Heart failure & cardiomyopathies
Sympathetic Response to 1-Leg Cycling Exercise Predicts Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction
Authors' conclusion
In contrast to CMCs, patients with HFpEF exhibit augmented MSNA at rest and during exercise. The magnitude of such paradoxical sympathoexcitation during dynamic cycling relates inversely to V̇O2peak, consistent with a neurogenic, vasoconstrictor limit on exercise capacity in HFpEF.
Study context
- Population
- Patients with heart failure with preserved EF (HFpEF), comorbidity-matched controls and healthy controls
- Participants
- 13 / 17 / 18
- Comparison
- HFpEF vs comorbidity-matched controls vs healthy controls
- HFpEFn = 13
- Comorbidity-matched controls (CMC)n = 17reference
- Healthy controlsn = 18reference
- Outcome
- MSNA (microneurography) response to 1-leg cycling and its relation to V̇O2peak
Methodological detailscomorbidity-matched controls
- Comorbidity-matched controls
Main finding
As reported in the abstract
Change in MSNA (bursts·min-1) during cycling
| Group | Mild cycling | Moderate cycling |
|---|---|---|
| Healthy controls | −4±4; P=0.01 | −8±6; P<0.001 |
| CMC | +1±7; P=0.42 | +2±8; P=0.28 |
| HFpEF | +8±8; P<0.001 | +9±10; P<0.001 |
Mild cycling
Healthy controls−4±4; P=0.01
CMC+1±7; P=0.42
HFpEF+8±8; P<0.001
Moderate cycling
Healthy controls−8±6; P<0.001
CMC+2±8; P=0.28
HFpEF+9±10; P<0.001
- HFpEF: change in muscle sympathetic nerve activity (MSNA) during moderate cycling vs relative V̇O2peak
- r=−0.72; R 2=0.51; P<0.01
- HFpEF: change in MSNA during moderate cycling vs percent-predicted V̇O2peak
- r=−0.63; R 2=0.39; P=0.03
- No statistically significant relationships in controls
- P > 0.05
Further findings
Resting MSNA and V̇O2peak
- Resting MSNA higher and V̇O2peak lower in HFpEF vs CMCs and healthy controls
- all P<0.05
MSNA during handgrip
- MSNA increased in all groups
- all P<0.05
- HFpEF MSNA greater than CMCs and healthy controls during HG and postexercise circulatory occlusion at 40% isometric handgrip
- all P<0.05
- HFpEF MSNA greater during HG only at 50% and 30% rhythmic handgrip
- all P<0.05
Original publication
Sympathetic Response to 1-Leg Cycling Exercise Predicts Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. Circ Heart Fail. Published 6 December 2024. doi:10.
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