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Hemodynamics Dys‐regulation during the Muscle Metaboreflex in Patients with Coronary Artery Disease
Author(s) -
Crisafulli Antonio,
Roberto Silvana,
Sainas Gianmarco,
Milia Raffaele,
Palazzolo Girolamo,
Vanni Samuele,
Pinna Virginia,
Doneddu Azzurra,
Tacco Filippo,
Magnani Sara
Publication year - 2017
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.31.1_supplement.838.7
Subject(s) - medicine , impedance cardiography , cardiology , hemodynamics , coronary artery disease , stroke volume , ctl* , haemodynamic response , vascular resistance , ischemia , cardiac output , heart rate , blood pressure , immune system , immunology , cd8
In healthy subjects, when the muscle metaboreflex (MM) is activated, mean blood pressure (MBP) increases because of a sympathetic‐induced increase in both systemic vascular resistance (SVR) and stroke volume (SV)1. In contrast, in the failing circulation the MBP response is achieved mainly by means of an increase in SVR, with exaggerated vasoconstriction2. Our aim was to discover whether hemodynamics was dys‐regulated in patients with coronary artery disease (CAD). 11 male patients with CAD (57.5±6.6 yrs) together with 11 male control subjects (CTL, 56.2±14.8 yrs) participated in this study. They underwent randomly assigned the following protocol: 1) post‐exercise muscle ischemia (PEMI) session, to study the MM, and 2) control exercise recovery (CER) session. Response to the metaboreflex for each cardiovascular parameter was assessed as PEMI minus CER level. Hemodynamic parameters were evaluated by impedance cardiography and Doppler‐echocardiography. Patients with CAD showed a higher SVR response in comparison with the CTL group (392.5±549.6 vs. 38.9±249.5 dynes•s‐1•cm‐5 respectively, p<0.05), a reduced SV response (−3.5±9.4 vs. 4.3±6.0 ml respectively, p<0.05) while MBP response was not different between groups (11.2±7.1 vs. 10.6±9.4 mmHg respectively). Moreover, cardiac output (CO) response was impaired in the CDA as compared to the CTL group (−175.1±513.6 vs. 396.6±580.8 ml•min‐1 respectively, p<0.05) Finally, ventricular filling rate, a measure of diastolic function, was enhanced in the CTL group (22.7±36.8 ml•s‐1) whereas it was reduced in the CAD group (−8.0±18.9 ml•s‐1, p<0.05 vs. the CTL group). This study indicates that patients with CAD have an abnormal hemodynamics during the MM with exaggerated vasoconstriction. Patients showed impaired diastolic function and reduced capacity to increase SV and CO in response to the MM recruitment. Finally, this study shows that the PEMI test provides a simple, useful tool to investigate on the cardiovascular consequences of CAD. Support or Funding Information This study was supported by the University of Cagliari and the Italian Ministry of Scientific Research. 1response in mean blood pressure (MBP), systemic vascular resistance (SVR), cardiac output (CO), and ventricular filling rate (VFR) in the CAD and in the CTL groups.