This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wilson, J. R. Articles by Jones, R. Search for Related Content PubMed PubMed Citation Articles by Wilson, J. R. Articles by Jones, R.

Circulation, Vol 79, 1021-1027, Copyright © 1989 by American Heart Association

ARTICLES

Sympathetic vasoconstriction during exercise in ambulatory patients with left ventricular failure

JR Wilson, MJ Frey, DM Mancini, N Ferraro and R Jones
Cardiovascular Section, Hospital of the University of Pennsylvania, Philadelphia 19104.

In patients with heart failure, exercise is thought to increase sympathetic vasoconstrictor tone. To investigate the extent of this sympathetic activation, we studied the effect of maximal exercise on nonexercising vascular beds in 35 patients with left ventricular failure (ejection fraction, 21 +/- 8%; peak exercise oxygen uptake (VO2), 12.3 +/- 3.5 ml/min/kg). In 28 patients, cardiac output and leg blood flow were measured during maximal upright bicycle exercise. Total flow to nonexercising tissue was then calculated as cardiac output--(2 x leg flow). In seven patients and six normal subjects, forearm blood flow was measured during supine bicycle exercise before and after alpha- adrenergic blockade with intravenous phentolamine. Maximal upright exercise increased the vascular resistance of nonexercising tissue from 34 +/- 16 units at upright rest to 45 +/- 25 units (p less than 0.02) but did not affect total flow to nonexercising tissue (rest, 2.9 +/- 1.0; maximal exercise, 2.8 +/- 1.4 l/min; p = NS). Supine exercise had no significant effect on forearm blood flow or vascular resistance in the normal subjects. In the patients with heart failure, supine exercise increased forearm vascular resistance from 45 +/- 17 to 58 +/- 25 mm Hg/ml/min/100 ml (p less than 0.02), again with no change in tissue flow (rest, 2.4 +/- 0.1; maximal exercise, 2.4 +/- 0.9 ml/min/100 ml; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				Y. Tanabe, M. Takahashi, Y. Hosaka, M. Ito, E. Ito, and K. Suzuki Prolonged recovery of cardiac output after maximal exercise in patients with chronic heart failure J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1228 - 1236. [Abstract] [Full Text] [PDF]

				L. Pavia, J. Myers, and R. Cesare Recovery Kinetics of Oxygen Uptake and Heart Rate in Patients With Coronary Artery Disease and Heart Failure Chest, September 1, 1999; 116(3): 808 - 813. [Abstract] [Full Text] [PDF]

				C.F. Notarius, S. Ando, G.A. Rongen, and J.S. Floras Resting muscle sympathetic nerve activity and peak oxygen uptake in heart failure and normal subjects Eur. Heart J., June 2, 1999; 20(12): 880 - 887. [Abstract] [PDF]

				A. Cohen-Solal, T. Laperche, D. Morvan, M. Geneves, B. Caviezel, and R. Gourgon Prolonged Kinetics of Recovery of Oxygen Consumption After Maximal Graded Exercise in Patients With Chronic Heart Failure : Analysis With Gas Exchange Measurements and NMR Spectroscopy Circulation, June 15, 1995; 91(12): 2924 - 2932. [Abstract] [Full Text]

				J. Myers and V. F. Froelicher Hemodynamic Determinants of Exercise Capacity in Chronic Heart Failure Ann Intern Med, September 1, 1991; 115(5): 377 - 386. [Abstract] [PDF]