Liu J L, Irvine S, Reid I A, Patel K P, Zucker I H
Department of Physiology and Biophysics, University of Nebraska College of Medicine, Omaha, NE, USA.
Circulation. 2000 Oct 10;102(15):1854-62. doi: 10.1161/01.cir.102.15.1854.
Chronic exercise (EX) improves the quality of life and increases the survival of patients with chronic heart failure (CHF). Because sympathetic nerve activity is elevated in the CHF state, it is possible that EX is beneficial in this disease due to a decrease in sympathetic outflow.
We evaluated arterial baroreflex function and resting renal sympathetic nerve activity (RSNA) in EX normal and CHF rabbits before and after angiotensin II type 1 (AT(1)) receptor blockade. Four groups of rabbits were studied: a normal non-EX group, a normal EX group, a CHF non-EX group, and a CHF EX group. EX lowered resting RSNA in rabbits with CHF but not in normal rabbits. In addition, EX increased arterial baroreflex sensitivity in the CHF group (heart rate slope: CHF 1. 7+/-0.3 bpm/mm Hg, EX CHF 4.9+/-0.3 bpm/mm Hg; P:<0.01; RSNA slope: CHF 2.2+/-0.2%max/mm Hg, EX CHF 5.7+/-0.4%max/mm Hg; P:<0.01. AT(1) receptor blockade enhanced baroreflex sensitivity in the non-EX CHF rabbits but had no effect in EX CHF rabbits. Concomitant with this effect, EX lowered the elevated plasma angiotensin II concentration in the CHF group. A significant positive correlation was observed between sympathetic nerve activity and plasma angiotensin II.
These data strongly suggest that EX reduces the sympathoexcitatory state in the setting of CHF. Enhanced arterial baroreflex sensitivity may contribute to this reduction. In addition, EX lowers plasma angiotensin II concentration in CHF. These data further suggest that the lowering of angiotensin II may contribute to the decrease in sympathetic nerve activity after EX in the CHF state.
长期运动（EX）可改善慢性心力衰竭（CHF）患者的生活质量并提高其生存率。由于CHF状态下交感神经活动增强，运动可能因交感神经传出减少而对该疾病有益。
我们评估了1型血管紧张素II（AT(1)）受体阻断前后，运动的正常兔和CHF兔的动脉压力反射功能及静息肾交感神经活动（RSNA）。研究了四组兔：正常非运动组、正常运动组、CHF非运动组和CHF运动组。运动降低了CHF兔的静息RSNA，但对正常兔无此作用。此外，运动增加了CHF组的动脉压力反射敏感性（心率斜率：CHF 1.7±0.3次/分/毫米汞柱，运动CHF 4.9±0.3次/分/毫米汞柱；P<0.01；RSNA斜率：CHF 2.2±0.2%最大值/毫米汞柱，运动CHF 5.7±0.4%最大值/毫米汞柱；P<0.01）。AT(1)受体阻断增强了非运动CHF兔的压力反射敏感性，但对运动CHF兔无影响。与此效应相伴，运动降低了CHF组升高的血浆血管紧张素II浓度。交感神经活动与血浆血管紧张素II之间存在显著正相关。
这些数据强烈表明，运动可降低CHF状态下的交感兴奋状态。增强的动脉压力反射敏感性可能有助于这种降低。此外，运动降低了CHF患者的血浆血管紧张素II浓度。这些数据进一步表明血管紧张素II的降低可能有助于CHF状态下运动后交感神经活动的减少。
