The long-range goal of the PI is to better understand the mechanisms that regulate the autonomic responses during exercise in normal subjects and in patients with heart failure (HF). It is known that sympathetic nervous system activity is increased with exercise in normal subjects and is increased in HF subjects at rest and in response to exercise. Heightened peripheral sympathetic nerve activity and the resultant increased neurovascular levels of norepinephrine (NE) evoke vasoconstriction. In this proposal, we will measure interstitial concentrations of NE with the microdialysis method. Interstitial concentrations of NE provide an outstanding index of NE concentrations at the neurovascular junction. The proposed experiments are based on recently published studies from our laboratory as well as pilot data that have been gathered over the past year. The first and second specific aims are to examine the mechanisms for the rise in interstitial NE (NEi) and adenosine triphosphate (ATPi) in exercising muscle. We will examine if enhanced NEi is due to: 1) activation of the sympathetic nerves; 2) an ATP mediated increase in NE release; and/or 3) an ATP mediated inhibition of neuronal re-uptake of NE (uptake 1). Our data suggests that ATPi concentrations in skeletal muscle rise with muscle contraction. We hypothesize that elevated ATP increases NEi by activation of P2X receptors on the sympathetic efferent nerves, and/or by inhibition of uptake 1. The third and fourth specific aims are to examine why NEi and ATPi are higher in skeletal muscle of rats with congestive heart failure (myocardial infarctions model). We will examine if higher levels of NEi in HF rats are due to: 1) an increase in NE release by sympathetic nerve; 2) an impairment of uptake 1; 3) an inhibition of uptake 1 by elevated ATP; or 4) to activation of sympathetic nerve terminal P2X receptors by ATP. The fifth specific aim is to determine if interstitial NE and ATP change as a function of time after the myocardial infarct that induces HF. These experiments will examine ATP and NE at rest, during muscle contraction, and during muscle stretch. A key feature of this proposal is that microdialysis techniques will be used to: 1) determine NEi and ATPi; and 2) deliver specific substances to the interstitial space. Our laboratory has substantial expertise with these methods. To the best of our knowledge, experiments such as these have never been performed in a HF model. Completion of these studies in this proposal will provide a systematic evaluation of circulatory regulation during exercise in an important cardiovascular disease. ? ?

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Cardiac Contractility, Hypertrophy, and Failure Study Section (CCHF)
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Varghese, Jamie
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Pennsylvania State University
Internal Medicine/Medicine
Schools of Medicine
United States
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