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Metaboreflex activity in multiple sclerosis patients

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Abstract

Purpose

The muscle metaboreflex activation has been shown essential to reach normal hemodynamic response during exercise. It has been demonstrated that patients with multiple sclerosis (MS) have impaired autonomic functions and cardiovascular regulation during exercise. However, to the best of our knowledge, no previous research to date has studied the metaboreflex in MS patients. The purpose of this study was to investigate the hemodynamic response to metaboreflex activation in patients with MS (n = 43) compared to an age-matched, control group (CTL, n = 21).

Methods

Cardiovascular response during the metaboreflex was evaluated using the post-exercise muscle ischemia (PEMI) method and during a control exercise recovery (CER) test. The difference in hemodynamics between the PEMI and the CER test was calculated and this procedure allowed for the assessment of the metaboreflex response. Hemodynamics was estimated by impedance cardiography.

Results

The MS group showed a normal mean blood pressure (MBP) response as compared to the CTL group (+6.5 ± 6.9 vs. +8±6.8 mmHg, respectively), but this response was achieved with an increase in systemic vascular resistance, that was higher in the MS with respect to the CTL group (+137.6 ± 300.5 vs. −14.3 ± 240 dyne·s−1 cm−5, respectively). This was the main consequence of the MS group’s incapacity to raise the stroke volume (−0.65 ± 10.6 vs. +6.2 ± 12.8 ml, respectively).

Conclusion

It was concluded that MS patients have an impaired capacity to increase stroke volume (SV) in response to low level metaboreflex, even if they could sustain the MBP response by vasoconstriction. This was probably a consequence of their chronic physical de-conditioning.

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Abbreviations

CER:

Control exercise-recovery

CO:

Cardiac output

CPT:

Cardiopulmonary test

CTL:

Controls subjects

DBP:

Diastolic blood pressure

DT:

Diastolic time

EDSS:

Expanded disability status scale

HF:

High frequency component of the HR power spectral analysis

HR:

Heart rate

HRmax :

Maximum heart rate

LF:

Low frequency component of the HR power spectral analysis

MBP:

Mean blood pressure

MS:

Multiple sclerosis

PEMI:

Post-exercise muscle ischemia

PEP:

Pre-ejection period

SBP:

Systolic blood pressure

SV:

Stroke volume

SVR:

Systemic vascular resistance

VET:

Ventricular ejection time

VFR:

Ventricular filling rate

VO2max :

Maximum oxygen uptake

Z0:

Thorax impedance

Wmax :

Maximum workload

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Acknowledgments

This study was supported by the University of Cagliari, the Regione Sardegna (legge regionale n°7 Agosto 2007, annualità 2011), and the Italian Ministry of Scientific Research. The authors wish to thank Mr. Barry Mark Wheaton for his editorial assistance.

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Correspondence to Antonio Crisafulli.

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The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

Ethical standards

Each subject gave written informed consent to take part in the study, which was approved by the local ethical committee and conforms to the principles of the declaration of Helsinki.

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Communicated by Massimo Pagani.

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Marongiu, E., Olla, S., Magnani, S. et al. Metaboreflex activity in multiple sclerosis patients. Eur J Appl Physiol 115, 2481–2490 (2015). https://doi.org/10.1007/s00421-015-3271-0

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