A differing role of oxidative stress in the regulation of central and peripheral hemodynamics during exercise in heart failure
A differing role of oxidative stress in the regulation of central and peripheral hemodynamics during exercise in heart failure
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DOI：
10.1152/ajpheart.00568.2012
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发表时间：
2012-11-01
影响因子：
4.8
通讯作者：
Richardson, Russell S.
中科院分区：
文献类型：
--
作者：
Witman, Melissa A. H.;McDaniel, John;Richardson, Russell S.
Witman MA，McDaniel J，Fjeldstad AS，伊韦斯SJ，Zhao J，Nativi JN，Stehlik J，Wray DW，Richardson RS.氧化应激在心力衰竭患者运动期间中枢和外周血流动力学调节中的不同作用。美国生理学杂志心脏循环生理学303：H1237-H1244，2012年。首次发表于2012年9月7日; doi：10.1152/ajpheart.00568.2012.-本研究旨在描述自由基在心力衰竭（HF）患者静息和运动时调节中枢和外周血流动力学中的作用。我们研究了心血管反应的动态握力运动（4，8和12公斤，1赫兹）后，消费的安慰剂或急性口服抗氧化剂鸡尾酒（AOC）组成的维生素C，E，和α-硫辛酸在平衡，交叉设计。在10名HF患者和10名年龄匹配的对照组中测定了中心和外周血流动力学、平均动脉压、心脏指数、全身血管阻力（SVR）、肱动脉血流和外周（手臂）血管阻力（PVR）。血液分析评估了氧化应激的标志物和AOC的功效。与对照组相比，HF患者表现出更大的氧化应激（通过丙二醛测量）（+36%）和内源性抗氧化剂补偿的证据（通过更大的超氧化物歧化酶活性测量）（+83%）。AOC增加了HF患者和对照组的血浆抗坏血酸（+50%），但显著的全身血流动力学效应仅在HF患者中明显，无论是在休息时还是在整个运动过程中。具体而言，AOC降低了平均动脉压（-5%）和SVR（-12%），并在每个工作负荷下增加了心脏指数（+7%）。相比之下，AOC对外周、肱动脉血流和PVR（手臂）无影响。总之，这些数据意味着HF患者的SVR至少部分由氧化应激介导。然而，这一发现似乎不是PVR肌肉特异性变化的直接结果。
Witman MA, McDaniel J, Fjeldstad AS, Ives SJ, Zhao J, Nativi JN, Stehlik J, Wray DW, Richardson RS. A differing role of oxidative stress in the regulation of central and peripheral hemodynamics during exercise in heart failure. Am J Physiol Heart Circ Physiol 303: H1237-H1244, 2012. First published September 7, 2012; doi:10.1152/ajpheart.00568.2012.-This study sought to characterize the role of free radicals in regulating central and peripheral hemodynamics at rest and during exercise in patients with heart failure (HF). We examined cardiovascular responses to dynamic handgrip exercise (4, 8, and 12 kg at 1 Hz) following consumption of either a placebo or acute oral antioxidant cocktail (AOC) consisting of vitamin C, E, and alpha-lipoic acid in a balanced, crossover design. Central and peripheral hemodynamics, mean arterial pressure, cardiac index, systemic vascular resistance (SVR), brachial artery blood flow, and peripheral (arm) vascular resistance (PVR) were determined in 10 HF patients and 10 age-matched controls. Blood assays evaluated markers of oxidative stress and efficacy of the AOC. When compared with controls, patients with HF exhibited greater oxidative stress, measured by malondialdehyde (+36%), and evidence of endogenous antioxidant compensation, measured by greater superoxide dismutase activity (+83%). The AOC increased plasma ascorbate (+50%) in both the HF patients and controls, but significant systemic hemodynamic effects were only evident in the patients with HF, both at rest and throughout exercise. Specifically, the AOC reduced mean arterial pressure (-5%) and SVR (-12%) and increased cardiac index (+7%) at each workload. In contrast, peripherally, brachial artery blood flow and PVR (arm) were unchanged by the AOC. In conclusion, these data imply that SVR in patients with HF is, at least in part, mediated by oxidative stress. However, this finding does not appear to be the direct result of muscle-specific changes in PVR.