Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metabo-receptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Whether patients with type 2 diabetes mellitus (DM2) have similar hemodynamic abnormalities is unknown. Here we contrast the hemodynamic response to PEMI in 14 patients suffering from DM2 (age 62.7 +/- 8.3 yr) and in 15 age-matched controls (CTLs). All participants underwent a control exercise recovery reference test and a PEMI test to obtain the metaboreflex response. Central hemodynamics were evaluated by unbiased operator-independent impedance cardiography. Although the blood pressure response to PEMI was not significantly different between the groups, we found that the SVR and CO responses were reversed in patients with DM2 as compared with the CTLs (SVR: 392.5 +/- 549.6 and -14.8 +/- 258.9 dyn.s(-1).cm(-5); CO: -0.25 +/- 0.63 and 0.46 +/- 0.50 l/m, respectively, in DM2 and in CTL groups. respectively; P < 0.05 for both). Of note, stroke volume (SV) increased during PEMI in the CTL group only. Failure to increase SV and CO was the consequence of reduced venous return, impaired cardiac performance, and augmented afterload in patients with DM2. We conclude that patients with DM2 have an exaggerated vasoconstriction in response to metaboreflex activation not accompanied by a concomitant increase in heart performance. Therefore, in these patients, blood pressure response to the metaboreflex relies more on SVR increases rather than on increases in SV and CO.

Hemodynamic abnormalities during muscle metaboreflex activation in patients with type 2 diabetes mellitus

Roberto S.;Milia R.;Doneddu A.;Pinna V.;Palazzolo G.;Orrù A.;Ghiani G.;Mulliri G.;Pagliaro P.;Crisafulli A.
2019-01-01

Abstract

Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metabo-receptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Whether patients with type 2 diabetes mellitus (DM2) have similar hemodynamic abnormalities is unknown. Here we contrast the hemodynamic response to PEMI in 14 patients suffering from DM2 (age 62.7 +/- 8.3 yr) and in 15 age-matched controls (CTLs). All participants underwent a control exercise recovery reference test and a PEMI test to obtain the metaboreflex response. Central hemodynamics were evaluated by unbiased operator-independent impedance cardiography. Although the blood pressure response to PEMI was not significantly different between the groups, we found that the SVR and CO responses were reversed in patients with DM2 as compared with the CTLs (SVR: 392.5 +/- 549.6 and -14.8 +/- 258.9 dyn.s(-1).cm(-5); CO: -0.25 +/- 0.63 and 0.46 +/- 0.50 l/m, respectively, in DM2 and in CTL groups. respectively; P < 0.05 for both). Of note, stroke volume (SV) increased during PEMI in the CTL group only. Failure to increase SV and CO was the consequence of reduced venous return, impaired cardiac performance, and augmented afterload in patients with DM2. We conclude that patients with DM2 have an exaggerated vasoconstriction in response to metaboreflex activation not accompanied by a concomitant increase in heart performance. Therefore, in these patients, blood pressure response to the metaboreflex relies more on SVR increases rather than on increases in SV and CO.
2019
blood pressure; cardiac preload; cardiovascular regulation; myocardial contractility; stroke volume
File in questo prodotto:
File Dimensione Formato  
metaboreflex DIA2 JAP 2019.pdf

Solo gestori archivio

Tipologia: versione editoriale (VoR)
Dimensione 733.33 kB
Formato Adobe PDF
733.33 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11584/263465
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 14
social impact