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Am J Physiol Heart Circ Physiol 280: H969-H976, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 3, H969-H976, March 2001

Impact of heart failure and exercise capacity on sympathetic response to handgrip exercise

Catherine F. Notarius, Deborah J. Atchison, and John S. Floras

Division of Cardiology, Toronto General and Mount Sinai Hospitals, University of Toronto, Toronto, Ontario M5G 1X5, Canada

Peak oxygen uptake (VO2 peak) in patients with heart failure (HF) is inversely related to muscle sympathetic nerve activity (MSNA) at rest. We hypothesized that the MSNA response to handgrip exercise is augmented in HF patients and is greatest in those with low VO2 peak. We studied 14 HF patients and 10 age-matched normal subjects during isometric [30% of maximal voluntary contraction (MVC)] and isotonic (10%, 30%, and 50% MVC) handgrip exercise that was followed by 2 min of posthandgrip ischemia (PHGI). MSNA was significantly increased during exercise in HF but not normal subjects. Both MSNA and HF levels remained significantly elevated during PHGI after 30% isometric and 50% isotonic handgrip in HF but not normal subjects. HF patients with lower VO2 peak (<56% predicted; n = 8) had significantly higher MSNA during rest and exercise than patients with VO2 peak > 56% predicted (n = 6) and normal subjects. The muscle metaboreflex contributes to the greater reflex increase in MSNA during ischemic or intense nonischemic exercise in HF. This occurs at a lower threshold than normal and is a function of VO2 peak.

muscle sympathetic nerve activity; metaboreflex; VO2 peak; left ventricular dysfunction; ischemia


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