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First published online on November 10, 2005.
Experimental Physiology (2005)
DOI: 10.1113/expphysiol.2005.032367
© The Physiological Society 2005
A more recent version of this article appeared on January 1, 2006
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Received September 28, 2005
Revised October 18, 2005
Accepted after revision October 25, 2005

Cardiovascular control

The Exercise Pressor Reflex in Health and Disease

Scott A Smith 1, Jere H Mitchell 1, Mary G Garry 1*

1 University of Texas Southwestern Medical Center

* To whom correspondence should be addressed. E-mail: mary.garry{at}utsouthwestern.edu.


  Abstract
The exercise pressor reflex (a peripheral neural reflex originating in skeletal muscle) contributes significantly to the regulation of the cardiovascular system during exercise. Exercise induced signals which comprise the afferent arm of the reflex are generated by activation of mechanically (muscle mechanoreflex) and chemically (muscle metaboreflex) sensitive skeletal muscle receptors. Activation of these receptors and their associated afferent fibers reflexively adjusts sympathetic and parasympathetic nerve activity during exercise. In heart failure, the cardiovascular response to exercise is augmented. Due to the peripheral skeletal myopathy that develops in heart failure (e.g. muscle atrophy, decreased peripheral blood flow, fiber-type transformation, and reduced oxidative capacity), the exercise pressor reflex has been implicated as a possible mechanism by which the cardiovascular response to physical activity is exaggerated in this disease. Accumulating evidence supports this conclusion. This review focuses, therefore, on the role of the exercise pressor reflex in regulating the cardiovascular system during exercise in both health and disease. Updates on our current understanding of the exercise pressor reflex neural pathway as well as experimental models used to study this reflex are presented. In addition, special emphasis is placed on the changes in exercise pressor reflex activity that develop in heart failure; including the contributions of the muscle mechanoreflex and metaboreflex to this pressor reflex dysfunction.

Key Words: Cardiovascular, Exercise, Reflex




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