Group III/IV muscle afferents impair limb blood in patients with chronic heart failure

Amann, Markus; Venturelli, Massimo; Ives, Stephen J.; Morgan, David; Gmelch, Benjamin S.; Witman, Melissa A. H.; Groot, H. Jonathan; Wray, D. Walter; Stehlik, Josef; Richardson, Russell S.

doi:10.1016/j.ijcard.2014.04.157

Cited by 81 publications

(129 citation statements)

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“…Understanding the plasticity of the exercise pressor reflex has relevance not only for healthy individuals, but also for patient groups such as heart failure patients if this reflex is exaggerated and acts to decrease exercise capacity (Amann et al 2014). …”

Section: Discussionmentioning

confidence: 99%

Effects of training with flow restriction on the exercise pressor reflex

et al. 2018

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PurposeWe hypothesized that 5 weeks of endurance training with blood flow restriction (R-training), providing relative ischemia and stimulation of the muscle chemoreflex, would decrease the exercise pressor reflex (EPR) when compared to training with the same workload in a free-flow condition (NR-training).Methods10 subjects performed one-leg knee-extension training four times a week during a 5-week period. Both legs were trained with identical workload, with one leg being trained during flow-restriction induced by lower body positive pressure. The EPR was assessed by measuring the increase in heart rate (HR) and mean arterial pressure (MAP) during an isometric knee extension of 35% of max torque for 90 s, this was done before (C), and after training in each leg (R and NR, respectively).ResultsAt the end of isometric contraction, the increase in mean AP (MAP) in the NR-trained leg and in the control condition were 41 ± 4 and 38 ± 4 mmHg, respectively, whereas the increase in the R-trained leg was 30 ± 4 mmHg (p < 0.05 R vs C and NR), corresponding to a decrease of about 25%. A similar patter was observed with respect to responses in HR, where the increase was 28 ± 3 and 28 ± 3 bpm in the NR and C, and 22 ± 4 in the R condition (p < 0.05 R vs C and NR).ConclusionsPeripheral metabolic changes induced by relative ischemia are important in modifying the EPR in response to exercise training.

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Section: Discussionmentioning

confidence: 99%

Effects of training with flow restriction on the exercise pressor reflex

et al. 2018

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“…It is important to note that the role of group III/IV muscle afferents in the development of peripheral fatigue might be different in patients with heart failure (12) which are characterized by muscle reflex abnormalities (29, 49) with exaggerated afferent feedback as the likely underlying mechanism (44, 46, 48). Although feedback from these neurons still facilitates central hemodynamics in this population (12), it has been documented to account for the excessive hyperventilatory response (47) and exaggerated sympathoexcitation (12, 46) during physical activity in these patients.…”

Section: Group Iii/iv Muscle Afferent Feedback Effects On the Developmentioning

confidence: 99%

“…Although feedback from these neurons still facilitates central hemodynamics in this population (12), it has been documented to account for the excessive hyperventilatory response (47) and exaggerated sympathoexcitation (12, 46) during physical activity in these patients. Recent data demonstrates that when heart failure patients perform single-leg knee-extensor exercise with pharmacologically (lumbar intrathecal fentanyl) blocked group III/IV muscle afferents, sympathetic outflow is attenuated and leg blood flow/O 2 delivery significantly increased compared to control exercise.…”

Section: Group Iii/iv Muscle Afferent Feedback Effects On the Developmentioning

confidence: 99%

“…Recent data demonstrates that when heart failure patients perform single-leg knee-extensor exercise with pharmacologically (lumbar intrathecal fentanyl) blocked group III/IV muscle afferents, sympathetic outflow is attenuated and leg blood flow/O 2 delivery significantly increased compared to control exercise. Importantly, this increase secondary to reduced input from group III/IV muscle afferents causes an attenuated rate of fatigue development in these patients (12) (Figure 2). Therefore, in contrast to healthy individuals in which group III/IV muscle afferent feedback attenuates the rate of peripheral fatigue during exercise (5, 54, 55), the abnormally elevated neural feedback associated with chronic heart failure exacerbates the rate of development of fatigue in these patients (12).…”

Section: Group Iii/iv Muscle Afferent Feedback Effects On the Developmentioning

confidence: 99%

“…Importantly, this increase secondary to reduced input from group III/IV muscle afferents causes an attenuated rate of fatigue development in these patients (12) (Figure 2). Therefore, in contrast to healthy individuals in which group III/IV muscle afferent feedback attenuates the rate of peripheral fatigue during exercise (5, 54, 55), the abnormally elevated neural feedback associated with chronic heart failure exacerbates the rate of development of fatigue in these patients (12). To our knowledge, there is currently no data available on the effects of other diseases characterized by abnormal neural feedback from group III/IV muscle afferents (e.g., hypertension) on the development of central and peripheral fatigue during exercise.…”

Section: Group Iii/iv Muscle Afferent Feedback Effects On the Developmentioning

confidence: 99%

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Autonomic responses to exercise: Group III/IV muscle afferents and fatigue

Amann

Sidhu

Weavil

et al. 2015

Autonomic Neuroscience

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146

115

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Group III and IV muscle afferents originating in exercising limb muscle play a significant role in the development of fatigue during exercise in humans. Feedback from these sensory neurons to the central nervous system (CNS) reflexively increases ventilation and central (cardiac output) and peripheral (limb blood flow) hemodynamic responses during exercise and thereby assures adequate muscle blood flow and O2 delivery. This response depicts a key factor in minimizing the rate of development of peripheral fatigue and in optimizing aerobic exercise capacity. On the other hand, the central projection of group III/IV muscle afferents impairs performance and limits the exercising human via its diminishing effect on the output from spinal motoneurons which decreases voluntary muscle activation (i.e. facilitates central fatigue). Accumulating evidence from recent animal studies suggests the existence of two subtypes of group III/IV muscle afferents. While one subtype only responds to physiological and innocuous levels of endogenous intramuscular metabolites (lactate, ATP, protons) associated with ‘normal’, predominantly aerobic exercise, the other subtype only responds to higher and concurrently noxious levels of metabolites present in muscle during ischaemic contractions or following, for example, hypertonic saline infusions. This review discusses the mechanisms through which group III/IV muscle afferent feedback mediates both central and peripheral fatigue in exercising humans. We also briefly summarize accumulating evidence from recent animal and human studies documenting the existence of two subtypes of group III/IV muscle afferents and the relevance of this discovery for the interpretation of previous work and the design of future studies.

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Exacerbated central fatigue and reduced exercise capacity in early-stage breast cancer patients treated with chemotherapy

et al. 2023

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Purpose The present study aimed to characterize the etiology of exercise-induced neuromuscular fatigue and its consequences on the force-duration relationship to provide mechanistic insights into the reduced exercise capacity characterizing early-stage breast cancer patients. Methods Fifteen early-stage breast cancer patients and fifteen healthy women performed 60 maximal voluntary isometric quadriceps contractions (MVCs, 3 s of contraction, 2 s of relaxation). The critical force was determined as the mean force of the last six contractions, while W’ was calculated as the force impulse generated above the critical force. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis and rectus femoris EMG. Central and peripheral fatigue were quantified via changes in pre- to postexercise quadriceps voluntary activation (ΔVA) and quadriceps twitch force (ΔQTw) evoked by supramaximal electrical stimulation, respectively. Results Early-stage breast cancer patients demonstrated lower MVC than controls preexercise (− 15%, P = 0.022), and this reduction persisted throughout the 60-MVC exercise (− 21%, P = 0.002). The absolute critical force was lower in patients than in controls (144 ± 29N vs. 201 ± 47N, respectively, P < 0.001), while W’ was similar (P = 0.546), resulting in lower total work done (− 23%, P = 0.001). This was associated with lower muscle activation in the vastus lateralis (P < 0.001), vastus medialis (P = 0.003) and rectus femoris (P = 0.003) in patients. Immediately following exercise, ΔVA showed a greater reduction in patients compared to controls (− 21.6 ± 13.3% vs. − 12.6 ± 7.7%, P = 0.040), while ΔQTw was similar (− 60.2 ± 13.2% vs. − 52.8 ± 19.4%, P = 0.196). Conclusion These findings support central fatigue as a primary cause of the reduction in exercise capacity characterizing early-stage breast cancer patients treated with chemotherapy. Clinical trials registration No. NCT04639609—November 20, 2020.

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Group III/IV muscle afferents impair limb blood in patients with chronic heart failure

Cited by 81 publications

References 40 publications

Effects of training with flow restriction on the exercise pressor reflex

Effects of training with flow restriction on the exercise pressor reflex

Autonomic responses to exercise: Group III/IV muscle afferents and fatigue

Exacerbated central fatigue and reduced exercise capacity in early-stage breast cancer patients treated with chemotherapy

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