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Mira PADC, Falci MFA, Moreira JB, Guerrero RVD, Ribeiro TCDR, Barbosa KVBD, Pace FHL, Martinez DG, Laterza MC. Blunted blood pressure response to exercise and isolated muscle metaboreflex activation in patients with cirrhosis. Appl Physiol Nutr Metab 2020; 46:273-279. [PMID: 32941782 DOI: 10.1139/apnm-2020-0407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We sought to test the hypothesis that the cardiovascular responses to isolated muscle metaboreflex activation would be blunted in patients with cirrhosis. Eleven patients with cirrhosis and 15 healthy controls were evaluated. Blood pressure (BP; oscillometric method), contralateral forearm blood flow (FBF; venous occlusion plethysmography), and heart rate (HR; electrocardiogram) were measured during baseline, isometric handgrip at 30% of maximal voluntary contraction followed by postexercise ischemia (PEI). Forearm vascular conductance (FVC) was calculated as follows: (FBF / mean BP) × 100. Changes in HR during handgrip were similar between groups but tended to be different during PEI (controls: Δ 0.5 ± 1.1 bpm vs. cirrhotic patients: Δ 3.6 ± 1.0 bpm, P = 0.057). Mean BP response to handgrip (controls: Δ 20.9 ± 2.7 mm Hg vs. cirrhotic patients: Δ 10.6 ± 1.5 mm Hg, P = 0.006) and PEI was attenuated in cirrhotic patients (controls: Δ 16.1 ± 1.9 mm Hg vs. cirrhotic patients: Δ 7.2 ± 1.4 mm Hg, P = 0.001). In contrast, FBF and FVC increased during handgrip and decreased during PEI similarly between groups. These results indicate that an abnormal muscle metaboreflex activation explained, at least partially, the blunted pressor response to exercise exhibited by cirrhotic patients. Novelty: Patients with cirrhosis present abnormal muscle metaboreflex activation. BP response was blunted but forearm vascular response was preserved. HR response was slightly elevated.
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Affiliation(s)
- Pedro Augusto de Carvalho Mira
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | - Maria Fernanda Almeida Falci
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | - Janaína Becari Moreira
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | - Rosa Virginia Diaz Guerrero
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | | | | | - Fábio Heleno Lima Pace
- Hepatology Unit of Gastroenterology, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, MG 36038-330, Brazil
| | - Daniel Godoy Martinez
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | - Mateus Camaroti Laterza
- Cardiovascular Research Unit and Exercise Physiology, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil.,Faculty of Physical Education and Sports, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
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