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Li Z, Kang S, Kang H. Development and validation of nomograms for predicting cardiovascular disease risk in patients with prediabetes and diabetes. Sci Rep 2024; 14:20909. [PMID: 39245747 PMCID: PMC11381537 DOI: 10.1038/s41598-024-71904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024] Open
Abstract
This study aimed to develop and validate distinct nomogram models for assessing CVD risk in individuals with prediabetes and diabetes. In a cross-sectional study design, we examined data from 2294 prediabetes and 1037 diabetics who participated in the National Health and Nutrition Examination Survey, which was conducted in the United States of America between 2007 and 2018. The dataset was randomly divided into training and validation cohorts at a ratio of 0.75-0.25. The Boruta feature selection method was used in the training cohort to identify optimal predictors for CVD diagnosis. A web-based dynamic nomogram was developed using the selected features, which were validated in the validation cohort. The Hosmer-Lemeshow test was performed to assess the nomogram's stability and performance. Receiver operating characteristics and calibration curves were used to assess the effectiveness of the nomogram. The clinical applicability of the nomogram was evaluated using decision curve analysis and clinical impact curves. In the prediabetes cohort, the CVD risk prediction nomogram included nine risk factors: age, smoking status, platelet/lymphocyte ratio, platelet count, white blood cell count, red cell distribution width, lactate dehydrogenase level, sleep disorder, and hypertension. In the diabetes cohort, the CVD risk prediction nomogram included eleven risk factors: age, material status, smoking status, systemic inflammatory response index, neutrophil-to-lymphocyte ratio, red cell distribution width, lactate dehydrogenase, high-density lipoprotein cholesterol, sleep disorder, hypertension, and physical activity. The nomogram models developed in this study have good predictive and discriminant utility for predicting CVD risk in patients with prediabetes and diabetes.
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Affiliation(s)
- Zhao Li
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea.
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Methi A, Islam MR, Kaurani L, Sakib MS, Krüger DM, Pena T, Burkhardt S, Liebetanz D, Fischer A. A Single-Cell Transcriptomic Analysis of the Mouse Hippocampus After Voluntary Exercise. Mol Neurobiol 2024; 61:5628-5645. [PMID: 38217668 PMCID: PMC11249425 DOI: 10.1007/s12035-023-03869-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/29/2023] [Indexed: 01/15/2024]
Abstract
Exercise has been recognized as a beneficial factor for cognitive health, particularly in relation to the hippocampus, a vital brain region responsible for learning and memory. Previous research has demonstrated that exercise-mediated improvement of learning and memory in humans and rodents correlates with increased adult neurogenesis and processes related to enhanced synaptic plasticity. Nevertheless, the underlying molecular mechanisms are not fully understood. With the aim to further elucidate these mechanisms, we provide a comprehensive dataset of the mouse hippocampal transcriptome at the single-cell level after 4 weeks of voluntary wheel-running. Our analysis provides a number of interesting observations. For example, the results suggest that exercise affects adult neurogenesis by accelerating the maturation of a subpopulation of Prdm16-expressing neurons. Moreover, we uncover the existence of an intricate crosstalk among multiple vital signaling pathways such as NF-κB, Wnt/β-catenin, Notch, and retinoic acid (RA) pathways altered upon exercise in a specific cluster of excitatory neurons within the Cornu Ammonis (CA) region of the hippocampus. In conclusion, our study provides an important resource dataset and sheds further light on the molecular changes induced by exercise in the hippocampus. These findings have implications for developing targeted interventions aimed at optimizing cognitive health and preventing age-related cognitive decline.
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Affiliation(s)
- Aditi Methi
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Md Rezaul Islam
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Lalit Kaurani
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - M Sadman Sakib
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Dennis M Krüger
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
- Bioinformatics Unit, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Tonatiuh Pena
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
- Bioinformatics Unit, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Susanne Burkhardt
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - David Liebetanz
- Department of Neurology, University Medical Center, Göttingen, Germany
| | - André Fischer
- Department for Epigenetics and Systems Medicine in Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Göttingen, Germany.
- Department for Psychiatry and Psychotherapy, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany.
- Cluster of Excellence "Multiscale Bioimaging: From Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Göttingen, Germany.
- DZHK (German Center for Cardiovascular Research), Partner Site, Göttingen, Germany.
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Xin C, Fu J, Zhou Z, Zhou Y, He H. Effects of aquatic and land high intensity interval training on hemodynamics and vascular function of middle-aged men. Front Physiol 2024; 15:1411277. [PMID: 39072213 PMCID: PMC11272582 DOI: 10.3389/fphys.2024.1411277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/11/2024] [Indexed: 07/30/2024] Open
Abstract
Objective: To investigate the effects of 8-week aquatic and land high intensity interval training (HIIT) on hemodynamics and vascular function in middle-aged men. Methods: Thirty middle-aged men with low physical activity were selected and divided into 15 men (52.43 ± 4.11) in aquatic group and 15 men (52.74 ± 5.62) in land group by random number table. They performed HIIT exercise in aquatic and land 3 times a week for 8 weeks. Pre-test, inter-test and post-test respectively measure hemodynamics and blood vessel function. Results: (1) Body composition: After 8 weeks of exercise, weight, body mass index (BMI) and body fat rate (BF) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of BF in the aquatic group was better than that in the land group (p < 0.05); (2) Cardiac function: After 8 weeks of exercise, stroke volume (SV), left ventricular end-diastolic volume (EDV), cardiac output (CO), and left ventricular fractional shortening (FS), were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05), heart rate (HR) and left ventricular end-systolic volume (ESV) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SV, HR, EDV, ESV, CO and FS in the aquatic group was better than that in the land group (p < 0.05); (3) Hemodynamics: After 8 weeks of exercise, systolic blood pressure (SBP), diastolic blood pressure (DBP) were lower than before exercise (aquatic group: p < 0.01, land group: p < 0.05), wall shear stress (WSS) and peak systolic velocity (PSV) were higher than before exercise (aquatic group: p < 0.01, land group: p < 0.05). The improvement of SBP, WSS and PSV in the aquatic group was better than that in the land group (p < 0.05); (4) Vascular function: basal diameter and brachial artery flow-mediated dilatation (FMD) level in aquatic group and land group was higher than before exercise, pulse wave velocity (PWV) level was lower than before exercise (aquatic and land group: p < 0.05). The improvement of FMD in the aquatic group was better than that in the land group. Conclusion: The body composition, hemodynamics and vascular function of middle-aged men were improved by 8-week aquatic and land HIIT. Aquatic HIIT has better effect on body fat rate, hemodynamics and vascular endothelial function in middle-aged men due to the effect of aquatic pressure and temperature.
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Affiliation(s)
- Chenxi Xin
- Physical Education Department, Shanghai University of Finance and Economics, Shanghai, China
- China Institute of Sports and Health, Beijing Sport University, Beijing, China
| | - Jiahao Fu
- Physical Education Department, Zhejiang Guangsha Vocational and Technical University of Construction, Zhejiang, China
| | - Zhihui Zhou
- Physical Education Department, Anhui Science and Technology University, Anhui, China
| | - Yujiao Zhou
- Physical Education Department, Beijing University of Aeronautics and Astronautics, Beijing, China
| | - Hui He
- China Institute of Sports and Health, Beijing Sport University, Beijing, China
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Martemucci G, Khalil M, Di Luca A, Abdallah H, D’Alessandro AG. Comprehensive Strategies for Metabolic Syndrome: How Nutrition, Dietary Polyphenols, Physical Activity, and Lifestyle Modifications Address Diabesity, Cardiovascular Diseases, and Neurodegenerative Conditions. Metabolites 2024; 14:327. [PMID: 38921462 PMCID: PMC11206163 DOI: 10.3390/metabo14060327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes.
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Affiliation(s)
| | - Mohamad Khalil
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70121 Bari, Italy;
| | - Alessio Di Luca
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, 70126 Bari, Italy; (A.D.L.); (A.G.D.)
| | - Hala Abdallah
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari Medical School, 70121 Bari, Italy;
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Hoseini R, Raed Hamid R. Lowering blood pressure by exercise: investigating the effect of sweating. Blood Press Monit 2024; 29:109-118. [PMID: 38299995 DOI: 10.1097/mbp.0000000000000691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
High blood pressure (hypertension), is a common medical condition, affecting millions of people and is associated with significant health risks. Exercise has been suggested to manage hypertension by inducing sweating and the corresponding loss of sodium and water from the body.Thus, a variety of epidemiological and clinical studies have been conducted to investigate the relationship between sweating and exercise-induced blood pressure reduction and its impacts on hypertension. The mechanisms underlying exercise-induced blood pressure reduction are complex and still not fully understood. However, several pathways have been suggested, including the loss of sodium and water through sweat, a decrease in peripheral resistance, and an improvement in endothelial function in the blood vessels. The decrease in sodium and water content in the body associated with sweating may result in a reduction in blood volume and thus a decrease in blood pressure. Moreover, the reduction in peripheral resistance is thought to be mediated by the activation of the nitric oxide synthase pathway and the release of vasodilators such as prostacyclin and bradykinin, which lead to vasodilation and, thus, a reduction in blood pressure. In conclusion, exercise-induced sweating and consequent sodium and water loss appear to be a reliable biological link to the blood pressure-reducing effects of exercise in hypertensive individuals. Additionally, the mechanisms underlying exercise-induced blood pressure reduction are complex and involve several biological pathways in the cardiovascular system. Therefore, understanding the role of sweat production in blood pressure management is important for developing effective exercise interventions to prevent and manage hypertension.
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Affiliation(s)
- Rastegar Hoseini
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah
| | - Rasha Raed Hamid
- Physical Education and Sport Sciences Department, University of Garmian, Kurdistan Region, Iraq
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Gholami F, Naderi A, Saeidpour A, Lefaucheur JP. Effect of exercise training on glycemic control in diabetic peripheral neuropathy: A GRADE assessed systematic review and meta-analysis of randomized-controlled trials. Prim Care Diabetes 2024; 18:109-118. [PMID: 38286719 DOI: 10.1016/j.pcd.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/03/2024] [Accepted: 01/20/2024] [Indexed: 01/31/2024]
Abstract
AIMS We conducted a systematic review and meta-analysis to investigate the effect of exercise training on HbA1c, and on fasting and postprandial plasma glucose concentrations in patients with diabetic peripheral neuropathy (DPN). METHODS Two independent researchers performed a systematic search in the electronic databases of PubMed, Web of Science and Scopus. Studies investigating the effect of exercise training on patients diagnosed with DPN using a randomized-controlled design were included in the meta-analysis. RESULTS Of 1254 retrieved studies, 68 studies were identified to undergo full-text review; out of these a total of 13 randomized trials met the inclusion criteria. Eleven studies assessed HbA1c, 8 fasting plasma-glucose concentration, and 3 postprandial plasma-glucose concentration. Overall, exercise training significantly decreased HbA1c [-0.54% (95% CI -0.78 to -0.31%)], fasting plasma glucose [-32.6 mg/dl [-1.8 mmol/L] (-44.2 to -20.9 mg/dl [-2.4 to -1.1 mmol/L])] and postprandial plasma glucose [-67.5 mg/dl [-3.7 mmol/L] (-129.5 to -5.4 mg/dl [-7.1 to -0.3 mmol/L])]. Studies with aerobic training intervention yielded the largest significant mean reduction in HbA1c (-0.75%) and fasting plasma glucose concertation (34.0 mg/dl). CONCLUSIONS aerobic training is the most effective modality to reduces HbA1c, fasting and postprandial plasma glucose concentration in patients with DPN. From a metabolic perspective, the magnitude precision range of the reduction in HbA1c is of clinical importance for patients with DPN. This area of research warrants further attention to investigate the impact of various exercise modalities on glycemic control. Registration number CRD42023413687.
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Affiliation(s)
- Farhad Gholami
- Department of Physical Education and Sport Sciences, Faculty of Physical Education, Shahrood University of Technology, Shahrood, Iran.
| | - Aynollah Naderi
- Department of Physical Education and Sport Sciences, Faculty of Physical Education, Shahrood University of Technology, Shahrood, Iran
| | - Asal Saeidpour
- Department of Physical Education and Sport Sciences, Faculty of Physical Education, Shahrood University of Technology, Shahrood, Iran
| | - Jean Pascal Lefaucheur
- ENT Team, EA4391, Faculty of Medicine, Paris Est Créteil University, Créteil, France; Clinical Neurophysiology Unit, Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France
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Halvorson BD, Bao Y, Singh KK, Frisbee SJ, Hachinski V, Whitehead SN, Melling CWJ, Chantler PD, Goldman D, Frisbee JC. Thromboxane-induced cerebral microvascular rarefaction predicts depressive symptom emergence in metabolic disease. J Appl Physiol (1985) 2024; 136:122-140. [PMID: 37969083 DOI: 10.1152/japplphysiol.00410.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Previous studies have suggested that the loss of microvessel density in the peripheral circulation with evolving metabolic disease severity represents a significant contributor to impaired skeletal muscle oxygenation and fatigue-resistance. Based on this and our recent work, we hypothesized that cerebral microvascular rarefaction was initiated from the increased prooxidant and proinflammatory environment with metabolic disease and is predictive of the severity of the emergence of depressive symptoms in obese Zucker rats (OZRs). In male OZR, cerebrovascular rarefaction followed the emergence of elevated oxidant and inflammatory environments characterized by increased vascular production of thromboxane A2 (TxA2). The subsequent emergence of depressive symptoms in OZR was associated with the timing and severity of the rarefaction. Chronic intervention with antioxidant (TEMPOL) or anti-inflammation (pentoxifylline) therapy blunted the severity of rarefaction and depressive symptoms, although the effectiveness was limited. Blockade of TxA2 production (dazmegrel) or action (SQ-29548) resulted in a stronger therapeutic effect, suggesting that vascular production and action represent a significant contributor to rarefaction and the emergence of depressive symptoms with chronic metabolic disease (although other pathways clearly contribute as well). A de novo biosimulation of cerebrovascular oxygenation in the face of progressive rarefaction demonstrates the increased probability of generating hypoxic regions within the microvascular networks, which could contribute to impaired neuronal metabolism and the emergence of depressive symptoms. The results of the present study also implicate the potential importance of aggressive prodromic intervention in reducing the severity of chronic complications arising from metabolic disease.NEW & NOTEWORTHY With clinical studies linking vascular disease risk to depressive symptom emergence, we used obese Zucker rats, a model of chronic metabolic disease, to identify potential mechanistic links between these two negative outcomes. Depressive symptom severity correlated with the extent of cerebrovascular rarefaction, after increased vascular oxidant stress/inflammation and TxA2 production. Anti-TxA2 interventions prevasculopathy blunted rarefaction and depressive symptoms, while biosimulation indicated that cerebrovascular rarefaction increased hypoxia within capillary networks as a potential contributing mechanism.
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Affiliation(s)
- Brayden D Halvorson
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Yuki Bao
- Department of Biomedical Engineering, University of Western Ontario, London, Ontario, Canada
| | - Krishna K Singh
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Vladimir Hachinski
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - C W James Melling
- Department of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | - Paul D Chantler
- Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia, United States
| | - Daniel Goldman
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
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Ramis TR, Boeno FP, Leal-Menezes R, Munhoz SV, Farinha JB, Ribeiro JL, Reischak-Oliveira A. Effects of exercise modalities on decreased blood pressure in patients with hypertension. Front Physiol 2022; 13:993258. [PMID: 36311227 PMCID: PMC9614347 DOI: 10.3389/fphys.2022.993258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the acute effects of aerobic and resistance exercises on blood pressure and endothelial blood markers. We also correlated post-exercise blood pressure response with baseline cardiovascular parameters in middle-aged patients with hypertension. This cross-sectional study randomized 54 volunteers into the aerobic exercise group (AG, n = 27; 45.6 ± 7.7 years) or dynamic resistance exercise group (RG, n = 27; 45.8 ± 8.4 years). Blood marker evaluation, cardiopulmonary exercise tests, resting blood pressure monitoring, ambulatory blood pressure monitoring (ABPM), flow-mediated dilatation monitoring, and body composition evaluation were carried out. Exercise sessions were performed to evaluate post-exercise hypotension (PEH) and endothelial marker responses, in addition to post-exercise ABPM (ABPMex). This study is an arm of the study which was approved by the local ethics committee (No. 69373217.3.0000.5347) in accordance with the Helsinki Declaration and was registered at ClinicalTrials.gov (NCT03282942). The AG performed walking/running at 60% of the reserve heart rate, while the RG performed 10 exercises with two sets of 15-20 repetitions. The mean 24 h ABPM and ABPMex values showed no significant statistical differences. Systolic and diastolic blood pressure hypotension after aerobic and dynamic resistance were -10.59 ± 5.24/-6.15 ± 6.41 mmHg and -5.56 ± 7.61/-6.20 ± 8.25 mmHg, respectively. For an up-to-7 h assessment of resting pressure, there was a positive effect in the aerobic group. The concentrations of nitrites/nitrates (NOx) and endothelin-1 (ET-1) did not change during hypotension. Moreover, PEH and ABPMex were significantly correlated with baseline health variables. Thus, when middle-aged patients with hypertension perform aerobic or resistance exercise, the NOx/ET-1 pathway does not provide the best explanation for PEH. Finally, we found associations between baseline cardiovascular variables and endothelial vasoconstrictors with PEH.
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Affiliation(s)
- Thiago Rozales Ramis
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Franccesco Pinto Boeno
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Rodrigo Leal-Menezes
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Samuel Vargas Munhoz
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliano Boufleur Farinha
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jerri Luiz Ribeiro
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alvaro Reischak-Oliveira
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Mone P, Izzo R, Marazzi G, Manzi MV, Gallo P, Campolongo G, Cacciotti L, Tartaglia D, Caminiti G, Varzideh F, Santulli G, Trimarco V. L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic. J Pharmacol Exp Ther 2022; 381:197-203. [PMID: 35339987 DOI: 10.1124/jpet.122.001149] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
Cardiac rehabilitation (CR) following acute myocardial infarction (AMI) improves physical capacities and decreases hospitalizations and cardiovascular mortality. L-Arginine is the substrate used by nitric oxide (NO) synthase (NOS) to generate NO and it has been shown to exert its beneficial effects on endothelium driving vasodilatation, reducing inflammation, and ameliorating physical function. We hypothesized that L-Arginine could enhance physical capacities in patients who underwent CR after AMI. We designed a study aimed to assess the effects of L-arginine administration on the physical capacity of patients who underwent coronary revascularization after AMI. The trial was carried out amid the COVID-19 pandemic. Patients were assigned, with a 2:1 ratio, to add to their standard therapy 1 bottle containing 1.66 g of L-arginine or 1 bottle of identical aspect apart from not containing L-arginine, twice a day orally for 3 weeks. Patients performed a 6-minute walking test (6MWT) and were assessed their Borg modified 0-10 rating of perceived exertion (BRPE) before starting and at the end of the treatment. Seventy-five patients receiving L-Arginine, and thirty-five receiving placebo successfully completed the study. The 6MWT distance increased significantly in the L-Arginine group compared to both baseline and placebo (p<0.0001). Additionally, we observed a significant improvement in the BRPE in patients treated with L-arginine but not in the placebo group. Taken together, our data indicate that L-arginine potentiates the response to CR, independently of age, sex, baseline functional capacity, and comorbid conditions. Significance Statement This study shows for the first time that oral supplementation of L-arginine potentiates the response to cardiac rehabilitation after myocardial infarction and cardiac revascularization. Indeed, we observed a significant improvement in two fundamental parameters, namely, the 6-minute walking test and the Borg modified 0-10 rating of perceived exertion. Strikingly, the beneficial effects of L-arginine were independent from age, sex, comorbid conditions, and baseline functional capacity.
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Nascimento DDC, Rolnick N, Neto IVDS, Severin R, Beal FLR. A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation. Front Physiol 2022; 13:808622. [PMID: 35360229 PMCID: PMC8963452 DOI: 10.3389/fphys.2022.808622] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Blood flow restriction training (BFRT) is a modality with growing interest in the last decade and has been recognized as a critical tool in rehabilitation medicine, athletic and clinical populations. Besides its potential for positive benefits, BFRT has the capability to induce adverse responses. BFRT may evoke increased blood pressure, abnormal cardiovascular responses and impact vascular health. Furthermore, some important concerns with the use of BFRT exists for individuals with established cardiovascular disease (e.g., hypertension, diabetes mellitus, and chronic kidney disease patients). In addition, considering the potential risks of thrombosis promoted by BFRT in medically compromised populations, BFRT use warrants caution for patients that already display impaired blood coagulability, loss of antithrombotic mechanisms in the vessel wall, and stasis caused by immobility (e.g., COVID-19 patients, diabetes mellitus, hypertension, chronic kidney disease, cardiovascular disease, orthopedic post-surgery, anabolic steroid and ergogenic substance users, rheumatoid arthritis, and pregnant/postpartum women). To avoid untoward outcomes and ensure that BFRT is properly used, efficacy endpoints such as a questionnaire for risk stratification involving a review of the patient's medical history, signs, and symptoms indicative of underlying pathology is strongly advised. Here we present a model for BFRT pre-participation screening to theoretically reduce risk by excluding people with comorbidities or medically complex histories that could unnecessarily heighten intra- and/or post-exercise occurrence of adverse events. We propose this risk stratification tool as a framework to allow clinicians to use their knowledge, skills and expertise to assess and manage any risks related to the delivery of an appropriate BFRT exercise program. The questionnaires for risk stratification are adapted to guide clinicians for the referral, assessment, and suggestion of other modalities/approaches if/when necessary. Finally, the risk stratification might serve as a guideline for clinical protocols and future randomized controlled trial studies.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Department of Physical Education, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States
| | - Ivo Vieira de Sousa Neto
- Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, University of Brasília, Brasília, Brazil
| | - Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL, United States
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States
| | - Fabiani Lage Rodrigues Beal
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Nutrition, Health and Medicine School, Catholic University of Brasília (UCB), Brasília, Brazil
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Novaković M, Prokšelj K, Jug B. Exercise capacity, cardiac and endothelial function in adults with repaired tetralogy of Fallot. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2022. [DOI: 10.1016/j.ijcchd.2022.100327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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12
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Barha CK, Dao E, Marcotte L, Hsiung GYR, Tam R, Liu-Ambrose T. Cardiovascular risk moderates the effect of aerobic exercise on executive functions in older adults with subcortical ischemic vascular cognitive impairment. Sci Rep 2021; 11:19974. [PMID: 34620933 PMCID: PMC8497597 DOI: 10.1038/s41598-021-99249-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022] Open
Abstract
Aerobic training (AT) can promote cognitive function in adults with Subcortical Ischemic Vascular Cognitive Impairment (SIVCI) by modifying cardiovascular risk factors. However, pre-existing cardiovascular health may attenuate the benefits of AT on cognitive outcomes in SIVCI. We examined whether baseline cardiovascular risk moderates the effect of a 6-month progressive AT program on executive functions with a secondary analysis of a randomized controlled trial in 71 adults, who were randomized to either: (1) 3×/week progressive AT; or (2) education program (CON). Three executive processes were measured: (1) response inhibition by Stroop Test; (2) working memory by digits backward test; and (3) set shifting by the Trail Making Test. Baseline cardiovascular risk was calculated using the Framingham cardiovascular disease (CVD) Risk Score (FCRS), and participants were classified as either low risk (< 20% FCRS score; LCVR) or high risk (≥ 20% FCRS score; HCVR). A complete case analysis (n = 58) was conducted using an analysis of covariance (ANCOVA) to evaluate between-group differences in the three executive processes. A significant interaction was found between cardiovascular risk group and intervention group (AT or CON) for the digit span backward and the Trail Making Test. AT improved performance compared with CON in those with LCVR, while in those with HCVR, AT did not improve performance compared with CON. Baseline cardiovascular risk significantly moderates the efficacy of AT on cognition. Our findings highlight the importance of intervening early in the disease course of SIVCI, when cardiovascular risk may be lower, to reap maximum benefits of aerobic exercise.
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Affiliation(s)
- Cindy K Barha
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Elizabeth Dao
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.,Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Lauren Marcotte
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Ging-Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.,Division of Neurology, University of British Columbia, Vancouver, Canada.,Vancouver Coastal Health Research Institute and University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders, Vancouver, Canada
| | - Roger Tam
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.,Department of Radiology, University of British Columbia, Vancouver, Canada.,School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada. .,Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada. .,Centre for Hip Health and Mobility, Vancouver, Canada.
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13
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Mattioni Maturana F, Soares RN, Murias JM, Schellhorn P, Erz G, Burgstahler C, Widmann M, Munz B, Thiel A, Nieß AM. Responders and non-responders to aerobic exercise training: beyond the evaluation of V˙O2max. Physiol Rep 2021; 9:e14951. [PMID: 34409753 PMCID: PMC8374384 DOI: 10.14814/phy2.14951] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/09/2021] [Accepted: 06/13/2021] [Indexed: 02/07/2023] Open
Abstract
The evaluation of the maximal oxygen uptake ( V ˙ O 2 max ) following exercise training is the classical assessment of training effectiveness. Research has lacked in investigating whether individuals that do not respond to the training intervention ( V ˙ O 2 max ), also do not improve in other health-related parameters. We aimed to investigate the cardiovascular and metabolic adaptations (i.e., performance, body composition, blood pressure, vascular function, fasting blood markers, and resting cardiac function and morphology) to exercise training among participants who showed different levels of V ˙ O 2 max responsiveness. Healthy sedentary participants engaged in a 6-week exercise training program, three times a week. Our results showed that responders had a greater increase in peak power output, second lactate threshold, and microvascular responsiveness, whereas non-responders had a greater increase in cycling efficiency. No statistical differences were observed in body composition, blood pressure, fasting blood parameters, and resting cardiac adaptations. In conclusion, our study showed, for the first time, that in addition to the differences in the V ˙ O 2 max , a greater increase in microvascular responsiveness in responders compared to non-responders was observed. Additionally, responders and non-responders did not show differences in the adaptations on metabolic parameters. There is an increasing need for personalized training prescription, depending on the target clinical outcome.
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Affiliation(s)
- Felipe Mattioni Maturana
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
- Interfaculty Research Institute for Sport and Physical ActivityEberhard Karls University of TübingenTübingenGermany
| | | | - Juan M. Murias
- Faculty of KinesiologyUniversity of CalgaryCalgaryCanada
| | - Philipp Schellhorn
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
| | - Gunnar Erz
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
| | | | - Manuel Widmann
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
- Interfaculty Research Institute for Sport and Physical ActivityEberhard Karls University of TübingenTübingenGermany
| | - Barbara Munz
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
- Interfaculty Research Institute for Sport and Physical ActivityEberhard Karls University of TübingenTübingenGermany
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical ActivityEberhard Karls University of TübingenTübingenGermany
- Institute of Sports ScienceEberhard Karls University TübingenTübingenGermany
| | - Andreas M. Nieß
- Sports Medicine DepartmentUniversity Hospital of TübingenTübingenGermany
- Interfaculty Research Institute for Sport and Physical ActivityEberhard Karls University of TübingenTübingenGermany
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14
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Belmonte Darraz S, González-Roldán AM, de María Arrebola J, Montoro-Aguilar CI. [Physical exercise impact on variables related to emotional and functional well-being in older adults]. Rev Esp Geriatr Gerontol 2021; 56:136-143. [PMID: 33775433 DOI: 10.1016/j.regg.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The benefits of the physical exercise in aging, and specially in frailty, have been associated with reduced risk of mortality, chronic disease, and cognitive and functional impairments. Multi-component training, which combines strength, endurance, balance, and gait training, represents the most beneficial kind of physical exercise in older adults. METHODS Given the effectiveness of the multi-component training, a physical exercise program «Actívate» (based on the methodology Vivifrail), with the focus on «active aging», was conducted in the present study. Forty-nine older adults over 60 years participated in this program. RESULTS The physical exercise intervention led to a reduction in diastolic blood pressure, pain threshold and sleep disturbances (e. g. hypersomnia) (t ≥ 2.72, p < 0.01), as well as an increase of walking speed (t = 7.84, p ≤ 0.001). Further, quality of life factors (GENCAT scale), like emotional well-being, personal development, physical well-being, self-determination, and social inclusion, were greater after intervention (t ≥ -2.06, p < 0.05). CONCLUSIONS These findings underline the benefits of multi-component training in functionality of older adults, and further, provide relevant aspects about the modulation of pain perception, sleep disturbances, social factors and physical and emotional well-being. Physical exercise programs such as «Actívate» should be promoted, in order to encourage healthy lifestyle habits, in the older adults' population.
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Affiliation(s)
- Saliha Belmonte Darraz
- Instituto de Investigación en Ciencias de la Salud (IUNICS) e Instituto de Investigación en Salud de las Islas Baleares (IdISBa), Universidad de las Islas Baleares (UIB), Palma, España; Área de Sanidad del Ayuntamiento de Palma de Mallorca, Palma, España
| | - Ana María González-Roldán
- Instituto de Investigación en Ciencias de la Salud (IUNICS) e Instituto de Investigación en Salud de las Islas Baleares (IdISBa), Universidad de las Islas Baleares (UIB), Palma, España
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15
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Han X, Li T, Li Y, Yang J, Chen S, Zhu X, Wang B, Cheng W, Wang L, Lu Z, Wu X, Jiang Y, Pan G, Zhao M. Exercise and Circulating Microparticles in Healthy Subjects. J Cardiovasc Transl Res 2021; 14:841-856. [PMID: 33495962 DOI: 10.1007/s12265-021-10100-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022]
Abstract
This study aimed to explore the relationship between exercise and circulating microparticles (CMPs). PubMed, Web of Science, Embase, and the Cochrane Library databases were searched until August 13, 2020, using the terms "exercise" and "cell-derived microparticles." The Cochrane tool of risk of bias and the Methodological Index for Non-Randomized Studies were used to grade the studies. Twenty-six studies that met criteria were included in this review, including one before-after self-control study, 2 cohort studies, 4 randomized control trials, 5 case-control studies, and 14 descriptive studies. The studies were divided into a single bout and long-term exercise. The types of MPs contained endothelium-derived microparticles (EMPs), leukocyte-derived microparticles (LMPs), platelet-derived microparticles (PMPs), and erythrocyte-derived microparticles (ErMPs). This first systematic review found that the levels of CMPs continued to increase after a single bout of exercise in untrained subjects and were lower in trained subjects. PMPs expressed a transient increase after a single bout of exercise, and the proportion and duration of PMPs increment reduced in long-term exercise. Most studies showed a decline in LMPs in trained subjects after a single bout and long-term exercise, and variable changes were found in EMPs and ErMPs after exercise. A single bout of exercise drives the vessels exposed to high shear stress that promotes the formation of CMPs. However, the decline in CMPs in trained subjects may be attributed to the fact that they have a better ability to adapt to changes in hemodynamics and cellular function during exercise.
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Affiliation(s)
- Xiaowan Han
- Dongzhimen Hospital, Department of Cardiovascular Medicine, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Tong Li
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Yang Li
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Jingjing Yang
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Shiqi Chen
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Xiangyu Zhu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Baofu Wang
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Wenkun Cheng
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Lei Wang
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Ziwen Lu
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Xiaoxiao Wu
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Yangyang Jiang
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China
| | - Guozhong Pan
- Dongzhimen Hospital, Department of Cardiovascular Medicine, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China.
| | - Mingjing Zhao
- Dongzhimen Hospital, Key Laboratory of Chinese Internal Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, People's Republic of China.
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16
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Senefeld JW, Harmer AR, Hunter SK. Greater Lower Limb Fatigability in People with Prediabetes than Controls. Med Sci Sports Exerc 2020; 52:1176-1186. [PMID: 31815831 DOI: 10.1249/mss.0000000000002238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The study purpose was to compare perceived fatigability and performance fatigability after high-velocity contractions with knee extensor muscles between people with prediabetes, people with type 2 diabetes (T2D), and controls without diabetes matched for age, body mass index, and physical activity. METHODS Twenty people with prediabetes (11 men, 9 women: 63.1 ± 6.0 yr, 26.9 ± 4.2 kg·m, 8030 ± 3110 steps per day), 39 with T2D (23 men, 16 women: 61.2 ± 8.5 yr, 29.4 ± 6.4 kg·m, 8440 ± 4220 steps per day), and 27 controls (13 men, 14 women: 58.1 ± 9.4 yr, 27.3 ± 4.3 kg·m, 8400 ± 3000 steps per day) completed the Fatigue Impact Scale as a measure of perceived fatigability and a fatigue protocol including 120 maximal-effort, high-velocity concentric contractions (MVCC; 1 contraction/3 s) with the knee extensors using a submaximal load (30% maximum) to quantify performance fatigability. Electrical stimulation was used to assess voluntary activation and contractile function of the knee extensor muscles before and after the fatigue protocol. RESULTS Fatigue Impact Scale scores were not different between people with prediabetes, people with T2D, and controls (12.5 ± 15.1, 18.3 ± 22.7, and 12.6 ± 18.6, respectively; P = 0.517). However, people with prediabetes had greater reductions in MVCC power during the fatigue protocol than did controls (31.8% ± 22.6% vs 22.1% ± 21.1%, P < 0.001), and both groups had lesser reductions than the T2D group (44.8% ± 21.9%, P < 0.001). Similarly, the prediabetes group had larger reductions in electrically evoked twitch amplitude than the control group (32.5% ± 24.9% vs 21.3% ± 33.0%, P < 0.001), but lesser reductions than those with T2D (44.0% ± 23.4%, P < 0.001). For all three groups, a greater decline in MVCC power was associated with larger reductions of twitch amplitude (r = 0.350, P < 0.001). CONCLUSION People with prediabetes have greater performance fatigability of the knee extensors due to contractile mechanisms compared with controls, although less performance fatigability than that of people with T2D.
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Affiliation(s)
- Jonathon W Senefeld
- Clinical and Translational Rehabilitation Health Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, AUSTRALIA
| | - Sandra K Hunter
- Clinical and Translational Rehabilitation Health Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
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17
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Continuous cardiac autonomic and haemodynamic responses to isometric exercise in females. Eur J Appl Physiol 2020; 121:319-329. [PMID: 33070245 DOI: 10.1007/s00421-020-04525-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Hypertension is associated with impaired haemodynamic control mechanisms and autonomic dysfunction. Isometric exercise (IE) interventions have been shown to improve autonomic modulation and reduce blood pressure (BP) predominantly in male participants. The physiological responses to IE are unexplored in female populations; therefore, this study investigated the continous cardiac autonomic and haemodynamic response to a single bout of IE in a large female population. METHODS Forty physically inactive females performed a single, individually prescribed isometric wall squat training session. Total power spectral density of heart rate variability (HRV) and associated low-frequency (LF) and high-frequency (HF) power spectral components were recorded in absolute (ms2) and normalised units (nu) pre, during and post an IE session. Heart rate (HR) was recorded via electrocardiography and baroreceptor reflex sensitivity (BRS) via the sequence method. Continuous blood pressure was recorded via the vascular unloading technique and stroke volume via impedance cardiography. Total peripheral resistance (TPR) was calculated according to Ohm's law. RESULTS During IE, there were significant reductions in HRV (p < 0.001) and BRS (p < 0.001), and significant increases in heart rate (p < 0.001), systolic, mean and diastolic BP (p < 0.001 for all). In recovery following the IE session, cardiac autonomic parameters returned to baseline (p = 0.974); however, total peripheral vascular resistance significantly reduced below baseline (p < 0.001). This peripheral vascular response was associated with significant reductions in systolic (-17.3 ± 16.5 mmHg, p < 0.001), mean (-18.8 ± 17.4 mmHg, p < 0.001) and diastolic BP (-17.3 ± 16.2 mmHg, p < 0.001), below baseline. CONCLUSION A single IE session is associated with improved haemodynamic cardiovascular responses in females. Cardiac autonomic responses return to baseline values, which suggests that alternative mechanisms are responsible for the post-exercise haemodynamic improvements in females. Future mechanistic research is required to investigate the acute and chronic effects of IE in female populations with different resting BP profiles.
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18
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Solinsky R, Mercier H, Picard G, Taylor JA. Cardiometabolic Effects of High-Intensity Hybrid Functional Electrical Stimulation Exercise after Spinal Cord Injury. PM R 2020; 13:937-944. [PMID: 33027550 DOI: 10.1002/pmrj.12507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The prevalence of cardiometabolic disease following spinal cord injury is known to be high. However, it is unknown whether engaging in high-intensity exercise, which is advocated by recent guidelines, is beneficial or feasible for these individuals. OBJECTIVE To assess the effects of high-intensity, whole-body exercise on the prevalence of cardiometabolic disease in individuals with spinal cord injury. DESIGN Combination of a randomized controlled trial and an open label intervention study of functional electrical stimulation legs plus arms rowing. SETTING Outpatient academic rehabilitation hospital. PARTICIPANTS Forty individuals with spinal cord injury, with American Spinal Injury Association (ASIA) impairments scales A-D and neurological levels of injury C1-T12. INTERVENTION Six months of high-intensity, hybrid-functional electrical stimulation rowing. MAIN OUTCOME MEASURES Change in VO2max , serum lipids, and insulin resistance, prevalence of cardiometabolic disease. RESULTS Individuals averaged 42.1 ± 22.0 minutes of hybrid-functional electrical stimulation rowing a week over an average of 1.69 sessions per week over the 6 months of intervention. This amounted to an average of 170.9 ± 100 km rowed, at a mean heart rate of 82.7% of individualized maximum. Only one of 40 individuals met current exercise guidelines for the full 6 months. VO2max increased significantly (P < .001), yet prevalence of cardiometabolic disease did not change significantly (decrease from 22.5% to 20%, P = .70). Hemoglobin A1c did decrease significantly over this time (P = .01), although serum lipids and fasting glucose/insulin levels were unchanged. In exploratory subanalyses assessing individuals injured ≤12 months, those with more chronic injuries decreased their triglyceride-to-high-density lipoprotein (HDL) ratio (P = .04), a marker of cardiac mortality. Stratifying by neurological level of injury, individuals with paraplegia had worsened low-density lipoprotein (LDL) level (P = .02) and total cholesterol-to-HDL ratio (P = .04) over the 6-month intervention. CONCLUSIONS Sustained high-intensity exercise with hybrid functional electrical stimulation rowing does not decrease the prevalence of cardiometabolic disease after spinal cord injury.
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Affiliation(s)
- Ryan Solinsky
- Spaulding Rehabilitation Hospital, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.,Spaulding Research Institute, Boston, MA
| | - Hannah Mercier
- Spaulding Rehabilitation Hospital, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | - Glen Picard
- Spaulding Rehabilitation Hospital, Boston, MA
| | - J Andrew Taylor
- Spaulding Rehabilitation Hospital, Boston, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.,Spaulding Research Institute, Boston, MA
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Takahashi C, Ribeiro F, Vanzella LM, Lima IM, Ricci-Vitor AL, Christofaro DGD, Vanderlei LCM. Are signs and symptoms in cardiovascular rehabilitation correlated with heart rate variability? An observational longitudinal study. Geriatr Gerontol Int 2020; 20:853-859. [PMID: 32886848 DOI: 10.1111/ggi.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/10/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
AIM To analyze the correlation between the appearance of signs/symptoms during a cardiovascular rehabilitation program and linear indexes of the heart rate variability (HRV) at rest. METHODS To carry out the present observational longitudinal study, 48 patients were analyzed. The protocol was divided into two stages. First, the patients had their personal details collected, and the autonomic modulation at rest was evaluated by HRV. Second, they underwent 36 sessions of the cardiovascular rehabilitation program to evaluate signs/symptoms. Then, just for analysis of the data, they were divided into two groups: the group without signs/symptoms (n = 26; 65.15 ± 9.7 years); and the group with signs/symptoms (n = 22; 66.77 ± 14.4 years). The HRV indexes were compared by ancova. The effect size was measured through the partial eta-squared. Pearson's and Spearman's correlations (P < 0.05) were used to analyze the data, and linear regression was applied. RESULTS A total of 103 signs/symptoms occurred. The group with signs/symptoms presented lower values of HRV indexes when compared with the group without signs/symptoms, especially for the parasympathetic indexes with a large effect size. The root mean square of successive differences (rMSSD), percentage of adjacent RR intervals with a difference of duration >50 ms (pNN50), high-frequency spectral component (HF) varying from 0.15 to 0.4 Hz (expressed as ms2 ), dispersion of the points perpendicular to the line of identity and represents the instantaneous record of the beat-to-beat variability (SD1) and SD1/scatter of points along the identity line and represents the HRV in long-term records (SD2) index presented a negative correlation with the appearance of signs/symptoms. When the linear regression was applied, the rMSSD, SD1 and SD1/SD2 showed negative values of β (P < 0.05). CONCLUSIONS Patients with lower HRV are more likely to have signs/symptoms. The rMSSD, pNN50, HF (expressed as ms2 ), SD1 and SD1/SD2 index presented a negative correlation with the appearance of signs/symptoms. For rMSSD, SD1 and SD1/SD2, the lower the values of these HRV indexes, the greater the risk of appearance of signs/symptoms. Geriatr Gerontol Int 2020; 20: 853-859.
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Affiliation(s)
- Carolina Takahashi
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Felipe Ribeiro
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Laís Manata Vanzella
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Isabelle Maina Lima
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Ana Laura Ricci-Vitor
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | | | - Luiz Carlos Marques Vanderlei
- Physiotherapy Department, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
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20
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da Cunha Nascimento D, Schoenfeld BJ, Prestes J. Potential Implications of Blood Flow Restriction Exercise on Vascular Health: A Brief Review. Sports Med 2020; 50:73-81. [PMID: 31559565 DOI: 10.1007/s40279-019-01196-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Blood flow restriction (BFR) exercise (a.k.a. occlusion training) has emerged as a viable surrogate to traditional heavy-load strength rehabilitation training for a broad range of clinical populations including elderly subjects and rehabilitating athletes. A particular benefit of BFR exercise is the lower stress upon the joints as compared to traditional heavy resistance training, with similar gains in muscle strength and size. The application of an inflatable cuff to the proximal portion of the limbs increases the pressure required for venous return, leading to changes in venous compliance and wall tension. However, it is not known if long-term benefits of BFR exercise on muscle strength and size outweigh potential short and long-term complications on vascular health. BFR exercise could lead to clinical deterioration of the vasculature along with sympathetic overactivity and decreased vascular function associated with retrograde shear stress. This raises a fundamental question: Given the concern that excessive restriction could cause injury to endothelial cells and might cause detrimental effects on endothelial function, even in healthy individuals, should we critically re-evaluate the safety of this method for the general population? From this perspective, the purpose of this manuscript is to review the effects of BFR exercise on vascular function, and to provide relevant insights for training practice as well as future directions for research.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Department of Physical Education, Catholic University of Brasilia (UCB), Q.S. 07, Lote 01, EPTC-Bloco G. Código Postal, Distrito Federal, Brasilia, 71966-700, Brazil. .,Department of Physical Education, University Center of the Federal District (UDF), Brasilia, Brazil.
| | | | - Jonato Prestes
- Department of Physical Education, Catholic University of Brasilia (UCB), Q.S. 07, Lote 01, EPTC-Bloco G. Código Postal, Distrito Federal, Brasilia, 71966-700, Brazil
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21
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Cardiac Rehabilitation and Endothelial Function. J Clin Med 2020; 9:jcm9082487. [PMID: 32756306 PMCID: PMC7463659 DOI: 10.3390/jcm9082487] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022] Open
Abstract
Endothelial dysfunction is an early abnormality in the process of atherosclerosis and cardiovascular disease and has been associated with worse clinical outcome. Cardiac rehabilitation (CR) has been reported to be helpful to reduce cardiovascular events in various types of cardiac disease, but the mechanisms of its beneficial effects remain only partially known. In this article, we review the studies that assessed the effect of CR on endothelial function in patients with various cardiac conditions. Available data show that CR significantly improves impaired endothelial function in these patients, which may contribute to the beneficial effects of CR on clinical outcome.
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22
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Parry-Williams G, Sharma S. The effects of endurance exercise on the heart: panacea or poison? Nat Rev Cardiol 2020; 17:402-412. [PMID: 32152528 DOI: 10.1038/s41569-020-0354-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2020] [Indexed: 02/08/2023]
Abstract
Regular aerobic physical exercise of moderate intensity is undeniably associated with improved health and increased longevity, with some studies suggesting that more is better. Endurance athletes exceed the usual recommendations for exercise by 15-fold to 20-fold. The need to sustain a large cardiac output for prolonged periods is associated with a 10-20% increase in left and right ventricular size and a substantial increase in left ventricular mass. A large proportion of endurance athletes have raised levels of cardiac biomarkers (troponins and B-type natriuretic peptide) and cardiac dysfunction for 24-48 h after events, but what is the relevance of these findings? In the longer term, some endurance athletes have an increased prevalence of coronary artery disease, myocardial fibrosis and arrhythmias. The inherent association between these 'maladaptations' and sudden cardiac death in the general population raises the question of whether endurance exercise could be detrimental for some individuals. However, despite speculation that these abnormalities confer an increased risk of future adverse events, elite endurance athletes have an increased life expectancy compared with the general population.
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Affiliation(s)
- Gemma Parry-Williams
- Cardiology Clinical and Academic Group, St. George's University of London, London, UK
| | - Sanjay Sharma
- Cardiology Clinical and Academic Group, St. George's University of London, London, UK.
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Ambulatory blood pressure reduction following 2 weeks of high-intensity interval training on an immersed ergocycle. Arch Cardiovasc Dis 2019; 112:680-690. [DOI: 10.1016/j.acvd.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 01/16/2023]
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Combined Exercise Training Performed by Elderly Women Reduces Redox Indexes and Proinflammatory Cytokines Related to Atherogenesis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6469213. [PMID: 31482005 PMCID: PMC6701434 DOI: 10.1155/2019/6469213] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/12/2019] [Accepted: 06/24/2019] [Indexed: 12/20/2022]
Abstract
Cardiovascular benefits for the general population of combined aerobic-resistance exercise training are well-known, but the impact of this exercise training modality on the plasma lipid, inflammatory, and antioxidant status in elderly women that are exposed to a great risk of developing ischemic cardio- and cerebrovascular diseases has not been well investigated. So, we aimed to evaluate the plasma lipids, oxidative stress, and inflammatory cytokines in 27 elderly women (TRAINED group, 69.1 ± 8.1 yrs) that were performing moderate intensity combined aerobic-resistance exercise training (3 times/week for at least 18 months) and in 27 sedentary elderly women (SED group, 72.0 ± 6.4 yrs), not submitted to exercise training for at least 5 yrs. Our results showed that BMI was lower in the TRAINED group than in the SED group (25.1 ± 3.2 vs. 28.7 ± 5.1, p < 0.05). The TRAINED group had lower glycemia (92 ± 3 vs. 118 ± 12, p < 0.05), glycated hemoglobin (5.9 ± 0.1 vs. 6.4 ± 0.2, p < 0.05), and triglycerides (98 (75-122) vs. 139 (109-214), p < 0.01); equal total cholesterol (199 (175-230) vs. 194 (165-220)), LDL-cholesterol (108 (83-133) vs. 109 (98-136)), and non-HDL-cholesterol (54 (30-74) vs. 62 (26-80)); and also higher HDL-cholesterol (64 (52-77) vs. 52 (44-63), p < 0.01) and LDL-C/oxLDL ratio (13378 ± 2570 vs. 11639 ± 3113, p < 0.05) compared to the SED group. Proinflammatory cytokines as IL-1β (11.31 ± 2.4 vs. 28.01 ± 4.7, p < 0.05), IL-6 (26.25 ± 7.4 vs. 49.41 ± 17.8, p < 0.05), and TNF-α (25.72 ± 2.8 vs. 51.73 ± 4.2, p < 0.05) were lower in the TRAINED group than in the SED group. The TRAINED group had lower total peroxides (26.3 ± 7.4 vs. 49.0 ± 17.8, p < 0.05) and oxidized LDL (1551 ± 50.33 vs. 1773 ± 74, p < 0.02) and higher total antioxidant capacity (26.25 ± 7.4 vs. 49.41 ± 17.8, p < 0.001) compared to the SED group. In conclusion, in TRAINED women, BMI was lower, plasma lipid profile was better, plasma oxidative stress was diminished, and there was less expression of proinflammatory interleukins than in SED, suggesting that combined aerobic-resistance exercise training may promote the protection against the complications of ischemic cardio- and cerebrovascular disease in elderly women.
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Soares RN, Murias JM, Saccone F, Puga L, Moreno G, Resnik M, De Roia GF. Effects of a rehabilitation program on microvascular function of CHD patients assessed by near-infrared spectroscopy. Physiol Rep 2019; 7:e14145. [PMID: 31190469 PMCID: PMC6562121 DOI: 10.14814/phy2.14145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 12/31/2022] Open
Abstract
This study aimed to evaluate whether near-infrared spectroscopy (NIRS)-derived reperfusion slope would detect the effects of a 12-week rehabilitation program on lower limb microvascular responsiveness in patients with coronary heart disease (CHD). Ten CHD patients (7 males and 3 females; 57.3 ± 7.6 years) underwent 12 weeks of drug treatment and high-intensity interval training (HIIT), 2 times per week (40 min/session). Microvascular responsiveness was assessed by using NIRS assessment of muscle oxygen saturation (StO2 ) combined with a vascular occlusion test (VOT) (NIRS-VOT). NIRS-VOT measures were taken at pre- and postintervention, and microvascular responsiveness was evaluated by examining the slope 2 of re-oxygenation rate (slope 2 StO2 ) and the area under the curve (StO2AUC ) of StO2 signal following cuff release subsequent to a 5-min occlusion period. The slope 2 StO2 was significantly steeper after 12 weeks of training (4.8 ± 1.6% sec-1 ) compared to the pretraining (3.1 ± 1.6% sec-1 ) (P < 0.05). The area under the curve for the change in the % StO2 signal during re-oxygenation increased significantly from 3494 ± 2372%∙sec at pretraining to 9006 ± 4311%∙sec at post-training (P < 0.05). NIRS-VOT technique detected the improvements of 12 weeks of rehabilitation program in the lower limb microvascular responsiveness of CHD patients.
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Affiliation(s)
| | - Juan M. Murias
- University of CalgaryFaculty of KinesiologyCalgaryAlbertaCanada
| | | | | | - Gustavo Moreno
- Sanatorio Dr. Julio MendezCABABuenos AiresArgentina
- CENARDCentro Nacional de Alto Rendimiento DeportivoCABABuenos AiresArgentina
| | - Miguel Resnik
- Sanatorio Dr. Julio MendezCABABuenos AiresArgentina
- CENARDCentro Nacional de Alto Rendimiento DeportivoCABABuenos AiresArgentina
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Novaković M, Krevel B, Rajkovič U, Vižintin Cuderman T, Janša Trontelj K, Fras Z, Jug B. Moderate-pain versus pain-free exercise, walking capacity, and cardiovascular health in patients with peripheral artery disease. J Vasc Surg 2019; 70:148-156. [PMID: 30922760 DOI: 10.1016/j.jvs.2018.10.109] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/22/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Supervised exercise training (walking) is recommended in patients with intermittent claudication, both as a means to improve symptoms (walking distance and quality of life [QoL]) and as a means to improve general cardiovascular health (including vascular function and heart rate variability [HRV]). Our aim was to compare two types of supervised training (moderate-pain and pain-free walking) with comparable intensity based on heart rate, in terms of walking capacity, QoL, vascular function, biomarkers, and HRV in patients with intermittent claudication. METHODS Thirty-six adults with intermittent claudication were randomized to either moderate-pain or pain-free exercise training (36 sessions, two or three times a week) or usual care (no supervised exercise). Initial walking distance and absolute walking distance using treadmill testing, flow-mediated vasodilation and pulse wave velocity using ultrasound, N-terminal pro-B-type natriuretic peptide and fibrinogen levels, HRV, and QoL (36-Item Short Form Health Survey questionnaire) were determined at baseline and after the intervention period. RESULTS Twenty-nine patients (mean age, 64 ± 9 years; 72% male) completed the study. Both training programs similarly improved walking capacity. Initial walking distance and absolute walking distance significantly increased with either moderate-pain walking (median, 50 m to 107 m [P = .005] and 85 m to 194 m [P = .005], respectively) or pain-free walking (median, 53 m to 128 m [P = .003] and 92 m to 163 m [P = .003], respectively). QoL also similarly improved with both training modalities, whereas only moderate-pain walking was also associated with a statistically significant improvement in the vascular parameters flow-mediated vasodilation (4.4% to 8.0%; P = .002) and pulse wave velocity (6.6 m/s to 6.1 m/s; P = .013). Neither training program was associated with changes in biomarker levels and HRV. CONCLUSIONS Both moderate-pain and pain-free training modalities were safe and similarly improved walking capacity and health-related QoL. Conversely, vascular function improvements were associated with only moderate-pain walking.
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Affiliation(s)
- Marko Novaković
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Barbara Krevel
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Uroš Rajkovič
- Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia
| | - Tjaša Vižintin Cuderman
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katja Janša Trontelj
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Zlatko Fras
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Jug
- Division of Internal Medicine, Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Qiu S, Cai X, Yang B, Du Z, Cai M, Sun Z, Zügel M, Michael Steinacker J, Schumann U. Association Between Cardiorespiratory Fitness and Risk of Type 2 Diabetes: A Meta-Analysis. Obesity (Silver Spring) 2019; 27:315-324. [PMID: 30604925 DOI: 10.1002/oby.22368] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/22/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This meta-analysis aimed to (1) quantify the association of cardiorespiratory fitness (CRF) with type 2 diabetes risk in the general population and statin users and (2) investigate the joint effects of CRF and fatness with type 2 diabetes risk. METHODS Databases were searched for cohort studies reporting the association between CRF and type 2 diabetes risk. Summary hazard ratios (HRs) were obtained using random-effects models. RESULTS Fifteen studies were included. The HRs of type 2 diabetes for every 1-metabolic equivalent increase in CRF were 0.90 (95% CI: 0.86-0.94) for the general population and 0.92 (95% CI: 0.87-0.97) for statin users, and the HRs were linearly shaped (both Pnonlinearity > 0.40). Compared with the nonstatin cohort, there was an increased risk of type 2 diabetes in statin users with the lowest and moderate CRF categories, but this was not present in the highest CRF category. The HR of type 2 diabetes for overweight/obesity-fit category versus normal weight-fit category was larger than that of the normal weight-unfit category versus the normal weight-fit category (Pinteraction = 0.004). CONCLUSIONS There was an inverse and dose-dependent association between CRF and type 2 diabetes risk. High CRF may eliminate the diabetogenic effect from statins, yet decreased body weight index seems superior in preventing type 2 diabetes.
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Affiliation(s)
- Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | - Xue Cai
- School of Nursing, Peking University, Beijing, China
| | - Bingquan Yang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Ziwei Du
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Min Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Martina Zügel
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | | | - Uwe Schumann
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
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Senefeld JW, Limberg JK, Lukaszewicz KM, Hunter SK. Exercise-induced hyperemia is associated with knee extensor fatigability in adults with type 2 diabetes. J Appl Physiol (1985) 2019; 126:658-667. [PMID: 30605399 DOI: 10.1152/japplphysiol.00854.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare fatigability, contractile function, and blood flow to the knee extensor muscles after dynamic exercise in patients with type 2 diabetes mellitus (T2DM) and controls. The hypotheses were that patients with T2DM would demonstrate greater fatigability than controls, and greater fatigability would be associated with a lower exercise-induced increase in blood flow and greater impairments in contractile function. Patients with T2DM ( n = 15; 8 men; 62.4 ± 9.0 yr; 30.4 ± 7.7 kg/m2; 7,144 ± 3,294 steps/day) and 15 healthy control subjects (8 men, 58.4 ± 6.9 yr; 28.4 ± 4.6 kg/m2; 7,893 ± 2,323 steps/day) were matched for age, sex, body mass index, and physical activity. Fatigability was quantified as the reduction in knee extensor power during a 6-min dynamic exercise. Before and after exercise, vascular ultrasonography and electrical stimulation were used to assess skeletal muscle blood flow and contractile properties, respectively. Patients with T2DM had greater fatigability (30.0 ± 20.1% vs. 14.6 ± 19.0%, P < 0.001) and lower exercise-induced hyperemia (177 ± 90% vs. 194 ± 79%, P = 0.04) than controls but similar reductions in the electrically evoked twitch amplitude (37.6 ± 24.8% vs. 31.6 ± 30.1%, P = 0.98). Greater fatigability of the knee extensor muscles was associated with postexercise reductions in twitch amplitude ( r = 0.64, P = 0.001) and lesser exercise-induced hyperemia ( r = -0.56, P = 0.009). Patients with T2DM had greater lower-limb fatigability during dynamic exercise, which was associated with reduced contractile function and lower skeletal muscle blood flow. Thus, treatments focused on enhancing perfusion and reversing impairments in contractile function in patients with T2DM may offset lower-limb fatigability and aid in increasing exercise capacity. NEW & NOTEWORTHY Although prior studies compare patients with type 2 diabetes mellitus (T2DM) with lean controls, our study includes controls matched for age, body mass, and physical activity to more closely assess the effects of T2DM. Patients with T2DM demonstrated no impairment in macrovascular endothelial function, evidenced by similar flow-mediated dilation to controls. However, patients with T2DM had greater fatigability and reduced exercise-induced increase in blood flow (hyperemia) after a lower-limb dynamic fatiguing exercise compared with controls.
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Affiliation(s)
- Jonathon W Senefeld
- Clinical and Translational Rehabilitation Health Sciences Program, Marquette University , Milwaukee, Wisconsin.,Department of Physical Therapy, Marquette University , Milwaukee, Wisconsin
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri , Columbia, Missouri
| | - Kathleen M Lukaszewicz
- Clinical and Translational Rehabilitation Health Sciences Program, Marquette University , Milwaukee, Wisconsin.,Department of Physical Therapy, Marquette University , Milwaukee, Wisconsin
| | - Sandra K Hunter
- Clinical and Translational Rehabilitation Health Sciences Program, Marquette University , Milwaukee, Wisconsin.,Department of Physical Therapy, Marquette University , Milwaukee, Wisconsin
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Frisbee JC, Lewis MT, Wiseman RW. Skeletal muscle performance in metabolic disease: Microvascular or mitochondrial limitation or both? Microcirculation 2018; 26:e12517. [PMID: 30471168 DOI: 10.1111/micc.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/14/2018] [Indexed: 12/20/2022]
Abstract
One of the clearly established health outcomes associated with chronic metabolic diseases (eg, type II diabetes mellitus) is that the ability of skeletal muscle to maintain contractile performance during periods of elevated metabolic demand is compromised as compared to the fatigue-resistance of muscle under normal, healthy conditions. While there has been extensive effort dedicated to determining the major factors that contribute to the compromised performance of skeletal muscle with chronic metabolic disease, the extent to which this poor outcome reflects a dysfunctional state of the microcirculation, where the delivery and distribution of metabolic substrates can be impaired, versus derangements to normal metabolic processes and mitochondrial function, versus a combination of the two, represents an area of considerable unknown. The purpose of this manuscript is to present some of the current concepts for dysfunction to both the microcirculation of skeletal muscle as well as to mitochondrial metabolism under these conditions, such that these diverse issues can be merged into an integrated framework for future investigation. Based on an interpretation of the current literature, it may be hypothesized that the primary site of dysfunction with earlier stages of metabolic disease may lie at the level of the vasculature, rather than at the level of the mitochondria.
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Affiliation(s)
- Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Matthew T Lewis
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Robert W Wiseman
- Department of Physiology, Michigan State University, East Lansing, Michigan.,Department of Radiology, Michigan State University, East Lansing, Michigan
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Mey JT, Haus JM. Dicarbonyl Stress and Glyoxalase-1 in Skeletal Muscle: Implications for Insulin Resistance and Type 2 Diabetes. Front Cardiovasc Med 2018; 5:117. [PMID: 30250846 PMCID: PMC6139330 DOI: 10.3389/fcvm.2018.00117] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/09/2018] [Indexed: 01/01/2023] Open
Abstract
Glyoxalase-1 (GLO1) is a ubiquitously expressed cytosolic protein which plays a role in the natural maintenance of cellular health and is abundantly expressed in human skeletal muscle. A consequence of reduced GLO1 protein expression is cellular dicarbonyl stress, which is elevated in obesity, insulin resistance and type 2 diabetes (T2DM). Both in vitro and pre-clinical models suggest dicarbonyl stress per se induces insulin resistance and is prevented by GLO1 overexpression, implicating a potential role for GLO1 therapy in insulin resistance and type 2 diabetes (T2DM). Recent work has identified the therapeutic potential of novel natural agents as a GLO1 inducer, which resulted in improved whole-body metabolism in obese adults. Given skeletal muscle is a major contributor to whole-body glucose, lipid, and protein metabolism, such GLO1 inducers may act, in part, through mechanisms in skeletal muscle. Currently, investigations examining the specificity of dicarbonyl stress and GLO1 biology in human skeletal muscle are lacking. Recent work from our lab indicates that dysregulation of GLO1 in skeletal muscle may underlie human insulin resistance and that exercise training may impart therapeutic benefits. This minireview will summarize the existing human literature examining skeletal muscle GLO1 and highlight the emerging therapeutic concepts for GLO1 gain-of-function in conditions such as insulin resistance and cardiometabolic disease.
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Affiliation(s)
- Jacob T Mey
- Department of Pathobiology, Cleveland Clinic, Cleveland, OH, United States
| | - Jacob M Haus
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
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de Carvalho Souza Vieira M, Boing L, Leitão AE, Vieira G, Coutinho de Azevedo Guimarães A. Effect of physical exercise on the cardiorespiratory fitness of men—A systematic review and meta-analysis. Maturitas 2018; 115:23-30. [DOI: 10.1016/j.maturitas.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/30/2018] [Accepted: 06/10/2018] [Indexed: 12/28/2022]
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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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Arena R, Daugherty J, Bond S, Lavie CJ, Phillips S, Borghi-Silva A. The combination of obesity and hypertension: a highly unfavorable phenotype requiring attention. Curr Opin Cardiol 2018; 31:394-401. [PMID: 27070650 DOI: 10.1097/hco.0000000000000294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Body habitus is a key lifestyle characteristic whose current status and future projections are disconcerting. The percentage of the global population who are either overweight or obese has substantially increased, with no indication that any country has a solution to this issue. Hypertension is a key unfavorable health metric that, like obesity, has disastrous health implications if left uncontrolled. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult to treat phenotypes. Excess body mass is such an example, creating an obesity-hypertension phenotype, which is the focus of this review. RECENT FINDINGS An increased risk for hypertension is clearly linked to obesity, indicating that the two conditions are intimately linked. The cascade of obesity-induced pathophysiologic adaptations creates a clear path to hypertension. Adopting a healthy lifestyle is a primary intervention for the prevention as well as treatment of the obesity-hypertension phenotype. SUMMARY The obesity-hypertension phenotype is highly prevalent and has disastrous health implications. A primordial prevention strategy, focused on lifelong healthy lifestyle patterns, is the optimal approach for this condition. For those individuals already afflicted by the obesity-hypertension phenotype, interventions must aggressively focus on weight loss and blood pressure control.
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Affiliation(s)
- Ross Arena
- aDepartment of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences bDepartment of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, Illinois cDepartment of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine; New Orleans, Louisiana, USA dCardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
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Brooks SD, Hileman SM, Chantler PD, Milde SA, Lemaster KA, Frisbee SJ, Shoemaker JK, Jackson DN, Frisbee JC. Protection from chronic stress- and depressive symptom-induced vascular endothelial dysfunction in female rats is abolished by preexisting metabolic disease. Am J Physiol Heart Circ Physiol 2018; 314:H1085-H1097. [PMID: 29451819 DOI: 10.1152/ajpheart.00648.2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
While it is known that chronic stress and clinical depression are powerful predictors of poor cardiovascular outcomes, recent clinical evidence has identified correlations between the development of metabolic disease and depressive symptoms, creating a combined condition of severely elevated cardiovascular disease risk. In this study, we used the obese Zucker rat (OZRs) and the unpredictable chronic mild stress (UCMS) model to determine the impact of preexisting metabolic disease on the relationship between chronic stress/depressive symptoms and vascular function. Additionally, we determined the impact of metabolic syndrome on sex-based protection from chronic stress/depressive effects on vascular function in female lean Zucker rats (LZRs). In general, vasodilator reactivity was attenuated under control conditions in OZRs compared with LZRs. Although still impaired, conduit arterial and resistance arteriolar dilator reactivity under control conditions in female OZRs was superior to that in male or ovariectomized (OVX) female OZRs, largely because of better maintenance of vascular nitric oxide and prostacyclin levels. However, imposition of metabolic syndrome in combination with UCMS in OZRs further impaired dilator reactivity in both vessel subtypes to a similarly severe extent and abolished any protective effect in female rats compared with male or OVX female rats. The loss of vascular protection in female OZRs with UCMS was reflected in vasodilator metabolite levels, which closely matched those in male and OVX female OZRs subjected to UCMS. These results suggest that presentation of metabolic disease in combination with depressive symptoms can overwhelm the vasoprotection identified in female rats and, thereby, may reflect a severe impairment to normal endothelial function. NEW & NOTEWORTHY This study addresses the protection from chronic stress- and depression-induced vascular dysfunction identified in female compared with male or ovariectomized female rats. We determined the impact of preexisting metabolic disease, a frequent comorbidity of clinical depression in humans, on that vascular protection. With preexisting metabolic syndrome, female rats lost all protection from chronic stress/depressive symptoms and became phenotypically similar to male and ovariectomized female rats, with comparably poor vasoactive dilator metabolite profiles.
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Affiliation(s)
- Steven D Brooks
- Department of Physiology and Pharmacology, West Virginia University , Morgantown, West Virginia
| | - Stanley M Hileman
- Department of Physiology and Pharmacology, West Virginia University , Morgantown, West Virginia
| | - Paul D Chantler
- Department of Exercise Physiology, West Virginia University , Morgantown, West Virginia
| | - Samantha A Milde
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada
| | - Kent A Lemaster
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada
| | - Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada
| | - J Kevin Shoemaker
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada.,School of Kinesiology, University of Western Ontario , London, Ontario , Canada
| | - Dwayne N Jackson
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada
| | - Jefferson C Frisbee
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Faculty of Health Sciences, University of Western Ontario , London, Ontario , Canada
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36
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Laughlin MH, Yang HT, Tharp DL, Rector RS, Padilla J, Bowles DK. Vascular cell transcriptomic changes to exercise training differ directionally along and between skeletal muscle arteriolar trees. Microcirculation 2018; 24. [PMID: 27889934 DOI: 10.1111/micc.12336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/14/2016] [Indexed: 01/10/2023]
Abstract
EXT-induced arteriolar adaptations in skeletal muscle are heterogeneous because of spatial variations in muscle fiber type composition and fiber recruitment patterns during exercise. The purpose of this report is to summarize a series of experiments conducted to test the hypothesis that changes in vascular gene expression are signaled by alterations in shear stress resulting from increases in blood flow, muscle fiber type composition, and fiber recruitment patterns. We also report results from a follow-up study of Ankrd23, one gene whose expression was changed by EXT. We expected to see differences in magnitude of changes in gene expression along arteriolar trees and between/among arteriolar trees but similar directional changes. However, transcriptional profiles of arterioles/arteries from OLETF rats exposed to END or SIT reveal that EXT does not lead to similar directional changes in the transcriptome among arteriolar trees of different skeletal muscles or along arteriolar trees within a particular muscle. END caused the most changes in gene expression in 2A arterioles of soleus and white gastrocnemius with little to no changes in the FAs. Ingenuity Pathway Analysis across vessels revealed significant changes in gene expression in 18 pathways. EXT increased expression of some genes (Shc1, desert hedgehog protein (Dhh), adenylate cyclase 4 (Adcy4), G protein-binding protein, alpha (Gnat1), and Bcl2l1) in all arterioles examined, but decreased expression of ubiquitin D (Ubd) and cAMP response element modulator (Crem). Many contractile and/or structural protein genes were increased by SIT in the gastrocnemius FA, but the same genes exhibited decreased expression in red gastrocnemius arterioles. Ankrd23 mRNA levels increased with increasing branch order in the gastrocnemius arteriolar tree and were increased 19-fold in gastrocnemius muscle FA by SIT. Follow-up experiments indicate that Ankrd23 mRNA level was increased 14-fold in cannulated gastrocnemius FA when intraluminal pressure was increased from 90 and 180 cm H2O for 4 hours. Also, Ankrd23-/- mice exhibit limited ability to form collateral arteries following femoral artery occlusion compared to WT mice (angioscore WT=0.18±0.03; Ankrd23-/- =0.04±0.01). Further research will be required to determine whether Ankrd23 plays an important role in mechanically induced vascular remodeling of the arterial tree in skeletal muscle.
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Affiliation(s)
- M Harold Laughlin
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - Hsiao T Yang
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - Darla L Tharp
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
| | - R Scott Rector
- Department of Nutrition & Exercise Physiology, University of Missouri, Columbia, MO, USA.,Harry S Truman Memorial VA Hospital, Columbia, MO, USA
| | - Jaume Padilla
- Department of Nutrition & Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Douglas K Bowles
- Department of Biomedical Sciences, College of Veterinary Medicine, Columbia, MO, USA
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Effect of Exercise Intervention on Flow-Mediated Dilation in Overweight and Obese Adults: Meta-Analysis. Int J Vasc Med 2017; 2017:7532702. [PMID: 29098086 PMCID: PMC5643022 DOI: 10.1155/2017/7532702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/22/2017] [Accepted: 07/17/2017] [Indexed: 01/28/2023] Open
Abstract
The objective of this meta-analysis is to summarize the effect of exercise intervention on flow-mediated dilatation (FMD) in overweight and obese adults. We searched four electronic databases (PubMed/Medline, Scopus, and CINAHL) through June 2016 for relevant studies pertaining to the effectiveness of exercise intervention on FMD. Seventeen of the 91 studies identified met the inclusion criteria. Comprehensive Meta-Analysis software (version 3) was used to compute the standardized mean difference effect size (ES) and 95% CI using a random effects model. We calculated 34 ESs. We found that exercise intervention had medium and positive effects on FMD, with an overall ES of 0.522 (95% CI = 0.257, 0.786). Heterogeneity of ESs was observed (Qb = 239, p ≤ 0.001, I2 = 86.19), and the effect was moderated by comorbidity (Qb = 6.39, df = 1, p = 0.011). A large ES for the combination exercise, low intensity exercise, and comorbidity subgroups (ES = 0.82~1.24) was found. We conclude that while exercise intervention significantly improves FMD in overweight and obese adults, the effect may depend on the different characteristics of exercise intervention and on participants' demographics.
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38
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Dao E, Hsiung GYR, Liu-Ambrose T. The role of exercise in mitigating subcortical ischemic vascular cognitive impairment. J Neurochem 2017; 144:582-594. [PMID: 28833160 DOI: 10.1111/jnc.14153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 12/14/2022]
Abstract
Subcortical ischemic vascular cognitive impairment (SIVCI) is the most preventable form of cognitive dysfunction. There is converging evidence from animal and human studies that indicate vascular injury as the primary cause of SIVCI. Currently, there are no curative pharmaceutical treatments for vascular dementia; however, exercise may be a promising strategy to combat SIVCI. This review will focus on the role of exercise as a strategy to prevent or slow the progression of SIVCI, with particular emphasis on the mechanisms by which exercise may improve cerebrovascular function. We propose that exercise may be an effective strategy to combat SIVCI by improving cognitive function, increasing the bioavailability of neurotrophins, stimulating endothelial function, and controlling vascular risk factors. This article is part of the Special Issue "Vascular Dementia".
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Affiliation(s)
- Elizabeth Dao
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada
| | - Ging-Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Department of Medicine, Division of Neurology, UBC, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
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Cardiovascular Responses to Skeletal Muscle Stretching: “Stretching” the Truth or a New Exercise Paradigm for Cardiovascular Medicine? Sports Med 2017; 47:2507-2520. [DOI: 10.1007/s40279-017-0768-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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40
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Dow CA, Stauffer BL, Brunjes DL, Greiner JJ, DeSouza CA. Regular aerobic exercise reduces endothelin-1-mediated vasoconstrictor tone in overweight and obese adults. Exp Physiol 2017. [DOI: 10.1113/ep086454] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Caitlin A. Dow
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Brian L. Stauffer
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
- Department of Medicine; University of Colorado Anschutz Medical Center; Aurora CO 80045 USA
- Denver Health Medical Center; Denver CO 80204 USA
| | - Danielle L. Brunjes
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Jared J. Greiner
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
| | - Christopher A. DeSouza
- Integrative Vascular Biology Laboratory; Department of Integrative Physiology; University of Colorado; Boulder CO 80309 USA
- Department of Medicine; University of Colorado Anschutz Medical Center; Aurora CO 80045 USA
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41
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Phillips SA, Andaku DK, Mendes RG, Caruso FR, Cabiddu R, Jaenisch RB, Arena R, Borghi-Silva A. Exploring Vascular Function Biomarkers: Implications for Rehabilitation. Braz J Cardiovasc Surg 2017; 32:125-135. [PMID: 28492794 PMCID: PMC5409260 DOI: 10.21470/1678-9741-2016-0085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 01/07/2017] [Indexed: 01/15/2023] Open
Abstract
The endothelium plays an important role in maintaining vascular homeostasis and
regulating blood vessel function. Endothelial function is considered an
independent predictor for risk of future cardiovascular events in cardiovascular
and non-cardiovascular patients, as well as a predictor for postoperative
complications in cardiovascular surgery patients. Brachial artery flow-mediated
dilation by high-resolution ultrasound is widely used to evaluate
endothelium-dependent vasodilation, which is mainly mediated by nitric oxide
release. Physical exercise exerts beneficial effects on endothelial function and
can be used in both primary and secondary prevention of cardiac and peripheral
artery diseases, even in the postoperative period of cardiovascular surgery.
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Affiliation(s)
- Shane A Phillips
- Department of Physical Therapy, Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Daniela Kuguimoto Andaku
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
| | - Flávia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
| | - Ramona Cabiddu
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
| | - Rodrigo Boemo Jaenisch
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Universidade Federal de São Carlos (UFSCAR), São Carlos, SP, Brazil
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Mirhosseini SM, Meghdadi S, Moghaddam AS. Anterior Spinal Artery Syndrome Following Coronary Artery Bypass Grafting: a Case Report. Braz J Cardiovasc Surg 2017; 32:136-137. [PMID: 28492795 PMCID: PMC5409248 DOI: 10.21470/1678-9741-2016-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/21/2016] [Indexed: 11/14/2022] Open
Abstract
We present a patient with unstable angina candidate for coronary artery bypass
grafting. Saphenous vein graft was used in obtuse marginal and left internal
mammary artery to left anterior descending artery properly. After surgery, the
patient experienced flaccid paralysis of lower limb and impaired sensation of
touch and warmth of knee and below. A computed tomography angiogram of lower
limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based
on the symptom, clinical diagnosis of anterior spinal artery syndrome was
considered. The artery of Adamkiewicz is an important supplier to the anterior
spinal artery. Internal thoracic mammary artery, used in coronary artery bypass
grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and
has been accused for cause of spinal infarction.
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43
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Favero G, Franceschetti L, Buffoli B, Moghadasian MH, Reiter RJ, Rodella LF, Rezzani R. Melatonin: Protection against age-related cardiac pathology. Ageing Res Rev 2017; 35:336-349. [PMID: 27884595 DOI: 10.1016/j.arr.2016.11.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/04/2016] [Accepted: 11/18/2016] [Indexed: 12/14/2022]
Abstract
Aging is a complex and progressive process that involves physiological and metabolic deterioration in every organ and system. Cardiovascular diseases are one of the most common causes of mortality and morbidity among elderly subjects worldwide. Most age-related cardiovascular disorders can be influenced by modifiable behaviours such as a healthy diet rich in fruit and vegetables, avoidance of smoking, increased physical activity and reduced stress. The role of diet in prevention of various disorders is a well-established factor, which has an even more important role in the geriatric population. Melatonin, an indoleamine with multiple actions including antioxidant properties, has been identified in a very large number of plant species, including edible plant products and medical herbs. Among products where melatonin has been identified include wine, olive oil, tomato, beer, and others. Interestingly, consumed melatonin in plant foods or melatonin supplementation may promote health benefits by virtue of its multiple properties and it may counteract pathological conditions also related to cardiovascular disorders, carcinogenesis, neurological diseases and aging. In the present review, we summarized melatonin effects against age-related cardiac alterations and abnormalities with a special focus on heart ischemia/reperfusion (IR) injury and myocardial infarction.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Lorenzo Franceschetti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Barbara Buffoli
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Mohammed H Moghadasian
- Department of Human Nutritional Sciences, University of Manitoba and the Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Research Centre, Winnipeg, MB, Canada
| | - Russel J Reiter
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Luigi F Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
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Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK. Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation 2017; 135:e894-e918. [PMID: 28336790 PMCID: PMC7252210 DOI: 10.1161/cir.0000000000000483] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.
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45
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Sauvet F, Arnal PJ, Tardo-Dino PE, Drogou C, Van Beers P, Bougard C, Rabat A, Dispersyn G, Malgoyre A, Leger D, Gomez-Merino D, Chennaoui M. Protective effects of exercise training on endothelial dysfunction induced by total sleep deprivation in healthy subjects. Int J Cardiol 2017; 232:76-85. [DOI: 10.1016/j.ijcard.2017.01.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 11/30/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022]
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46
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Novakovic M, Jug B, Lenasi H. Clinical impact of exercise in patients with peripheral arterial disease. Vascular 2016; 25:412-422. [PMID: 28256934 DOI: 10.1177/1708538116678752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increasing prevalence, high morbidity and mortality, and decreased health-related quality of life are hallmarks of peripheral arterial disease. About one-third of peripheral arterial disease patients have intermittent claudication with deleterious effects on everyday activities, such as walking. Exercise training improves peripheral arterial disease symptoms and is recommended as first line therapy for peripheral arterial disease. This review examines the effects of exercise training beyond improvements in walking distance, namely on vascular function, parameters of inflammation, activated hemostasis and oxidative stress, and quality of life. Exercise training not only increases walking distance and physiologic parameters in patients with peripheral arterial disease, but also improves the cardiovascular risk profile by helping patients achieve better control of hypertension, hyperglycemia, obesity and dyslipidemia, thus further reducing cardiovascular risk and the prevalence of coexistent atherosclerotic diseases. American guidelines suggest supervised exercise training, performed for a minimum of 30-45 min, at least three times per week, for at least 12 weeks. Walking is the most studied exercise modality and its efficacy in improving cardiovascular parameters in patients with peripheral arterial disease has been extensively proven. As studies have shown that supervised exercise training improves walking performance, cardiovascular parameters and quality of life in patients with peripheral arterial disease, it should be encouraged and more often prescribed.
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Affiliation(s)
- Marko Novakovic
- 1 Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.,2 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Jug
- 1 Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.,2 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Helena Lenasi
- 3 Faculty of Medicine, Institute of Physiology, University of Ljubljana, Ljubljana, Slovenia
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47
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Obesity, Vascular Disease, and Lumbar Disk Degeneration: Associations of Comorbidities in Low Back Pain. PM R 2016; 9:398-402. [DOI: 10.1016/j.pmrj.2016.09.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/18/2016] [Accepted: 09/28/2016] [Indexed: 11/23/2022]
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48
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Exercise and Hypertension: Uncovering the Mechanisms of Vascular Control. Prog Cardiovasc Dis 2016; 59:226-234. [PMID: 27697533 DOI: 10.1016/j.pcad.2016.09.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 09/25/2016] [Indexed: 12/18/2022]
Abstract
Hypertension (HTN) has recently been determined to be the number one overall risk factor of disease. With direct and indirect costs amounting to $46.4 billion in 2011 and projections of six-fold increases by 2030, the importance of low-cost nonpharmacological interventions can be appreciated. Vascular structural changes, endothelial dysfunction, and sympathetic overstimulation are major contributing factors to the pathophysiology of HTN. Exercise training (ET) for blood pressure (BP) control has been shown to be an effective and integral component of nonpharmacological interventions for BP control. Different ET modalities (aerobic, resistance, and concurrent training) have contributed differently to BP reduction and control, driving scientific discourse regarding the optimum ET prescription (modality, volume, and intensity) for such effects; ET results in a multitude of physiological effects, with vascular and autonomic adaptations providing major contributions to BP control. Despite widespread acceptance of the role and importance of ET for BP reduction, only 15% of US adults have been found to meet ET/physical activity recommendations. The purpose of this review is to explore BP lowering effects of aerobic and resistance ET and the underlying physiological mechanisms that result in such effects. Further research is required to enhance our understanding of the proper ET prescription for BP control across different age groups and racial ethnicities. Furthermore, research into methods of improving awareness and adherence to ET recommendations proves to be equally important.
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49
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Kamil-Rosenberg S, Garber CE. Cardiac conditioning for healthy individuals: primary prevention of heart disease. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Redox Signaling and Neural Control of Cardiovascular Function. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:7086018. [PMID: 27123156 PMCID: PMC4829727 DOI: 10.1155/2016/7086018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 11/18/2022]
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