Left ventricular function during interval and steady state exercise

Vive la radiorésistance!: converging research in radiobiology and biogerontology to enhance human radioresistance for deep space exploration and colonization

While many efforts have been made to pave the way toward human space colonization, little consideration has been given to the methods of protecting spacefarers against harsh cosmic and local radioactive environments and the high costs associated with protection from the deleterious physiological effects of exposure to high-Linear energy transfer (high-LET) radiation. Herein, we lay the foundations of a roadmap toward enhancing human radioresistance for the purposes of deep space colonization and exploration. We outline future research directions toward the goal of enhancing human radioresistance, including upregulation of endogenous repair and radioprotective mechanisms, possible leeways into gene therapy in order to enhance radioresistance via the translation of exogenous and engineered DNA repair and radioprotective mechanisms, the substitution of organic molecules with fortified isoforms, and methods of slowing metabolic activity while preserving cognitive function. We conclude by presenting the known associations between radioresistance and longevity, and articulating the position that enhancing human radioresistance is likely to extend the healthspan of human spacefarers as well.

High-intensity aerobic interval exercise in chronic heart failure

Aerobic exercise training is strongly recommended in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF) to improve symptoms and quality of life. Moderate-intensity aerobic continuous exercise (MICE) is the best established training modality in HF patients. For about a decade, however, another training modality, high-intensity aerobic interval exercise (HIIE), has aroused considerable interest in cardiac rehabilitation. Originally used by athletes, HIIE consists of repeated bouts of high-intensity exercise interspersed with recovery periods. The rationale for its use is to increase exercise time spent in high-intensity zones, thereby increasing the training stimulus. Several studies have demonstrated that HIIE is more effective than MICE, notably for improving exercise capacity in patients with HF. The aim of the present review is to describe the general principles of HIIE prescription, the acute physiological effects, the longer-term training effects, and finally the future perspectives of HIIE in patients with HF.

The effect of aerobic continuous and interval training on left ventricular structure and function in male non-athletes

Exercise plays an important role to improve cardiovascular performance. The aim of this study was to compare the effect of aerobic continuous and interval training on the left ventricular structure and function. Twenty untrained healthy male students (aged 18-22 years) were randomly divided into two groups: continuous (C; n = 10) and interval (I; n = 10). The training programme consisted of countryside jogging for 45 min during 8 weeks three times a week at 70% of maximum heart rate (MHR). In each session group C was jogging for 45 min and in group I jogging was performed in 5 nine-minute stages with a four-minute inactive rest between them. M-mode, 2-dimensional, colour and Doppler transthoracic echocardiography were performed, during resting conditions, before and after the training period. After 8-week training the end diastolic diameter, systolic blood pressure and diastolic blood pressure in groups C and I, and the posterior wall thickness and the end systolic diameter in group I showed no significant difference (P > 0.05). On the other hand, the percentage of ejection fraction and shortening fraction in groups C and I, the end systolic diameter and the posterior wall thickness in group C and the interventricular septum thickness in group I demonstrated a significant difference (P ≤ 0.05). Comparing the two groups, only the value of the interventricular septum thickness was significant (P ≤ 0.05). In general, eight-week aerobic continuous and interval training can affect left ventricular structure and function.

Central hemodynamic responses during acute high-intensity interval exercise and moderate continuous exercise in patients with heart failure

The aim of this study was to compare the acute hemodynamic responses during high-intensity intermittent exercise (HIIE) session compared with moderate-intensity continuous exercise (MICE) session in patients with heart failure and reduced ejection fraction (HFREF). Thirteen patients with HFREF (age, 59 ± 6 years; left ventricular ejection fraction, 27% ± 6%; New York Heart Association class I to III) were randomly assigned to a single session of HIIE (2 × 8 min) corresponding to 30 s at 100% of peak power output (PPO) and 30 s passive recovery intervals or to a MICE (22 min) at 60% of PPO. Gas exchange and central hemodynamic parameters (cardiac bioimpedance) were measured continuously during exercise. Oxygen uptake, stroke volume (SV), cardiac output (CO), and arterio-venous difference (C(a-v)O(2)) were compared. Mean oxygen uptake and ventilation were lower during HIIE vs. MICE. CO, SV, and C(a-v)O(2)) were not different between MICE and HIIE. Optimized HIIE was well tolerated (similar perceived exertion) and no significant ventricular arrhythmias and (or) abnormal blood pressure responses occurred during HIEE session. Compared with MICE, optimized HIIE elicited similar central hemodynamic and C(a-v)O(2) responses in HFREF patients with lower oxygen uptake and ventilation. HIIE may be an efficient exercise training modality in patients with HFREF.

Left ventricular systolic function and diastolic filling after intermittent high intensity team sports

BACKGROUND

Prolonged steady state exercise can lead to a decrease in left ventricular (LV) function as well as promote the release of cardiac troponin T (cTnT). There is limited information on the effect of intermittent high intensity exercise of moderate duration.

OBJECTIVES

To determine the effect of intermittent high intensity exercise of moderate duration on LV function.

METHODS

Nineteen male rugby and football players (mean (SD) age 21 (2) years) volunteered. Assessments, before, immediately after, and 24 hours after competitive games, included body mass, heart rate (HR), and systolic blood pressure (sBP) as well as echocardiography to assess stroke volume (SV), ejection fraction (EF), systolic blood pressure/end systolic volume ratio (sBP/ESV), and global diastolic filling (E:A) as well as to indirectly quantify preload (LV internal dimension at end diastole (LVIDd)). Serum cTnT was analysed using a 3rd generation assay. Changes in LV function were analysed by repeated measures analysis of variance. cTnT data are presented descriptively.

RESULTS

SV (91 (26) v 91 (36) v 90 (35) ml before, after, and 24 hours after the game respectively), EF (71 (8) v 70 (9) v 71 (7)%), and sBP/ESV (4.2 (1.8) v 3.8 (1.9) v 4.1 (1.6) mm Hg/ml) were not significantly altered (p>0.05). Interestingly, whereas LVIDd was maintained after the game (50 (5) v 50 (6) mm), sBP was transiently but significantly reduced (131 (3) v 122 (3) mm Hg; p<0.05). E:A was moderately (p<0.05) reduced after the game (2.0 (0.4) v 1.5 (0.4)) but returned to baseline within 24 hours. No blood sample contained detectable levels of cTnT.

CONCLUSIONS

In this cohort, LV systolic function was not significantly altered after intermittent activity. A transient depression in global diastolic filling was partially attributable to a raised HR and could not be explained by myocyte disruption as represented by cTnT release.

Hemodynamic responses during aerobic and resistance exercise

PURPOSE

Resistance training has become an accepted part of cardiac rehabilitation programs. Because of the potential for a high afterload to have a negative impact on left ventricular function, there has been concern regarding the safety of resistance training for patients with congestive heart failure.

METHODS

This study addressed this concern by studying 12 healthy volunteers, 12 patients with stable coronary artery disease, and 12 patients with stable congestive heart failure during upright cycling at 90% of ventilatory threshold, and during one set of 10 repeated leg presses, shoulder presses, and biceps curls at 60% to 70% of 1-repetition maximum. Left ventricular function was measured by echocardiography.

RESULTS

The pattern of changes in heart rate, blood pressure, left ventricular ejection fraction, wall thickness, and left ventricular internal diameters was similar across all three groups of subjects, although there were large differences in absolute values. Despite elevations in diastolic and mean arterial pressures during resistance exercise, there was no evidence of significant rest-to-exercise deterioration in left ventricular function during leg press (ejection fraction, 60%-59%, 56%-55%, and 38%-37%), shoulder press (66%-65%, 59%-53%, and 38%-35%), or biceps curls (63%-58%, 53%-54%, and 35%-36%), as compared with cycle ergometry (63%-69%, 51%-57%, and 35%-42%) in the healthy control subjects, the patients with coronary artery disease, and the patients with congestive heart failure, respectively.

CONCLUSIONS

Left ventricular function remains stable during moderate-intensity resistance exercise, even in patients with congestive heart failure, suggesting that this form of exercise therapy can be used safely in rehabilitation programs.

Physical activity and exercise training prescriptions for patients

The dominant outcome from exercise prescription is an increase in various markers of exercise capacity. A very large group of studies have demonstrated that the VO2max is increased in response to exercise performed according to well-accepted principles of exercise prescription. Other markers of exercise capacity, such as the VT, also improve substantially following exercise training. Finally, improvement in exercise capacity is generally related to improved quality of life, particularly in patients with exercise capacity limited by various disease processes. Beyond the specific physiologic gains from training, exercise contributes to a better overall clinical outcome. Although there are few data conclusively demonstrating that exercise independently causes favorable changes in other risk factors, it should be recognized that exercise can contribute indirectly to modulation of other risk factors. Exercise represents positive health advice. Since most of our other recommendations to patients are in the nature of negative advice (e.g., don't smoke, don't eat high-fat foods), and since people are infamous for ignoring negative advice, the value of using a positive recommendation that may indirectly lead the patient to discontinue bad behaviors can hardly be overstated.

Intensity-controlled treadmill running in rats: VO(2 max) and cardiac hypertrophy

Physiological studies of long-term cardiovascular adaptation to exercise require training regimens that give robust conditioning effects and adequate testing procedures to quantify the outcome. We developed a valid and reproducible protocol for measuring maximal oxygen uptake (VO(2 max)), which was reached at a 25 degrees inclination with a respiratory exchange ratio > 1.05 and blood lactate > 6 mmol/l. The effect of intensity-controlled aerobic endurance training was studied in adult female and male rats that ran 2 h/day, 5 days/wk, in intervals of 8 min at 85-90% of VO(2 max) and 2 min at 50-60% of VO(2 max), with adjustment of exercise level according to VO(2 max) every week. After 7 wk, the increase in VO(2 max) plateaued at 60-70% above sedentary controls. Ventricular weights and myocyte length were up 25-30% and 6-12%, respectively. Work economy, oxygen pulse, and heart rate were sufficiently changed to indicate substantial cardiovascular adaptation. The model mimics important human responses to training and could be used in future studies on cellular, molecular, and integrative mechanisms of improved cardiovascular function.

Metabolic responses associated with deer hunting

PURPOSE

Deer hunting is a popular recreational activity with a high rate of cardiovascular events. Previous studies have demonstrated large HR responses during deer hunting. This study compared the HR and metabolic costs of maximal treadmill (TM) exercise with those of hiking while deer hunting and while dragging a deer.

METHODS

Healthy male volunteers (N = 16) performed a maximal TM exercise test, a 0.8-km hiking test, and a 0.4-km dragging test over lightly rolling terrain. VO2 was measured by portable spirometry and HR by radiotelemetry.

RESULTS

HR averaged 74.0 +/- 7.0% and 89.1 +/- 4.5% of peak TM HR during the hike and drag, respectively. The peak HR observed during hiking and dragging was 83.2 +/- 6.0% and 94.9 +/- 4.2% of peak TM HR, respectively. VO2 averaged 62.2 +/- 15.8% and achieved a peak of 77.2 +/- 19.0% of TM VO2 while hiking. This corresponded to 86.8 +/- 17.3% and 108.1 +/- 22.3% of ventilatory threshold (VT), respectively. VO2 averaged 72.3 +/- 21.0% and achieved a peak of 91.2 +/- 21.4% of peak TM VO2 while dragging the deer. This corresponded to 101.5 +/- 27.7% and 128.5 +/- 26.8% of VT, respectively. The VO2/HR relationship showed significant (P < 0.05) difference between the dragging test and the TM test with a disproportionately high HR. The VO2/HR relationship between the hiking and TM tests was comparable.

CONCLUSION

In part, the previously described large HR responses and high rate of cardiovascular complications associated with deer hunting may attributable to the elevated metabolic costs of associated activities.