Physical capacity increase in patients with heart failure is associated with improvement in muscle sympathetic nerve activity.

Autor: Goes-Santos BR; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Rondon E; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Fonseca GWP; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Sales ARK; D'Or Institute for Research and Education (IDOR), São Paulo, Brazil., Santos MR; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Antunes-Correa LM; School of Physical Education, University of Campinas (UNICAMP), Campinas, SP, Brazil., Ueno-Pardi LM; Escola de Artes, Ciencias e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil., Oliveira P; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Trevizan PF; Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil., Mello Franco FG; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Fraga R; Alta Diagnóstico/DASA, São Paulo, SP, Brazil., Alves MJNN; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Rondon MUPB; Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, SP, Brazil., Hajjar LA; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Filho RK; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Negrão CE; Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: cndnegrao@incor.usp.br.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 May 01; Vol. 378, pp. 48-54. Date of Electronic Publication: 2023 Feb 13.
DOI: 10.1016/j.ijcard.2023.02.018
Abstrakt: Background: Exercise training improves physical capacity in patients with heart failure with reduced ejection fraction (HFrEF), but the mechanisms involved in this response is not fully understood. The aim of this study was to determine if physical capacity increase in patients HFrEF is associated with muscle sympathetic nerve activity (MSNA) reduction and muscle blood flow (MBF) increase.
Methods: The study included 124 patients from a 17-year database, divided according to exercise training status: 1) exercise-trained (ET, n = 83) and 2) untrained (UNT, n = 41). MSNA and MBF were obtained using microneurography and venous occlusion plethysmography, respectively. Physical capacity was evaluated by cardiopulmonary exercise test. Moderate aerobic exercise was performed 3 times/wk. for 4 months.
Results: Exercise training increased peak oxygen consumption (V̇O 2 , 16.1 ± 0.4 vs 18.9 ± 0.5 mL·kg -1 ·min -1 , P < 0.001), LVEF (28 ± 1 vs 30 ± 1%, P = 0.027), MBF (1.57 ± 0.06 vs 2.05 ± 0.09 mL.min -1 .100 ml -1 , P < 0.001) and muscle vascular conductance (MVC, 1.82 ± 0.07 vs 2.45 ± 0.11 units, P < 0.001). Exercise training significantly decreased MSNA (45 ± 1 vs 32 ± 1 bursts/min, P < 0.001). The logistic regression analyses showed that MSNA [(OR) 0.921, 95% CI 0.883-0.962, P < 0.001] was independently associated with peak V̇O 2 .
Conclusions: The increase in physical capacity provoked by aerobic exercise in patients with HFrEF is associated with the improvement in MSNA.
Competing Interests: Declaration of Competing Interest All authors have reported that there is no relationship with industry or financial associations, which might pose a conflict of interest in connection to this article.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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