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Debray A, Enea C, Ravanelli N, Chaseling GK, Gravel H, Bosquet L, Bherer L, Gagnon D. Comparison of Blood Pressure and Vascular Health in Physically Active Late Pre- and Early Postmenopausal Females. Med Sci Sports Exerc 2022; 54:1066-1075. [PMID: 35704437 DOI: 10.1249/mss.0000000000002887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The benefits of exercise on vascular health are inconsistent in postmenopausal females. We investigated if blood pressure and markers of vascular function differ between physically active early post- and late premenopausal females. METHODS We performed a cross-sectional comparison of 24-h blood pressure, brachial artery flow-mediated dilation, microvascular reactivity (reactive hyperemia), carotid-femoral pulse wave velocity, and cardiac baroreflex sensitivity between physically active late premenopausal (n = 16, 48 ± 2 yr) and early postmenopausal (n = 14, 53 ± 2 yr) females. RESULTS Physical activity level was similar between premenopausal (490 ± 214 min·wk-1) and postmenopausal (550 ± 303 min·wk-1) females (P = 0.868). Brachial artery flow-mediated dilation (pre, 4.6 ± 3.9, vs post, 4.7% ± 2.2%; P = 0.724), 24-h systolic (+5 mm Hg, 95% confidence interval [CI] = -1 to +10, P = 0.972) and diastolic (+4 mm Hg, 95% CI = -1 to +9, P = 0.655) blood pressures, total reactive hyperemia (pre, 1.2 ± 0.5, vs post, 1.0 ± 0.5 mL·mm Hg-1; P = 0.479), carotid-femoral pulse wave velocity (pre, 7.9 ± 1.7, vs post, 8.1 ± 1.8 m·s-1; P = 0.477), and cardiac baroreflex sensitivity (-8 ms·mm Hg-1, 95% CI = -20.55 to 4.62, P = 0.249) did not differ between groups. By contrast, peak reactive hyperemia (-0.36 mL·min-1⋅mm Hg-1, 95% CI = -0.87 to +0.15, P = 0.009) was lower in postmenopausal females. CONCLUSIONS These results suggest that blood pressure and markers of vascular function do not differ between physically active late pre- and early postmenopausal females.
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Affiliation(s)
| | - Carina Enea
- Laboratoire Mobilité Vieillissement et Exercice, Université de Poitiers, Poitiers, FRANCE
| | | | | | - Hugo Gravel
- Montreal Heart Institute, Montreal, QC, CANADA
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2
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Age- and sex-related profiles for macro, macro/micro and microvascular reactivity indexes: Association between indexes and normative data from 2609 healthy subjects (3-85 years). PLoS One 2021; 16:e0254869. [PMID: 34280235 PMCID: PMC8289111 DOI: 10.1371/journal.pone.0254869] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023] Open
Abstract
Vascular reactivity (VR), defined as blood vessels’ capability to actively modify the diameter and flow resistances can be non-invasively assessed analyzing vascular response to forearm occlusion. Several VR indexes can be quantified: (i) ´microvascular´, which consider variables that depend almost exclusively on changes in distal resistances, (ii)´ macrovascular´, that evaluate the changes in brachial artery (BA) diameter, adjusting for blood flow stimulus, and (iii) ´macro/micro´, whose values depend on the micro and macrovascular response without discriminating each one´s contribution. VR indexes could not be associated. Many VR indexes have been used without availability of adequate normative data (reference intervals, RIs). Aims: (1) to evaluate macro, macro/micro and micro VR indexes obtained in a cohort of healthy children, adolescents and adults, (2) to evaluate the association between VR indexes, (3) to determine the need for age and/or sex-specific RIs, and (4) to define RIs for VR indexes. Methods: Ultrasound (B-mode/Doppler) and automatic computerized analysis were used to assess BA diameter, blood flow velocity and distal resistances, at rest and in conditions of decreased and increased blood flow. Macro, macro/micro and micro VR indexes were quantified (n = 3619). RIs-subgroups were defined according to European Reference Values for Arterial Measurements Collaboration Group (n = 1688, 3–84 years) and HUNT3-Fitness Study Group (n = 2609, 3–85 years) criteria. Mean value and standard deviation equations were obtained for VR indexes. The need for age or sex-specific RIs was analyzed. Percentile curves were defined and data were compared with those obtained in other populations. Conclusion: Macro and macro/micro VR indexes showed no association (or it was very weak) with microvascular indexes. Age- and sex-related profiles and RIs for macro, macro/micro and micro VR indexes were defined in a large population of healthy subjects (3–85 y). Equations for mean, standard deviation and percentiles values (year-to-year) were included in text and spreadsheet formats.
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3
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Boidin M, Erskine RM, Thijssen DHJ, Dawson EA. Exercise modality, but not exercise training, alters the acute effect of exercise on endothelial function in healthy men. J Appl Physiol (1985) 2021; 130:1716-1723. [PMID: 33955262 DOI: 10.1152/japplphysiol.00004.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We used a within-subject crossover design to examine the impact of exercise modality, i.e., resistance (RT) and endurance (END), on the acute impact of exercise on endothelial function. Then, we examined whether a 4-wk period of chronic exercise training altered the acute exercise-induced change in endothelial function in healthy individuals. Thirty-four healthy, young men (21 ± 2 yr) reported to our laboratory and completed assessment of endothelial function [using the brachial artery flow-mediated dilation test (FMD)] before and immediately after a single bout of RT (leg-extension) or END (cycling). Subsequently, participants completed a 4-wk period of training (12 sessions), followed by evaluation of the FMD before and after a single bout of exercise. Following a 3-wk washout, participants repeated these experiments with the different exercise modality (in a balanced crossover design). An exercise × modality interaction effect was found (P < 0.001). Post hoc pairwise analyses revealed a decrease in FMD after END (P < 0.001) but not after RT (P = 0.06). Four weeks of exercise training improved resting FMD after END and RT (P = 0.04) but did not alter the acute effect of exercise on FMD (exercise × modality × training effect: P = 0.63), an effect independent of the modality of exercise (exercise × training interaction: P = 0.46 and P = 0.11 in RT and END, respectively). These distinct changes in FMD following acute exercise may relate to the different prolonged physiological responses induced by endurance versus resistance exercise. Specifically, endurance exercise, but not resistance exercise, causes a decrease in brachial artery endothelial function, which was unaffected by 4 wk of chronic exercise training.NEW & NOTEWORTHY We found that resistance and endurance exercise modalities lead to different endothelial function responses after a single bout of exercise. Endothelial function increased after an acute bout of resistance exercise, whereas it decreased after an acute bout of endurance exercise. Four weeks of chronic exercise training did not affect the acute endothelial function response.
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Affiliation(s)
- Maxime Boidin
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute, Montreal, Québec, Canada.,Faculty of Medicine, School of Kinesiology and Exercise Science, Université de Montréal, Montreal, Québec, Canada
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Institute of Sport, Exercise and Health, University College London, London, United Kingdom
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Department of Physiology, Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ellen Adele Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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4
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Holder SM, Bruno RM, Shkredova DA, Dawson EA, Jones H, Hopkins ND, Hopman MTE, Bailey TG, Coombes JS, Askew CD, Naylor L, Maiorana A, Ghiadoni L, Thompson A, Green DJ, Thijssen DHJ. Reference Intervals for Brachial Artery Flow-Mediated Dilation and the Relation With Cardiovascular Risk Factors. Hypertension 2021; 77:1469-1480. [PMID: 33745297 DOI: 10.1161/hypertensionaha.120.15754] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Sophie M Holder
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., L.G.).,INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B.).,Paris Descartes University, France (R.M.B.)
| | - Daria A Shkredova
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.).,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia, Kelowna, Canada (D.A.S.)
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.)
| | - Tom G Bailey
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Australia (T.G.B., J.S.C.)
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Australia (T.G.B., J.S.C.)
| | - Christopher D Askew
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia (C.D.A.).,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia (C.D.A.)
| | - Louise Naylor
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Crawley (L.N., D.J.G.)
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia (A.M.).,Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia (A.M.)
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., L.G.)
| | - Andrew Thompson
- Wolfson Centre for Personalised Medicine, University of Liverpool, United Kingdom (A.T.)
| | - Daniel J Green
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Crawley (L.N., D.J.G.)
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.).,Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.)
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5
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Naylor LH, Zimmermann D, Guitard-Uldry M, Poquet L, Lévêques A, Eriksen B, Bel Rhlid R, Galaffu N, D'Urzo C, De Castro A, Van Schaick E, Green DJ, Actis-Goretta L. Acute dose-response effect of coffee-derived chlorogenic acids on the human vasculature in healthy volunteers: a randomized controlled trial. Am J Clin Nutr 2021; 113:370-379. [PMID: 33330899 PMCID: PMC7851825 DOI: 10.1093/ajcn/nqaa312] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Epidemiological studies have reported lower risk of cardiovascular disease with moderate coffee consumption. In addition, emerging evidence indicates that consumption of coffee beverages enriched in chlorogenic acids (CGAs) may influence blood pressure and endothelial function, suggesting that the beneficial cardiovascular effect of coffee may relate to its CGA content. OBJECTIVES We conducted a double-blind randomized crossover trial to test the effect of acute consumption of a decaffeinated green coffee extract (DGCE), rich in CGAs, on endothelial function in healthy subjects. METHODS We compared 3 different doses of DGCE (302, 604, and 906 mg, respectively) with a placebo. Endothelial function was defined as the percentage change in the internal diameter of the brachial artery in response to flow-mediated dilation (%FMD). In addition, we followed the plasma concentration-time profiles of 25 systemic CGA metabolites over 24 h after DGCE consumption and we explored the relation between systemic concentrations of CGAs and the effect on %FMD. RESULTS The DGCE formulations containing different amounts of CGAs resulted in dose-proportional increases in overall total polyphenol concentrations. The systemic appearance of total CGAs was biphasic, in agreement with previous results suggesting 2 sites of absorption in the gastrointestinal tract. Compared with the placebo group, a significant FMD increase (>1%) was observed 8.5, 10, and 24 h after consumption of 302 mg DGCE (∼156.4 mg CGAs). The differences with placebo observed in the other 2 groups were not statistically significant. Evaluation of the relation between phenolic exposure and %FMD showed a positive tendency toward a larger effect at higher concentrations and different behavior of CGA metabolites depending on the conjugated chemical position. CONCLUSIONS We demonstrated an acute improvement in %FMD over time after ingestion of a DGCE, explained at least partly by the presence in the blood circulation of CGAs and their metabolites. This trial was registered at clinicaltrials.gov as NCT03520452.
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Affiliation(s)
- Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | | | | | | | | | | | | | | | | | | | | | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
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Sen S, Chandran DS, Jaryal AK, Deepak KK. The Low-Flow-Mediated Arterial Constriction in the Upper Limbs of Healthy Human Subjects are Artery Specific and Handedness Independent. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1949-1959. [PMID: 32456806 DOI: 10.1016/j.ultrasmedbio.2020.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
Low-flow-mediated constriction (LFMC) has been used to assess resting endothelial function in peripheral conduit arteries. The literature describes discrepancies in the behaviour of radial versus brachial artery in response to low-flow state, the reasons for which were not addressed in a systematic and scientific way. Moreover, the influence of handedness on observed LFMC responses has not been investigated. The present study aimed at systematic measurement and comparison of the LFMC responses in radial and brachial arteries of both dominant and non-dominant arms of healthy human volunteers. We also investigated the physiological factors associated with differential LFMC response of radial versus brachial artery in the same group of subjects. Longitudinal B mode ultrasonographic cine loops of radial and brachial arteries were acquired at baseline and after producing distal circulatory arrest. Cine loops were screen grabbed and analyzed later using automated edge detection algorithms to measure end-diastolic diameters. Distal circulatory arrest was produced over the proximal forearm (for the brachial artery) and over the wrist (for the radial artery) at 250 mm Hg for 5 min after baseline measurements. Results suggested that arterial location (p = 0.0001) and baseline diameter (p < 0.0021) emerged as independent predictors of LFMC response. Differences in the LFMC responses are handedness independent and could be attributed to the arterial location along with the differences in their baseline diameters.
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Affiliation(s)
- Sakshi Sen
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Ashok K Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - K K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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7
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Johns JA, O'Brien MW, Bungay A, Kimmerly DS. Sex and light physical activity impact popliteal, but not brachial artery flow-mediated dilation in physically active young adults. Appl Physiol Nutr Metab 2020; 45:1387-1395. [PMID: 32687716 DOI: 10.1139/apnm-2020-0308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
When controlling for baseline diameter, males have greater brachial flow-mediated dilation (BA-FMD) responses than females. It is unclear whether sex differences in baseline diameter also influences popliteal FMD (POP-FMD), which may be impacted by cardiorespiratory fitness and physical activity levels. We hypothesized that males would exhibit greater BA-FMD and POP-FMD when allometrically scaled to baseline diameter. FMD (ultrasonography), cardiorespiratory fitness (indirect calorimetry), and objectively measured physical activity were assessed in males (n = 13; age, 23 ± 3 years; peak oxygen consumption, 48.0 ± 7.1 mL·kg-1·min-1) and females (n = 13; age, 24 ± 2 years; peak oxygen consumption, 36.8 ± 6.0 mL·kg-1·min-1). Both groups had similarly high levels of moderate-to-vigorous intensity physical activity (503 ± 174 vs. 430 ± 142 min·week-1, p = 0.25). However, males were more aerobically fit (p < 0.001) and females accumulated more light-intensity physical activity (182 ± 67 vs. 127 ± 53 min·week-1, p = 0.03). Relative and allometrically scaled BA-FMD were similar (both, p ≥ 0.09) between sexes. In contrast, relative (6.2% ± 1.0% vs. 4.6% ± 1.4%, p = 0.001) and scaled (6.8% ± 1.7% vs. 4.7% ± 1.7%, p = 0.03) POP-FMD were greater in females. Relative POP-FMD was related to light-intensity physical activity in the pooled sample (r = 0.43; p = 0.04). However, the enhanced relative POP-FMD in females remained after adjusting for higher light-intensity physical activity levels (p = 0.01). Young females have enhanced popliteal, but not brachial, endothelial health than males with similar moderate-to-vigorous intensity physical activity levels and higher cardiorespiratory fitness. Novelty In physically active adults, females had greater POP-FMD but not BA-FMD than males. The enhanced POP-FMD in females was not related to greater vascular smooth muscle sensitivity to nitric oxide or their smaller baseline diameters. POP-FMD was associated with light physical activity levels in the pooled sample.
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Affiliation(s)
- Jarrett A Johns
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada.,Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Myles W O'Brien
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada.,Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Amanda Bungay
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada.,Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Derek S Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada.,Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
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8
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Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, Zock PL, Taddei S, Deanfield JE, Luscher T, Green DJ, Ghiadoni L. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J 2019; 40:2534-2547. [DOI: 10.1093/eurheartj/ehz350] [Citation(s) in RCA: 338] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 06/13/2018] [Accepted: 05/24/2019] [Indexed: 12/18/2022] Open
Abstract
Abstract
Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations of cardiovascular disease (CVD). Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation represents an endothelium-dependent, largely nitric oxide (NO)-mediated dilatation of conduit arteries in response to an imposed increase in blood flow and shear stress. Flow-mediated dilation is affected by cardiovascular (CV) risk factors, relates to coronary artery endothelial function, and independently predicts CVD outcome. Accordingly, FMD is a tool for examining the pathophysiology of CVD and possibly identifying subjects at increased risk for future CV events. Moreover, it has merit in examining the acute and long-term impact of physiological and pharmacological interventions in humans. Despite concerns about its reproducibility, the available evidence shows that highly reliable FMD measurements can be achieved when specialized laboratories follow standardized protocols. For this purpose, updated expert consensus guidelines for the performance of FMD are presented, which are based on critical appraisal of novel technical approaches, development of analysis software, and studies exploring the physiological principles underlying the technique. Uniformity in FMD performance will (i) improve comparability between studies, (ii) contribute to construction of reference values, and (iii) offer an easy accessible and early marker of atherosclerosis that could complement clinical symptoms of structural arterial disease and facilitate early diagnosis and prediction of CVD outcomes.
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Affiliation(s)
- Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Anke C C M van Mil
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie M Holder
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Francesco Faita
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Arno Greyling
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Peter L Zock
- Department Nutrition & Health, Unilever Vlaardingen, Vlaardingen, The Netherlands
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - John E Deanfield
- Institute of Cardiovascular Sciences, University College of London, 1 St Martin le Grand, London, UK
| | - Thomas Luscher
- Royal Brompton and Harefield Hospitals, London University Heart Center, Sydney Street, London, UK
| | - Daniel J Green
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Perth, Australia
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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9
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Kranen SH, Bond B, Williams CA, Barker AR. Reliability of low-flow vasoreactivity in the brachial artery of adolescents. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:133-138. [PMID: 30474121 DOI: 10.1002/jcu.22664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/01/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Macrovascular endothelial function is commonly assessed using flow-mediated dilation (FMD) and is nitric oxide (NO) dependent. However, the vasoreactivity to low flow during the FMD protocol may complement FMD interpretation. This study aimed to investigate in adolescents: (1) the day-to-day reliability of low-flow-mediated constriction (L-FMC) and composite vessel reactivity (CVR); and (2) the relationship between L-FMC and FMD. METHODS A retrospective analysis of data on 27 adolescents (14.3 ± 0.6 year, 12 males) was performed. Participants had two repeat measures, on separate days, of macrovascular function using high-resolution ultrasound for assessment of L-FMC, FMD, and CVR. RESULTS On average, the L-FMC response was vasoconstriction on both days (-0.59 ± 2.22% and -0.16 ± 1.50%, respectively). In contrast, an inconsistent response to low flow (vasoconstriction, dilation, or no change) was observed on an individual level. Cohen's Kappa revealed poor agreement for classifying the L-FMC measurement between visits (k = 0.04, P > .05). Assessment of the actual vessel diameter was robust with a coefficient of variation of 1.7% (baseline and peak) and 2.7% (low-flow). The between-day correlation coefficient between measures was r = .18, r = .96 and r = .52 for L-FMC, FMD, and CVR, respectively. No significant correlation between FMD and L-FMC was observed for either visit (r = -.06 and r = -.07, respectively; P > .05). CONCLUSION In adolescents, the low-flow vasoreactivity is inconsistent between days. Whereas the actual vessel diameter is reproducible, the measurement of L-FMC and CVR has poor between-day reliability compared to FMD. Finally, L-FMC, and FMD are not significantly correlated.
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Affiliation(s)
- Sascha H Kranen
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
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10
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Mannaerts D, Faes E, Cornette J, Gyselaers W, Spaanderman M, Goovaerts I, Stoop T, Roelant E, Jacquemyn Y, Van Craenenbroeck EM. Low-flow mediated constriction as a marker of endothelial function in healthy pregnancy and preeclampsia: A pilot study. Pregnancy Hypertens 2019; 17:75-81. [PMID: 31487661 DOI: 10.1016/j.preghy.2019.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 01/27/2019] [Accepted: 02/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Overwhelming clinical evidence exists on disturbed vascular and endothelial function in the pathophysiology of preeclampsia (PE). In a non-pregnant (NP) population, L-FMC (low-flow mediated constriction) provides insight in the 'resting' endothelial capacity in contrast to the gold standard of flow mediated dilatation (FMD), reflecting endothelial nitric oxide bioavailability. STUDY DESIGN Longitudinal follow-up of 100 healthy pregnant (HP) women, 33 PE women and 16 NP controls with non-invasive vascular assessments. HP women were evaluated at 12 and 35 weeks of gestation and at 6 months postpartum. PE patients were assessed at diagnosis (mean 30 weeks) and 6 months postpartum. MAIN OUTCOME MEASURES Endothelial function (L-FMC, FMD, peripheral arterial tonometry (PAT)) and arterial stiffness (pulse wave velocity (PWV) and analysis (PWA)) were measured at the different visits and compared between groups. RESULTS Overall endothelial dysfunction is present in PE (FMD HP 9.09 ± 4.20 vs PE 5.21 ± 4.47, p = 0.0004; L-FMC HP -1.90 ± 2.66 vs PE -0.40 ± 2.09, p = 0.03). L-FMC gradually elevates during the course of a HP (1st trim -0.31 ± 1.75 vs 3rd trim -1.97 ± 3.02, p < 0.0001) and is present in 85% of women in the third trimester. In NP, only 27% of women has L-FMC. In PE, L-FMC is present in 50% of cases. Arterial stiffness is increased in PE (all p < 0.0001). There is no correlation between L-FMC and other markers of vascular function (p > 0.05). CONCLUSION PE is characterized by dysfunction of both resting and recruitable endothelial capacity. This study offers new insights in different aspects of endothelial function in pregnancy, since L-FMC reflects an adaptation in HP that is absent in PE.
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Affiliation(s)
- Dominique Mannaerts
- Research Group ASTARC, Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Belgium; Department of Obstetrics and Gynaecology, Antwerp University Hospital, Belgium.
| | - Ellen Faes
- Research Group ASTARC, Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Belgium; Department of Obstetrics and Gynaecology, Antwerp University Hospital, Belgium
| | - Jerome Cornette
- Department of Obstetrics and Gynaecology, Erasmus M.C. Rotterdam, The Netherlands
| | - Wilfried Gyselaers
- Department of Obstetrics and Gynaecology, Ziekenhuis-Oost Limburg, Genk, Belgium
| | - Marc Spaanderman
- Department of Obstetrics and Gynaecology, MUMC Maastricht University, The Netherlands
| | - Inge Goovaerts
- Laboratory for Cellular and Molecular Cardiology and Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Tibor Stoop
- Laboratory for Cellular and Molecular Cardiology and Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Ella Roelant
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Yves Jacquemyn
- Research Group ASTARC, Antwerp Surgical Training, Anatomy and Research Centre, University of Antwerp, Belgium; Department of Obstetrics and Gynaecology, Antwerp University Hospital, Belgium
| | - Emeline M Van Craenenbroeck
- Laboratory for Cellular and Molecular Cardiology and Department of Cardiology, Antwerp University Hospital, Edegem, Belgium; Research Group Cardiovascular Diseases, Translational Pathophysiological Research, University of Antwerp, Edegem, Belgium
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11
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Green DJ, Smith KJ. Effects of Exercise on Vascular Function, Structure, and Health in Humans. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a029819. [PMID: 28432115 DOI: 10.1101/cshperspect.a029819] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Physical activity has profound impacts on the vasculature in humans. Acute exercise induces immediate changes in artery function, whereas repeated episodic bouts of exercise induce chronic functional adaptation and, ultimately, structural arterial remodeling. The nature of these changes in function and structure are dependent on the characteristics of the training load and may be modulated by other factors such as exercise-induced inflammation and oxidative stress. The clinical implications of these physiological adaptations are profound. Exercise impacts on the development of atherosclerosis and on the incidence of primary and secondary cardiovascular events, including myocardial infarction and stroke. Exercise also plays a role in the amelioration of other chronic diseases that possess a vascular etiology, including diabetes and dementia. The mechanisms responsible for these effects of exercise on the vasculature are both primary and secondary in nature, in that the benefits conferred by changes in cardiovascular risk factors such as lipid profiles and blood pressure occur in concert with direct effects of arterial shear stress and mechanotransduction. From an evolutionary perspective, exercise is an essential stimulus for the maintenance of vascular health: exercise is vascular medicine.
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Affiliation(s)
- Daniel J Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L33AF, United Kingdom.,School of Human Sciences, The University of Western Australia, Crawley 6009, Australia.,Principal Research Fellow, National Health and Medical Research Council of Australia, Canberra 2601, Australia
| | - Kurt J Smith
- School of Human Sciences, The University of Western Australia, Crawley 6009, Australia
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12
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Giles LV, Tebbutt SJ, Carlsten C, Koehle MS. The effect of low and high-intensity cycling in diesel exhaust on flow-mediated dilation, circulating NOx, endothelin-1 and blood pressure. PLoS One 2018; 13:e0192419. [PMID: 29466393 PMCID: PMC5821322 DOI: 10.1371/journal.pone.0192419] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 01/11/2018] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Exposure to air pollution impairs aspects of endothelial function such as flow-mediated dilation (FMD). Outdoor exercisers are frequently exposed to air pollution, but how exercising in air pollution affects endothelial function and how these effects are modified by exercise intensity are poorly understood. OBJECTIVES Therefore, the purpose of this study was to determine the effects of low-intensity and high-intensity cycling with diesel exhaust (DE) exposure on FMD, blood pressure, plasma nitrite and nitrate (NOx) and endothelin-1. METHODS Eighteen males performed 30-minute trials of low or high-intensity cycling (30% and 60% of power at VO2peak) or a resting control condition. For each subject, each trial was performed once while breathing filtered air (FA) and once while breathing DE (300ug/m3 of PM2.5, six trials in total). Preceding exposure, immediately post-exposure, 1 hour and 2 hours post-exposure, FMD, blood pressure and plasma endothelin-1 and NOx concentrations were measured. Data were analyzed using repeated-measures ANOVA and linear mixed model. RESULTS Following exercise in DE, plasma NOx significantly increased and was significantly greater than FA (p<0.05). Two hours following DE exposure, endothelin-1 was significantly less than FA (p = 0.037) but exercise intensity did not modify this response. DE exposure did not affect FMD or blood pressure. CONCLUSION Our results suggest that exercising in DE did not adversely affect plasma NOX, endothelin-1, FMD and blood pressure. Therefore, recommendations for healthy individuals to moderate or avoid exercise during bouts of high pollution appear to have no acute protective effect.
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Affiliation(s)
- Luisa V. Giles
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott J. Tebbutt
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Christopher Carlsten
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul’s Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S. Koehle
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Sports Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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13
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Peace A, van Mil A, Jones H, Thijssen DH. Similarities and Differences Between Carotid Artery and Coronary Artery Function. Curr Cardiol Rev 2018; 14:254-263. [PMID: 30198437 PMCID: PMC6300794 DOI: 10.2174/1573403x14666180910125638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cardiovascular Disease (CVD) remains one of the leading causes of morbidity and mortality. Strategies to predict development of CVD are therefore key in preventing and managing CVD. One stratergy in predicting CVD is by examining the role of traditional risk factors for CVD (e.g. age, sex, weight, blood pressure, blood lipids, blood glucose, smoking and physical activity). Although these measures are non-invasive and simple to perform, they provide limited information of CVD prediction. Directly examining functional characteristics of arteries that are involved in the pathophysiological changes that contribute to the development of CVD improve prediction of future CVD. Nevertheless, examining the function of arteries susceptible to atherosclortic changes, such as the coronary arteries, is invasive, expensive, and associated with high risk for complications. More accessible arteries can be used as a surrogate measure of coronary artery function. For example, the carotid artery may be a superior surrogate measure of coronary artery function given that, the carotid artery represents a central vessel that shows similarities in vasomotor function and anatomical structure with coronary arteries. CONCLUSION This review summarises the similarities between the carotid and coronary arteries, describes how both arteries respond to specific vasoactive stimuli, and discusses if the easily assessible carotid artery can provide information about vascular function (e.g. vasomotor reactivity to sympathetic stimulation) which is prognostic for future cardiovascular events. Finally, the impact of older age and lifestyle interventions (e.g. exercise training) on carotid artery function will be discussed.
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Affiliation(s)
| | | | | | - Dick H.J. Thijssen
- Address correspondence to this author at the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street L3 3AF, Liverpool, United Kingdom;
Tel: +441519046264; E-mail:
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14
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Aizawa K, Sbragi S, Ramalli A, Tortoli P, Casanova F, Morizzo C, Thorn CE, Shore AC, Gates PE, Palombo C. Brachial artery vasodilatory response and wall shear rate determined by multigate Doppler in a healthy young cohort. J Appl Physiol (1985) 2017; 124:150-159. [PMID: 28935823 DOI: 10.1152/japplphysiol.00310.2017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Wall shear rate (WSR) is an important stimulus for the brachial artery flow-mediated dilation (FMD) response. However, WSR estimation near the arterial wall by conventional Doppler is inherently difficult. To overcome this limitation, we utilized multigate Doppler to accurately determine the WSR stimulus near the vessel wall simultaneously with the FMD response using an integrated FMD system [Ultrasound Advanced Open Platform (ULA-OP)]. Using the system, we aimed to perform a detailed analysis of WSR-FMD response and establish novel WSR parameters in a healthy young population. Data from 33 young healthy individuals (27.5 ± 4.9 yr, 19 females) were analyzed. FMD was assessed with reactive hyperemia using ULA-OP. All acquired raw data were postprocessed using custom-designed software to obtain WSR and diameter parameters. The acquired velocity data revealed that nonparabolic flow profiles within the cardiac cycle and under different flow states, with heterogeneity between participants. We also identified seven WSR magnitude and four WSR time-course parameters. Among them, WSR area under the curve until its return to baseline was the strongest predictor of the absolute ( R2 = 0.25) and percent ( R2 = 0.31) diameter changes in response to reactive hyperemia. For the first time, we identified mono- and biphasic WSR stimulus patterns within our cohort that produced different magnitudes of FMD response [absolute diameter change: 0.24 ± 0.10 mm (monophasic) vs. 0.17 ± 0.09 mm (biphasic), P < 0.05]. We concluded that accurate and detailed measurement of the WSR stimulus is important to comprehensively understand the FMD response and that this advance in current FMD technology could be important to better understand vascular physiology and pathology. NEW & NOTEWORTHY An estimation of wall shear rate (WSR) near the arterial wall by conventional Doppler ultrasound is inherently difficult. Using a recently developed integrated flow-mediated dilation ultrasound system, we were able to accurately estimate WSR near the wall and identified a number of novel WSR variables that may prove to be useful in the measurement of endothelial function, an important biomarker of vascular physiology and disease.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, National Institute of Health Research Exeter Clinical Research Facility, University of Exeter Medical School , Exeter , United Kingdom
| | - Sara Sbragi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa , Pisa , Italy
| | - Alessandro Ramalli
- Department of Information Engineering, University of Florence , Florence , Italy
| | - Piero Tortoli
- Department of Information Engineering, University of Florence , Florence , Italy
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, National Institute of Health Research Exeter Clinical Research Facility, University of Exeter Medical School , Exeter , United Kingdom
| | - Carmela Morizzo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa , Pisa , Italy
| | - Clare E Thorn
- Diabetes and Vascular Medicine Research Centre, National Institute of Health Research Exeter Clinical Research Facility, University of Exeter Medical School , Exeter , United Kingdom
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, National Institute of Health Research Exeter Clinical Research Facility, University of Exeter Medical School , Exeter , United Kingdom
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, National Institute of Health Research Exeter Clinical Research Facility, University of Exeter Medical School , Exeter , United Kingdom
| | - Carlo Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa , Pisa , Italy
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15
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McLay KM, Nederveen JP, Koval JJ, Paterson DH, Murias JM. Allometric scaling of flow-mediated dilation: is it always helpful? Clin Physiol Funct Imaging 2017; 38:663-669. [PMID: 28804951 DOI: 10.1111/cpf.12465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/03/2017] [Indexed: 11/28/2022]
Abstract
Flow-mediated dilation (FMD) is calculated as the greatest percent change in arterial diameter following an ischaemic challenge. This Traditional %FMD calculation is thought to have statistical bias towards baseline diameter (Dbase ), which is reduced by allometric scaling. This study examined whether allometric scaling FMD influenced the difference between a group of healthy young and older adults compared to the Traditional %FMD, and to determine whether a New (allometric) scaling %FMD improved the ability to obtain individually scaled FMD. Popliteal artery FMD was assessed in 18 young (26 ± 3 years) and 17 older adults (77 ± 5 years). 'Corrected' mean FMD was generated from a log-linked ANCOVA model. Individual %FMD was evaluated using three calculations: (1) Traditional %FMD calculation; (2) Atkinson (allometric) scaling %FMD (peak diameter (Dpeak)/(Dbasescalingexponent)); and (3) New scaling %FMD ((Dpeak-Dbase)/(Dbasescalingexponent)). Traditional %FMD was significantly larger in young (5·82 ± 2·58%) versus old (3·72 ± 1·26%). 'Corrected' FMD means (Y: 5·97 ± 2·12%; O: 3·98 ± 2·06%) were similar to Traditional %FMD; however, the logarithmic transformation prevents statistical interpretation of group differences. Individually scaled %FMD using the Atkinson scaling resulted in values that were corrected for variations in Dbase but that were twofold to threefold larger than those of the Traditional calculation. New scaling %FMD resulted in values that were similar to values expected (Y: 6·21 ± 2·75%; O: 3·98 ± 1·36%); however, it did not effectively correct for variation in Dbase . Recommendations regarding the advantages of allometrically scaling %FMD should be made with caution until research clearly establishes the benefits of this approach.
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Affiliation(s)
- K M McLay
- Canadian Centre for Activity and Aging, London, ON, Canada.,School of Kinesiology, The University of Western Ontario, London, ON, Canada
| | - J P Nederveen
- Canadian Centre for Activity and Aging, London, ON, Canada.,School of Kinesiology, The University of Western Ontario, London, ON, Canada
| | - J J Koval
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, ON, Canada
| | - D H Paterson
- Canadian Centre for Activity and Aging, London, ON, Canada.,School of Kinesiology, The University of Western Ontario, London, ON, Canada
| | - J M Murias
- School of Kinesiology, The University of Western Ontario, London, ON, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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16
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Maessen MFH, van Mil ACCM, Straathof Y, Riksen NP, Rongen GAPJM, Hopman MTE, Eijsvogels TMH, Thijssen DHJ. Impact of lifelong exercise training on endothelial ischemia-reperfusion and ischemic preconditioning in humans. Am J Physiol Regul Integr Comp Physiol 2017; 312:R828-R834. [DOI: 10.1152/ajpregu.00466.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 12/26/2022]
Abstract
Reperfusion is essential for ischemic tissue survival, but causes additional damage to the endothelium [i.e., ischemia-reperfusion (I/R) injury]. Ischemic preconditioning (IPC) refers to short repetitive episodes of ischemia that can protect against I/R. However, IPC efficacy attenuates with older age. Whether physical inactivity contributes to the attenuated efficacy of IPC to protect against I/R injury in older humans is unclear. We tested the hypotheses that lifelong exercise training relates to 1) attenuated endothelial I/R and 2) maintained IPC efficacy that protects veteran athletes against endothelial I/R. In 18 sedentary male individuals (SED, <1 exercise h/wk for >20 yr, 63 ± 7 yr) and 20 veteran male athletes (ATH, >5 exercise h/wk for >20 yr, 63 ± 6 yr), we measured brachial artery endothelial function with flow-mediated dilation (FMD) before and after I/R. We induced I/R by 20 min of ischemia followed by 20 min of reperfusion. Randomized over 2 days, participants underwent either 35-min rest or IPC (3 cycles of 5-min cuff inflation to 220 mmHg with 5 min of rest) before I/R. In SED, FMD decreased after I/R [median (interquartile range)]: [3.0% (2.0–4.7) to 2.1% (1.5–3.9), P = 0.046] and IPC did not prevent this decline [4.1% (2.6–5.2) to 2.8% (2.2–3.6), P = 0.012]. In ATH, FMD was preserved after I/R [3.0% (1.7–5.4) to 3.0% (1.9–4.1), P = 0.82] and when IPC preceded I/R [3.2% (1.9–4.2) to 2.8% (1.4–4.6), P = 0.18]. These findings indicate that lifelong exercise training is associated with increased tolerance against endothelial I/R. These protective, preconditioning effects of lifelong exercise against endothelial I/R may contribute to the cardioprotective effects of exercise training.
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Affiliation(s)
- Martijn F. H. Maessen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anke C. C. M. van Mil
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Yaïra Straathof
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niels P. Riksen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; and
| | - Gerard A. P. J. M. Rongen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; and
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T. E. Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M. H. Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Dick H. J. Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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17
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Ostrem JD, Evanoff NG, Ryder JR, Dengel DR. Intra- and interday reproducibility of high-flow-mediated constriction response in young adults. Clin Physiol Funct Imaging 2016; 38:200-205. [PMID: 28025878 DOI: 10.1111/cpf.12399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/30/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previously, we have demonstrated that high-flow-mediated constriction (H-FMC) of the brachial artery has been shown to negatively affect flow-mediated dilation (FMD). However, the reproducibility of an H-FMC response is unknown. OBJECTIVE The aim of this study was to determine the intra- and interday reproducibility of H-FMC in young adults. METHODS Thirty young adults (15 male, 15 female; 24 ± 3 years) were assessed for H-FMC reproducibility via high-resolution ultrasound imaging of the brachial artery during and after forearm occlusion of a normal FMD procedure. Two vascular assessments were conducted for all participants during two separate visits with a minimum of 7 days in between. H-FMC was characterized as the greatest 10-s average constriction occurring after 3-s postocclusion compared to baseline brachial artery diameter and considered present if the percent change was <-0·1%. RESULTS Of the 120 total vascular assessments performed in this study, 98 of the assessments (80·3%) displayed an H-FMC. H-FMC diameter was not statistically different for intraday comparisons for visit 1 (P = 0·39) or visit 2 (P = 0·55) or interday comparisons between the first (P = 0·61) or second (P = 0·10) assessments. H-FMC percentage was also not statistically different for intra-day comparison for visit 1 (P = 0·94) or visit 2 (P = 0·15) or interday comparisons between the first (P = 0·63) or second (P = 0·16) assessments. CONCLUSION These data are supportive of H-FMC being reproducible in young adults and included in future FMD studies. The impact of H-FMC on future CVD risk and development warrants evaluation.
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Affiliation(s)
- Joseph D Ostrem
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA.,Kinesiology and Health Sciences, College of Education and Science, Concordia University - St. Paul, St. Paul, MN, USA
| | - Nicholas G Evanoff
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Justin R Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Donald R Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA.,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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18
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Caldwell JT, Wardlow GC, Branch PA, Ramos M, Black CD, Ade CJ. Effect of exercise-induced muscle damage on vascular function and skeletal muscle microvascular deoxygenation. Physiol Rep 2016; 4:4/22/e13032. [PMID: 27884955 PMCID: PMC5358004 DOI: 10.14814/phy2.13032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 11/24/2022] Open
Abstract
This paper investigated the effects of unaccustomed eccentric exercise‐induced muscle damage (EIMD) on macro‐ and microvascular function. We tested the hypotheses that resting local and systemic endothelial‐dependent flow‐mediated dilation (FMD) and microvascular reactivity would decrease, V˙O2max would be altered, and that during ramp exercise, peripheral O2 extraction, evaluated via near‐infrared‐derived spectroscopy (NIRS) derived deoxygenated hemoglobin + myoglobin ([HHb]), would be distorted following EIMD. In 13 participants, measurements were performed prior to (Pre) and 48 h after a bout of knee extensor eccentric exercise designed to elicit localized muscle damage (Post). Flow‐mediated dilation and postocclusive reactive hyperemic responses measured in the superficial femoral artery served as a measurement of local vascular function relative to the damaged tissue, while the brachial artery served as an index of nonlocal, systemic, vascular function. During ramp‐incremental exercise on a cycle ergometer, [HHb] and tissue saturation (TSI%) in the m. vastus lateralis were measured. Superficial femoral artery FMD significantly decreased following EIMD (pre 6.75 ± 3.89%; post 4.01 ± 2.90%; P < 0.05), while brachial artery FMD showed no change. The [HHb] and TSI% amplitudes were not different following EIMD ([HHb]: pre, 16.9 ± 4.7; post 17.7 ± 4.9; TSI%: pre, 71.0 ± 19.7; post 71.0 ± 19.7; all P > 0.05). At each progressive increase in workload (i.e., 0–100% peak), the [HHb] and TOI% responses were similar pre‐ and 48 h post‐EIMD (P > 0.05). Additionally, V˙O2max was similar at pre‐ (3.0 ± 0.67 L min−1) to 48 h post (2.96 ± 0.60 L min−1)‐EIMD (P > 0.05). Results suggest that moderate eccentric muscle damage leads to impaired local, but not systemic, macrovascular dysfunction.
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Affiliation(s)
- Jacob T Caldwell
- Department of Kinesiology, Kansas State University, Manhattan, Kansas .,Department of Health and Exercise Science, the University of Oklahoma, Norman, Oklahoma
| | - Garrett C Wardlow
- Department of Health and Exercise Science, the University of Oklahoma, Norman, Oklahoma
| | - Patrece A Branch
- Department of Health and Exercise Science, the University of Oklahoma, Norman, Oklahoma
| | - Macarena Ramos
- Department of Health and Exercise Science, the University of Oklahoma, Norman, Oklahoma
| | - Christopher D Black
- Department of Health and Exercise Science, the University of Oklahoma, Norman, Oklahoma
| | - Carl J Ade
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
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19
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Aizawa K, Elyas S, Adingupu DD, Casanova F, Gooding KM, Strain WD, Shore AC, Gates PE. Reactivity to low-flow as a potential determinant for brachial artery flow-mediated vasodilatation. Physiol Rep 2016; 4:4/12/e12808. [PMID: 27335431 PMCID: PMC4923229 DOI: 10.14814/phy2.12808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/30/2016] [Indexed: 01/17/2023] Open
Abstract
Previous studies have reported a vasoconstrictor response in the radial artery during a cuff-induced low-flow condition, but a similar low-flow condition in the brachial artery results in nonuniform reactivity. This variable reactivity to low-flow influences the subsequent flow-mediated dilatation (FMD) response following cuff-release. However, it is uncertain whether reactivity to low-flow is important in data interpretation in clinical populations and older adults. This study aimed to determine the influence of reactivity to low-flow on the magnitude of brachial artery FMD response in middle-aged and older individuals with diverse cardiovascular risk profiles. Data were analyzed from 165 individuals, divided into increased cardiovascular risk (CVR: n = 115, 85M, 67.0 ± 8.8 years) and healthy control (CTRL: n = 50, 30M, 63.2 ± 7.2 years) groups. Brachial artery diameter and blood velocity data obtained from Doppler ultrasound were used to calculate FMD, reactivity to low-flow and estimated shear rate (SR) using semiautomated edge-detection software. There was a significant association between reactivity to low-flow and FMD in overall (r = 0.261), CTRL (r = 0.410) and CVR (r = 0.189, all P < 0.05) groups. Multivariate regression analysis found that reactivity to low-flow, peak SR, and baseline diameter independently contributed to FMD along with sex, the presence of diabetes, and smoking (total R(2) = 0.450). There was a significant association between reactivity to low-flow and the subsequent FMD response in the overall dataset, and reactivity to low-flow independently contributed to FMD These findings suggest that reactivity to low-flow plays a key role in the subsequent brachial artery FMD response and is important in the interpretation of FMD data.
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Affiliation(s)
- Kunihiko Aizawa
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Salim Elyas
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Damilola D Adingupu
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Francesco Casanova
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Kim M Gooding
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Angela C Shore
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
| | - Phillip E Gates
- Diabetes and Vascular Medicine Research Centre, University of Exeter Medical School, Exeter, UK NIHR Exeter Clinical Research Facility, Exeter, UK
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20
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Ostrem JD, Evanoff N, Kelly AS, Dengel DR. Presence of a high-flow-mediated constriction phenomenon prior to flow-mediated dilation in normal weight, overweight, and obese children and adolescents. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:495-501. [PMID: 25801746 PMCID: PMC4565738 DOI: 10.1002/jcu.22267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 01/13/2015] [Indexed: 05/24/2023]
Abstract
PURPOSE When assessing vasomotor endothelial function by reactive hyperemia, the brachial artery, in some individuals, constricts immediately before beginning to dilate following cuff release. We call this response high-flow-mediated constriction (H-FMC). The aim of this study was to describe the rate of the H-FMC during reactive hyperemia in children and adolescents throughout a range of body mass index (BMI) values, and to investigate differences in flow-mediated dilation (FMD), cardiovascular, and anthropometric measures between subjects with and without H-FMC. METHODS FMD was assessed in 136 children and adolescents (61 male, 75 female; 13 ± 3 years) by sonographic imaging of the brachial artery. H-FMC was characterized as the lowest point from the baseline brachial artery diameter immediately following reactive cuff release. Independent t tests were used to compare subjects with and without H-FMC. RESULTS H-FMC was observed in 91 of the 136 participants (66.9%). No significant difference was found between H-FMC and non-H-FMC subjects for age (p = 0.602), gender (p = 0.767), height (p = 0.227), or weight (p = 0.171). BMI percentile was nonsignificantly higher (91.8 ± 4.9th versus 84.6 ± 22.8th percentile, p = 0.057) and FMD was significantly lower (5.43 ± 3.41% versus 8.05 ± 3.97%, p < 0.001) in H-FMC than in non-H-FMC subjects. Adding H-FMC to FMD produced no significant difference between H-FMC and non-H-FMC individuals (8.03 ± 3.27% versus 8.05 ± 3.97%, p = 0.977). CONCLUSIONS Approximately 67% of participants demonstrated an H-FMC during reactive hyperemia. BMI percentile was nonsignificantly higher and FMD was significantly lower in children and adolescents who displayed this phenomenon.
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Affiliation(s)
- Joseph D Ostrem
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN 55455
| | - Nicholas Evanoff
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN 55455
| | - Aaron S Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Donald R Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN 55455
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455
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Normal Pregnancy Is Associated with Changes in Central Hemodynamics and Enhanced Recruitable, but Not Resting, Endothelial Function. Int J Reprod Med 2015; 2015:250951. [PMID: 26421317 PMCID: PMC4572473 DOI: 10.1155/2015/250951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/18/2015] [Indexed: 01/14/2023] Open
Abstract
Introduction. Flow-mediated dilation (FMD), low flow-mediated constriction (L-FMC), and reactive hyperemia-related changes in carotid-to-radial pulse wave velocity (ΔPWVcr%) could offer complementary information about both “recruitability” and “resting” endothelial function (EF). Carotid-to-femoral pulse wave velocity (PWVcf) and pulse wave analysis-derived parameters (i.e., AIx@75) are the gold standard methods for noninvasive evaluation of aortic stiffness and central hemodynamics. If healthy pregnancy is associated with both changes in resting and recruitable EF, as well as in several arterial parameters, it remains unknown and/or controversial. Objectives. To simultaneously and noninvasively assess in healthy pregnant (HP) and nonpregnant (NP) women central parameters in conjunction with “basal and recruitable” EF, employing new complementary approaches. Methods. HP (n = 11, 34.2 ± 3.3 weeks of gestation) and age- and cardiovascular risk factors-matched NP (n = 22) were included. Aortic blood pressure (BP), AIx@75, PWVcf, common carotid stiffness, and intima-media thickness, as well as FMD, L-FMC, and ΔPWVcr %, were measured. Results. Aortic BP, stiffness, and AIx@75 were reduced in HP. ΔPWVcr% and FMD were enhanced in HP in comparison to NP. No differences were found in L-FMC between groups. Conclusion. HP is associated with reduced aortic stiffness, central BP, wave reflections, and enhanced recruitable, but not resting, EF.
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Preeclampsia Is Associated with Increased Central Aortic Pressure, Elastic Arteries Stiffness and Wave Reflections, and Resting and Recruitable Endothelial Dysfunction. Int J Hypertens 2015; 2015:720683. [PMID: 26351578 PMCID: PMC4550743 DOI: 10.1155/2015/720683] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/22/2015] [Indexed: 01/22/2023] Open
Abstract
Introduction. An altered endothelial function (EF) could be associated with preeclampsia (PE). However, more specific and complementary analyses are required to confirm this topic. Flow-mediated dilation (FMD), low-flow-mediated constriction (L-FMC), and hyperemic-related changes in carotid-radial pulse wave velocity (PWVcr) offer complementary information about “recruitability” of EF. Objectives. To evaluate, in healthy and hypertensive pregnant women (with and without PE), central arterial parameters in conjunction with “basal and recruitable” EF. Methods. Nonhypertensive (HP) and hypertensive pregnant women (gestational hypertension, GH; preeclampsia, PE) were included. Aortic blood pressure (BP), wave reflection parameters (AIx@75), aortic pulse wave velocity (PWVcf) and PWVcr, and brachial and common carotid stiffness and intima-media thickness were measured. Brachial FMD and L-FMC and hyperemic-related change in PWVcr were measured. Results. Aortic BP and AIx@75 were elevated in PE. PE showed stiffer elastic but not muscular arteries. After cuff deflation, PWVcr decreased in HP, while GH showed a blunted PWVcr response and PE showed a tendency to increase. Maximal FMD and L-FMC were observed in HP followed by GH; PE did not reach significant arterial constriction. Conclusion. Aortic BP and wave reflections as well as elastic arteries stiffness are increased in PE. PE showed both “resting and recruitable” endothelial dysfunctions.
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Frolow M, Drozdz A, Kowalewska A, Nizankowski R, Chlopicki S. Comprehensive assessment of vascular health in patients; towards endothelium-guided therapy. Pharmacol Rep 2015; 67:786-92. [PMID: 26321282 DOI: 10.1016/j.pharep.2015.05.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
Endothelial function has diagnostic, prognostic and therapeutic significance. A number of non-invasive techniques were introduced for its assessment, including flow-mediated dilation (FMD), finger plethysmography (RH-PAT) and digital thermal monitoring (DTM). All these methods can be performed simultaneously. In addition, various methods for measuring arterial wall stiffness are available such as: pulse wave analysis (PWA), pulse wave velocity (PWV), pulse contour analysis (PCA) and carotid wall distensibility coefficient (DC). Finally, carotid intima-media thickness (cIMT) and ankle brachial index (ABI) are used as surrogate read-outs of atherosclerosis. Here, we briefly describe the advantages, limitations and interrelationships of various methods used for the assessment of endothelial function, arterial stiffness, and present the concept of an integrated evaluation of vascular health based on multiple methods. This strategy may be useful to stratify cardiovascular risk and represents a step towards multiparametric assessment of endothelium for effective endothelium-guided therapy in patients with cardiovascular diseases.
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Affiliation(s)
- Marzena Frolow
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland; Department of Angiology, Jagiellonian University, Kraków, Poland.
| | - Agata Drozdz
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland; Faculty of Mechanical Engineering, Cracow University of Technology, Kraków, Poland
| | - Agata Kowalewska
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Rafal Nizankowski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland
| | - Stefan Chlopicki
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Kraków, Poland; Department of Experimental Pharmacology, Chair of Pharmacology, Jagiellonian University, Medical College, Kraków, Poland
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24
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Impact of handgrip exercise intensity on brachial artery flow-mediated dilation. Eur J Appl Physiol 2015; 115:1705-13. [PMID: 25805181 DOI: 10.1007/s00421-015-3157-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/17/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE Previous studies that have examined the impact of exercise intensity on conduit artery endothelial function have involved large muscle group exercise which induces local and systemic effects. The aim of this study was to examine flow-mediated dilation (FMD) before and after incremental intensities of handgrip exercise (HE), to assess the role of local factors such as blood flow and shear rate on post-exercise brachial artery function. METHODS Eleven healthy men attended the laboratory on three occasions. Subjects undertook 30 min of handgrip exercise at three intensities (5, 10 or 15 % MVC). Brachial artery FMD, shear and blood flow patterns were examined before, immediately after and 60 min post exercise. RESULTS Handgrip exercise increased mean and antegrade shear rate (SR) and blood flow (BF) and reduced retrograde SR and BF (all P < 0.01). Exercise intensity was associated with a dose-dependent increase in both mean and antegrade BF and SR (interaction, P < 0.01). Post-hoc tests revealed that, whilst handgrip exercise did not immediately induce post-exercise changes, FMD was significantly higher 60 min post-exercise following the highest exercise intensity (5.9 ± 2.8-10.4 ± 5.8 %, P = 0.01). CONCLUSIONS Handgrip exercise leads to intensity-and time-dependent changes in conduit artery function, possibly mediated by local increases in shear, with improvement in function evident at 1 h post-exercise when performed at a higher intensity.
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van Bussel FCG, van Bussel BCT, Hoeks APG, Op 't Roodt J, Henry RMA, Ferreira I, Vanmolkot FHM, Schalkwijk CG, Stehouwer CDA, Reesink KD. A control systems approach to quantify wall shear stress normalization by flow-mediated dilation in the brachial artery. PLoS One 2015; 10:e0115977. [PMID: 25693114 PMCID: PMC4333124 DOI: 10.1371/journal.pone.0115977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/28/2014] [Indexed: 12/14/2022] Open
Abstract
Flow-mediated dilation is aimed at normalization of local wall shear stress under varying blood flow conditions. Blood flow velocity and vessel diameter are continuous and opposing influences that modulate wall shear stress. We derived an index FMDv to quantify wall shear stress normalization performance by flow-mediated dilation in the brachial artery. In 22 fasting presumed healthy men, we first assessed intra- and inter-session reproducibilities of two indices pFMDv and mFMDv, which consider the relative peak and relative mean hyperemic change in flow velocity, respectively. Second, utilizing oral glucose loading, we evaluated the tracking performance of both FMDv indices, in comparison with existing indices [i.e., the relative peak diameter increase (%FMD), the peak to baseline diameter ratio (Dpeak/Dbase), and the relative peak diameter increase normalized to the full area under the curve of blood flow velocity with hyperemia (FMD/shearAUC) or with area integrated to peak hyperemia (FMD/shearAUC_peak)]. Inter-session and intra-session reproducibilities for pFMDv, mFMDv and %FMD were comparable (intra-class correlation coefficients within 0.521-0.677 range). Both pFMDv and mFMDv showed more clearly a reduction after glucose loading (reduction of ~45%, p≤0.001) than the other indices (% given are relative reductions): %FMD (~11%, p≥0.074); Dpeak/Dbase (~11%, p≥0.074); FMD/shearAUC_peak (~20%, p≥0.016) and FMD/shearAUC (~38%, p≤0.038). Further analysis indicated that wall shear stress normalization under normal (fasting) conditions is already far from ideal (FMDv << 1), which (therefore) does not materially change with glucose loading. Our approach might be useful in intervention studies to detect intrinsic changes in shear stress normalization performance in conduit arteries.
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Affiliation(s)
- Frank C. G. van Bussel
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bas C. T. van Bussel
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Arnold P. G. Hoeks
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Jos Op 't Roodt
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Isabel Ferreira
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Floris H. M. Vanmolkot
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Casper G. Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Koen D. Reesink
- Department of Biomedical Engineering, Maastricht University Medical Centre+, Maastricht, The Netherlands
- School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
- * E-mail:
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26
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Katayama K, Yamashita S, Iwamoto E, Ishida K. Flow-mediated dilation in the inactive limb following acute hypoxic exercise. Clin Physiol Funct Imaging 2014; 36:60-9. [DOI: 10.1111/cpf.12194] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/01/2014] [Indexed: 01/24/2023]
Affiliation(s)
- Keisho Katayama
- Research Center of Health; Physical Fitness and Sports; Nagoya University; Nagoya Japan
| | - Shin Yamashita
- Graduate School of Education and Human Development; Nagoya University; Nagoya Japan
| | - Erika Iwamoto
- School of Health Sciences; Sapporo Medical University; Sapporo Japan
| | - Koji Ishida
- Research Center of Health; Physical Fitness and Sports; Nagoya University; Nagoya Japan
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27
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Veglia F, Amato M, Giovannardi M, Ravani A, Tedesco CC, Frigerio B, Sansaro D, Tremoli E, Baldassarre D. Potentially spurious correlations between arterial size, flow-mediated dilation, and shear rate. Hypertension 2014; 64:1328-33. [PMID: 25245392 DOI: 10.1161/hypertensionaha.114.03608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The use of indices formed from the ratio of 2 variables often generates spurious correlations with other variables that are mathematically coupled. In this context, we examined the correlations between percent flow-mediated dilation, baseline diameter, and shear rate. In a sample of 315 participants, with and without substantial vascular risk factors, the observed correlation coefficients between the variables were of a similar magnitude to those reported in the literature. We then applied a Monte Carlo procedure based on random permutations to remove any physical or physiological explanation for these correlations. We found that the median residual correlation coefficients were comparable with those observed in our original sample. When the confounding influence of artery size was adjusted for, the mean difference in percent flow-mediated dilation between high-risk and low-risk samples was halved. These findings indicate that the widely reported correlations between flow-mediated dilation, basal artery diameter, and shear rate have a substantial spurious component. This is because percent flow-mediated dilation and shear rate are mathematically coupled to artery size.
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Affiliation(s)
- Fabrizio Veglia
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.).
| | - Mauro Amato
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Marta Giovannardi
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Alessio Ravani
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Calogero C Tedesco
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Beatrice Frigerio
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Daniela Sansaro
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Elena Tremoli
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
| | - Damiano Baldassarre
- From Centro Cardiologico Monzino IRCCS, Milan, Italy (F.V., M.A., M.G., A.R., C.C.T., B.F., E.T., D.B.); and Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (E.T., D.B.)
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28
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Fox BM, Brantley L, White C, Seigler N, Harris RA. Association beween resting heart rate, shear and flow-mediated dilation in healthy adults. Exp Physiol 2014; 99:1439-48. [PMID: 25037565 DOI: 10.1113/expphysiol.2014.080960] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preclinical data have demonstrated that heart rate (HR) can directly impact vascular endothelial function, in part, through a shear-stress mechanism. This study sought to explore, in humans, the associations between resting heart rate and both shear and endothelial function assessed by flow-mediated dilation (FMD). The brachial artery FMD test was performed in 31 apparently healthy volunteers. Basal (B) and hyperaemic (H) shear were quantified in the following two ways using data from the FMD test: the traditional cumulative shear area under the curve up to peak dilation (Shearcum) method; and our novel method of shear summation (Shearsum), which accounts for HR by summing each individual cardiac cycle shear up to peak dilation. Data were grouped by tertiles based on resting HR as follows: low (LHR = 43-56 beats min(-1); n = 10); middle (MHR = 58-68 beats min(-1); n = 11); and high (HHR = 69-77 beats min(-1); n = 10). Within the LHR group, both B-Shearcum and H-Shearcum were significantly higher (P < 0.001) than B-Shearsum and H-Shearsum, respectively, whereas in the HHR group B-Shearcum and H-Shearcum were significantly lower (P < 0.001) than B-Shearsum and H-Shearsum, respectively. The FMD in the LHR group (8.8 ± 0.8%) was significantly greater than that in both the MHR group (5.5 ± 0.8%; P = 0.009) and the HHR group (5.9 ± 0.8%; P = 0.024). These findings demonstrate the existence of a relationship between heart rate and both shear and endothelial function in humans. Moreover, these findings have implications for considering heart rate as an important physiological variable when quantifying shear and performing the FMD test.
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Affiliation(s)
- Brandon M Fox
- Institute of Preventive and Public Health, Georgia Prevention Center, Georgia Regents University, Augusta, GA, UK
| | - Lucy Brantley
- Institute of Preventive and Public Health, Georgia Prevention Center, Georgia Regents University, Augusta, GA, UK
| | - Claire White
- Institute of Preventive and Public Health, Georgia Prevention Center, Georgia Regents University, Augusta, GA, UK
| | - Nichole Seigler
- Institute of Preventive and Public Health, Georgia Prevention Center, Georgia Regents University, Augusta, GA, UK
| | - Ryan A Harris
- Institute of Preventive and Public Health, Georgia Prevention Center, Georgia Regents University, Augusta, GA, UK Sport and Exercise Science Research Institute, University of Ulster, Jordanstown, County Antrim, UK
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Sponton CH, Esposti R, Rodovalho CM, Ferreira MJ, Jarrete AP, Anaruma CP, Bacci M, Zanesco A. The presence of the NOS3 gene polymorphism for intron 4 mitigates the beneficial effects of exercise training on ambulatory blood pressure monitoring in adults. Am J Physiol Heart Circ Physiol 2014; 306:H1679-91. [PMID: 24748593 DOI: 10.1152/ajpheart.00844.2013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The number of studies that have evaluated exercise training (ET) and nitric oxide synthase (NOS)3 gene polymorphisms is scarce. The present study was designed to evaluate the relationship between exercise training and NOS3 polymorphisms at -786T>C, 894G>T, and intron 4b/a on blood pressure (BP) using 24-h ambulatory BP monitoring (ABPM), nitrate/nitrite levels (NOx), and redox state. Eighty-six volunteers (51 ± 0.6 yr old) were genotyped into nonpolymorphic and polymorphic groups for each of the three positions of NOS3 polymorphisms. Auscultatory BP, ABPM, SOD activity, catalase activity, NOx levels, and malondialdehyde levels were measured. DNA was extracted from leukocytes, and PCR followed by sequencing was applied for genotype analysis. Aerobic ET consisted of 24 sessions for 3 days/wk for 40 min at moderate intensity. This study was performed in a double-blind and crossover format. ET was effective in lowering office BP (systolic BP: 3.2% and diastolic BP: 3%) as well as ABPM (systolic BP: 2% and diastolic BP: 1.3%). Increased SOD and catalase activity (42.6% and 15.1%, respectively) were also observed. The NOS3 polymorphism for intron 4 mitigated the beneficial effect of ET for systolic BP (nonpolymorphic group: -3.0% and polymorphic group: -0.6%) and diastolic BP (nonpolymorphic group: -3.2% and polymorphic group: -0.5%), but it was not associated with NOx level and redox state. Paradoxical responses were found for positions T786-C and G894T for the NOS3 gene. Consistently, the presence of the polymorphism for intron 4 blunted the beneficial effects of ET in middle-aged adults. Possibly, this effect might be as consequence of intron 4 acting as a short intronic repeat RNA controlling endothelial NOS activity epigenetically.
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Affiliation(s)
- Carlos H Sponton
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
| | - Rodrigo Esposti
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
| | - Cynara M Rodovalho
- Laboratory of Molecular Evolution, Institute of Bioscience, University of São Paulo State, Rio Claro, São Paulo, Brazil
| | - Maycon J Ferreira
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
| | - Aline P Jarrete
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
| | - Chadi P Anaruma
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
| | - Mauricio Bacci
- Laboratory of Molecular Evolution, Institute of Bioscience, University of São Paulo State, Rio Claro, São Paulo, Brazil
| | - Angelina Zanesco
- Laboratory of Cardiovascular Physiology and Exercise Science, University of São Paulo State, Rio Claro, São Paulo, Brazil; and
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30
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Humphreys RE, Green DJ, Cable NT, Thijssen DHJ, Dawson EA. Low-flow mediated constriction: the yin to FMD's yang? Expert Rev Cardiovasc Ther 2014; 12:557-64. [PMID: 24745959 DOI: 10.1586/14779072.2014.909728] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Given the prevalence of cardiovascular disease (CVD), early detection is crucial. Although traditional cardiovascular risk factors relate to future CVD, the predictive value of these risk factors can be relatively limited. Contemporary scientific attention has focused on alternative direct measures of arterial function. Based on the ability of the endothelium to acutely dilate in response to an increase in flow, 'flow mediated dilation' (FMD) was introduced approximately 20 years ago and is now an established non-invasive index of endothelial function predictive of future cardiovascular events. Recently, 'low-flow mediated constriction' (L-FMC) has been proposed as a complementary addition to FMD. The technique is based on the constrictor response to decreased flow and is claimed to improve the sensitivity and specificity of FMD. The aim of this review is to examine literature pertaining to this novel technique and to provide insight into the potential use of L-FMC in future research.
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Affiliation(s)
- Ruth E Humphreys
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
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Ostrem JD, Dengel DR, Marlatt KL, Steinberger J. Comparison of baseline brachial artery measurements and effect on peak flow‐mediated dilation. Clin Physiol Funct Imaging 2014; 35:34-40. [PMID: 24438447 DOI: 10.1111/cpf.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/11/2013] [Indexed: 01/21/2023]
Affiliation(s)
- Joseph D. Ostrem
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
| | - Donald R. Dengel
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
- Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA
| | - Kara L. Marlatt
- Laboratory of Integrative Human Physiology School of Kinesiology University of MinnesotaMinneapolis MN USA
| | - Julia Steinberger
- Department of Pediatrics University of Minnesota Medical School Minneapolis MN USA
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Liu JYJ, Jones B, Cheung MMH, Galati JC, Koleff J, Konstantinov IE, Grigg LE, Brizard CP, d'Udekem Y. Favourable anatomy after end-to-side repair of interrupted aortic arch. Heart Lung Circ 2013; 23:256-64. [PMID: 24060690 DOI: 10.1016/j.hlc.2013.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 07/13/2013] [Accepted: 08/09/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate cardiovascular outcomes in patients with aortic arch repair and their possible correlation with arch geometry. METHODS Ten patients who underwent end-to-side repair for aortic arch interruption (IAA), older than 10 years were compared to a cohort of 10 post coarctation (CoA) repair patients matched for age, sex and age at repair. Mean age at operation was 9.7±6.5 days. Patients underwent a resting and 24 h blood pressure measurements, exercise study, MRI, transthoracic echocardiography and vascular studies. RESULTS Seven patients developed hypertension, two from IAA group and five from CoA group. Nine patients (45%) had gothic arch geometry, three from IAA group and six from CoA group. Despite differences in arch geometry, both groups had normal LV mass, LV function and vascular function. CONCLUSION No differences in functional or morphologic outcomes could be demonstrated between the end-to-side repair of the arch by sternotomy and the conventional coarctation repair by thoracotomy. A favourable arch geometry can be achieved after the end-to-side repair of the aortic arch. In the present study, we could not correlate adverse arch geometry with any adverse cardio-vascular outcomes. After neonatal arch repair, the contributive role of aortic arch geometry to late hypertension remains uncertain.
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Affiliation(s)
- Jessamine Y J Liu
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Bryn Jones
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - Michael M H Cheung
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - John C Galati
- Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia
| | - Jane Koleff
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - Igor E Konstantinov
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Leeanne E Grigg
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | - Christian P Brizard
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Yves d'Udekem
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children Research Institute, Melbourne, Australia.
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Atkinson G, Batterham AM, Thijssen DH, Green DJ. A new approach to improve the specificity of flow-mediated dilation for indicating endothelial function in cardiovascular research. J Hypertens 2013; 31:287-91. [DOI: 10.1097/hjh.0b013e32835b8164] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Atkinson G, Batterham AM. Allometric scaling of diameter change in the original flow-mediated dilation protocol. Atherosclerosis 2012; 226:425-7. [PMID: 23261170 DOI: 10.1016/j.atherosclerosis.2012.11.027] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 11/19/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
The negative correlation between percent flow-mediated dilation (FMD%) and baseline diameter (D(base)) has only recently been recognised as a fundamental ratio-scaling problem, which is not resolved by significance-testing of D(base) inequality between groups/conditions, nor by covariate-adjusting FMD% itself by D(base). It is resolved appropriately by allometric scaling of the relationship between peak diameter (D(peak)) and D(base) using statistical models. Therefore, we extracted data from a seminal study on FMD%, and re-analysed it using allometric methods. We found that D(peak) did not increase as a constant proportion of D(base), rendering FMD% a biased estimator of differences in endothelial function between artery sites (brachial vs femoral) and age-groups (children vs. adults). The allometric expression was D(peak)/D(base)(≈ 0.90), rather than a simple ratio. In agreement with our previous research, a proper allometric perspective on FMD led to unbiased estimates of endothelial function, with full adjustment for the influence of baseline diameter.
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Affiliation(s)
- Greg Atkinson
- Health and Social Care Institute, School of Health and Social Care, Parkside West, Teesside University, Middlesbrough, Tees Valley TS1 3BA, UK.
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36
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Gurovich AN, Braith RW. Enhanced external counterpulsation creates acute blood flow patterns responsible for improved flow-mediated dilation in humans. Hypertens Res 2012; 36:297-305. [DOI: 10.1038/hr.2012.169] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Birk GK, Dawson EA, Timothy Cable N, Green DJ, Thijssen DHJ. Effect of unilateral forearm inactivity on endothelium-dependent vasodilator function in humans. Eur J Appl Physiol 2012; 113:933-40. [DOI: 10.1007/s00421-012-2505-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 09/18/2012] [Indexed: 11/29/2022]
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Short-term Statin Treatment Does Not Prevent Ischemia and Reperfusion-induced Endothelial Dysfunction in Humans. J Cardiovasc Pharmacol 2012; 59:22-8. [DOI: 10.1097/fjc.0b013e318232b1a4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Barton M, Turner AT, Newens KJ, Williams CM, Thompson AK. Minimum recovery time between reactive hyperemia stimulus in the repeated measurement of brachial flow-mediated dilatation. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:879-883. [PMID: 21531496 DOI: 10.1016/j.ultrasmedbio.2011.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Revised: 02/17/2011] [Accepted: 03/13/2011] [Indexed: 05/30/2023]
Abstract
The ability to undertake repeat measurements of flow-mediated dilatation (FMD) within a short time of a previous measurement would be useful to improve accuracy or to repeat a failed initial procedure. Although standard methods report that a minimum of 10 min is required between measurements, there is no published data to support this. Thirty healthy volunteers had five FMD measurements performed within a 2-h period, separated by various time intervals (5, 15 and 30 min). In 19 volunteers, FMD was also performed as soon as the vessel had returned to its baseline diameter. There was no significant difference between any of the FMD measurements or parameters across the visits indicating that repeat measurements may be taken after a minimum of 5 min or as soon as the vessel has returned to its baseline diameter, which in some subjects may be less than 5 min.
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Affiliation(s)
- Matthew Barton
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutrition Science, University of Reading, Reading, United Kingdom
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Harrison M, Parkhurst K, Tarumi T, Lin HF, Tanaka H. Low flow-mediated constriction: prevalence, impact and physiological determinant. Clin Physiol Funct Imaging 2011; 31:394-8. [PMID: 21771260 DOI: 10.1111/j.1475-097x.2011.01032.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Flow-mediated dilation (FMD) is a surrogate marker for endothelial function. In the FMD procedure, arterial response during cuff inflation is not taken into consideration yet studies have demonstrated vasoconstriction, vasodilation and no change in the brachial artery during cuff inflation. The term low flow-mediated constriction (L-FMC) has been introduced to describe the vasoconstriction that occurs in some individuals during inflation of the cuff. The aims of this study were to examine (i) whether brachial artery response during cuff inflation differed in a population with varied coronary artery disease (CAD) risk factor profiles, (ii) the impact of this response on the subsequent calculation of FMD and (iii) the role of arterial stiffness in this variable response. L-FMC, 'traditional' FMD and 'modified' FMD, which accounts for brachial artery response during cuff inflation, were studied in a total of 46 subjects varying in risk factor profiles for coronary artery disease. During cuff inflation, brachial artery responses varied widely from -5·6% (vasoconstriction) to 5·0% (vasodilation). When subjects were divided into healthy versus multiple risk factors (n = 34), L-FMC and FMD were not different between the groups but modified FMD was significantly different (P = 0·02). L-FMC was modestly but significantly associated with FMD (r = 0·41) and positively correlated with brachial artery pulse wave velocity (r = 0·30). Our results indicate that brachial artery responses to inflation of the cuff are very variable and are associated with arterial stiffness and that accounting for so-called L-FMC may provide a more comprehensive assessment of endothelial vasodilatory function.
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Affiliation(s)
- Michelle Harrison
- Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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Lunder M, Janić M, Habjan S, Šabovič M. Subtherapeutic, low-dose fluvastatin improves functional and morphological arterial wall properties in apparently healthy, middle-aged males – a pilot study. Atherosclerosis 2011; 215:446-51. [DOI: 10.1016/j.atherosclerosis.2010.12.041] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 12/13/2010] [Accepted: 12/28/2010] [Indexed: 11/16/2022]
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Thijssen DHJ, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, Parker B, Widlansky ME, Tschakovsky ME, Green DJ. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol 2010; 300:H2-12. [PMID: 20952670 DOI: 10.1152/ajpheart.00471.2010] [Citation(s) in RCA: 1049] [Impact Index Per Article: 74.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Endothelial dysfunction is now considered an important early event in the development of atherosclerosis, which precedes gross morphological signs and clinical symptoms. The assessment of flow-mediated dilation (FMD) was introduced almost 20 years ago as a noninvasive approach to examine vasodilator function in vivo. FMD is widely believed to reflect endothelium-dependent and largely nitric oxide-mediated arterial function and has been used as a surrogate marker of vascular health. This noninvasive technique has been used to compare groups of subjects and to evaluate the impact of interventions within individuals. Despite its widespread adoption, there is considerable variability between studies with respect to the protocols applied, methods of analysis, and interpretation of results. Moreover, differences in methodological approaches have important impacts on the response magnitude, can result in spurious data interpretation, and limit the comparability of outcomes between studies. This review results from a collegial discussion between physiologists with the purpose of developing considered guidelines. The contributors represent several distinct research groups that have independently worked to advance the evidence base for improvement of the technical approaches to FMD measurement and analysis. The outcome is a series of recommendations on the basis of review and critical appraisal of recent physiological studies, pertaining to the most appropriate methods to assess FMD in humans.
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Affiliation(s)
- Dick H J Thijssen
- Research Inst. for Sport and Exercise Science, Henry Cotton Campus, Liverpool John Moores Univ., 15-21 Webster St., Liverpool, L3 2ET, UK.
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Abstract
Developed in 1992, the flow-mediated dilation test is now the most commonly used noninvasive assessment of vascular endothelial function in humans. Since its inception, scientists have refined their understanding of the physiology, analysis, and interpretation of this measurement. Recently, a significant growth of knowledge has added to our understanding and implementation of this clinically relevant research methodology. Therefore, this tutorial provides timely insight into recent advances and practical information related to the ultrasonic assessment of vascular endothelial function in humans.
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Affiliation(s)
- Ryan A Harris
- Georgia Prevention Institute, Medical College of Georgia, Augusta, GA 30912, USA.
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Weissgerber TL, Davies GAL, Tschakovsky ME. Low flow-mediated constriction occurs in the radial but not the brachial artery in healthy pregnant and nonpregnant women. J Appl Physiol (1985) 2010; 108:1097-105. [PMID: 20185630 DOI: 10.1152/japplphysiol.00815.2009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Radial artery diameter decreases when a wrist cuff is inflated to stop blood flow to distal tissue. This phenomenon, referred to as low flow-mediated vasoconstriction (L-FMC), was proposed as a vascular function test. Recommendations that L-FMC be measured concurrently with flow-mediated dilation (FMD) were based on radial artery data. However, cardiovascular disease prediction studies traditionally measure brachial artery FMD. Therefore, studies should determine whether L-FMC occurs in the brachial artery. The hypothesis that reduced shear causes L-FMC has not been tested. Brachial and radial artery L-FMC and FMD were assessed in active nonpregnant (n=17), inactive nonpregnant (n=10), active pregnant (n=15, 34.1+/-1.2 wk gestation), and inactive pregnant (n=8, 34.2+/-2.2 wk gestation) women. Radial artery diameter decreased significantly during occlusion in all groups (nonpregnant, -4.4+/-4.2%; pregnant, -6.4+/-3.2%). Brachial artery diameter did not change in active and inactive nonpregnant, and inactive pregnant women; however, the small decrease in active pregnant women was significant. Occlusion decreased shear rate in both arteries, yet L-FMC only occurred in the radial artery. Radial artery L-FMC was not correlated with the reduction in shear rate. L-FMC occurs in the radial but not the brachial artery and is not related to changes in shear rate. Positive correlations between L-FMC (negative values) and FMD (positive values) suggest that radial artery FMD may be reduced among women who experience greater L-FMC. Studies should clarify the underlying stimulus and mechanisms regulating L-FMC, and test the hypothesis that endothelial dysfunction is manifested as enhanced brachial artery L-FMC, but attenuated radial artery L-FMC.
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Affiliation(s)
- Tracey L Weissgerber
- Department of Obstetrics, Gynecology, and Reproductive Science, Magee Women's Research Institute, 204 Craft Ave., Pittsburgh, PA 15213, USA.
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van Duijnhoven NTL, Thijssen DHJ, Green DJ, Felsenberg D, Belavý DL, Hopman MTE. Resistive exercise versus resistive vibration exercise to counteract vascular adaptations to bed rest. J Appl Physiol (1985) 2010; 108:28-33. [DOI: 10.1152/japplphysiol.00760.2009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Bed rest results in marked vascular adaptations, and resistive vibration exercise (RVE) has been shown to be an effective countermeasure. As vibration exercise has practical and logistical limitations, the use of resistive exercise (RES) alone has the preference under specific circumstances. However, it is unknown if RES is sufficient to prevent vascular adaptations to bed rest. Therefore, the purpose of the present study was to examine the impact of RES and RVE on the vascular function and structure of the superficial femoral artery in young men exposed to 60 days of bed rest. Eighteen healthy men (age: 31 ± 8 yr) were assigned to bed rest and randomly allocated to control, RES, or RVE groups. Exercise was applied 3 times/wk for 5–7 min/session. Resting diameter, blood flow, flow-mediated dilation (FMD), and dilator capacity of the superficial femoral artery were measured using echo-Doppler ultrasound. Bed rest decreased superficial femoral artery diameter and dilator capacity ( P < 0.001), which were significantly attenuated in the RVE group ( P < 0.01 and P < 0.05, respectively) but not in the RES group ( P = 0.202 and P = 0.696, respectively). Bed rest significantly increased FMD ( P < 0.001), an effect that was abolished by RVE ( P < 0.005) but not RES ( P = 0.078). Resting and hyperemic blood flow did not change in any of the groups. Thus, RVE abolished the marked increase in FMD and decrease in baseline diameter and dilator capacity normally associated with prolonged bed rest. However, the stimulus provided by RES alone was insufficient to counteract the vascular adaptations to bed rest.
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Affiliation(s)
| | - Dick H. J. Thijssen
- Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Research Institute for Sports and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Daniel J. Green
- Research Institute for Sports and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
- School of Sport Science, Exercise and Health, University of Western Australia, Crawley, Western Australia, Australia; and
| | - Dieter Felsenberg
- Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel L. Belavý
- Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Maria T. E. Hopman
- Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Heffernan KS, Karas RH, Mooney PJ, Patel AR, Kuvin JT. Pulse wave amplitude is associated with brachial artery diameter: implications for gender differences in microvascular function. Vasc Med 2009; 15:39-45. [PMID: 20026517 DOI: 10.1177/1358863x09349523] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The ratio of pulse wave amplitude (PWA) during reactive hyperemia compared to baseline as measured by peripheral arterial tonometry (PAT) is a non-invasive measure of microvascular endothelial function referred to as the pulse wave amplitude reactive hyperemia index (PWA-RHI). Whether upstream conduit vessel structure may affect downstream resistance vessel PWA has not been clearly examined. We tested the hypothesis that digital PWA is influenced by brachial artery diameter (BAD) and that this association would influence comparison of PWA-RHI between genders. Measures of vascular structure and microvascular function were carried out in 115 patients varying in cardiovascular risk profiles (average age 57 years, male n = 79, CAD n = 43). PWA was assessed using plethysmography at baseline and following 5 minutes of brachial artery occlusion. BAD was assessed using high-resolution ultrasonography. Results : There was a negative association between BAD and PWA-RHI ( r = -0.34, p < 0.05). Women had greater PWA-RHI and smaller BAD compared with men (p < 0.05). When co-varying for BAD, there were no longer gender differences in PWA-RHI. Moreover, when a sub-group of men and women without CAD (n = 40), matched for BAD, were examined, there were no gender differences in PWA-RHI. In conclusion, PWA-RHI obtained from PAT is associated with BAD. Studies examining gender differences in microvascular endothelial function with PAT may need to correct for BAD as a potential confounder.
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Affiliation(s)
- Kevin S Heffernan
- Vascular Function Study Group, Department of Medicine, Division of Cardiology, Tufts Medical Center, Boston, MA 02111, USA.
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Parker BA, Trehearn TL, Meendering JR. Pick your Poiseuille: normalizing the shear stimulus in studies of flow-mediated dilation. J Appl Physiol (1985) 2009; 107:1357-9. [DOI: 10.1152/japplphysiol.91302.2009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Beth A. Parker
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut; and
| | - Tamra L. Trehearn
- Department of Health, Physical Education, and Recreation, University of Nebraska Omaha, Omaha, Nebraska
| | - Jessica R. Meendering
- Department of Health, Physical Education, and Recreation, University of Nebraska Omaha, Omaha, Nebraska
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