title: Chronic heart failure does not attenuate the total activity of sympathetic outflow to skin during whole-body heating.
abstract: BACKGROUND
  Previous studies show that the rise in skin blood flow and cutaneous vascular conductance during heat stress is substantially attenuated in chronic heart failure (CHF) patients. The mechanisms responsible for this finding are not clear. In particular, little is known regarding the responses of skin sympathetic nerve activity (SSNA) that control the skin blood flow during heat stress in CHF patients. We examined the effects of a modest heat stress to test the hypothesis that SSNA responses could be attenuated in CHF.
  
  
  RESULTS
  We assessed SSNA (microneurography) from the peroneal nerve and skin blood flow (forearm laser Doppler) in 9 patients with stable class II-III CHF and in matched healthy subjects during passive whole-body heating with a water-perfused suit. Whole-body heating induced similar increases in internal temperature (≈0.6 °C) in both groups. Whole-body heat stress evoked similar SSNA activation in CHF patients (Δ891±110 U/min) and the control subjects (Δ787±84 U/min; P=0.66), whereas the elevation in forearm cutaneous vascular conductance in patients with CHF was significantly lower than that in healthy control subjects (Δ131±29% vs. Δ623±131%; P=0.001).
  
  
  CONCLUSIONS
  The present data show that SSNA activation during a modest whole-body heat stress is not attenuated in CHF. Thus, the attenuated skin vasodilator response in CHF patients is not attributable to a reduction in total activity of sympathetic outflow to skin.
authors: Penn State Hershey Heart and Vascular Institute, Hershey, PA 17033, USA.
authors: Jian
authors: J
authors: Cui
authors: John P
authors: JP
authors: Boehmer
authors: Cheryl
authors: C
authors: Blaha
authors: Robert
authors: R
authors: Lucking
authors: Allen R
authors: AR
authors: Kunselman
authors: Lawrence I
authors: LI
authors: Sinoway
mesh_terms: D001794:Blood Pressure; D001808:Blood Vessels / Q000294:innervation*; D001833:Body Temperature Regulation; D016022:Case-Control Studies; D002908:Chronic Disease; D005542:Forearm; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate; D018882:Heat Stress Disorders / Q000503:physiopathology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D010543:Peroneal Nerve / Q000503:physiopathology; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply* / Q000294:innervation*; D013546:Sweating; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013997:Time Factors; D014664:Vasodilation
references: Am J Med Sci. 1961 Oct;242:468-74
references: 13885529
references: J Appl Physiol (1985). 2008 Dec;105(6):1873-6
references: 18845779
references: Physiol Rev. 1979 Oct;59(4):919-57
references: 227005
references: J Appl Physiol (1985). 2010 Jun;108(6):1575-81
references: 20360429
references: J Appl Physiol (1985). 1987 Sep;63(3):930-6
references: 2820920
references: Nature. 1980 Apr 10;284(5756):515-21
references: 6154244
references: Clin Sci (Lond). 2003 Dec;105(6):699-707
references: 12848618
references: Clin Transplant. 1998 Aug;12(4):324-32
references: 9686327
references: J Appl Physiol (1985). 1989 Apr;66(4):1586-92
references: 2732150
references: J Appl Physiol (1985). 1998 May;84(5):1551-9
references: 9572798
references: Circulation. 1994 Oct;90(4):1794-8
references: 7923664
references: J Am Coll Cardiol. 1992 Apr;19(5):918-25
references: 1552112
references: Auton Neurosci. 2002 May 31;97(2):122-8
references: 12132645
references: N Engl J Med. 1996 Jul 11;335(2):84-90
references: 8649494
references: Am J Physiol. 1989 Nov;257(5 Pt 2):H1599-606
references: 2589514
references: Am J Cardiol. 1992 Jun 15;69(19):1596-601
references: 1598876
references: Eur J Heart Fail. 2002 Dec;4(6):779-86
references: 12453550
references: Circ Res. 1995 Dec;77(6):1222-8
references: 7586235
references: Am J Physiol. 1995 Dec;269(6 Pt 2):H1973-80
references: 8594906
references: Circulation. 1996 Jan 15;93(2):210-4
references: 8548890
references: J Physiol. 1980 Sep;306:537-52
references: 7463376
references: J Physiol. 1957 May 23;136(3):489-97
references: 13429515
references: Med Sci Sports Exerc. 1998 Mar;30(3):468-72
references: 9526896
references: J Physiol. 1957 Dec 31;139(3):455-65
references: 13492236
references: N Engl J Med. 1984 Sep 27;311(13):819-23
references: 6382011
references: J Clin Invest. 1968 Apr;47(4):960-70
references: 5641631
references: Eur Heart J. 2006 Feb;27(3):338-43
references: 16299022
references: J Appl Physiol. 1975 Jan;38(1):58-63
references: 1110244
references: Med Sci Sports Exerc. 1990 Apr;22(2):222-8
references: 2355819
references: J Appl Physiol (1985). 1987 Apr;62(4):1448-52
references: 2885298
references: Auton Neurosci. 2004 Nov 30;116(1-2):54-61
references: 15556838
references: Am J Physiol Heart Circ Physiol. 2006 Apr;290(4):H1601-9
references: 16306217
references: Circulation. 2005 Oct 11;112(15):2286-92
references: 16216975
references: Circulation. 1995 May 15;91(10):2582-90
references: 7743620
references: J Physiol. 2001 Oct 15;536(Pt 2):615-23
references: 11600694
references: Acta Physiol Scand. 1972 Feb;84(2):164-76
references: 5015184
references: Circulation. 1995 Dec 1;92(11):3212-9
references: 7586306
references: J Appl Physiol (1985). 1986 Nov;61(5):1701-5
references: 3023274
references: Circulation. 1991 Oct;84(4):1589-96
references: 1914099
references: J Invest Dermatol. 1977 Jul;69(1):154-66
references: 326990
references: Circulation. 2003 Aug 12;108(6):729-35
references: 12885757
references: Int Arch Occup Environ Health. 2006 Oct;80(1):16-24
references: 16523319
references: Hypertension. 1998 Jan;31(1):64-7
references: 9449392
references: Am J Physiol. 1981 Apr;240(4):H571-5
references: 7223909
references: Circulation. 1995 Dec 1;92(11):3206-11
references: 7586305