Comparison of metabolic, ventilatory, and neurohumoral responses during light forearm isometric exercise and isotonic exercise in congestive heart failure

MacGowan, Guy A.; Murali, Srinivas; Loftus, Susan; Uretsky, Barry F.

doi:10.1016/s0002-9149(97)89370-8

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…Interestingly, it has been shown that an isometric hand grip test results in hemodynamic responses associated with increased syrnpathetic tone in normal people, such as increased heart rate, arterial blood pressure, and cardiac outpuf.%ll When cardiac responses to voluntary and nonvoluntary (e.g., electrically induced) static exercises are compared, it should be noted that in the latter, central neural com- mand does not contribute to hemodynamic augmentation, while such command can play an important role during voluntary exercise. 4 Our results indicate that the hernodynamic responses to in situ TDN stimulation depend on the severity of heart failure. Multiple neurohumoral mechanisms are activated in patients with heart failure, and activation of the sympathetic nervous system represents one of the major compensatory mechanisms mobilized in response to a decrease in cardiac output.:!…”

Section: Discussionmentioning

confidence: 61%

“…3 For example, an isometric exercise with minimal effort, such as a grip test by the dominant hand for a few minutes, may induce hemodynamic responses via increased sympathetic tone. 4 We therefore tested the hypothesis that electrical stimulation of the thoracodorsal nerve (TDN) in cardiomyoplasty may by itself affect the cardiac function, presumably via the neurohumoral mechanism described above. Such findings may enhance our understanding of the physiological basis of the effects of dynamic cardiomyoplasty (DCM) in our patients.…”

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confidence: 99%

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Hemodynamic Response To In Situ Latissimus Dorsi Muscle Stimulation: Implications in Dynamic Cardiomyoplasty

Badhwar

Chiu

1997

J Cardiac Surgery

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Dynamic cardiomyoplasty (DCM) involves the electrical stimulation of a pedicled latissimus dorsi muscle flap wrapped around the falling ventricle as a means of cardiac assist. To further elucidate a potential neurohumoral mechanism for improvement of cardiac output after myoplasty, we evaluated the hemodynamic effects of in situ stimulation of the latissimus dorsi muscle (in the absence of cardiomyoplasty). In seven mongrel dogs, a nerve cuff electrode (Medtronic 6901) was placed around the left thoracodorsal nerve (TDN). This was attached to a pulse generator (Medtronic, Itrel 7420), delivering a 4.0 volt, 0.19 second on, 0.81 second off, 33 Hz, 210 microsecond pulse width, cyclic bursts similar to that used in DCM. Stroke volume index (SVI) and other hemodynamic parameters as well as plasma norepinephrine (NE) levels were measured at five stages: baseline, stimulator on at 0, 2, and 5 minutes, and stimulator off at 30 minutes after. The animals were then subjected to 4 weeks of rapid pacing at 240 beats/min (Medtronic 8329) to induce heart failure, and as the rapid pacing was discontinued, measurements were repeated as above. After rapid pacing, cardiac function was significantly depressed, and NE was elevated (133 +/- 69 versus 500 +/- 353 pg/mL, p < 0.05). In the normal hearts, TDN stimulation increased SVI, heart rate, systemic pressure, and NE levels. In heart failure, however, no significant changes in cardiac function and NE levels were noted. In conclusion, our data indicate that in the normal hearts, afferent impulses from TDN stimulation alone may augment cardiac function by means of a neurohumoral effect that is not seen in severe heart failure. The implications of these findings in DCM are discussed.

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Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

Hemodynamic Response To In Situ Latissimus Dorsi Muscle Stimulation: Implications in Dynamic Cardiomyoplasty

Badhwar

Chiu

1997

J Cardiac Surgery

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“…Muscle atrophy and skeletal muscle defects are common in patients with HF and contribute to the limitation of their physical activity. 15,16,[18][19][20][21] In addition to skeletal muscle atrophy, abnormalities of muscle blood flow, 15,[22][23][24] derangements in skeletal muscle metabolism, [21][22][23][24][25] histologic and biochemical aberrations, 19,26,27 and chronotropic intolerance [28][29][30] also contribute to skeletal muscle metabolic defects. However, it is unlikely that these negative changes completely explain the exercise intolerance noted in patients with HF.…”

Section: Skeletal Muscle Pathology and Hfmentioning

confidence: 99%

The Effects of Resistance Exercise on Skeletal Muscle Abnormalities in Patients With Advanced Heart Failure

King

2001

Progress Cardiovascular Nurs

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Resistance exercise increases muscular strength and endurance, which prevents injuries associated with musculoskeletal disorders, favorably alters muscle fiber type distribution, and up-regulates the genetic expression of certain enzymes seen in dysfunctional skeletal muscles. Although the benefits of resistance exercise are well documented in the literature, this form of exercise is not routinely recommended for patients with heart failure for fear of symptom exacerbation, and because of poor understanding of how best to prescribe this type of exercise. Because muscle atrophy and deconditioning states are common findings in patients with heart failure, these patients stand to benefit substantially from resistance training because this type of physical activity results in functional adaptations in the neuromuscular system. This article addresses changes in skeletal muscle pathophysiology that occur in patients with heart failure and the potential role resistance training may play in reversing this sequela, and recommends a weight lifting exercise prescription for these patients.

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Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison

Arena

Myers

Aslam

et al. 2004

American Heart Journal

388

236

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Comparison of metabolic, ventilatory, and neurohumoral responses during light forearm isometric exercise and isotonic exercise in congestive heart failure

Cited by 7 publications

References 10 publications

Hemodynamic Response To In Situ Latissimus Dorsi Muscle Stimulation: Implications in Dynamic Cardiomyoplasty

Hemodynamic Response To In Situ Latissimus Dorsi Muscle Stimulation: Implications in Dynamic Cardiomyoplasty

The Effects of Resistance Exercise on Skeletal Muscle Abnormalities in Patients With Advanced Heart Failure

Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison

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