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Chemoreflex model parameters measurement.

R M Mohan·C E Amara·P Vasiliou·E P Corriveau·D A Cunningham·J Duffin
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R M Mohan, C E Amara, P Vasiliou, E P Corriveau, D A Cunningham, J Duffin. 1998. Chemoreflex model parameters measurement.. https://doi.org/10.1007/978-1-4757-9077-1_30

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Reproducibility of the measurement of the muscle ergoreflex activity in chronic heart failure.

BACKGROUND: A causative role for symptom generation in heart failure has been attributed to overactive muscle afferents, metaboreflex and mechanoreflex. We examined the reproducibility of the methods commonly used to assess these reflexes. MATERIAL AND METHODS: Twelve stable heart failure patients (62.8+/-2.4 years) and 18 normals were studied. The metaboreflex was evaluated on both leg and arm exercises, by performing two runs of 5-min submaximal handgrip and leg exercises. On one run the subjects recovered normally (control recovery), while on the other a post-exercise regional circulatory occlusion (PE-RCO) was induced in the exercising limb, to isolate the stimulation of the metaboreceptor after exercise. The metaboreflex was quantified as the difference in ventilation between the PE-RCO and the control recovery periods with respect to rest. The existence of a mechanoreflex was sought by comparing the ventilatory increment per unit of active work (dV(E)/dVO(2) ratio) between leg passive movement and active low level exercise. The coefficients of variation (CV) were computed to express the reproducibility of these reflexes in heart failure. RESULTS: The metaboreflex was overactive in patients vs. normals during both arm (7.2+/-2.8 l/min vs. 0.06+/-0.3 l/min) and leg (5.6+/-1.2 l/min vs. 0.5+/-0.2 l/min) tests. The mechanoreflex was not different between patients and normals: dV(E)/dVO(2) during passive movement 48.9+/-18.3 and 22.4+/-26.5; active exercise 42.3+/-18.4 and 31.9+/-18.7 (P=NS). In patients, the CV for the metaboreflex was 23.4% in the arm and 35.3% in the leg, while for the mechanoreflex test CV was 38.1% during passive movement and 21.1% during active exercise. CONCLUSION: The described method of measuring the muscle reflex activity shows an adequate reproducibility in heart failure patients.

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We propose a mathematical model based on the occupation theory and on the hypothesis that, for a given stimulus, there exist two kinds of receptors. The receptors of the first kind react by a two-step process, first forming an intermediate inactive compound which is then changed into an active depolarizing form (this scheme was already used by Del Castillo & Katz, 1957). In the same way, the receptors of the second kind react by a two-step process, first forming an intermediate inactive compound which is then changed into an active hyperpolarizing form. The response is assumed to be proportional to the difference between the fraction of the active depolarizing compound and that of the active hyperpolarizing compound. The present paper deals only with the time course of the intensity of the response: in the first part, when a continuous flow of stimulus is applied and in the second part, when this continuous flow is removed. It does not deal with the quality and the discrimination of odours. The proposed mathematical model accounts for the depolarizing responses (which are the most frequent ones), the hyperpolarizing responses, the mixed responses reported by Patte et al. (1989), the off-responses reported by Takagi & Shibuya (1959) and for their variability, and the latent period in the olfactory response (Ottoson, 1974).

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