Blunted blood pressure response to exercise and isolated muscle metaboreflex activation in patients with cirrhosis

• Published in: Applied physiology, nutrition, and metabolism Vol. 46; no. 3; pp. 273 - 279
• Main Authors: Mira, Pedro Augusto de Carvalho, Falci, Maria Fernanda Almeida, Moreira, Janaína Becari, Guerrero, Rosa Virginia Diaz, Ribeiro, Tarsila Campanha da Rocha, Barbosa, Kátia Valéria Bastos Dias, Pace, Fábio Heleno Lima, Martinez, Daniel Godoy, Laterza, Mateus Camaroti
• Format: Journal Article
• Language: English
• Published: 1840 Woodward Drive, Suite 1, Ottawa, ON K2C 0P7 NRC Research Press 01.03.2021; Canadian Science Publishing NRC Research Press
• Subjects: activation du métaboréflexe musculaire isolé; Blood pressure; blood vessels; cirrhose; exercice physique; Exercise; Exercise physiology; Health aspects; Ischemia; ischémie postexercice; isolated muscle metaboreflex activation; Liver cirrhosis; Metabolism; Muscle function; Physiological aspects; Physiological research; postexercise ischemia; tension artérielle; vaisseaux sanguins; Brazil; blood pressure; isolated muscle metaboreflex activation; exercice physique; postexercise ischemia; blood vessels; ischémie postexercice; exercise; tension artérielle; activation du métaboréflexe musculaire isolé; cirrhose; vaisseaux sanguins; liver cirrhosis
• ISSN: 1715-5312; 1715-5320
• DOI: 10.1139/apnm-2020-0407

We sought to test the hypothesis that the cardiovascular responses to isolated muscle metaboreflex activation would be blunted in patients with cirrhosis. Eleven patients with cirrhosis and 15 healthy controls were evaluated. Blood pressure (BP; oscillometric method), contralateral forearm blood flow (FBF; venous occlusion plethysmography), and heart rate (HR; electrocardiogram) were measured during baseline, isometric handgrip at 30% of maximal voluntary contraction followed by postexercise ischemia (PEI). Forearm vascular conductance (FVC) was calculated as follows: (FBF / mean BP) × 100. Changes in HR during handgrip were similar between groups but tended to be different during PEI (controls: Δ 0.5 ± 1.1 bpm vs. cirrhotic patients: Δ 3.6 ± 1.0 bpm, P = 0.057). Mean BP response to handgrip (controls: Δ 20.9 ± 2.7 mm Hg vs. cirrhotic patients: Δ 10.6 ± 1.5 mm Hg, P = 0.006) and PEI was attenuated in cirrhotic patients (controls: Δ 16.1 ± 1.9 mm Hg vs. cirrhotic patients: Δ 7.2 ± 1.4 mm Hg, P = 0.001). In contrast, FBF and FVC increased during handgrip and decreased during PEI similarly between groups. These results indicate that an abnormal muscle metaboreflex activation explained, at least partially, the blunted pressor response to exercise exhibited by cirrhotic patients. Novelty: Patients with cirrhosis present abnormal muscle metaboreflex activation. BP response was blunted but forearm vascular response was preserved. HR response was slightly elevated.