{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T22:44:23Z","timestamp":1769121863507,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The muscular metaboreflex, whose activation regulates blood flow during isometric and aerobic exercise, is blunted in patients with heart failure (HF), and cardiac resynchronization therapy (CRT) may restore this regulatory reflex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate metaboreflex responses after CRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirteen HF patients and 12 age\u2010matched healthy control subjects underwent the following evaluations (pre\u2010 and post\u2010CRT implantation in the patient group): (a) heart rate, blood pressure, and forearm blood flow measurements; (b) muscle sympathetic nerve activity (MSNA) evaluation; and (c) peak oxygen consumption (VO<jats:sub>2peak<\/jats:sub>). Examinations were performed at rest, during moderate isometric exercise (IE), and during forearm ischemia (metaboreflex activation). The primary outcome was the increment in MSNA during limb ischemia compared to the rest moment (\u0394MSNA rest to metaboreflex activation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After CRT, rest MSNA decreased in the HF participants: 50.4 \u00b1 9.2 bursts\/min pre\u2010CRT vs 34.0 \u00b1 14.4 bursts\/min post\u2010CRT, <jats:italic>P<\/jats:italic> = .001, accompanied by an improvement in systolic blood pressure and in rate\u2010pressure product. MSNA during limb ischemia decreased: 56.6 \u00b1 11.5 bursts\/min pre\u2010CRT vs 43.6 \u00b1 12.7 bursts\/min post\u2010CRT, <jats:italic>P<\/jats:italic> = .001, and the \u0394MSNA rest to metaboreflex activation increased: 0% (interquartile range [IQR)], \u22127 to 9) vs 13% (IQR, 5\u201030), <jats:italic>P<\/jats:italic> = .03. An augmentation of mean blood pressure during limb ischemia post\u2010CRT was noticed: 94\u2009mmHg (IQR, 81\u2010104) vs 110\u2009mmHg (IQR, 100\u2010117), <jats:italic>P<\/jats:italic> = .04. CRT improved VO<jats:sub>2peak<\/jats:sub>, and this improvement was correlated with diminution in \u0394MSNA pre\u2010 to post\u2010CRT at rest moment (r<jats:sub>s<\/jats:sub> = \u20100.74, <jats:italic>P<\/jats:italic> = .006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CRT provides metaboreflex sensitization and MSNA enhancement. The restoration of sympathetic responsiveness correlates with the improvement in functional capacity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14195","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T04:14:00Z","timestamp":1569212040000},"page":"2591-2598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cardiac resynchronization therapy restores muscular metaboreflex control"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-1621","authenticated-orcid":false,"given":"Caio V.","family":"Spaggiari","sequence":"first","affiliation":[{"name":"Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo R.","family":"Kuniyoshi","sequence":"additional","affiliation":[{"name":"Centrocor Cardilogia Vit\u00f3ria Esp\u00edrito Santo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00edgia M.","family":"Antunes\u2010Correa","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphaela V.","family":"Groehs","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9rgio F.","family":"de Siqueira","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martino","family":"Martinelli Filho","sequence":"additional","affiliation":[{"name":"Department of Artificial Cardiac Stimulation and Department of Cardiac Rehabilitation, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"e_1_2_6_1_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.5.2034"},{"key":"e_1_2_6_1_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00136.2014"},{"key":"e_1_2_6_1_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.2001.280.3.H1286"},{"key":"e_1_2_6_1_5_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1937.sp003485"},{"key":"e_1_2_6_1_6_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1989.sp017787"},{"key":"e_1_2_6_1_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00008.2007"},{"key":"e_1_2_6_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.02.030"},{"key":"e_1_2_6_1_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl099"},{"key":"e_1_2_6_1_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441202"},{"key":"e_1_2_6_1_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000065226.24159.E9"},{"key":"e_1_2_6_1_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12254"},{"key":"e_1_2_6_1_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_6_1_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht150"},{"key":"e_1_2_6_1_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi146"},{"key":"e_1_2_6_1_16_1","first-page":"17","volume-title":"Cardiopulmonary Exercise Testing and Cardiovascular Health","author":"Cohen\u2010Solal A","year":"1996"},{"key":"e_1_2_6_1_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1979.59.4.919"},{"key":"e_1_2_6_1_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.2_Suppl.S36"},{"key":"e_1_2_6_1_19_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/914071"},{"key":"e_1_2_6_1_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.2010.02133.x"},{"key":"e_1_2_6_1_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2005.03.002"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjce.14195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.14195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T16:25:46Z","timestamp":1693844746000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.14195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,30]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/jce.14195"],"URL":"https:\/\/doi.org\/10.1111\/jce.14195","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,30]]},"assertion":[{"value":"2019-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}