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Most A, Kraushaar L, Dörr O, Keranov S, Hoelscher S, Weber R, Akdogan E, Groesser V, Husain-Syed F, Nef H, Hamm CW, Bauer P. Association of central blood pressure with an exaggerated blood pressure response to exercise among elite athletes. Eur J Appl Physiol 2024; 124:1239-1252. [PMID: 37987923 PMCID: PMC10955016 DOI: 10.1007/s00421-023-05353-7] [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: 07/06/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The systolic blood pressure/workload (SBP/MET) slope was recently reported to be a reliable parameter to identify an exaggerated blood pressure response (eBPR) in the normal population and in athletes. However, it is unclear whether an eBPR correlates with central blood pressure (CBP) and vascular function in elite athletes. METHODS We examined 618 healthy male elite athletes (age 25.8 ± 5.1 years) of mixed sports with a standardized maximum exercise test. CBP and vascular function were measured non-invasively with a validated oscillometric device. The SBP/MET slope was calculated and the threshold for an eBPR was set at > 6.2 mmHg/MET. Two groups were defined according to ≤ 6.2 and > 6.2 mmHg/MET, and associations of CBP and vascular function with the SBP/MET slope were compared for each group. RESULTS Athletes with an eBPR (n = 180, 29%) displayed a significantly higher systolic CBP (102.9 ± 7.5 vs. 100 ± 7.7 mmHg, p = 0.001) but a lower absolute (295 ± 58 vs. 384 ± 68 W, p < 0.001) and relative workload (3.14 ± 0.54 vs. 4.27 ± 1.1 W/kg, p < 0.001) compared with athletes with a normal SBP/MET slope (n = 438, 71%). Systolic CBP was positively associated with the SBP/MET slope (r = 0.243, p < 0.001). In multiple logistic regression analyses, systolic CBP (odds ratio [OR] 1.099, 95% confidence interval [CI] 1.045-1.155, p < 0.001) and left atrial volume index (LAVI) (OR 1.282, CI 1.095-1.501, p = 0.002) were independent predictors of an eBPR. CONCLUSION Systolic CBP and LAVI were independent predictors of an eBPR. An eBPR was further associated with a lower performance level, highlighting the influence of vascular function on the BPR and performance of male elite athletes.
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Affiliation(s)
- Astrid Most
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | | | - Oliver Dörr
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Stanislav Keranov
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Sophie Hoelscher
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Rebecca Weber
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Ebru Akdogan
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Vincent Groesser
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Faeq Husain-Syed
- Department of Internal Medicine, Member of the German Center for Lung Research, Universities of Giessen and Marburg Lung Center, Justus Liebig University Giessen, Giessen, Germany
| | - Holger Nef
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
| | - Christian W Hamm
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Rhein-Main Partner Site, Bad Nauheim, Germany
| | - Pascal Bauer
- Department of Cardiology and Angiology, Justus Liebig University Giessen, 35390, Giessen, Germany.
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Falcioni L, Gallotta MC, Baldari C, Cardinali L, Campanella M, Ferrari D, Guidetti L, Meucci M. Influence of training status on cardiac and vascular functioning in young recreational and competitive male rowers. Front Pediatr 2023; 11:1162594. [PMID: 37090920 PMCID: PMC10118033 DOI: 10.3389/fped.2023.1162594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/10/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction The aim of the study was to investigate the influence of training status on cardiovascular function in young male recreational and competitive rowers. Methods Ejection duration in percentage to the heart rate period (ED%), subendocardial viability ratio (SEVR), augmentation index at 75 bpm (AIx75) and carotid to femoral pulse wave velocity (cf-PWV) of competitive rowers (CR) (age 17.6 ± 4.1 years), recreational rowers (RR) (age 16.7 ± 2.70 years) and athletes practicing other recreational sports (ORS) (age 15.3 ± 1.4 years) were assessed. Results ED% was lower in CR compared to ORS (31.9 ± 3.9% vs. 38.4 ± 4.8%; p = 0.026) and cf-PWV was higher in CR compared to ORS (5.5 ± 1.0 m/s vs. 4.7 ± 0.5 m/s; p = 0.032). SEVR was higher in CR compared to RR and ORS (165.8 ± 33.7% vs. 127.4 ± 30.4% and 128.3 ± 27.8%; p = 0.022) and AIx75 was lower in CR compared to RR and ORS (-15.7 ± 8.6% vs. 1.2 ± 9.9% and 1.5 ± 9.1; p = 0.001). Discussion Healthy, young competitive male rowers reported higher myocardial performance and better cardiovascular health than recreational athletes. Interpretations of cf-PWV in competitive rowers should be performed alongside other cardiovascular indicators.
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Affiliation(s)
- Lavinia Falcioni
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Maria Chiara Gallotta
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Ludovica Cardinali
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Matteo Campanella
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
| | - Dafne Ferrari
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Italy
- Departement of Unicusano, Università Degli Studi Niccolò Cusano, Rome, Italy
| | - Laura Guidetti
- Departement of Unicusano, Università Degli Studi Niccolò Cusano, Rome, Italy
| | - Marco Meucci
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
- Correspondence: Marco Meucci
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Differential Effects of Angiotensin-II Compared to Phenylephrine on Arterial Stiffness and Hemodynamics: A Placebo-Controlled Study in Healthy Humans. Cells 2021; 10:cells10051108. [PMID: 34062957 PMCID: PMC8147945 DOI: 10.3390/cells10051108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
The α1-adrenoceptor agonist phenylephrine (PE) and Angiotensin II (Ang II) are both potent vasoconstrictors at peripheral resistance arteries. PE has pure vasoconstrictive properties. Ang II, additionally, modulates central nervous blood pressure (BP) control via sympathetic baroreflex resetting. However, it is unknown whether Ang II vs. PE mediated vasoconstriction at equipressor dose uniformly or specifically modifies arterial stiffness. We conducted a three-arm randomized placebo-controlled cross-over trial in 30 healthy volunteers (15 female) investigating the effects of Ang II compared to PE at equal systolic pressor dose on pulse wave velocity (PWV), pulse wave reflection (augmentation index normalized to heart rate 75/min, AIx) and non-invasive hemodynamics by Mobil-O-Graph™ and circulating core markers of endothelial (dys-)function. PE but not Ang II-mediated hypertension induced a strong reflex-decrease in cardiac output. Increases in PWV, AIx, total peripheral resistance and pulse pressure, in contrast, were stronger during PE compared to Ang II at equal mean aortic BP. This was accompanied by minute changes in circulating markers of endothelial function. Moreover, we observed differential hemodynamic changes after stopping either vasoactive infusion. Ang II- and PE-mediated BP increase specifically modifies arterial stiffness and hemodynamics with aftereffects lasting beyond mere vasoconstriction. This appears attributable in part to different interactions with central nervous BP control including modified baroreflex function.
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Verwoert GC, Jorstad HT. Mixed Signals: Arterial Stiffness and Elite Sports. Cardiology 2020; 146:127-129. [PMID: 33311029 DOI: 10.1159/000511491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Germaine Claudette Verwoert
- Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands, .,Department of Cardiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands,
| | - Harald T Jorstad
- Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Zhang Y, Qi L, van de Vosse F, Du C, Yao Y, Du J, Wu G, Xu L. Recovery Responses of Central Hemodynamics in Basketball Athletes and Controls After the Bruce Test. Front Physiol 2020; 11:593277. [PMID: 33281624 PMCID: PMC7688748 DOI: 10.3389/fphys.2020.593277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose It is commonly believed that central hemodynamics is closely associated with the presence of cardiovascular events. However, controversial data exist on the acute response of competitive sports on central hemodynamics. Moreover, the central hemodynamic response to exercise is too transient to be investigated. Therefore, this study aimed to investigate the central hemodynamic response in young basketball athletes and controls after 1 h recovery after exercise. Methods Fifteen young basketball athletes and fifteen aged-matched controls were recruited to perform the Bruce test. Central hemodynamics were measured and calculated, including heart rate (HR), aortic systolic, diastolic, and pulse pressure (ASP, ADP, and APP), ejection duration (ED), sub-endocardial viability ratio (SEVR), central augmentation index (AIx), and AIx@HR75. Intra-group and inter-group differences were analyzed by two-way repeated measures ANOVA. Results ASP significantly decreased at 10 min after exercise in athletes, while it markedly declined at 15 min after exercise in controls (p < 0.01). Additionally, only in the athlete group, ADP significantly decreased at 50 min and at 1 h after exercise. AIx was also significantly reduced at 1-2, 20, 30, and 40 min after exercise (all p < 0.05). Moreover, there were significant differences in the changes of these parameters between the two groups at these measurement points (p < 0.05). SEVR significantly recovered to the baseline level after 30 min, while ED and HR returned to baseline levels at 40 min after exercise in both groups. Conclusion Sustained decrease of aortic BPs was sooner after the cessation of exercise in athletes than in controls, and changes of aortic stiffness were more evident in athletes than those in controls during the 1 h recovery period. Additionally, SEVR returned to the baseline sooner than ED and HR in athletes.
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Affiliation(s)
- Yahui Zhang
- College of Medicine and Biomedical Information Engineering, Northeastern University, Shenyang, China.,Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Lin Qi
- College of Medicine and Biomedical Information Engineering, Northeastern University, Shenyang, China
| | - Frans van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Chenglin Du
- Department of Physical Education, Northeastern University, Shenyang, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Jianhang Du
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Guifu Wu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Lisheng Xu
- College of Medicine and Biomedical Information Engineering, Northeastern University, Shenyang, China
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Elite athletes as research model: vitamin D insufficiency associates with elevated central blood pressure in professional handball athletes. Eur J Appl Physiol 2019; 119:2265-2274. [PMID: 31428859 DOI: 10.1007/s00421-019-04210-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Low vitamin D levels have been associated with elevated blood pressure in the general population. Prospective studies, however, have produced conflicting evidence about the blood pressure-lowering effects of vitamin D supplementation. Cardiorespiratory fitness may modulate the vitamin D-blood pressure association. We therefore examined this association in professional athletes, whose high training load serves as a biological control for physical fitness. METHODS 50 male professional handball players (age 26 ± 5 years) were examined. We assessed the central aortic pressure parameters using transfer function-based analysis of oscillometrically obtained peripheral arterial waveforms. Serum 25-OH vitamin D concentrations were determined by chemiluminescent immunoassay. The threshold for insufficiency was set at values of < 30 ng/mL. RESULTS Central blood pressure (cBP) was 98 ± 7/60 ± 10 mmHg. The aortic pulse wave velocity (PWV) was 6.3 ± 1.0 m/s. Nine athletes (18%) displayed insufficient 25-OH vitamin D levels and had a significantly (p < 0.01) higher cBP compared with the 41 (82%) athletes with sufficient 25-OH vitamin D levels (106 ± 5/68 ± 8 vs. 97 ± 7/58 ± 9 mmHg). Central systolic blood pressure (cSBP) in vitamin D-sufficient athletes was significantly lower in comparison to the healthy reference population (97 mmHg vs. 103 mmHg, p < 0.001). This significance of difference was lost in vitamin D-insufficient athletes (106 mmHg vs. 103 mmHg, p = 0.12). CONCLUSION Significantly raised central systolic and diastolic blood pressure in vitamin D-insufficient elite athletes implicates vitamin D as a potential modifier of vascular functional health.
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Carotid Arterial Stiffness and Hemodynamic Responses to Acute Cycling Intervention at Different Times during 12-Week Supervised Exercise Training Period. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2907548. [PMID: 30112375 PMCID: PMC6077594 DOI: 10.1155/2018/2907548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/08/2018] [Accepted: 07/02/2018] [Indexed: 02/05/2023]
Abstract
This paper studied the alterations in arterial stiffness and hemodynamic responses during resting state and immediately following acute cycling intervention at different times across 12-week supervised exercise training. Twenty-six sedentary young males participated in the exercise training program at moderate intensity. Arterial stiffness and hemodynamic variables of the right common carotid artery were measured and computed during resting state and immediately following acute cycling intervention at weeks 0, 4, 8, and 12. Across the 12-week exercise training, carotid arterial stiffness was decreased at weeks 8 and 12 and hemodynamic variables were improved at week 12 during resting state. In response to acute cycling intervention, carotid arterial stiffness exhibited an acute increase foremost at 8 weeks, and arterial maximal and mean diameters showed acute decreases at weeks 0 and 4. Despite significant differences in arterial stiffness and hemodynamic variables between resting state and immediately after acute intervention for each time period, these differences presented a progressive decrease across the 12-week exercise training. In conclusion, long-term exercise training not only improved carotid arterial stiffness and hemodynamic alterations when at rest but also negated the acute responses of carotid arterial stiffness and hemodynamic variables to acute cycling intervention.
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Zhang Y, Fan X, Qi L, Xu L, Du C. Comparison of central hemodynamic parameters for young basketball athletes and control group. Acta Cardiol 2017; 73:1-7. [PMID: 29283315 DOI: 10.1080/00015385.2017.1421123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 12/15/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Long-term exercise training may have negative effects on cardiovascular functions. Measurement and calculation of central hemodynamic parameters can comprehensively evaluate the cardiovascular functions. This study aims to compare the central hemodynamics between young basketball athletes and matched controls. METHODS Total 19 young long-term trained male basketball athletes and 17 matched male recreationally active controls participated. The central hemodynamic parameters such as central blood pressure, pulse pressure, heart rate (HR), augmentation index normalised to 75 bpm (AIx@HR75), augmentation index (AIx), ejection duration (ED), sub-endocardial viability ratio (SEVR) were measured, and total peripheral resistance (TPR), stroke volume (SV) and cardiac output (CO) were calculated. Non-parameter tests and t-test were used to analyse the central hemodynamic parameters between athletes and controls. RESULTS HR (56 ± 5 bpm versus 79 ± 9 bpm, p < .001), AIx@HR75 (-8 ± 10% versus -1 ± 10%, p < .05), ED (28 ± 2% versus 36 ± 3%, p < .001) and TPR (0.004 ± 0.006 mmHg s/mL versus 0.012 ± 0.006 mmHg s/mL, p < .001) were significantly lower in basketball athletes compared to the controls. SEVR (231 ± 32% versus 159 ± 21%, p < .001) and SV (154 ± 50 mL versus 101 ± 43 mL, p < .01) were significantly higher in basketball athletes than those in the controls. However, there were no significant differences in central blood pressure, pulse pressure, AIx and CO between them. CONCLUSIONS There is no negative effect on central hemodynamics in young basketball athletes after long-term exercise training. The young basketball athletes have a higher myocardial perfusion, higher efficiency of blood supply, stronger vascular functions and better balance of myocardial oxygen of supply and demand than the controls in this central hemodynamic parameters analysis.
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Affiliation(s)
- Yahui Zhang
- a Sino-Dutch Biomedical and Information Engineering School , Northeastern University , Shenyang , Liaoning , China
| | - Xiaobing Fan
- b Department of Radiology , University of Chicago , Chicago , IL , USA
| | - Lin Qi
- a Sino-Dutch Biomedical and Information Engineering School , Northeastern University , Shenyang , Liaoning , China
| | - Lisheng Xu
- a Sino-Dutch Biomedical and Information Engineering School , Northeastern University , Shenyang , Liaoning , China
- c Key Laboratory of Medical Image Computing , Ministry of Education , Shenyang, Liaoning, China
| | - Chenglin Du
- d Department of Physical Education , Northeastern University , Shenyang , Liaoning Province , China
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Acute effects of incremental exercise on central hemodynamics in young basketball athletes. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1356-1359. [PMID: 29060128 DOI: 10.1109/embc.2017.8037084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Acute effects of competitive sports on central hemodynamics are controversial. This study was aimed to evaluate acute effects of incremental exercise on central hemodynamics in young basketball athletes during 1-hour recovery. Fifteen young basketball athletes and fifteen controls underwent the acquisition of peripheral and central blood pressure before exercise and at 0, 5, 10, 15, 20, 30, 40, 50, 60 min after incremental exercise. The incremental exercise was performed by Bruce test. Aortic systolic pressure (ASP), sub-endocardial viability ratio and stroke volume were significantly higher in athletes at all time points measured before and after exercise (P<;0.05). Heart rate and ejection duration were significantly lower in athletes (P<;0.01 for all). Augmentation index (AIx) was higher in athletes than that in controls at rest. AIx significantly reduced in athletes at 0 min after exercise (P<;0.01), but not in controls. Both Cardiac output and total peripheral resistance significantly changed in athletes at 0 min after exercise (P<;0.01). Cardiac functions to incremental exercise at all time points in basketball athletes are stronger than those in controls. However, potential mechanism of vascular functions should be further explored because basketball athletes have higher ASP and AIx than those in controls.
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Simmons EE, Bergeron ER, Florian JP. The impact of repetitive long-duration water immersion on vascular function. PLoS One 2017; 12:e0181673. [PMID: 28750006 PMCID: PMC5531465 DOI: 10.1371/journal.pone.0181673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 07/04/2017] [Indexed: 01/11/2023] Open
Abstract
While physiological responses to water immersion (WI) are well-studied, the vascular responses after WI are less understood. Fifteen male subjects performed six-hour resting thermoneutral water immersions (WI) at 1.35 atmospheres absolute for four consecutive days, with follow-up on the fifth day. Measurements included peripheral endothelial function and augmentation index (PAT, peripheral arterial tonometry), beat-to-beat blood pressure (BP, photoplethysmography), heart rate (HR), and plasma volume (PV) calculated from changes in hemoglobin and hematocrit. The reactive hyperemia index (RHI), a marker of peripheral endothelial function, increased with repeated immersions (p = 0.008). By WI2 and WI3, RHI increased 12% and 16%, respectively, compared to WI1 values, but no significant differences were detected between WI4 and WI1 for either measure. Absolute augmentation index (AI) increased by an average of 33% (p<0.001) and AI normalized for HR (AI@75) by 11% (p = 0.12) following each WI. PV decreased significantly by 13.2% following WI and remained 6.8% lower at follow-up compared to pre-WI. Systolic blood pressure significantly decreased by an average of 2.5% following each WI (p = 0.012). Compared to pre-WI HR, average post-WI HR decreased 4.3% lower (p<0.001), but increased overall by 8.2% over the course of repeated WI (p<0.001). Total peripheral resistance increased by an average of 13.1% following WI (p = 0.003). Thus, peripheral endothelial function increases after two days of WI, and PAT-derived measures of arterial stiffness increase transiently post-WI. Additionally, BP and PAT-derived endothelial function diverge from their usual associations with arterial stiffness (i.e. augmentation index) in the context of WI.
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Affiliation(s)
- Erin E. Simmons
- Navy Experimental Diving Unit, Panama City, Florida, United States of America
| | | | - John P. Florian
- Navy Experimental Diving Unit, Panama City, Florida, United States of America
- * E-mail:
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Efecto del ejercicio aeróbico en la rigidez vascular en una población sana. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2016.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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