Differences in hemodynamic response to metaboreflex activation between obese patients with metabolic syndrome and healthy subjects with obese phenotype

Abstract

Patients suffering from obesity and metabolic syndrome (OMS) manifest a dysregulation in hemodynamic response during exercise, with an exaggerated systemic vascular increase. However, it is not clear whether this is the consequence of metabolic syndrome per se or whether it is due to concomitant obesity. The aim of the present investigation was to discover whether OMS and noncomplicated obesity resulted in different hemodynamic responses during the metaboreflex. Twelve metabolically healthy but obese subjects (MHO; 7 women), 13 OMS patients (5 women), and 12 normal age-matched controls (CTL; 6 women) took part in this study. All participants underwent a postexercise muscle ischemia protocol to evaluate the metaboreflex activity. Central hemodynamics were evaluated by impedance cardiography. The main result shows an exaggerated increase in systemic vascular resistance from baseline during the metaboreflex in the OMS patients as compared with the other groups (481.6 ± 180.3, -0.52 ± 177.6, and -60.5 ± 58.6 dynes·s(-1)·cm(-5) for the OMS, the MHO, and the CTL groups, respectively; P < 0.05). Moreover, the MHO subjects and the CTL group showed an increase in cardiac output during the metaboreflex (288.7 ± 325.8 and 703.8 ± 276.2 ml/m increase with respect to baseline), whereas this parameter tended to decrease in the OMS group (-350 ± 236.5 ml/m). However, the blood pressure response, which tended to be higher in the OMS patients, was not statistically different between groups. The results of the present investigation suggest that OMS patients have an exaggerated vasoconstriction in response to metaboreflex activation and that this fact is not due to obesity per se

Effects of Six Months Training on Physical Capacity and Metaboreflex Activity in Patients with Multiple Sclerosis

“…The hemodynamic scenario depicted in the present study resembled the typical response observed in several diseases such as heart failure, obesity, metabolic syndrome, and hypertension, where an excessive sympathetic tone has often been reported (Crisafulli et al, 2007; Delaney et al, 2010; Milia et al, 2015b), whereas in normal subjects vasoconstriction is limited and the target blood pressure is reached mainly by a cardiac output-mediated mechanism (Crisafulli et al, 2003). …”

“…Moreover, our group has recently demonstrated that MS patients had an altered hemodynamic response to metaboreflex activation (Marongiu et al, 2015). This response resembled that showed by patients with cardiovascular and metabolic disease, where the target blood pressure is reached mainly by means of vasoconstriction (Piepoli et al, 2008; Delaney et al, 2010; Dipla et al, 2010; Choi et al, 2013; Crisafulli et al, 2013; Milia et al, 2015b). In healthy subjects, during the metaboreflex, a cardiac output-mediated mechanism is primarily responsible for the normal increase in mean blood pressure (MBP; Crisafulli et al, 2003, 2008; Delaney et al, 2010; Roberto et al, 2012; Spranger et al, 2013).…”

“…To assess metaboreflex activity, the following procedure was employed: for each parameter, the difference between the PEMI and the CER test was calculated. This procedure allowed us to assess metaboreflex response, i.e., the response due to the metaboreflex activity (Milia et al, 2015a,b; Crisafulli et al, 2013). Differences between groups in mean ± SD of measured variables due to metaboreflex response were assessed by means of two way ANOVA for repeated measures (factors: group and time) followed by Tukey post-hoc when appropriate.…”

Cardiovascular consequences of metabolic syndrome

“…(55) Importantly, cardiac functional responses to physiologic perturbations (e.g. exercise),(56-58) pathologic conditions (e.g. myocardial ischemia)(59-61), or pharmacologic stimuli (e.g.…”

Effect of Metaboreflex on Cardiovascular System in Subjects of Metabolic Syndrome

“…In a study by Milia R et al, an exaggerated increase in systemic vas cular resistance from baseline during the metaboreflex was found in the Metabolically Healthy but Obese (MHO) patients 0.52±177.6 [20]. Assuming 80% power, 5% significance level with 95% confidence interval as well as absolute error being 40, the total sample size calculated was 38.…”