ABSTRACT
BACKGROUND: Exercise training improves endothelium-dependent vasodilation in animals. This study was designed to determine whether forearm exercise training improves endothelium-dependent vasodilation in control subjects and patients with heart failure, a disease associated with abnormal endothelium-dependent vasodilation. METHODS AND RESULTS: We used strain gauge plethysmography to assess the effects of short-term forearm exercise training on resistance vessel function in 11 control subjects and 7 patients with New York Heart Association class II and III heart failure. Subjects performed 30 minutes of handgrip exercise four times a week for 4-6 weeks. In the control subjects, exercise training increased forearm blood flow (FBF) responses to intra-arterial acetylcholine (20 microg/min) from 6.9 +/- 3.1 to 12.2 +/- 3.0 mL/min/100 mL and peak reactive hyperemic FBF responses from 38.1 +/- 5.6 to 47.4 +/- 5.6 (P < .05). Basal FBF and responses to nitroprusside, L-N-monomethyl arginine and acute forearm exercise were not significantly changed. In the patients with heart failure, chronic forearm exercise did not significantly change any of the above-measured parameters. CONCLUSION: Forearm exercise training improves endothelium-dependent vasodilation and peak hyperemic FBF in control subjects but not in patients with heart failure. These data suggest that resistance vessel abnormalities may not be as readily modifiable by exercise training in patients with heart failure compared with control subjects.
Subject(s)
Endothelium, Vascular/metabolism , Exercise/physiology , Forearm/blood supply , Heart Failure/physiopathology , Vascular Resistance/physiology , Acetylcholine/pharmacology , Adult , Aged , Aged, 80 and over , Analysis of Variance , Arginine/blood , Brachial Artery/drug effects , Brachial Artery/physiopathology , Dose-Response Relationship, Drug , Enzyme Inhibitors/pharmacology , Exercise Therapy , Female , Hand Strength/physiology , Heart Failure/rehabilitation , Humans , Infusions, Intra-Arterial , Male , Middle Aged , Muscle Contraction/physiology , Nitric Oxide/metabolism , Nitroprusside/administration & dosage , Nitroprusside/pharmacology , Plethysmography , Regional Blood Flow/drug effects , Vasodilation/drug effects , Vasodilator Agents/pharmacology , omega-N-Methylarginine/pharmacologyABSTRACT
Previous studies showed that baroreflex control of heart rate is impaired during operant shock avoidance conditioning and classical aversive conditioning. However, the effects of such "emotionally stressful" paradigms on the ability of the baroreflex to control arterial pressure have not been directly assessed. We prepared the carotid sinus regions of dogs for reversible isolation from the systemic circulation, and we derived complete stimulus-response relations for the effects of carotid sinus pressure on both heart rate and arterial pressure. For any given carotid sinus pressure, arterial pressure and heart rate were higher during operant shock-avoidance conditioning and during classical aversive conditioning than in a neutral environment, which indicates an upward resetting of the baroreflex. However, threshold and saturation carotid sinus pressures were unaffected by operant conditioning or classical conditioning, which indicates that the baroreceptors themselves were not reset. The ranges over which the carotid baroreflex could vary arterial pressure and heart rate were significantly increased during both operant conditioning and classical conditioning. Baroreflex gain was unchanged during operant conditioning and was significantly increased during classical conditioning. We conclude that the baroreflex is not impaired during operant shock-avoidance conditioning or classical aversive conditioning in dogs. However, the baroreflex is reset and regulates blood pressure at an elevated level.
