| Skeletal muscle reflex in heart failure patients: role of hydrogen. | |
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MedLine Citation:
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PMID: 12538432 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: An important role of the increased stimulation of skeletal muscle ergoreceptors (intramuscular afferents sensitive to products of muscle work) in the genesis of symptoms of exertion intolerance in chronic heart failure (CHF) has been proposed. With the use of selective infusions and dietary manipulation methods, we sought to identify the role of H+, K+, lactate, and peripheral hemodynamics on ergoreflex overactivation. METHODS AND RESULTS: Ten stable CHF patients (aged 67.9+/-2.5 years, peak oxygen uptake 16.3+/-1.2 mL x kg(-1) x min(-1)) and 10 age-matched and sex-matched healthy subjects were studied. The ergoreflex contribution to ventilation was assessed by post-handgrip regional circulatory occlusion (PH-RCO) and computed as the difference in ventilation between PH-RCO and a control run without PH-RCO. This test was performed on 6 separate occasions. On each occasion a different chemical was infused (insulin, sodium nitroprusside, sodium bicarbonate, dopamine, or saline) or a 36-hour glucose-free diet was undertaken before the test. During all stages of the protocol, the local muscular blood effluent concentrations of H+, K+, glucose, and lactate were assessed. An ergoreflex effect on the ventilatory response was seen in patients (versus control subjects) during the saline infusions (6.7+/-2.3 L/min versus -0.1+/-0.5 L/min, P<0.01). The only intervention to significantly lower the ergoreflex was sodium bicarbonate (0.4+/-0.3 L/min versus -0.2+/-0.4 L/min in control subjects, P=NS; versus saline P<0.05), which also reduced H(+) concentration during exercise (47.4+/-1.3 versus 50.0+/-1.4 nmol/L on saline, P<0.05). CONCLUSION: A reduction of the H+ concentration by infusion of sodium bicarbonate abolishes the increased ergoreceptor activity in CHF, suggesting a role of H+ in ergoreflex activation, either directly or indirectly. |
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Authors:
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Adam C Scott; Roland Wensel; Constantinos H Davos; Panagiota Georgiadou; Michael Kemp; James Hooper; Andrew J S Coats; Massimo F Piepoli |
Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-01-22 Completed Date: 2003-01-28 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 300-6 Citation Subset: AIM; IM |
Affiliation:
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National Heart and Lung Institute, and Royal Brompton Hospital, Imperial College School of Science, Technology and Medicine, London, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Chemoreceptor Cells / physiology Dopamine / pharmacology Exercise Test Female Food, Formulated Hand Strength Heart Failure / physiopathology* Hemodynamics Humans Hydrogen-Ion Concentration / drug effects Infusions, Intravenous Insulin / pharmacology Lactic Acid / metabolism Male Middle Aged Muscle, Skeletal / physiopathology* Nitroprusside / pharmacology Potassium / metabolism Protons* Reference Values Reflex* Sodium Bicarbonate / pharmacology Sodium Chloride / pharmacology Ventilation |
| Chemical | |
Reg. No./Substance:
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0/Protons; 11061-68-0/Insulin; 144-55-8/Sodium Bicarbonate; 15078-28-1/Nitroprusside; 50-21-5/Lactic Acid; 7440-09-7/Potassium; 7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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