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Cardiovascular Responses to Rhythmic Handgrip Exercise in Heart Failure with Preserved Ejection Fraction.
Journal of Applied Physiology ( IF 3.3 ) Pub Date : 2020-09-17 , DOI: 10.1152/japplphysiol.00468.2020
Stephen M Ratchford 1, 2, 3 , Heather L Clifton 1, 2 , D Taylor La Salle 4 , Ryan M Broxterman 1, 2 , Joshua F Lee 1, 2 , John J Ryan 5 , Paul N Hopkins 5 , Josephine B Wright 5 , Joel D Trinity 1, 2, 4 , Russell S Richardson 1, 2, 4 , D Walter Wray 1, 2, 4
Affiliation  

While the contribution of non-cardiac complications to the pathophysiology of heart failure with preserved ejection fraction (HFpEF) have been increasingly recognized, disease-related changes in peripheral vascular control remain poorly understood. We utilized small muscle mass handgrip exercise to concomitantly evaluate exercising muscle blood flow and conduit vessel endothelium-dependent vasodilation in individuals with HFpEF (n = 25) compared to hypertensive controls (HTN) (n = 25). Heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure (MAP), brachial artery blood velocity, and brachial artery diameter were assessed during progressive intermittent handgrip (HG) exercise (15-30-45% MVC). Forearm blood flow (FBF) and vascular conductance (FVC) were determined to quantify the peripheral hemodynamic response to HG exercise, and changes in brachial artery diameter were evaluated to assess endothelium-dependent vasodilation. HR, SV, and CO were not different between groups across exercise intensities. However, although FBF was not different between groups at the lowest exercise intensity, FBF was significantly lower (20-40%), in individuals with HFpEF at the two higher exercise intensities (30% MVC: 229±8 vs. 274±23 ml/min; 45% MVC: 283±17 vs. 399±34 ml/min, HFpEF vs. HTN). FVC was not different between groups at 15 and 30% MVC, but was ≈20% lower in HFpEF at the highest exercise intensity. Brachial artery diameter increased across exercise intensities in both HFpEF and HTN, with no difference between groups. These findings demonstrate an attenuation in muscle blood flow during exercise in HFpEF in the absence of disease-related changes in central hemodynamics or endothelial function.

中文翻译:

保留射血分数的心力衰竭患者对节律性握力运动的心血管反应。

虽然非心脏并发症对射血分数保留的心力衰竭 (HFpEF) 的病理生理学的贡献已得到越来越多的认可,但外周血管控制中与疾病相关的变化仍然知之甚少。我们利用小肌肉握力运动来同时评估与高血压对照 (HTN) (n = 25) 相比,患有 HFpEF (n = 25) 的个体的运动肌肉血流和导管血管内皮依赖性血管舒张。心率 (HR)、每搏量 (SV)、心输出量 (CO)、平均动脉压 (MAP)、肱动脉血流速度和肱动脉直径在进行性间歇握力 (HG) 运动期间进行评估 (15-30-45 %MVC)。确定前臂血流量 (FBF) 和血管传导 (FVC) 以量化对 HG 运动的外周血流动力学反应,并评估肱动脉直径的变化以评估内皮依赖性血管舒张。不同运动强度的组间 HR、SV 和 CO 没有差异。然而,尽管 FBF 在最低运动强度组之间没有差异,但在两个较高运动强度(30% MVC:229±8 vs. 274±23 ml)的 HFpEF 个体中,FBF 显着降低 (20-40%) /min;45% MVC:283±17 与 399±34 ml/min,HFpEF 与 HTN)。FVC 在 15% 和 30% MVC 组之间没有差异,但在最高运动强度下 HFpEF 降低约 20%。在 HFpEF 和 HTN 中,肱动脉直径随着运动强度的增加而增加,两组之间没有差异。
更新日期:2020-09-20
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