Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"Novel role for purinergic 2× subtype 4 (P2X4) receptors in the exercise pressor reflex and mechanoreflex: Effect of heart failure","authors":"Alec L.E. Butenas ,&nbsp;Ashley M. Baranczuk ,&nbsp;Raimi J. Carroll ,&nbsp;Shannon K. Parr ,&nbsp;Carl J. Ade ,&nbsp;K. Sue Hageman ,&nbsp;Timothy I. Musch ,&nbsp;Steven W. Copp","doi":"10.1016/j.autneu.2025.103277","DOIUrl":"10.1016/j.autneu.2025.103277","url":null,"abstract":"<div><div>We investigated the role played by ATP-sensitive purinergic 2 × 4 (P2X4) receptors on the sensory endings of thin fibre muscle afferents in exercise pressor reflex and mechanoreflex activation in healthy/SHAM rats and rats with heart failure with reduced ejection fraction (HF-rEF). We hypothesized that infusion of the P2X4 receptor antagonist 5-BDBD (8 μg) into the hindlimb arterial supply would reduce the mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) responses to 30s of electrically-induced hindlimb skeletal muscle contraction (model of exercise pressor reflex activation) and 30s of hindlimb skeletal muscle stretch (model of mechanoreflex activation) in decerebrate, unanesthetized HF-rEF rats but not SHAM rats. Ejection fraction was significantly lower in HF-rEF (46 ± 3 %) compared to SHAM (83 ± 2 %; <em>P</em> &lt; 0.001) rats. In SHAM rats, P2X4 receptor blockade had no effect on the pressor response to hindlimb muscle contraction (<em>n</em> = 8) or the pressor and RSNA response to muscle stretch (<em>n</em> = 4). However, in SHAM rats we found that P2X4 receptor blockade significantly reduced the RSNA response to muscle contraction. In HF-rEF rats, P2X4 receptor blockade reduced the pressor and RSNA response to hindlimb muscle contraction (<em>n</em> = 7) as well as the pressor, but not the RNSA, response to hindlimb muscle stretch (<em>n</em> = 8). Collectively, the data suggest that P2X4 receptors on thin fibre muscle afferent sensory endings play a role in the evoking the exercise pressor reflex in healthy subjects that is limited to RSNA, and that in HF-rEF this expands to a significant role in mechanoreflex and exercise pressor reflex-mediated blood pressure control.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103277"},"PeriodicalIF":3.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid chemoreceptor inhibition improves exercise tolerance in participants with elevated carotid chemosensitivity: A secondary analysis","authors":"Sophie É. Collins ,&nbsp;Devin B. Phillips ,&nbsp;Michael K. Stickland","doi":"10.1016/j.autneu.2025.103278","DOIUrl":"10.1016/j.autneu.2025.103278","url":null,"abstract":"<div><h3>Rationale</h3><div>Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are characterized by exaggerated carotid chemoreceptor (CC) sensitivity and exercise intolerance. We tested the hypothesis that participants with elevated CC sensitivity would have the greatest improvement in exercise tolerance with CC inhibition, secondary to increased vascular conductance, and lower ventilatory requirements, dyspnea and leg discomfort.</div></div><div><h3>Methods</h3><div>Data from healthy controls, and patients with CHF or COPD were included in this secondary analysis of results from 2 randomized placebo-controlled double-blind crossover trials. Assessments included pulmonary function, incremental cardiopulmonary exercise test, and basal CC sensitivity assessment. High CC sensitivity was defined as either a stepwise hypoxic ventilatory response (HVR) or transient HVR greater than one SD above the mean in healthy controls. Participants received 2 μg/kg/min dopamine or placebo infusions (randomized) during 2 separate constant work-rate exercise tests to examine exercise endurance time (EET) and cardiopulmonary responses.</div></div><div><h3>Results</h3><div>Among 33 adults, 17 were categorized to normal HVR (11 controls/3 COPD/3 CHF), and 16 to high HVR (1 control/7 COPD/8 CHF). Participants with high HVR experienced significant dopamine-induced improvements in EET (p_interaction = 0.011), and reduced leg discomfort at the 4-min isotime (p_interaction = 0.024). Those with improved vascular conductance and leg discomfort had the greatest improvements in EET (<em>p</em> = 0.042 and <em>p</em> = 0.021, respectively).</div></div><div><h3>Conclusions</h3><div>CC inhibition with dopamine in participants with high HVR was associated with improvement in EET. These findings suggest that high HVR is related to exercise limitation, and that improvement in EET is associated with a CC-mediated increase in vascular conductance and leg discomfort.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103278"},"PeriodicalIF":3.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cardiopulmonary baroreflex on sympathetic vasomotor outflow and blood pressure regulation during dynamic exercise","authors":"Keisho Katayama ,&nbsp;Shigehiko Ogoh","doi":"10.1016/j.autneu.2025.103276","DOIUrl":"10.1016/j.autneu.2025.103276","url":null,"abstract":"<div><div>Precise cardiovascular adjustments are necessary to meet the metabolic demands of working skeletal muscle during dynamic exercise. Appropriate regulation of sympathetic vasomotor outflow is key for maintaining arterial blood pressure (ABP) and facilitating the delivery of blood flow to active skeletal muscle. Central command, the exercise pressor reflex (including mechanoreflex and metaboreflex within skeletal muscle), and the arterial baroreflex work in concert, creating complex interactions that regulate sympathetic vasomotor outflow during dynamic exercise. Although less well studied, limited evidence suggests that the cardiopulmonary baroreflex plays a significant role in modulating MSNA (muscle sympathetic nerve activity) and ABP responses during mild-intensity dynamic exercise, as well as in resetting the arterial baroreflex during dynamic exercise. This review provides an updated and comprehensive overview of the sympathetic vasomotor outflow and the ABP response during dynamic exercise via the cardiopulmonary baroreflex.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103276"},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of sleep on autonomic nervous system regulation in women across the lifespan","authors":"Jeremy A. Bigalke,&nbsp;Jason R. Carter","doi":"10.1016/j.autneu.2025.103275","DOIUrl":"10.1016/j.autneu.2025.103275","url":null,"abstract":"<div><div>Sleep and autonomic regulation are closely related processes which incur significant influence on health and wellbeing in women across the lifespan. Aging in women is associated with increases in cardiovascular risk through greater sympathetic predominance compared to premenopausal women, as well as reductions in sleep quality and quantity. Women remain an understudied population with regards to sleep, autonomic function, and cardiovascular risk. Understanding the interplay between sleep and autonomic function across the lifespan of women is crucial to improve subsequent lifelong health outcomes. The present review integrates knowledge that has accrued regarding experimental sleep deprivation, restriction, and chronic sleep disturbance and their respective impacts on autonomic regulation at various life stages in women. The review focuses on high-fidelity measures of sympathetic regulation (i.e., microneurography), as aging in women is associated with a disproportionate increase in sympathetic activity compared to men. Evidence summarized within this review delineates a significant impact of sleep processes on autonomic function in women across the lifespan. However, there remain substantial gaps in our knowledge of this interplay between sleep processes and autonomic regulation of cardiovascular control in women. There is a need for further research efforts to disentangle the complexity associated with sleep and autonomic regulation in women at all life stages. Efforts in this area will improve our understanding of women's health and factors such as sleep and sleep disturbance which precipitate lifelong health and chronic cardiovascular risk.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103275"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic control of blood pressure in women: The roles of hypertension and aging","authors":"John D. Akins,&nbsp;Takuro Washio,&nbsp;Qi Fu","doi":"10.1016/j.autneu.2025.103274","DOIUrl":"10.1016/j.autneu.2025.103274","url":null,"abstract":"<div><div>Hypertension remains a leading cause of cardiovascular morbidity and mortality worldwide, with implications in women's health across the lifespan. Of note, autonomic nervous system imbalances have been linked to the development of hypertension and are present with natural aging and various conditions unique to women (e.g., menopause, hypertensive disorders of pregnancy, polycystic ovary syndrome). As such, this article reviews the critical changes in the sympathetic and parasympathetic nervous systems that occur in women and may contribute to the development of hypertension. Special focus is paid to the regulating pathways across the baroreflex arc, including baroreflex sensitivity, efferent sympathetic outflow, and peripheral sympathetic transduction, at rest and during various physiological stressors. To this point, aging women experience increasing sympathetic outflow, blunted sympathetic transduction, and reduced cardiovagal baroreflex sensitivity, which may be further potentiated by the presence of hypertension. Additionally, this review applies some clinical perspective to the physiological findings in order to identify potential therapeutic pathways. The information gathered in this review has important implications for future research into women's autonomic blood pressure regulation and its impact on the genesis of hypertension.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103274"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of rhythmic handgrip exercise on muscle sympathetic nerve activity: A systematic review and meta-analysis","authors":"Lauren E. Maier ,&nbsp;Sarah E. Meyer ,&nbsp;Andy Deprato ,&nbsp;Stephen Busch ,&nbsp;Allison Sivak ,&nbsp;Margie H. Davenport ,&nbsp;Craig D. Steinback","doi":"10.1016/j.autneu.2025.103272","DOIUrl":"10.1016/j.autneu.2025.103272","url":null,"abstract":"<div><div>This systematic review and meta-analysis was conducted to quantify the sympathetic response to rhythmic handgrip exercise in healthy and diseased populations. Structured searches of databases were performed until June 12, 2024. We included all primary studies (other than systematic reviews and meta-analyses), and inclusion criteria were: population (all populations); intervention (rhythmic handgrip); comparator (baseline); and outcome (MSNA, BP, HR). Forty-nine studies (n = 930) were included. Burst frequency was elevated by 6.1 bursts/min during rhythmic handgrip (95 % CI, 4.52, 7.63; I² = 53 %; p &lt; 0.00001) across all populations. Similarly, burst incidence and total activity showed significant increases during handgrip (BI: MD, 3.0 bursts/100 hbs; 95 % CI, 0.11, 5.85; I² = 0 %; p = 0.04; TA: MD, 49.4 a.u.; 95 % CI, 36.56, 62.20; I² = 86 %; p &lt; 0.00001). Subgroup analyses found greater responses in MSNA during rhythmic handgrip in healthy individuals compared to cardiovascular diseases and other conditions. Specifically, the change in burst frequency during handgrip (p = 0.0009) and total activity during handgrip (p &lt; 0.00001) suggest a blunted sympathetic response to rhythmic handgrip in diseased populations. Meta-regression analyses in healthy populations found no relationship between the volume of handgrip applied with the associated change in sympathetic activity; however, there was a significant positive relationship between both the change in heart rate (slope = 0.131; adjusted R² = 0.2773; p = 0.002) and the change in mean blood pressure (slope = 0.163; adjusted R² = 0.3594; p &lt; 0.001) with handgrip volume. An increase in MSNA is observed during rhythmic handgrip despite ranging protocols, populations, and co-interventions. These results suggest exercise is a unique stressor and challenges the understanding of general sympathetic hyperactivity in diseased populations.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"259 ","pages":"Article 103272"},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic cardiovascular responses to postural sway and discreet counterpressure maneuvers","authors":"E.L. Williams ,&nbsp;J. Lando ,&nbsp;V.-E.M. Lucci ,&nbsp;B.C.D. Hockin ,&nbsp;K. Elabd ,&nbsp;S.N. Robinovitch ,&nbsp;I.T. Parsons ,&nbsp;V.E. Claydon","doi":"10.1016/j.autneu.2025.103271","DOIUrl":"10.1016/j.autneu.2025.103271","url":null,"abstract":"<div><div>Counterpressure maneuvers (CPM) are movements used to delay or abort syncope, but may have practical barriers to use. We recently showed exaggerated postural sway produces protective responses against syncope. Accordingly, we aimed to evaluate a series of discreet, accessible movements as novel preventative CPM.</div><div>We tested 26 healthy adults (12 female) aged 28.9 ± 1.2 years. Participants performed a baseline stand (BL), followed by three randomized CPM trials (exaggerated anteroposterior sway, AP; toe clenching, TC; gluteal muscle clenching, GC). Non-invasive beat-to-beat systolic arterial pressure (SAP), heart rate, stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR), mean middle cerebral artery blood velocity (mMCAv), and total path length moved (TPL) were measured. Muscularity was assessed using bioelectrical impedance.</div><div>All discreet CPM augmented orthostatic SV (<em>p</em> &lt; 0.001) and CO (<em>p</em> &lt; 0.001), while reducing TPR (<em>p</em> &lt; 0.001). SAP increased during AP (<em>p</em> &lt; 0.001) and GC (<em>p</em> &lt; 0.001), but not TC. GC responses were unstable, with increased standard deviation of SAP (<em>p</em> = 0.002) and SV (<em>p</em> = 0.022) that may predispose syncope. Only AP improved mMCAv (<em>p</em> = 0.005) and sympathovagal balance (<em>p</em> &lt; 0.001). Responses were largest in those with greater initial cardiovascular instability (<em>p</em> &lt; 0.003), larger leg muscle mass (<em>p</em> &lt; 0.02), and where TPL was greater (<em>p</em> &lt; 0.002).</div><div>These novel CPM hold clinical potential for the prevention of orthostatic syncope and presyncope, while addressing real-world patient-reported barriers to CPM. Exaggerated AP sway was most robust and stable at improving orthostatic hemodynamics in healthy controls, with reduced reliance on sympathetic baroreflex-mediated vasoconstriction during enhanced muscle pumping activity. Accordingly, AP shows the most promise as a simple and discrete CPM.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103271"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic mucosal TRPA1 expression profiles in irritable bowel syndrome and its correlation to symptom severity: An exploratory study","authors":"Sylvester R. Groen ,&nbsp;Daniel Keszthelyi ,&nbsp;Ellen Wilms ,&nbsp;Justin Huig ,&nbsp;Pan Xu ,&nbsp;Montserrat Elizalde ,&nbsp;Lisa Vork ,&nbsp;Daisy M.A.E. Jonkers ,&nbsp;Zsuzsanna Helyes ,&nbsp;Ad A.M. Masclee ,&nbsp;Zsa Zsa R.M. Weerts","doi":"10.1016/j.autneu.2025.103273","DOIUrl":"10.1016/j.autneu.2025.103273","url":null,"abstract":"<div><h3>Introduction</h3><div>Visceral hypersensitivity is a hallmark of irritable bowel syndrome (IBS). A putative involvement of the Transient Receptor Potential Ankyrin-1 (TRPA1) cation channel has been suggested by several animal studies. Main objective of this study is to assess location-specific TRPA1 expression in the colonic mucosa and its correlation with symptom severity in IBS patients.</div></div><div><h3>Methods</h3><div>Biopsies were obtained from the sigmoid of 30 IBS patients (Rome III; median age 39.0 years, 80 % female) and 23 healthy controls (median age 22.7 years, 43.5 % female). Additional biopsies of the proximal colon were obtained in 24 IBS patients. TRPA1 expression levels were measured in duplicate by quantitative reverse-transcriptase–polymerase-chain-reaction, normalized to GAPDH, and assessed as relative mRNA values using the −2^ΔCt method. In IBS patients, symptoms were assessed and correlated with TRPA1 expression.</div></div><div><h3>Results</h3><div>Relative TRPA1 expression in the sigmoid was significantly higher in IBS patients compared to healthy controls (<em>P</em> &lt; 0.001). Within IBS patients TRPA1 expression of sigmoid biopsies was significantly higher compared to proximal colon samples (<em>p</em> &lt; 0.001). No significant correlation was found between TRPA1 expression in sigmoid or proximal colon samples and the symptom severity (abdominal discomfort, abdominal pain and bloating).</div></div><div><h3>Conclusion</h3><div>These findings suggest a potential role for the TRPA1 related pathway as a target for IBS treatment in the future. Since there was no correlation found in the current exploratory study between TRPA1 expression and symptom severity, further research towards the clinical relevance of the increased TRPA1 expression in IBS-patients along with its location-specific expression is warranted.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"259 ","pages":"Article 103273"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and sympathetic neural responses during acute vagus nerve stimulation and subsequent static handgrip exercise in healthy adults","authors":"Takuro Washio ,&nbsp;John D. Akins ,&nbsp;Sarah L. Hissen ,&nbsp;Anna K. Geib ,&nbsp;Skyler A. Robles ,&nbsp;Qi Fu","doi":"10.1016/j.autneu.2025.103270","DOIUrl":"10.1016/j.autneu.2025.103270","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate cardiovascular and sympathetic neural responses during acute cervical non-invasive vagus nerve stimulation (nVNS) and subsequent static handgrip (SHG) exercise with post-exercise circulatory occlusion (PECO) in healthy humans.</div></div><div><h3>Methods</h3><div>Ten healthy adults (5 men and 5 women, 33 ± 9 [standard deviation] yrs) participated in this double-blinded, randomized, crossover study. Each participant was studied twice on two separate days, with approximately 4 weeks apart: once during the actual cervical nVNS and once during sham stimulation for 4 min each. Mean arterial pressure (MAP), heart rate (HR), and muscle sympathetic nerve activity (MSNA) were measured during nVNS and sham stimulation. In addition, participants performed SHG at 40 % of maximal voluntary contraction until fatigue, followed by 2-min PECO to isolate muscle metaboreflex activation before and after each stimulation.</div></div><div><h3>Results</h3><div>During both nVNS and sham stimulation, HR decreased (△−4 ± 4 and △−4 ± 5 bpm; both <em>P</em> &lt; 0.001), and MSNA increased (△4 ± 6 and △2 ± 3 bursts/min; both P &lt; 0.001) in all participants, although MAP remained unchanged (<em>P</em> = 0.312). However, these responses did not differ between nVNS and sham stimulation (all <em>P</em> &gt; 0.05). Additionally, there were no differences in cardiovascular and MSNA responses to fatiguing SHG and PECO between stimulations (all <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Compared to the sham condition, cervical nVNS had no significant impact on cardiovascular variables and MSNA during acute stimulation, nor on the responses to SHG or PECO. These findings suggest that cervical nVNS has no or minimal acute effect on sympathetic neural (re)activity in healthy adults.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"259 ","pages":"Article 103270"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the exercise pressor reflex in heart failure: A multi-step failure","authors":"Danilo Iannetta ,&nbsp;Fabio Giuseppe Laginestra ,&nbsp;D. Walter Wray ,&nbsp;Markus Amann","doi":"10.1016/j.autneu.2025.103269","DOIUrl":"10.1016/j.autneu.2025.103269","url":null,"abstract":"<div><div>The contribution of neural feedback originating from exercising limb muscles to the cardiovascular response to exercise was first recognized nearly 100 years ago. Today, it is well established that this influence is initiated by the activation of group III and IV sensory neurons with terminal endings located within contracting skeletal muscle. During exercise, these sensory neurons project feedback related to intramuscular mechanical and metabolic perturbations to medullary neural circuits which reflexively evoke decreases in parasympathetic and increases in sympathetic nervous system activity with the purpose of optimizing central and peripheral hemodynamics. Considerable evidence from animal and human studies suggests that the function of this regulatory control system, known as the exercise pressor reflex (EPR), is abnormal in heart failure and exaggerates sympatho-excitation which impairs the hemodynamic response to exercise and contributes to the functional limitations characterizing these patients. This review briefly introduces the key determinants of EPR control in health and covers the impact of heart failure on the integrity of each of its components and overall function. These include the sensitivity of group III/IV muscle afferents, afferent signal transmission in the spinal cord, and the central integration and processing of sensory feedback within the brainstem. Importantly, although most data relevant for this review come from studies in HFrEF, the limited HFpEF-specific insights are included when available. While arguably not part of the EPR, we also discuss the impact of heart failure on the exercise-induced increase of intramuscular stimuli of group III/IV muscle afferents and end-organ responsiveness to sympathetic/neurochemical stimulation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"259 ","pages":"Article 103269"},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}