Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure
Peripheral chemoreceptors (PChRs), because of their strategic localization at the bifurcation of the common carotid artery and along the aortic arch, play an important protective role against hypoxia. Stimulation of PChRs evokes hyperventilation and hypertension to maintain adequate oxygenation of c...
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| Format: | Article |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.878363/full |
| _version_ | 1818273808464740352 |
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| author | Katarzyna Kulej-Lyko Katarzyna Kulej-Lyko Piotr Niewinski Piotr Niewinski Stanislaw Tubek Stanislaw Tubek Piotr Ponikowski Piotr Ponikowski |
| author_facet | Katarzyna Kulej-Lyko Katarzyna Kulej-Lyko Piotr Niewinski Piotr Niewinski Stanislaw Tubek Stanislaw Tubek Piotr Ponikowski Piotr Ponikowski |
| author_sort | Katarzyna Kulej-Lyko |
| collection | DOAJ |
| description | Peripheral chemoreceptors (PChRs), because of their strategic localization at the bifurcation of the common carotid artery and along the aortic arch, play an important protective role against hypoxia. Stimulation of PChRs evokes hyperventilation and hypertension to maintain adequate oxygenation of critical organs. A relationship between increased sensitivity of PChRs (hyperreflexia) and exercise intolerance (ExIn) in patients with heart failure (HF) has been previously reported. Moreover, some studies employing an acute blockade of PChRs (e.g., using oxygen or opioids) demonstrated improvement in exercise capacity, suggesting that hypertonicity is also involved in the development of ExIn in HF. Nonetheless, the precise mechanisms linking dysfunctional PChRs to ExIn remain unclear. From the clinical perspective, there are two main factors limiting exercise capacity in HF patients: subjective perception of dyspnoea and muscle fatigue. Both have many determinants that might be influenced by abnormal signalling from PChRs, including: exertional hyperventilation, oscillatory ventilation, ergoreceptor oversensitivity, and augmented sympathetic tone. The latter results in reduced muscle perfusion and altered muscle structure. In this review, we intend to present the milieu of abnormalities tied to malfunctioning PChRs and discuss their role in the complex relationships leading, ultimately, to ExIn. |
| first_indexed | 2024-12-12T22:03:51Z |
| format | Article |
| id | doaj.art-45e797af29714f1dbaa7681f6a50f995 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-12T22:03:51Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-45e797af29714f1dbaa7681f6a50f9952022-12-22T00:10:26ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-04-011310.3389/fphys.2022.878363878363Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart FailureKatarzyna Kulej-Lyko0Katarzyna Kulej-Lyko1Piotr Niewinski2Piotr Niewinski3Stanislaw Tubek4Stanislaw Tubek5Piotr Ponikowski6Piotr Ponikowski7Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, PolandDepartment of Cardiology, University Clinical Hospital, Wroclaw, PolandInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, PolandDepartment of Cardiology, University Clinical Hospital, Wroclaw, PolandInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, PolandDepartment of Cardiology, University Clinical Hospital, Wroclaw, PolandInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, PolandDepartment of Cardiology, University Clinical Hospital, Wroclaw, PolandPeripheral chemoreceptors (PChRs), because of their strategic localization at the bifurcation of the common carotid artery and along the aortic arch, play an important protective role against hypoxia. Stimulation of PChRs evokes hyperventilation and hypertension to maintain adequate oxygenation of critical organs. A relationship between increased sensitivity of PChRs (hyperreflexia) and exercise intolerance (ExIn) in patients with heart failure (HF) has been previously reported. Moreover, some studies employing an acute blockade of PChRs (e.g., using oxygen or opioids) demonstrated improvement in exercise capacity, suggesting that hypertonicity is also involved in the development of ExIn in HF. Nonetheless, the precise mechanisms linking dysfunctional PChRs to ExIn remain unclear. From the clinical perspective, there are two main factors limiting exercise capacity in HF patients: subjective perception of dyspnoea and muscle fatigue. Both have many determinants that might be influenced by abnormal signalling from PChRs, including: exertional hyperventilation, oscillatory ventilation, ergoreceptor oversensitivity, and augmented sympathetic tone. The latter results in reduced muscle perfusion and altered muscle structure. In this review, we intend to present the milieu of abnormalities tied to malfunctioning PChRs and discuss their role in the complex relationships leading, ultimately, to ExIn.https://www.frontiersin.org/articles/10.3389/fphys.2022.878363/fullperipheral chemoreceptorscarotid bodiesheart failureexercise intolerancedyspnoeamuscle fatigue |
| spellingShingle | Katarzyna Kulej-Lyko Katarzyna Kulej-Lyko Piotr Niewinski Piotr Niewinski Stanislaw Tubek Stanislaw Tubek Piotr Ponikowski Piotr Ponikowski Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure Frontiers in Physiology peripheral chemoreceptors carotid bodies heart failure exercise intolerance dyspnoea muscle fatigue |
| title | Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure |
| title_full | Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure |
| title_fullStr | Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure |
| title_full_unstemmed | Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure |
| title_short | Contribution of Peripheral Chemoreceptors to Exercise Intolerance in Heart Failure |
| title_sort | contribution of peripheral chemoreceptors to exercise intolerance in heart failure |
| topic | peripheral chemoreceptors carotid bodies heart failure exercise intolerance dyspnoea muscle fatigue |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.878363/full |
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