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Article
Group III/IV Muscle Afferents Impair Limb Blood in Patients with Chronic Heart Failure
Health and Human Physiological Sciences
  • Markus Amann
  • Massimo Venturelli
  • Stephen J. Ives, Skidmore College
  • David E. Morgan
  • Benjamin Gmelch
  • Melissa A.H. Witman
  • H. Jonathan Groot
  • D. Walter Wray
  • Josef Stehlik
  • Russell S. Richardson
Document Type
Article
Publication Date
1-1-2014
Keywords
  • Circulation,
  • exercise pressor reflex,
  • sensory neurons,
  • autonomic control
Abstract

OBJECTIVE: To better understand the hemodynamic and autonomic reflex abnormalities in heart-failure patients (HF), we investigated the influence of group III/IV muscle afferents on their cardiovascular response to rhythmic exercise.

METHODS: Nine HF-patients (NYHA class-II, mean left ventricular ejection-fraction: 27 ± 3%) performed single leg knee-extensor exercise (25/50/80% peak-workload) under control conditions and with lumbar intrathecal fentanyl impairing μ-opioid receptor-sensitive muscle afferents.

RESULTS:Cardiac-output (Q) and femoral blood-flow (QL) were determined, and arterial/venous blood samples collected at each workload. Exercise-induced fatigue was estimated via pre/post-exercise changes in quadriceps strength. There were no hemodynamic differences between conditions at rest. During exercise, Q was 8-13% lower with Fentanyl-blockade, secondary to significant reductions in stroke volume and heart rate. Lower norepinephrine spillover during exercise with Fentanyl revealed an attenuated sympathetic outflow that likely contributed to the 25% increase in leg vascular conductance (p

CONCLUSION/PRACTICE/IMPLICATIONS: Although group III/IV muscle afferents play a critical role for central hemodynamics in HF-patients, it also appears that these sensory neurons cause excessive sympatho-excitation impairing QL which likely contributes to the exercise intolerance in this population.

Published In
International journal of cardiology
Pages
368-375
DOI
10.1016/j.ijcard.2014.04.157
Citation Information
Amann M, Venturelli M, Ives SJ, Morgan DE, Gmelch B, Witman MA, Jonathan Groot H, Walter Wray D, Stehlik J, Richardson RS. Group III/IV muscle afferents impair limb blood in patients with chronic heart failure. Int J Cardiol. 2014 Jun 15;174(2):368-75. doi: 10.1016/j.ijcard.2014.04.157. Epub 2014 Apr 21. PubMed PMID: 24794967; PubMed Central PMCID: PMC4075285.