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Progressive improvement in hemodynamic response to muscle metaboreflex in heart transplant recipients.
MedLine Citation:
PMID:  23195627     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Exercise capacity remains lower in heart transplant recipients (HTR) following transplant compared to normal subjects despite improved cardiac function. Moreover, metaboreceptor activity in the muscle has been reported to increase. The aim of the present investigation was to assess exercise capacity together with metaboreflex activity in HTR patients for one year following heart transplant in order to test the hypothesis that recovery in exercise capacity was paralleled by improvements in response to metaboreflex. Cardiopulmonary test (CPX) for exercise capacity and VO(2max) and hemodynamic response to metaboreflex activation obtained by post-exercise ischemia were gathered in six HTR and nine healthy controls (CTL) four times: at the beginning of the study (T0, 42±6 days after transplant), at the 3(rd), 6(th), and 12(th) month after TO (T1, T2, and T3). The main results were: 1) exercise capacity and VO(2max) were seen to progressively increase in HTR; 2) at T0 and T1 HTR achieved higher blood pressure response in response to metaboreflex compared to CTL, this difference disappeared at T2 and T3; and 3) this exaggerated blood pressure response was the result of a systemic vascular resistance increment. This study demonstrates that exercise capacity progressively improves in HTR after transplant and that this phenomenon is accompanied by a progressive reduction of the metaboreflex-induced increase in blood pressure and systemic vascular resistance. These facts indicate that, despite improved cardiac function, re-setting of cardiovascular regulation in HTR requires months.
Authors:
Antonio Crisafulli; Filippo Tocco; Raffaele Milia; Luca Angius; Marco Pinna; Sergio Olla; Silvana Roberto; Elisabetta Marongiu; Maurizio Porcu; Alberto Concu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  -     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1university of cagliari.
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