1
|
Alotaibi M, Yang JZ, Papamatheakis DG, McGuire WC, Fernandes TM, Morris TA. Cardiopulmonary exercise test to detect cardiac dysfunction from pulmonary vascular disease. Respir Res 2024; 25:121. [PMID: 38468264 PMCID: PMC10926602 DOI: 10.1186/s12931-024-02746-w] [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: 10/04/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Cardiac dysfunction from pulmonary vascular disease causes characteristic findings on cardiopulmonary exercise testing (CPET). We tested the accuracy of CPET for detecting inadequate stroke volume (SV) augmentation during exercise, a pivotal manifestation of cardiac limitation in patients with pulmonary vascular disease. METHODS We reviewed patients with suspected pulmonary vascular disease in whom CPET and right heart catheterization (RHC) measurements were taken at rest and at anaerobic threshold (AT). We correlated CPET-determined O2·pulseAT/O2·pulserest with RHC-determined SVAT/SVrest. We evaluated the sensitivity and specificity of O2·pulseAT/O2·pulserest to detect SVAT/SVrest below the lower limit of normal (LLN). For comparison, we performed similar analyses comparing echocardiographically-measured peak tricuspid regurgitant velocity (TRVpeak) with SVAT/SVrest. RESULTS From July 2018 through February 2023, 83 simultaneous RHC and CPET were performed. Thirty-six studies measured O2·pulse and SV at rest and at AT. O2·pulseAT/O2·pulserest correlated highly with SVAT/SVrest (r = 0.72, 95% CI 0.52, 0.85; p < 0.0001), whereas TRVpeak did not (r = -0.09, 95% CI -0.47, 0.33; p = 0.69). The AUROC to detect SVAT/SVrest below the LLN was significantly higher for O2·pulseAT/O2·pulserest (0.92, SE 0.04; p = 0.0002) than for TRVpeak (0.69, SE 0.10; p = 0.12). O2·pulseAT/O2·pulserest of less than 2.6 was 92.6% sensitive (95% CI 76.6%, 98.7%) and 66.7% specific (95% CI 35.2%, 87.9%) for deficient SVAT/SVrest. CONCLUSIONS CPET detected deficient SV augmentation more accurately than echocardiography. CPET-determined O2·pulseAT/O2·pulserest may have a prominent role for noninvasive screening of patients at risk for pulmonary vascular disease, such as patients with persistent dyspnea after pulmonary embolism.
Collapse
Affiliation(s)
- Mona Alotaibi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA
| | - Jenny Z Yang
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA
| | - Demosthenes G Papamatheakis
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA
| | - W Cameron McGuire
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA
| | - Timothy M Fernandes
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA
| | - Timothy A Morris
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego Healthcare, 200 West Arbor Drive, San Diego, CA, 92103-8378, USA.
| |
Collapse
|
2
|
Perrone MA, Iellamo F, D’Antoni V, Gismondi A, Di Biasio D, Vadalà S, Marazzi G, Morsella V, Volterrani M, Caminiti G. Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study. J Pers Med 2023; 13:1272. [PMID: 37623522 PMCID: PMC10456046 DOI: 10.3390/jpm13081272] [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: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND the aim of this study was to assess acute changes in left atrial (LA) function during incremental aerobic exercise in patients with heart failure with mildly reduced ejection fraction (HFmrEF) in comparison to healthy subjects (HS). METHODS twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subjects performed a stepwise exercise test on a cycle ergometer. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 min of recovery. RESULTS HS obtained a higher value of METs at peak exercise than HFmrEF (7.4 vs. 5.6; between group p = 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between groups p = 0.006 and 0.003, respectively). In the HFmrEF group, peak atrial longitudinal strain (PALS) and conduit strain were both increased at submaximal exercise (p < 0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the HS group, PALS and PACS increased significantly at submaximal level (p < 0.05 for both versus baseline), but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise, SV remained constant in the HFmrEF, while it decreased in controls (between groups p = 0.002). CONCLUSIONS patients with HFmrEF show a proper increase in LA reservoir function during incremental aerobic exercise that contributes to maintain SV throughout the physical effort.
Collapse
Affiliation(s)
- Marco Alfonso Perrone
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (M.A.P.); (F.I.)
| | - Ferdinando Iellamo
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (M.A.P.); (F.I.)
| | - Valentino D’Antoni
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Alessandro Gismondi
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Deborah Di Biasio
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Sara Vadalà
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Giuseppe Marazzi
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Valentina Morsella
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
| | - Maurizio Volterrani
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
- Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, Italy
| | - Giuseppe Caminiti
- Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy; (V.D.); (A.G.); (D.D.B.); (S.V.); (G.M.); (V.M.); (M.V.)
- Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, Italy
| |
Collapse
|
3
|
Schierbauer J, Ficher S, Zimmermann P, Wachsmuth NB, Schmidt WFJ. Cardiac stroke volume in females and its correlation to blood volume and cardiac dimensions. Front Physiol 2022; 13:895805. [PMID: 36237526 PMCID: PMC9551173 DOI: 10.3389/fphys.2022.895805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
We aimed to continuously determine the stroke volume (SV) and blood volume (BV) during incremental exercise to evaluate the individual SV course and to correlate both variables across different exercise intensities. Twenty-six females with heterogeneous endurance capacities performed an incremental cycle ergometer test to continuously determine the oxygen uptake (V̇O2), cardiac output (Q̇) and changes in BV. Q̇ was determined by impedance cardiography and resting cardiac dimensions by 2D echocardiography. Hemoglobin mass and BV were determined using a carbon monoxide-rebreathing method. V̇O2max ranged from 32 to 62 mL·kg−1·min−1. Q̇max and SVmax ranged from 16.4 to 31.6 L·min−1 and 90–170 mL, respectively. The SV significantly increased from rest to 40% and from 40% to 80% V̇O2max. Changes in SV from rest to 40% V̇O2max were negatively (r = −0.40, p = 0.05), between 40% and 80% positively correlated with BV (r = 0.45, p < 0.05). At each exercise intensity, the SV was significantly correlated with the BV and the cardiac dimensions, i.e., left ventricular muscle mass (LVMM) and end-diastolic diameter (LVEDD). The BV decreased by 280 ± 115 mL (5.7%, p = 0.001) until maximum exercise. We found no correlation between the changes in BV and the changes in SV between each exercise intensity. The hemoglobin concentration [Hb] increased by 0.8 ± 0.3 g·dL−1, the capillary oxygen saturation (ScO2) decreased by 4.0% (p < 0.001). As a result, the calculated arterial oxygen content significantly increased (18.5 ± 1.0 vs. 18.9 ± 1.0 mL·dL−1, p = 0.001). A 1 L higher BV at V̇O2max was associated with a higher SVmax of 16.2 mL (r = 0.63, p < 0.001) and Q̇max of 2.5 L·min−1 (r = 0.56, p < 0.01). In conclusion, the SV strongly correlates with the cardiac dimensions, which might be the result of adaptations to an increased volume load. The positive effect of a high BV on SV is particularly noticeable at high and severe intensity exercise. The theoretically expected reduction in V̇O2max due to lower SV as a consequence of reduced BV is apparently compensated by the increased arterial oxygen content due to a higher [Hb].
Collapse
Affiliation(s)
- Janis Schierbauer
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
- *Correspondence: Janis Schierbauer,
| | - Sandra Ficher
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Cardiology, Klinikum Bamberg, Bamberg, Germany
| | - Nadine B. Wachsmuth
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Walter F. J. Schmidt
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| |
Collapse
|
4
|
Soós I, Borysławski K, Boraczyński M, Ihasz F, Podstawski R. Anthropometric and Physiological Profiles of Hungarian Youth Male Soccer Players of Varying Ages and Playing Positions: A Multidimensional Assessment with a Critical Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11041. [PMID: 36078756 PMCID: PMC9518191 DOI: 10.3390/ijerph191711041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND This study aimed to create preliminary anthropometric and physiological profiles of Hungarian male soccer players belonging to different age categories (14, 15, 16, and 17-18-years) and assigned to different playing positions (forward, defender, midfielder, goalkeeper). METHODS Anthropometric and physiological profiles were created for four age groups: 14- (n = 20), 15- (n = 16), 16- (n = 22) and 17-18-year-olds (n = 23) representing the Hungarian soccer academy. Additionally, the variables were analyzed across the four player positions mentioned above. RESULTS The mean values of body mass, fat mass and BMI were within normal limits, although in some cases the anthropometric and body composition values were too high, particularly among the 17-18-year-olds. The mean values of HRrest were lowest among the 15-year-olds. The highest mean and maximal values of rVO2max and rVO2/AT [57.6 ± 8.12 (43.8-68.3) and 51.2 ± 7.24 (38.9-60.8) mL/kg/min, respectively] were noted in 14-year-olds. Goalkeepers performed significantly better than the remaining soccer players in terms of the most anthropometric and physiological characteristics, except for the Yo-Yo test (p < 0.001). CONCLUSIONS The values of anthropometric parameters increased with age. As expected, the oldest group achieved the best results in the performance tests. Goalkeepers outperformed the players representing other playing positions in the tests when assessing lower limb strength, sprint performance (5- and 10-m distance), and agility tests. From a practical point of view, the presented anthropometric and physiological profiles of players representing different age groups and playing positions can be useful for soccer coaches, strength and conditioning specialists, and athletic trainers of other soccer clubs in terms of the individualization and optimalization of soccer training.
Collapse
Affiliation(s)
- Imre Soós
- Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, H-7622 Pécs, Hungary
| | | | - Michał Boraczyński
- Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Ferenc Ihasz
- Faculty of Psychology and Pedagogy, Institute of Sports Sciences, Eötvös Lóránd University, 9700 Szombathely, Hungary
| | - Robert Podstawski
- Department of Tourism, Recreation and Ecology, University of Warmia and Mazury in Olsztyn, 10-957 Olsztyn, Poland
| |
Collapse
|
5
|
Lloyd A, Fiala D, Heyde C, Havenith G. A mathematical model for predicting cardiovascular responses at rest and during exercise in demanding environmental conditions. J Appl Physiol (1985) 2022; 133:247-261. [PMID: 35652831 PMCID: PMC9342140 DOI: 10.1152/japplphysiol.00619.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The present research describes the development and validation of a cardiovascular model (CVR Model) for use in conjunction with advanced thermophysiological models, where usually only a total cardiac output is estimated. The CVR Model detailed herein estimates cardio-dynamic parameters (changes in cardiac output, stroke volume, and heart rate), regional blood flow, and muscle oxygen extraction, in response to rest and physical workloads, across a range of ages and aerobic fitness levels, as well as during exposure to heat, dehydration, and altitude. The model development strategy was to first establish basic resting and exercise predictions for cardio-dynamic parameters in an "ideal" environment (cool, sea level, and hydrated person). This basic model was then advanced for increasing levels of altitude, heat strain, and dehydration, using meta-analysis and reaggregation of published data. Using the estimated altitude- and heat-induced changes in maximum oxygen extraction and maximum cardiac output, the decline in maximum oxygen consumption at high altitude and in the heat was also modeled. A validation of predicted cardiovascular strain using heart rate was conducted using a dataset of 101 heterogeneous individuals (1,371 data points) during rest and exercise in the heat and at altitude, demonstrating that the CVR Model performs well (R2 = 0.82-0.84) in predicting cardiovascular strain, particularly at a group mean level (R2 = 0.97). The development of the CVR Model is aimed at providing the Fiala thermal Physiology & Comfort (FPC) Model and other complex thermophysiological models with improved estimations of cardiac strain and exercise tolerance, across a range of individuals during acute exposure to environmental stressors.NEW & NOTEWORTHY The present research promotes the adaption of thermophysiological modeling to the estimation of cardiovascular strain in individuals exercising under acute environmental stress. Integration with advanced models of human thermoregulation opens doors for detailed numerical analysis of athletes' performance and physiology during exercise, occupational safety, and individual work tolerability. The research provides a simple-to-validate metric of cardiovascular function (heart rate), as well as a method to evaluate key principles influencing exercise- and thermoregulation in humans.
Collapse
Affiliation(s)
- Alex Lloyd
- 1Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Dusan Fiala
- 2ERGONSIM—Human Thermal Modelling, Messstetten, Germany
| | | | - George Havenith
- 1Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| |
Collapse
|
6
|
Sex Differences in VO 2max and the Impact on Endurance-Exercise Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094946. [PMID: 35564339 PMCID: PMC9105160 DOI: 10.3390/ijerph19094946] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
It was not until 1984 that women were permitted to compete in the Olympic marathon. Today, more women than men participate in road racing in all distances except the marathon where participation is near equal. From the period of 1985 to 2004, the women’s marathon record improved at a rate three times greater than men’s. This has led many to question whether women are capable of surpassing men despite the fact that there remains a 10–12% performance gap in all distance events. The progressive developments in sports performance research and training, beginning with A.V. Hill’s establishment of the concept of VO2max, have allowed endurance athletes to continue performance feats previously thought to be impossible. However, even today women are significantly underrepresented in sports performance research. By focusing more research on the female physiology and sex differences between men and women, we can better define how women differ from men in adapting to training and potentially use this information to improve endurance-exercise performance in women. The male advantage in endurance-exercise performance has commonly been attributed to their higher VO2max, even when expressed as mL/kg/min. It is widely known that oxygen delivery is the primary limiting factor in elite athletes when it comes to improving VO2max, but little research has explored the sex differences in oxygen delivery. Thus, the purpose of this review is to highlight what is known about the sex differences in the physiological factors contributing to VO2max, more specifically oxygen delivery, and the impacts on performance.
Collapse
|
7
|
Gelman R, Berg M, Ilan Y. A Subject-Tailored Variability-Based Platform for Overcoming the Plateau Effect in Sports Training: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1722. [PMID: 35162745 PMCID: PMC8834821 DOI: 10.3390/ijerph19031722] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 12/16/2022]
Abstract
The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms contribute to a lack of continuous improvement with most exercise regimens. Attempts to overcome this plateau in exercise have been only partially successful, and it remains a significant unmet need in both healthy subjects and those suffering from chronic neuromuscular, cardiopulmonary, and metabolic diseases. Variability patterns characterize many biological processes, from cellular to organ levels. The present review discusses the significant obstacles in overcoming the plateau in training and establishes a platform to implement subject-tailored variability patterns to prevent and overcome this plateau in muscle and cardiorespiratory performance.
Collapse
Affiliation(s)
- Ram Gelman
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem 9103401, Israel;
| | - Marc Berg
- Department of Pediatrics, Lucile Packard Children’s Hospital, Stanford University, Palo Alto, CA 94304, USA;
| | - Yaron Ilan
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem 9103401, Israel;
| |
Collapse
|
8
|
Yamagishi T, Saito A, Kawakami Y. Determinants of whole-body maximal aerobic performance in young male and female athletes: The roles of lower extremity muscle size, strength and power. PLoS One 2022; 17:e0262507. [PMID: 35020757 PMCID: PMC8754349 DOI: 10.1371/journal.pone.0262507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
This study sought to determine whether lower extremity muscle size, power and strength could be a determinant of whole-body maximal aerobic performance in athletes. 20 male and 19 female young athletes (18 ± 4 years) from various sporting disciplines participated in this study. All athletes performed a continuous ramp-incremental cycling to exhaustion for the determination of peak oxygen uptake ( V˙O2peak: the highest V˙O2 over a 15-s period) and maximal power output (MPO: power output corresponding to V˙O2peak). Axial scanning of the right leg was performed with magnetic resonance imaging, and anatomical cross-sectional areas (CSAs) of quadriceps femoris (QF) and hamstring muscles at 50% of thigh length were measured. Moreover, bilateral leg extension power and unilateral isometric knee extension and flexion torque were determined. All variables were normalised to body mass, and six independent variables ( V˙O2peak, CSAs of thigh muscles, leg extension power and knee extension and flexion torque) were entered into a forward stepwise multiple regression model with MPO being dependent variable for males and females separately. In the males, V˙O2peak was chosen as the single predictor of MPO explaining 78% of the variance. In the females, MPO was attributed to, in the order of importance, V˙O2peak (p < 0.001) and the CSA of QF (p = 0.011) accounting for 84% of the variance. This study suggests that while oxygen transport capacity is the main determinant of MPO regardless of sex, thigh muscle size also has a role in whole-body maximal aerobic performance in female athletes.
Collapse
Affiliation(s)
- Takaki Yamagishi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Department of Sport Science, Japan Institute of Sport Sciences, Tokyo, Japan
| | - Akira Saito
- Center for Health and Sports Science, Kyushu Sangyo University, Fukuoka, Japan
| | - Yasuo Kawakami
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Human Performance Laboratory, Comprehensive Research Organization, Waseda University, Tokyo, Japan
- * E-mail:
| |
Collapse
|
9
|
Avina-Bravo EG, Cassirame J, Escriba C, Acco P, Fourniols JY, Soto-Romero G. Smart Electrically Assisted Bicycles as Health Monitoring Systems: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:468. [PMID: 35062429 PMCID: PMC8780236 DOI: 10.3390/s22020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/24/2021] [Accepted: 01/05/2022] [Indexed: 05/03/2023]
Abstract
This paper aims to provide a review of the electrically assisted bicycles (also known as e-bikes) used for recovery of the rider's physical and physiological information, monitoring of their health state, and adjusting the "medical" assistance accordingly. E-bikes have proven to be an excellent way to do physical activity while commuting, thus improving the user's health and reducing air pollutant emissions. Such devices can also be seen as the first step to help unhealthy sedentary people to start exercising with reduced strain. Based on this analysis, the need to have e-bikes with artificial intelligence (AI) systems that recover and processe a large amount of data is discussed in depth. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to complete the relevant papers' search and selection in this systematic review.
Collapse
Affiliation(s)
- Eli Gabriel Avina-Bravo
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Johan Cassirame
- EA4660, Culture, Sport, Health and Society Department and Exercise Performance, University of Bourgogne-France Comté, 25000 Besançon, France
- EA7507, Laboratoire Performance Santé Métrologie Société, 51100 Reims, France
- Société Mtraining, R&D Division, 25480 Ecole Valentin, France
| | - Christophe Escriba
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Pascal Acco
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Jean-Yves Fourniols
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| | - Georges Soto-Romero
- Laboratory for Analysis and Architecture of Systems (LAAS), University of Toulouse, F-31077 Toulouse, France
| |
Collapse
|
10
|
Coyle MA, Goss CS, Manz WJ, Greenshields JT, Chapman RF, Stager JM. Nedocromil sodium and diphenhydramine HCl ameliorate exercise-induced arterial hypoxemia in highly trained athletes. Physiol Rep 2022; 10:e15149. [PMID: 35001564 PMCID: PMC8743671 DOI: 10.14814/phy2.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Exercise-induced arterial hypoxemia (EIAH) has been observed in highly trained endurance athletes during near maximal exercise, which may be influenced by a histamine-mediated inflammatory response at the pulmonary capillary-alveolar membrane. In order to test this hypothesis, we examined whether the mast cell stabilizer nedocromil sodium (NS) and H1 -receptor antagonist diphenhydramine HCL (DH) would ameliorate EIAH and mitigate the drop in arterial oxyhemoglobin saturation (Sa O2 ) during intensive exercise. METHODS Seven highly trained male cross country runners (age, 21 ± 2 years; V̇O2max , 74.7 ± 3.5 ml·kg-1 ·min-1 ) participated in the study. All subjects completed a maximal exercise treadmill test to exhaustion, followed by three 5-min constant-load exercise bouts at 70%, 80%, and 90% V̇O2max . Prior to testing, subjects received either placebo (PL), NS, or DH. RESULTS Compared to PL, there was a significant treatment effect on Sa O2 (p < 0.001) for both NS and DH during both constant-load exercise and at V̇O2max . Post hoc tests revealed Sa O2 values, compared to PL, were significantly higher at V̇O2max and during DH trials and higher with NS at constant-load intensities except at 70% (p = 0.13). CONCLUSION The findings provide further evidence that histamine contributes directly or indirectly to the development of EIAH during intense exercise in highly trained athletes.
Collapse
Affiliation(s)
- Michael A. Coyle
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Curtis S. Goss
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Wesley J. Manz
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Department of Orthopaedic SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | - Joel T. Greenshields
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Dr. Lawrence D. Rink Center for Sports Medicine and TechnologyDepartment of Intercollegiate AthletesIndiana UniversityBloomingtonIndianaUSA
| | - Robert F. Chapman
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Joel M. Stager
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| |
Collapse
|
11
|
Schwendinger F, Wagner J, Infanger D, Schmidt-Trucksäss A, Knaier R. Methodological aspects for accelerometer-based assessment of physical activity in heart failure and health. BMC Med Res Methodol 2021; 21:251. [PMID: 34775952 PMCID: PMC8590791 DOI: 10.1186/s12874-021-01350-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
Background For valid accelerometer-assessed physical activity (PA) data, several methodological aspects should be considered. We aimed to 1) visualize the applicability of absolute accelerometer cut-offs to classify PA intensity, 2) verify recommendations to measure PA over 7 days by examining inter-day variability and reactivity, 3) examine seasonal differences in PA, and 4) recommend during which 10 h day period accelerometers should be worn to capture the most PA in patients with heart failure (HEART) and healthy individuals (HEALTH). Methods Fifty-six HEART (23% female; mean age 66 ± 13 years) and 299 HEALTH (51% female; mean age 54 ± 19 years) of the COmPLETE study wore accelerometers for 14 days. Aim 1 was analyzed descriptively. Key analyses were performed using linear mixed models. Results The results yielded poor applicability of absolute cut-offs. The day of the week significantly affected PA in both groups. PA-reactivity was not present in either group. A seasonal influence on PA was only found in HEALTH. Large inter-individual variability in PA timing was present. Conclusions Our data indicated that absolute cut-offs foster inaccuracies in both populations. In HEART, Sunday and four other days included in the analyses seem sufficient to estimate PA and the consideration of seasonal differences and reactivity seems not necessary. For healthy individuals, both weekend days plus four other days should be integrated into the analyses and seasonal differences should be considered. Due to substantial inter-individual variability in PA timing, accelerometers should be worn throughout waking time. These findings may improve future PA assessment. Trial registration The COmPLETE study was registered at clinicaltrials.gov (NCT03986892). Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01350-6.
Collapse
Affiliation(s)
- Fabian Schwendinger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Jonathan Wagner
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Denis Infanger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Raphael Knaier
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| |
Collapse
|
12
|
Petek BJ, Churchill TW, Sawalla Guseh J, Loomer G, Gustus SK, Lewis GD, Weiner RB, Baggish AL, Wasfy MM. Utility of the oxygen pulse in the diagnosis of obstructive coronary artery disease in physically fit patients. Physiol Rep 2021; 9:e15105. [PMID: 34767313 PMCID: PMC8587175 DOI: 10.14814/phy2.15105] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/24/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
Cardiopulmonary exercise testing (CPET) guidelines recommend analysis of the oxygen (O2 ) pulse for a late exercise plateau in evaluation for obstructive coronary artery disease (OCAD). However, whether this O2 pulse trajectory is within the range of normal has been debated, and the diagnostic performance of the O2 pulse for OCAD in physically fit individuals, in whom V ˙ O 2 may be more likely to plateau, has not been evaluated. Using prospectively collected data from a sports cardiology program, patients were identified who were free of other cardiac disease and underwent clinically-indicated CPET within 90 days of invasive or computed tomography coronary angiography. The diagnostic performance of quantitative O2 pulse metrics (late exercise slope, proportional change in slope during late exercise) and qualitative assessment for O2 pulse plateau to predict OCAD was assessed. Among 104 patients (age:56 ± 12 years, 30% female, peak V ˙ O 2 119 ± 34% predicted), the diagnostic performance for OCAD (n = 24,23%) was poor for both quantitative and qualitative metrics reflecting an O2 pulse plateau (late exercise slope: AUC = 0.55, sensitivity = 68%, specificity = 41%; proportional change in slope: AUC = 0.55, sensitivity = 91%, specificity = 18%; visual plateau/decline: AUC = 0.51, sensitivity = 33%, specificity = 67%). When O2 pulse parameters were added to the electrocardiogram, the change in AUC was minimal (-0.01 to +0.02, p ≥ 0.05). Those patients without OCAD with a plateau or decline in O2 pulse were fitter than those with linear augmentation (peak V ˙ O 2 133 ± 31% vs. 114 ± 36% predicted, p < 0.05) and had a longer exercise ramp time (9.5 ± 3.2 vs. 8.0 ± 2.5 min, p < 0.05). Overall, a plateau in O2 pulse was not a useful predictor of OCAD in a physically fit population, indicating that the O2 pulse should be integrated with other CPET parameters and may reflect a physiologic limitation of stroke volume and/or O2 extraction during intense exercise.
Collapse
Affiliation(s)
- Bradley J Petek
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Timothy W Churchill
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - J Sawalla Guseh
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Garrett Loomer
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah K Gustus
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gregory D Lewis
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rory B Weiner
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aaron L Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Meagan M Wasfy
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| |
Collapse
|
13
|
Lima-Silva AE, Cristina-Souza G, Silva-Cavalcante MD, Bertuzzi R, Bishop DJ. Caffeine during High-Intensity Whole-Body Exercise: An Integrative Approach beyond the Central Nervous System. Nutrients 2021; 13:2503. [PMID: 34444663 PMCID: PMC8400708 DOI: 10.3390/nu13082503] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
Caffeine is one of the most consumed ergogenic aids around the world. Many studies support the ergogenic effect of caffeine over a large spectrum of exercise types. While the stimulatory effect of caffeine on the central nervous system is the well-accepted mechanism explaining improvements in exercise performance during high-intensity whole-body exercise, in which other physiological systems such as pulmonary, cardiovascular, and muscular systems are maximally activated, a direct effect of caffeine on such systems cannot be ignored. A better understanding of the effects of caffeine on multiple physiological systems during high-intensity whole-body exercise might help to expand its use in different sporting contexts (e.g., competitions in different environments, such as altitude) or even assist the treatment of some diseases (e.g., chronic obstructive pulmonary disease). In the present narrative review, we explore the potential effects of caffeine on the pulmonary, cardiovascular, and muscular systems, and describe how such alterations may interact and thus contribute to the ergogenic effects of caffeine during high-intensity whole-body exercise. This integrative approach provides insights regarding how caffeine influences endurance performance and may drive further studies exploring its mechanisms of action in a broader perspective.
Collapse
Affiliation(s)
- Adriano E. Lima-Silva
- Human Performance Research Group, Federal University of Technology Parana (UTFPR), Curitiba 81310900, PR, Brazil; (A.E.L.-S.); (G.C.-S.)
| | - Gislaine Cristina-Souza
- Human Performance Research Group, Federal University of Technology Parana (UTFPR), Curitiba 81310900, PR, Brazil; (A.E.L.-S.); (G.C.-S.)
- Nutrition and Exercise Research Group, State University of Minas Gerais (UEMG), Passos 37902092, MG, Brazil
| | - Marcos D. Silva-Cavalcante
- Postgraduate Program in Nutrition (PPGNUT), Faculty of Nutrition (FANUT), Federal University of Alagoas (UFAL), Maceio 57072900, AL, Brazil;
| | - Romulo Bertuzzi
- Endurance Sports Research Group (GEDAE-USP), University of São Paulo, Sao Paulo 05508030, SP, Brazil;
| | - David J. Bishop
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC 8001, Australia
| |
Collapse
|
14
|
Development of Maximal Dynamic Strength During Concurrent Resistance and Endurance Training in Untrained, Moderately Trained, and Trained Individuals: A Systematic Review and Meta-analysis. Sports Med 2021; 51:991-1010. [PMID: 33751469 PMCID: PMC8053170 DOI: 10.1007/s40279-021-01426-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 01/01/2023]
Abstract
Background The effect of concurrent training on the development of maximal strength is unclear, especially in individuals with different training statuses. Objective The aim of this systematic review and meta-analysis study was to compare the effect of concurrent resistance and endurance training with that of resistance training only on the development of maximal dynamic strength in untrained, moderately trained, and trained individuals. Methods On the basis of the predetermined criteria, 27 studies that compared effects between concurrent and resistance training only on lower-body 1-repetition maximum (1RM) strength were included. The effect size (ES), calculated as the standardised difference in mean, was extracted from each study, pooled, and analysed with a random-effects model. Results The 1RM for leg press and squat exercises was negatively affected by concurrent training in trained individuals (ES = – 0.35, p < 0.01), but not in moderately trained ( – 0.20, p = 0.08) or untrained individuals (ES = 0.03, p = 0.87) as compared to resistance training only. A subgroup analysis revealed that the negative effect observed in trained individuals occurred only when resistance and endurance training were conducted within the same training session (ES same session = – 0.66, p < 0.01 vs. ES different sessions = – 0.10, p = 0.55). Conclusion This study demonstrated the novel and quantifiable effects of training status on lower-body strength development and shows that the addition of endurance training to a resistance training programme may have a negative impact on lower-body strength development in trained, but not in moderately trained or untrained individuals. This impairment seems to be more pronounced when training is performed within the same session than in different sessions. Trained individuals should therefore consider separating endurance from resistance training during periods where the development of dynamic maximal strength is prioritised. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01426-9.
Collapse
|
15
|
Vähä-Ypyä H, Sievänen H, Husu P, Tokola K, Vasankari T. Intensity Paradox-Low-Fit People Are Physically Most Active in Terms of Their Fitness. SENSORS 2021; 21:s21062063. [PMID: 33804220 PMCID: PMC8002087 DOI: 10.3390/s21062063] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/29/2022]
Abstract
Depending on their cardiorespiratory fitness (CRF), people may perceive the exertion of incident physical activity (PA) differently. Therefore, the use of relative intensity thresholds based on individual fitness have been proposed to evaluate the accumulation of PA at different intensity levels. A subsample of the FinFit2017-study, 1952 adults (803 men and 1149 women) aged 20–69 years, participated in this study. Their maximal oxygen uptake (VO2max) was predicted with a 6 min walk test, and they were instructed to wear a triaxial hip-worn accelerometer for one week. The participants were divided into CRF tertiles by five age groups and sex. Raw acceleration data were analyzed with the mean amplitude deviation method in 6 s epochs. Additionally, the data were smoothed with 1 min and 6 min exponential moving averages. The absolute intensity threshold for moderate activity was 3.0 metabolic equivalent (MET) and for vigorous 6.0 MET. Correspondingly, the relative thresholds were 40% and 60% of the oxygen uptake reserve. Participants in the lowest CRF tertile were the most active with relative thresholds, and participants in the highest CRF tertile were the most active with absolute thresholds. High-fit people easily reached the absolute thresholds, while people in the lowest CRF tertile had to utilize most of their aerobic capacity on a daily basis simply to keep up with their daily chores or peers.
Collapse
Affiliation(s)
- Henri Vähä-Ypyä
- UKK-Institute, 33500 Tampere, Finland; (H.V.-Y.); (P.H.); (K.T.); (T.V.)
| | - Harri Sievänen
- UKK-Institute, 33500 Tampere, Finland; (H.V.-Y.); (P.H.); (K.T.); (T.V.)
- Correspondence:
| | - Pauliina Husu
- UKK-Institute, 33500 Tampere, Finland; (H.V.-Y.); (P.H.); (K.T.); (T.V.)
| | - Kari Tokola
- UKK-Institute, 33500 Tampere, Finland; (H.V.-Y.); (P.H.); (K.T.); (T.V.)
| | - Tommi Vasankari
- UKK-Institute, 33500 Tampere, Finland; (H.V.-Y.); (P.H.); (K.T.); (T.V.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| |
Collapse
|
16
|
Cardiorespiratory Responses to Constant and Varied-Load Interval Training Sessions. Int J Sports Physiol Perform 2021; 16:1021-1028. [PMID: 33607627 DOI: 10.1123/ijspp.2020-0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/02/2020] [Accepted: 08/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the cardiorespiratory responses of a traditional session of high-intensity interval training session with that of a session of similar duration and average load, but with decreasing workload within each bout in cyclists and runners. METHODS A total of 15 cyclists (maximal oxygen uptake [V˙O2max] 62 [6] mL·kg-1·min-1) and 15 runners (V˙O2max 58 [4] mL·kg-1·min-1) performed both sessions at the maximal common tolerable load on different days. The sessions consisted of four 4-minute intervals interspersed with 3 minutes of active recovery. Power output was held constant for each bout within the traditional day, whereas power started 40 W (2 km·h-1) higher and finished 40 W (2 km·h-1) lower than average within each bout of the decremental session. RESULTS Average oxygen uptake during the high-intensity intervals was higher in the decremental session in cycling (89 [4]% vs 86 [5]% of V˙O2max, P = .002) but not in running (91 [4]% vs 90 [4]% of V˙O2max, P = .38), as was the time spent >90% of V˙O2max and the time spent >90% of peak heart rate. Average heart rate (P < .001), pulmonary ventilation (P < .001), and blood lactate concentration (P < .001) were higher during the decremental sessions in both cycling and running. CONCLUSIONS Higher levels of physiological perturbations were achieved during decremental sessions in both cycling and running. These differences were, however, more prominent in cycling, thus making cycling a more attractive modality for testing the effects of a training intervention.
Collapse
|
17
|
Bhatt A, Flink L, Lu DY, Fang Q, Bibby D, Schiller NB. Exercise physiology of the left atrium: quantity and timing of contribution to cardiac output. Am J Physiol Heart Circ Physiol 2020; 320:H575-H583. [PMID: 33275524 DOI: 10.1152/ajpheart.00402.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Although the phases of left atrial (LA) function at rest have been studied, the physiological response of the LA to exercise is undefined. This study defines the exercise behavior of the normal left atrium by quantitating its volumetric response to graded effort. Healthy subjects (n = 131) were enrolled from the Health eHeart cohort. Echocardiograms were obtained at baseline and during ramped supine bicycle exercise. Left ventricular volume index, stroke volume index (LVSVI), left atrial end-systolic volume index (LAESVI), left atrial end-diastolic volume index (LAEDVI), and left atrial emptying fraction (LAEF), reservoir fraction, and conduit fraction were analyzed. The LVSVI increased with low exercise but did not increase further with peak exercise; cardiac output increased through the agency of heart rate. The LAESVI and LAEDVI decreased and the LAEF increased with exercise. As a result, the LA reservoir volume index was static throughout exercise. The reservoir fraction decreased from 46% at rest to 40% with low exercise (P < 0.001) in association with increased LVSVI and remained similar at peak exercise. The conduit volume index increased from 20 mL/m2 at rest to 24 mL/m2 at low exercise and stayed the same at peak exercise. Similarly, the conduit fraction increased from 54% at rest to 60% at low exercise (P < 0.001) and did not change further with peak exercise. Although atrial function increased with exercise, the major contribution to the augmentation of LV stroke volume is LA conduit fraction, a marker of active ventricular relaxation. Furthermore, the major determinant of raising cardiac output during high-level exercise is heart rate.NEW & NOTEWORTHY Diseases of the left atrium (LA) are major sources of disability (e.g., strokes and fatigue), but its exercise physiology has been unstudied. Such knowledge may allow early recognition of disease and suggest therapies. We show that in normal subjects, low-level exercise decreases LA volume and increases its ejection fraction. However, these changes offset each other volumetrically, and the contribution to LV filling from a full to an empty LA (reservoir function) is static. Higher levels of exercise do not change LA reservoir contribution. Blood flowing directly from the pulmonary vein to LV (conduit flow) impelled by augmented LV active relaxation (suction) is the major source of a modest increase in LV stroke volume. The major source of increased cardiac output with exercise is heart rate. During all stages of exercise, the LA works hard but only to keep up. We believe that our findings provide an additional set of benchmarks through which to quantitate LA pathology and gauge its progression.
Collapse
Affiliation(s)
- Anish Bhatt
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California.,Cardiovascular Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Laura Flink
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California.,Kaiser Permanente San Leandro Medical Center, San Leandro, California
| | - Dai-Yin Lu
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California
| | - Qizhi Fang
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California
| | - Dwight Bibby
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California
| | - Nelson B Schiller
- Division of Cardiology, University of California, San Francisco, California.,Health eHeart Study and Research Cardiac Physiology Laboratory, University of California, San Francisco, California
| |
Collapse
|
18
|
Addis DR, Townsley MM. Imaging Considerations for the Athletically Conditioned Heart: An Echocardiography-Focused Overview of the 2020 American Society of Echocardiography Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes. J Cardiothorac Vasc Anesth 2020; 34:2867-2870. [DOI: 10.1053/j.jvca.2020.06.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/21/2022]
|
19
|
Waldron M, Papavasileiou G, Jeffries O, Nevola V, Heffernan S M, Kilduff L, Tallent J. Concurrent adaptations in maximal aerobic capacity, heat tolerance, microvascular blood flow and oxygen extraction following heat acclimation and ischemic preconditioning. J Therm Biol 2020; 93:102724. [PMID: 33077136 DOI: 10.1016/j.jtherbio.2020.102724] [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: 06/16/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
Abstract
We investigated the effects of: 1) Ischemic pre-conditioning (IPC) plus a concurrent five-day heat acclimation + IPC (IPC + HA), 2) five-day HA with sham IPC (HA), or 3) control (CON) on thermoneutral measurements of endurance performance, resting measures of skeletal muscle oxygenation and blood flow. Twenty-nine participants were randomly allocated to three groups, which included: 1) five-days of repeated leg occlusion (4 x 5-min) IPC at limb occlusive pressure, plus fixed-intensity (55% V˙ O2max) cycling HA at ~36 °C/40% humidity; 2) HA plus sham IPC (20 mmHg) or 3) or CON (thermoneutral 55% V˙ O2max plus sham IPC). In IPC + HA and HA, there were increases in maximal oxygen consumption (O2max) (7.8% and 5.4%, respectively; P < 0.05), ventilatory threshold (VT) (5.6% and 2.4%, respectively, P < 0.05), delta efficiency (DE) (2.0% and 1.4%, respectively; P < 0.05) and maximum oxygen pulse (O2pulse-Max) (7.0% and 6.9%, respectively; P < 0.05) during an exhaustive incremental test. There were no changes for CON (P > 0.05). Changes (P < 0.05) in resting core temperature (TC), muscle oxygen consumption (m V˙ O2), and limb blood flow (LBF) were also found pre-to-post intervention among the HA and IPC + HA groups, but not in CON (P > 0.05). Five-days of either HA or IPC + HA can enhance markers of endurance performance in cooler environments, alongside improved muscle oxygen extraction, blood flow, exercising muscle efficiency and O2 pulse at higher intensities, thus suggesting the occurrence of peripheral adaptation. Both HA and IPC + HA enhance the adaptation of endurance capacity, which might partly relate to peripheral changes.
Collapse
Affiliation(s)
- M Waldron
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK; School of Science and Technology, University of New England, NSW, Australia; Welsh Institute of Performance Science, Swansea University, Swansea, UK.
| | - G Papavasileiou
- Sport, Health and Applied Sciences, St Mary's University, London, UK
| | - O Jeffries
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - V Nevola
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK; Defence Science and Technology Laboratory (Dstl), Fareham, Hampshire, UK
| | - M Heffernan S
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
| | - L Kilduff
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK; Welsh Institute of Performance Science, Swansea University, Swansea, UK
| | - J Tallent
- Sport, Health and Applied Sciences, St Mary's University, London, UK
| |
Collapse
|
20
|
Furlong RJ, Weaver SR, Sutherland R, Burley CV, Imi GM, Lucas RAI, Lucas SJE. Exercise-induced elevations in cerebral blood velocity are greater in running compared to cycling at higher intensities. Physiol Rep 2020; 8:e14539. [PMID: 32786068 PMCID: PMC7422808 DOI: 10.14814/phy2.14539] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Abstract
The optimal exercise intensity and modality for maximizing cerebral blood flow (CBF) and hence potential exposure to positive, hemodynamically derived cerebral adaptations is yet to be fully determined. This study compared CBF velocity responses between running and cycling across a range of exercise intensities. Twenty-six participants (12 females; age: 26 ± 8 years) completed four exercise sessions; two mode-specific maximal oxygen consumption (VO2max ) tests, followed by (order randomized) two incremental exercise protocols (3-min stages at 35%, 50%, 65%, 80%, 95% VO2max ). Continuous measures of middle cerebral artery velocity (MCAv), oxygen consumption, end-tidal CO2 (PET CO2 ), and heart rate were obtained. Modality-specific MCAv changes were observed for the whole group (interaction effect: p = .01). Exercise-induced increases in MCAvmean during cycling followed an inverted-U pattern, peaking at 65% VO2max (Δ12 ± 7 cm/s from rest), whereas MCAvmean during running increased linearly up to 95% VO2max (change from rest: Δ12 ± 13 vs. Δ7 ± 8 cm/s for running vs. cycling at 95% VO2max ; p = .01). In contrast, both modalities had an inverted-U pattern for PET CO2 changes, although peaked at different intensities (running: 50% VO2max , Δ6 ± 2 mmHg; cycling: 65% VO2max , Δ7 ± 2 mmHg; interaction effect: p = .01). Further subgroup analysis revealed that the running-specific linear MCAvmean response was fitness dependent (Fitness*modality*intensity interaction effect: p = .04). Above 65% VO2max , fitter participants (n = 16; male > 45 mL/min/kg and female > 40 mL/min/kg) increased MCAvmean up to 95% VO2max , whereas in unfit participants (n = 7, male < mL/min/kg and female < 35 mL/min/kg) MCAvmean returned toward resting values. Findings demonstrate that modality- and fitness-specific profiles for MCAvmean are seen at exercise intensities exceeding 65% VO2max .
Collapse
Affiliation(s)
- Rhodri J. Furlong
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Samuel R. Weaver
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
- Centre for Human Brain HealthUniversity of BirminghamBirminghamUK
| | - Rory Sutherland
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Claire V. Burley
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
- Centre for Human Brain HealthUniversity of BirminghamBirminghamUK
- Dementia Centre for Research CollaborationSchool of PsychiatryUniversity of New South WalesSydneyAustralia
| | - Gabriella M. Imi
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Rebekah A. I. Lucas
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation SciencesCollege of Life and Environmental SciencesUniversity of BirminghamBirminghamUK
- Centre for Human Brain HealthUniversity of BirminghamBirminghamUK
| |
Collapse
|
21
|
Colakoglu M, Ozkaya O, Balci GA. The importance of the verification phase following an incremental exercise to ensure maximum oxygen consumption. J Sports Med Phys Fitness 2020; 60:1342-1348. [PMID: 32639117 DOI: 10.23736/s0022-4707.20.10945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to analyze cardiac output (Qc), stroke volume (SV), heart rate (HR), and arterio-venous O<inf>2</inf> difference (a-vO<inf>2diff</inf>) responses throughout a graded exercise test (GXT) and verification phase (VP) to examine whether SV decrement during the GXT is a main factor for underestimation of the maximal O<inf>2</inf> uptake (V̇O<inf>2max</inf>), or not. METHODS Seven well-trained male cyclists volunteered for this study (V̇O<inf>2max</inf>: 61.7±6.13 mL∙min<sup>-1</sup>∙kg<sup>-1</sup>). Following submaximal tests, participants were asked to perform GXT until exhaustion. Then, multisession verifications were performed on different days using ±3% constant work rates. The highest 30-second mean of V̇O<inf>2</inf> was considered as the V̇O<inf>2max</inf> and corresponding external power as peak power output (PPO). The Qc, SV, HR, and a-vO<inf>2diff</inf> responses were evaluated at both GXT and VP by nitrous-oxide rebreathing method. After repeated-measures analyses, possible significant differences were investigated by LSD/Wilcoxon. RESULTS It was shown that the HR and a-vO<inf>2diff</inf> reached their potentially highest values at the end of the both GXT and VP (192.9±8.8 vs. 190.7±7.9 bpm; 17.1±1.6 vs. 16.9±1.1%, respectively; P>0.05); however, SV (128.8±11.2 vs. 137.3±11.2 mL; P=0.029) and Qc (24.8±2.02 vs. 26.2±2.71 L·min<sup>-1</sup>; P=0.046) were lower at GXT when compared to the VP. V̇O<inf>2</inf> means were, therefore, higher in VP when compared to the GXT (61.7±6.13 vs. 59.1±6.2 mL∙min<sup>-1</sup>∙kg<sup>-1</sup>; P=0.041). CONCLUSIONS The GXT provided only a peak V̇O<inf>2</inf> but not the V̇O<inf>2max</inf>. Consequently, the real V̇O<inf>2max</inf> and PPO could be provided by only VP administrations. This is likely to result from the lower Qc and SV responses observed from a prolonged incremental test protocol when compared to short bouts of constant work rate trials.
Collapse
Affiliation(s)
- Muzaffer Colakoglu
- Department of Education, Faculty of Sport Sciences, Ege University, Bornova, Turkey -
| | - Ozgur Ozkaya
- Department of Education, Faculty of Sport Sciences, Ege University, Bornova, Turkey
| | - Gorkem A Balci
- Department of Education, Faculty of Sport Sciences, Ege University, Bornova, Turkey
| |
Collapse
|
22
|
Bassareo PP, Crisafulli A. Gender Differences in Hemodynamic Regulation and Cardiovascular Adaptations to Dynamic Exercise. Curr Cardiol Rev 2020; 16:65-72. [PMID: 30907327 PMCID: PMC7393595 DOI: 10.2174/1573403x15666190321141856] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/27/2019] [Accepted: 03/15/2019] [Indexed: 01/28/2023] Open
Abstract
Exercise is a major challenge for cardiovascular apparatus since it recruits chronotropic, inotropic, pre-load, and afterload reserves. Regular physical training induces several physiological adaptations leading to an increase in both cardiac volume and mass. It appears that several gender-related physiological and morphological differences exist in the cardiovascular adjustments and adaptations to dynamic exercise in humans. In this respect, gender may be important in determining these adjustments and adaptations to dynamic exercise due to genetic, endocrine, and body composition differences between sexes. Females seem to have a reduced vasoconstriction and a lower vascular resistance in comparison to males, especially after exercise. Significant differences exist also in the cardiovascular adaptations to physical training, with trained women showing smaller cardiac volume and wall thickness compared with male athletes. In this review, we summarize these differences.
Collapse
Affiliation(s)
- Pier P Bassareo
- University College of Dublin, Mater Misericordiae University Teaching Hospital, Dublin, Ireland
| | - Antonio Crisafulli
- Department of Medical Sciences and Public Health, Sports Physiology Lab., University of Cagliari, Cagliari, Italy
| |
Collapse
|
23
|
Bekris E, Mylonis E, Gissis I, Katis A, Metaxas T, Komsis S, Kompodieta N. Variation of aerobic performance indices of professional elite soccer players during the annual macrocycle. J Sports Med Phys Fitness 2019; 59:1628-1634. [DOI: 10.23736/s0022-4707.19.09800-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
24
|
Degens H, Stasiulis A, Skurvydas A, Statkeviciene B, Venckunas T. Physiological comparison between non-athletes, endurance, power and team athletes. Eur J Appl Physiol 2019; 119:1377-1386. [DOI: 10.1007/s00421-019-04128-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/20/2019] [Indexed: 01/09/2023]
|
25
|
Kurpaska M, Krzesiński P, Gielerak G, Uziębło-Życzkowska B, Banak M, Piotrowicz K, Stańczyk A. Multiparameter assessment of exercise capacity in patients with arterial hypertension. Clin Exp Hypertens 2018; 41:599-606. [PMID: 30380940 DOI: 10.1080/10641963.2018.1523917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Arterial hypertension (AH) can lead to the development of heart failure. Aim: Evaluating the relationship between parameters of exercise capacity assessed via a six-minute walk test (6MWT) and cardiopulmonary exercise test (CPET), with a hemodynamic assessment via impedance cardiography (ICG), in patients with AH. Methods: Exercise capacity was assessed in 98 hypertensive patients (54.5 ± 8.2 years) by means of oxygen uptake (VO2) get from CPET, 6MWT distance (6MWTd) and hemodynamic parameters measured by ICG: heart rate (HR), stroke volume (SV), cardiac output (CO). Correlations between these parameters at rest, at anaerobic threshold (AT) and at peak of exercise as well as their changes (Δpeak-rest, Δpeak-AT, ΔAT-rest) were evaulated. Results: A large proportion of patients exhibited reduced exercise capacity, with 45.9% not reaching 80% of predicted peak VO2 and 43.9% not reaching predicted 6MWTd. Clinically relevant correlations were noted between the absolute peak values and AT values of VO2 vs HR and VO2 vs CO. Furthermore ΔVO2(peak-AT) correlated with ΔHR(peak-AT), ΔCO(peak-AT) and ΔSV(peak-AT); ΔVO2(peak-rest) with ΔHR(peak-rest) and ΔCO(peak-rest); ΔVO2(AT-rest) with ΔHR(AT-rest) and ΔCO(AT-rest). Stronger correlations between changes in the evaluated parameters were demonstrated in the subgroup of subjects with peak VO2 < 80% of the predicted value; particularly ΔVO2(peak-AT) correlated with ΔSV(peak-AT) and ΔCO(peak-AT). Conclusions: The hemodynamic parameters show significant correlations with more measures of cardiovascular capacity of proven clinical utility. Impedance cardiography is a reliable method for assessing the cardiovascular response to exercise.
Collapse
Affiliation(s)
- Małgorzata Kurpaska
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Paweł Krzesiński
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Grzegorz Gielerak
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Beata Uziębło-Życzkowska
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Małgorzata Banak
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Katarzyna Piotrowicz
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Adam Stańczyk
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| |
Collapse
|
26
|
Brown SP, Smith JW, McAllister M, Joe L. Superhero physiology: the case for Captain America. ADVANCES IN PHYSIOLOGY EDUCATION 2017; 41:16-24. [PMID: 28143818 DOI: 10.1152/advan.00106.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 12/02/2016] [Accepted: 12/20/2016] [Indexed: 06/06/2023]
Abstract
Using pop icons in the science classroom represents a creative way to engage often-distracted students in a relevant and, perhaps more importantly, fun way. When the pop icon is as universally known as Captain America, the pedagogical stage is set. However, when the movies can also be employed to link dramatic references to the science concepts at hand, we may have a very powerful tool by which linkages between fiction and science can be forged. In this regard, Captain America's performances in several movies to date can be used to explain actual science. Granted, script writers and movie directors may or may not be interested in whether the physical performances they depict can be explained, but that is irrelevant. The point is to make a connection using science to explain how the superhero can run faster, jump higher, or lift more than is humanly possible. If a teachable moment has occurred and an important concept has been communicated, the educator has accomplished his or her job well.
Collapse
Affiliation(s)
- Stanley P Brown
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - JohnEric W Smith
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - Matthew McAllister
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| | - LeeAnn Joe
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi
| |
Collapse
|
27
|
Leprêtre P, Lopes P, Koralzstein J, Billat V. Heavy cycling exercise at fixed heart rate prevent the decline of stroke volume and delay time to exhaustion in trained adolescents. Sci Sports 2017. [DOI: 10.1016/j.scispo.2016.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Bækkerud FH, Solberg F, Leinan IM, Wisløff U, Karlsen T, Rognmo Ø. Comparison of Three Popular Exercise Modalities on V˙O2max in Overweight and Obese. Med Sci Sports Exerc 2017; 48:491-8. [PMID: 26440134 DOI: 10.1249/mss.0000000000000777] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION In this prospective randomized trial, we examined the effect of three popular exercise training modalities on maximal oxygen uptake (V˙O2max) in overweight and obese individuals. In addition, we examined possible concomitant adaptations in endurance exercise performance (time to exhaustion (TTE)), citrate synthase (CS) activity, venous and arterial function, blood volume, and calculated stroke volume (SV). METHODS Thirty subjects were recruited (age, 41 ± 9 yr; weight, 91 ± 14 kg; height, 173 ± 8 cm; body mass index, 30 ± 4 kg·m(-2)) and randomized to either 6 wk of 4 × 4-min high-intensity interval training (4HIIT) at 85%-95% of HRmax, 10 × 1-min HIIT (1HIIT) at V˙O2max load, or 45-min moderate-intensity continuous training (MICT) at 70% of HRmax. V˙O2max, TTE, CS activity, venous and arterial function, as well as blood volume were measured before and after the training period. O2 pulse was calculated and used to estimate SV. Analysis was conducted per protocol. RESULTS Only 4HIIT increased V˙O2max (P < 0.01) and significantly more compared with 1HIIT (P = 0.04) and MICT (P = 0.03) (4HIIT, 10%; 1HIIT, 3.3%; and MICT, 3.1%). All groups increased TTE (4HIIT, 198%; 1HIIT, 116%; MICT, 52%), with a higher increase after 4HIIT compared with that after MICT (P = 0.02). Calculated SV increased only after 4HIIT (14.4%). Plasma volume and hemoglobin mass increased after 1HIIT only (5.6% and 6.5%); however, no group differences were found. All groups increased CS activity (4HIIT, 35%; 1HIIT, 35%; MICT, 56%), with no group differences. Arterial inflow (15.7%) and venous outflow (22.7%) decreased after MICT, but there were no group differences. CONCLUSIONS 4HIIT was superior to 1HIIT and MICT in improving V˙O2max likely because of an increased SV.
Collapse
Affiliation(s)
- Fredrik Hjulstad Bækkerud
- 1K. G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, NORWAY; and 2Department of Cardiology, St. Olav's University Hospital, Trondheim, NORWAY
| | | | | | | | | | | |
Collapse
|
29
|
Graded Exercise Testing Protocols for the Determination of VO 2max: Historical Perspectives, Progress, and Future Considerations. JOURNAL OF SPORTS MEDICINE 2016; 2016:3968393. [PMID: 28116349 PMCID: PMC5221270 DOI: 10.1155/2016/3968393] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/14/2016] [Accepted: 10/31/2016] [Indexed: 01/17/2023]
Abstract
Graded exercise testing (GXT) is the most widely used assessment to examine the dynamic relationship between exercise and integrated physiological systems. The information from GXT can be applied across the spectrum of sport performance, occupational safety screening, research, and clinical diagnostics. The suitability of GXT to determine a valid maximal oxygen consumption (VO2max) has been under investigation for decades. Although a set of recommended criteria exists to verify attainment of VO2max, the methods that originally established these criteria have been scrutinized. Many studies do not apply identical criteria or fail to consider individual variability in physiological responses. As an alternative to using traditional criteria, recent research efforts have been directed toward using a supramaximal verification protocol performed after a GXT to confirm attainment of VO2max. Furthermore, the emergence of self-paced protocols has provided a simple, yet reliable approach to designing and administering GXT. In order to develop a standardized GXT protocol, additional research should further examine the utility of self-paced protocols used in conjunction with verification protocols to elicit and confirm attainment of VO2max.
Collapse
|
30
|
Chen CL, Yu NY, Tang JS, Chang SH, Yang YR, Wang L. Effect of yelling on maximal aerobic power during an incremental test of cycling performance. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:456-461. [PMID: 30356551 PMCID: PMC6188878 DOI: 10.1016/j.jshs.2015.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 04/10/2015] [Accepted: 05/25/2015] [Indexed: 06/08/2023]
Abstract
BACKGROUND People experiencing strong feelings of fatigue during exercise sometimes subconsciously yell to refocus their efforts and, thus, maintain exercise performance. The present study examined the influence of yelling during high-intensity exercise by analysing cardiorespiratory reactions and integrated electromyography (iEMG) changes in the vastus lateralis during a cycle ergometer test. METHODS A total of 23 moderately trained people were recruited. The cycling test began with a resistance of 25 W/min, which was gradually increased. During the experimental trial, the participants were required to yell at least 3 times when they felt exhausted; during the controlled trial, they were not allowed to produce any yelling sounds. The testing order was randomly assigned and the 2 trials were completed within an interval between 3-10 days. Two-way repeated measures ANOVA was applied to analyse the differences within and between the trials, and interaction of trial and time. RESULTS The peak power and time to exhaustion (p < 0.01) in the yelling trial were higher than those in the control trial. However, the vastus lateralis iEMG values of both trials at peak power were not significantly different. During the yelling period at 90%-100% of the maximal effort, a significant time-by-trial interaction (p < 0.05) was observed in oxygen consumption (VO2), CO2 production, O2 pulse, ventilation, and respiratory rate. All the above measures showed a significant between-trial difference (p < 0.02). However, heart rate, respiratory exchange ratio, end-tidal oxygen pressure, and ventilatory equivalent for oxygen showed only significant between-trial difference (p < 0.05), but without interaction of trial and time. CONCLUSION Yelling enhances the peak O2 pulse and VO2 and maintains CO2-exclusion efficiency during high-intensity exercise. It may enable maintaining muscle activation without stronger EMG signals being required during high-intensity exercise.
Collapse
Affiliation(s)
- Chien-Liang Chen
- Department of Physical Therapy, I-Shou University, Kaohsiung 82445, Taiwan, China
| | - Nan-Ying Yu
- Department of Physical Therapy, I-Shou University, Kaohsiung 82445, Taiwan, China
| | - Jing-Shia Tang
- Department of Nursing, Chung-Hwa University of Medical Technology, Tainan 71703, Taiwan, China
| | - Shao-Hsia Chang
- Department of Occupational Therapy, I-Shou University, Kaohsiung 82445, Taiwan, China
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei 11221, Taiwan, China
| | - Lin Wang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan, China
| |
Collapse
|
31
|
Colakoglu M, Ozkaya O, Balci GA, Yapicioglu B. Stroke volume responses may be related to the gap between peak and maximal O2 consumption. ISOKINET EXERC SCI 2016. [DOI: 10.3233/ies-160610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
32
|
Vieira SS, Lemes B, de T C de Carvalho P, N de Lima R, S Bocalini D, A S Junior J, Arsa G, A Casarin C, L Andrade E, J Serra A. Does Stroke Volume Increase During an Incremental Exercise? A Systematic Review. Open Cardiovasc Med J 2016; 10:57-63. [PMID: 27347221 PMCID: PMC4896996 DOI: 10.2174/1874192401610010057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 09/20/2015] [Accepted: 10/22/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. METHODS A comprehensive review of the Cochrane Library's, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. RESULTS The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. CONCLUSION The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load.
Collapse
Affiliation(s)
- Stella S Vieira
- Universidade Federal de São Paulo, Laboratório de Fisiologia e Fisiopatologia Cardíaca, São Paulo, SP, Brazil
| | - Brunno Lemes
- Universidade Federal de São Paulo, Laboratório de Fisiologia e Fisiopatologia Cardíaca, São Paulo, SP, Brazil
| | - Paulo de T C de Carvalho
- Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada a Ciências da Saúde, São Paulo, SP, Brazil
| | - Rafael N de Lima
- Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada a Ciências da Saúde, São Paulo, SP, Brazil
| | - Danilo S Bocalini
- Laboratorio de Fisiologia Transacional dos Programas de Pos Graduacao em Educacao Fisica e Ciências do En-velhecimento, São Paulo, SP, Brasil
| | - José A S Junior
- Universidade Nove de Julho, Programa de Pós-Graduação em Medicina, São Paulo, SP, Brazil
| | - Gisela Arsa
- Universidade Federal do Mato Grosso, Programa de Mestrado em Educação Física, Cuiabá, MT, Brazil
| | - Cezar A Casarin
- Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada a Ciências da Saúde, São Paulo, SP, Brazil
| | - Erinaldo L Andrade
- Laboratorio de Fisiologia Transacional dos Programas de Pos Graduacao em Educacao Fisica e Ciências do En-velhecimento, São Paulo, SP, Brasil
| | - Andrey J Serra
- Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada a Ciências da Saúde, São Paulo, SP, Brazil
| |
Collapse
|
33
|
Cardiac troponin T and echocardiographic dimensions after repeated sprint vs. moderate intensity continuous exercise in healthy young males. Sci Rep 2016; 6:24614. [PMID: 27090032 PMCID: PMC4835763 DOI: 10.1038/srep24614] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/31/2016] [Indexed: 12/17/2022] Open
Abstract
Regular physical exercise can positively influence cardiac function; however, investigations have shown an increase of myocardial damage biomarkers after acute prolonged endurance exercises. We investigated the effect of repeated sprint vs. moderate long duration exercise on markers of myocardial necrosis, as well as cardiac dimensions and functions. Thirteen healthy males performed two different running sessions (randomized, single blinded cross-over design): 60 minutes moderate intensity continuous training (MCT, at 70% of peak heart rate (HRpeak)) and two series of 12 × 30-second sprints with set recovery periods in-between (RST, at 90% HRpeak). Venous blood samples for cardiac troponin T (cTnT), creatine kinase (CK) and MB isoenzyme (CK-MB) were taken 1 and 4 hours after exercise sessions. After each session electrocardiographic (ECG) and transthoracic echocardiographic (TTE) data were recorded. Results showed that all variables - average heart rate, serum lactate concentration during RST, subjective exertion and cTnT after RST - were significantly higher compared to MCT. CK and CK-MB significantly increased regardless of exercise protocol, while ECG and TTE indicated normal cardiac function. Our results provide evidence that RST contributes significantly to cTnT and CK release. This biomarker increase seems to reflect a physiological rather than a pathological phenomenon in healthy, exercising subjects.
Collapse
|
34
|
Abstract
Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved contractility, and an increase in blood volume, allowing for greater filling of the ventricles and a consequent larger stroke volume. In parallel with the greater maximal cardiac output, the perfusion capacity of the muscle is increased, permitting for greater oxygen delivery. To accommodate the higher aerobic demands and perfusion levels, arteries, arterioles, and capillaries adapt in structure and number. The diameters of the larger conduit and resistance arteries are increased minimizing resistance to flow as the cardiac output is distributed in the body and the wall thickness of the conduit and resistance arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle allowing for an improved capacity for oxygen extraction by the muscle through a greater area for diffusion, a shorter diffusion distance, and a longer mean transit time for the erythrocyte to pass through the smallest blood vessels. The present article addresses the effect of endurance training on systemic and peripheral cardiovascular adaptations with a focus on humans, but also covers animal data.
Collapse
Affiliation(s)
- Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
35
|
Nikooie R. Determination of Anaerobic Threshold by Monitoring the O2 Pulse Changes in Endurance Cyclists. J Strength Cond Res 2015; 30:1700-7. [PMID: 26554552 DOI: 10.1519/jsc.0000000000001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to determine the validity of anaerobic threshold (AnT)-equivalent to the second turn point for lactate (LTP2)-estimation using the O2 pulse changes in highly trained endurance cyclists who do not show heart rate deflection point (HRDP) during incremental testing. Sixteen endurance cyclists (age, 24.8 ± 4.7 years) and fifteen active men (age, 24.8 ± 3.7 years) performed an incremental cycling test to exhaustion. Pulmonary oxygen uptake (V[Combining Dot Above]O2) and other hemodynamic variables, heart rate, and blood lactate concentration were measured continuously throughout the test. O2 pulse anaerobic threshold (O2 pulse-AnT) was defined as the second turn point in O2 pulse-workload curve. LTP2 was considered as gold standard assessment of AnT and was applied to confirm the validity of O2 pulse-AnT. Intraclass correlation coefficients and the Bland-Altman method were used to determine the relationship and agreement between the O2 corresponding to LTP2 and O2 pulse-AnT, respectively. The active men and 68.7% of the endurance cyclists showed HRDP, whereas all subjects showed O2 pulse-AnT during incremental testing. In both groups, the values for V[Combining Dot Above]O2 corresponding to LTP2 were not significantly different from the V[Combining Dot Above]O2 at O2 pulse-AnT. The V[Combining Dot Above]O2 at LTP2 and O2 pulse-AnT were highly correlated (endurance cyclists: R = 0.68; standard error of estimate [SEE] = 3.74 ml·kg·min and active men: R = 0.58; SEE = 2.91 ml·kg·min) and Bland-Altman plot revealed the limit of agreement of O2 at LTP2 and O2 pulse-AnT differences between 5.1 and 8.6 ml·kg·min (95% CI). In summary, results of this study showed that the second turn point in the O2 pulse-workload curve occurs around LTP2. Therefore, using O2 pulse-AnT is recommended for the noninvasive determination of AnT in highly trained endurance cyclists who do not show HRDP during incremental exercise.
Collapse
Affiliation(s)
- Rohollah Nikooie
- Department of Exercise Physiology, Faculty of Physical Education and Sport Science, Shahid Bahonar University of Kerman, Kerman, Iran
| |
Collapse
|
36
|
Marongiu E, Crisafulli A. Gender differences in cardiovascular functions during exercise: a brief review. SPORT SCIENCES FOR HEALTH 2015. [DOI: 10.1007/s11332-015-0237-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
37
|
Sugiura Kojima M, Noda A, Miyata S, Kojima J, Hara Y, Minoshima M, Murohara T. The Effect of Habitual Physical Training on Left Ventricular Function During Exercise Assessed by Three-Dimensional Echocardiography. Echocardiography 2015; 32:1670-5. [PMID: 25817077 DOI: 10.1111/echo.12934] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Stroke volume (SV) in trained athletes continuously increases with progressive exercise intensity. We studied whether physical training affected left ventricle (LV) function response to exercise using 3D echocardiography and tissue Doppler imaging (TDI). METHODS Eleven male university athletes and 12 male university nonathletes were enrolled in this study. After baseline data were collected, subjects performed a symptom-limited supine bicycle ergometer exercise test. Initial workload was 25 Watts (W) and increased 25 W every 3 minutes. At rest and every exercise stage, LV end-systolic and diastolic volume index (LVEDVI and LVESVI), SV index (SVI), cardiac index (CI), LV ejection fraction (LVEF), and early lateral mitral flow velocity (Ea) were evaluated. Heart rate (HR), and systolic and diastolic blood pressure (SBP and DBP) were continuously recorded. RESULTS Nonathletes showed a slow increase in CI, and SVI reached a plateau value at a HR of 90 beats per minute (bpm). In contrast, CI and SVI increased progressively and continuously in athletes. Both CI and SVI were significantly higher in athletes than in nonathletes at HRs of 100, 110, and 120 bpm. LVEDVI kept increasing in athletes while it plateaued in nonathletes. In contrast, LVESV decreased continuously during exercise in both groups. There was no significant difference in LVEF, Ea, SBP, or DBP at rest and during exercise between the two groups. CONCLUSION LV responses to exercise in athletes were different from those of in nonathletes; thus, habitual physical training may play an important role in the increase in both SVI and CI in young individuals.
Collapse
Affiliation(s)
| | - Akiko Noda
- Department of Biomedical Sciences, Chubu University, Kasugai, Japan
| | - Seiko Miyata
- Department of Biomedical Sciences, Chubu University, Kasugai, Japan
| | - Jun Kojima
- Nagoya University School of Health Sciences, Nagoya, Japan
| | - Yuki Hara
- Nagoya University School of Health Sciences, Nagoya, Japan
| | | | | |
Collapse
|
38
|
Wallert J, Madison G. Recovery after aerobic exercise is manipulated by tempo change in a rhythmic sound pattern, as indicated by autonomic reaction on heart functioning. Front Hum Neurosci 2014; 8:738. [PMID: 25285076 PMCID: PMC4168701 DOI: 10.3389/fnhum.2014.00738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 09/02/2014] [Indexed: 11/13/2022] Open
Abstract
Physical prowess is associated with rapid recovery from exhaustion. Here we examined whether recovery from aerobic exercise could be manipulated with a rhythmic sound pattern that either decreased or increased in tempo. Six men and six women exercised repeatedly for six minutes on a cycle ergometer at 60 percent of their individual maximal oxygen consumption, and then relaxed for six minutes while listening to one of two sound pattern conditions, which seemed to infinitely either decrease or increase in tempo, during which heart and breathing activity was measured. Participants exhibited more high-frequent heart rate variability when listening to decreasing tempo than when listening to increasing tempo, accompanied by a non-significant trend towards lower heart rate. The results show that neuropsychological entrainment to a sound pattern may directly affect the autonomic nervous system, which in turn may facilitate physiological recovery after exercise. Applications using rhythmic entrainment to aid physical recovery are discussed.
Collapse
Affiliation(s)
- John Wallert
- Department of Psychology, Umeå University Umeå, Sweden
| | - Guy Madison
- Department of Psychology, Umeå University Umeå, Sweden
| |
Collapse
|
39
|
Agiovlasitis S, Rossow LM, Yan H, Ranadive SM, Fahs CA, Motl RW, Fernhall B. Predicting METs from the heart rate index in persons with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2423-2429. [PMID: 24981191 DOI: 10.1016/j.ridd.2014.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/05/2014] [Accepted: 06/06/2014] [Indexed: 06/03/2023]
Abstract
Persons with Down syndrome (DS) have altered heart rate modulation and very low aerobic fitness. These attributes may impact the relationship between metabolic equivalent units (METs) and the heart rate index (HRindex-the ratio between heart rate during activity and resting heart rate), thereby altering the HRindex thresholds for moderate- and vigorous-intensity physical activity. This study examined whether the relationship between METs and HRindex differs between persons with and without DS and attempted to develop thresholds for activity intensity based on the HRindex for persons with DS. METs were measured with portable spirometry and heart rate with a monitor in 18 persons with DS (25 ± 7 years; 10 women) and 18 persons without DS (26 ± 5 years; 10 women) during 6 over-ground walking trials, each lasting 6min, at the preferred walking speed and at 0.5, 0.75, 1.0, 1.25, and 1.5m/s. The relationship between METs and HRindex in the two groups was analyzed with multi-level modeling with random intercepts and slopes. Group, HRindex, and the square of HRindex were significant predictors of METs (p<0.001; R(2)=0.65). Absolute percent error did not differ significantly between groups across speeds (DS: 19.6 ± 14.4%; non-DS: 21.0 ± 14.5%). Bland-Altman plots demonstrated somewhat greater variability in the difference between actual and predicted METs in participants with than without DS. The HRindex threshold for moderate-intensity activity was 1.32 and 1.20 for persons with and without DS, respectively. The HRindex threshold for vigorous-intensity activity was 1.80 and 1.65 for persons with and without DS, respectively. Persons with DS have an altered relationship between METs and HRindex and higher HRindex thresholds for moderate- and vigorous-intensity physical activity.
Collapse
Affiliation(s)
- Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, 233 McCarthy Gym, P.O. Box 6186, Mississippi State, MS 39762, United States.
| | - Lindy M Rossow
- Department of Exercise and Sports Science, Fitchburg State University, 155 North Street, Fitchburg, MA 01420, United States
| | - Huimin Yan
- Department of Kinesiology, East Carolina University, Greenville, NC 27858, United States
| | - Sushant M Ranadive
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Christopher A Fahs
- Department of Exercise and Sports Science, Fitchburg State University, 155 North Street, Fitchburg, MA 01420, United States
| | - Robert W Motl
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 906 S Goodwin Avenue, Urbana, IL 61801, United States
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, 808 S. Wood Street, MC 518, Chicago, IL 60612, United States
| |
Collapse
|
40
|
Mitchell JR, Wang JJ. Expanding application of the Wiggers diagram to teach cardiovascular physiology. ADVANCES IN PHYSIOLOGY EDUCATION 2014; 38:170-175. [PMID: 24913453 PMCID: PMC4056172 DOI: 10.1152/advan.00123.2013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/13/2014] [Indexed: 06/03/2023]
Abstract
Dr. Carl Wiggers' careful observations have provided a meaningful resource for students to learn how the heart works. Throughout the many years from his initial reports, the Wiggers diagram has been used, in various degrees of complexity, as a fundamental tool for cardiovascular instruction. Often, the various electrical and mechanical plots are the novice learner's first exposure to simulated data. As the various temporal relationships throughout a heartbeat could simply be memorized, the challenge for the cardiovascular instructor is to engage the learner so the underlying mechanisms governing the changing electrical and mechanical events are truly understood. Based on experience, we suggest some additions to the Wiggers diagram that are not commonly used to enhance cardiovascular pedagogy. For example, these additions could be, but are not limited to, introducing the concept of energy waves and their role in influencing pressure and flow in health and disease. Also, integrating concepts of exercise physiology, and the differences in cardiac function and hemodynamics between an elite athlete and normal subject, can have a profound impact on student engagement. In describing the relationship between electrical and mechanical events, the instructor may find the introduction of premature ventricular contractions as a useful tool to further understanding of this important principle. It is our hope that these examples can aid cardiovascular instructors to engage their learners and promote fundamental understanding at the expense of simple memorization.
Collapse
Affiliation(s)
- Jamie R Mitchell
- Faculty of Medicine and Dentistry, Department of Physiology, University of Alberta, Edmonton, Alberta, Canada; and
| | - Jiun-Jr Wang
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| |
Collapse
|
41
|
Nytrøen K, Gullestad L. Exercise after heart transplantation: An overview. World J Transplant 2013; 3:78-90. [PMID: 24392312 PMCID: PMC3879527 DOI: 10.5500/wjt.v3.i4.78] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/15/2013] [Accepted: 07/25/2013] [Indexed: 02/05/2023] Open
Abstract
While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and health-related quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation (HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been fully established. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.
Collapse
|
42
|
Gordon D, Wood M, Porter A, Vetrivel V, Gernigon M, Caddy O, Merzbach V, Keiller D, Baker J, Barnes R. Influence of blood donation on the incidence of plateau at $$ \dot{V}{\text{O}} $$ V ˙ O 2max. Eur J Appl Physiol 2013; 114:21-7. [DOI: 10.1007/s00421-013-2743-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 09/28/2013] [Indexed: 11/24/2022]
|
43
|
Elliott AD, Skowno J, Prabhu M, Noakes TD, Ansley L. Evidence of cardiac functional reserve upon exhaustion during incremental exercise to determine VO2max. Br J Sports Med 2013; 49:128-32. [PMID: 23293009 DOI: 10.1136/bjsports-2012-091752] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There remains considerable debate regarding the limiting factor(s) for maximal oxygen uptake (VO2max). Previous studies have shown that the central circulation may be the primary limiting factor for VO2max and that cardiac work increases beyond VO2max. AIM We sought to evaluate whether the work of the heart limits VO2max during upright incremental cycle exercise to exhaustion. METHODS Eight trained men completed two incremental exercise trials, each terminating with exercise at two different rates of work eliciting VO2max (MAX and SUPRAMAX). During each exercise trial we continuously recorded cardiac output using pulse-contour analysis calibrated with a lithium dilution method. Intra-arterial pressure was recorded from the radial artery while pulmonary gas exchange was measured continuously for an assessment of oxygen uptake. RESULTS The workload during SUPRAMAX (mean±SD: 346.5±43.2 W) was 10% greater than that achieved during MAX (315±39.3 W). There was no significant difference between MAX and SUPRAMAX for Q (28.7 vs 29.4 L/min) or VO2 (4.3 vs 4.3 L/min). Mean arterial pressure was significantly higher during SUPRAMAX, corresponding to a higher cardiac power output (8.1 vs 8.5 W; p<0.06). CONCLUSIONS Despite similar VO2 and Q, the greater cardiac work during SUPRAMAX supports the view that the heart is working submaximally at exhaustion during an incremental exercise test (MAX).
Collapse
Affiliation(s)
- Adrian D Elliott
- School of Life Sciences, Kingston University, Surrey, UK Discipline of Physiology, University of Adelaide, Adelaide, Australia
| | - Justin Skowno
- The Children's Hospital at Westmead, Sydney, Australiai Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, Australia
| | | | - Timothy David Noakes
- UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Newlands, South Africa
| | - Les Ansley
- School of Psychology and Sports Sciences, Northumbria University, Newcastle Upon Tyne, UK
| |
Collapse
|
44
|
Gusso S, Salvador C, Hofman P, Cutfield W, Baldi JC, Taberner A, Nielsen P. Design and testing of an MRI-compatible cycle ergometer for non-invasive cardiac assessments during exercise. Biomed Eng Online 2012; 11:13. [PMID: 22423637 PMCID: PMC3334686 DOI: 10.1186/1475-925x-11-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 03/18/2012] [Indexed: 12/30/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is an important tool for cardiac research, and it is frequently used for resting cardiac assessments. However, research into non-pharmacological stress cardiac evaluation is limited. Methods We aimed to design a portable and relatively inexpensive MRI cycle ergometer capable of continuously measuring pedalling workload while patients exercise to maintain target heart rates. Results We constructed and tested an MRI-compatible cycle ergometer for a 1.5 T MRI scanner. Resting and sub-maximal exercise images (at 110 beats per minute) were successfully obtained in 8 healthy adults. Conclusions The MRI-compatible cycle ergometer constructed by our research group enabled cardiac assessments at fixed heart rates, while continuously recording power output by directly measuring pedal force and crank rotation.
Collapse
Affiliation(s)
- Silmara Gusso
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | | | | | | | | | |
Collapse
|
45
|
Petot H, Meilland R, Le Moyec L, Mille-Hamard L, Billat VL. A new incremental test for VO2max accurate measurement by increasing VO2max plateau duration, allowing the investigation of its limiting factors. Eur J Appl Physiol 2011; 112:2267-76. [DOI: 10.1007/s00421-011-2196-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 09/28/2011] [Indexed: 10/16/2022]
|
46
|
Perim RR, Signorelli GR, Araújo CGS. Stability of relative oxygen pulse curve during repeated maximal cardiopulmonary testing in professional soccer players. Braz J Med Biol Res 2011; 44:700-6. [PMID: 21837356 DOI: 10.1590/s0100-879x2011007500073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 05/24/2011] [Indexed: 12/17/2022] Open
Abstract
During cardiopulmonary exercise testing (CPET), stroke volume can be indirectly assessed by O(2) pulse profile. However, for a valid interpretation, the stability of this variable over time should be known. The objective was to analyze the stability of the O(2) pulse curve relative to body mass in elite athletes. VO(2), heart rate (HR), and relative O(2) pulse were compared at every 10% of the running time in two maximal CPETs, from 2005 to 2010, of 49 soccer players. Maximal values of VO(2) (63.4 ± 0.9 vs 63.5 ± 0.9 mL O(2)•kg(-1)•min(-1)), HR (190 ± 1 vs188 ± 1 bpm) and relative O(2) pulse (32.9 ± 0.6 vs 32.6 ± 0.6 mL O(2)•beat(-1)•kg(-1)) were similar for the two CPETs (P > 0.05), while the final treadmill velocity increased from 18.5 ± 0.9 to 18.9 ± 1.0 km/h (P < 0.01). Relative O(2) pulse increased linearly and similarly in both evaluations (r(2) = 0.64 and 0.63) up to 90% of the running time. Between 90 and 100% of the running time, the values were less stable, with up to 50% of the players showing a tendency to a plateau in the relative O(2) pulse. In young healthy men in good to excellent aerobic condition, the morphology of the relative O(2) pulse curve is consistent up to close to the peak effort for a CPET repeated within a 1-year period. No increase in relative O(2)pulse at peak effort could represent a physiologic stroke volume limitation in these athletes.
Collapse
Affiliation(s)
- R R Perim
- Programa de Pós-Graduação em Educação Física, Universidade Gama Filho, Rio de Janeiro, Brasil
| | | | | |
Collapse
|
47
|
Wang B, Tian Q, Zhang Z, Gong H. Comparisons of local and systemic aerobic fitness parameters between finswimmers with different athlete grade levels. Eur J Appl Physiol 2011; 112:567-78. [PMID: 21611824 DOI: 10.1007/s00421-011-2007-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 05/10/2011] [Indexed: 11/30/2022]
Abstract
To study the relationship between the local and systemic aerobic fitness parameters, and between the muscle oxygenation and aerobic performance, 16 female finswimmers were recruited and divided into high-level (HL) group and low-level group. Cardiorespiratory function, blood lactate concentration and near infrared spectroscopy muscle oxygenation in the vastus lateralis (VL) were monitored simultaneously during a maximal incremental exercise. We found that the break point (Bp) of the oxygenation index (OI) in the VL (BpVL) had significant correlations with lactate threshold (LT) and gas exchange threshold (GET), and the appearance sequence of the three thresholds was BpVL ≈ LT ≤ GET. When considering different levels, the [Formula: see text] at BpVL, LT and GET were higher in the HL group. During intensive exercise, there were significantly faster [Formula: see text] increase and evidently slower OI decrease in the HL group, suggesting that faster [Formula: see text] increase in the HL group slowed down the muscle deoxygenation and facilitated subjects to cycle to higher workloads. In conclusion, multi-modality approaches combining local and systemic physiological monitoring technologies might provide better explanations of the relationship between local and systemic aerobic fitness parameters, and might be a novel way to analyze the difference between groups of different levels.
Collapse
Affiliation(s)
- Bangde Wang
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
| | | | | | | |
Collapse
|
48
|
Perim RR, Signorelli GR, Myers J, Arena R, de Araújo CGS. The slope of the oxygen pulse curve does not depend on the maximal heart rate in elite soccer players. Clinics (Sao Paulo) 2011; 66:829-35. [PMID: 21789388 PMCID: PMC3109383 DOI: 10.1590/s1807-59322011000500020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 04/01/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION It is unknown whether an extremely high heart rate can affect oxygen pulse profile during progressive maximal exercise in healthy subjects. OBJECTIVE Our aim was to compare relative oxygen pulse (adjusted for body weight) curves in athletes at their maximal heart rate during treadmill cardiopulmonary exercise testing. METHODS A total of 180 elite soccer players were categorized in quartiles according to their maximum heart rate values (n = 45). Oxygen consumption, maximum heart rate and relative oxygen pulse curves in the extreme quartiles, Q1 and Q4, were compared at intervals corresponding to 10% of the total duration of a cardiopulmonary exercise testing. RESULTS Oxygen consumption was similar among all subjects during cardiopulmonary exercise testing; however subjects in Q1 started to exhibit lower maximum heart rate values when 20% of the test was complete. Conversely, the relative oxygen pulse was higher in this group when cardiopulmonary exercise testing was 40% complete (p<.01). Although the slopes of the lines were similar (p = .25), the regression intercepts differed (p<.01) between Q1 and Q4. During the last two minutes of testing, a flat or decreasing oxygen pulse was identified in 20% of the soccer players, and this trend was similar between subjects in Q1 and Q4. CONCLUSION Relative oxygen pulse curve slopes, which serve as an indirect and non-invasive surrogate for stroke volume, suggest that the stroke volume is similar in young and aerobically fit subjects regardless of the maximum heart rate reached.
Collapse
|
49
|
Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T. Effects of Acute Hypoxia at Moderate Altitude on Stroke Volume and Cardiac Output During Exercise. Int Heart J 2010; 51:170-5. [DOI: 10.1536/ihj.51.170] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Taira Fukuda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | | | - Akihiro Matsumoto
- Japan Women’s College of Physical Education
- Tokyo University of Foreign Studies
| | | | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Ryozo Nagai
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | | |
Collapse
|
50
|
Abstract
Over the past 13 years, Noakes and his colleagues have argued repeatedly for the existence of a 'Central Governor', a specific brain centre that provides a feed-forward regulation of the intensity of vigorous effort in order to conserve homeostasis, protecting vital organs such as the brain, heart and skeletal muscle against damage from hyperthermia, ischaemia and other manifestations of catastrophic failure. This brief article reviews evidence concerning important corollaries of the hypothesis, examining the extent of evolutionary pressures for the development of such a mechanism, the effectiveness of protection against hyperthermia and ischaemia during exhausting exercise, the absence of peripheral factors limiting peak performance (particularly a plateauing of cardiac output and oxygen consumption) and proof that electromyographic activity is limiting exhausting effort. As yet, there is a lack of convincing experimental evidence to support these corollaries of the hypothesis; furthermore, some findings, such as the rather consistent demonstration of an oxygen consumption plateau in young adults, argue strongly against the limiting role of a 'Central Governor'.
Collapse
Affiliation(s)
- Roy J Shephard
- Faculty of Physical Education and Health, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|