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Influence of the metaboreflex on arterial blood pressure in heart failure patients
Author(s) -
Keller Manda Linea,
Johnson Bruce D,
Joyner Michael J,
O'Malley Kathy A,
Miller Andrew,
Olson Thomas P
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.712.2
Subject(s) - blood pressure , medicine , heart failure , cardiology , heart rate , pulse pressure , ejection fraction , stimulation , hemodynamics
Feedback from active locomotor muscles contributes to the pressor response and may be more prominent in heart failure (HF) due to muscle myopathy, greater metabolite production and/or heightened sensitivity of receptors. We sought to examine the influence of metaboreflex stimulation on mean arterial pressure (MAP) in HF. Eleven HF patients (51±15yrs, NYHA Class I/II, LVEF 32±9%) and 11 controls (CTL) (42±9yrs) were recruited. Participants completed 3 study visits; 1) maximal cycle ergometry, 2) and 3) constant‐work cycling (60% peak power) for 4 min with 2 min recovery. Recovery was randomized to normal or regional circulatory occlusion (metaboreflex stimulation). Oxygen consumption (VO 2 ), carbon dioxide production (VCO 2 ), blood pressure and heart rate (HR) were measured at rest, end‐exercise and recovery. With metaboreflex stimulation, MAP and systolic blood pressure (SBP) increased in HF compared to CTL (6.8±5.8% vs −3.0±7.8%, p <0.01 and 3.4±6.4% vs −12.7±10.4%, p <0.01, respectively), with no difference in diastolic pressure ( p =0.61). HR and O 2 pulse demonstrated an attenuated return to baseline in HF (6.7±5.9% vs 1.0±6.6%, p <0.01 and −50.4±15.6 vs −72.4±6.9%, p <0.01, respectively). Metaboreflex stimulation resulted in a marked pressor response in HF relative to CTL due primarily to an influence of SBP and attenuated cardiac recovery as suggested by the persistent elevation in HR and O 2 pulse.