{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:49:25Z","timestamp":1784072965387,"version":"3.55.0"},"reference-count":56,"publisher":"American Physiological Society","issue":"4","funder":[{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["T4938"],"award-info":[{"award-number":["T4938"]}],"id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["NA6298"],"award-info":[{"award-number":["NA6298"]}],"id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000037","name":"Gouvernement du Canada | CIHR | Institute of Health Services and Policy Research","doi-asserted-by":"publisher","award":["PJT148836"],"award-info":[{"award-number":["PJT148836"]}],"id":[{"id":"10.13039\/501100000037","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"crossref","award":["06019"],"award-info":[{"award-number":["06019"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Regulatory, Integrative and Comparative Physiology"],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:p> Muscle sympathetic nerve activity (MSNA) decreases during low-intensity dynamic one-leg exercise in healthy subjects but increases in patients with heart failure with reduced ejection fraction (HFrEF). We hypothesized that increased peak oxygen uptake (V\u0307o<jats:sub>2peak<\/jats:sub>) after aerobic training would be accompanied by less sympathoexcitation during both mild and moderate one-leg dynamic cycling, an attenuated muscle metaboreflex, and greater skin vasodilation. We studied 27 stable, treated HFrEF patients (6 women; mean age: 65\u2009\u00b1\u20092 SE yr; mean left ventricular ejection fraction: 30\u2009\u00b1\u20091%) and 18 healthy age-matched volunteers (6 women; mean age: 57\u2009\u00b1\u20092 yr). We assessed V\u0307o<jats:sub>2peak<\/jats:sub> (open-circuit spirometry) and the skin microcirculatory response to reactive hyperemia (laser flowmetry). Fibular MSNA (microneurography) was recorded before and during one-leg cycling (2 min unloaded and 2 min at 50% of V\u0307o<jats:sub>2peak<\/jats:sub>) and, to assess the muscle metaboreflex, during posthandgrip ischemia (PHGI). HFrEF patients were evaluated before and after 6 mo of exercise-based cardiac rehabilitation. Pretraining V\u0307o<jats:sub>2peak<\/jats:sub> and skin vasodilatation were lower ( P &lt; 0.001) and resting MSNA higher ( P = 0.01) in HFrEF than control subjects. Training improved V\u0307o<jats:sub>2peak<\/jats:sub> (+3.0\u2009\u00b1\u20091.0 mL\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7min<jats:sup>\u22121<\/jats:sup>; P &lt; 0.001) and cutaneous vasodilation and diminished resting MSNA (\u22126.0\u2009\u00b1\u20092.0, P = 0.01) plus exercise MSNA during unloaded (\u22124.0\u2009\u00b1\u20092.5, P = 0.04) but not loaded cycling (\u22121.0\u2009\u00b1\u20094.0 bursts\/min, P = 0.34) and MSNA during PHGI ( P &lt; 0.05). In HFrEF patients, exercise training lowers MSNA at rest, desensitizes the sympathoexcitatory metaboreflex, and diminishes MSNA elicited by mild but not moderate cycling. Training-induced downregulation of resting MSNA and attenuated reflex sympathetic excitation may improve exercise capacity and survival. <\/jats:p>","DOI":"10.1152\/ajpregu.00104.2019","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T12:29:22Z","timestamp":1564576162000},"page":"R503-R512","source":"Crossref","is-referenced-by-count":31,"title":["Training heart failure patients with reduced ejection fraction attenuates muscle sympathetic nerve activation during mild dynamic exercise"],"prefix":"10.1152","volume":"317","author":[{"given":"Catherine F.","family":"Notarius","sequence":"first","affiliation":[{"name":"Division of Cardiology, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2177-1061","authenticated-orcid":false,"given":"Philip 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