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慢性心力衰竭中的运动不耐受和疲劳:III/IV 类传入反馈是否起作用?

Exercise intolerance and fatigue in chronic heart failure: is there a role for group III/IV afferent feedback?

机构信息

Faculty of Health and Life Sciences, Sport, Exercise and Rehabilitation, Northumbria University, UK.

Department of Medical Sciences and Public Health, Sports Physiology Laboratory, University of Cagliari, Italy.

出版信息

Eur J Prev Cardiol. 2020 Nov;27(17):1862-1872. doi: 10.1177/2047487320906919. Epub 2020 Feb 11.

Abstract

Exercise intolerance and early fatiguability are hallmark symptoms of chronic heart failure. While the malfunction of the heart is certainly the leading cause of chronic heart failure, the patho-physiological mechanisms of exercise intolerance in these patients are more complex, multifactorial and only partially understood. Some evidence points towards a potential role of an exaggerated afferent feedback from group III/IV muscle afferents in the genesis of these symptoms. Overactivity of feedback from these muscle afferents may cause exercise intolerance with a double action: by inducing cardiovascular dysregulation, by reducing motor output and by facilitating the development of central and peripheral fatigue during exercise. Importantly, physical inactivity appears to affect the progression of the syndrome negatively, while physical training can partially counteract this condition. In the present review, the role played by group III/IV afferent feedback in cardiovascular regulation during exercise and exercise-induced muscle fatigue of healthy people and their potential role in inducing exercise intolerance in chronic heart failure patients will be summarised.

摘要

运动不耐受和早期疲劳是慢性心力衰竭的标志性症状。虽然心脏功能障碍肯定是慢性心力衰竭的主要原因,但这些患者运动不耐受的病理生理机制更为复杂、多因素,且仅部分被理解。一些证据表明,肌肉传入纤维中 III/IV 组传入纤维的传入反馈过度可能在这些症状的发生中起潜在作用。这些肌肉传入纤维的过度活动可能通过双重作用导致运动不耐受:通过引起心血管失调,通过降低运动输出,并通过在运动期间促进中枢和外周疲劳的发展。重要的是,身体活动不足似乎会对综合征的进展产生负面影响,而身体训练可以部分抵消这种情况。在本综述中,将总结 III/IV 组传入纤维反馈在健康人运动期间心血管调节和运动诱导肌肉疲劳中的作用及其在诱导慢性心力衰竭患者运动不耐受中的潜在作用。

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