivity, which is believed to contribute to dyspnoea on effort, fatigue and sympatho‐vagal imbalance, which are hallmarks of HF. Ergoreflex sensitivity increases significantly also in patients with neuromuscular disorders. Exercise training is a valuable therapeutic option for both HF and neuromuscular disorders to blunt ergoreflex sensitivity, restore the sympatho‐vagal balance, and increase tolerance to physical exercise. A deeper knowledge of the mechanisms mediating ergoreflex sensitivity might enable a drug or device modulation of this reflex when patients cannot exercise because of advanced skeletal myopathy.