Exercise Intolerance in Heart Failure: Did We Forget the Brain?
Patrice Brassard1, Finn Gustafsson2
1Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada; Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Québec, Canada.
The Canadian Journal of Cardiology
|February 15, 2016
Summary
Heart failure (HF) patients have reduced exercise tolerance due to complex mechanisms. Lowered cerebral blood flow (CBF) and oxygenation, not just cardiac output, are key limiting factors in HF exercise intolerance.
Area of Science:
- Cardiology
- Neurology
- Exercise Physiology
Background:
- Heart failure (HF) significantly impairs exercise tolerance.
- Traditionally, reduced cardiac output was the main explanation for exercise intolerance in HF.
- Emerging evidence points to more complex pathophysiological mechanisms.
Purpose of the Study:
- To review cardiac and noncardiac mechanisms of exercise intolerance in HF.
- To explore the influence of HF on cerebral blood flow (CBF) and oxygenation.
- To suggest future research directions regarding the brain's role in HF exercise intolerance.
Main Methods:
- Overview of cardiac and peripheral responses to exercise in healthy individuals.
- Review of cardiac and noncardiac mechanisms in HF-related exercise intolerance.
- Analysis of HF, comorbidity, and treatment effects on CBF and oxygenation.
Main Results:
- Exercise intolerance in HF involves more than just cardiac dysfunction.
- Reduced cerebral blood flow (CBF) and oxygenation are identified as critical limiting factors.
- HF, comorbidities, and treatments impact brain circulation during rest and exercise.
Conclusions:
- Cerebral factors play a significant role in exercise limitation in heart failure patients.
- Understanding the brain's role is crucial for developing effective interventions.
- Further research is needed to fully elucidate the brain's contribution to HF exercise intolerance.
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