(Circulation. 1996;93:940-952.)
© 1996 American Heart Association, Inc.
Articles |
Contribution of Muscle Afferents to the Hemodynamic, Autonomic, and Ventilatory Responses to Exercise in Patients With Chronic Heart Failure
Effects of Physical Training
From the Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London (M.P., A.L.C., M.V., S.A., A.J.S.C.), and the Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford (M.P., P.S.), UK.
Correspondence to Massimo Piepoli, MD, Department of Cardiac Medicine, National Heart and Lung Institute, Dovehouse St, London SW3 6LY, UK.
Background A neural linkage between peripheral abnormalities and the exaggerated exercise responses in chronic heart failure (CHF) was postulated. We studied the ergoreceptors (afferents sensitive to skeletal muscle work) in CHF and whether training can affect their activity.
Methods and Results In 12 stable CHF patients (ejection fraction [EF]=26.4%) and 10 control subjects (EF=55.3%), we compared the responses to dynamic handgrip and during a 3-minute period of posthandgrip regional circulatory occlusion (PH-RCO). The ergoreflex contribution was quantified as the percentage responses to exercise maintained by PH-RCO compared with recovery without PH-RCO. Patients showed ergoreflex overactivation compared with control subjects in terms of ventilation (86.5% versus 54.5%), diastolic pressure (97.8% versus 53.5%), and leg vascular resistance (108.1% versus 48.9%) (all P<.05). The contribution of the ergoreflex to vagal withdrawal (high frequency of RR variability) and sympathetic activation (low frequency of RR, pressure variability) was evident in both groups. Nine control subjects and nine CHF patients participated in 6 weeks of forearm training. Training reduced the ergoreflex contributions more in CHF than in control subjects: diastolic pressure (-33.2% versus -4.6%), ventilation (-57.6% versus -24.6%), and leg vascular resistance (-59.9% versus -8.0%) (all P<.05).
Conclusions (1) The ergoreflex role has a larger effect on the responses to exercise in CHF than in control subjects. (2) Training may reduce this exaggerated ergoreflex activity, thereby improving the responses to exercise.
Key Words: heart failure • exercise • muscles
This article has been cited by other articles:
 |
|
 |
|
  R. Wensel, C. Jilek, M. Dorr, D. P. Francis, H. Stadler, T. Lange, F. Blumberg, C. Opitz, M. Pfeifer, and R. Ewert Impaired cardiac autonomic control relates to disease severity in pulmonary hypertension Eur. Respir. J., October 1, 2009; 34(4): 895 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Caminiti, M. Volterrani, F. Iellamo, G. Marazzi, R. Massaro, M. Miceli, C. Mammi, M. Piepoli, M. Fini, and G. M.C. Rosano Effect of long-acting testosterone treatment on functional exercise capacity, skeletal muscle performance, insulin resistance, and baroreflex sensitivity in elderly patients with chronic heart failure a double-blind, placebo-controlled, randomized study. J. Am. Coll. Cardiol., September 1, 2009; 54(10): 919 - 927. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Murai, M. Takamura, M. Maruyama, M. Nakano, T. Ikeda, D. Kobayashi, K.-i. Otowa, H. Ootsuji, M. Okajima, H. Furusho, et al. Altered firing pattern of single-unit muscle sympathetic nerve activity during handgrip exercise in chronic heart failure J. Physiol., June 1, 2009; 587(11): 2613 - 2622. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. K.A. Witte and A. L. Clark Dyspnoea versus fatigue: Additional prognostic information from symptoms in chronic heart failure? Eur J Heart Fail, December 1, 2008; 10(12): 1224 - 1228. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. R. Middlekauff, J. Chiu, M. A. Hamilton, G. C. Fonarow, W. R. MacLellan, A. Hage, J. Moriguchi, and J. Patel Cyclooxygenase products sensitize muscle mechanoreceptors in humans with heart failure Am J Physiol Heart Circ Physiol, April 1, 2008; 294(4): H1956 - H1962. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Drew, M. P. D. Bell, and M. J. White Modulation of spontaneous baroreflex control of heart rate and indexes of vagal tone by passive calf muscle stretch during graded metaboreflex activation in humans J Appl Physiol, March 1, 2008; 104(3): 716 - 723. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Ingle Prognostic value and diagnostic potential of cardiopulmonary exercise testing in patients with chronic heart failure Eur J Heart Fail, February 1, 2008; 10(2): 112 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D E Barrow, A Bedford, G Ives, L O'Toole, and K S Channer An evaluation of the effects of Tai Chi Chuan and Chi Kung training in patients with symptomatic heart failure: a randomised controlled pilot study Postgrad. Med. J., November 1, 2007; 83(985): 717 - 721. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Iellamo, J. A. Sala-Mercado, M. Ichinose, R. L. Hammond, M. Pallante, T. Ichinose, L. W. Stephenson, and D. S. O'Leary Spontaneous baroreflex control of heart rate during exercise and muscle metaboreflex activation in heart failure Am J Physiol Heart Circ Physiol, September 1, 2007; 293(3): H1929 - H1936. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Page, S. Cazeau, P. Ritter, D. Galley, and C. Casset Physiological approach to monitor patients in congestive heart failure: application of a new implantable device-based system to monitor daily life activity and ventilation Europace, August 1, 2007; 9(8): 687 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fraga, F. G. Franco, F. Roveda, L. N.J. de Matos, A. M.F.W. Braga, M. U.P.B. Rondon, D. R. Rotta, P. C. Brum, A. C.P. Barretto, H. R. Middlekauff, et al. Exercise training reduces sympathetic nerve activity in heart failure patients treated with carvedilol Eur J Heart Fail, June 1, 2007; 9(6-7): 630 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Crisafulli, E. Salis, F. Tocco, F. Melis, R. Milia, G. Pittau, M. A. Caria, R. Solinas, L. Meloni, P. Pagliaro, et al. Impaired central hemodynamic response and exaggerated vasoconstriction during muscle metaboreflex activation in heart failure patients Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2988 - H2996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Piepoli and A. J. S. Coats COUNTERPOINT: INCREASED METABORECEPTOR STIMULATION EXPLAINS THE EXAGGERATED EXERCISE PRESSOR REFLEX SEEN IN HEART FAILURE J Appl Physiol, January 1, 2007; 102(1): 494 - 496. [Full Text] [PDF]
|
|
|
|
|
|
I. H. Zucker, H. D. Schultz, W. Wang, M. Guazzi, A. C. Scott, C. E. Negrao, M. U. P. B. Rondon, E. S. Prakash, A. L. Clark, A. Crisafulli, et al. Increased mechanoreceptor/metaboreceptor stimulation explains the exaggerated exercise pressor reflex seen in heart failure J Appl Physiol, January 1, 2007; 102(1): 498 - 501. [Full Text] [PDF]
|
|
|
|
|
|
M. Guazzi, M. Berti, S. Belletti, G. Reina, and M. D. Guazzi Exercise metaboreflex activation and endothelial function impairment in atrial fibrillation Am J Physiol Heart Circ Physiol, November 1, 2006; 291(5): H2396 - H2402. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Piepoli, A. Kaczmarek, D. P. Francis, L. C. Davies, M. Rauchhaus, E. A. Jankowska, S. D. Anker, A. Capucci, W. Banasiak, and P. Ponikowski Reduced Peripheral Skeletal Muscle Mass and Abnormal Reflex Physiology in Chronic Heart Failure Circulation, July 11, 2006; 114(2): 126 - 134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Jankowska, P. Ponikowski, M. F. Piepoli, W. Banasiak, S. D. Anker, and P. A. Poole-Wilson Autonomic imbalance and immune activation in chronic heart failure - Pathophysiological links Cardiovasc Res, June 1, 2006; 70(3): 434 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Passino, S. Severino, R. Poletti, M. F. Piepoli, C. Mammini, A. Clerico, A. Gabutti, G. Nassi, and M. Emdin Aerobic Training Decreases B-Type Natriuretic Peptide Expression and Adrenergic Activation in Patients With Heart Failure J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1835 - 1839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. L Clark Exercise and heart failure: assessment and treatment. Heart, May 1, 2006; 92(5): 699 - 703. [Full Text] [PDF]
|
|
|
|
|
|
F. Iellamo, M. Di Rienzo, D. Lucini, J. M. Legramante, P. Pizzinelli, P. Castiglioni, F. Pigozzi, M. Pagani, and G. Parati Muscle metaboreflex contribution to cardiovascular regulation during dynamic exercise in microgravity: insights from mission STS-107 of the space shuttle Columbia J. Physiol., May 1, 2006; 572(3): 829 - 838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K K A Witte, J G F Cleland, and A L Clark Chronic heart failure, chronotropic incompetence, and the effects of {beta} blockade Heart, April 1, 2006; 92(4): 481 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. C. Davies, R. Wensel, P. Georgiadou, M. Cicoira, A. J.S. Coats, M. F. Piepoli, and D. P. Francis Enhanced prognostic value from cardiopulmonary exercise testing in chronic heart failure by non-linear analysis: oxygen uptake efficiency slope Eur. Heart J., March 2, 2006; 27(6): 684 - 690. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Dall'Ago, G. R.S. Chiappa, H. Guths, R. Stein, and J. P. Ribeiro Inspiratory Muscle Training in Patients With Heart Failure and Inspiratory Muscle Weakness: A Randomized Trial J. Am. Coll. Cardiol., February 21, 2006; 47(4): 757 - 763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Corra, M. Pistono, A. Mezzani, A. Braghiroli, A. Giordano, P. Lanfranchi, E. Bosimini, M. Gnemmi, and P. Giannuzzi Sleep and Exertional Periodic Breathing in Chronic Heart Failure: Prognostic Importance and Interdependence Circulation, January 3, 2006; 113(1): 44 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A L Clark Origin of symptoms in chronic heart failure Heart, January 1, 2006; 92(1): 12 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M Gallagher, P. J Fadel, S. A Smith, M. Stromstad, K. Ide, N. H Secher, and P. B Raven The interaction of central command and the exercise pressor reflex in mediating baroreflex resetting during exercise in humans Exp Physiol, January 1, 2006; 91(1): 79 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A Smith, J. H Mitchell, and M. G Garry The mammalian exercise pressor reflex in health and disease Exp Physiol, January 1, 2006; 91(1): 89 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Banerjee, B. Caulfield, L. Crowe, and A. Clark Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults J Appl Physiol, December 1, 2005; 99(6): 2307 - 2311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Wensel, D. P. Francis, P. Georgiadou, A. Scott, S. Genth-Zotz, S. D. Anker, A. J.S. Coats, and M. F. Piepoli Exercise hyperventilation in chronic heart failure is not caused by systemic lactic acidosis Eur J Heart Fail, December 1, 2005; 7(7): 1105 - 1111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Smith, J. H. Mitchell, R. H. Naseem, and M. G. Garry Mechanoreflex Mediates the Exaggerated Exercise Pressor Reflex in Heart Failure Circulation, October 11, 2005; 112(15): 2293 - 2300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Hayashi, S. Koba, and T. Yoshida Disuse atrophy increases the muscle mechanoreflex in rats J Appl Physiol, October 1, 2005; 99(4): 1442 - 1445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Guazzi, G. Reina, G. Tumminello, and M. D. Guazzi Alveolar-capillary membrane conductance is the best pulmonary function correlate of exercise ventilation efficiency in heart failure patients Eur J Heart Fail, October 1, 2005; 7(6): 1017 - 1022. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. I. Sinoway and J. Li A perspective on the muscle reflex: implications for congestive heart failure J Appl Physiol, July 1, 2005; 99(1): 5 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K.A. Witte, S. Thackray, N. P. Nikitin, J. G.F. Cleland, and A. L. Clark The effects of long-term {beta}-blockade on the ventilatory responses to exercise in chronic heart failure Eur J Heart Fail, June 1, 2005; 7(4): 612 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Smith, M. A. Williams, J. H. Mitchell, P. P.A. Mammen, and M. G. Garry The Capsaicin-Sensitive Afferent Neuron in Skeletal Muscle Is Abnormal in Heart Failure Circulation, April 26, 2005; 111(16): 2056 - 2065. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Houssiere, B. Najem, A. Ciarka, S. Velez-Roa, R. Naeije, and P. van de Borne Chemoreflex and metaboreflex control during static hypoxic exercise Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1724 - H1729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Guazzi, G. Reina, G. Tumminello, and M. D. Guazzi Exercise ventilation inefficiency and cardiovascular mortality in heart failure: the critical independent prognostic value of the arterial CO2 partial pressure Eur. Heart J., March 1, 2005; 26(5): 472 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J.S. Coats Why ventilatory inefficiency matters in chronic heart failure Eur. Heart J., March 1, 2005; 26(5): 426 - 427. [Full Text] [PDF]
|
|
|
|
|
|
A. Momen, D. Bower, J. Boehmer, A. R. Kunselman, U. A. Leuenberger, and L. I. Sinoway Renal blood flow in heart failure patients during exercise Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2834 - H2839. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Guazzi, S. Belletti, G. Tumminello, C. Fiorentini, and M. D. Guazzi Exercise hyperventilation, dyspnea sensation, and ergoreflex activation in lone atrial fibrillation Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2899 - H2905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Li, A. N. Sinoway, Z. Gao, M. D. Maile, M. Pu, and L. I. Sinoway Muscle Mechanoreflex and Metaboreflex Responses After Myocardial Infarction in Rats Circulation, November 9, 2004; 110(19): 3049 - 3054. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Middlekauff, J. Chiu, M. A. Hamilton, G. C. Fonarow, W. R. MacLellan, A. Hage, J. Moriguchi, and J. Patel Muscle mechanoreceptor sensitivity in heart failure Am J Physiol Heart Circ Physiol, November 1, 2004; 287(5): H1937 - H1943. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P Fisher and M. J White Muscle afferent contributions to the cardiovascular response to isometric exercise Exp Physiol, November 1, 2004; 89(6): 639 - 646. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C. Scott, R. Wensel, C. H. Davos, P. Georgiadou, L. Ceri Davies, A. J.S. Coats, D. P. Francis, and M. F. Piepoli Putative contribution of prostaglandin and bradykinin to muscle reflex hyperactivity in patients on Ace-inhibitor therapy for chronic heart failure Eur. Heart J., October 2, 2004; 25(20): 1806 - 1813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K.A. Witte and A. L. Clark The effect of aspirin on the ventilatory response to exercise in chronic heart failure Eur J Heart Fail, October 1, 2004; 6(6): 745 - 748. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. T. Robertson, R. Pellegrino, D. Pini, J. Oreglia, S. DeVita, V. Brusasco, and P. Agostoni Exercise response after rapid intravenous infusion of saline in healthy humans J Appl Physiol, August 1, 2004; 97(2): 697 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Costes, F. Roche, V. Pichot, J.M. Vergnon, M. Garet, and J-C. Barthelemy Influence of exercise training on cardiac baroreflex sensitivity in patients with COPD Eur. Respir. J., March 1, 2004; 23(3): 396 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Larsen and K. Dickstein Can sedentary patients with heart failure achieve the beneficial effect of exercise training without moving? Eur. Heart J., January 2, 2004; 25(2): 104 - 106. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Dalla Libera, B. Ravara, M. Volterrani, V. Gobbo, M. Della Barbera, A. Angelini, D. D. Betto, E. Germinario, and G. Vescovo Beneficial effects of GH/IGF-1 on skeletal muscle atrophy and function in experimental heart failure Am J Physiol Cell Physiol, January 1, 2004; 286(1): C138 - C144. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. U. Pliquett, K. G. Cornish, K. P. Patel, H. D. Schultz, J. D. Peuler, and I. H. Zucker Amelioration of depressed cardiopulmonary reflex control of sympathetic nerve activity by short-term exercise training in male rabbits with heart failure J Appl Physiol, November 1, 2003; 95(5): 1883 - 1888. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K K A Witte, S D R Thackray, N P Nikitin, J G F Cleland, and A L Clark The effects of {alpha} and {beta} blockade on ventilatory responses to exercise in chronic heart failure Heart, October 1, 2003; 89(10): 1169 - 1173. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Roveda, H. R. Middlekauff, M. U. P. B. Rondon, S. F. Reis, M. Souza, L. Nastari, A. C. P. Barretto, E. M. Krieger, and C. E. Negrao The effects of exercise training on sympathetic neural activation in advanced heart failure: A randomized controlled trial J. Am. Coll. Cardiol., September 3, 2003; 42(5): 854 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Smith, P. P.A. Mammen, J. H. Mitchell, and M. G. Garry Role of the Exercise Pressor Reflex in Rats With Dilated Cardiomyopathy Circulation, September 2, 2003; 108(9): 1126 - 1132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Leite, A. J. Mansur, H. F. G. de Freitas, P. R. Chizola, E. A. Bocchi, M. Terra-Filho, J. A. Neder, and G. Lorenzi-Filho Periodic breathing during incremental exercise predicts mortality in patients with chronic heart failure evaluated for cardiac transplantation J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2175 - 2181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Tomita, H Takaki, Y Hara, F Sakamaki, T Satoh, S Takagi, Y Yasumura, N Aihara, Y Goto, and K Sunagawa Attenuation of hypercapnic carbon dioxide chemosensitivity after postinfarction exercise training: possible contribution to the improvement in exercise hyperventilation Heart, April 1, 2003; 89(4): 404 - 410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. L. Pina, C. S. Apstein, G. J. Balady, R. Belardinelli, B. R. Chaitman, B. D. Duscha, B. J. Fletcher, J. L. Fleg, J. N. Myers, and M. J. Sullivan Exercise and Heart Failure: A Statement From the American Heart Association Committee on Exercise, Rehabilitation, and Prevention Circulation, March 4, 2003; 107(8): 1210 - 1225. [Full Text] [PDF]
|
|
|
|
|
|
A. C. Scott, R. Wensel, C. H. Davos, P. Georgiadou, M. Kemp, J. Hooper, A. J.S. Coats, and M. F. Piepoli Skeletal Muscle Reflex in Heart Failure Patients: Role of Hydrogen Circulation, January 21, 2003; 107(2): 300 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Agostoni, M. Guazzi, M. Bussotti, S. De Vita, and P. Palermo Carvedilol Reduces the Inappropriate Increase of Ventilation During Exercise in Heart Failure Patients Chest, December 1, 2002; 122(6): 2062 - 2067. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Corra, A. Giordano, E. Bosimini, A. Mezzani, M. Piepoli, A. J. S. Coats, and P. Giannuzzi Oscillatory Ventilation During Exercise in Patients With Chronic Heart Failure* : Clinical Correlates and Prognostic Implications Chest, May 1, 2002; 121(5): 1572 - 1580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. P. Ponikowski, T. P. Chua, D. P. Francis, A. Capucci, A. J.S. Coats, and M. F. Piepoli Muscle Ergoreceptor Overactivity Reflects Deterioration in Clinical Status and Cardiorespiratory Reflex Control in Chronic Heart Failure Circulation, November 6, 2001; 104(19): 2324 - 2330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J S Coats HEART FAILURE: What causes the symptoms of heart failure? Heart, November 1, 2001; 86(5): 574 - 578. [Full Text] [PDF]
|
|
|
|
|
|
Y. Goso, H. Asanoi, H. Ishise, T. Kameyama, T. Hirai, T. Nozawa, S. Takashima, K. Umeno, and H. Inoue Respiratory Modulation of Muscle Sympathetic Nerve Activity in Patients With Chronic Heart Failure Circulation, July 24, 2001; 104(4): 418 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L TAVAZZI and P GIANNUZZI Physical training as a therapeutic measure in chronic heart failure: time for recommendations Heart, July 1, 2001; 86(1): 7 - 11. [Full Text] [PDF]
|
|
|
|
|
|
M. Cicoira, L. Zanolla, L. Franceschini, A. Rossi, G. Golia, M. Zamboni, P. Tosoni, and P. Zardini Skeletal muscle mass independently predicts peak oxygen consumption and ventilatory response during exercise in noncachectic patients with chronic heart failure J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2080 - 2085. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. T. Pu, M. T. Johnson, D. E. Forman, J. M. Hausdorff, R. Roubenoff, M. Foldvari, R. A. Fielding, and M. A. F. Singh Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure J Appl Physiol, June 1, 2001; 90(6): 2341 - 2350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.I Larsen, T Aarsland, M Kristiansen, A Haugland, and K Dickstein Assessing the effect of exercise training in men with heart failure. Comparison of maximal, submaximal and endurance exercise protocols Eur. Heart J., April 2, 2001; 22(8): 684 - 692. [Abstract] [PDF]
|
|
|
|
|
|
C. F. Notarius, D. J. Atchison, and J. S. Floras Impact of heart failure and exercise capacity on sympathetic response to handgrip exercise Am J Physiol Heart Circ Physiol, March 1, 2001; 280(3): H969 - H976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. Negrao, M. U. P. B. Rondon, T. Tinucci, M. J. N. Alves, F. Roveda, A. M. W. Braga, S. F. Reis, L. Nastari, A. C. P. Barretto, E. M. Krieger, et al. Abnormal neurovascular control during exercise is linked to heart failure severity Am J Physiol Heart Circ Physiol, March 1, 2001; 280(3): H1286 - H1292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Johnson Jr Gas Exchange Efficiency in Congestive Heart Failure II Circulation, February 20, 2001; 103(7): 916 - 918. [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, D. P. Francis, M. F. Piepoli, L. C. Davies, T. P. Chua, C. H. Davos, V. Florea, W. Banasiak, P. A. Poole-Wilson, A. J. S. Coats, et al. Enhanced Ventilatory Response to Exercise in Patients With Chronic Heart Failure and Preserved Exercise Tolerance : Marker of Abnormal Cardiorespiratory Reflex Control and Predictor of Poor Prognosis Circulation, February 20, 2001; 103(7): 967 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Recommendations for exercise testing in chronic heart faliure patients Eur. Heart J., January 1, 2001; 22(1): 37 - 45. [PDF]
|
|
|
|
|
|
C. A. Carrington, W. J. Fisher, M. K. Davies, and M. J. White Is there a relationship between muscle fatigue resistance and cardiovascular responses to isometric exercise in mild chronic heart failure? Eur J Heart Fail, January 1, 2001; 3(1): 53 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C Scott, D. P Francis, L C. Davies, P. Ponikowski, A. J S Coats, and M. F Piepoli Contribution of skeletal muscle 'ergoreceptors' in the human leg to respiratory control in chronic heart failure J. Physiol., December 15, 2000; 529(3): 863 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. Spencer, K. Collins, C. Korcarz, R. Fentzke, R. M. Lang, and J. M. Leiden Effects of exercise training on LV performance and mortality in a murine model of dilated cardiomyopathy Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H210 - H215. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N G Mahon, S Sharma, P M Elliott, M K Baig, M W Norman, S Barbeyto, and W J McKenna Abnormal cardiopulmonary exercise variables in asymptomatic relatives of patients with dilated cardiomyopathy who have left ventricular enlargement Heart, May 1, 2000; 83(5): 511 - 517. [Abstract] [Full Text]
|
|
|
|
|
|
P. Ponikowski, M. Piepoli, T.P. Chua, W. Banasiak, D. Francis, S.D. Anker, and A.J.S. Coats The impact of cachexia on cardiorespiratory reflex control in chronic heart failure Eur. Heart J., November 2, 1999; 20(22): 1667 - 1675. [Abstract] [PDF]
|
|
|
|
|
|
L. dalla Libera, R. Zennaro, M. Sandri, G. B. Ambrosio, and G. Vescovo Apoptosis and atrophy in rat slow skeletal muscles in chronic heart failure Am J Physiol Cell Physiol, November 1, 1999; 277(5): C982 - C986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W J Fisher and M J White Training-induced adaptations in the central command and peripheral reflex components of the pressor response to isometric exercise of the human triceps surae J. Physiol., October 15, 1999; 520(2): 621 - 628. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. Smith, P. J. Cowburn, M. E. Parker, M. Denvir, S. Puri, K. R. Patel, and J. G. F. Cleland Impaired Pulmonary Diffusion During Exercise in Patients With Chronic Heart Failure Circulation, September 28, 1999; 100(13): 1406 - 1410. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Opasich, N. Ambrosino, G. Felicetti, R. Aquilani, E. Pasini, D. Bergitto, A. Mazza, F. Cobelli, and L. Tavazzi Heart failure-related myopathy. Clinical and pathophysiological insights Eur. Heart J., August 2, 1999; 20(16): 1191 - 1200. [Abstract] [PDF]
|
|
|
|
|
|
K. Narkiewicz, C. A. Pesek, P. J. H. van de Borne, M. Kato, and V. K. Somers Enhanced Sympathetic and Ventilatory Responses to Central Chemoreflex Activation in Heart Failure Circulation, July 20, 1999; 100(3): 262 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Shoemaker, H. L. Naylor, C. S. Hogeman, and L. I. Sinoway Blood Flow Dynamics in Heart Failure Circulation, June 15, 1999; 99(23): 3002 - 3008. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.P. Wielenga, I.A. Huisveld, E. Bol, P.H.J.M. Dunselman, R.A.M. Erdman, M.R.P. Baselier, and W.L. Mosterd Safety and effects of physical training in chronic heart failure. Results of the Chronic Heart Failure and Graded Exercise study (CHANGE): (CHANGE) Eur. Heart J., June 2, 1999; 20(12): 872 - 879. [Abstract] [PDF]
|
|
|
|
|
|
N. Francis, A. Cohen-Solal, and D. Logeart Peripheral muscle ergoreceptors and ventilatory response during exercise recovery in heart failure Am J Physiol Heart Circ Physiol, March 1, 1999; 276(3): H913 - H917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Hambrecht, E. Fiehn, C. Weigl, S. Gielen, C. Hamann, R. Kaiser, J. Yu, V. Adams, J. Niebauer, and G. Schuler Regular Physical Exercise Corrects Endothelial Dysfunction and Improves Exercise Capacity in Patients With Chronic Heart Failure Circulation, December 15, 1998; 98(24): 2709 - 2715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. V. Kamath, S. Hollerbach, A. Bajwa, E. L. Fallen, A. R.M. Upton, and G. Tougas Neurocardiac and cerebral responses evoked by esophageal vago-afferent stimulation in humans: effect of varying intensities Cardiovasc Res, December 1, 1998; 40(3): 591 - 599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Shoemaker, A. R. Kunselman, D. H. Silber, and L. I. Sinoway Maintained exercise pressor response in heart failure J Appl Physiol, November 1, 1998; 85(5): 1793 - 1799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Evans, L. W. Tsai, D. A. Oelberg, H. Kazemi, and D. M. Systrom Skeletal muscle ECF pH error signal for exercise ventilatory control J Appl Physiol, January 1, 1998; 84(1): 90 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mostoufi-Moab, E. J. Widmaier, J. A. Cornett, K. Gray, and L. I. Sinoway Forearm training reduces the exercise pressor reflex during ischemic rhythmic handgrip J Appl Physiol, January 1, 1998; 84(1): 277 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A L CLARK and T MCDONAGH The origin of symptoms in chronic heart failure Heart, November 1, 1997; 78(5): 429 - 430. [Full Text] [PDF]
|
|
|
|
|
|
R. P Wielenga, A. J S Coats, W. L Mosterd, and I. A Huisveld The role of exercise training in chronic heart failure Heart, November 1, 1997; 78(5): 431 - 436. [Full Text] [PDF]
|
|
|
|
|
|
P. Ponikowski, T. P. Chua, M. Piepoli, D. Ondusova, K. Webb-Peploe, D. Harrington, S. D. Anker, M. Volterrani, R. Colombo, G. Mazzuero, et al. Augmented Peripheral Chemosensitivity as a Potential Input to Baroreflex Impairment and Autonomic Imbalance in Chronic Heart Failure Circulation, October 21, 1997; 96(8): 2586 - 2594. [Abstract] [Full Text]
|
|