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Lav Madsen P, Sejersen C, Nyberg M, Sørensen MH, Hellsten Y, Gaede P, Bojer AS. The cardiovascular changes underlying a low cardiac output with exercise in patients with type 2 diabetes mellitus. Front Physiol 2024; 15:1294369. [PMID: 38571722 PMCID: PMC10987967 DOI: 10.3389/fphys.2024.1294369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
The significant morbidity and premature mortality of type 2 diabetes mellitus (T2DM) is largely associated with its cardiovascular consequences. Focus has long been on the arterial atheromatosis of DM giving rise to early stroke and myocardial infarctions, whereas less attention has been given to its non-ischemic cardiovascular consequences. Irrespective of ischemic changes, T2DM is associated with heart failure (HF) most commonly with preserved ejection fraction (HFpEF). Largely due to increasing population ages, hypertension, obesity and T2DM, HFpEF is becoming the most prevalent form of heart failure. Unfortunately, randomized controlled trials of HFpEF have largely been futile, and it now seems logical to address the important different phenotypes of HFpEF to understand their underlying pathophysiology. In the early phases, HFpEF is associated with a significantly impaired ability to increase cardiac output with exercise. The lowered cardiac output with exercise results from both cardiac and peripheral causes. T2DM is associated with left ventricular (LV) diastolic dysfunction based on LV hypertrophy with myocardial disperse fibrosis and significantly impaired ability for myocardial blood flow increments with exercise. T2DM is also associated with impaired ability for skeletal muscle vasodilation during exercise, and as is the case in the myocardium, such changes may be related to vascular rarefaction. The present review discusses the underlying phenotypical changes of the heart and peripheral vascular system and their importance for an adequate increase in cardiac output. Since many of the described cardiovascular changes with T2DM must be considered difficult to change if fully developed, it is suggested that patients with T2DM are early evaluated with respect to their cardiovascular compromise.
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Affiliation(s)
- Per Lav Madsen
- Department Cardiology, Herlev-Gentofte Hospital, Copenhagen University, Copenhagen, Denmark
- Department Clinical Medicine, Copenhagen University, Copenhagen, Denmark
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
| | - Casper Sejersen
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
- Department of Anaesthesia, Rigshospitalet, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department Kidney and Vascular Biology, Global Drug Discovery, Novo Nordisk, Copenhagen, Denmark
| | | | - Ylva Hellsten
- The August Krogh Section for Human Physiology, Department Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
| | - Peter Gaede
- Department Endocrinology, Slagelse-Næstved Hospital, Copenhagen, Denmark
| | - Annemie Stege Bojer
- Department Cardiology, Herlev-Gentofte Hospital, Copenhagen University, Copenhagen, Denmark
- Department Endocrinology, Slagelse-Næstved Hospital, Copenhagen, Denmark
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Hellsten Y, Gliemann L. Peripheral limitations for performance: Muscle capillarization. Scand J Med Sci Sports 2024; 34:e14442. [PMID: 37770233 DOI: 10.1111/sms.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 10/03/2023]
Abstract
Sufficient delivery of oxygen and metabolic substrates, together with removal of waste products, are key elements of muscle performance. Capillaries are the primary site for this exchange in skeletal muscle and the degree of muscle capillarization affects diffusion conditions by influencing mean transit time, capillary surface area and diffusion distance. Muscle capillarization may thus represent a limiting factor for performance. Exercise training increases the number of capillaries per muscle fiber by about 10%-20% within a few weeks in untrained subjects, whereas capillary growth progresses more slowly in well-trained endurance athletes. Studies show that capillaries are tortuous, situated along and across the length of the fibers with an arrangement related to muscle fascicles. Although direct data is lacking, it is possible that years of training not only enhances capillary density but also optimizes the positioning of capillaries, to further improve the diffusion conditions. Muscle capillarization has been shown to increase oxygen extraction during exercise in humans, but direct evidence for a causal link between increased muscle capillarization and performance is scarce. This review covers current knowledge on the implications of muscle capillarization for oxygen and glucose uptake as well as performance. A brief overview of the process of capillary growth and of physical factors, inherent to exercise, which promote angiogenesis, provides the foundation for a discussion on how different training modalities may influence muscle capillary growth. Finally, we identify three areas for future research on the role of capillarization for exercise performance.
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Affiliation(s)
- Ylva Hellsten
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Ugwoke CK, Cvetko E, Umek N. Skeletal Muscle Microvascular Dysfunction in Obesity-Related Insulin Resistance: Pathophysiological Mechanisms and Therapeutic Perspectives. Int J Mol Sci 2022; 23:ijms23020847. [PMID: 35055038 PMCID: PMC8778410 DOI: 10.3390/ijms23020847] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
Obesity is a worrisomely escalating public health problem globally and one of the leading causes of morbidity and mortality from noncommunicable disease. The epidemiological link between obesity and a broad spectrum of cardiometabolic disorders has been well documented; however, the underlying pathophysiological mechanisms are only partially understood, and effective treatment options remain scarce. Given its critical role in glucose metabolism, skeletal muscle has increasingly become a focus of attention in understanding the mechanisms of impaired insulin function in obesity and the associated metabolic sequelae. We examined the current evidence on the relationship between microvascular dysfunction and insulin resistance in obesity. A growing body of evidence suggest an intimate and reciprocal relationship between skeletal muscle microvascular and glucometabolic physiology. The obesity phenotype is characterized by structural and functional changes in the skeletal muscle microcirculation which contribute to insulin dysfunction and disturbed glucose homeostasis. Several interconnected etiologic molecular mechanisms have been suggested, including endothelial dysfunction by several factors, extracellular matrix remodelling, and induction of oxidative stress and the immunoinflammatory phenotype. We further correlated currently available pharmacological agents that have deductive therapeutic relevance to the explored pathophysiological mechanisms, highlighting a potential clinical perspective in obesity treatment.
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Horie H, Hisatome I, Kurata Y, Yamamoto Y, Notsu T, Adachi M, Li P, Kuwabara M, Sakaguchi T, Kinugasa Y, Miake J, Koba S, Tsuneto M, Shirayoshi Y, Ninomiya H, Ito S, Kitakaze M, Yamamoto K, Yoshikawa Y, Nishimura M. α1-Adrenergic receptor mediates adipose-derived stem cell sheet-induced protection against chronic heart failure after myocardial infarction in rats. Hypertens Res 2021; 45:283-291. [PMID: 34853408 DOI: 10.1038/s41440-021-00802-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022]
Abstract
Cell-based therapy using adipose-derived stem cells (ADSCs) has emerged as a novel therapeutic approach to treat heart failure after myocardial infarction (MI). The purpose of this study was to determine whether inhibition of α1-adrenergic receptors (α1-ARs) in ADSCs attenuates ADSC sheet-induced improvements in cardiac functions and inhibition of remodeling after MI. ADSCs were isolated from fat tissues of Lewis rats. In in vitro studies using cultured ADSCs, we determined the mRNA levels of vascular endothelial growth factor (VEGF)-A and α1-AR under normoxia or hypoxia and the effects of norepinephrine and an α1-blocker, doxazosin, on the mRNA levels of angiogenic factors. Hypoxia increased α1-AR and VEGF mRNA levels in ADSCs. Norepinephrine further increased VEGF mRNA expression under hypoxia; this effect was abolished by doxazosin. Tube formation of human umbilical vein endothelial cells was promoted by conditioned media of ADSCs treated with the α1 stimulant phenylephrine under hypoxia but not by those of ADSCs pretreated with phenylephrine plus doxazosin. In in vivo studies using rats with MI, transplanted ADSC sheets improved cardiac functions, facilitated neovascularization, and suppressed fibrosis after MI. These effects were abolished by doxazosin treatment. Pathway analysis from RNA sequencing data predicted significant upregulation of α1-AR mRNA expression in transplanted ADSC sheets and the involvement of α1-ARs in angiogenesis through VEGF. In conclusion, doxazosin abolished the beneficial effects of ADSC sheets on rat MI hearts as well as the enhancing effect of norepinephrine on VEGF expression in ADSCs, indicating that ADSC sheets promote angiogenesis and prevent cardiac dysfunction and remodeling after MI via their α1-ARs.
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Affiliation(s)
- Hiromu Horie
- Division of Cardiovascular Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Ichiro Hisatome
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Yasutaka Kurata
- Department of Physiology II, Kanazawa Medical University, Uchinada, Japan.
| | - Yasutaka Yamamoto
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Tomomi Notsu
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Maaya Adachi
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Peili Li
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Masanari Kuwabara
- Intensive Care Unit and Department of Cardiology, Toranomon Hospital, Tokyo, Japan
| | - Takuki Sakaguchi
- Division of Medical Education, Department of Medical Education, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiharu Kinugasa
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Junichiro Miake
- Department of Pharmacology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Satoshi Koba
- Division of Integrative Physiology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Motokazu Tsuneto
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Yasuaki Shirayoshi
- Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Science, Yonago, Japan
| | - Haruaki Ninomiya
- Department of Biological Regulation, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shin Ito
- Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Kazuhiro Yamamoto
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yasushi Yoshikawa
- Division of Cardiovascular Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Motonobu Nishimura
- Division of Cardiovascular Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
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Gliemann L, Rytter N, Jørgensen TS, Piil P, Carter H, Nyberg M, Grassi M, Daumer M, Hellsten Y. The Impact of Lower Limb Immobilization and Rehabilitation on Angiogenic Proteins and Capillarization in Skeletal Muscle. Med Sci Sports Exerc 2021; 53:1797-1806. [PMID: 33787530 DOI: 10.1249/mss.0000000000002665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Skeletal muscle vascularization is important for tissue regeneration after injury and immobilization. We examined whether complete immobilization influences capillarization and oxygen delivery to the muscle and assessed the efficacy of rehabilitation by aerobic exercise training. METHODS Young healthy males had one leg immobilized for 14 d and subsequently completed 4 wk of intense aerobic exercise training. Biopsies were obtained from musculus vastus lateralis, and arteriovenous blood sampling for assessment of oxygen extraction and leg blood flow during exercise was done before and after immobilization and training. Muscle capillarization, muscle and platelet content of vascular endothelial growth factor (VEGF), and muscle thrombospondin-1 were determined. RESULTS Immobilization did not have a significant impact on capillary per fiber ratio or capillary density. The content of VEGF protein in muscle samples was reduced by 36% (P = 0.024), and VEGF to thrombospondin-1 ratio was 94% lower (P = 0.046). The subsequent 4-wk training period increased the muscle VEGF content and normalized the muscle VEGF to thrombospondin-1 ratio but did not influence capillarization. Platelet VEGF content followed the trend of muscle VEGF. At the functional level, oxygen extraction, blood flow, and oxygen delivery at rest and during submaximal exercise were not affected by immobilization or training. CONCLUSIONS The results demonstrate that just 2 wk of leg immobilization leads to a strongly reduced angiogenic potential as evidenced by reduced muscle and platelet VEGF content and a reduced muscle VEGF to thrombospondin-1 ratio. Moreover, a subsequent period of intensive aerobic exercise training fails to increase capillarization in the previously immobilized leg, possibly because of the angiostatic condition caused by immobilization.
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Affiliation(s)
- Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Peter Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Howard Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Marcello Grassi
- Technical University of Munich, Germany. Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, GERMANY
| | - Martin Daumer
- Technical University of Munich, Germany. Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, GERMANY
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
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Pérez-Gómez J, Rytter N, Mandrup C, Egelund J, Stallknecht B, Nyberg M, Hellsten Y. Menopausal transition does not influence skeletal muscle capillary growth in response to cycle training in women. J Appl Physiol (1985) 2021; 131:369-375. [PMID: 34080923 DOI: 10.1152/japplphysiol.00122.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The influence of the menopausal transition, with a consequent loss of estrogen, on capillary growth in response to exercise training remains unknown. In the present study, we evaluated the effect of a period of intense endurance training on skeletal muscle angiogenesis in late premenopausal and recent postmenopausal women with an age difference of <4 yr. Skeletal muscle biopsies were obtained from the thigh muscle before and after 12 wk of intense aerobic cycle training and analyzed for capillarization, fiber-type distribution, and content of vascular endothelial growth factor (VEGF). At baseline, there was no difference in capillary per fiber ratio (C:F; 1.41 ± 0.22 vs. 1.40 ± 0.30), capillary density (CD; 305 ± 61 vs. 336 ± 52 mm2), muscle fiber area (MFA; 4,889 ± 1,868 vs. 4,195 ± 749), or distribution of muscle fiber type I (47.3% ± 10.1% vs. 49.3% ± 15.1%), between the pre- and postmenopausal women, respectively. There was a main effect of training on the C:F ratio (+9.2% and +12.1%, for the pre- and postmenopausal women, respectively) and the CD (+6.9% and +8.9%, for the pre- and postmenopausal women, respectively). MFA and fiber-type distribution were unaltered by training. Skeletal muscle VEGF protein content was similar between groups at baseline, and there was a main effect of training (+21.1% and +27.2%, for the pre- and postmenopausal women, respectively). In conclusion, the loss of estrogen per se at menopause does not influence the capillary growth response to intense aerobic exercise training.NEW & NOTEWORTHY We evaluated the effect of 12 wk of intense aerobic exercise training on skeletal muscle angiogenesis in late pre- and recent postmenopausal women, with <4 yr of age difference. There was a main effect of training on capillary per fiber ratio, capillary density, and muscle VEGF protein content, with no difference between groups. It is concluded that the loss of estrogen per se at menopause does not influence the capillary growth response to intense aerobic training.
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Affiliation(s)
- Jorge Pérez-Gómez
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,HEME Research Group, Faculty of Sport Science, University of Extremadura, Cáceres, Spain
| | - Nicolai Rytter
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Mandrup
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jon Egelund
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Gliemann L, Rytter N, Yujia L, Tamariz-Ellemann A, Carter H, Hellsten Y. A High Activity Level Is Required for Augmented Muscle Capillarization in Older Women. Med Sci Sports Exerc 2021; 53:894-903. [PMID: 33844669 DOI: 10.1249/mss.0000000000002566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to evaluate the influence of lifelong regular physical activity on skeletal muscle capillarization in women. METHODS Postmenopausal women, 61±4 yr old, were divided according to self-reported physical activity level over the past 20 yrs: sedentary (SED; n = 14), moderately active (MOD; n = 12), and very active (VERY; n = 15). Leg blood flow (LBF) was determined by ultrasound Doppler, and blood samples were drawn from the femoral artery and vein for calculation of leg oxygen uptake (LVO2) at rest and during one-legged knee extensor exercise. A skeletal muscle biopsy was obtained from the vastus lateralis and analyzed for capillarization and vascular endothelial growth factor (VEGF) and mitochondrial OXPHOS proteins. Platelets were isolated from venous blood and analyzed for VEGF content and effect on endothelial cell proliferation. RESULTS The exercise-induced rise in LBF and LVO2 was faster (P = 0.008) in VERY compared with SED and MOD. Steady-state LBF and LVO2 were lower (P < 0.04) in MOD and VERY compared with SED. Capillary-fiber ratio and capillary density were greater (P < 0.03) in VERY (1.65 ± 0.48 and 409.3 ± 57.5) compared with MOD (1.30 ± 0.19 and 365.0 ± 40.2) and SED (1.30 ± 0.30 and 356.2 ± 66.3). Skeletal muscle VEGF and OXPHOS complexes I, II, and V were ~1.6-fold and ~1.25-fold (P < 0.01) higher, respectively, in VERY compared with SED. Platelets from all groups induced an approximately nine-fold (P < 0.001) increase in endothelial cell proliferation. CONCLUSION A very active lifestyle is associated with superior skeletal muscle exercise hemodynamics and greater potential for oxygen extraction concurrent with a higher skeletal muscle capillarization and mitochondrial capacity.
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Affiliation(s)
- Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | | | | | - Howard Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
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Hoier B, Olsen LN, Leinum M, Jørgensen TS, Carter HH, Hellsten Y, Bangsbo J. Aerobic High-Intensity Exercise Training Improves Cardiovascular Health in Older Post-menopausal Women. FRONTIERS IN AGING 2021; 2:667519. [PMID: 35822005 PMCID: PMC9261406 DOI: 10.3389/fragi.2021.667519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/22/2021] [Indexed: 11/13/2022]
Abstract
The aim of this study was to determine the effect of a period of aerobic high intensity training on central- and peripheral cardiovascular parameters in older post-menopausal women. Eleven healthy post-menopausal (>10 years after menopause) women (mean age: 64 years; BMI: 25.3 kg m−2) completed an 8-week period of supervised, high intensity cycle training, with sessions conducted three times per week. Before and after the training period maximal oxygen uptake, body composition, popliteal artery flow mediated dilation, exercise hyperemia, arterial blood pressure, and plasma lipids were assessed. In addition, levels of estrogen related receptor α (ERRα) and vasodilator enzymes were determined in muscle biopsy samples. Training induced an 18% increase (P < 0.001) in maximal oxygen uptake. Plasma High-density lipoprotein (HDL) was higher (P < 0.05) after than before the training period. Fat mass was reduced (4.9%; P < 0.01), whereas lean body mass was unaltered. Mean arterial blood pressure was unchanged (91 vs. 88 mmHg; P = 0.058) with training. Training did not induce a change in popliteal flow mediated dilation. Exercise hyperemia at submaximal exercise was lower (P < 0.01; 11 and 4.6% at 10 and 16 W, respectively) after compared to before training. Muscle ERRα (~1.7-fold; P < 0.01) and eNOS (~1.4-fold; P < 0.05) were higher after the training intervention. The current study demonstrates that, in older post-menopausal women, a period of aerobic high intensity training effectively increases maximal oxygen uptake and improves the cardiovascular health profile, without a parallel improvement in conduit artery function.
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Affiliation(s)
- Birgitte Hoier
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Line Nørregaard Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Maria Leinum
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Herlev Hospital, Copenhagen, Denmark
| | - Howard Henry Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Kissane RWP, Tickle PG, Doody NE, Al-Shammari AA, Egginton S. Distinct structural and functional angiogenic responses are induced by different mechanical stimuli. Microcirculation 2021; 28:e12677. [PMID: 33417723 PMCID: PMC8614118 DOI: 10.1111/micc.12677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/23/2020] [Indexed: 11/29/2022]
Abstract
Objective Adequacy of the microcirculation is essential for maintaining repetitive skeletal muscle function while avoiding fatigue. It is unclear, however, whether capillary remodelling after different angiogenic stimuli is comparable in terms of vessel distribution and consequent functional adaptations. We determined the physiological consequences of two distinct mechanotransductive stimuli: (1) overload‐mediated abluminal stretch (OV); (2) vasodilator‐induced shear stress (prazosin, PR). Methods In situ EDL fatigue resistance was determined after 7 or 14 days of intervention, in addition to measurements of femoral artery flow. Microvascular composition (muscle histology) and oxidative capacity (citrate synthase activity) were quantified, and muscle PO2 calculated using advanced mathematical modelling. Results Compared to controls, capillary‐to‐fiber ratio was higher after OV14 (134%, p < .001) and PR14 (121%, p < .05), although fatigue resistance only improved after overload (7 days: 135%, 14 days: 125%, p < .05). In addition, muscle overload improved local capillary supply indices and reduced CS activity, while prazosin treatment failed to alter either index of aerobic capacity. Conclusion Targeted capillary growth in response to abluminal stretch is a potent driver of improved muscle fatigue resistance, while shear stress‐driven angiogenesis has no beneficial effect on muscle function. In terms of capillarity, more is not necessarily better.
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Affiliation(s)
- Roger W P Kissane
- Department of Musculoskeletal & Ageing Science, University of Liverpool, Liverpool, UK.,School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Peter G Tickle
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Natalie E Doody
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Abdullah A Al-Shammari
- Department of Mathematics, Faculty of Sciences, Kuwait University, Khaldiya, Kuwait.,Department of Genetics & Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait
| | - Stuart Egginton
- School of Biomedical Sciences, University of Leeds, Leeds, UK
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10
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Hoier B, Olsen K, Hanskov DJA, Jorgensen M, Norup LR, Hellsten Y. Early time course of change in angiogenic proteins in human skeletal muscle and vascular cells with endurance training. Scand J Med Sci Sports 2020; 30:1117-1131. [PMID: 32246511 DOI: 10.1111/sms.13665] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/16/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
Abstract
Angiogenic, mitochondrial, and related transcriptional proteins were assessed in human skeletal muscle and isolated vascular cells during the early phase of endurance training. Thigh muscle biopsies were obtained in healthy young subjects, after one acute bout (n = 9) and after 3, 5, 7, and 14 days (n = 9) of cycle ergometer training. Whole muscle homogenates were analyzed for angiogenic, mitochondrial, and regulatory mRNA and protein levels. Angiogenic proteins were determined in muscle-derived endothelial cells and pericytes sorted by fluorescence-activated cell sorting. Acute exercise induced an increase in whole muscle mRNA of peroxisome proliferator-activated receptor gamma coactivator 1α (4.5-fold; P = .002) and vascular endothelial growth factor (VEGF) (2.4-fold; P = .001) at 2 hours post. After 14 days of training, there was an increase in CD31 protein (63%; P = .010) in whole muscle indicating capillary growth. There was also an increase in muscle VEGF receptor 2 (VEGFR2) (1.5-fold; P = .013), in OXPHOS proteins (complex I, II, IV, V; 1.4- to 1.9-fold; P < .05) after 14 days of training and an increase in estrogen-related receptorα protein (1.5-fold; P = .039) at 14 days compared to 5 days of training. Both endothelial cells and pericytes expressed VEGF and other angiogenic factors at the protein level but with a distinctively lower expression of VEGFR2 and thrombospondin-1 (TSP-1) in pericytes. The findings illustrate that initiation of capillary and mitochondrial adaptations occurs within 14 days of training and suggest that sustained changes in angiogenic proteins including VEGF and TSP-1 are moderate in whole muscle and vascular cells.
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Affiliation(s)
- Birgitte Hoier
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Karina Olsen
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Dorte J A Hanskov
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Maria Jorgensen
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Liselotte R Norup
- Core Facility for Flow Cytometry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- Integrative Physiology Section, Cardiovascular Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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11
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Sciesielski LK, Kirschner KM. ExActa HIF prolyl hydroxylase inhibitors-The new lifestyle drug? Acta Physiol (Oxf) 2019; 227:e13370. [PMID: 31465609 DOI: 10.1111/apha.13370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/23/2019] [Accepted: 08/23/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Lina K. Sciesielski
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität BerlinHumboldt‐Universität zu Berlin, and Berlin Institute of HealthDepartment of Neonatology Berlin Germany
| | - Karin M. Kirschner
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität BerlinHumboldt‐Universität zu Berlin, and Berlin Institute of HealthInstitute of Vegetative Physiology Berlin Germany
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Steinach M, Lichti J, Maggioni MA, Fähling M. A fluid shift for endurance exercise-Why hydration matters. Acta Physiol (Oxf) 2019; 227:e13347. [PMID: 31329350 DOI: 10.1111/apha.13347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Mathias Steinach
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Julia Lichti
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
- Institute of Vegetative Physiology, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Martina Anna Maggioni
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
- Department of Biomedical Sciences for Health Università degli Studi di Milano Milan Italy
| | - Michael Fähling
- Institute of Vegetative Physiology, Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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13
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14
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Gliemann L, Vestergaard Hansen C, Rytter N, Hellsten Y. Regulation of skeletal muscle blood flow during exercise. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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15
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Proctor DN, Luck JC, Maman SR, Leuenberger UA, Muller MD. Esmolol acutely alters oxygen supply-demand balance in exercising muscles of healthy humans. Physiol Rep 2019; 6:e13673. [PMID: 29665297 PMCID: PMC5903697 DOI: 10.14814/phy2.13673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 01/13/2023] Open
Abstract
Beta‐adrenoreceptor antagonists (β blockers) reduce systemic O2 delivery and blood pressure (BP) during exercise, but the subsequent effects on O2 extraction within the active limb muscles are unknown. In this study, we examined the effects of the fast‐acting, β1 selective blocker esmolol on systemic hemodynamics and leg muscle O2 saturation (near infrared spectroscopy, NIRS) during submaximal leg ergometry. Our main hypothesis was that esmolol would augment exercise‐induced reductions in leg muscle O2 saturation. Eight healthy adults (6 men, 2 women; 23–67 year) performed light and moderate intensity bouts of recumbent leg cycling before (PRE), during (β1‐blocked), and 45 min following (POST) intravenous infusion of esmolol. Oxygen uptake, heart rate (HR), BP, and O2 saturation (SmO2) of the vastus lateralis (VL) and medial gastrocnemius (MG) muscles were measured continuously. Esmolol attenuated the increases in HR and systolic BP during light (−12 ± 9 bpm and −26 ± 12 mmHg vs. PRE) and moderate intensity (−20 ± 10 bpm and −40 ± 18 mmHg vs. PRE) cycling (all P < 0.01). Exercise‐induced reductions in SmO2 occurred to a greater extent during the β1‐blockade trial in both the VL (P = 0.001 vs. PRE) and MG muscles (P = 0.022 vs. PRE). HR, SBP and SmO2 were restored during POST (all P < 0.01 vs. β1‐blocked). In conclusion, esmolol rapidly and reversibly increases O2 extraction within exercising muscles of healthy humans.
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Affiliation(s)
- David N Proctor
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - J Carter Luck
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Stephan R Maman
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Urs A Leuenberger
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Matthew D Muller
- Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pennsylvania.,Master of Science in Anesthesia Program, Case Western Reserve University School of Medicine, Cleveland, Ohio
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16
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Persson PB, Bondke Persson A. Metabolism, obesity and the metabolic syndrome. Acta Physiol (Oxf) 2018; 223:e13096. [PMID: 29754459 DOI: 10.1111/apha.13096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- P. B. Persson
- Charité - Universitätsmedizin Berlin; Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Vegetative Physiology; Berlin Germany
| | - A. Bondke Persson
- Charité - Universitätsmedizin Berlin; Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Germany
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