The exercise pressor reflex – a pressure‐raising mechanism with a limited role in regulating leg perfusion during locomotion in young healthy men
Authors: Thurston Taylor S. , Weavil Joshua C. , Georgescu Vincent P. , Wan Hsuan‐Yu , Birgenheier Nathaniel M. , Morrissey Candice K. , Jessop Jacob E. , Amann Markus 
Published: September 2023

We investigated the role of the exercise pressor reflex (EPR) in regulating the haemodynamic response to locomotor exercise. Eight healthy participants (23 ± 3 years, : 49 ± 6 ml/kg/min) performed constant‐load cycling exercise (∼36/43/52/98% ; 4 min each) without (CTRL) and with (FENT) lumbar intrathecal fentanyl attenuating group III/IV locomotor muscle afferent feedback and, thus, the EPR. To avoid different respiratory muscle metaboreflex and arterial chemoreflex activation during FENT, subjects mimicked the ventilatory response recorded during CTRL. Arterial and leg perfusion pressure (femoral arterial and venous catheters), femoral blood flow (Doppler‐ultrasound), microvascular quadriceps blood flow index (indocyanine green), cardiac output (inert gas breathing), and systemic and leg vascular conductance were quantified during exercise. There were no cardiovascular and ventilatory differences between conditions at rest. Pulmonary ventilation, arterial blood gases and oxyhaemoglobin saturation were not different during exercise. Furthermore, cardiac output (−2% to −12%), arterial pressure (−7% to −15%) and leg perfusion pressure (−8% to −22%) were lower, and systemic (up to 16%) and leg (up to 27%) vascular conductance were higher during FENT compared to CTRL. Leg blood flow, microvascular quadriceps blood flow index, and leg O2‐transport and utilization were not different between conditions (P > 0.5). These findings reflect a critical role of the EPR in the autonomic control of the heart, vasculature and, ultimately, arterial pressure during locomotor exercise. However, the lack of a net effect of the EPR on leg blood flow challenges the idea of this cardiovascular reflex as a key determinant of leg O2‐transport during locomotor exercise in healthy, young individuals.

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Key points

The role of the exercise pressor reflex (EPR) in regulating leg O2‐transport during human locomotion remains uncertain.

We investigated the influence of the EPR on the cardiovascular response to cycling exercise.

Lumbar intrathecal fentanyl was used to block group III/IV leg muscle afferents and debilitate the EPR at intensities ranging from 30% to 100% .

To avoid different respiratory muscle metaboreflex and arterial chemoreflex activation during exercise with blocked leg muscle afferents, subjects mimicked the ventilatory response recorded during control exercise.

Afferent blockade increased leg and systemic vascular conductance, but reduced cardiac output and arterial‐pressure, with no net effect on leg blood flow.

The EPR influenced the cardiovascular response to cycling exercise by contributing to the autonomic control of the heart and vasculature, but did not affect leg blood flow.

These findings challenge the idea of the EPR as a key determinant of leg O2‐transport during locomotor exercise in healthy, young individuals.