Journal of Applied Physiology
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J Appl Physiol 71: 1070-1075, 1991;
8750-7587/91 $5.00
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Journal of Applied Physiology, Vol 71, Issue 3 1070-1075, Copyright © 1991 by American Physiological Society

ARTICLES

Dynamic regulation of leg vasomotor tone in patients with chronic heart failure

M. J. Sullivan and F. R. Cobb
Division of Cardiology, Duke University Medical Center, Durham, North Carolina 27710.

We examined the central hemodynamic (n = 5) and leg blood flow (n = 9) responses to one- and two-leg bicycle exercise in nine ambulatory patients with chronic heart failure due to left ventricular systolic dysfunction (ejection fraction 17 +/- 9%). During peak one- vs. two-leg exercise, leg blood flow (thermodilution) tended to be higher (1.99 +/- 0.91 vs. 1.67 +/- 0.91 l/min, P = 0.07), whereas femoral arteriovenous oxygen difference was lower (13.6 +/- 3.1 vs. 15.0 +/- 2.9 ml/dl, P less than 0.01). Comparison of data from exercise stages matched for single-leg work rate during one- vs. two-leg exercise demonstrated that cardiac output was similar while both oxygen consumption and central arteriovenous oxygen differences were lower, indicating relative improvement in the cardiac output response at a given single-leg work rate during one-leg exercise. This was accompanied by higher leg blood flow (1.56 +/- 0.76 vs. 1.83 +/- 0.72 l/min, P = 0.02) and a tendency for leg vascular resistance to be lower (92 +/- 54 vs. 80 +/- 48 Torr.l-1.min, P = 0.08) without any change in blood lactate. These data indicate that, in patients with chronic heart failure, leg vasomotor tone is dynamically regulated, independent of skeletal muscle metabolism, and is not determined solely by intrinsic abnormalities in skeletal muscle vasodilator capacity. Our results suggest that relative improvements in central cardiac function may lead to a reflex release of skeletal muscle vasoconstrictor tone in this disorder.


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B. D. Duscha, W. E. Kraus, S. J. Keteyian, M. J. Sullivan, H. J. Green, F. H. Schachat, A. M. Pippen, C. A. Brawner, J. M. Blank, and B. H. Annex
Capillary density of skeletal muscle: A contributing mechanism for exercise intolerance in class II-III chronic heart failure independent of other peripheral alterations
J. Am. Coll. Cardiol., June 1, 1999; 33(7): 1956 - 1963.
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