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Louis M, Hwang R, Sabapathy S, Roberts LA, Morris NR. High-Intensity Small Muscle Mass Training in Patients With Heart Failure: Rationale and Design of a Randomized Controlled Trial. Phys Ther 2024; 104:pzad130. [PMID: 37758445 DOI: 10.1093/ptj/pzad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/20/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Small muscle mass training localized to the quadriceps femoris muscle group has been proposed as an intervention to reverse heart failure-related skeletal muscle impairments. Although this training paradigm has demonstrated efficacy in heart failure, it remains to be evaluated in a conventional clinical context. Hence, the aim of this proposed study is to determine the effects of integrating high-intensity small muscle mass training (HISMT) isolated to the knee extensor muscles within a standard heart failure rehabilitation program. METHODS This single-blind, randomized controlled trial will aim to recruit 70 participants with heart failure. Participants will be randomized to either (1) standard training: combination of upper and lower extremity cardiovascular and resistance-based exercises, or (2) HISMT plus modified standard training: bilateral knee extensor HISMT and a modified version of the standard training, so that the total volume of work will be similar to standard training alone. The training interventions will be undertaken twice weekly for 12 weeks in an outpatient clinical setting. Outcome measurements will be performed at baseline and after the 12-week intervention period. The primary outcome will be exercise capacity (6-Minute Walk Test), with secondary outcomes being physical performance measures, muscle strength, and health-related quality of life. Data will be analyzed using the intention-to-treat principle. IMPACT This study will address a gap in the literature regarding the efficacy of small muscle training under routine clinical conditions for individuals with heart failure. The findings will also provide insight into the effects of HISMT within a heart failure rehabilitation program, thus enabling the optimization of exercise prescription for this patient population.
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Affiliation(s)
- Menaka Louis
- Chronic Disease and Post-Acute Programs, Gold Coast Hospital and Health Service, Robina Health Precinct, Robina, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Rita Hwang
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- Department of Physiotherapy, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Surendran Sabapathy
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Llion Arwyn Roberts
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Norman Rolston Morris
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- The Menzies Health Institute, Griffith University, Southport, Queensland, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, Queensland, Australia
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Gillet A, Forton K, Lamotte M, Macera F, Roussoulières A, Louis P, Ibrahim M, Dewachter C, van de Borne P, Deboeck G. Effects of High-Intensity Interval Training Using the 3/7 Resistance Training Method on Metabolic Stress in People with Heart Failure and Coronary Artery Disease: A Randomized Cross-Over Study. J Clin Med 2023; 12:7743. [PMID: 38137812 PMCID: PMC10743906 DOI: 10.3390/jcm12247743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
The 3/7 resistance training (RT) method involves performing sets with increasing numbers of repetitions, and shorter rest periods than the 3x9 method. Therefore, it could induce more metabolic stress in people with heart failure with reduced ejection fraction (HFrEF) or coronary artery disease (CAD). This randomized cross-over study tested this hypothesis. Eleven individuals with HFrEF and thirteen with CAD performed high-intensity interval training (HIIT) for 30 min, followed by 3x9 or 3/7 RT according to group allocation. pH, HCO3-, lactate, and growth hormone were measured at baseline, after HIIT, and after RT. pH and HCO3- decreased, and lactate increased after both RT methods. In the CAD group, lactate increased more (6.99 ± 2.37 vs. 9.20 ± 3.57 mmol/L, p = 0.025), pH tended to decrease more (7.29 ± 0.06 vs. 7.33 ± 0.04, p = 0.060), and HCO3- decreased more (18.6 ± 3.1 vs. 21.1 ± 2.5 mmol/L, p = 0.004) after 3/7 than 3x9 RT. In the HFrEF group, lactate, pH, and HCO3- concentrations did not differ between RT methods (all p > 0.248). RT did not increase growth hormone in either patient group. In conclusion, the 3/7 RT method induced more metabolic stress than the 3x9 method in people with CAD but not HFrEF.
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Affiliation(s)
- Alexis Gillet
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
- Department of Physiotherapy, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium;
- Research Unit in Rehabilitation Sciences, Faculty of Motor Skills Science, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Kevin Forton
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
- Department of Physiotherapy, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium;
| | - Michel Lamotte
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
- Department of Physiotherapy, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium;
| | - Francesca Macera
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
| | - Ana Roussoulières
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
| | - Pauline Louis
- Department of Physiotherapy, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium;
| | - Malko Ibrahim
- Research Unit in Rehabilitation Sciences, Faculty of Motor Skills Science, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Céline Dewachter
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Philippe van de Borne
- Department of Cardiology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles (H.U.B), Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; (A.G.); (K.F.); (M.L.); (F.M.); (A.R.); (C.D.); (P.v.d.B.)
| | - Gaël Deboeck
- Research Unit in Rehabilitation Sciences, Faculty of Motor Skills Science, Université Libre de Bruxelles, 1070 Brussels, Belgium;
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Mohammadian M, Choobineh A, Razeghi M, Daneshmandi H, Ghaem H, Kazemi R, Jahani Y, Hashemi Nejad N. Knee Extension Exercise Effects on Physiological and Psychophysical Performance: Normal Weight Versus Obese Office Workers. Workplace Health Saf 2023; 71:589-596. [PMID: 37530211 DOI: 10.1177/21650799231188133] [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] [Indexed: 08/03/2023]
Abstract
BACKGROUND Knee extension exercise is useful and practical for obese and overweight people as this form of exercise is effective in minimizing body weight loading on joints and improving the body's physiological function. This study aimed to compare the physiological and psychophysical parameters of office workers while computer-based working in an active workstation equipped with an active footrest (AFR) prototype with a mechanism for performing knee extension exercises in a sitting position, and also to compare the physiological and psychophysical parameters among normal-weight and obese office workers. METHODS In this quasi-experimental study, the physiological parameters of heart rate (HR) and energy expenditure (EE) (measured with the Fitbit Charge HR smartwatch) were measured in two cross-over random sessions for 32 office workers (16 normal-weight and 16 obese) aged 28 to 50 years (M = 42.72, standard deviation [SD] = 4.37) while performing office tasks in sitting and active workstations (equipped with AFR). Perceived physical exertion, comfort, fatigue, and liking were also measured by rating the participants. FINDINGS Short-term activity of the participants with AFR performing computer tasks significantly improved physiological and psychophysical parameters compared with the participants in sitting workstations. However, there was no significant difference in the effect of AFR on physiological and psychophysical parameters between normal-weight and obese participants. CONCLUSIONS/APPLICATION TO PRACTICE Given the significant increase in EE and HR resulting from exercise with AFR compared with the conventional workstation, the use of AFR can help office workers achieve the minimum standard of physical activity at their workplace.
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Affiliation(s)
- Mostafa Mohammadian
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences
| | - Alireza Choobineh
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences
| | - Mohsen Razeghi
- Department of Physiotherapy, Shiraz University of Medical Sciences
| | - Hadi Daneshmandi
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences
| | - Haleh Ghaem
- Department of Epidemiology, Shiraz University of Medical Sciences
| | - Reza Kazemi
- Ergonomics Department, Shiraz University of Medical Sciences
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences
| | - Naser Hashemi Nejad
- Occupational Health and Safety at Work Department, Kerman University of Medical Sciences
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Danduboyina A, Panjiyar BK, Borra SR, Panicker SS. Cardiovascular Benefits of Resistance Training in Patients With Heart Failure With Reduced Ejection Fraction: A Systematic Review. Cureus 2023; 15:e47813. [PMID: 38021681 PMCID: PMC10676736 DOI: 10.7759/cureus.47813] [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] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Cardiovascular diseases pose a serious problem for health globally. Among these, congestive heart failure is the leading cause of mortality and morbidity worldwide. According to the recent census, heart failure contributes to a huge financial burden annually. Exercise therapy is an integral part of the non-pharmacological management of heart failure. Due to the availability of various types of exercise therapies and rapid advancements in the existing evidence, it is often challenging to prescribe an appropriate exercise program. Although there is unequivocal evidence supporting the cardiovascular benefits of aerobic therapy, the incorporation of resistance training into exercise regimens should also be encouraged due to its effects on muscular endurance and ameliorating skeletal myopathy in heart failure. In this study, we used a systematic literature review (SLR) approach to give an overview of the current literature and highlight the cardiovascular benefits of resistance training, alone or in combination with aerobic training. We reviewed articles from well-recognized journals published between 2013 and 2023, finally narrowing down to nine selected papers for a thorough analysis. The inclusion criteria comprise studies dealing with heart failure with reduced ejection fraction (HFrEF), resistance training alone or in combination with aerobic therapy, and studies available for free in either the PubMed or Google Scholar databases. The systematic review revealed that resistance training in combination with aerobic therapy has greater cardiovascular benefits than either resistance or aerobic therapy alone. A few unique approaches, like periodic intermittent muscular exercise (PRIME) and super circuit training (SCT), have demonstrated an improvement in cardiac and non-cardiac clinical outcomes compared to conventional exercise therapies. Moreover, various factors, like lack of motivation and lack of time, contribute to poor adherence to exercise therapy. Approaches like telerehabilitation and designing exercise regimens with activities that patients enjoy have led to improvements in long-term adherence rates. Nevertheless, further exploration and research by conducting randomized controlled trials on a larger scale is essential to explore the potential of resistance training in the rehabilitation of patients with heart failure with reduced ejection fraction and to develop the most effective exercise therapy.
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Affiliation(s)
| | - Binay K Panjiyar
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Saatvika R Borra
- Department of Internal Medicine, Jawaharlal Nehru Medical College, Belagavi, IND
| | - Sourav S Panicker
- Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
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Gasser B, Wagner J, Schoch R, Schmidt-Trucksäss A. Skeletal muscle and heart failure - What is the relationship between central versus peripheral affections? Nutr Metab Cardiovasc Dis 2023; 33:1907-1913. [PMID: 37500344 DOI: 10.1016/j.numecd.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND AND AIM Heart failure is considered as a systemic disease as beside the heart, skeletal muscle is affected. METHODS AND RESULTS In this retrospective case-control study 64 men and 15 women with heart failure as well as an individually pairwise matched sample by sex, age and body mass index of healthy individuals from the COmPLETE cohort study performed an exhaustive cardiopulmonary exercise test, strength tests and anthropometric measurements. V̇O2peak was 28.6% lower in male and 24.6% lower in female patients with heart failure as compared to healthy controls. Strength parameters are significantly higher for counter movement jump in male subjects. In females, significant differences were detected for mid-thigh pull in healthy versus patients with heart failure. Skeletal muscle mass of patients was in male as well as female 3.7% lower than in controls. Furthermore, the function of skeletal muscle seems impaired as the ability to accelerate is significantly lower in affected male with a heart pathology. CONCLUSION It seems that severe affections (approx. 25 to 30%) on cardiocirculatory level are associated with moderate to low affections on functional and structural capacity on skeletal muscle level. Further, as in the male cohort with a heart pathology acceleration meaning 'fast' contracting is impaired, it is suggested, that the central limitations respectively the low perfusion of skeletal muscle over years yield to adaptions on muscle cell level ingoing with a decreased ability of fast contracting. It is therefore suggested, that the central circulatory limitations in patients with heart failure, respectively the low perfusion of skeletal muscle over years, promote maladaptation's in the periphery.
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Affiliation(s)
- Benedikt Gasser
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, Section Rehabilitative and Regenerative Sport Medicine, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland.
| | - Jonathan Wagner
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, Section Rehabilitative and Regenerative Sport Medicine, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Raphael Schoch
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, Section Rehabilitative and Regenerative Sport Medicine, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sport and Exercise Medicine, Section Rehabilitative and Regenerative Sport Medicine, University of Basel, Grosse Allee 6, CH-4052 Basel, Switzerland
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Gallagher H, Hendrickse PW, Pereira MG, Bowen TS. Skeletal muscle atrophy, regeneration, and dysfunction in heart failure: Impact of exercise training. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:557-567. [PMID: 37040849 PMCID: PMC10466197 DOI: 10.1016/j.jshs.2023.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/30/2022] [Accepted: 02/20/2023] [Indexed: 05/31/2023]
Abstract
This review highlights some established and some more contemporary mechanisms responsible for heart failure (HF)-induced skeletal muscle wasting and weakness. We first describe the effects of HF on the relationship between protein synthesis and degradation rates, which determine muscle mass, the involvement of the satellite cells for continual muscle regeneration, and changes in myofiber calcium homeostasis linked to contractile dysfunction. We then highlight key mechanistic effects of both aerobic and resistance exercise training on skeletal muscle in HF and outline its application as a beneficial treatment. Overall, HF causes multiple impairments related to autophagy, anabolic-catabolic signaling, satellite cell proliferation, and calcium homeostasis, which together promote fiber atrophy, contractile dysfunction, and impaired regeneration. Although both wasting and weakness are partly rescued by aerobic and resistance exercise training in HF, the effects of satellite cell dynamics remain poorly explored.
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Affiliation(s)
- Harrison Gallagher
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Paul W Hendrickse
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Marcelo G Pereira
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - T Scott Bowen
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK.
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Shafie N, Kordi N, Gadruni K, SalehFard Z, Jung F, Heidari N. Cardiac rehabilitation in coronary artery bypass grafting patients: Effect of eight weeks of moderate-intensity continuous training versus high-intensity interval training. Clin Hemorheol Microcirc 2023; 83:305-314. [PMID: 36683497 DOI: 10.3233/ch-221605] [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: 01/19/2023]
Abstract
BACKGROUND Physical training in patients with heart failure can affect hemodynamic, cardiac and angiogenesis parameters. OBJECTIVE The aim of the present study was to investigate the effects of traditional moderate-intensity rehabilitation training and interval training on some angiogenesis factors in coronary artery bypass graft (CABG) patients. METHODS Thirty CABG patients (mean age±SD, 55±3 years) were randomly assigned to one of three groups: high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) or the control group. After the initial assessments, eligible patients in the experimental groups (HIIT and MICT) performed exercise training for 8 weeks, while the control group did not. Angiogenesis and angiostatic indices, including pro-adrenomedullin (pro-ADM), basic fibroblast growth factor (bFGF), and endostatin, were then measured. RESULTS The results showed no significant difference between pro-ADM in the HIIT and MICT groups (P = 0.99), but a significant difference was found between MICT and the control group and between HIIT and the control group (P = 0.001). There is also no significant difference between the bFGF levels in the HIIT and MICT training groups (P = 1.00), but the changes in this factor between the training groups and the control group were significant (P = 0.001). There was a significant difference between the levels of endostatin in all three groups. CONCLUSIONS Two methods of cardiac rehabilitation (HIIT and MICT) may be useful for the recovery of patients with coronary artery bypass grafting. This improvement manifested itself in changes in angiogenesis and angiostatic indices in this study. However, more extensive studies are needed to investigate the effects of these two types of rehabilitation programs on other indicators of angiogenesis and angiostatic.
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Affiliation(s)
- Neda Shafie
- Department of Sport Physiology, Faculty of Sport Sciences, The University of Mazandaran, Babolsar, Iran
| | - Negin Kordi
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Keivan Gadruni
- Faculty of Physical Education, University of Tabriz, Tabriz, Iran; Kurdistan Education Office, Ministry of Education, Kurdistan, Iran; Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ziba SalehFard
- Department of Sport Physiology, School of Physical Education and Sport Sciences, Alzahra University, Tehran, Iran
| | - Friedrich Jung
- Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Naser Heidari
- Faculty of Sport Science, Shahid Rajaei Teacher Training University, Tehran, Iran
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8
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Skeletal muscle mitochondrial remodeling in heart failure: An update on mechanisms and therapeutic opportunities. Biomed Pharmacother 2022; 155:113833. [DOI: 10.1016/j.biopha.2022.113833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/22/2022] Open
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The Effects of Exercise Training on Mitochondrial Function in Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Int J Mol Sci 2022; 23:ijms232012559. [PMID: 36293409 PMCID: PMC9603958 DOI: 10.3390/ijms232012559] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
Mitochondria dysfunction is implicated in the pathogenesis of cardiovascular diseases (CVD). Exercise training is potentially an effective non-pharmacological strategy to restore mitochondrial health in CVD. However, how exercise modifies mitochondrial functionality is inconclusive. We conducted a systematic review using the PubMed; Scopus and Web of Science databases to investigate the effect of exercise training on mitochondrial function in CVD patients. Search terms included “mitochondria”, “exercise”, “aerobic capacity”, and “cardiovascular disease” in varied combination. The search yielded 821 records for abstract screening, of which 20 articles met the inclusion criteria. We summarized the effect of exercise training on mitochondrial morphology, biogenesis, dynamics, oxidative capacity, antioxidant capacity, and quality. Amongst these parameters, only oxidative capacity was suitable for a meta-analysis, which demonstrated a significant effect size of exercise in improving mitochondrial oxidative capacity in CVD patients (SMD = 4.78; CI = 2.99 to 6.57; p < 0.01), but with high heterogeneity among the studies (I2 = 75%, p = 0.003). Notably, aerobic exercise enhanced succinate-involved oxidative phosphorylation. The majority of the results suggested that exercise improves morphology and biogenesis, whereas findings on dynamic, antioxidant capacity, and quality, were inadequate or inconclusive. A further randomized controlled trial is clearly required to explain how exercise modifies the pathway of mitochondrial quantity and quality in CVD patients.
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Hearon CM, Samels M, Dias KA, MacNamara JP, Levine BD, Sarma S. Isolated knee extensor exercise training improves skeletal muscle vasodilation, blood flow, and functional capacity in patients with HFpEF. Physiol Rep 2022; 10:e15419. [PMID: 35924338 PMCID: PMC9350466 DOI: 10.14814/phy2.15419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 05/07/2023] Open
Abstract
Patients with HFpEF experience severe exercise intolerance due in part to peripheral vascular and skeletal muscle impairments. Interventions targeting peripheral adaptations to exercise training may reverse vascular dysfunction, increase peripheral oxidative capacity, and improve functional capacity in HFpEF. Determine if 8 weeks of isolated knee extension exercise (KE) training will reverse vascular dysfunction, peripheral oxygen utilization, and exercise capacity in patients with HFpEF. Nine HFpEF patients (66 ± 5 years, 6 females) performed graded IKE exercise (5, 10, and 15 W) and maximal exercise testing (cycle ergometer) before and after IKE training (3x/week, 30 min/leg). Femoral blood flow (ultrasound) and leg vascular conductance (LVC; index of vasodilation) were measured during graded IKE exercise. Peak pulmonary oxygen uptake (V̇O2 ; Douglas bags) and cardiac output (QC ; acetylene rebreathe) were measured during graded maximal cycle exercise. IKE training improved LVC (pre: 810 ± 417, post: 1234 ± 347 ml/min/100 mmHg; p = 0.01) during 15 W IKE exercise and increased functional capacity by 13% (peak V̇O2 during cycle ergometry; pre:12.4 ± 5.2, post: 14.0 ± 6.0 ml/min/kg; p = 0.01). The improvement in peak V̇O2 was independent of changes in Q̇c (pre:12.7 ± 3.5, post: 13.2 ± 3.9 L/min; p = 0.26) and due primarily to increased a-vO2 difference (pre: 10.3 ± 1.6, post: 11.0 ± 1.7; p = 0.02). IKE training improved vasodilation and functional capacity in patients with HFpEF. Exercise interventions aimed at increasing peripheral oxidative capacity may be effective therapeutic options for HFpEF patients.
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Affiliation(s)
- Christopher M. Hearon
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
- University of Texas Southwestern Medical CenterDepartment of Internal MedicineDallasTexasUSA
| | - Mitchel Samels
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
| | - Katrin A. Dias
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
- University of Texas Southwestern Medical CenterDepartment of Internal MedicineDallasTexasUSA
| | - James P. MacNamara
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
- University of Texas Southwestern Medical CenterDepartment of Internal MedicineDallasTexasUSA
| | - Benjamin D. Levine
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
- University of Texas Southwestern Medical CenterDepartment of Internal MedicineDallasTexasUSA
| | - Satyam Sarma
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital DallasDallasTexasUSA
- University of Texas Southwestern Medical CenterDepartment of Internal MedicineDallasTexasUSA
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Mohammadian M, Choobineh A, Razeghi M, Nejad NH, Karamooz-Ravari MR, Sheykhshoaei M, Kazemi R, Daneshmandi H. Designing and Usability testing of a New Prototype Active Footrest for Knee Extension Exercise Among Office Workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2492-2500. [PMID: 34789065 DOI: 10.1080/10803548.2021.2008183] [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: 10/19/2022]
Abstract
OBJECTIVES The active factor along with light exercise can reduce static muscle work and increase muscle flexibility and endurance. Accordingly, this study aimed to design and prototype a new active footrest, implemented in conventional sitting workstations and to test its usability among office workers. METHODS The steps taken to design and prototype the active footrest were a) selection of an exercise appropriate for goals of ergonomic interventions, b) idea development, c) selection of the best conceptual design, d) design with SOLIDWORKS version 2016 software, and e) fabrication of a prototype. Afterward, the usability of the active footrest prototype was assessed among 20 office workers (10 females) using field data by the System Usability Scale. RESULTS Upon the completion of the design steps, the active footrest prototype was prototyped by taking into account design criteria (e.g. functionality, inclusive design, easy application, and reduction of additional body movement), anthropometric data and mechanical properties. The participants rated the usability of the active workstation as 89 ± 8.21 (out of 100) and indicating good usability results. CONCLUSION In this study, an active footrest was designed and prototyped to perform knee extension exercise with the capability of being implemented in conventional sitting workstations.
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Affiliation(s)
| | - Alireza Choobineh
- Research Center for Health Sciences, Shiraz University of Medical Sciences, Iran
| | - Mohsen Razeghi
- Department of Physiotherapy, Shiraz University of Medical Sciences, Iran
| | - Naser Hashemi Nejad
- Occupational Health and Safety at Work Department, Kerman University of Medical Sciences, Iran
| | - M R Karamooz-Ravari
- Department of Design and Manufacturing Engineering, Graduate University of Advanced Technology, Iran
| | - Morteza Sheykhshoaei
- Department of Design and Manufacturing Engineering, Graduate University of Advanced Technology, Iran
| | - Reza Kazemi
- Ergonomics Department, Shiraz University of Medical Sciences, Iran
| | - Hadi Daneshmandi
- Research Center for Health Sciences, Shiraz University of Medical Sciences, Iran
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13
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Amin SB, Mugele H, Dobler FE, Marume K, Moore JP, Lawley JS. Intra-rater reliability of leg blood flow during dynamic exercise using Doppler ultrasound. Physiol Rep 2021; 9:e15051. [PMID: 34617675 PMCID: PMC8496156 DOI: 10.14814/phy2.15051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/24/2022] Open
Abstract
Developing an exercise model that resembles a traditional form of aerobic exercise and facilitates a complete simultaneous assessment of multiple parameters within the oxygen cascade is critically for understanding exercise intolerances in diseased populations. Measurement of muscle blood flow is a crucial component of such a model and previous studies have used invasive procedures to determine blood flow kinetics; however, this may not be appropriate in certain populations. Furthermore, current models utilizing Doppler ultrasound use isolated limb exercise and while these studies have provided useful data, the exercise model does not mimic the whole-body physiological response to continuous dynamic exercise. Therefore, we aimed to measure common femoral artery blood flow using Doppler ultrasound during continuous dynamic stepping exercise performed at three independent workloads to assess the within day and between-day reliability for such an exercise modality. We report a within-session coefficient of variation of 5.8% from three combined workloads and a between-day coefficient of variation of 12.7%. These values demonstrate acceptable measurement accuracy and support our intention of utilizing this noninvasive exercise model for an integrative assessment of the whole-body physiological response to exercise in a range of populations.
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Affiliation(s)
- Sachin B. Amin
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | - Hendrik Mugele
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | - Florian E. Dobler
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
| | | | | | - Justin S. Lawley
- Department Sport ScienceDivision of Performance Physiology and PreventionUniversity InnsbruckInnsbruckAustria
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14
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Tryfonos A, Tzanis G, Pitsolis T, Karatzanos E, Koutsilieris M, Nanas S, Philippou A. Exercise Training Enhances Angiogenesis-Related Gene Responses in Skeletal Muscle of Patients with Chronic Heart Failure. Cells 2021; 10:1915. [PMID: 34440684 PMCID: PMC8392138 DOI: 10.3390/cells10081915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/12/2021] [Accepted: 07/23/2021] [Indexed: 01/31/2023] Open
Abstract
Peripheral myopathy consists of a hallmark of heart failure (HF). Exercise enhanced skeletal muscle angiogenesis, and thus, it can be further beneficial towards the HF-induced myopathy. However, there is limited evidence regarding the exercise type that elicits optimum angiogenic responses of skeletal muscle in HF patients. This study aimed to (a) compare the effects of a high-intensity-interval-training (HIIT) or combined HIIT with strength training (COM) exercise protocol on the expression of angiogenesis-related factors in skeletal muscle of HF patients, and (b) examine the potential associations between the expression of those genes and capillarization in the trained muscles. Thirteen male patients with chronic HF (age: 51 ± 13 y; BMI: 27 ± 4 kg/m2) were randomly assigned to a 3-month exercise program that consisted of either HIIT (N = 6) or COM training (N = 7). Vastus lateralis muscle biopsies were performed pre- and post-training. RT-PCR was used to quantify the fold changes in mRNA expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR-2), hypoxia-inducible factor 1 alpha (HIF-1α), angiopoietin 1 (Ang-1), angiopoietin 2 (Ang-2), angiopoietin receptor (Tie2), and matrix metallopeptidase 9 (MMP-9), and immunohistochemistry to assess capillarization in skeletal muscle post-training. There was an overall increase in the expression levels of VEGF, VEGFR-2, HIF-1α, Ang2, and MMP9 post-training, while these changes were not different among groups. Changes in capillary-to-fibre ratio were found to be strongly associated with Tie2 and HIF-1α expression. This was the first study demonstrating that both HIIT and combined HIIT with strength training enhanced similarly the expression profile of angiogenic factors in skeletal muscle of HF patients, possibly driving the angiogenic program in the trained muscles, although those gene expression increases were found to be only partially related with muscle capillarization.
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Affiliation(s)
- Andrea Tryfonos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.T.); (M.K.)
| | - Giorgos Tzanis
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, Evaggelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (G.T.); (E.K.); (S.N.)
| | - Theodore Pitsolis
- First Department of Intensive Care, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Eleftherios Karatzanos
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, Evaggelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (G.T.); (E.K.); (S.N.)
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.T.); (M.K.)
| | - Serafim Nanas
- Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, Evaggelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece; (G.T.); (E.K.); (S.N.)
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.T.); (M.K.)
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15
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Malenfant S, Lebret M, Breton-Gagnon É, Potus F, Paulin R, Bonnet S, Provencher S. Exercise intolerance in pulmonary arterial hypertension: insight into central and peripheral pathophysiological mechanisms. Eur Respir Rev 2021; 30:200284. [PMID: 33853885 PMCID: PMC9488698 DOI: 10.1183/16000617.0284-2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/08/2020] [Indexed: 11/05/2022] Open
Abstract
Exercise intolerance is a cardinal symptom of pulmonary arterial hypertension (PAH) and strongly impacts patients' quality of life (QoL). Although central cardiopulmonary impairments limit peak oxygen consumption (V' O2peak ) in patients with PAH, several peripheral abnormalities have been described over the recent decade as key determinants in exercise intolerance, including impaired skeletal muscle (SKM) morphology, convective O2 transport, capillarity and metabolism indicating that peripheral abnormalities play a greater role in limiting exercise capacity than previously thought. More recently, cerebrovascular alterations potentially contributing to exercise intolerance in patients with PAH were also documented. Currently, only cardiopulmonary rehabilitation has been shown to efficiently improve the peripheral components of exercise intolerance in patients with PAH. However, more extensive studies are needed to identify targeted interventions that would ultimately improve patients' exercise tolerance and QoL. The present review offers a broad and comprehensive analysis of the present literature about the complex mechanisms and their interactions limiting exercise in patients and suggests several gaps in knowledge that need to be addressed in the future for a better understanding of exercise intolerance in patients with PAH.
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Affiliation(s)
- Simon Malenfant
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Marius Lebret
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Émilie Breton-Gagnon
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - François Potus
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
| | - Roxane Paulin
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Sébastien Bonnet
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Steeve Provencher
- Pulmonary Hypertension and Vascular Biology Research Group, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
- Dept of Medicine, Faculty of Medicine, Université Laval, Quebec City, Canada
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16
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Tickle PG, Hendrickse PW, Weightman A, Nazir MH, Degens H, Egginton S. Impaired skeletal muscle fatigue resistance during cardiac hypertrophy is prevented by functional overload- or exercise-induced functional capillarity. J Physiol 2021; 599:3715-3733. [PMID: 34107075 DOI: 10.1113/jp281377] [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: 01/16/2021] [Accepted: 06/04/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Capillary rarefaction is hypothesized to contribute to impaired exercise tolerance in cardiovascular disease, but it remains a poorly exploited therapeutic target for improving skeletal muscle performance. Using an abdominal aortic coarctation rat model of compensatory cardiac hypertrophy, we determine the efficacy of aerobic exercise for the prevention of, and mechanical overload for, restoration of hindlimb muscle fatigue resistance and microvascular impairment in the early stages of heart disease. Impaired muscle fatigue resistance was found after development of cardiac hypertrophy, but this impairment was prevented by low-intensity aerobic exercise and recovered after mechanical stretch due to muscle overload. Changes in muscle fatigue resistance were closely related to functional (i.e. perfused) microvascular density, independent of arterial blood flow, emphasizing the critical importance of optimal capillary diffusion for skeletal muscle function. Pro-angiogenic therapies are an important tool for improving skeletal muscle function in the incipient stages of heart disease. ABSTRACT Microvascular rarefaction may contribute to declining skeletal muscle performance in cardiac and vascular diseases. It remains uncertain to what extent microvascular rarefaction occurs in the earliest stages of these conditions, if impaired blood flow is an aggravating factor and whether angiogenesis restores muscle performance. To investigate this, the effects of aerobic exercise (voluntary wheel running) and functional muscle overload on the performance, femoral blood flow (FBF) and microvascular perfusion of the extensor digitorum longus (EDL) were determined in a chronic rat model of compensatory cardiac hypertrophy (CCH, induced by surgically imposed abdominal aortic coarctation). CCH was associated with hypertension (P = 0.001 vs. Control) and increased relative heart mass (P < 0.001). Immediately upon placing the aortic band (i.e. before development of CCH), post-fatigue test FBF was reduced (P < 0.003), coinciding with attenuated fatigue resistance (P = 0.039) indicating an acute arterial perfusion constraint on muscle performance. While FBF was normalized during CCH in chronic groups (P > 0.05) fatigue resistance remained reduced (P = 0.039) and was associated with reduced (P = 0.009) functional capillarity after development of CCH without intervention, indicating a microvascular limitation to muscle performance. Normalization of functional capillarity after aerobic exercise (P = 0.065) and overload (P = 0.329) in CCH coincided with restoration to control levels of muscle fatigue resistance (P > 0.999), although overload-induced EDL hypertrophy (P = 0.027) and wheel-running velocity and duration (both P < 0.05) were attenuated after aortic banding. These data show that reductions in skeletal muscle performance during CCH can be countered by improving functional capillarity, providing a therapeutic target to improve skeletal muscle function in chronic diseases.
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Affiliation(s)
- Peter G Tickle
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Paul W Hendrickse
- Department of Life Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Andrew Weightman
- Department of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, UK
| | - M Hakam Nazir
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Hans Degens
- Department of Life Sciences, Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Stuart Egginton
- School of Biomedical Sciences, University of Leeds, Leeds, UK
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17
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Sympathetic neural responses in heart failure during exercise and after exercise training. Clin Sci (Lond) 2021; 135:651-669. [DOI: 10.1042/cs20201306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 12/25/2022]
Abstract
Abstract
The sympathetic nervous system coordinates the cardiovascular response to exercise. This regulation is impaired in both experimental and human heart failure with reduced ejection fraction (HFrEF), resulting in a state of sympathoexcitation which limits exercise capacity and contributes to adverse outcome. Exercise training can moderate sympathetic excess at rest. Recording sympathetic nerve firing during exercise is more challenging. Hence, data acquired during exercise are scant and results vary according to exercise modality. In this review we will: (1) describe sympathetic activity during various exercise modes in both experimental and human HFrEF and consider factors which influence these responses; and (2) summarise the effect of exercise training on sympathetic outflow both at rest and during exercise in both animal models and human HFrEF. We will particularly highlight studies in humans which report direct measurements of efferent sympathetic nerve traffic using intraneural recordings. Future research is required to clarify the neural afferent mechanisms which contribute to efferent sympathetic activation during exercise in HFrEF, how this may be altered by exercise training, and the impact of such attenuation on cardiac and renal function.
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18
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Poole DC, Behnke BJ, Musch TI. The role of vascular function on exercise capacity in health and disease. J Physiol 2021; 599:889-910. [PMID: 31977068 PMCID: PMC7874303 DOI: 10.1113/jp278931] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
Three sentinel parameters of aerobic performance are the maximal oxygen uptake ( V ̇ O 2 max ), critical power (CP) and speed of the V ̇ O 2 kinetics following exercise onset. Of these, the latter is, perhaps, the cardinal test of integrated function along the O2 transport pathway from lungs to skeletal muscle mitochondria. Fast V ̇ O 2 kinetics demands that the cardiovascular system distributes exercise-induced blood flow elevations among and within those vascular beds subserving the contracting muscle(s). Ideally, this process must occur at least as rapidly as mitochondrial metabolism elevates V ̇ O 2 . Chronic disease and ageing create an O2 delivery (i.e. blood flow × arterial [O2 ], Q ̇ O 2 ) dependency that slows V ̇ O 2 kinetics, decreasing CP and V ̇ O 2 max , increasing the O2 deficit and sowing the seeds of exercise intolerance. Exercise training, in contrast, does the opposite. Within the context of these three parameters (see Graphical Abstract), this brief review examines the training-induced plasticity of key elements in the O2 transport pathway. It asks how structural and functional vascular adaptations accelerate and redistribute muscle Q ̇ O 2 and thus defend microvascular O2 partial pressures and capillary blood-myocyte O2 diffusion across a ∼100-fold range of muscle V ̇ O 2 values. Recent discoveries, especially in the muscle microcirculation and Q ̇ O 2 -to- V ̇ O 2 heterogeneity, are integrated with the O2 transport pathway to appreciate how local and systemic vascular control helps defend V ̇ O 2 kinetics and determine CP and V ̇ O 2 max in health and how vascular dysfunction in disease predicates exercise intolerance. Finally, the latest evidence that nitrate supplementation improves vascular and therefore aerobic function in health and disease is presented.
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Affiliation(s)
- David C Poole
- Departments of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, KS, 66506, USA
| | - Brad J Behnke
- Departments of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, KS, 66506, USA
| | - Timothy I Musch
- Departments of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, KS, 66506, USA
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19
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Exercise as a Therapeutic Strategy for Sarcopenia in Heart Failure: Insights into Underlying Mechanisms. Cells 2020; 9:cells9102284. [PMID: 33066240 PMCID: PMC7602002 DOI: 10.3390/cells9102284] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/16/2022] Open
Abstract
Sarcopenia, a syndrome commonly seen in elderly populations, is often characterized by a gradual loss of skeletal muscle, leading to the decline of muscle strength and physical performance. Growing evidence suggests that the prevalence of sarcopenia increases in patients with heart failure (HF), which is a dominant pathogenesis in the aging heart. HF causes diverse metabolic complications that may result in sarcopenia. Therefore, sarcopenia may act as a strong predictor of frailty, disability, and mortality associated with HF. Currently, standard treatments for slowing muscle loss in patients with HF are not available. Therefore, here, we review the pathophysiological mechanisms underlying sarcopenia in HF as well as current knowledge regarding the beneficial effects of exercise on sarcopenia in HF and related mechanisms, including hormonal changes, myostatin, oxidative stress, inflammation, apoptosis, autophagy, the ubiquitin-proteasome system, and insulin resistance.
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20
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Leardini-Tristão M, Andrade G, Garcia C, Reis PA, Lourenço M, Moreira ETS, Lima FRS, Castro-Faria-Neto HC, Tibirica E, Estato V. Physical exercise promotes astrocyte coverage of microvessels in a model of chronic cerebral hypoperfusion. J Neuroinflammation 2020; 17:117. [PMID: 32299450 PMCID: PMC7161182 DOI: 10.1186/s12974-020-01771-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/12/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Brain circulation disorders such as chronic cerebral hypoperfusion have been associated with a decline in cognitive function during the development of dementia. Astrocytes together with microglia participate in the immune response in the CNS and make them potential sentinels in the brain parenchyma. In addition, astrocytes coverage integrity has been related to brain homeostasis. Currently, physical exercise has been proposed as an effective intervention to promote brain function improvement. However, the neuroprotective effects of early physical exercise on the astrocyte communication with the microcirculation and the microglial activation in a chronic cerebral hypoperfusion model are still unclear. The aim of this study was to investigate the impact of early intervention with physical exercise on cognition, brain microcirculatory, and inflammatory parameters in an experimental model of chronic cerebral hypoperfusion induced by permanent bilateral occlusion of the common carotid arteries (2VO). METHODS Wistar rats aged 12 weeks were randomly divided into four groups: Sham-sedentary group (Sham-Sed), Sham-exercised group (Sham-Ex), 2VO-sedentary group (2VO-Sed), and 2VO-exercised group (2VO-Ex). The early intervention with physical exercise started 3 days after 2VO or Sham surgery during 12 weeks. Then, the brain functional capillary density and endothelial-leukocyte interactions were evaluated by intravital microscopy; cognitive function was evaluated by open-field test; hippocampus postsynaptic density protein 95 and synaptophysin were evaluated by western blotting; astrocytic coverage of the capillaries, microglial activation, and structural capillary density were evaluated by immunohistochemistry. RESULTS Early moderate physical exercise was able to normalize functional capillary density and reduce leukocyte rolling in the brain of animals with chronic cerebral hypoperfusion. These effects were accompanied by restore synaptic protein and the improvement of cognitive function. In addition, early moderate exercise improves astrocytes coverage in blood vessels of the cerebral cortex and hippocampus, decreases microglial activation in the hippocampus, and improves structural capillaries in the hippocampus. CONCLUSIONS Microcirculatory and inflammatory changes in the brain appear to be involved in triggering a cognitive decline in animals with chronic cerebral ischemia. Therefore, early intervention with physical exercise may represent a preventive approach to neurodegeneration caused by chronic cerebral hypoperfusion.
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Affiliation(s)
- Marina Leardini-Tristão
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Giulia Andrade
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Celina Garcia
- Laboratory of Glial Cell Biology, Biomedical Sciences Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patrícia A Reis
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Millena Lourenço
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Emilio T S Moreira
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Flavia R S Lima
- Laboratory of Glial Cell Biology, Biomedical Sciences Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hugo C Castro-Faria-Neto
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil
| | - Eduardo Tibirica
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Vanessa Estato
- Laboratory of Immunopharmacology, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-900, Brazil.
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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21
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22
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Bisconti AV, Cè E, Longo S, Venturelli M, Coratella G, Shokohyar S, Ghahremani R, Rampichini S, Limonta E, Esposito F. Evidence of Improved Vascular Function in the Arteries of Trained but Not Untrained Limbs After Isolated Knee-Extension Training. Front Physiol 2019; 10:727. [PMID: 31244682 PMCID: PMC6581732 DOI: 10.3389/fphys.2019.00727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2019] [Indexed: 01/22/2023] Open
Abstract
Vascular endothelial function is a strong marker of cardiovascular health and it refers to the ability of the body to maintain the homeostasis of vascular tone. The endothelial cells react to mechanical and chemical stimuli modulating the smooth muscle cells relaxation. The extent of the induced vasodilation depends on the magnitude of the stimulus. During exercise, the peripheral circulation is mostly controlled by the endothelial cells response that increases the peripheral blood flow in body districts involved but also not involved with exercise. However, whether vascular adaptations occur also in the brachial artery as a result of isolated leg extension muscles (KE) training is still an open question. Repetitive changes in blood flow occurring during exercise may act as vascular training for vessels supplying the active muscle bed as well as for the vessels of body districts not directly involved with exercise. This study sought to evaluate whether small muscle mass (KE) training would induce improvements in endothelial function not only in the vasculature of the lower limb (measured at the femoral artery level in the limb directly involved with training), but also in the upper limb (measured at the brachial artery level in the limb not directly involved with training) as an effect of repetitive increments in the peripheral blood flow during training sessions. Ten young healthy participants (five females, and five males; age: 23 ± 3 years; stature: 1.70 ± 0.11 m; body mass: 66 ± 11 kg; BMI: 23 ± 1 kg ⋅ m-2) underwent an 8-week KE training study. Maximum work rate (MWR), vascular function and peripheral blood flow were assessed pre- and post-KE training by KE ergometer, flow mediated dilatation (FMD) in the brachial artery (non-trained limb), and by passive limb movement (PLM) in femoral artery (trained limb), respectively. After 8 weeks of KE training, MWR and PLM increased by 44% (p = 0.015) and 153% (p = 0.003), respectively. Despite acute increase in brachial artery blood flow during exercise occurred (+25%; p < 0.001), endothelial function did not change after training. Eight weeks of KE training improved endothelial cells response only in the lower limb (measured at the femoral artery level) directly involved with training, likely without affecting the endothelial response of the upper limb (measured at the brachial artery level) not involved with training.
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Affiliation(s)
- Angela Valentina Bisconti
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States.,Geriatric Research, Education, and Clinical Centre, Veterans Affairs Medical Centre, Salt Lake City, UT, United States
| | - Emiliano Cè
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Stefano Longo
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Venturelli
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Coratella
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Sheida Shokohyar
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Reza Ghahremani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Susanna Rampichini
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
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23
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Cardiac adaptation to exercise training in health and disease. Pflugers Arch 2019; 472:155-168. [PMID: 31016384 DOI: 10.1007/s00424-019-02266-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/13/2019] [Accepted: 02/15/2019] [Indexed: 02/08/2023]
Abstract
The heart is the primary pump that circulates blood through the entire cardiovascular system, serving many important functions in the body. Exercise training provides favorable anatomical and physiological changes that reduce the risk of heart disease and failure. Compared with pathological cardiac hypertrophy, exercise-induced physiological cardiac hypertrophy leads to an improvement in heart function. Exercise-induced cardiac remodeling is associated with gene regulatory mechanisms and cellular signaling pathways underlying cellular, molecular, and metabolic adaptations. Exercise training also promotes mitochondrial biogenesis and oxidative capacity leading to a decrease in cardiovascular disease. In this review, we summarized the exercise-induced adaptation in cardiac structure and function to understand cellular and molecular signaling pathways and mechanisms in preclinical and clinical trials.
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24
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Barrett-O'Keefe Z, Lee JF, Ives SJ, Trinity JD, Witman MAH, Rossman MJ, Groot HJ, Sorensen JR, Morgan DE, Nelson AD, Stehlik J, Richardson RS, Wray DW. α-Adrenergic receptor regulation of skeletal muscle blood flow during exercise in heart failure patients with reduced ejection fraction. Am J Physiol Regul Integr Comp Physiol 2019; 316:R512-R524. [PMID: 30789790 DOI: 10.1152/ajpregu.00345.2018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patients suffering from heart failure with reduced ejection fraction (HFrEF) experience impaired limb blood flow during exercise, which may be due to a disease-related increase in α-adrenergic receptor vasoconstriction. Thus, in eight patients with HFrEF (63 ± 4 yr) and eight well-matched controls (63 ± 2 yr), we examined changes in leg blood flow (Doppler ultrasound) during intra-arterial infusion of phenylephrine (PE; an α1-adrenergic receptor agonist) and phentolamine (Phen; a nonspecific α-adrenergic receptor antagonist) at rest and during dynamic single-leg knee-extensor exercise (0, 5, and 10 W). At rest, the PE-induced reduction in blood flow was significantly attenuated in patients with HFrEF (-15 ± 7%) compared with controls (-36 ± 5%). During exercise, the controls exhibited a blunted reduction in blood flow induced by PE (-12 ± 4, -10 ± 4, and -9 ± 2% at 0, 5, and 10 W, respectively) compared with rest, while the PE-induced change in blood flow was unchanged compared with rest in the HFrEF group (-8 ± 5, -10 ± 3, and -14 ± 3%, respectively). Phen administration increased leg blood flow to a greater extent in the HFrEF group at rest (+178 ± 34% vs. +114 ± 28%, HFrEF vs. control) and during exercise (36 ± 6, 37 ± 7, and 39 ± 6% vs. 13 ± 3, 14 ± 1, and 8 ± 3% at 0, 5, and 10 W, respectively, in HFrEF vs. control). Together, these findings imply that a HFrEF-related increase in α-adrenergic vasoconstriction restrains exercising skeletal muscle blood flow, potentially contributing to diminished exercise capacity in this population.
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Affiliation(s)
| | - Joshua F Lee
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah
| | - Stephen J Ives
- Department of Exercise and Sport Science, University of Utah , Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Melissa A H Witman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Kinesiology and Applied Physiology, University of Delaware , Newark, Delaware
| | - Matthew J Rossman
- Department of Exercise and Sport Science, University of Utah , Salt Lake City, Utah
| | - H Jon Groot
- Department of Exercise and Sport Science, University of Utah , Salt Lake City, Utah
| | - Jacob R Sorensen
- Department of Exercise and Sport Science, University of Utah , Salt Lake City, Utah
| | - David E Morgan
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Ashley D Nelson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Josef Stehlik
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - D Walter Wray
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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25
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Engineer A, Albers SS, Kucey AS. The role of submaximal exercise-induced skeletal muscle remodelling in heart failure with reduced ejection fraction patients. J Physiol 2018; 597:669-671. [PMID: 30488441 DOI: 10.1113/jp277307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Anish Engineer
- Department of Physiology and Pharmacology, Western University, London, Canada
| | - Shawn S Albers
- School of Medicine, University College Cork, Cork, Ireland
| | - Andrew S Kucey
- School of Medicine, University College Cork, Cork, Ireland
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