Limb movement-induced hyperemia has a central hemodynamic component: evidence from a neural blockade study

Trinity JD, Amann M, McDaniel J, Fjeldstad AS, Barrett-O'Keefe Z, Runnels S, Morgan DE, Wray DW, Richardson RS. Limb movement-induced hyperemia has a central hemodynamic component: evidence from a neural blockade study. Am J Physiol Heart Circ Physiol 299: H1693-H1700, 2010. First published August 27, 2010; doi:10.1152/ajpheart.00482.2010.-The purpose of this investigation was to partially remove feedback from type III/IV skeletal muscle afferents and determine how this feedback influences the central and peripheral hemodynamic responses to passive leg movement. Heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure, leg vascular conductance (LVC), and leg blood flow (LBF) were measured during 2 min of passive knee extension in eight young men before and after intrathecal fentanyl injection. Passive movement increased HR by 14 beats/min from baseline to maximal response during control (CON) (65 +/- 4 to 79 +/- 5 beats/min, P < 0.05), whereas HR did not significantly increase with the fentanyl block (BLK). LBF and LVC increased in both conditions; however, these increases were attenuated and delayed during BLK [% change from baseline to maximum, LBF: CON 295 +/- 109 vs. BLK 210 +/- 86%, (P < 0.05); LVC: CON 322 +/- 40% vs. BLK 231 +/- 32%, (P < 0.04)]. In CON, HR, SV, CO, and LVC increased contributing to the hyperemic response. However, under BLK conditions, statistically insignificant increases in HR and SV combined to yield a small, but significant, increase in CO and an attenuated hyperemic response. Therefore, partially blocking skeletal muscle afferent feedback blunts the central hemodynamic response due to passive limb movement, which then results in an attenuated and delayed movement-induced hyperemia. In combination, these findings provide evidence that limb movement-induced hyperemia has a significant central hemodynamic component induced by peripheral nerve activation.