351
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Scott SN, Shepherd SO, Hopkins N, Dawson EA, Strauss JA, Wright DJ, Cooper RG, Kumar P, Wagenmakers AJM, Cocks M. Home‐hit improves muscle capillarisation and eNOS/NAD(P)Hoxidase protein ratio in obese individuals with elevated cardiovascular disease risk. J Physiol 2019; 597:4203-4225. [DOI: 10.1113/jp278062] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/05/2019] [Indexed: 12/17/2022] Open
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352
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Muller PDT, Barbosa GW, O'Donnell DE, Neder JA. Cardiopulmonary and Muscular Interactions: Potential Implications for Exercise (In)tolerance in Symptomatic Smokers Without Chronic Obstructive Pulmonary Disease. Front Physiol 2019; 10:859. [PMID: 31354517 PMCID: PMC6635481 DOI: 10.3389/fphys.2019.00859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/20/2019] [Indexed: 12/15/2022] Open
Abstract
Smoking and physical inactivity are important preventable causes of disability and early death worldwide. Reduced exercise tolerance has been described in smokers, even in those who do not fulfill the extant physiological criteria for chronic obstructive pulmonary disease (COPD) and are not particularly sedentary. In this context, it is widely accepted that exercise capacity depends on complex cardio-pulmonary interactions which support oxygen (O2) delivery to muscle mitochondria. Although peripheral muscular factors, O2 transport disturbances (including the effects of increased carboxyhemoglobin) and autonomic nervous system unbalance have been emphasized, other derangements have been more recently described, including early microscopic emphysema, pulmonary microvascular disease, ventilatory and gas exchange inefficiency, and left ventricular diastolic dysfunction. Using an integrative physiological approach, the present review summarizes the recent advances in knowledge on the effects of smoking on the lung-heart-muscle axis under the stress of exercise. Special attention is given to the mechanisms connecting physiological abnormalities such as early cardio-pulmonary derangements, inadequate oxygen delivery and utilization, and generalized bioenergetic disturbances at the muscular level with the negative sensations (sense of heightened muscle effort and breathlessness) that may decrease the tolerance of smokers to physical exercise. A deeper understanding of the systemic effects of smoking in subjects who did not (yet) show evidences of COPD and ischemic heart disease - two devastating smoking related diseases - might prove instrumental to fight their ever-growing burden.
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Affiliation(s)
- Paulo de Tarso Muller
- Laboratory of Respiratory Pathophysiology, Respiratory Division, Department of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Gisele Walter Barbosa
- Laboratory of Respiratory Pathophysiology, Respiratory Division, Department of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Denis E O'Donnell
- Laboratory of Clinical Exercise Physiology, Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada
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353
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Vogel J, Niederer D, Engeroff T, Vogt L, Troidl C, Schmitz-Rixen T, Banzer W, Troidl K. Effects on the Profile of Circulating miRNAs after Single Bouts of Resistance Training with and without Blood Flow Restriction-A Three-Arm, Randomized Crossover Trial. Int J Mol Sci 2019; 20:E3249. [PMID: 31269677 PMCID: PMC6651802 DOI: 10.3390/ijms20133249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The effects of blood flow restriction (training) may serve as a model of peripheral artery disease. In both conditions, circulating micro RNAs (miRNAs) are suggested to play a crucial role during exercise-induced arteriogenesis. We aimed to determine whether the profile of circulating miRNAs is altered after acute resistance training during blood flow restriction (BFR) as compared with unrestricted low- and high-volume training, and we hypothesized that miRNA that are relevant for arteriogenesis are affected after resistance training. METHODS Eighteen healthy volunteers (aged 25 ± 2 years) were enrolled in this three-arm, randomized-balanced crossover study. The arms were single bouts of leg flexion/extension resistance training at (1) 70% of the individual single-repetition maximum (1RM), (2) at 30% of the 1RM, and (3) at 30% of the 1RM with BFR (artificially applied by a cuff at 300 mm Hg). Before the first exercise intervention, the individual 1RM (N) and the blood flow velocity (m/s) used to validate the BFR application were determined. During each training intervention, load-associated outcomes (fatigue, heart rate, and exhaustion) were monitored. Acute effects (circulating miRNAs, lactate) were determined using pre-and post-intervention measurements. RESULTS All training interventions increased lactate concentration and heart rate (p < 0.001). The high-intensity intervention (HI) resulted in a higher lactate concentration than both lower-intensity training protocols with BFR (LI-BFR) and without (LI) (LI, p = 0.003; 30% LI-BFR, p = 0.008). The level of miR-143-3p was down-regulated by LI-BFR, and miR-139-5p, miR-143-3p, miR-195-5p, miR-197-3p, miR-30a-5p, and miR-10b-5p were up-regulated after HI. The lactate concentration and miR-143-3p expression showed a significant positive linear correlation (p = 0.009, r = 0.52). A partial correlation (intervention partialized) showed a systematic impact of the type of training (LI-BFR vs. HI) on the association (r = 0.35 remaining after partialization of training type). CONCLUSIONS The strong effects of LI-BFR and HI on lactate- and arteriogenesis-associated miRNA-143-3p in young and healthy athletes are consistent with an important role of this particular miRNA in metabolic processes during (here) artificial blood flow restriction. BFR may be able to mimic the occlusion of a larger artery which leads to increased collateral flow, and it may therefore serve as an external stimulus of arteriogenesis.
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Affiliation(s)
- Johanna Vogel
- Department of Sports Medicine, Institute of Sport Sciences, Goethe University, Ginnheimer Landstraße 39, 60487 Frankfurt, Germany.
| | - Daniel Niederer
- Department of Sports Medicine, Institute of Sport Sciences, Goethe University, Ginnheimer Landstraße 39, 60487 Frankfurt, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Institute of Sport Sciences, Goethe University, Ginnheimer Landstraße 39, 60487 Frankfurt, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Institute of Sport Sciences, Goethe University, Ginnheimer Landstraße 39, 60487 Frankfurt, Germany
| | - Christian Troidl
- Department of Experimental Cardiology, Medical Faculty, Justus-Liebig-University, 35392 Giessen, Germany
- Department of Cardiology, Kerckhoff Heart and Thorax Center, 61231 Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, Frankfurt am Main, Germany
| | - Thomas Schmitz-Rixen
- Department of Vascular and Endovascular Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Winfried Banzer
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Kerstin Troidl
- Department of Vascular and Endovascular Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
- Department of Pharmacology, Max-Planck-Institute for Heart and Lung Research, Ludwigstrasse 43, 61231 Bad Nauheim, Germany.
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354
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Gliemann L, Hellsten Y. The exercise timing hypothesis: can exercise training compensate for the reduction in blood vessel function after menopause if timed right? J Physiol 2019; 597:4915-4925. [DOI: 10.1113/jp277056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/03/2019] [Indexed: 12/29/2022] Open
Affiliation(s)
- L. Gliemann
- Department of Nutrition, Exercise and SportsUniversity of Copenhagen Copenhagen Denmark
| | - Y. Hellsten
- Department of Nutrition, Exercise and SportsUniversity of Copenhagen Copenhagen Denmark
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355
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Bisconti AV, Cè E, Longo S, Venturelli M, Coratella G, Shokohyar S, Ghahremani R, Rampichini S, Limonta E, Esposito F. Evidence of Improved Vascular Function in the Arteries of Trained but Not Untrained Limbs After Isolated Knee-Extension Training. Front Physiol 2019; 10:727. [PMID: 31244682 PMCID: PMC6581732 DOI: 10.3389/fphys.2019.00727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2019] [Indexed: 01/22/2023] Open
Abstract
Vascular endothelial function is a strong marker of cardiovascular health and it refers to the ability of the body to maintain the homeostasis of vascular tone. The endothelial cells react to mechanical and chemical stimuli modulating the smooth muscle cells relaxation. The extent of the induced vasodilation depends on the magnitude of the stimulus. During exercise, the peripheral circulation is mostly controlled by the endothelial cells response that increases the peripheral blood flow in body districts involved but also not involved with exercise. However, whether vascular adaptations occur also in the brachial artery as a result of isolated leg extension muscles (KE) training is still an open question. Repetitive changes in blood flow occurring during exercise may act as vascular training for vessels supplying the active muscle bed as well as for the vessels of body districts not directly involved with exercise. This study sought to evaluate whether small muscle mass (KE) training would induce improvements in endothelial function not only in the vasculature of the lower limb (measured at the femoral artery level in the limb directly involved with training), but also in the upper limb (measured at the brachial artery level in the limb not directly involved with training) as an effect of repetitive increments in the peripheral blood flow during training sessions. Ten young healthy participants (five females, and five males; age: 23 ± 3 years; stature: 1.70 ± 0.11 m; body mass: 66 ± 11 kg; BMI: 23 ± 1 kg ⋅ m-2) underwent an 8-week KE training study. Maximum work rate (MWR), vascular function and peripheral blood flow were assessed pre- and post-KE training by KE ergometer, flow mediated dilatation (FMD) in the brachial artery (non-trained limb), and by passive limb movement (PLM) in femoral artery (trained limb), respectively. After 8 weeks of KE training, MWR and PLM increased by 44% (p = 0.015) and 153% (p = 0.003), respectively. Despite acute increase in brachial artery blood flow during exercise occurred (+25%; p < 0.001), endothelial function did not change after training. Eight weeks of KE training improved endothelial cells response only in the lower limb (measured at the femoral artery level) directly involved with training, likely without affecting the endothelial response of the upper limb (measured at the brachial artery level) not involved with training.
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Affiliation(s)
- Angela Valentina Bisconti
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States.,Geriatric Research, Education, and Clinical Centre, Veterans Affairs Medical Centre, Salt Lake City, UT, United States
| | - Emiliano Cè
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Stefano Longo
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Venturelli
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Coratella
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Sheida Shokohyar
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Reza Ghahremani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Susanna Rampichini
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
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356
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Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, Zock PL, Taddei S, Deanfield JE, Luscher T, Green DJ, Ghiadoni L. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J 2019; 40:2534-2547. [DOI: 10.1093/eurheartj/ehz350] [Citation(s) in RCA: 338] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 06/13/2018] [Accepted: 05/24/2019] [Indexed: 12/18/2022] Open
Abstract
Abstract
Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations of cardiovascular disease (CVD). Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation represents an endothelium-dependent, largely nitric oxide (NO)-mediated dilatation of conduit arteries in response to an imposed increase in blood flow and shear stress. Flow-mediated dilation is affected by cardiovascular (CV) risk factors, relates to coronary artery endothelial function, and independently predicts CVD outcome. Accordingly, FMD is a tool for examining the pathophysiology of CVD and possibly identifying subjects at increased risk for future CV events. Moreover, it has merit in examining the acute and long-term impact of physiological and pharmacological interventions in humans. Despite concerns about its reproducibility, the available evidence shows that highly reliable FMD measurements can be achieved when specialized laboratories follow standardized protocols. For this purpose, updated expert consensus guidelines for the performance of FMD are presented, which are based on critical appraisal of novel technical approaches, development of analysis software, and studies exploring the physiological principles underlying the technique. Uniformity in FMD performance will (i) improve comparability between studies, (ii) contribute to construction of reference values, and (iii) offer an easy accessible and early marker of atherosclerosis that could complement clinical symptoms of structural arterial disease and facilitate early diagnosis and prediction of CVD outcomes.
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Affiliation(s)
- Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Anke C C M van Mil
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie M Holder
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Francesco Faita
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Arno Greyling
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Peter L Zock
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College of London, 1 St Martin le Grand, London, UK
| | - Thomas Luscher
- Royal Brompton and Harefield Hospitals, London University Heart Center, Sydney Street, London, UK
| | - Daniel J Green
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Perth, Australia
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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357
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Somani YB, Pawelczyk JA, De Souza MJ, Kris-Etherton PM, Proctor DN. Aging women and their endothelium: probing the relative role of estrogen on vasodilator function. Am J Physiol Heart Circ Physiol 2019; 317:H395-H404. [PMID: 31173499 DOI: 10.1152/ajpheart.00430.2018] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite significant decreases in cardiovascular disease (CVD) mortality in the past three decades, it still remains the leading cause of death in women. Following menopause and the accompanying loss of estrogen, women experience a unique, accelerated rise in CVD risk factors. Dysfunction of the endothelium represents an important antecedent to CVD development, with rapid declines in endothelial vasodilator function reportedly taking place across the menopause transition. Importantly, the decline in endothelial function is independent of chronological age and is associated with estrogen deficiency. Estrogen-mediated effects, including increasing nitric oxide bioavailability and attenuating oxidative stress and inflammation, contribute to preserving endothelial health. This review will discuss studies that have probed the role of estrogen on endothelial vasodilator function in women at discrete stages of the menopause transition and the effects of estradiol supplementation in postmenopausal women. Estrogen receptor signaling is also an important aspect of endothelial function in women, and studies suggest that expression is reduced with both acute and prolonged estrogen deficiency. Changes in regulatory mechanisms of estrogen receptor-α expression as well as sensitivity to estrogen may underlie the differential effects of estrogen therapy in early (≤5 yr past final menstrual period) and late postmenopausal women (>5 yr past final menstrual period). Lastly, this review presents potential therapeutic targets that include increasing l-arginine bioavailability and estrogen receptor activation to prevent endothelial dysfunction in postmenopausal women as a strategy for decreasing CVD mortality in this high-risk population.
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Affiliation(s)
- Yasina B Somani
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania
| | - James A Pawelczyk
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania
| | - Mary Jane De Souza
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - David N Proctor
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania
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358
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A three-step approach identifies novel shear stress-sensitive endothelial microRNAs involved in vasculoprotective effects of high-intensity interval training (HIIT). Oncotarget 2019. [DOI: 10.18632/oncotarget.26944] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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359
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Schmitz B, Breulmann FL, Jubran B, Rolfes F, Thorwesten L, Krüger M, Klose A, Schnittler HJ, Brand SM. A three-step approach identifies novel shear stress-sensitive endothelial microRNAs involved in vasculoprotective effects of high-intensity interval training (HIIT). Oncotarget 2019; 10:3625-3640. [PMID: 31217898 PMCID: PMC6557206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/03/2019] [Indexed: 11/22/2022] Open
Abstract
Circulatory microRNAs (c-miRNAs) are regulated in response to physical activity and may exert anti-atherosclerotic effects. Since the vascular endothelium is an abundant source of c-miRNAs, we aimed to identify novel vasculoprotective exercise-induced c-miRNAs by the combined analysis of published endothelial miRNA array data followed by in vivo and in vitro validation. We identified 8 different array-based publications reporting 185 endothelial shear stress-regulated miRNAs of which 13 were identified in ≥3 independent reports. Nine miRNAs had already been associated with physical activity. Of the remaining novel miRNAs, miR-98-3p and miR-125-5p were selected for further analysis due to reported vasculoprotective effects. Analysis in two different 4-week high-intensity interval training (HIIT) groups (group 1 [n=27]: 4x30 s, group 2 [n=25]: 8x15 s; all-out running) suggested significantly elevated miR-98 and miR-125a-5p levels in response to acute exercise at baseline and at follow-up. Endothelial in vitro shear stress experiments revealed increased miR-125a-5p and miR-98-3p levels in medium of human umbilical vein endothelial cells at 30 dyn/cm2 after 20 and 60 min, respectively. Our results suggest that miR-98-3p and miR-125a-5p can be rapidly secreted by endothelial cells, which might be the source of increased c-miR-98-3p and -125a-5p levels in response to HIIT. Both miRNAs attenuate endothelial inflammation and may mediate vasculoprotective effects of physical exercise including HIIT.
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Affiliation(s)
- Boris Schmitz
- 1 Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Franziska L. Breulmann
- 1 Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Bothaynah Jubran
- 2 Institute of Anatomy and Vascular Biology, University of Muenster, Muenster, Germany
| | - Florian Rolfes
- 1 Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Lothar Thorwesten
- 1 Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Michael Krüger
- 3 Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | - Andreas Klose
- 3 Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | | | - Stefan-Martin Brand
- 1 Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
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360
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Schmitz B, Niehues H, Lenders M, Thorwesten L, Klose A, Krüger M, Brand E, Brand SM. Effects of high-intensity interval training on microvascular glycocalyx and associated microRNAs. Am J Physiol Heart Circ Physiol 2019; 316:H1538-H1551. [DOI: 10.1152/ajpheart.00751.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
High-intensity interval training (HIIT) has been proposed to exert vasculoprotective effects. This study aimed to evaluate whether HIIT affects the microvasculature, including the endothelial glycocalyx barrier, and to identify associated microRNAs (miRNAs). Fifty healthy participants (23.1 ± 3.0 yr) performed a 4-wk 4 × 30-s all-out running HIIT. Sidestream dark-field imaging was performed at baseline and follow-up to detect changes of the sublingual microvasculature including the endothelial glycocalyx. Exercise parameters were determined by continuous running field test and documentation of high-intensity runs. miRNAs potentially associated with glycocalyx thickness were selected by structured literature search and blood samples for miRNA, and lactate measurements were drawn at baseline and follow-up HIIT. At baseline, a correlation between maximal exercise performance capacity and glycocalyx thickness (determined by perfused boundary region) was detected ( P = 0.045, r = 0.303). Increased exercise performance at follow-up also correlated with glycocalyx thickness ( P = 0.031, r = 0.416), and increased high-intensity sprinting speed was associated with an increased number of perfused vessels ( P = 0.0129, r = 0.449). Literature search identified miR-143, -96-5p, and -24, which were upregulated by HIIT already at baseline and showed an association with peak blood lactate levels after sprints (all P < 0.05). Moreover, increased baseline miR-143 levels predicted increased glycocalyx thickness at follow-up (AUCmiR-143 = 0.92, 95% confidence interval, 0.81–1.0, P = 0.0008). Elevated resting miR-126 levels after the intervention were associated with cell-free versican mRNA levels. We conclude that HIIT induces changes in the endothelial glycocalyx of the microvasculature. Associated miRNAs such as miR-143 may represent a tool for monitoring early vasculoprotective adaptations to physical activity. NEW & NOTEWORTHY High-intensity interval training is known to improve health-related fitness in general and in lifestyle-induced chronic diseases. To visualize microvasculature structure and to detect exercise-induced changes, sublingual sidestream dark-field imaging microscopy was used, and circulating miRNAs were measured. This study shows that exercise-induced changes correlate with associated circulating miRNA, which might be useful for monitoring vasculoprotective effects. Furthermore, sidestream dark-field imaging may represent a sensitive tool for the early detection of exercise-induced systemic vascular changes.
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Affiliation(s)
- Boris Schmitz
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Hannah Niehues
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Malte Lenders
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Muenster, Muenster, Germany
| | - Lothar Thorwesten
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
| | - Andreas Klose
- Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | - Michael Krüger
- Department of Physical Education and Sports History, University of Muenster, Muenster, Germany
| | - Eva Brand
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Muenster, Muenster, Germany
| | - Stefan-Martin Brand
- Institute of Sports Medicine, Molecular Genetics of Cardiovascular Disease, University Hospital Muenster, Muenster, Germany
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361
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Akerman AP, Thomas KN, van Rij AM, Body ED, Alfadhel M, Cotter JD. Heat therapy vs. supervised exercise therapy for peripheral arterial disease: a 12-wk randomized, controlled trial. Am J Physiol Heart Circ Physiol 2019; 316:H1495-H1506. [DOI: 10.1152/ajpheart.00151.2019] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Peripheral arterial disease (PAD) is characterized by lower limb atherosclerosis impairing blood supply and causing walking-induced leg pain or claudication. Adherence to traditional exercise training programs is poor due to these symptoms despite exercise being a mainstay of conservative treatment. Heat therapy improves many cardiovascular health outcomes, so this study tested if this was a viable alternative cardiovascular therapy for PAD patients. Volunteers with PAD were randomized to 12 wk of heat ( n = 11; mean age 76 ± 8 yr, BMI 28.7 ± 3.5 kg/m2, 4 females) or exercise ( n = 11; 74 ± 10 yr, 28.5 ± 6.8 kg/m2, 3 females). Heat involved spa bathing at ∼39°C, 3–5 days/wk for ≤30 min, followed by ≤30 min of callisthenics. Exercise involved ≤90 min of supervised walking and gym-based exercise, 1–2 days/wk. Following the interventions, total walking distance during a 6-min walk test increased (from ∼350 m) by 41 m (95% CI: [13, 69], P = 0.006) regardless of group, and pain-free walking distance increased (from ∼170 m) by 43 m ([22, 63], P < 0.001). Systolic blood pressure was reduced more following heat (−7 mmHg, [−4, −10], P < 0.001) than following exercise (−3 mmHg, [0, −6], P = 0.078), and diastolic and mean arterial pressure decreased by 4 mmHg in both groups ( P = 0.002). There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were no differences in the improvement in functional or blood pressure outcomes between heat and exercise in individuals with PAD. NEW & NOTEWORTHY Heat therapy via hot-water immersion and supervised exercise both improved walking distance and resting blood pressure in peripheral arterial disease (PAD) patients over 12 wk. Adherence to heat therapy was excellent, and the heat intervention was well tolerated. The results of the current study indicate that heat therapy can improve functional ability and has potential as an effective cardiovascular conditioning tool for individuals with PAD. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/heat-therapy-vs-exercise-in-peripheral-arterial-disease/ .
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Affiliation(s)
- Ashley P. Akerman
- School of Physical Education, Sport, and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Kate N. Thomas
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Andre M. van Rij
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - E. Dianne Body
- Physiotherapy Department, Dunedin Public Hospital, Dunedin, New Zealand
| | - Mesfer Alfadhel
- Cardiology Department, Dunedin Public Hospital, Dunedin, New Zealand
| | - James D. Cotter
- School of Physical Education, Sport, and Exercise Sciences, University of Otago, Dunedin, New Zealand
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362
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Yin MZ, Kim HJ, Suh EY, Zhang YH, Yoo HY, Kim SJ. Endurance exercise training restores atrophy-induced decreases of myogenic response and ionic currents in rat skeletal muscle artery. J Appl Physiol (1985) 2019; 126:1713-1724. [DOI: 10.1152/japplphysiol.00962.2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Atrophic limbs exhibit decreased blood flow and histological changes in the arteries perfusing muscles. However, the effect of atrophy on vascular smooth muscle function is poorly understood. Here, we investigated the effect of unilateral sciatic denervation on the myogenic response (MR) and the ionic currents in deep femoral artery (DFA) smooth muscles from Sprague-Dawley rats. Because denervated rats were capable of treadmill exercise (20 m/min, 30 min, 3 times/wk), the impact of exercise training on these effects was also assessed. Skeletal arteries were harvested 3 or 5 wk after surgery. Then skeletal arteries or myocytes were subjected to video analysis of pressurized artery, myography, whole-cell patch clamp, and real-time quantitative PCR to determine the effect of hindlimb paralysis in the presence/absence of exercise training on MR, contractility, ionic currents, and channel transcription, respectively. In sedentary rats, atrophy was associated with loss of MR in the DFA at 5 wk. The contralateral DFA had a normal MR. At 5 wk after surgery, DFA myocytes from the atrophic limbs exhibited depressed L-type Ca2+currents, GTPγS-induced transient receptor potential cation channel (TRPC)-like currents, 80 mM KCl-induced vasoconstriction, TRPC6 mRNA, and voltage-gated K+and inwardly rectifying K+currents. Exercise training abrogated the differences in all of these functions between atrophic side and contralateral side DFA myocytes. These results suggest that a probable increase in hemodynamic stimuli in skeletal artery smooth muscle plays an important role in maintaining MR and ionic currents in skeletal artery smooth muscle. This may also explain the observed benefits of exercise in patients with limb paralysis.NEW & NOTEWORTHY Myogenic responses (MRs) in rat skeletal arteries feeding the unilateral atrophic hindlimb were impaired. In addition, the L-type Ca2+channel current, the TRPC6-like current, and TRPC6 mRNA levels in the corresponding myocytes decreased. Voltage-gated K+channel currents and inwardly rectifying K+channel currents were also attenuated in atrophic side myocytes. Exercise training effectively abrogated electrophysiological dysfunction of atrophic side myocytes and prevented loss of the MR.
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Affiliation(s)
- Ming Zhe Yin
- Department of Physiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hae Jin Kim
- Department of Physiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Yeong Suh
- Department of Physiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yin Hua Zhang
- Department of Physiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hae Young Yoo
- Chung-Ang University Red Cross College of Nursing, Seoul, Republic of Korea
| | - Sung Joon Kim
- Department of Physiology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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363
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Holder SM, Dawson EA, Brislane Á, Hisdal J, Green DJ, Thijssen DHJ. Fluctuation in shear rate, with unaltered mean shear rate, improves brachial artery flow-mediated dilation in healthy, young men. J Appl Physiol (1985) 2019; 126:1687-1693. [DOI: 10.1152/japplphysiol.00009.2019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Increase in mean shear stress represents an important and potent hemodynamic stimulus to improve conduit artery endothelial function in humans. No previous study has examined whether fluctuations in shear rate patterns, without altering mean shear stress, impacts conduit artery endothelial function. This study examined the hypothesis that 30-min exposure to fluctuations in shear rate patterns, in the presence of unaltered mean shear rate, improves brachial artery flow-mediated dilation. Fifteen healthy men (27.3 ± 5.0 yr) completed the study. Bilateral brachial artery flow-mediated dilation was assessed before and after unilateral exposure to 30 min of intermittent negative pressure (10 s, −40mmHg; 7 s, 0 mmHg) to induce fluctuation in shear rate, while the contralateral arm was exposed to a resting period. Negative pressure significantly increased shear rate, followed by a decrease in shear rate upon pressure release (both P < 0.001). Across the 30-min intervention, mean shear rate was not different compared with baseline ( P = 0.458). A linear mixed model revealed a significant effect of time observed for flow-mediated dilation ( P = 0.029), with exploratory post hoc analysis showing an increase in the intervention arm (∆FMD +2.0%, P = 0.008), but not in the contralateral control arm (∆FMD +0.5%, P = 0.664). However, there was no effect for arm ( P = 0.619) or interaction effect ( P = 0.096). In conclusion, we found that fluctuations in shear patterns, with unaltered mean shear, improves brachial artery flow-mediated dilation. These novel data suggest that fluctuations in shear pattern, even in the absence of altered mean shear, represent a stimulus to acute change in endothelial function in healthy individuals. NEW & NOTEWORTHY Intermittent negative pressure applied to the forearm induced significant fluctuations in antegrade and retrograde shear rate, while mean shear was preserved relative to baseline. Our exploratory study revealed that brachial artery flow-mediated dilation was significantly improved following 30-min exposure to intermittent negative pressure. Fluctuations in blood flow or shear rate, with unaltered mean shear, may have important implications for vascular health; however, further research is required to identify the underlying mechanisms and potential long-term health benefits.
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Affiliation(s)
- Sophie M. Holder
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Ellen A. Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Áine Brislane
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- School of Sport and Exercise Science, York St. John University, York, United Kingdom
| | - Jonny Hisdal
- Section of Vascular Investigations, Division of Cardiovascular and Pulmonary Diseases, Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Daniel J. Green
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Crawley, Western Australia, Australia
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Radboud, the Netherlands
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364
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Reanpang T, Prasannarong M, Pongtam S, Murray ST, Rerkasem K. Upper limb exercise for people on haemodialysis following arteriovenous fistula surgery. Hippokratia 2019. [DOI: 10.1002/14651858.cd013327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Termpong Reanpang
- Chiang Mai University; Department of Surgery, Faculty of Medicine; Chiang Mai Thailand
| | - Mujalin Prasannarong
- Chiang Mai University; Department of Physical Therapy, Faculty of Associated Medical Sciences; 110 Inthavaroros Road, Sriphum sub-district Chiang Mai Chiang Mai Thailand 50200
| | - Sasinat Pongtam
- Chiang Mai University; NCD Center of Excellence, Research Institute of Health Science; 110 Invthavaroros Road, Sriphum sub-district Chiang Mai Chiang Mai Thailand 50200
| | - Scott T Murray
- University Hospital Crosshouse; Department of Surgery; Kilmarnock UK
| | - Kittipan Rerkasem
- Chiang Mai University; Department of Surgery, Faculty of Medicine; Chiang Mai Thailand
- Chiang Mai University; NCD Center of Excellence, Research Institute of Health Science; 110 Invthavaroros Road, Sriphum sub-district Chiang Mai Chiang Mai Thailand 50200
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365
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Smith KJ, Hoiland RL, Grove R, McKirdy H, Naylor L, Ainslie PN, Green DJ. Matched increases in cerebral artery shear stress, irrespective of stimulus, induce similar changes in extra-cranial arterial diameter in humans. J Cereb Blood Flow Metab 2019; 39:849-858. [PMID: 29125372 PMCID: PMC6501503 DOI: 10.1177/0271678x17739220] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The mechanistic role of arterial shear stress in the regulation of cerebrovascular responses to physiological stimuli (exercise and hypercapnia) is poorly understood. We hypothesised that, if shear stress is a key regulator of arterial dilation, then matched increases in shear, induced by distinct physiological stimuli, would trigger similar dilation of the large extra-cranial arteries. Participants ( n = 10) participated in three 30-min experimental interventions, each separated by ≥48 h: (1) mild-hypercapnia (FICO2:∼0.045); (2) submaximal cycling (EX; 60%HRreserve); or (3) resting (time-matched control, CTRL). Blood flow, diameter, and shear rate were assessed (via Duplex ultrasound) in the internal carotid and vertebral arteries (ICA, VA) at baseline, during and following the interventions. Hypercapnia and EX produced similar elevations in blood flow and shear rate through the ICA and VA ( p < 0.001), which were both greater than CTRL. Vasodilation of ICA and VA diameter in response to hypercapnia (5.3 ± 0.8 and 4.4 ± 2.0%) and EX (4.7 ± 0.7 and 4.7 ± 2.2%) were similar, and greater than CTRL ( p < 0.001). Our findings indicate that matched levels of shear, irrespective of their driving stimulus, induce similar extra-cranial artery dilation. We demonstrate, for the first time in humans, an important mechanistic role for the endothelium in regulating cerebrovascular response to common physiological stimuli in vivo.
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Affiliation(s)
- Kurt J Smith
- 1 Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Ryan L Hoiland
- 2 Centre for Hearth Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Ryan Grove
- 1 Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Hamish McKirdy
- 1 Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Louise Naylor
- 1 Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
| | - Philip N Ainslie
- 2 Centre for Hearth Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Daniel J Green
- 1 Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia.,3 Research Institute for Sport and Exercise Sciences, John Moores Liverpool University, UK
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366
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Serviente C, Witkowski S. Follicle-stimulating hormone, but not cardiorespiratory fitness, is associated with flow-mediated dilation with advancing menopausal stage. Menopause 2019; 26:531-539. [PMID: 30489425 PMCID: PMC6483873 DOI: 10.1097/gme.0000000000001267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate if there are differences in endothelial function before and after acute exercise in women at different menopausal stages with high and low cardiorespiratory fitness. METHODS Participants were healthy high-fit premenopausal (n = 11), perimenopausal (n = 12), and postmenopausal women (n = 13) and low-fit perimenopausal (n = 7) and postmenopausal women (n = 8). Brachial artery flow-mediated dilation (FMD) was measured before and after acute moderate intensity exercise. FMD was calculated as (Diameterpeak-Diameterbaseline)/ Diameterbaseline) × 100. Differences between high-fit women and between high- and low-fit perimenopausal and postmenopausal women were assessed with repeated-measure ANOVAs. Relations with FMD were assessed with Pearson correlations. RESULTS FMD was reduced with progressive menopausal stage in high-fit women (P = 0.005) and was lower in perimenopausal compared to postmenopausal women (P = 0.047). FMD was lower in high-fit compared to low-fit women (P = 0.006) and there was no relation between FMD and VO2peak (P > 0.05). There was an inverse relation between FMD and follicle-stimulating hormone (P < 0.05), but not estradiol (P > 0.05). CONCLUSIONS These data suggest that endothelial function is lower with progressive menopausal stage in women with high cardiorespiratory fitness; that FMD is lower in women with higher cardiorespiratory fitness; and that FSH, but not estradiol, is associated with FMD.
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Affiliation(s)
- Corinna Serviente
- University of Massachusetts Amherst, Department of Kinesiology, Amherst, MA
- Pennsylvania State University, Center for Healthy Aging, University Park, PA
| | - Sarah Witkowski
- University of Massachusetts Amherst, Department of Kinesiology, Amherst, MA
- Smith College, Department of Exercise and Sports Studies, Northampton, MA
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367
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Pouwels S, Van Genderen ME, Kreeftenberg HG, Ribeiro R, Parmar C, Topal B, Celik A, Ugale S. Utility of the cold pressor test to predict future cardiovascular events. Expert Rev Cardiovasc Ther 2019; 17:305-318. [PMID: 30916592 DOI: 10.1080/14779072.2019.1598262] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The cold pressor test (CPT) is a common and extensively validated test, which induces systemic stress involving immersion of an individual's hand in ice water (normally temperature between 0 and 5 degrees Celsius) for a period of time. CPT has been used in various fields, like examining effects of stress on memory, decision-making, pain and cardiovascular health. Areas covered: In terms of cardiovascular health, current research is mainly interested in predicting the occurrence of cardiovascular (CV) events. The objective of this review is to give an overview of the history and methodology of the CPT, and clinical utility in possibly predicting CV events in CAD and other atherosclerotic diseases. Secondly, we will discuss possible future applications of the CPT in clinical care. Expert opinion: An important issue to address is the fact that the physiology of the CPT is not fully understood at this moment. As pointed out multiple mechanisms might be responsible for contributing to either coronary vasodilatation or coronary vasoconstriction. Regarding the physiological mechanism of the CPT and its effect on the measurements of the carotid artery reactivity even less is known.
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Affiliation(s)
- Sjaak Pouwels
- a Department of Surgery , Franciscus Gasthuis & Vlietland , Rotterdam/Schiedam , The Netherlands
| | - Michel E Van Genderen
- b Department of Internal Medicine , Franciscus Gasthuis & Vlietland , Rotterdam/Schiedam , The Netherlands
| | - Herman G Kreeftenberg
- c Department of Internal Medicine , Catharina Hospital , Eindhoven , The Netherlands.,d Department of Intensive Care Medicine , Catharina Hospital , Eindhoven , The Netherlands
| | - Rui Ribeiro
- e Metabolic Patient Multidisciplinary Centre , Clínica de Santo António , Lisbon , Portugal
| | - Chetan Parmar
- f Department of Surgery , Whittington Hospital , London , UK
| | - Besir Topal
- g Department of Cardiothoracic Surgery , OLVG , Amsterdam , The Netherlands
| | - Alper Celik
- h Department of metabolic surgery , Metabolic Surgery Clinic , Istanbul , Turkey
| | - Surendra Ugale
- i Department of Surgery , Virinchi Hospitals , Hyderbad , India
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368
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Wheeler MJ, Dunstan DW, Smith B, Smith KJ, Scheer A, Lewis J, Naylor LH, Heinonen I, Ellis KA, Cerin E, Ainslie PN, Green DJ. Morning exercise mitigates the impact of prolonged sitting on cerebral blood flow in older adults. J Appl Physiol (1985) 2019; 126:1049-1055. [PMID: 30730813 PMCID: PMC6485691 DOI: 10.1152/japplphysiol.00001.2019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/22/2019] [Accepted: 02/01/2019] [Indexed: 12/20/2022] Open
Abstract
Preventing declines in cerebral blood flow is important for maintaining optimal brain health with aging. We compared the effects of a morning bout of moderate-intensity exercise, with and without subsequent light-intensity walking breaks from sitting, on cerebral blood velocity over 8 h in older adults. In a randomized crossover trial, overweight/obese older adults ( n = 12, 70 ± 7 yr; 30.4 ± 4.3 kg/m2), completed three acute conditions (6-day washout); SIT: prolonged sitting (8 h, control); EX+SIT: sitting (1 h), moderate-intensity walking (30 min), followed by uninterrupted sitting (6.5 h); and EX + BR: sitting (1 h), moderate-intensity walking (30 min), followed by sitting (6.5 h) interrupted with 3 min of light-intensity walking every 30 min. Bilateral middle cerebral artery velocities (MCAv) were determined using transcranial Doppler at 13 time points across the day. The temporal pattern and average MCAv over 8 h was determined. The pattern of MCAv over 8 h was a negative linear trend in SIT ( P < 0.001), but a positive quadratic trend in EX + SIT ( P < 0.001) and EX + BR ( P < 0.01). Afternoon time points in SIT were lower than baseline within condition ( P ≤ 0.001 for all). A morning dip in MCAv was observed in EX + SIT and EX + BR ( P < 0.05 relative to baseline), but afternoon time points were not significantly lower than baseline. The average MCAv over 8 h was higher in EX + SIT than SIT ( P = 0.007) or EX + BR ( P = 0.024). Uninterrupted sitting should be avoided, and moderate-intensity exercise should be encouraged for the daily maintenance of cerebral blood flow in older adults. The clinical implications of maintaining adequate cerebral blood flow include the delivery of vital oxygen and nutrients to the brain. NEW & NOTEWORTHY This is the first study to measure the combined effects of an exercise bout with breaks in sitting on cerebral blood velocity in older adults. Using frequent recordings over an 8-h period, we have performed a novel analysis of the pattern of cerebral blood velocity, adjusting for concurrent measures of mean arterial pressure and other potential confounders in a linear mixed effects regression.
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Affiliation(s)
- Michael J Wheeler
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
- Baker Heart and Diabetes Institute , Melbourne, Victoria , Australia
| | - David W Dunstan
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
- Baker Heart and Diabetes Institute , Melbourne, Victoria , Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University , Melbourne, Victoria , Australia
| | - Brianne Smith
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
| | - Kurt J Smith
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
- School of Kinesiology, Lakehead University, Thunderbay, Ontario , Canada
| | - Anna Scheer
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University , Perth, Western Australia , Australia
| | - Jaye Lewis
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
| | - Ilkka Heinonen
- Turku PET Centre, University of Turku , Finland
- Rydberg Laboratory of Applied Sciences, School of Engineering and Science (ETN), Halmstad University, Halmstad, Sweden
| | - Kathryn A Ellis
- Department of Psychiatry, University of Melbourne, Parkville, Melbourne, Victoria , Australia
| | - Ester Cerin
- Baker Heart and Diabetes Institute , Melbourne, Victoria , Australia
- School of Public Health, The University of Hong Kong , Hong Kong
- Mary MacKillop Institute for Health Research, Australian Catholic University , Melbourne, Victoria , Australia
| | - Philip N Ainslie
- School of Health and Exercise Sciences, The University of British Columbia , Vancouver, British Columbia , Canada
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia , Perth, Western Australia , Australia
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369
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Demirel A, Baykara M, Koca TT, Berk E, Gençay ÖA. Comparison of vascular arterial stiffness parameters of adolescent wrestlers with healthy subjects: Is heavy training harmful for wrestlers? J Back Musculoskelet Rehabil 2019; 32:155-160. [PMID: 30248031 DOI: 10.3233/bmr-171083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKROUND The effect of different exercise modalities on the vascular structure has been the subject of clinical trials but there is not enough data about wrestlers. OBJECTIVE This study aimed to compare the arterial stiffness parameters in adolescent wrestlers with those of age-matched sedentary controls to show the effects of long and heavy training. METHODS This study was carried out as a case-control study. Thirty three (N= 33) elite male adolescent wrestlers (12-18 years) and 35 age and sex-matched control subjects (P= 0.438) with a sedentary lifestyle were included the study. The data was obtained by using sonography and a sphygmomanometer. Systolic and diastolic diameters and intima media thickness (IMT) measurements were performed from the carotid arteries of the subjects. The arterial tension was measured in the same session, and arterial stiffness parameters were calculated using specific formulas. RESULTS The mean age range was 15.9 ± 0.9 years and 16.0 ± 0.8 years for the wrestlers and control subjects, respectively (P= 0.43). Statistically, the Body Mass Index (BMI) was significantly higher in wrestlers (mean = 23.7 ± 4.0 kg/m2; P= 0.00). The groups had no difference in height (P= 0.80) and weight (P= 0.05). The systolic blood pressure (SBP) was significantly higher in wrestlers (mean = 120 ± 13.4 mmHg; P= 0.00); the pulse was significantly lower in wrestlers (mean = 69.61 ± 17.2 beats/min; P= 0.00); the IMT was significantly lower in wrestlers (IMT mean = 0.288 ± 0.1 mm; P= 0.01); the diastolic wall stress (DWS) was significantly higher in wrestlers (DWS mean = 933.64 ± 298.0 mmHg; P= 0.03) than controls. No significant differences were found in the elastic modulus (P= 0.11), compliance (P= 0.86), and distensibility (P= 0.86) parameters between the groups. CONCLUSION Bradycardia is an expected condition for athletes. SBP and DWS were found to be high in wrestlers, suggesting that arterial tissue is more susceptible to stress. The low IMT indicates the protective effect of regular exercise against atherosclerosis. It is known that regular exercise is good for the vascular structure while heavy exercise puts a load on the vascular structure. The fact that the elastic modulus, compliance, and distensibility do not differ between the groups suggests that structural changes in the adolescents have no effect on the vascular wall.
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Affiliation(s)
- Adnan Demirel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Murat Baykara
- Department of Radiology, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Tuba Tülay Koca
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ejder Berk
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ökkeş Alparslan Gençay
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
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Magalhães JP, Melo X, Correia IR, Ribeiro RT, Raposo J, Dores H, Bicho M, Sardinha LB. Effects of combined training with different intensities on vascular health in patients with type 2 diabetes: a 1-year randomized controlled trial. Cardiovasc Diabetol 2019; 18:34. [PMID: 30885194 PMCID: PMC6423850 DOI: 10.1186/s12933-019-0840-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = − 4.25, p < 0.01) and HIIT group (β = − 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = − 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = − 0.14, p < 0.01), and on the distensibility coefficient (β = − 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505
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Affiliation(s)
- João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Xavier Melo
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.,GCP Lab, Ginásio Clube Português, Lisbon, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Rogério T Ribeiro
- Education and Research Centre, APDP-Diabetes Portugal (APDP-ERC), Lisbon, Portugal
| | - João Raposo
- Education and Research Centre, APDP-Diabetes Portugal (APDP-ERC), Lisbon, Portugal
| | - Hélder Dores
- Military Forces Hospital, Lisbon, Portugal.,Light Hospital, Lisbon, Portugal.,NOVA Medical School, Lisbon, Portugal
| | - Manuel Bicho
- Genetics Laboratory Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Institute of Scientific Research Bento da Rocha Cabral, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Thijssen DHJ, Benda NMM, Kerstens TP, Seeger JPH, van Dijk APJ, Hopman MTE. 12-Week Exercise Training, Independent of the Type of Exercise, Attenuates Endothelial Ischaemia-Reperfusion Injury in Heart Failure Patients. Front Physiol 2019; 10:264. [PMID: 30930798 PMCID: PMC6428763 DOI: 10.3389/fphys.2019.00264] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/28/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction: Reperfusion is required to salvage ischaemic tissue, but also causes further damage (i.e., ischaemia/reperfusion-injury). Heart failure patients reveal exaggerated ischaemia/reperfusion-injury, whilst traditional ischaemic preconditioning cannot prevent ischaemia/reperfusion-injury. Exercise training may be a more powerful preconditioning stimulus, especially high-intensity interval training given the similarities with ischaemic preconditioning. Therefore, we examined the impact of 12-week continuous training vs. high-intensity interval training on brachial artery endothelial ischaemia/reperfusion-injury in heart failure patients New York Heart Association-class II-III. Methods: Twenty heart failure patients (male:female 19:1, 64 ± 8 years, ejection fraction 38 ± 6%) were allocated to 12-weeks of high-intensity interval training (10∗1-min 90% maximal workload – 2.5-min 30% maximal workload) or continuous training (30-min 60–75% maximal workload). Before and after the intervention, we measured brachial artery endothelial function with flow-mediated dilation (FMD) before and after ischaemia/reperfusion (5-min ischemic exercise, 15-min reperfusion). Results: Ischaemia/reperfusion caused a significant decline in FMD (continuous training (n = 10): 5.2 ± 2.5 to 3.4 ± 1.6%, high-intensity interval training (n = 10): 5.3 ± 2.6 to 3.5 ± 1.6%, P = 0.01), which was not different between groups (P > 0.05). Training improved maximal workload and fitness (P < 0.05), with no differences between groups (P > 0.05). Exercise training did not alter FMD (P > 0.05), whilst ischaemia/reperfusion did not impair FMD after exercise training (continuous training: 4.8 ± 3.0 to 4.2 ± 2.3%, high-intensity interval training: 4.7 ± 2.5 to 3.8 ± 2.3%, P > 0.05). No changes were found in FMD before or after ischaemia/reperfusion after 12-weeks in controls (n = 9). Conclusion: We found that 12-week exercise training in heart failure patients mitigated endothelial ischaemia-reperfusion injury, an effect independent of the type of exercise. These changes may contribute to the cardioprotective effects of exercise training, whilst our findings highlight the potency of exercise as a preconditioning stimulus.
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Affiliation(s)
- Dick H J Thijssen
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Nathalie M M Benda
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Thijs P Kerstens
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Joost P H Seeger
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Arie P J van Dijk
- Department of Cardiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
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372
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Morales‐Acuna F, Ochoa L, Valencia C, Gurovich AN. Characterization of blood flow patterns and endothelial shear stress during flow‐mediated dilation. Clin Physiol Funct Imaging 2019; 39:240-245. [DOI: 10.1111/cpf.12564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Francisco Morales‐Acuna
- Department of Rehabilitation Sciences College of Health Sciences The University of Texas at El PasoEl Paso TX USA
| | - Luis Ochoa
- Department of Mechanical Engineering W.M. Keck Center for 3D Innovation The University of Texas at El Paso El Paso TX USA
| | - Carolina Valencia
- Department of Rehabilitation Sciences College of Health Sciences The University of Texas at El PasoEl Paso TX USA
| | - Alvaro N. Gurovich
- Department of Rehabilitation Sciences College of Health Sciences The University of Texas at El PasoEl Paso TX USA
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373
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Beale AL, Nanayakkara S, Segan L, Mariani JA, Maeder MT, van Empel V, Vizi D, Evans S, Lam CS, Kaye DM. Sex Differences in Heart Failure With Preserved Ejection Fraction Pathophysiology. JACC-HEART FAILURE 2019; 7:239-249. [DOI: 10.1016/j.jchf.2019.01.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 12/19/2022]
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374
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Holder SM, Brislane Á, Dawson EA, Hopkins ND, Hopman MTE, Cable NT, Jones H, Schreuder THA, Sprung VS, Naylor L, Maiorana A, Thompson A, Thijssen DHJ, Green DJ. Relationship Between Endothelial Function and the Eliciting Shear Stress Stimulus in Women: Changes Across the Lifespan Differ to Men. J Am Heart Assoc 2019; 8:e010994. [PMID: 30764688 PMCID: PMC6405684 DOI: 10.1161/jaha.118.010994] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/18/2018] [Indexed: 01/26/2023]
Abstract
Background Premenopausal women have a lower incidence of cardiovascular disease, which may partly be due to a protective effect of estrogen on endothelial function. Animal studies suggest that estrogen may also improve the relationship between shear rate ( SR ) and endothelial function. We aimed to explore the relationship between endothelial function (ie, flow-mediated dilation [ FMD ]) and SR (ie, SR area under the curve [ SRAUC ]) in women versus men, and between pre- versus postmenopausal women. Methods and Results Brachial artery FMD and SRAUC were measured in accordance with expert-consensus guidelines in 932 healthy participants who were stratified into young adults (18-40 years, 389 men, 144 women) and older adults (>40 years, 260 men, 139 women). Second, we compared premenopausal (n=173) and postmenopausal women (n=110). There was evidence of a weak correlation between SRAUC and FMD in all groups but older men, although there was variation in strength of outcomes. Further exploration using interaction terms (age-sex× SRAUC ) in linear regression revealed differential relationships with FMD (young women versus young men [β=-5.8-4, P=0.017] and older women [β=-5.9-4, P=0.049]). The correlation between SRAUC and FMD in premenopausal women ( r2=0.097) was not statistically different from that in postmenopausal women ( r2=0.025; Fisher P=0.30). Subgroup analysis using stringent inclusion criteria for health markers (n=505) confirmed a stronger FMD - SRAUC correlation in young women compared with young men and older women. Conclusions Evidence for a stronger relationship between endothelial function and the eliciting SR stimulus is present in young women compared with men. Estrogen may contribute to this finding, but larger healthy cohorts are required for conclusive outcomes.
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Affiliation(s)
- Sophie M. Holder
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Áine Brislane
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Ellen A. Dawson
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Maria T. E. Hopman
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - N. Timothy Cable
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamUnited Kingdom
| | - Helen Jones
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Tim H. A. Schreuder
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Victoria S. Sprung
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of Musculoskeletal Biology IIInstitute of Ageing and Chronic DiseaseUniversity of LiverpoolUnited Kingdom
| | - Louise Naylor
- School of Human Sciences (Exercise and Sport Science)The University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Andrew Maiorana
- School of Physiotherapy and Exercise ScienceCurtin UniversityPerthAustralia
- Allied Health Department & Advanced Heart Failure and Cardiac Transplant ServiceFiona Stanley HospitalPerthAustralia
| | - Andrew Thompson
- Wolfson Centre for Personalised MedicineUniversity of LiverpoolUnited Kingdom
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Daniel J. Green
- School of Human Sciences (Exercise and Sport Science)The University of Western AustraliaCrawleyWestern AustraliaAustralia
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375
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Tryfonos A, Green DJ, Dawson EA. Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention? Sports Med 2019; 49:397-416. [PMID: 30719682 DOI: 10.1007/s40279-019-01055-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronary artery disease (CAD) is a leading cause of death worldwide, and percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty) are commonly used to diagnose and/or treat the obstructed coronaries. Exercise-based rehabilitation is recommended for all CAD patients; however, most guidelines do not specify when exercise training should commence following PTCA and/or PCI. Catheterization can result in arterial dysfunction and acute injury, and given the fact that exercise, particularly at higher intensities, is associated with elevated inflammatory and oxidative stress, endothelial dysfunction and a pro-thrombotic milieu, performing exercise post-PTCA/PCI may transiently elevate the risk of cardiac events. This review aims to summarize extant literature relating to the impacts of coronary interventions on arterial function, including the time-course of recovery and the potential deleterious and/or beneficial impacts of acute versus long-term exercise. The current literature suggests that arterial dysfunction induced by catheterization recovers 4-12 weeks following catheterization. This review proposes that a period of relative arterial vulnerability may exist and exercise during this period may contribute to elevated event susceptibility. We therefore suggest that CAD patients start an exercise training programme between 2 and 4 weeks post-PCI, recognizing that the literature suggest there is a 'grey area' for functional recovery between 2 and 12 weeks post-catheterization. The timing of exercise onset should take into consideration the individual characteristics of patients (age, severity of disease, comorbidities) and the intensity, frequency and duration of the exercise prescription.
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Affiliation(s)
- Andrea Tryfonos
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, 6009, Australia
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK.
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376
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Ramírez-Vélez R, Hernández-Quiñones PA, Tordecilla-Sanders A, Álvarez C, Ramírez-Campillo R, Izquierdo M, Correa-Bautista JE, Garcia-Hermoso A, Garcia RG. Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults. Lipids Health Dis 2019; 18:42. [PMID: 30717757 PMCID: PMC6362599 DOI: 10.1186/s12944-019-0981-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases, such as cardiovascular disease (CVD), metabolic syndrome, and breast and colon cancers, and shortens life expectancy. We aimed to determine the effects of moderate (MCT)- versus high-intensity interval training (HIT) on vascular function parameters in physically inactive adults. We hypothesized that individualized HIT prescription would improve the vascular function parameters more than the MCT in a greater proportion of individuals. METHODS Twenty-one inactive adults were randomly allocated to receive either MCT group (60-75% of their heart rate reserve, [HRR] or HIT group (4 min at 85-95% of peak HRR), 3 days a week for 12 weeks. Vascular function (brachial artery flow-mediated dilation, FMD [%], normalized brachial artery flow-mediated dilation, FMDn [%], aortic pulse wave velocity, PWV [m·s- 1], AIx, augmentation index: aortic and brachial [%]), were measured at baseline and over 12 weeks of training. In order for a participant to be considered a responder to improvements in vascular function parameters (FMDn and PWV), the typical error was calculated in a favorable direction. RESULTS FMD changed by - 1.0% (SE 2.1, d = 0.388) in the MCT group, and + 1.8% (SE 1.8, d = 0.699) in the HIT group (no significant difference between groups: 2.9% [95% CI, - 3.0 to 8.8]. PWV changed by + 0.1 m·s- 1 (SE 0.2, d = 0.087) in the MCT group but decreased by - 0.4 m·s- 1 in the HIT group (SE 0.2, d = 0.497), with significant difference between groups: - 0.4 [95% CI, - 0.2 to - 0.7]. There was not a significant difference in the prevalence of no-responder for FMD (%) between the MCT and HIT groups (66% versus 36%, P = 0.157). Regarding PWV (m·s- 1), an analysis showed that the prevalence of no-responder was 77% (7 cases) in the MCT group and 45% (5 cases) in the HIT group (P = 0.114). CONCLUSIONS Under the conditions of the present study, both groups experienced changed in vascular function parameters. Compared to MCT group, HIT is more efficacious for improving FMD and decreasing PWV, in physically inactive adults. TRIAL REGISTRATION ClinicalTrials.gov NCT02738385 registered on 23 March 2016.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física “CEMA”. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC Colombia
| | | | - Alejandra Tordecilla-Sanders
- Centro de Estudios para la Medición de la Actividad Física “CEMA”. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC Colombia
| | - Cristian Álvarez
- Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile
- Research Nucleus in Health, Physical Activity and Sports, Universidad de Los Lagos, Osorno, Chile
| | - Rodrigo Ramírez-Campillo
- Research Nucleus in Health, Physical Activity and Sports, Universidad de Los Lagos, Osorno, Chile
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315), Tudela, Navarre Spain
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física “CEMA”. Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, DC Colombia
| | - Antonio Garcia-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Ronald G. Garcia
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
- Neurovascular Science Group, Fundación Cardiovascular de Colombia, Floridablanca, Santander Colombia
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
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377
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Abstract
In addition to its role as an environmental stressor, scientists have recently demonstrated the potential for heat to be a therapy for improving or mitigating declines in arterial health. Many studies at both ends of the scientific controls spectrum (tightly controlled, experimental vs. practical) have demonstrated the beneficial effects of heating on microvascular function (e.g., reactive hyperemia, cutaneous vascular conductance); endothelial function (e.g., flow-mediated dilation); and arterial stiffness (e.g., pulse-wave velocity, compliance, β-stiffness index). It is important to note that findings of beneficial effects are not unanimous, likely owing to the varied methodology in both heating protocols and assessments of outcome measures. Mechanisms of action for the effects of both acute and chronic heating are also understudied. Heat science is a very promising area of human physiology research, as it has the potential to contribute to approaches addressing the global cardiovascular disease burden, particularly in aging and at risk populations, and those for whom exercise is not feasible or recommended.
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Affiliation(s)
- Jem L Cheng
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
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378
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Haynes A, Linden MD, Robey E, Watts GF, Barrett PHR, Naylor LH, Green DJ. Acute Impact of Different Exercise Modalities on Arterial and Platelet Function. Med Sci Sports Exerc 2019; 50:785-791. [PMID: 29240651 DOI: 10.1249/mss.0000000000001505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Acute coronary syndromes and ischemic stroke are associated with arterial events involving platelets, the endothelium, and atherosclerosis. Although regular physical activity is associated with lower risk of cardiovascular events and mortality, risk is transiently increased during and immediately after participation in an acute bout of exercise. No previous study has investigated the acute impact of exercise on platelet activation and arterial function in the same participants; it is also unknown if responses are dependent on exercise modality. We hypothesized that commonly adopted, yet physiologically distinct, modalities of exercise ("aerobic" vs "resistance") have differing effects on in vivo platelet activation and conduit artery diameter. METHODS Eight apparently healthy middle-age (53.5 ± 1.6 yr) male subjects took part in four 30-min experimental interventions (aerobic exercise, resistance exercise, combined aerobic/resistance exercise, or no-exercise), in random order. Blood samples were collected, and the measurement of brachial artery diameter by ultrasound was performed before, immediately after, and 1 h after each intervention. Platelet activation was determined by the positive binding of antibodies to surface receptors exposed on activated platelets (anti-CD62P and PAC-1). RESULTS Brachial artery diameter increased immediately after all three exercise modalities (P < 0.001) and remained above preexercise levels 1 h after resistance exercise and after combined aerobic/resistance exercise. No changes were observed in markers of in vivo platelet activation with any experimental protocol. CONCLUSIONS These data suggest that postexercise enhancement in arterial function may mitigate the acute impact of exercise on platelet activation.
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Affiliation(s)
- Andrew Haynes
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - Matthew D Linden
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - Elisa Robey
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - Gerald F Watts
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA.,School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - P Hugh R Barrett
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA.,School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA.,School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, AUSTRALIA
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379
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Carotid Artery Function Is Restored in Subjects With Elevated Cardiovascular Disease Risk After a 12-Week Physical Activity Intervention. Can J Cardiol 2019; 35:23-26. [DOI: 10.1016/j.cjca.2018.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 12/24/2022] Open
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380
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Coombs GB, Barak OF, Phillips AA, Mijacika T, Sarafis ZK, Lee AHX, Squair JW, Bammert TD, DeSouza NM, Gagnon D, Krassioukov AV, Dujic Z, DeSouza CA, Ainslie PN. Acute heat stress reduces biomarkers of endothelial activation but not macro- or microvascular dysfunction in cervical spinal cord injury. Am J Physiol Heart Circ Physiol 2018; 316:H722-H733. [PMID: 30575438 DOI: 10.1152/ajpheart.00693.2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cardiovascular diseases (CVD) are highly prevalent in spinal cord injury (SCI), and peripheral vascular dysfunction might be a contributing factor. Recent evidence demonstrates that exposure to heat stress can improve vascular function and reduce the risk of CVD in uninjured populations. We therefore aimed to examine the extent of vascular dysfunction in SCI and the acute effects of passive heating. Fifteen participants with cervical SCI and 15 uninjured control (CON) participants underwent ultrasound assessments of vascular function and venous blood sampling for biomarkers of endothelial activation (i.e., CD62e+) and apoptosis (i.e., CD31+/42b-) before and after a 60-min exposure to lower limb hot water immersion (40°C). In SCI, macrovascular endothelial function was reduced in the brachial artery [SCI: 4.8 (3.2)% vs. CON: 7.6 (3.4)%, P = 0.04] but not the femoral artery [SCI: 3.7 (2.6)% vs. CON: 4.0 (2.1)%, P = 0.70]. Microvascular function, via reactive hyperemia, was ~40% lower in SCI versus CON in both the femoral and brachial arteries ( P < 0.01). Circulating concentrations of CD62e+ were elevated in SCI versus CON [SCI: 152 (106) microparticles/µl vs. CON: 58 (24) microparticles/µl, P < 0.05]. In response to heating, macrovascular and microvascular function remained unchanged, whereas increases (+83%) and decreases (-93%) in antegrade and retrograde shear rates, respectively, were associated with heat-induced reductions of CD62e+ concentrations in SCI to levels similar to CON ( P = 0.05). These data highlight the potential of acute heating to provide a safe and practical strategy to improve vascular function in SCI. The chronic effects of controlled heating warrant long-term testing. NEW & NOTEWORTHY Individuals with cervical level spinal cord injury exhibit selectively lower flow-mediated dilation in the brachial but not femoral artery, whereas peak reactive hyperemia was lower in both arteries compared with uninjured controls. After 60 min of lower limb hot water immersion, femoral artery blood flow and shear patterns were acutely improved in both groups. Elevated biomarkers of endothelial activation in the spinal cord injury group decreased with heating, but these biomarkers remained unchanged in controls.
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Affiliation(s)
- Geoff B Coombs
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan , Kelowna, British Columbia , Canada
| | - Otto F Barak
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Cardiac Sciences, Clinical Neurosciences, Hotchkiss Brain Institute, Libin Cardiovascular Institute, University of Calgary, Alberta, Canada
| | - Tanja Mijacika
- Department of Integrative Physiology, School of Medicine, University of Split , Split , Croatia
| | - Zoe K Sarafis
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada
| | - Amanda H X Lee
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada
| | - Jordan W Squair
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada
| | - Tyler D Bammert
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado , Boulder, Colorado
| | - Noah M DeSouza
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado , Boulder, Colorado
| | - Daniel Gagnon
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute Research Centre, Département de pharmacologie et physiologie, Faculté de Médecine, Université de Montréal , Montreal, Quebec , Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada.,Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada
| | - Zeljko Dujic
- Department of Integrative Physiology, School of Medicine, University of Split , Split , Croatia
| | - Christopher A DeSouza
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado , Boulder, Colorado
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan , Kelowna, British Columbia , Canada.,International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia , Vancouver, British Columbia , Canada
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381
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Nowak-Flück D, Ainslie PN, Bain AR, Ahmed A, Wildfong KW, Morris LE, Phillips AA, Fisher JP. Effect of healthy aging on cerebral blood flow, CO2 reactivity, and neurovascular coupling during exercise. J Appl Physiol (1985) 2018; 125:1917-1930. [DOI: 10.1152/japplphysiol.00050.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We sought to make the first comparisons of duplex Doppler ultrasonography-derived measures of cerebral blood flow during exercise in young and older individuals and to assess whether healthy aging influences the effect of exercise on neurovascular coupling (NVC) and cerebral vascular reactivity to changes in carbon dioxide (CVRco2). In 10 healthy young (23 ± 2 yr; mean ± SD) and 9 healthy older (66 ± 3 yr) individuals, internal carotid artery (ICA) and vertebral artery (VA) blood flows were concurrently measured, along with middle and posterior cerebral artery mean blood velocity (MCAvmean and PCAvmean). Measures were made at rest and during leg cycling (75 W and 35% maximum aerobic workload). ICA and VA blood flow during dynamic exercise, undertaken at matched absolute (ICA: young 336 ± 95, older 352 ± 155; VA: young 95 ± 43, older 100 ± 30 ml/min) and relative (ICA: young 355 ± 125, older 323 ± 153; VA: young 115 ± 48, older 110 ± 32 ml/min) intensities, were not different between groups ( P > 0.670). The PCAvmean responses to visual stimulation (NVC) were blunted in older versus younger group at rest (16 ± 6% vs. 23 ± 7%, P < 0.026) and exercise; however, these responses were not changed from rest to exercise in either group. The ICA and VA CVRco2 were comparable in both groups and unaltered during exercise. Collectively, our findings suggest that 1) ICA and VA blood flow responses to dynamic exercise are similar in healthy young and older individuals, 2) NVC is blunted in healthy older individuals at rest and exercise but is not different between rest to exercise in either group, and 3) CVRco2 is similar during exercise in healthy young and older groups. NEW & NOTEWORTHY Internal carotid artery and vertebral artery blood flow responses to dynamic exercise are similar in healthy young and older individuals. Neurovascular coupling and cerebrovascular carbon dioxide reactivity, two key mechanisms mediating the cerebral blood flow responses to exercise, are generally unaffected by exercise in both healthy young and older individuals.
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Affiliation(s)
- Daniela Nowak-Flück
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Philip N. Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Anthony R. Bain
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Amar Ahmed
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Kevin W. Wildfong
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Laura E. Morris
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Aaron A. Phillips
- Departments of Physiology and Pharmacology and Clinical Neurosciences, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James P. Fisher
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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382
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Walsh LK, Ghiarone T, Olver TD, Medina-Hernandez A, Edwards JC, Thorne PK, Emter CA, Lindner JR, Manrique-Acevedo C, Martinez-Lemus LA, Padilla J. Increased endothelial shear stress improves insulin-stimulated vasodilatation in skeletal muscle. J Physiol 2018; 597:57-69. [PMID: 30328623 DOI: 10.1113/jp277050] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS It has been postulated that increased blood flow-associated shear stress on endothelial cells is an underlying mechanism by which physical activity enhances insulin-stimulated vasodilatation. This report provides evidence supporting the hypothesis that increased shear stress exerts insulin-sensitizing effects in the vasculature and this evidence is based on experiments in vitro in endothelial cells, ex vivo in isolated arterioles and in vivo in humans. Given the recognition that vascular insulin signalling, and associated enhanced microvascular perfusion, contributes to glycaemic control and maintenance of vascular health, strategies that stimulate an increase in limb blood flow and shear stress have the potential to have profound metabolic and vascular benefits mediated by improvements in endothelial insulin sensitivity. ABSTRACT The vasodilator actions of insulin contribute to glucose uptake by skeletal muscle, and previous studies have demonstrated that acute and chronic physical activity improves insulin-stimulated vasodilatation and glucose uptake. Because this effect of exercise primarily manifests in vascular beds highly perfused during exercise, it has been postulated that increased blood flow-associated shear stress on endothelial cells is an underlying mechanism by which physical activity enhances insulin-stimulated vasodilatation. Accordingly, herein we tested the hypothesis that increased shear stress, in the absence of muscle contraction, can acutely render the vascular endothelium more insulin-responsive. To test this hypothesis, complementary experiments were conducted using (1) cultured endothelial cells, (2) isolated and pressurized skeletal muscle arterioles from swine, and (3) humans. In cultured endothelial cells, 1 h of increased shear stress from 3 to 20 dynes cm-2 caused a significant shift in insulin signalling characterized by greater activation of eNOS relative to MAPK. Similarly, isolated arterioles exposed to 1 h of intraluminal shear stress (20 dynes cm-2 ) subsequently exhibited greater insulin-induced vasodilatation compared to arterioles kept under no-flow conditions. Finally, we found in humans that increased leg blood flow induced by unilateral limb heating for 1 h subsequently augmented insulin-stimulated popliteal artery blood flow and muscle perfusion. In aggregate, these findings across models (cells, isolated arterioles and humans) support the hypothesis that elevated shear stress causes the vascular endothelium to become more insulin-responsive and thus are consistent with the notion that shear stress may be a principal mechanism by which physical activity enhances insulin-stimulated vasodilatation.
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Affiliation(s)
- Lauren K Walsh
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Thaysa Ghiarone
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
| | - T Dylan Olver
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatchewan, Canada
| | | | - Jenna C Edwards
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Pamela K Thorne
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Jonathan R Lindner
- Knight Cardiovascular Institute and the Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Camila Manrique-Acevedo
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Missouri, Columbia, MO, USA.,Diabetes and Cardiovascular Research Center, University of Missouri, Columbia, MO, USA.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA
| | - Luis A Martinez-Lemus
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA.,Department of Child Health, University of Missouri, Columbia, MO, USA
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383
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Hieda M, Howden EJ, Sarma S, Cornwell W, Lawley JS, Tarumi T, Palmer D, Samels M, Everding B, Livingston S, Fu Q, Zhang R, Levine BD. The impact of 2 years of high-intensity exercise training on a model of integrated cardiovascular regulation. J Physiol 2018; 597:419-429. [PMID: 30387144 DOI: 10.1113/jp276676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/31/2018] [Indexed: 12/19/2022] Open
Abstract
KEY POINTS Heart rate variability, a common and easily measured index of cardiovascular dynamics, is the output variable of complicated cardiovascular and respiratory control systems. Both neural and non-neural control mechanisms may contribute to changes in heart rate variability. We previously developed an innovative method using transfer function analysis to assess the effect of prolonged exercise training on integrated cardiovascular regulation. In the present study, we modified and applied this to investigate the effect of 2 years of high-intensity training on circulatory components to tease out the primary effects of training. Our method incorporated the dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function. The dynamic Starling mechanism gain and arterial-cardiac baroreflex gain were significantly increased in the exercise group. These parameters remained unchanged in the controls. Conversely, neither group experienced a change in dynamic arterial elastance. The integrated cardiovascular regulation gain in the exercise group was 1.34-fold larger than that in the control group after the intervention. In these previously sedentary, otherwise healthy, middle-aged adults, 2 years of high-intensity exercise training improved integrated cardiovascular regulation by enhancing the dynamic Starling mechanism and arterial-cardiac baroreflex sensitivity. ABSTRACT Assessing the effects of exercise training on cardiovascular variability is challenging because of the complexity of multiple mechanisms. In a prospective, parallel-group, randomized controlled study, we examined the effect of 2 years of high-intensity exercise training on integrated cardiovascular function, which incorporates the dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function. Sixty-one healthy participants (48% male, aged 53 years, range 52-54 years) were randomized to either 2 years of exercise training (exercise group: n = 34) or control/yoga group (controls: n = 27). Before and after 2 years, subjects underwent a 6 min recording of beat-by-beat pulmonary artery diastolic pressure (PAD), stroke volume index (SV index), systolic blood pressure (sBP) and RR interval measurements with controlled respiration at 0.2 Hz. The dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function were calculated by transfer function gain between PAD and SV index; SV index and sBP; and sBP and RR interval, respectively. Fifty-three participants (controls: n = 25; exercise group: n = 28) completed the intervention. After 2 years, the dynamic Starling mechanism gain (Group × Time interaction: P = 0.008) and the arterial-cardiac baroreflex gain (P = 0.005) were significantly increased in the exercise group but remained unchanged in the controls. There was no change in dynamic arterial elastance in either of the two groups. The integrated cardiovascular function gain in the exercise group increased 1.34-fold, whereas there was no change in the controls (P = 0.02). In these previously sedentary, otherwise healthy middle-aged adults, a 2 year programme of high-intensity exercise training improved integrated cardiovascular regulation by enhancing the dynamic Starling mechanism and arterial-cardiac baroreflex sensitivity, without changing dynamic arterial elastance.
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Affiliation(s)
- Michinari Hieda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Erin J Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - William Cornwell
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,University of Colorado, School of Medicine, CO, USA
| | - Justin S Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,University of Innsbruck, Department of Sport Science, Innsbruck, Austria
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Dean Palmer
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Sheryl Livingston
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
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384
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Chen CK, Huang MH, Liang WL, Lin RT, Juo SHH. Early functional improvement after stroke correlates with cardiovascular fitness. Kaohsiung J Med Sci 2018; 34:643-649. [PMID: 30392571 DOI: 10.1016/j.kjms.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 11/26/2022] Open
Abstract
Cardiovascular fitness exerts directly beneficial effects on functional and cognitive outcomes in patients of chronic stroke. However, the effect of early rehabilitation on cardiovascular function has not yet been thoroughly examined. We tested whether complementary rehabilitation program could influence cardiovascular fitness in an early stage of stroke patients. The associations for post-acute stroke functional recovery with cardiovascular fitness were explored. Thirty-seven patients with mean poststroke interval of 8.6 ± 3.8 days underwent inpatient rehabilitation of 22.8 ± 3.8 days. Functional outcomes of 15.3 points (17.2%) in functional independence measure improved after rehabilitation program. The therapeutic cardiovascular fitness was determined in ramp exercise test on a cycling ergometer. Peak oxygen uptake (V˙O2peak) significantly increased by 24.8% after early stroke rehabilitation. Multivariate regression analysis was performed to assess for associations of functional improvement with respect to change in V˙O2peak and extremities motor impairment. V˙O2peak gain accounted for more functional recovery than extremities motor improvement (R2 = 0.42). In conclusion, these results suggest that cardiovascular fitness appears to increase after complementary program in early stroke rehabilitation, and better cardiovascular fitness may be associated with greater functional improvement.
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Affiliation(s)
- Chun-Kai Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, Collage of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mao-Hsiung Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Lung Liang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ruey-Tay Lin
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Suh-Hang H Juo
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Institute of New Drug Development, China Medical University, Taichung, Taiwan; Drug Development Center, China Medical University, Taichung, Taiwan; Centre for Myopia and Eye Disease, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
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385
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Iwamoto E, Bock JM, Casey DP. Hypercapnia-induced shear-mediated dilation in the internal carotid artery is blunted in healthy older adults. Am J Physiol Heart Circ Physiol 2018; 315:H1279-H1286. [DOI: 10.1152/ajpheart.00335.2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study aimed to elucidate the effect of aging on shear-mediated dilation of the common and internal carotid arteries (CCA and ICA, respectively). Hypercapnia-induced shear-mediated dilation in the CCA and ICA were assessed in 10 young (5 women and 5 men, 23 ± 1 yr) and 10 older (6 women/4 men, 68 ± 1 yr) healthy adults. Shear-mediated dilation was induced by two levels of hypercapnia (target end-tidal Pco2, +5 and +10 mmHg from individual baseline values) and was calculated as the percent rise in peak diameter from baseline diameter. There were no differences in shear-mediated dilation between young and older adults in either artery under lower levels of hypercapnia (CCA: 2.8 ± 0.6 vs. 2.0 ± 0.3%, P = 0.35; ICA: 4.6 ± 0.8 vs 3.6 ± 0.4%, P = 0.37). However, shear-mediated dilation in response to higher levels of hypercapnia was attenuated in older compared with young adults in the ICA (4.5 ± 0.5 vs. 7.9 ± 1.2%, P < 0.01) but not in the CCA (3.7 ± 0.6 vs. 4.5 ± 0.8%, P = 0.35). Shear-mediated dilation was significantly correlated to the percent change in shear rate in the ICA (young: r = 0.55, P = 0.01; older: r = 0.49, P = 0.03) but not in the CCA in either young or older adults (young: r = −0.30, P = 0.90; older: r = 0.16, P = 0.50). These data indicate that aging attenuates shear-mediated dilation of the ICA in response to higher levels of hypercapnia, and shear rate is an important stimulus for hypercapnic vasodilation of the ICA in both young and older adults. The present results may provide insights into age-related changes in the regulation of cerebral circulation in healthy adults. NEW & NOTEWORTHY We explored the effect of aging on shear-mediated dilation in the common and internal carotid arteries (CCA and ICA, respectively) in healthy adults. Our findings suggest that 1) aging attenuates shear-mediated dilation of the ICA but not the CCA and 2) shear rate is an important stimulus for hypercapnic vasodilation of the ICA in young and older adults. These findings may provide insights into the age-related changes in cerebrovascular regulation of healthy adults.
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Affiliation(s)
- Erika Iwamoto
- Human Integrative and Cardiovascular Physiology Laboratory, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa
- School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Joshua M. Bock
- Human Integrative and Cardiovascular Physiology Laboratory, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Darren P. Casey
- Human Integrative and Cardiovascular Physiology Laboratory, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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386
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Baeyens N. Fluid shear stress sensing in vascular homeostasis and remodeling: Towards the development of innovative pharmacological approaches to treat vascular dysfunction. Biochem Pharmacol 2018; 158:185-191. [PMID: 30365948 DOI: 10.1016/j.bcp.2018.10.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023]
Abstract
Blood circulation, facilitating gas exchange and nutrient transportation, is a quintessential feature of life in vertebrates. Any disruption to blood flow, may it be by blockade or traumatic rupture, irrevocably leads to tissue infarction or death. Therefore, it is not surprising that hemostasis and vascular adaptation measures have been evolutionarily selected to mitigate the adverse consequences of altered circulation. Blood vessels can be broadly categorized as arteries, veins, or capillaries, based on their structure, hemodynamics, and gas exchange. However, all of them share one property: they are lined with an epithelial sheet called the endothelium, which typically lies on a basement membrane. This endothelium is the primary interface between the flowing blood and the rest of the body, and it has highly specialized molecular mechanisms to detect and respond to changes in blood perfusion. The purpose of this commentary will be to highlight some of the recent developments in the research on blood flow sensing, vascular remodeling, and homeostasis and to discuss the development of innovative pharmaceutical approaches targeting mechanosensing mechanisms to prolong patient survival and improve quality of life.
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Affiliation(s)
- Nicolas Baeyens
- Laboratoire de physiologie et pharmacologie, Faculté de Médecine, Université libre de Bruxelles, ULB, Belgium.
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387
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Pierce DR, Doma K, Raiff H, Golledge J, Leicht AS. Influence of Exercise Mode on Post-exercise Arterial Stiffness and Pressure Wave Measures in Healthy Adult Males. Front Physiol 2018; 9:1468. [PMID: 30459633 PMCID: PMC6232940 DOI: 10.3389/fphys.2018.01468] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Exercise mode has been reported to be an important determinant of arterial stiffness and wave reflection changes following a brief bout of exercise with inconsistent results to date. This study examined the impact of exercise mode on arterial stiffness and pressure wave measures following acute aerobic exercise (AER), resistance exercise (RES), and a control (CON) condition with no exercise. Methods: In a randomized, cross-over, repeated measures design, 21 healthy adult males (26.7 ± 7.2 years) undertook three experimental intervention sessions: AER (30-min cycle ergometry at 70-75% maximum heart rate), RES (3 × 10 repetitions of six upper and lower body exercises at 80-90% of 10-repetition maximum) and CON (30-min seated rest). Measures of arterial stiffness and pressure waves, such as carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), AIx corrected for heart rate of 75 (AIx75), and forward wave (Pf), backward wave (Pb) and reflection magnitude, were assessed at Rest and at 10-min intervals for 60 min after the intervention sessions. Comparisons between interventions and over time were assessed via repeated measures ANOVA and post-hoc Tukey's tests. Results: No significant differences in cf-PWV were noted between the three interventions at rest or post-intervention. However, RES led to significantly greater post-intervention AIx, AIx75, Pf, and Pb compared to AER and CON with AIx75 also remaining significantly elevated throughout the post-intervention period. In contrast, AER resulted in a brief, significant elevation of AIx75 and no change in cf-PWV, Pf, Pb, and reflection magnitude. Conclusions: Exercise mode, specifically RES and AER, significantly influenced the time course of pressure wave reflection responses following a brief bout of exercise in healthy adult males. Distinct adjustments during exercise including changes in blood pressure and vasomotor tone may be key modulators of post-exercise arterial function. Identification of modal differences may assist in understanding the impact of exercise on cardiovascular function and the mechanisms by which exercise benefits vascular health.
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Affiliation(s)
- Doris R Pierce
- Sport & Exercise Science, James Cook University, Cairns, QLD, Australia
| | - Kenji Doma
- Sport & Exercise Science, James Cook University, Townsville, QLD, Australia
| | - Hayleigh Raiff
- Department of Health and Sport Science, University of Dayton, Dayton, OH, United States
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, QLD, Australia.,Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, QLD, Australia
| | - Anthony S Leicht
- Sport & Exercise Science, James Cook University, Townsville, QLD, Australia
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388
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Rice PE, Gurchiek RD, McBride JM. Physiological and Biomechanical Responses to an Acute Bout of High Kicking in Dancers. J Strength Cond Res 2018; 32:2954-2961. [DOI: 10.1519/jsc.0000000000002748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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389
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Shih WS, Wu CH, Wang TG. How does ballet training alter ankle tendinous morphology and hemodynamics in asymptomatic pre-professional dancers? An ultrasonographic study. J Sci Med Sport 2018; 22:392-396. [PMID: 30297215 DOI: 10.1016/j.jsams.2018.09.231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 08/18/2018] [Accepted: 09/20/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Among symptomatic dancers, sonographic abnormalities are common. Whether asymptomatic dancers have any abnormalities remains unknown. Some dancers became cyanosis over distal feet after ballet training. The hemodynamic changes at the feet in ballet are not clearly understood. DESIGN Cross-sectional study. METHODS In 25 dancers and 14 non-dancers, B-mode ultrasonography was used to measure cross-sectional areas (CSA) of tendons of deep posterior compartment muscles. Doppler ultrasonography was used to measure peak velocity (Vpeak) of posterior tibial artery in three ankle postures: the neutral position, passively and forced actively plantar flexion (en pointe). The big toe oxygen saturation was recorded in neutral position and during 1-min en pointe. Single-leg standing heel rise test was performed to represent the muscle function. RESULTS The CSA of FHL was larger in dancers (0.26cm2 [0.20, 0.30] vs 0.21cm2 [0.17, 0.24], p<0.01), while other tendons were not different (all p>0.05). Higher Vpeak was recorded in passively plantar flexion than in neutral position (p<0.01, in both groups). The blood flow was undetectable during en pointe, more frequently in dancers (54.9% vs 14.3%, p<0.01). Oxygen saturation decreased during en pointe more prominently in dancers (85% [80, 90] vs 94% [84, 97], p<0.01). There was no significant difference in muscle function. CONCLUSIONS US showed the FHL tendon thickening and en pointe-related vascular compromise in pre-professional dancers, even when they are asymptomatic.
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Affiliation(s)
- Wen-Shiuan Shih
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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390
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Nystoriak MA, Bhatnagar A. Cardiovascular Effects and Benefits of Exercise. Front Cardiovasc Med 2018; 5:135. [PMID: 30324108 PMCID: PMC6172294 DOI: 10.3389/fcvm.2018.00135] [Citation(s) in RCA: 318] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/07/2018] [Indexed: 12/19/2022] Open
Abstract
It is widely accepted that regular physical activity is beneficial for cardiovascular health. Frequent exercise is robustly associated with a decrease in cardiovascular mortality as well as the risk of developing cardiovascular disease. Physically active individuals have lower blood pressure, higher insulin sensitivity, and a more favorable plasma lipoprotein profile. Animal models of exercise show that repeated physical activity suppresses atherogenesis and increases the availability of vasodilatory mediators such as nitric oxide. Exercise has also been found to have beneficial effects on the heart. Acutely, exercise increases cardiac output and blood pressure, but individuals adapted to exercise show lower resting heart rate and cardiac hypertrophy. Both cardiac and vascular changes have been linked to a variety of changes in tissue metabolism and signaling, although our understanding of the contribution of the underlying mechanisms remains incomplete. Even though moderate levels of exercise have been found to be consistently associated with a reduction in cardiovascular disease risk, there is evidence to suggest that continuously high levels of exercise (e.g., marathon running) could have detrimental effects on cardiovascular health. Nevertheless, a specific dose response relationship between the extent and duration of exercise and the reduction in cardiovascular disease risk and mortality remains unclear. Further studies are needed to identify the mechanisms that impart cardiovascular benefits of exercise in order to develop more effective exercise regimens, test the interaction of exercise with diet, and develop pharmacological interventions for those unwilling or unable to exercise.
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Affiliation(s)
- Matthew A Nystoriak
- Division of Cardiovascular Medicine, Department of Medicine, Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, Louisville, KY, United States
| | - Aruni Bhatnagar
- Division of Cardiovascular Medicine, Department of Medicine, Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, Louisville, KY, United States
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391
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Garten RS, Hogwood AC, Weggen JB, Fralin RC, LaRosa K, Lee D, Michael A, Scott M. Aerobic training status does not attenuate prolonged sitting-induced lower limb vascular dysfunction. Appl Physiol Nutr Metab 2018; 44:425-433. [PMID: 30257099 DOI: 10.1139/apnm-2018-0420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study examined if the degree of aerobic training protects against the lower limb vascular dysfunction associated with a prolonged sitting bout. Ten young, aerobically trained (AT) and 10 young, untrained (UT) individuals completed a prolonged (3 h) sitting bout. Leg vascular function was measured prior to and at 1.5 and 3 h into the prolonged sitting bout using the passive leg movement (PLM) technique. PLM-induced hyperemia was significantly reduced from baseline at 1.5 and 3 h into the prolonged sitting bout in both groups when evaluated as peak change in leg blood flow from baseline (Δ LBF) (UT: 956 ± 140, 586 ± 80, and 599 ± 96 mL·min-1 at baseline, 1.5 h, and 3 h, respectively; AT: 955 ± 183, 789 ± 193, and 712 ± 131 mL·min-1 at baseline, 1.5 h, and 3 h, respectively) and LBF area under the curve (UT: 283 ± 73, 134 ± 31, and 164 ± 42 mL·min-1 at baseline, 1.5 h, and 3 h, respectively; AT: 336 ± 86, 242 ± 86, and 245 ± 73 mL·min-1 at baseline, 1.5 h, and 3 h, respectively), but no significant differences between groups were revealed. No significant correlations were observed when examining the relationship between maximal oxygen uptake (relative and absolute) and reductions in leg vascular function at 1.5 and 3 h into the prolonged sitting bout. This study revealed that aerobic training did not provide a protective effect against prolonged sitting-induced lower limb vascular dysfunction and further highlights the importance of reducing excessive sitting in all populations.
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Affiliation(s)
- Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Austin C Hogwood
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Jennifer B Weggen
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - R Carson Fralin
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Kathryn LaRosa
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - David Lee
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Austin Michael
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Matthew Scott
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
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392
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da Silva RA, Fernandes CJDC, Feltran GDS, Gomes AM, Andrade AF, Andia DC, Peppelenbosch MP, Zambuzzi WF. Laminar shear stress‐provoked cytoskeletal changes are mediated by epigenetic reprogramming of
TIMP1
in human primary smooth muscle cells. J Cell Physiol 2018; 234:6382-6396. [DOI: 10.1002/jcp.27374] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 08/17/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Rodrigo A. da Silva
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
| | - Célio Jr da C. Fernandes
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
| | - Geórgia da S. Feltran
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
| | - Anderson M. Gomes
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
| | - Amanda Fantini Andrade
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
| | - Denise C. Andia
- Faculdade de Odontologia Área de Pesquisa em Epigenética, Universidade Paulista, UNIP São Paulo São Paulo Brazil
| | - Maikel P. Peppelenbosch
- Department of Gastroenterology & Hepatology Erasmus MC, University Medical Center Rotterdam Rotterdam The Netherlands
| | - Willian F. Zambuzzi
- Department of Chemistry and Biochemistry Laboratory of Bioassays and Cellular Dynamics, São Paulo State University (UNESP), Institute of Biosciences, Campus Botucatu Botucatu Brazil
- Electron Microscopy Center, São Paulo State University (UNESP), Institute of Biosciences, campus Botucatu Botucatu Brazil
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393
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Woodman CR, Seawright JW, Luttrell MJ, Shin SY, Trache A. Importance of mechanical signals in promoting exercise-induced improvements in vasomotor function of aged skeletal muscle resistance arteries. Am J Physiol Heart Circ Physiol 2018; 315:H602-H609. [PMID: 29906226 DOI: 10.1152/ajpheart.00732.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Current research indicates that vasomotor responses are altered with aging in skeletal muscle resistance arteries. The changes in vasomotor function are characterized by impaired vasodilator and vasoconstrictor responses. The detrimental effects of aging on vasomotor function are attenuated in some vascular beds after a program of endurance exercise training. The signals associated with exercise responsible for inducing improvements in vasomotor function have been proposed to involve short-duration increases in intraluminal shear stress and/or pressure during individual bouts of exercise. Here, we review evidence that increases in shear stress and pressure, within a range believed to present in these arteries during exercise, promote healthy vasomotor function in aged resistance arteries. We conclude that available research is consistent with the interpretation that short-duration mechanical stimulation, through increases in shear stress and pressure, contributes to the beneficial effects of exercise on vasomotor function in aged skeletal muscle resistance arteries.
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Affiliation(s)
- Christopher R Woodman
- Department of Health and Kinesiology, Texas A&M University , College Station, Texas.,Department of Veterinary Physiology and Pharmacology, Texas A&M University , College Station, Texas
| | - John W Seawright
- Department of Health and Kinesiology, Texas A&M University , College Station, Texas
| | | | - Song Yi Shin
- Department of Health and Kinesiology, Texas A&M University , College Station, Texas
| | - Andreea Trache
- Department of Medical Physiology, Texas A&M University , College Station, Texas.,Department of Biomedical Engineering, Texas A&M University , College Station, Texas
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394
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Looft‐Wilson RC, Todd SE, Berberich KM, Wolfert MR. Flow does not alter eNOS phosphoryation at Ser1179 or Thr495 in preconstricted mouse mesenteric arteries. Physiol Rep 2018; 6:e13864. [PMID: 30247813 PMCID: PMC6129772 DOI: 10.14814/phy2.13864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/23/2022] Open
Abstract
In arteries, endothelium-dependent vasodilatory agonists and flow-induced shear stress cause vasodilation largely by activation of the endothelial enzyme eNOS, which generates nitric oxide that relaxes vascular smooth muscle. Agonists activate eNOS in part through increased phosphorylation at Ser1179 and decreased phosphorylation at Thr495. We previously found that preconstriction of intact, isolated mouse mesenteric arteries with phenylephrine also caused increased Ser1179 and decreased Thr495 eNOS phosphorylation, and sequential treatment with the vasodilatory agonist acetylcholine did not cause any further change in phosphorylation at these sites, despite producing vasodilation. The present study tests the hypothesis that luminal flow in these arteries preconstricted with phenylephrine also produces vasodilation without phosphorylation changes at these sites. First-order mesenteric arteries, isolated from male C57/BL6 mice (7-20 weeks of age) anesthetized with pentobarbital (50 mg/kg, i.p.), were cannulated, pressurized, and treated with stepped increases in luminal flow (15-120 μL/min). Flow resulted in dilation that plateaued at ~60 μL/min (31.3 ± 3.0% dilation) and was significantly (P < 0.001) NOS-dependent at all flow rates (determined by 10-4 mol/L L-NAME treatment). In separate arteries, preconstriction with phenylephrine (10-5 mol/L) resulted in increased eNOS phosphorylation at Ser1179 (P < 0.05) and decreased phosphorylation at Thr495, but subsequent flow at 60 μL/min for 5 or 15 min did not cause further changes in phosphorylation, despite causing dilation. Thus, flow-induced dilation does not require changes in these eNOS phosphorylation sites beyond those induced by alpha1-adrenergic stimulation with phenylephrine, indicating that eNOS is activated by other mechanisms during acute flow-induced dilation of preconstricted arteries.
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Affiliation(s)
- Robin C. Looft‐Wilson
- Department of Kinesiology and Health SciencesThe College of William & MaryWilliamsburgVirginia
| | - Sarah E. Todd
- Department of Kinesiology and Health SciencesThe College of William & MaryWilliamsburgVirginia
| | - Kristen M. Berberich
- Department of Kinesiology and Health SciencesThe College of William & MaryWilliamsburgVirginia
| | - Madeline R. Wolfert
- Department of Kinesiology and Health SciencesThe College of William & MaryWilliamsburgVirginia
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395
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Hashimoto Y, Okamoto T. Acute effects of walking in water on vascular endothelial function and heart rate variability in healthy young men. Clin Exp Hypertens 2018; 41:452-459. [PMID: 30141976 DOI: 10.1080/10641963.2018.1506468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM Aquatic exercise might improve endothelial function due to hydrostatic pressure increasing blood flow and causing shear stress to the endothelium. However, the acute effect of aerobic exercise in water on endothelial function is unclear. The present study compares the acute effect of aerobic exercise at moderate intensity in water and on land on endothelial function. METHODS Nine healthy young men walked on a treadmill for 30 min while immersed in water up to the xiphoid at 30.0 ± 0.2°C and on land at an intensity equivalent to 60% heart rate reserve in a crossover trial. Brachial artery flow-mediated dilation (FMD) was measured at baseline and at 30 and 60 min after exercise. Autonomic nervous activity was compared among conditions at the heart rate variability (HRV) during exercise. RESULTS FMD significantly decreased at 30 min after exercise on land trial (p < 0.05), but did not change after the aquatic trial. However, FMD was significantly higher after aquatic trial than land trial (p < 0.05) at 30 and 60 min after exercise, whereas heart rate, blood pressure, and HRV did not significantly differ between them. CONCLUSION These findings demonstrate that aerobic exercise in water suppressed the decrease in FMD compared with that on land, regardless of autonomic nervous activity.
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Affiliation(s)
- Yuto Hashimoto
- a Department of Health and Sport Science , Nippon Sport Science University , Tokyo , Japan
| | - Takanobu Okamoto
- b Department of Exercise Physiology , Nippon Sport Science University , Tokyo , Japan
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396
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Differences in vascular function between trained and untrained limbs assessed by near-infrared spectroscopy. Eur J Appl Physiol 2018; 118:2241-2248. [PMID: 30073561 DOI: 10.1007/s00421-018-3955-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/29/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of this study was to examine whether differences in vascular responsiveness associated with training status would be more prominent in the trained limb (leg) than in the untrained limb (arm) microvasculature. METHODS Thirteen untrained (26 ± 5 year) and twelve trained (29 ± 4 year) healthy men were submitted to a vascular occlusion test (VOT) (2 min baseline, 5 min occlusion, and 8 min re-oxygenation). The oxygen saturation signal (StO2) was assessed using near-infrared spectroscopy (NIRS) throughout the VOT. Vascular responsiveness within the microvasculature was evaluated by the re-oxygenation Slope 2 (Slope 2 StO2) and the area under the curve (StO2AUC) of (StO2) signal during re-oxygenation in the leg and arm. RESULTS There was a significant interaction between training status and limb for the slope 2 StO2 (P < 0.01). The leg of the trained group showed a steeper slope 2 StO2 (1.35 ± 0.12% s-1) when compared to the slope 2 StO2 of the leg in their untrained counterparts (0.86 ± 0.09% s-1) (P < 0.05). There was a medium effect size of 0.58 for slope 2 StO2 on the arm and a large effect size of 1.21 for slope 2 StO2 on the leg. In addition, there was a small effect size of 0.24 for StO2AUC on the arm and a medium effect size of 0.64 for StO2AUC on the leg. CONCLUSION The present study suggests that the vascular adaptations induced by lower limb endurance exercise training are more prominent in the trained limb than in the untrained limb microvasculature.
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397
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Pugh CJA, Stone KJ, Stöhr EJ, McDonnell BJ, Thompson JES, Talbot JS, Wakeham DJ, Cockcroft JR, Shave R. Carotid artery wall mechanics in young males with high cardiorespiratory fitness. Exp Physiol 2018; 103:1277-1286. [DOI: 10.1113/ep087067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/28/2018] [Indexed: 01/10/2023]
Affiliation(s)
| | - Keeron J. Stone
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- School of Sport & Exercise; University of Gloucester; Gloucester UK
| | - Eric J. Stöhr
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- Columbia University Irving Medical Center; Columbia University in the City of New York; New York NY USA
| | - Barry J. McDonnell
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Jane E. S. Thompson
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Jack S. Talbot
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Denis J. Wakeham
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - John R. Cockcroft
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Robert Shave
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- Centre for Heart, Lung & Vascular Health; University of British Columbia; Kelowna BC Canada
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398
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Butcher JT, Ali MI, Ma MW, McCarthy CG, Islam BN, Fox LG, Mintz JD, Larion S, Fulton DJ, Stepp DW. Effect of myostatin deletion on cardiac and microvascular function. Physiol Rep 2018; 5. [PMID: 29192067 PMCID: PMC5727279 DOI: 10.14814/phy2.13525] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 10/13/2017] [Accepted: 10/20/2017] [Indexed: 12/20/2022] Open
Abstract
The objective of this study is to test the hypothesis that increased muscle mass has positive effects on cardiovascular function. Specifically, we tested the hypothesis that increases in lean body mass caused by deletion of myostatin improves cardiac performance and vascular function. Echocardiography was used to quantify left ventricular function at baseline and after acute administration of propranolol and isoproterenol to assess β‐adrenergic reactivity. Additionally, resistance vessels in several beds were removed, cannulated, pressurized to 60 mmHg and reactivity to vasoactive stimuli was assessed. Hemodynamics were measured using in vivo radiotelemetry. Myostatin deletion results in increased fractional shortening at baseline. Additionally, arterioles in the coronary and muscular microcirculations are more sensitive to endothelial‐dependent dilation while nonmuscular beds or the aorta were unaffected. β‐adrenergic dilation was increased in both coronary and conduit arteries, suggesting a systemic effect of increased muscle mass on vascular function. Overall hemodynamics and physical characteristics (heart weight and size) remained unchanged. Myostatin deletion mimics in part the effects of exercise on cardiovascular function. It significantly increases lean muscle mass and results in muscle‐specific increases in endothelium‐dependent vasodilation. This suggests that increases in muscle mass may serve as a buffer against pathological states that specifically target cardiac function (heart failure), the β‐adrenergic system (age), and nitric oxide bio‐availability (atherosclerosis). Taken together, pharmacological inhibition of the myostatin pathway could prove an excellent mechanism by which the benefits of exercise can be conferred in patients that are unable to exercise.
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Affiliation(s)
- Joshua T Butcher
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - M Irfan Ali
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Merry W Ma
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Cameron G McCarthy
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Bianca N Islam
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Lauren G Fox
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - James D Mintz
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - Sebastian Larion
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - David J Fulton
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
| | - David W Stepp
- Department of Pharmacology, Department of Physiology, Vascular Biology Center, Augusta University, Augusta, Georgia
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399
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Marchio P, Guerra-Ojeda S, Vila JM, Aldasoro M, Valles SL, Soler C, Mauricio MD. Chronic exercise impairs nitric oxide pathway in rabbit carotid and femoral arteries. J Physiol 2018; 596:4361-4374. [PMID: 29968308 DOI: 10.1113/jp275611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 06/27/2018] [Indexed: 01/03/2023] Open
Abstract
KEY POINTS Some of the beneficial effects of exercise in preventing vascular related diseases are mediated by the enhancement of endothelial function where the role of nitric oxide (NO) is well documented, although the relevance of calcium activated potassium channels is not fully understood. The impact of oxidative stress induced by training on endothelial function remains to be clarified. By evaluating different endothelial vasodilator pathways on two vascular beds in a rabbit model of chronic exercise, we found a decreased NO bioavailability and endothelial nitric oxide synthase expression in both carotid and femoral arteries. Physical training induced carotid endothelial dysfunction as a result of an increase in oxidative stress and a reduction in superoxide dismutase expression. In the femoral artery, the lower production of NO was counteracted by an increased participation of large conductance calcium activated potassium channels, preventing endothelial dysfunction. ABSTRACT The present study aimed to evaluate the effects of chronic exercise on vasodilator response in two different arteries. Rings of carotid and femoral arteries from control and trained rabbits were suspended in organ baths for isometric recording of tension. Endothelial nitric oxide synthase (eNOS), Cu/Zn and Mn-superoxide dismutase (SOD), and large conductance calcium activated potassium (BKCa) channel protein expression were measured by western blotting. In the carotid artery, training reduced the relaxation to ACh (10-9 to 3 × 10-6 m) that was reversed by N-acetylcysteine (10-3 m). l-NAME (10-4 m) reduced the relaxation to ACh in both groups, although the effect was lower in the trained group (in mean ± SEM, 39 ± 2% vs. 28 ± 3%). Physical training did not modify the relaxation to ACh in femoral arteries, although the response to l-NAME was lower in the trained group (in mean ± SEM, 41 ± 5% vs. 17 ± 2%). Charybdotoxin (10-7 m) plus apamin (10-6 m) further reduced the maximal relaxation to ACh only in the trained group. The remaining relaxation in both carotid and femoral arteries was abolished by KCl (2 × 10-2 m) and BaCl2 (3 × 10-6 m) plus ouabain (10-4 m) in both groups. Physical training decreased eNOS expression in both carotid and femoral arteries and Cu/Zn and Mn-SOD expression only in the carotid artery. BKCa channels were overexpressed in the trained group in the femoral artery. In conclusion, chronic exercise induces endothelial dysfunction in the carotid artery as a result of oxidative stress. In the femoral artery, it modifies the vasodilator pathways, enhancing the participation of BKCa channels, thus compensating for the impairment of NO-mediated vasodilatation.
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Affiliation(s)
- Patricia Marchio
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Solanye Guerra-Ojeda
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - José M Vila
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Martín Aldasoro
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Soraya L Valles
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Carlos Soler
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Maria D Mauricio
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
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400
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Ried-Larsen M, MacDonald CS, Johansen MY, Hansen KB, Christensen R, Almdal TP, Pedersen BK, Karstoft K. Why prescribe exercise as therapy in type 2 diabetes? We have a pill for that! Diabetes Metab Res Rev 2018; 34:e2999. [PMID: 29488311 DOI: 10.1002/dmrr.2999] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/16/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
Abstract
The majority of T2D cases are preventable through a healthy lifestyle, leaving little room for questions that lifestyle should be the first line of defence in the fight against the development of T2D. However, when it comes to the clinical care of T2D, the potential efficacy of lifestyle is much less clear-cut, both in terms of impacting the pathological metabolic biomarkers of the disease, and long-term complications. A healthy diet, high leisure-time physical activity, and exercise are considered to be cornerstones albeit adjunct to drug therapy in the management of T2D. The prescription and effective implementation of structured exercise and other lifestyle interventions in the treatment of T2D have not been routinely used. In this article, we critically appraise and debate our reflections as to why exercise and physical activity may not have reached the status of a viable and effective treatment in the clinical care of T2D to the same extent as pharmaceutical drugs. We argue that the reason why exercise therapy is not utilized to a satisfactory degree is multifaceted and primarily relates to a "vicious cycle" with lack of proven efficacy on T2D complications and a lack of proven effectiveness on risk factors in the primary care of T2D. Furthermore, there is a lack of experimental research establishing the optimal dose of exercise. This precludes widespread and sustained implementation of physical activity and exercise in the clinical treatment of T2D will not succeed.
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Affiliation(s)
- Mathias Ried-Larsen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | - Christopher S MacDonald
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- CopenRehab, Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Y Johansen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katrine B Hansen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Internal Medicine, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Robin Christensen
- Musculoskeletal Statistics Unit, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Thomas P Almdal
- Department of Endocrinology PE, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bente K Pedersen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Karstoft
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
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