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Soares LL, Leite LB, Freitas MO, Ervilha LOG, Píccolo MS, Portes AMO, Drummond FR, Rezende LMTDE, Neves MM, Reis ECC, Carneiro-Júnior MA, Natali AJ. Effect of experimental pulmonary arterial hypertension on renal and bone parameters of rats submitted to resistance exercise training. AN ACAD BRAS CIENC 2024; 96:e20230446. [PMID: 38655920 DOI: 10.1590/0001-3765202420230446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/01/2023] [Indexed: 04/26/2024] Open
Abstract
Pulmonary arterial hypertension (PAH) is characterized by right ventricular failure and diminished cardiac output, potentially leading to renal and bone impairments. In contrast, resistance exercise training (RT) offers cardiovascular and bone health benefits. This study aimed to assess the impacts of stable PAH induced by monocrotaline (MCT) and RT on renal morphometry, as well as bone morphometry and biomechanical properties in male Wistar rats. Four experimental groups, untrained control (UC, n=7), trained control (TC, n=7), untrained hypertensive (UH, n=7), trained hypertensive (TH, n=7), were defined. After the first MCT or saline injection (20 mg/kg), trained rats were submitted to a RT program (i.e., Ladder climbing), 5 times/week. Seven days later the rats received the second MCT or saline dose. After euthanasia, renal and femoral histomorphometry and femoral biomechanical properties were assessed. PAH reduced renal glomerular area and volume, which was prevented by the RT. While PAH did not harm the femoral morphometry, structural and mechanical properties, RT improved the femoral parameters (e.g., length, percentage of trabeculae and bone marrow, ultimte and yield loads). Experimental stable PAH promotes renal but not bone damages, whereas RT prevents renal deteriorations and improves the femoral morphological and biomechanical properties.
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Affiliation(s)
- Leôncio L Soares
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Luciano B Leite
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Maíra O Freitas
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Luiz Otávio G Ervilha
- Federal University of Viçosa, Department of General Biology, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Mayra S Píccolo
- Federal University of Viçosa, Department of Biochemistry and Molecular Biology, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Alexandre M O Portes
- Federal University of Ouro Preto, Department of Pharmacology, Professor Paulo Magalhães Gomes Street, 122, Bauxita, 35400-000 Ouro Preto, MG, Brazil
| | - Filipe R Drummond
- Federal University of Viçosa, Department of General Biology, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Leonardo Mateus T DE Rezende
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Mariana M Neves
- Federal University of Viçosa, Department of General Biology, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Emily C C Reis
- Federal University of Viçosa, Department of Veterinary, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Miguel A Carneiro-Júnior
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
| | - Antônio José Natali
- Federal University of Viçosa, Department of Physical Education, Av. PH Rolfs, s/n, University Campus, Center, 36570-900 Viçosa, MG, Brazil
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Drummond FR, Soares LL, Leal TF, Leite LB, Rezende LMT, Fidelis MR, Lavorato VN, Miranda DC, Carneiro-Júnior MA, Neves MM, Alberici LC, Carlo Reis EC, Neves CA, Natali AJ. Effects of voluntary running on the skeletal muscle of rats with pulmonary artery hypertension. Front Physiol 2023; 14:1206484. [PMID: 37469567 PMCID: PMC10352770 DOI: 10.3389/fphys.2023.1206484] [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: 04/15/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
The effects of voluntary running on the skeletal muscle of rats with pulmonary arterial hypertension (PAH) were tested in the present study. PAH was induced in rats by a single injection of monocrotaline (MCT, 60 mg/kg). Rats in the sedentary hypertension (HS) group had their tolerance to physical exertion reduced throughout the experiment, while those in the sedentary control (SC), exercise control (EC), exercise hypertension (EH) and median exercise (EM) groups maintained or increased. Despite that, the muscular citrate synthase activity was not different between groups. The survival time was higher in the EH (32 days) than in the SH (28 days) (p = 0.0032). SH and EH groups showed a lower percentage of muscle fiber and a higher percentage of extracellular matrix compared to control groups (p < 0.0001). However, the EM and EH groups presented higher percentage of muscle fiber and lower percentage of extracellular matrix than SH group (p < 0.0001). Regarding muscular gene expression, the SH and EM groups showed a lower expression of PGC1-α (p = 0.0024) and a higher expression of VEGF (p = 0.0033) compared to SC, while PGC1-α was elevated in the EH. No difference between groups was found for the carbonylated protein levels (p > 0.05), while the TNF-α/IL-10 ratio was augmented in the EH (p = 0.0277). In conclusion, voluntary running augments the proportion of fiber and affects the gene expression of inflammatory and mitochondrial biogenesis' markers in the skeletal muscle of rats with MCT-induced PAH, which benefits their survival and tolerance to physical effort.
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Affiliation(s)
- Filipe Rios Drummond
- Department of General Biology, Laboratory of Structural Biology, Federal University of Viçosa, Viçosa, Brazil
| | - Leôncio Lopes Soares
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, Brazil
| | - Tiago Ferreira Leal
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, Brazil
| | - Luciano Bernardes Leite
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, Brazil
| | | | - Meilene Ribeiro Fidelis
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, Brazil
| | - Victor Neiva Lavorato
- Department of Physical Education, Governador Ozanam Coelho University Center (UNIFAGOC), Ubá, Minas Gerais, Brazil
| | - Denise Coutinho Miranda
- Department of Physical Education, Governador Ozanam Coelho University Center (UNIFAGOC), Ubá, Minas Gerais, Brazil
| | | | - Mariana Machado Neves
- Department of General Biology, Laboratory of Structural Biology, Federal University of Viçosa, Viçosa, Brazil
| | - Luciane Carla Alberici
- Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of Sao Paulo, Ribeirão Preto, Brazil
| | | | - Clovis Andrade Neves
- Department of General Biology, Laboratory of Structural Biology, Federal University of Viçosa, Viçosa, Brazil
| | - Antônio José Natali
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, Brazil
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Drummond FR, Leite LB, de Miranda DC, Drummond LR, Lavorato VN, Soares LL, Neves CA, Natali AJ. Skeletal muscle dysfunctions in pulmonary arterial hypertension: Effects of aerobic exercise training. Front Physiol 2023; 14:1148146. [PMID: 37035672 PMCID: PMC10076612 DOI: 10.3389/fphys.2023.1148146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Pulmonary arterial hypertension is associated with skeletal muscle myopathy and atrophy and impaired exercise tolerance. Aerobic exercise training has been recommended as a non-pharmacological therapy for deleterious effects imposed by pulmonary arterial hypertension. Aerobic physical training induces skeletal muscle adaptations via reduced inflammation, improved anabolic processes, decreased hypoxia and regulation of mitochondrial function. These benefits improve physical exertion tolerance and quality of life in patients with pulmonary arterial hypertension. However, the mechanisms underlying the therapeutic potential of aerobic exercise to skeletal muscle disfunctions in patients with pulmonary arterial hypertension are not well understood yet. This minireview highlights the pathways involved in skeletal muscle adaptations to aerobic exercise training in patients with pulmonary arterial hypertension.
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Affiliation(s)
- Filipe Rios Drummond
- Department of General Biology, Laboratory of Structural Biology, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Luciano Bernardes Leite
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, MG, Brazil
- *Correspondence: Luciano Bernardes Leite,
| | - Denise Coutinho de Miranda
- Department of Biological Sciences, Laboratory of Cell Signaling, Federal University of Ouro Preto, Viçosa, MG, Brazil
- Department of Physical Education, Governador Ozanam Coelho University Center (UNIFAGOC), Ubá, Brazil
| | - Lucas Rios Drummond
- Department of Physiology and Biophysics, Laboratory of Endocrinology and Metabolism, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Victor Neiva Lavorato
- Department of Physical Education, Governador Ozanam Coelho University Center (UNIFAGOC), Ubá, Brazil
| | - Leôncio Lopes Soares
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, MG, Brazil
| | - Clóvis Andrade Neves
- Department of General Biology, Laboratory of Structural Biology, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Antônio José Natali
- Department of Physical Education, Laboratory of Exercise Biology Federal University of Viçosa, Viçosa, MG, Brazil
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Neder JA, Phillips DB, O'Donnell DE, Dempsey JA. Excess ventilation and exertional dyspnoea in heart failure and pulmonary hypertension. Eur Respir J 2022; 60:13993003.00144-2022. [PMID: 35618273 DOI: 10.1183/13993003.00144-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/05/2022] [Indexed: 01/11/2023]
Abstract
Increased ventilation relative to metabolic demands, indicating alveolar hyperventilation and/or increased physiological dead space (excess ventilation), is a key cause of exertional dyspnoea. Excess ventilation has assumed a prominent role in the functional assessment of patients with heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction, pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). We herein provide the key pieces of information to the caring physician to 1) gain unique insights into the seeds of patients' shortness of breath and 2) develop a rationale for therapeutically lessening excess ventilation to mitigate this distressing symptom. Reduced bulk oxygen transfer induced by cardiac output limitation and/or right ventricle-pulmonary arterial uncoupling increase neurochemical afferent stimulation and (largely chemo-) receptor sensitivity, leading to alveolar hyperventilation in HFrEF, PAH and small-vessel, distal CTEPH. As such, interventions geared to improve central haemodynamics and/or reduce chemosensitivity have been particularly effective in lessening their excess ventilation. In contrast, 1) high filling pressures in HFpEF and 2) impaired lung perfusion leading to ventilation/perfusion mismatch in proximal CTEPH conspire to increase physiological dead space. Accordingly, 1) decreasing pulmonary capillary pressures and 2) mechanically unclogging larger pulmonary vessels (pulmonary endarterectomy and balloon pulmonary angioplasty) have been associated with larger decrements in excess ventilation. Exercise training has a strong beneficial effect across diseases. Addressing some major unanswered questions on the link of excess ventilation with exertional dyspnoea under the modulating influence of pharmacological and nonpharmacological interventions might prove instrumental to alleviate the devastating consequences of these prevalent diseases.
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Affiliation(s)
- J Alberto Neder
- Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Devin B Phillips
- Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Denis E O'Donnell
- Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, Dept of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Re F, Halasz G, Moroni F, Beltrami M, Baratta P, Avella A, Zachara E, Olivotto I. Exercise-induced pulmonary hypertension in hypertrophic cardiomyopathy: a combined cardiopulmonary exercise test—echocardiographic study. Int J Cardiovasc Imaging 2022; 38:2345-2352. [DOI: 10.1007/s10554-022-02671-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/02/2022] [Indexed: 11/05/2022]
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Lunardi M, Wu S, Serruys PW, Onuma Y, Soliman O, Wijns W, Mullens W, Sharif F. Acute and chronic exercise training in patients with Class II pulmonary hypertension: effects on haemodynamics and symptoms. ESC Heart Fail 2022; 9:791-799. [PMID: 35132779 PMCID: PMC8934934 DOI: 10.1002/ehf2.13819] [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: 04/17/2021] [Revised: 12/10/2021] [Accepted: 01/17/2022] [Indexed: 11/24/2022] Open
Abstract
More than half of heart failure (HF) patients have concomitant pulmonary hypertension, impacting symptoms and prognosis. The role of exercise in this category of patients is still unclear, probably because of the lack of a clear relationship between exercise and acute and chronic pulmonary artery pressure variations and related changes in symptoms. The limited evidence on this topic is contradictory and hardly comparable due to use of different exercise programmes and pulmonary artery pressure assessment techniques. This is further compounded by different functional and structural classes of HF making definite assessments and interpretations of exercise effect on outcomes difficult. Exercise training programmes were proven beneficial in HF patients; however, the lack of data about their pulmonary haemodynamic effects prevents clear indications on the best exercise types for patients presenting secondary pulmonary hypertension and different HF categories. Indeed, some data suggest that not all HF patients have similar responses to training, leading to either beneficial or detrimental effects, depending on the HF type. Future studies, involving modern technologies such as continuous pulmonary artery pressure monitoring implantable devices, may clarify the current gaps in this field, aiming at patient‐tailored exercise training rehabilitation programmes, in order to improve clinical outcomes, quality of life, and hopefully prognosis.
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Affiliation(s)
- Mattia Lunardi
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland.,Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Sijing Wu
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland.,Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Patrick W Serruys
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland.,International Centre for Circulatory Health, NHLI, Imperial College, London, UK
| | - Yoshinobu Onuma
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland
| | - Osama Soliman
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland
| | - William Wijns
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland.,The Lambe Institute for Translational Medicine and CURAM, National University of Ireland Galway (NUIG), Galway, Ireland
| | - Wilfried Mullens
- Department of Cardiovascular Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Faisal Sharif
- Department of Cardiology, Saolta Group, Galway University Hospital, Health Service Executive and National University of Ireland Galway (NUIG), Galway, Ireland
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Romer LM. Respiratory influences on oxygen transport and exercise performance in health and disease. Exp Physiol 2020; 105:1977-1978. [PMID: 33372725 DOI: 10.1113/ep089199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Lee M Romer
- Centre for Human Performance, Exercise and Rehabilitation, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UK
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