(Circulation. 2000;102:1854.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the Department of Physiology and Biophysics (J.-L.L., S.I., K.P.P., I.H.Z.), University of Nebraska College of Medicine, Omaha, Neb; and Department of Physiology (I.A.R.), University of California at San Francisco.
BackgroundChronic exercise (EX) improves the quality of life and increases the survival of patients with chronic heart failure (CHF). Because sympathetic nerve activity is elevated in the CHF state, it is possible that EX is beneficial in this disease due to a decrease in sympathetic outflow.
Methods and ResultsWe evaluated arterial baroreflex function and resting renal sympathetic nerve activity (RSNA) in EX normal and CHF rabbits before and after angiotensin II type 1 (AT1) receptor blockade. Four groups of rabbits were studied: a normal non-EX group, a normal EX group, a CHF non-EX group, and a CHF EX group. EX lowered resting RSNA in rabbits with CHF but not in normal rabbits. In addition, EX increased arterial baroreflex sensitivity in the CHF group (heart rate slope: CHF 1.7±0.3 bpm/mm Hg, EX CHF 4.9±0.3 bpm/mm Hg; P<0.01; RSNA slope: CHF 2.2±0.2%max/mm Hg, EX CHF 5.7±0.4%max/mm Hg; P<0.01. AT1 receptor blockade enhanced baroreflex sensitivity in the non-EX CHF rabbits but had no effect in EX CHF rabbits. Concomitant with this effect, EX lowered the elevated plasma angiotensin II concentration in the CHF group. A significant positive correlation was observed between sympathetic nerve activity and plasma angiotensin II.
Conclusions-These data strongly suggest that EX reduces the sympathoexcitatory state in the setting of CHF. Enhanced arterial baroreflex sensitivity may contribute to this reduction. In addition, EX lowers plasma angiotensin II concentration in CHF. These data further suggest that the lowering of angiotensin II may contribute to the decrease in sympathetic nerve activity after EX in the CHF state.
Key Words: exercise angiotensin heart failure nervous system, sympathetic
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