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. 2020 Feb 11;27(17):1862–1872. doi: 10.1177/2047487320906919

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© The European Society of Cardiology 2020

This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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Figure 1. — Putative mechanisms responsible for the exercise intolerance and early fatigue induced by type III/IV afferent feedback in chronic heart failure. Abnormal central haemodynamics initiate a cascade which ultimately results in an increase in III/IV afferent feedback activity. It is to be emphasised that physical training may potentially counteract this malfunctioning at various levels, while, to date, no pharmacological intervention has been demonstrated to be able to correct this abnormal regulation.