Key result
Diaphragm relaxation is a complex physiological process regulated by calcium removal and cross-bridge dynamics, and its impairment serves as an early index of respiratory muscle fatigue.
This review highlights the physiological mechanisms of diaphragm muscle relaxation, emphasizing the role of calcium handling and its implications for respiratory muscle fatigue.
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Advances molecular models of diaphragm relaxation; leaves open clinical validation for fatigue assessment in respiratory disease.
Relaxation is the process by which, after contraction, the muscle actively returns to its initial conditions of length and load. In rhythmically active muscles such as diaphragm, relaxation is of physiological importance because diaphragm must return to a relatively constant resting position at the end of each contraction-relaxation cycle. Rapid and complete relaxation of the diaphragm is likely to play an important role in adaptation to changes in respiratory load and breathing frequency. Regulation of diaphragm relaxation at the molecular and cellular levels involves Ca(2+) removal from the myofilaments, active Ca(2+) pumping by the sarcoplasmic reticulum (SR), and decrease in the number of working cross bridges. The relative contribution of these mechanisms mainly depends on sarcomere length, muscle tension, and the intrinsic contractile function. Increased capacity of SR to take up Ca(2+) can arise from increased density of active SR pumping sites or in slow-twitch fibers from phosphorylation of phospholamban, whereas impaired coupling between ATP hydrolysis and Ca(2+) transport into the SR or intracellular acidosis reduces SR Ca(2+) pump activity. In experimental conditions of decreased contractile performance, slowed, enhanced, or unchanged relaxation rates have been reported in vitro. In vivo, a slowing in the rate of decline of the respiratory pressure is generally considered an early reliable index of respiratory muscle fatigue. Impaired relaxation rate may, in turn, favor mismatch between blood flow and metabolic demand, especially at high breathing frequencies.
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Coirault et al. (1999) conducted a review in Diaphragm muscle relaxation and respiratory muscle fatigue. Diaphragm relaxation is a complex physiological process regulated by calcium removal and cross-bridge dynamics, and its impairment serves as an early index of respiratory muscle fatigue.
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