Exercise modulates sympathetic and vascular function in chronic kidney disease.
Exercise modulates sympathetic and vascular function in chronic kidney disease.
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DOI：
10.1172/jci.insight.164221
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发表时间：
2023-02-22
期刊：
影响因子：
8
通讯作者：
Park, Jeanie
中科院分区：
文献类型：
--
作者：
Jeong, Jinhee;Sprick, Justin D.;DaCosta, Dana R.;Mammino, Kevin;Nocera, Joe R.;Park, Jeanie
慢性肾病（CKD）的特征是交感神经系统（SNS）的慢性过度激活，这会增加心血管（CV）疾病和死亡率的风险。SNS过度活动通过多种机制增加CV风险，包括血管僵硬。我们检验了有氧运动训练会降低CKD患者静息SNS活动和血管僵硬度的假设。在这项随机对照试验中，患有CKD的久坐老年人接受了12周的运动（骑自行车，n = 32）或拉伸（活性对照组，n = 26）。运动和拉伸干预进行20-45分钟/次，每周3天，持续时间相匹配。主要终点包括通过显微神经造影术测定的静息肌肉交感神经活动（MSNA）、通过中心脉搏波速度（PWV）测定的动脉硬度和通过增强指数（AIx）测定的主动脉波反射。MSNA和AIx存在显著的组×时间相互作用，运动组没有变化，但在12周后拉伸组有所增加。运动组MSNA的变化幅度与基线MSNA呈负相关。在研究期间，两组的PWV均无变化。我们的数据表明，12周的自行车运动对CKD患者的神经血管有有益的影响。具体而言，运动训练安全有效地改善了对照组随时间推移观察到的MSNA和AIx的增加。运动训练的这种交感神经抑制作用在静息MSNA较高的CKD患者中表现出更大的幅度。ClinicalTrials.gov，NCT02947750。NIH R01HL135183; NIH R61AT10457; NIH NCATS KL 2TR 002381;和NIH T32 DK 00756; NIH F32HL147547;和VA Merit I01CX 001065。
Chronic kidney disease (CKD) is characterized by chronic overactivation of the sympathetic nervous system (SNS), which increases the risk of cardiovascular (CV) disease and mortality. SNS overactivity increases CV risk by multiple mechanisms, including vascular stiffness. We tested the hypothesis that aerobic exercise training would reduce resting SNS activity and vascular stiffness in patients with CKD. In this randomized controlled trial, sedentary older adults with CKD underwent 12 weeks of exercise (cycling, n = 32) or stretching (an active control group, n = 26). Exercise and stretching interventions were performed 20–45 minutes/session at 3 days/week and were matched for duration. Primary endpoints include resting muscle sympathetic nerve activity (MSNA) via microneurography, arterial stiffness by central pulse wave velocity (PWV), and aortic wave reflection by augmentation index (AIx). There was a significant group × time interaction in MSNA and AIx with no change in the exercise group but with an increase in the stretching group after 12 weeks. The magnitude of change in MSNA was inversely associated with baseline MSNA in the exercise group. There was no change in PWV in either group over the study period. Our data demonstrate that 12 weeks of cycling exercise has beneficial neurovascular effects in patients with CKD. Specifically, exercise training safely and effectively ameliorated the increase in MSNA and AIx observed over time in the control group. This sympathoinhibitory effect of exercise training showed greater magnitude in patients with CKD with higher resting MSNA. ClinicalTrials.gov, NCT02947750. NIH R01HL135183; NIH R61AT10457; NIH NCATS KL2TR002381; and NIH T32 DK00756; NIH F32HL147547; and VA Merit I01CX001065.
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影响因子：
8.3
作者：
BEVAN, RD
通讯作者：
BEVAN, RD
影响因子：
8.3
作者：
Antunes-Correa, Ligia M.;Kanamura, Bianca Y.;Negrao, Carlos E.
通讯作者：
Negrao, Carlos E.
DOI：
10.1111/j.1748-1716.1972.tb05157.x
发表时间：
1972-01-01
期刊：
ACTA PHYSIOLOGICA SCANDINAVICA
影响因子：
--
作者：
DELIUS, W;HAGBARTH, KE;HONGELL, A
通讯作者：
HONGELL, A
影响因子：
19.6
作者：
BERETTAPICCOLI, C;WEIDMANN, P;REUBI, FC
通讯作者：
REUBI, FC
影响因子：
8.3
作者：
Grassi, Guido;Quarti-Trevano, Fosca;Mancia, Giuseppe
通讯作者：
Mancia, Giuseppe