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Ratchford SM, Broxterman RM, La Salle DT, Kwon OS, Hopkins PN, Richardson RS, Trinity JD. Obesity does not alter vascular function and handgrip exercise hemodynamics in middle-aged patients with hypertension. Am J Physiol Regul Integr Comp Physiol 2024; 326:R1-R9. [PMID: 37842741 PMCID: PMC11283903 DOI: 10.1152/ajpregu.00105.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
Lifestyle modification including exercise training is often the first line of defense in the treatment of obesity and hypertension (HTN), however, little is known regarding how these potentially compounding disease states impact vasodilatory and hemodynamic responses at baseline and exercise. Therefore, this study sought to compare the impact of obesity on vascular function and hemodynamics at baseline and during handgrip (HG) exercise among individuals with HTN. Non-obese (13M/7F, 56 ± 16 yr, 25 ± 4 kg/m2) and obese (17M/4F, 50 ± 7 yr, 35 ± 4 kg/m2) middle-aged individuals with HTN forwent antihypertensive medication use for ≥2 wk before assessment of vascular function by brachial artery flow-mediated dilation (FMD) and exercise hemodynamics during progressive HG exercise at 15-30-45% maximal voluntary contraction (MVC). FMD was not different between Non-Obese (4.1 ± 1.7%) and Obese (5.2 ± 1.9%, P = 0.11). Systolic blood pressure (SBP) was elevated by ∼15% during the supine baseline and during HG exercise in the obese group. The blood flow response to HG exercise at 30% and 45% MVC was ∼20% greater (P < 0.05) in the obese group but not different after normalizing for the higher, albeit, nonsignificant differences in workloads (MVC: obese: 24 ± 5 kg, non-obese: 21 ± 5 kg, P = 0.11). Vascular conductance and the brachial artery shear-induced vasodilatory response during HG were not different between groups (P > 0.05). Taken together, despite elevated SBP during HG exercise, obesity does not lead to additional impairments in vascular function and peripheral exercising hemodynamics in patients with HTN. Obesity may not be a contraindication when prescribing exercise for the treatment of HTN among middle-aged adults, however, the elevated SBP should be appropriately monitored.NEW & NOTEWORTHY This study examined vascular function and handgrip exercise hemodynamics in obese and nonobese individuals with hypertension. Obesity, when combined with hypertension, was neither associated with additional vascular function impairments at baseline nor peripheral hemodynamics and vasodilation during exercise compared with nonobese hypertension. Interestingly, systolic blood pressure and pulse pressure were greater in the obese group during supine baseline and exercise. These findings should not be ignored and may be particularly important for rehabilitation strategies.
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Affiliation(s)
- Stephen M Ratchford
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veteran Affairs Medical Center, Salt Lake City, Utah, United States
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veteran Affairs Medical Center, Salt Lake City, Utah, United States
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, United States
| | - D Taylor La Salle
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Oh Sung Kwon
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, United States
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, United States
| | - Paul N Hopkins
- Department of Internal Medicine, Division of Cardiovascular Genetics, University of Utah, Salt Lake City, Utah, United States
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veteran Affairs Medical Center, Salt Lake City, Utah, United States
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veteran Affairs Medical Center, Salt Lake City, Utah, United States
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
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Zuccarelli L, Baldassarre G, Winnard A, Harris KM, Weber T, Green DA, Petersen LG, Kamine TH, Roberts L, Kim DS, Greaves DK, Arya R, Laws JM, Elias A, Rittweger J, Grassi B, Goswami N. Effects of whole-body vibration or resistive-vibration exercise on blood clotting and related biomarkers: a systematic review. NPJ Microgravity 2023; 9:87. [PMID: 38057333 DOI: 10.1038/s41526-023-00338-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
Whole-body vibration (WBV) and resistive vibration exercise (RVE) are utilized as countermeasures against bone loss, muscle wasting, and physical deconditioning. The safety of the interventions, in terms of the risk of inducing undesired blood clotting and venous thrombosis, is not clear. We therefore performed the present systematic review of the available scientific literature on the issue. The review was conducted following the guidelines by the Space Biomedicine Systematic Review Group, based on Cochrane review guidelines. The relevant context or environment of the studies was "ground-based environment"; space analogs or diseased conditions were not included. The search retrieved 801 studies; 77 articles were selected for further consideration after an initial screening. Thirty-three studies met the inclusion criteria. The main variables related to blood markers involved angiogenic and endothelial factors, fibrinolysis and coagulation markers, cytokine levels, inflammatory and plasma oxidative stress markers. Functional and hemodynamic markers involved blood pressure measurements, systemic vascular resistance, blood flow and microvascular and endothelial functions. The available evidence suggests neutral or potentially positive effects of short- and long-term interventions with WBV and RVE on variables related to blood coagulation, fibrinolysis, inflammatory status, oxidative stress, cardiovascular, microvascular and endothelial functions. No significant warning signs towards an increased risk of undesired clotting and venous thrombosis were identified. If confirmed by further studies, WBV and RVE could be part of the countermeasures aimed at preventing or attenuating the muscular and cardiovascular deconditioning associated with spaceflights, permanence on planetary habitats and ground-based simulations of microgravity.
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Affiliation(s)
| | | | | | - Katie M Harris
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Tobias Weber
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany
- KBR GmbH, Cologne, Germany
| | - David A Green
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany
- KBR GmbH, Cologne, Germany
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | - Lonnie G Petersen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tovy Haber Kamine
- Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Baystate Medical Center, Springfield, MA, USA
| | - Lara Roberts
- Kings College Hospital, NHS Foundation Trust, London, UK
| | - David S Kim
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Kelowna, Canada
| | - Danielle K Greaves
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Roopen Arya
- Kings College Hospital, NHS Foundation Trust, London, UK
| | | | - Antoine Elias
- Department of Vascular Medicine, Sainte Musse Hospital, Toulon La Seyne Hospital Centre, Toulon, France
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy.
| | - Nandu Goswami
- Division of Physiology, Otto Löwi Research Center for Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
- Mohammed Bin Rashid University of Medicine and Applied Health Sciences, Dubai, UAE
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Jinakote M, Yoysungnoen B, Vaddhanaphuti CS, Kasiyaphat A. Combined effects of whole-body vibration and dynamic squats on cardiovascular and salivary biomarker responses in healthy adults. J Exerc Rehabil 2023; 19:280-292. [PMID: 37928824 PMCID: PMC10622938 DOI: 10.12965/jer.2346340.170] [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: 07/18/2023] [Accepted: 08/12/2023] [Indexed: 11/07/2023] Open
Abstract
This study aimed to investigate the acute effects of combining whole-body vibration with dynamic squats on cardiovascular and salivary bio-marker responses in healthy adults. A randomized crossover design was conducted with 20 healthy adults. Each participant underwent three exercise sessions, with a 2-week washout period between each session. The sessions consisted of: (1) whole-body vibration (VB) at 25 Hz for 2 minutes, with an amplitude of 2 mm, and 2 minutes of rest between sets, for a total of 5 sets; (2) dynamic squats (SQ) performed 15 times within 2 minutes, with a 2-minute rest between sets, for a total of 5 sets; and (3) a combination of whole-body VB and SQ (VB+SQ). The cardiovascular variables and salivary biomarkers related to exercise intensity were assessed. Only the VB+SQ session significantly decreased the unstimulated salivary flow rate, and caused greater changes in heart rate, systolic blood pressure, mean arterial pressure, rate-pressure product, and heart rate variability compared to VB or SQ alone. Moreover, the VB+SQ session significantly increased the salivary total protein concentration from 0.56±0.05 mg/mL (baseline) to 0.74± 0.06 mg/mL (postexercise condition) and the salivary alpha-amylase activity from 33.83±5.56 U/mL (baseline) to 63.63±12.33 U/mL (postexercise condition) (P<0.05). These changes were recovered at 1-hr postexercise condition. Our findings provide information for designing exercise programs that incorporate VB+SQ to enhance hemodynamic and cardiac autonomic responses in healthy adults and for application during rehabilitation periods.
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Affiliation(s)
- Metee Jinakote
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Bhornprom Yoysungnoen
- Division of Physiology, Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathum Thani,
Thailand
| | | | - Atchareeya Kasiyaphat
- School of Human Kinetics and Health, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok,
Thailand
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Karatrantou K, Gerodimos V. Does Obesity Affect Neuromuscular and Cardiovascular Adaptations after a 3-Month Combined Exercise Program in Untrained Premenopausal Middle-Aged Women? Sports (Basel) 2023; 11:sports11040082. [PMID: 37104156 PMCID: PMC10140894 DOI: 10.3390/sports11040082] [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: 03/10/2023] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 04/28/2023] Open
Abstract
Previous studies indicated different acute adaptations between obese and lean individuals, while there is limited information with conflicting results regarding long-term adaptations. The aim of this study was to compare the efficacy of a 3-month integrated combined training between obese and lean middle-aged untrained premenopausal women. In total, 72 women (36 obese/36 lean) were divided into four groups: (a) obese exercise (OB-EG), (b) obese control (OB-CG), (c) lean exercise (L-EG), and (d) lean control (L-CG). The exercise groups followed a 3-month (3 times/week) integrated combined aerobic and strength training program. Health indices (body composition, body circumferences, blood pressure, respiratory function), functional capacity (flexibility, balance), and physical fitness (strength, aerobic capacity) were measured before and after the 3-month time period. Participants' enjoyment was also assessed following the program. OB-EG and L-EG significantly improved (p < 0.05) similarly across all functional capacity and physical fitness indices (10-76%; depending on the evaluation index), except balance and strength indices of the non-preferred limb where OB-EG showed greater improvement (reducing the existing pre-training strength/balance asymmetries) than L-EG. Furthermore, both obese and lean individuals showed similarly high levels of enjoyment. This program could be effectively used in fitness settings causing similar neuromuscular and cardiovascular adaptations in obese and lean women.
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Affiliation(s)
- Konstantina Karatrantou
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Vassilis Gerodimos
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
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Niewiadomski W, Gąsiorowska A, Żyliński M, Karbowniczek A, Cebrat J, Stępniewska A. Exaggerated pressor response to static squats in Parkinson's disease (PD) and healthy subjects is likely an individual trait, not influenced by whole body vibration (WBV). NeuroRehabilitation 2023; 52:289-298. [PMID: 36641689 PMCID: PMC9986697 DOI: 10.3233/nre-220234] [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: 01/12/2023]
Abstract
BACKGROUND Reduced muscle strength is one symptom of Parkinson's disease (PD). Strength can be increased by strength training, which may cause exaggerated blood pressure (BP) rise. It is believed that exercises performed on vibrating platform can strengthen leg muscles without excessive BP increase. OBJECTIVE To measure the pressor response to static exercises performed during whole body vibration in PD patients. METHODS Twenty-four aged PD patients and twelve healthy young volunteers participated in the study. PD subjects performed six repetitions of deep-, semi-squat, and calves at vibration frequency of 30 Hz. Each 30 s exercise was followed by 30 s rest. The young volunteers performed two sessions of above-mentioned exercises with and without vibration. BP was measured continuously. RESULTS In PD patients, the highest BP values were observed during deep squat; systolic blood pressure rose 10 mmHg in 'weak responders', and 50 mmHg in 'strong responders'. This difference correlated with the rise in pulse pressure suggesting indirectly the role of stoke volume in individual response. In healthy subjects pressor response was also individually differentiated and not influenced by vibration. CONCLUSION Deep and semi squat can evoke a strong cardiovascular response in some PD and healthy subjects. Low-magnitude vibrations likely did not affect pressor response.
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Affiliation(s)
- Wiktor Niewiadomski
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Gąsiorowska
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Marek Żyliński
- Institute of Metrology and Biomedical Engineering, Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | | | - Justyna Cebrat
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Stępniewska
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
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Boutou AK, Dipla K, Theodorakopoulou MP, Markopoulou K, Pitsiou G, Papadopoulos S, Kritikou S, Stanopoulos I, Zafeiridis A. Effects of oxygen supplementation in autonomic nervous system function during exercise in patients with idiopathic pulmonary fibrosis and exertional desaturation. CLINICAL RESPIRATORY JOURNAL 2021; 15:1088-1096. [PMID: 34143559 DOI: 10.1111/crj.13412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients with idiopathic pulmonary fibrosis (IPF) have reduced exercise capacity and often present exertional dyspnea and desaturation. The role of autonomic nervous system (ANS) as a pathogenetic contributor to this dysfunction has not been evaluated. OBJECTIVE To evaluate whether improvement of arterial oxygen saturation (SpO2 ) via oxygen supplementation results to ANS function improvement, during steady state submaximal exercise. METHODS This is a secondary analysis of a single-blind, randomized, placebo-controlled, cross-over trial, including 12 IPF patients, with isolated exertional desaturation. Following a maximal cardiopulmonary test, participants underwent two submaximal steady state tests during which they received either supplementary oxygen or medical air. Continuous beat-to-beat blood pressure measurements were recorded (Finapres Medical Systems, Amsterdam, The Netherlands). Autonomic function was assessed non-invasively by heart rate variability (HRV); root mean square of successive differences (RMSSD) and standard-deviation-Poincare-plot (SD1) were used as indices of parasympathetic output. Entropy and detrended fluctuation analysis (DFA) were also used. RESULTS During rest, oxygen supplementation did not significantly alter RMSSD and SD1. During exercise, subjects presented no significant alterations compared with baseline, in most HRV indices examined. There was no improvement of this behavior with O2 -supplementation. Approximate-entropy increased during exercise, with no differences between protocols. CONCLUSIONS IPF patients presented an inadequate adaptive response of their ANS to exercise and recovery. Although oxygen supplementation significantly prolonged exercise duration and prevented the substantial exertional desaturation, the blunted vagal response to steady-state exercise in these patients was not improved, suggesting that acute oxygen supplementation does not sufficiently improve ANS dysfunction in these patients.
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Affiliation(s)
- Afroditi K Boutou
- Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Katerina Markopoulou
- Department of Respiratory Medicine, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Georgia Pitsiou
- Department of Respiratory Failure, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Papadopoulos
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Kritikou
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Stanopoulos
- Department of Respiratory Failure, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dillon K, Shariffi B, Gillum T, Boyer W, Sullivan S, Kim JK. Effects of chronic dietary grape seed extract supplementation on aortic stiffness and hemodynamic responses in obese/overweight males during submaximal exercise. Eur J Sport Sci 2021; 22:1057-1064. [PMID: 33905304 DOI: 10.1080/17461391.2021.1923815] [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] [Indexed: 10/21/2022]
Abstract
We investigated the effect of chronic grape seed extract (GSE) on blood pressure and aortic stiffness (AoS) among overweight and obese males. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), stroke volume (SV), cardiac output (Q), total vascular conductance (TVC), and AoS were measured during two submaximal cycling exercises (40% and 60% VO2max), after 7 consecutive days of GSE or placebo (PL) ingestion with one week washout period. Compared with PL, GSE supplementation significantly decreased MAP at rest (85 ± 3 mmHg vs. 82 ± 3 mmHg), 40% (102 ± 3 mmHg vs. 99 ± 3 mmHg), and 60% workloads (109 ± 3 mmHg vs. 107 ± 3 mmHg) (P = 0.001, ES = 0.2). AoS was significantly reduced (13.0 ± 1.9 AU vs. 10.2 ± 1.0 AU) at rest (P = 0.002, ES = 0.6). Q was decreased at rest and across all workloads, but there were no significant differences (7.5 ± 0.4 L/min vs. 7.1 ± 0.4 L/min; 20.4 ± 1.2 L/min vs. 19.6 ± 0.9 L/min; 26.3 ± 1.1 L/min vs. 25.5 ± 1.6 L/min, respectively). GSE had no effect on HR, TVC, and SV. Our study indicates that chronic supplementation with GSE reduces arterial pressure at rest and during exercise primarily via the substantial reduction in AoS. Thus, GSE can be a dietary supplement to treat augmented blood pressure responses in obese and overweight males at rest and during exercise.Trial registration: ClinicalTrials.gov identifier: NCT04465110.
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Affiliation(s)
- Katherine Dillon
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Brian Shariffi
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Trevor Gillum
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - William Boyer
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Sean Sullivan
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Jong-Kyung Kim
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
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Boutou AK, Dipla K, Zafeiridis A, Markopoulou A, Papadopoulos S, Kritikou S, Panagiotidou E, Stanopoulos I, Pitsiou G. A randomized placebo-control trial of the acute effects of oxygen supplementation on exercise hemodynamics, autonomic modulation, and brain oxygenation in patients with pulmonary hypertension. Respir Physiol Neurobiol 2021; 290:103677. [PMID: 33957299 DOI: 10.1016/j.resp.2021.103677] [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: 12/25/2020] [Revised: 04/05/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The integrative physiological effects of O2 treatment on patients with pulmonary hypertension (PH) during exercise, have not been fully investigated. We simultaneously evaluated, for the first time, the effect of oxygen supplementation on hemodynamic responses, autonomic modulation, tissue oxygenation, and exercise performance in patients with pulmonary arterial hypertension (PAH)/Chronic Thromboembolic PH(CTEPH). MATERIAL-METHODS In this randomized, cross-over, placebo-controlled trial, stable outpatients with PAH/CTEPH underwent maximal cardiopulmonary exercise testing, followed by two submaximal trials, during which they received supplementary oxygen (O2) or medical-air. Continuous, non-invasive hemodynamics were monitored via photophlythesmography. Cerebral and quadriceps muscle oxygenation were recorded via near-infrared spectroscopy. Autonomic function was assessed by heart rate variability; root mean square of successive differences (RMSSD) and standard-deviation-Poincare-plot (SD1) were used as indices of parasympathetic output. Baroreceptor sensitivity (BRS) was assessed throughout the protocols. RESULTS Nine patients (51.4 ± 9.4 years) were included. With O2-supplementation patients exercised for longer (p = 0.01), maintained higher cerebral oxygenated hemoglobin (O2Hb;p = 0.02) levels, exhibited an amelioration in cortical deoxygenation (HHb;p = 0.02), and had higher average cardiac output (CO) during exercise (p < 0.05), compared to medical air; with no differences in muscle oxygenation. With O2-supplementation patients exhibited higher BRS and sample-entropy throughout the protocol (p < 0.05) vs. medical air, and improved the blunted RMSSD, SD1 responses during exercise (p = 0.024). CONCLUSION We show that O2 administration improves BRS and autonomic function during submaximal exercise in PAH/CTEPH, without significantly affecting muscle oxygenation. The improved autonomic function, along with enhancements in cardiovascular function and cerebral oxygenation, probably contributes to increased exercise tolerance with O2-supplementation in PH patients.
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Affiliation(s)
- Afroditi K Boutou
- Department of Respiratory Medicine, "G. Papanikolaou Hospital", Thessaloniki, Greece.
| | - Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | | | - Stavros Papadopoulos
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Stella Kritikou
- Exercise Physiology & Biochemistry Laboratory, Dept. of Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Evangelia Panagiotidou
- Respiratory Failure Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Greece
| | - Ioannis Stanopoulos
- Respiratory Failure Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Greece
| | - Georgia Pitsiou
- Respiratory Failure Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Greece
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Abstract
Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Regular exercise is important for a healthy pregnancy and can lower the risk of developing GDM. For women with GDM, exercise is safe and can affect the pregnancy outcomes beneficially. A single exercise bout increases skeletal muscle glucose uptake, minimizing hyperglycemia. Regular exercise training promotes mitochondrial biogenesis, improves oxidative capacity, enhances insulin sensitivity and vascular function, and reduces systemic inflammation. Exercise may also aid in lowering the insulin dose in insulin-treated pregnant women. Despite these benefits, women with GDM are usually inactive or have poor participation in exercise training. Attractive individualized exercise programs that will increase adherence and result in optimal maternal and offspring benefits are needed. However, as women with GDM have a unique physiology, more attention is required during exercise prescription. This review (i) summarizes the cardiovascular and metabolic adaptations due to pregnancy and outlines the mechanisms through which exercise can improve glycemic control and overall health in insulin resistance states, (ii) presents the pathophysiological alterations induced by GDM that affect exercise responses, and (iii) highlights cardinal points of an exercise program for women with GDM.
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Augmented Hemodynamic Responses in Obese Young Men during Dynamic Exercise: Role of the Muscle Metaboreflex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197321. [PMID: 33036416 PMCID: PMC7579031 DOI: 10.3390/ijerph17197321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 02/03/2023]
Abstract
Studies found that cardiovascular responses to exercise are enhanced in individuals with obesity and are associated with a greater cardiac output (CO) response compared to normal weight controls. However, the mechanisms underlying these altered responses during dynamic exercise are not clear. We investigated whether the cardiovascular responses mediated by the muscle metaboreflex (MMR) activation are augmented in obese men during both static and dynamic exercise. Twenty males (10 obese (OG) and 10 non-obese (NOG)) were studied. Changes in CO, mean arterial pressure (MAP), and total vascular conductance (TVC) were compared between the two groups during dynamic handgrip exercise (DHE), post-exercise muscular ischemia (PEMI), and dynamic exercise corresponding to 40%, 60% and 80% workloads. Subjects completed 2 min of DHE at 30% of MVC, followed by 2 min of PEMI. MAP, CO, and TVC responses to DHE and dynamic exercise were significantly higher in OG, whereas there were no differences during PEMI. Increases in CO and MAP during mild to heavy dynamic exercise were seen in both groups, but the changes in these variables were greater in the OG. There were no significant differences in TVC between the two groups. Compared to NOG, the augmented blood pressure response to DHE and dynamic exercise in OG was associated with a greater increase in CO. Thus, the augmented CO and MAP responses were not associated with the activation of the MMR. Consequently, additional factors specific to obesity, such as the mechanoreflex, may have been involved.
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Abstract
Hypertension is a fatal yet preventable risk factor for cardiovascular disease and is responsible for majority of cardiovascular mortality. Hypertension is closely associated with inactive lifestyle. Physical activity and/or exercise are shown to delay development of hypertension. Both aerobic and resistance exercise have been proven to reduce blood pressure (BP) effectively. Since brisk walking is an easy, inexpensive, simple, and effective way of exercise, this type of an aerobic workout can be recommended to society. All professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 min on at least 3 days of the week or resistance exercise on 2-3 days of the week. Exercise sessions can either be continuous for 30 min or be composed of at least 10 min of short exercise duration to a daily total of 30 min. After an exercise session, BP decreases, and this decline continues for up to 24 h; which is called post-exercise hypotension. Overall 5 mmHg decrease in BP with regular exercise may be ensured. With a decrease of 5 mmHg in systolic BP, mortality due to coronary heart disease decreases by 9%, mortality due to stroke decreases by 14% and all-cause mortality decreases by 7%. Regular exercise should therefore be recommended for all individuals including normotensives, prehypertensives, and hypertensives.
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Affiliation(s)
- Şeref Alpsoy
- Faculty of Medicine, Department of Cardiology, Namık Kemal University, Tekirdag, Turkey.
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Koletsos N, Dipla K, Triantafyllou A, Gkaliagkousi E, Sachpekidis V, Zafeiridis A, Douma S. A brief submaximal isometric exercise test 'unmasks' systolic and diastolic masked hypertension. J Hypertens 2019; 37:710-719. [PMID: 30817451 DOI: 10.1097/hjh.0000000000001943] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES An exaggerated blood pressure (BP) response during dynamic exercise testing has been proposed as an additional screening tool to identify systolic masked hypertension (masked-HYP). However, masked-HYP in young people is often characterized by an elevated DBP. Static/isometric exercise elicits augmented sympathetic stimulation causing greater increases in both SBP and DBP than dynamic exercise. AIMS To examine whether individuals with masked-HYP exhibit exaggerated BP responses during a submaximal handgrip vs. normotensive individuals and individuals with sustained hypertension (true-HYP), and the possible associations of exercise BP with total peripheral resistance (TPR), central/aortic BP, and 24-h-ambulatory BP (24-h BP). METHODS Eighty-six participants [untreated, newly diagnosed, masked-HYP (n = 27), true-HYP (n = 31), and normotensive individuals (n = 28); 46.3 ± 10.7 years], following evaluation of office BP, central/aortic BP, pulse wave velocity, carotid intima-media thickness, echocardiocardiography, and 24-h BP, underwent a 3-min handgrip (30% maximal voluntary contraction) with beat-by-beat BP and hemodynamics assessment (Finapres Medical Systems). RESULTS Despite similar baseline-BP in masked-HYP and normotensive individuals, during exercise masked-HYP exhibited a markedly greater (P < 0.01) SBP and DBP vs. normotensive individuals, and similar BP to true-HYP. TPR significantly increased (P < 0.001) during exercise, in masked-HYP and true-HYP. The exaggerated BP responses in masked-HYP were evident from the 1st minute of exercise and correlated (P < 0.05) with central/aortic-BP, aortic stiffness, 24-h BP, day-BP, night-time-BP, and interventricular septum thickness. CONCLUSION During handgrip, masked-HYP exhibited exaggerated BP and TPR responses, similar to those of true-HYP. These responses were evident from the 1st minute of exercise and correlated with 24-h BP, suggesting that systolic and diastolic masked-HYP can be 'unmasked' during a brief, submaximal, handgrip test.
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Affiliation(s)
| | - Konstantina Dipla
- Department of Sports Science at Serres, Exercise Physiology and Biochemistry Laboratory, Aristotle University of Thessaloniki
| | | | | | | | - Andreas Zafeiridis
- Department of Sports Science at Serres, Exercise Physiology and Biochemistry Laboratory, Aristotle University of Thessaloniki
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital
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Zafeiridis A, Triantafyllou A, Papadopoulos S, Koletsos N, Touplikioti P, Zafeiridis AS, Gkaliagkousi E, Dipla K, Douma S. Dietary nitrate improves muscle microvascular reactivity and lowers blood pressure at rest and during isometric exercise in untreated hypertensives. Microcirculation 2019; 26:e12525. [DOI: 10.1111/micc.12525] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Andreas Zafeiridis
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Areti Triantafyllou
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Stavros Papadopoulos
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Nikolaos Koletsos
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Alexandros S. Zafeiridis
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Eugenia Gkaliagkousi
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Stella Douma
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
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15
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Zago M, Capodaglio P, Ferrario C, Tarabini M, Galli M. Whole-body vibration training in obese subjects: A systematic review. PLoS One 2018; 13:e0202866. [PMID: 30183742 PMCID: PMC6124767 DOI: 10.1371/journal.pone.0202866] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/12/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE (i) to determine the outcomes of whole-body vibration training (WBVT) on obese individuals, and the intervention settings producing such effects; (ii) identify potential improper or harmful use of WBVT. DESIGN Systematic review. DATA SOURCES Medline, Scopus, Web of Science, PEDro and Scielo until July 2018. ELIGIBILITY CRITERIA Full papers evaluating the effect of WBVT on body composition, cardiovascular status and functional performance in obese adults. Papers with PEDro score<4 were excluded. STUDY APPRAISAL AND SYNTHESIS Risk of bias and quality of WBVT reporting were assessed with PEDro scale (randomized controlled trials) or TREND checklist (non-randomized studies) and a 14-items checklist, respectively. Weighted acceleration, daily exposure and Hedges' adjusted g were computed. RESULTS We included 18 papers published 2010-2017. Typical interventions consisted in three sessions/week of exercises (squats, calf-raises) performed on platforms vibrating at 25-40 Hz (amplitude: 1-2 mm); according to ISO 2631-1:1997, daily exposure was "unsafe" in 7/18 studies. Interventions lasting ≥6 weeks improved cardiac autonomic function and reduced central/peripheral arterial stiffness in obese women; 10 weeks of WBVT produced significant weight/fat mass reduction, leg strength improvements as resistance training, and enhanced glucose regulation when added to hypocaloric diet. No paper evidenced losses of lean mass. Isolated cases of adverse effects were reported. SUMMARY To date, WBVT is a promising adjuvant intervention therapy for obese women; long-term studies involving larger cohorts and male participants are required to demonstrate the associated safety and health benefits. The therapeutic use of WBVT in the management of obese patients is still not standardised and should be supported by an extensive knowledge on the causality between vibration parameters and outcomes.
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Affiliation(s)
- Matteo Zago
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano–Italy
- Fondazione Istituto Farmacologico “Filippo Serpero”, Milano–Italy
- * E-mail:
| | - Paolo Capodaglio
- Research Laboratory in Biomechanics and Rehabilitation, Orthopedic Rehabilitation Unit, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Cristina Ferrario
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano–Italy
- Dipartimento di Meccanica, Politecnico di Milano, Milano–Italy
| | - Marco Tarabini
- Dipartimento di Meccanica, Politecnico di Milano, Milano–Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano–Italy
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16
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Wong A, Figueroa A. Effects of whole-body vibration on heart rate variability: acute responses and training adaptations. Clin Physiol Funct Imaging 2018; 39:115-121. [PMID: 29775234 DOI: 10.1111/cpf.12524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 04/23/2018] [Indexed: 11/28/2022]
Abstract
Heart rate variability (HRV) is a noninvasive and practical measure of cardiac autonomic nervous system function, mainly the sympathetic and parasympathetic modulations of heart rate. A low HRV has been shown to be indicative of compromised cardiovascular health. Interventions that enhance HRV are therefore beneficial to cardiovascular health. Whole-body vibration (WBV) training has been proposed as an alternative time-efficient exercise intervention for the improvement of cardiovascular health. In this review, we discuss the effect of WBV both acute and after training on HRV. WBV training appears to be a useful therapeutic intervention to improve cardiac autonomic function in different populations, mainly through decreases in sympathovagal balance. Although the mechanisms by which WBV training improves symphathovagal balance are not yet well understood; enhancement of baroreflex sensitivity, nitric oxide bioavailability and angiotensin II levels seem to play an important role.
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Affiliation(s)
- Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, Virginia, USA
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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17
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The association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters in young Saudi females. J Taibah Univ Med Sci 2017; 13:51-57. [PMID: 31435302 PMCID: PMC6695083 DOI: 10.1016/j.jtumed.2017.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/30/2017] [Accepted: 05/07/2017] [Indexed: 12/31/2022] Open
Abstract
Objectives In this study, we assessed the possible association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters as intermediate risk factors for cardiovascular health in young Saudi women. Methods A total of 87 young healthy Saudi women were recruited in this cross-sectional study during 2014–2015. The body weight, height, waist and hip circumference, and plasma 25-hydroxyvitamin D (25[OH] D) levels were measured. The exercise stress test was performed to determine the pulse rate, blood pressure (BP), ECG, and VO2max. Multiple linear regression models were generated for the resting (r) and maximum (m) diastolic (D) and systolic (s) arterial BP and pulse rate (PR), adiposity markers, VO2max, and plasma levels of 25(OH) D. Results A multiple linear regression model was significant for the rDBP, mDBP, rSBP, and mSBP with adjusted R2 (6.5, 10.2, 8.3, and 4.5%, respectively). Except for VO2max in the mDBP model, none of the included risk factors were significant according to the t-test. Conclusion This study showed the association of high adiposity and decreased physical fitness with haemodynamic parameters in young Saudi women. An exaggerated exercise DBP might predict future cardiovascular risk in unfit young women.
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18
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Anyfanti P, Triantafyllidou E, Papadopoulos S, Triantafyllou A, Nikolaidis MG, Kyparos A, Vrabas IS, Douma S, Zafeiridis A, Dipla K. Smoking before isometric exercise amplifies myocardial stress and dysregulates baroreceptor sensitivity and cerebral oxygenation. ACTA ACUST UNITED AC 2017; 11:376-384. [DOI: 10.1016/j.jash.2017.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/02/2017] [Accepted: 04/05/2017] [Indexed: 11/15/2022]
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19
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Alvarez-Alvarado S, Jaime SJ, Ormsbee MJ, Campbell JC, Post J, Pacilio J, Figueroa A. Benefits of whole-body vibration training on arterial function and muscle strength in young overweight/obese women. Hypertens Res 2017; 40:487-492. [DOI: 10.1038/hr.2016.178] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/22/2022]
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