Exaggerated muscle mechanoreflex control of reflex renal vasoconstriction in heart failure

被引:91
作者
Middlekauff, HR
Nitzsche, EU
Hoh, CK
Hamilton, MA
Fonarow, GC
Hage, A
Moriguchi, JD
机构
[1] Univ Calif Los Angeles, Dept Med, Div Cardiol, Los Angeles, CA 90095 USA
[2] Univ Basel, Sch Med, Dept Radiol, Div Nucl Med, CH-4031 Basel, Switzerland
[3] Univ Basel, Med Ctr, CH-4031 Basel, Switzerland
关键词
exercise; sympathetic nervous system; renal circulation; congestive heart failure;
D O I
10.1152/jappl.2001.90.5.1714
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
In heart failure (HF) patients, reflex renal vasoconstriction during exercise is exaggerated. We hypothesized that muscle mechanoreceptor control of renal vasoconstriction is exaggerated in HF. Nineteen HF patients and nineteen controls were enrolled in two exercise protocols: 1) low-level rhythmic handgrip (mechanoreceptors and central command) and 2) involuntary biceps contractions (mechanoreceptors). Renal cortical blood flow was measured by positron emission tomography, and renal cortical vascular resistance (RCVR) was calculated. During rhythmic handgrip, peak RCVR was greater in HF patients compared with controls (37 +/- 1 vs. 27 +/- 1 units; P < 0.01). Change in (<Delta>) RCVR tended to be greater as well but did not reach statistical significance (10 +/- 1 vs. 7 +/- 0.9 units; P = 0.13). RCVR was returned to baseline at 2-3 min postexercise in controls but remained significantly elevated in HF patients. During involuntary muscle contractions, peak RCVR was greater in HF patients compared with controls (36 +/- 0.7 vs. 24 +/- 0.5 units; P < 0.0001). The <Delta> RCVR was also significantly greater in HF patients compared with controls (6 +/- 1 vs. 4 +/- 0.6 units; P = 0.05). The data suggest that reflex renal vasoconstriction is exaggerated in both magnitude and duration during dynamic exercise in HF patients. Given that the exaggerated response was elicited in both the presence and absence of central command, it is clear that intact muscle mechanoreceptor sensitivity contributes to this augmented reflex renal vasoconstriction.
引用
收藏
页码:1714 / 1719
页数:6
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