Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, CANADA.
Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, CANADA.
Med Sci Sports Exerc. 2021 Nov 1;53(11):2233-2244. doi: 10.1249/MSS.0000000000002716.
In normotensive patients with obstructive sleep apnea (OSA), the muscle sympathetic nerve activity (MSNA) response to exercise is increased while metaboreflex control of MSNA is decreased. We tested the hypotheses that acute intermittent hypercapnic hypoxia (IHH) in males free from OSA and associated comorbidities would augment the MSNA response to exercise but attenuate the change in MSNA during metaboreflex activation.
Thirteen healthy males (age = 24 ± 4 yr) were exposed to 40 min of IHH. Before and after IHH, the pressor response to exercise was studied during 2 min of isometric handgrip exercise (at 30% maximal voluntary contraction), whereas the metaboreflex was studied during 4 min of postexercise circulatory occlusion (PECO). Mean arterial pressure (MAP), heart rate (HR), and fibular MSNA were recorded continuously. MSNA was quantified as burst frequency (BF) and total activity (TA). Mixed effects linear models were used to compare the exercise pressor and metaboreflex before and after IHH.
As expected, IHH led to significant increases in MSNA BF, TA, and MAP at baseline and throughout exercise and PECO. However, during handgrip exercise, the change from baseline in MAP, HR, MSNA BF, and TA was similar before and after IHH (All P > 0.31). During PECO, the change from baseline in MSNA BF and TA was similar after IHH, whereas the change from baseline in MAP (Δ14 mm Hg, 95% CI = 7-19, vs Δ16 mm Hg, 95% CI = 10-21; P < 0.01) was modestly increased.
After acute IHH, MSNA response to handgrip exercise and metaboreflex activation were preserved in healthy young males despite overall increases in resting MSNA and MAP. Chronic IHH and comorbidities often associated with OSA may be required to modulate the exercise pressor reflex and metaboreflex.
在无阻塞性睡眠呼吸暂停(OSA)的正常血压患者中,运动时肌肉交感神经活动(MSNA)的反应增加,而 MSNA 的代谢反射控制降低。我们检验了以下假设:无 OSA 及相关合并症的男性急性间歇性高碳酸血症性低氧(IHH)会增强 MSNA 对运动的反应,但会减弱代谢反射激活期间 MSNA 的变化。
13 名健康男性(年龄=24±4 岁)接受了 40 分钟的 IHH。在 IHH 前后,通过 2 分钟的等长握力运动(达到最大自主收缩的 30%)研究运动时的升压反应,而通过 4 分钟的运动后循环闭塞(PECO)研究代谢反射。连续记录平均动脉压(MAP)、心率(HR)和腓肠肌 MSNA。MSNA 以爆发频率(BF)和总活动(TA)来量化。使用混合效应线性模型比较 IHH 前后的运动升压和代谢反射。
如预期的那样,IHH 导致基线和整个运动及 PECO 期间 MSNA BF、TA 和 MAP 的显著增加。然而,在握力运动期间,MAP、HR、MSNA BF 和 TA 从基线的变化在 IHH 前后相似(所有 P>0.31)。在 PECO 期间,MSNA BF 和 TA 从基线的变化在 IHH 后相似,而 MAP 从基线的变化(Δ14mmHg,95%CI=7-19,vs Δ16mmHg,95%CI=10-21;P<0.01)略有增加。
在急性 IHH 后,健康年轻男性的握力运动时 MSNA 反应和代谢反射激活得以保留,尽管静息 MSNA 和 MAP 总体增加。可能需要慢性 IHH 和与 OSA 相关的合并症来调节运动升压反射和代谢反射。