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Hanson BE, Lee JF, Garten RS, O'Keefe ZB, Layec G, Ruple BA, Wray DW, Richardson RS, Trinity JD. Acute sympathetic activation blunts the hyperemic and vasodilatory response to passive leg movement. RESEARCH SQUARE 2024:rs.3.rs-4356062. [PMID: 38765959 PMCID: PMC11100891 DOI: 10.21203/rs.3.rs-4356062/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Heightened muscle sympathetic nerve activity (MSNA) contributes to impaired vasodilatory capacity and vascular dysfunction associated with aging and cardiovascular disease. The contribution of elevated MSNA to the vasodilatory response during passive leg movement (PLM) has not been adequately addressed. This study sought to test the hypothesis that elevated MSNA diminishes the vasodilatory response to PLM in healthy young males (n = 11, 25 ± 2 year). Post exercise circulatory occlusion (PECO) following 2 min of isometric handgrip (HG) exercise performed at 25% (ExPECO 25%) and 40% (ExPECO 40%) of maximum voluntary contraction was used to incrementally engage the metaboreceptors and augment MSNA. Control trials were performed without PECO (ExCON 25% and ExCON 40%) to account for changes due to HG exercise. PLM was performed 2 min after the cessation of exercise and central and peripheral hemodynamics were assessed. MSNA was directly recorded by microneurography in the peroneal nerve (n = 8). Measures of MSNA (i.e., burst incidences) increased during ExPECO 25% (+ 15 ± 5 burst/100 bpm) and ExPECO 40% (+ 22 ± 4 burst/100 bpm) and returned to pre-HG levels during ExCON trials. Vasodilation, assessed by the change in leg vascular conductance during PLM, was reduced by 16% and 44% during ExPECO 25% and ExPECO 40%, respectively. These findings indicate that elevated MSNA attenuates the vasodilatory response to PLM and that the magnitude of reduction in vasodilation during PLM is graded in relation to the degree of sympathoexcitation.
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Ferreira-Santos L, Martinez-Lemus LA, Padilla J. Sitting leg vasculopathy: potential adaptations beyond the endothelium. Am J Physiol Heart Circ Physiol 2024; 326:H760-H771. [PMID: 38241008 PMCID: PMC11221807 DOI: 10.1152/ajpheart.00489.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/27/2023] [Accepted: 01/18/2024] [Indexed: 02/29/2024]
Abstract
Increased sitting time, the most common form of sedentary behavior, is an independent risk factor for all-cause and cardiovascular disease mortality; however, the mechanisms linking sitting to cardiovascular risk remain largely elusive. Studies over the last decade have led to the concept that excessive time spent in the sitting position and the ensuing reduction in leg blood flow-induced shear stress cause endothelial dysfunction. This conclusion has been mainly supported by studies using flow-mediated dilation in the lower extremities as the measured outcome. In this review, we summarize evidence from classic studies and more recent ones that collectively support the notion that prolonged sitting-induced leg vascular dysfunction is likely also attributable to changes occurring in vascular smooth muscle cells (VSMCs). Indeed, we provide evidence that prolonged constriction of resistance arteries can lead to modifications in the structural characteristics of the vascular wall, including polymerization of actin filaments in VSMCs and inward remodeling, and that these changes manifest in a time frame that is consistent with the vascular changes observed with prolonged sitting. We expect this review will stimulate future studies with a focus on VSMC cytoskeletal remodeling as a potential target to prevent the detrimental vascular ramifications of too much sitting.
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Affiliation(s)
| | - Luis A Martinez-Lemus
- NextGen Precision Health, University of Missouri, Columbia, Missouri, United States
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri, United States
- Center for Precision Medicine, Department of Medicine, University of Missouri, Columbia, Missouri, United States
| | - Jaume Padilla
- NextGen Precision Health, University of Missouri, Columbia, Missouri, United States
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, United States
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Dorff A, Bradford C, Hunsaker A, Atkinson J, Rhees J, Leach OK, Gifford JR. Vascular dysfunction and the age-related decline in critical power. Exp Physiol 2024; 109:240-254. [PMID: 37934136 PMCID: PMC10988715 DOI: 10.1113/ep091571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/08/2023]
Abstract
Ageing results in lower exercise tolerance, manifested as decreased critical power (CP). We examined whether the age-related decrease in CP occurs independently of changes in muscle mass and whether it is related to impaired vascular function. Ten older (63.1 ± 2.5 years) and 10 younger (24.4 ± 4.0 years) physically active volunteers participated. Physical activity was measured with accelerometry. Leg muscle mass was quantified with dual X-ray absorptiometry. The CP and maximum power during a graded exercise test (PGXT ) of single-leg knee-extension exercise were determined over the course of four visits. During a fifth visit, vascular function of the leg was assessed with passive leg movement (PLM) hyperaemia and leg blood flow and vascular conductance during knee-extension exercise at 10 W, 20 W, slightly below CP (90% CP) and PGXT . Despite not differing in leg lean mass (P = 0.901) and physical activity (e.g., steps per day, P = 0.735), older subjects had ∼30% lower mass-specific CP (old = 3.20 ± 0.94 W kg-1 vs. young = 4.60 ± 0.87 W kg-1 ; P < 0.001). The PLM-induced hyperaemia and leg blood flow and/or conductance were blunted in the old at 20 W, 90% CP and PGXT (P < 0.05). When normalized for leg muscle mass, CP was strongly correlated with PLM-induced hyperaemia (R2 = 0.52; P < 0.001) and vascular conductance during knee-extension exercise at 20 W (R2 = 0.34; P = 0.014) and 90% CP (R2 = 0.39; P = 0.004). In conclusion, the age-related decline in CP is not only an issue of muscle quantity, but also of impaired muscle quality that corresponds to impaired vascular function.
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Affiliation(s)
- Abigail Dorff
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
| | - Christy Bradford
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Ashley Hunsaker
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Jake Atkinson
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Joshua Rhees
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Olivia K. Leach
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
| | - Jayson R. Gifford
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
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Fermoyle CC, La Salle DT, Alpenglow JK, Craig JC, Jarrett CL, Broxterman RM, McKenzie AI, Morgan DE, Birgenheier NM, Wray DW, Richardson RS, Trinity JD. Pharmacological modulation of adrenergic tone alters the vasodilatory response to passive leg movement in young but not in old adults. J Appl Physiol (1985) 2023; 134:1124-1134. [PMID: 36927146 PMCID: PMC10125034 DOI: 10.1152/japplphysiol.00682.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
The age-related increase in α-adrenergic tone may contribute to decreased leg vascular conductance (LVC) both at rest and during exercise in the old. However, the effect on passive leg movement (PLM)-induced LVC, a measure of vascular function, which is markedly attenuated in this population, is unknown. Thus, in eight young (25 ± 5 yr) and seven old (65 ± 7 yr) subjects, this investigation examined the impact of systemic β-adrenergic blockade (propanalol, PROP) alone, and PROP combined with either α1-adrenergic stimulation (phenylephrine, PE) or α-adrenergic inhibition (phentolamine, PHEN), on PLM-induced vasodilation. LVC, calculated from femoral artery blood flow and pressure, was determined and PLM-induced Δ peak (LVCΔpeak) and total vasodilation (LVCAUC, area under curve) were documented. PROP decreased LVCΔpeak (PROP: 4.8 ± 1.8, Saline: 7.7 ± 2.7 mL·mmHg-1, P < 0.001) and LVCAUC (PROP: 1.1 ± 0.7, Saline: 2.4 ± 1.6 mL·mmHg-1, P = 0.002) in the young, but not in the old (LVCΔpeak, P = 0.931; LVCAUC, P = 0.999). PE reduced baseline LVC (PE: 1.6 ± 0.4, PROP: 2.3 ± 0.4 mL·min-1·mmHg-1, P < 0.01), LVCΔpeak (PE: 3.2 ± 1.3, PROP: 4.8 ± 1.8 mL·min-1·mmHg-1, P = 0.004), and LVCAUC (PE: 0.5 ± 0.4, PROP: 1.1 ± 0.7 mL·mmHg-1, P = 0.011) in the young, but not in the old (baseline LVC, P = 0.199; LVCΔpeak, P = 0.904; LVCAUC, P = 0.823). PHEN increased LVC at rest and throughout PLM in both groups (drug effect: P < 0.05), however LVCΔpeak was only improved in the young (PHEN: 6.4 ± 3.1, PROP: 4.4 ± 1.5 mL·min-1·mmHg-1, P = 0.004), and not in the old (P = 0.904). Furthermore, the magnitude of α-adrenergic modulation (PHEN - PE) of LVCΔpeak was greater in the young compared with the old (Young: 3.35 ± 2.32, Old: 0.40 ± 1.59 mL·min-1·mmHg-1, P = 0.019). Therefore, elevated α-adrenergic tone does not appear to contribute to the attenuated vascular function with age identified by PLM.NEW & NOTEWORTHY Stimulation of α1-adrenergic receptors eliminated age-related differences in passive leg movement (PLM) by decreasing PLM-induced vasodilation in the young. Systemic β-blockade attenuated the central hemodynamic component of the PLM response in young individuals. Inhibition of α-adrenergic receptors did not improve the PLM response in older individuals, though withdrawal of α-adrenergic modulation augmented baseline and maximal vasodilation in both groups. Accordingly, α-adrenergic signaling plays a role in modulating the PLM vasodilatory response in young but not in old adults, and elevated α-adrenergic tone does not appear to contribute to the attenuated vascular function with age identified by PLM.
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Affiliation(s)
- Caitlin C Fermoyle
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - D Taylor La Salle
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Jeremy K Alpenglow
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Jesse C Craig
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - Catherine L Jarrett
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - Ryan M Broxterman
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Alec I McKenzie
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - David E Morgan
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Nathaniel M Birgenheier
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - D Walter Wray
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Russell S Richardson
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Joel D Trinity
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
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D’Agata MN, Matias AA, Witman MA. We like to move it, move it: A perspective on performing passive leg movement as a non-invasive assessment of vascular function in pediatric populations. Front Physiol 2023; 14:1165800. [PMID: 37179828 PMCID: PMC10169695 DOI: 10.3389/fphys.2023.1165800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
The passive leg movement (PLM) technique is a non-invasive assessment of lower-limb vascular function. PLM is methodologically simple to perform and utilizes Doppler ultrasound to determine leg blood flow (LBF) through the common femoral artery at rest and in response to passive movement of the lower leg. LBF responses to PLM have been reported to be mostly nitric oxide (NO)-mediated when performed in young adults. Moreover, PLM-induced LBF responses, as well as the NO contribution to PLM-induced LBF responses, are reduced with age and in various diseased populations, demonstrating the clinical utility of this non-invasive test. However, no PLM studies to date have included children or adolescents. Since its conception in 2015, our laboratory has performed PLM on hundreds of individuals including a large cohort of children and adolescents. Thus, the purpose of this perspective article is threefold: 1) to uniquely discuss the feasibility of performing PLM in children and adolescents, 2) to report PLM-induced LBF values from our laboratory in 7-17-year-olds, and 3) to discuss considerations for making comparisons among pediatric populations. Based on our experiences performing PLM in children and adolescents (among various other age groups), it is our perspective that PLM can feasibly be performed in this population. Further, data from our laboratory may be used to provide context for typical PLM-induced LBF values that could be observed in children and adolescents, as well as across the lifespan.
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Affiliation(s)
| | | | - Melissa A. Witman
- Vascular Function in Chronic Disease Research Laboratory, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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Ratchford SM, Bunsawat K, Alpenglow JK, Zhao J, Wright JB, Ryan JJ, Wray DW. Improved vascular function and functional capacity following l-citrulline administration in patients with heart failure with preserved ejection fraction: a single-arm, open-label, prospective pilot study. J Appl Physiol (1985) 2023; 134:328-338. [PMID: 36476159 PMCID: PMC9886346 DOI: 10.1152/japplphysiol.00445.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
There is accumulating evidence for both peripheral vascular dysfunction and impaired functional capacity in patients with heart failure with a preserved ejection fraction (HFpEF). Although derangements in the l-arginine-nitric oxide (l-Arg-NO) pathway are likely to contribute to these aspects of HFpEF pathophysiology, the impact of increased NO substrate on vascular health and physical capacity has not been evaluated in this patient population. Thus, using a single-arm study design, we evaluated the impact of enteral l-citrulline (l-Cit, 6 g/day for 7 days), a precursor for l-Arg biosynthesis, on vascular function [flow-mediated dilation (FMD), reactive hyperemia (RH), and passive limb movement (PLM)], functional capacity [6-min walk test (6MWT)], and biomarkers of l-Arg-NO signaling in 14 patients with HFpEF (n = 14, 4 M/10 F, 70 ± 10 yr, EF: 66 ± 7%). Compared with baseline (0d), 7 days of l-Cit administration improved FMD (0d: 2.5 ± 1.6%, 7d: 4.5 ± 2.9%), RH (0d: 468 ± 167 mL, 7d: 577 ± 199 mL), PLM blood flow area-under-the-curve (0d: 139 ± 130 mL, 7d: 198 ± 115 mL), and 6MWT distance (0d: 377 ± 27 m, 7d: 397 ± 27 m) (P < 0.05). An increase in plasma l-Cit (0d: 42 ± 11 µM/L, 7d: 369 ± 201 µM/L), l-Arg (0d: 65 ± 8 µM/L, 7d: 257 ± 25 µM/L), and the ratio of l-Arg to asymmetric dimethylarginine (ADMA) (0d: 136 ± 13 AU, 7d: 481 ± 49 AU) (P < 0.05) was also observed. Though preliminary in nature, these functional and biomarker assessments demonstrate a potential benefit of l-Cit administration in patients with HFpEF, findings that provide new insight into the mechanisms that govern vascular and physical dysfunction in this patient group.NEW & NOTEWORTHY The current investigation has demonstrated that l-Cit administration may improve brachial artery endothelium-dependent vasodilation, upper and lower limb microvascular function, and physical capacity in patients with HFpEF, highlighting the potential therapeutic potential of interventions targeting the l-Arg-NO signaling cascade to improve outcomes in this patient group.
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Affiliation(s)
- Stephen M Ratchford
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Kanokwan Bunsawat
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jeremy K Alpenglow
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jia Zhao
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Josephine B Wright
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - John J Ryan
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - D Walter Wray
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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Adams JA, Uryash A, Lopez JR. Non-Invasive Pulsatile Shear Stress Modifies Endothelial Activation; A Narrative Review. Biomedicines 2022; 10:biomedicines10123050. [PMID: 36551807 PMCID: PMC9775985 DOI: 10.3390/biomedicines10123050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
The monolayer of cells that line both the heart and the entire vasculature is the endothelial cell (EC). These cells respond to external and internal signals, producing a wide array of primary or secondary messengers involved in coagulation, vascular tone, inflammation, and cell-to-cell signaling. Endothelial cell activation is the process by which EC changes from a quiescent cell phenotype, which maintains cellular integrity, antithrombotic, and anti-inflammatory properties, to a phenotype that is prothrombotic, pro-inflammatory, and permeable, in addition to repair and leukocyte trafficking at the site of injury or infection. Pathological activation of EC leads to increased vascular permeability, thrombosis, and an uncontrolled inflammatory response that leads to endothelial dysfunction. This pathological activation can be observed during ischemia reperfusion injury (IRI) and sepsis. Shear stress (SS) and pulsatile shear stress (PSS) are produced by mechanical frictional forces of blood flow and contraction of the heart, respectively, and are well-known mechanical signals that affect EC function, morphology, and gene expression. PSS promotes EC homeostasis and cardiovascular health. The archetype of inducing PSS is exercise (i.e., jogging, which introduces pulsations to the body as a function of the foot striking the pavement), or mechanical devices which induce external pulsations to the body (Enhanced External Pulsation (EECP), Whole-body vibration (WBV), and Whole-body periodic acceleration (WBPA aka pGz)). The purpose of this narrative review is to focus on the aforementioned noninvasive methods to increase PSS, review how each of these modify specific diseases that have been shown to induce endothelial activation and microcirculatory dysfunction (Ischemia reperfusion injury-myocardial infarction and cardiac arrest and resuscitation), sepsis, and lipopolysaccharide-induced sepsis syndrome (LPS)), and review current evidence and insight into how each may modify endothelial activation and how these may be beneficial in the acute and chronic setting of endothelial activation and microvascular dysfunction.
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Affiliation(s)
- Jose A. Adams
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
- Correspondence:
| | - Arkady Uryash
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
| | - Jose R. Lopez
- Department of Research, Mount Sinai Medical Center, Miami Beach, FL 33140, USA
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Murrant CL, Fletcher NM. Capillary communication: the role of capillaries in sensing the tissue environment, coordinating the microvascular, and controlling blood flow. Am J Physiol Heart Circ Physiol 2022; 323:H1019-H1036. [PMID: 36149771 DOI: 10.1152/ajpheart.00088.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Historically, capillaries have been viewed as the microvascular site for flux of nutrients to cells and removal of waste products. Capillaries are the most numerous blood vessel segment within the tissue, whose vascular wall consists of only a single layer of endothelial cells and are situated within microns of each cell of the tissue, all of which optimizes capillaries for the exchange of nutrients between the blood compartment and the interstitial space of tissues. There is, however, a growing body of evidence to support that capillaries play an important role in sensing the tissue environment, coordinating microvascular network responses, and controlling blood flow. Much of our growing understanding of capillaries stems from work in skeletal muscle and more recent work in the brain, where capillaries can be stimulated by products released from cells of the tissue during increased activity and are able to communicate with upstream and downstream vascular segments, enabling capillaries to sense the activity levels of the tissue and send signals to the microvascular network to coordinate the blood flow response. This review will focus on the emerging role that capillaries play in communication between cells of the tissue and the vascular network required to direct blood flow to active cells in skeletal muscle and the brain. We will also highlight the emerging central role that disruptions in capillary communication may play in blood flow dysregulation, pathophysiology, and disease.
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Affiliation(s)
- Coral L Murrant
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Nicole M Fletcher
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Gonzalez MR, Zuelch ML, Smiljanec K, Mbakwe AU, Axler MR, Witman MA, Lennon SL. Arterial Stiffness and Endothelial Function are Comparable in Young Healthy Vegetarians and Omnivores. Nutr Res 2022; 105:163-172. [PMID: 36054948 DOI: 10.1016/j.nutres.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/26/2022] [Accepted: 07/06/2022] [Indexed: 11/15/2022]
Abstract
Vegetarians (VEG) are reported to have lower body weight, blood pressure (BP), and cardiovascular disease (CVD) risk compared with omnivores (OMN), yet the mechanisms remain unclear. A vegetarian diet may protect the vascular endothelium, reducing the risk of atherosclerosis and CVD. This cross-sectional study compared vascular function between OMN and VEG. We hypothesized that VEG would have greater vascular function compared with OMN. Fifty-eight normotensive young healthy adults participated (40 women [W]/18 men [M]; 28 OMN [15W/13M] and 30 VEG [25W/5M]; 26 ± 7 years; BP: 112 ± 11/67 ± 8 mm Hg). Arterial stiffness, assessed by carotid-to-femoral pulse wave velocity (OMN: 5.6 ± 0.8 m/s, VEG: 5.3 ± 0.8 m/s; P = .17) and wave reflection assessed by aortic augmentation index (OMN: 6.9 ± 12.3%, VEG: 8.8 ± 13.5%; P = .57) were not different between groups. However, central pulse pressure (OMN: 32 ± 5; VEG: 29 ± 5 mm Hg; P = .048) and forward wave reflection were greater in omnivores (OMN: 26 ± 3; VEG: 24 ± 3 mm Hg; P = .048). Endothelial-dependent dilation measured by brachial artery flow-mediated dilation was not different between groups (OMN: 6.0 ± 2.9%, VEG: 6.9 ± 3.3%; P = .29). Percent change in femoral blood flow from baseline during passive leg movement, another assessment of nitric oxide-mediated endothelial dilation, was similar between groups (OMN: 203 ± 88 mL/min, VEG: 253 ± 192 mL/min; P = .50). These data suggest that in healthy young adults, normotensive VEG do not have significantly improved vascular function compared with OMN; however, they have a lower central pulse pressure and forward wave amplitude which may lower the risk of future CVD.
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Affiliation(s)
- Macarena Ramos Gonzalez
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Michelle L Zuelch
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19713, USA
| | - Katarina Smiljanec
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Alexis U Mbakwe
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Michael R Axler
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Melissa A Witman
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA.
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10
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Adams JA, Lopez JR, Nadkarni V, Zolkipli‐Cunningham Z, Ischiropoulos H, Sackner MA. The effects of a motorized passive simulated jogging device on descent of the arterial pulse waveform dicrotic notch: A single arm placebo-controlled cross-over trial. Physiol Rep 2022; 10:e15418. [PMID: 35924333 PMCID: PMC9350470 DOI: 10.14814/phy2.15418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/19/2022] [Indexed: 11/06/2023] Open
Abstract
Whole Body Periodic Acceleration (WBPA, pGz), is a bed that moves the body headward to forward, adds pulses to the circulation inducing descent of the dicrotic notch (DN) on the pulse waveform with an increase in a/b ratio (a = the height of the pulse waveform and b = the height of the secondary wave). Since the WBPA is large, heavy, and non-portable, we engineered a portable device (Jogging Device, JD). JD simulates passive jogging and introduces pulsations to the circulation. We hypothesized that JD would increase the a/b ratio during and after its use. In Study A, a single-arm placebo-controlled cross-over trial was conducted in24 adults (53.8 ± 14.4 years) using JD or control (CONT) for 30 min. Blood pressure (BPs and BPd) and photoplethysmograph pulse (a/b) were measured at baseline (BL), during 30 min of JD or CONT, and 5 and 60 min after. In Study B (n = 20, 52.2 ± 7 years), a single-arm observational trial of 7 consecutive days of JD on BP and a/b, measured at BL, and after 7 days of JD and 48 and 72 hr after its discontinuation. In Study A, BPs, and BPd decreased during JD by 13% and 16%, respectively, while in CONT both increased by 2% and 2.5%, respectively. The a/b increased by 2-fold and remained greater than 2-fold at all-time points, with no change in a/b during CONT. In Study B, BPs and BPd decreased by 9% and remained below BL, at 72 hr after discontinuation of JD. DN descent also occurred after 7 days of JD with a/b increase of 80% and remained elevated by 60% for at least 72 h. JD improves acute and longer-term vascular hemodynamics with an increase in a/b, consistent with increased effects of nitric oxide (NO). JD may have significant clinical and public health implications.
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Affiliation(s)
- Jose A. Adams
- Division NeonatologyMt Sinai Medical Center of Greater MiamiMiami BeachFloridaUSA
| | - Jose R. Lopez
- Department of ResearchMt Sinai Medical Center of Greater MiamiMiami BeachFloridaUSA
| | - Vinay Nadkarni
- Anesthesiology, Critical Care, and Pediatrics, The Children's Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Zarazuela Zolkipli‐Cunningham
- Mitochondrial Medicine Frontier Program (MMFP), Center for Mitochondrial and Epigenomic Medicine (CMEM), Division of Human Genetics, The Children's Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Harry Ischiropoulos
- Children's Hospital of Philadelphia Research Institute and Division of Neonatology, Departments of Pediatrics and Systems Pharmacology and Translational Therapeutics, the Raymond and Ruth Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Marvin A. Sackner
- Department of ResearchMt Sinai Medical Center of Greater MiamiMiami BeachFloridaUSA
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11
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Fermoyle CC, Broxterman RM, La Salle DT, Ratchford SM, Hopkins PN, Richardson RS, Trinity JD. Persistent vascular dysfunction following an acute nonpharmacological reduction in blood pressure in hypertensive patients. J Hypertens 2022; 40:1115-1125. [PMID: 35703879 PMCID: PMC9204754 DOI: 10.1097/hjh.0000000000003104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vascular dysfunction, an independent risk factor for cardiovascular disease, often persists in patients with hypertension, despite improvements in blood pressure control induced by antihypertensive medications. METHODS As some of these medications may directly affect vascular function, this study sought to comprehensively examine the impact of reducing blood pressure, by a nonpharmacological approach (5 days of sodium restriction), on vascular function in 22 hypertensive individuals (14 men/8 women, 50 ± 10 years). Following a 2-week withdrawal of antihypertensive medications, two 5-day dietary phases, liberal sodium (liberal sodium, 200 mmol/day) followed by restricted sodium (restricted sodium, 10 mmol/day), were completed. Resting blood pressure was assessed and vascular function, at both the conduit and microvascular levels, was evaluated by brachial artery flow-mediated dilation (FMD), reactive hyperemia, progressive handgrip exercise, and passive leg movement (PLM). RESULTS Despite a sodium restriction-induced fall in blood pressure (liberal sodium: 141 ± 14/85 ± 9; restricted sodium 124 ± 12/79 ± 9 mmHg, P < 0.01 for both SBP and DBP), FMD (liberal sodium: 4.6 ± 1.8%; restricted sodium: 5.1 ± 2.1%, P = 0.27), and reactive hyperemia (liberal sodium: 548 ± 201; restricted sodium: 615 ± 206 ml, P = 0.08) were not altered. Similarly, brachial artery vasodilation during handgrip exercise was not different between conditions (liberal sodium: Δ0.36 ± 0.19 mm; restricted sodium: Δ0.42 ± 0.18 mm, P = 0.16). Lastly, PLM-induced changes in peak blood flow (liberal sodium: 5.3 ± 2.5; restricted sodium: 5.8 ± 3.6 ml/min per mmHg, P = 0.30) and the total vasodilatory response [liberal sodium: 2 (0.9-2.5) vs. restricted sodium: 1.7 (1.1-2.6) ml/min per mmHg; P = 0.5] were also not different between conditions. CONCLUSION Thus vascular dysfunction, at both the conduit and microvascular levels, persists in patients with hypertension even when blood pressure is acutely reduced by a nonpharmacological approach.
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Affiliation(s)
- Caitlin C Fermoyle
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center
- Division of Geriatrics, Department of Internal Medicine
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center
- Division of Geriatrics, Department of Internal Medicine
| | | | - Stephen M Ratchford
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center
- Division of Geriatrics, Department of Internal Medicine
| | - Paul N Hopkins
- Division of Cardiovascular Genetics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center
- Division of Geriatrics, Department of Internal Medicine
- Department of Nutrition and Integrative Physiology
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, George E. Whalen VA Medical Center
- Division of Geriatrics, Department of Internal Medicine
- Department of Nutrition and Integrative Physiology
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12
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Barcena ML, Aslam M, Pozdniakova S, Norman K, Ladilov Y. Cardiovascular Inflammaging: Mechanisms and Translational Aspects. Cells 2022; 11:cells11061010. [PMID: 35326461 PMCID: PMC8946971 DOI: 10.3390/cells11061010] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
Aging is one of the major non-reversible risk factors for several chronic diseases, including cancer, type 2 diabetes, dementia, and cardiovascular diseases (CVD), and it is a key cause of multimorbidity, disability, and frailty (decreased physical activity, fatigue, and weight loss). The underlying cellular mechanisms are complex and consist of multifactorial processes, such as telomere shortening, chronic low-grade inflammation, oxidative stress, mitochondrial dysfunction, accumulation of senescent cells, and reduced autophagy. In this review, we focused on the molecular mechanisms and translational aspects of cardiovascular aging-related inflammation, i.e., inflammaging.
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Affiliation(s)
- Maria Luisa Barcena
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.P.); (K.N.); (Y.L.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-525-359
| | - Muhammad Aslam
- Experimental Cardiology, Department of Internal Medicine I, Justus Liebig University, Aulweg 129, 35392 Giessen, Germany;
- Department of Cardiology, Kerckhoff Clinic GmbH, 61231 Bad Nauheim, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Rhein-Main, 61231 Bad Nauheim, Germany
| | - Sofya Pozdniakova
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.P.); (K.N.); (Y.L.)
- Barcelona Biomedical Research Park (PRBB), Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader, 88, 08003 Barcelona, Spain
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.P.); (K.N.); (Y.L.)
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
- Department of Nutrition & Gerontology, Institute of Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - Yury Ladilov
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.P.); (K.N.); (Y.L.)
- Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School Theodor Fontane, University Hospital, Ladeburger Str. 17, 16321 Bernau, Germany
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13
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CÈ EMILIANO, VENTURELLI MASSIMO, BISCONTI ANGELAVALENTINA, LONGO STEFANO, PEDRINOLLA ANNA, CORATELLA GIUSEPPE, SCHENA FEDERICO, ESPOSITO FABIO. Long-Term Passive Leg Stretch Improves Systemic Vascular Responsiveness as Much as Single-Leg Exercise Training. Med Sci Sports Exerc 2022; 54:475-488. [PMID: 34690287 PMCID: PMC10097495 DOI: 10.1249/mss.0000000000002811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The current study compared the local and systemic vascular responsiveness after small muscle mass endurance training or passive stretching training (PST). METHODS Thirty-six sex-matched healthy participants underwent 8-wk single-leg knee extension (SLKE) (n = 12) training or PST (n = 12), or no intervention (control, n = 12). Before and after the intervention, local and systemic vascular responsiveness was assessed by Doppler ultrasound at the femoral (local effect) and brachial artery (systemic effect) during single passive leg movement and brachial flow-mediated dilation (FMD) test, respectively. RESULTS After training, delta femoral blood flow (representing the local vascular responsiveness) increased after SLKE and PST by +54 (7)% (effect size, 2.72; P < 0.001) and +20 (2)% (effect size, 2.43; P < 0.001), respectively, albeit with a greater extent in SLKE (post-SLKE vs post-PST: +56 [8]% [effect size, 2.92; P < 0.001]). Interestingly, the %FMD (standing for the systemic effect) increased after SLKE and PST by +12 (2)% (effect size, 0.68; P < 0.001) and +11 (1)% (effect size, 0.83; P < 0.001), respectively, without any between-groups difference (P > 0.05). No changes occurred in control. CONCLUSIONS The present findings revealed that both active and passive training modalities induced similar improvements in the brachial artery dilatation capacity, whereas the former was more effective in improving femoral artery blood flow. Passive stretching could be used in people with limited mobility to improve vascular responsiveness both at the local and systemic level and in this latter case has similar effects as small muscle mass endurance training.
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Affiliation(s)
- EMILIANO CÈ
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ITALY
- IRCCS Istituto Ortopedico Galeazzi, Milan, ITALY
| | - MASSIMO VENTURELLI
- Section of Movement Science, Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, ITALY
- Section of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - ANGELA VALENTINA BISCONTI
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ITALY
- Section of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - STEFANO LONGO
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ITALY
| | - ANNA PEDRINOLLA
- Section of Movement Science, Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, ITALY
| | - GIUSEPPE CORATELLA
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ITALY
| | - FEDERICO SCHENA
- Section of Movement Science, Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Verona, ITALY
| | - FABIO ESPOSITO
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, ITALY
- IRCCS Istituto Ortopedico Galeazzi, Milan, ITALY
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14
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Francisco MA, Lee JF, Barrett-O'Keefe Z, Groot HJ, Ratchford SM, Bunsawat K, Alpenglow JK, Ryan JJ, Nativi JN, Richardson RS, Wray DW. Locomotor Muscle Microvascular Dysfunction in Heart Failure With Preserved Ejection Fraction. Hypertension 2021; 78:1750-1759. [PMID: 34719934 DOI: 10.1161/hypertensionaha.121.17875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Michael A Francisco
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - Joshua F Lee
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - Zachary Barrett-O'Keefe
- Department of Nutrition and Integrative Physiology (Z.B.-O., H.J.G., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - H Jonathan Groot
- Department of Nutrition and Integrative Physiology (Z.B.-O., H.J.G., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - Stephen M Ratchford
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.).,Department of Health and Exercise Science, Appalachian State University, Boone, NC (S.M.R.)
| | - Kanokwan Bunsawat
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City
| | - Jeremy K Alpenglow
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - John J Ryan
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City
| | - Jose N Nativi
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City
| | - Russell S Richardson
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Department of Nutrition and Integrative Physiology (Z.B.-O., H.J.G., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
| | - D Walter Wray
- Department of Internal Medicine (M.A.F., J.F.L., K.B., J.J.R., J.N.N., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Department of Nutrition and Integrative Physiology (Z.B.-O., H.J.G., R.S.R., D.W.W.), University of Utah, Salt Lake City.,Geriatric Research, Education, and Clinical Center, VA Medical Center, Salt Lake City, UT (M.A.F., J.F.L., Z.B.-O., H.J.G., S.M.R., J.K.A., R.S.R., D.W.W.)
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15
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Shields KL, Broxterman RM, Jarrett CL, Bisconti AV, Park SH, Richardson RS. The passive leg movement technique for assessing vascular function: the impact of baseline blood flow. Exp Physiol 2021; 106:2133-2147. [PMID: 34411365 DOI: 10.1113/ep089818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the central question of this study? The passive leg movement (PLM) assessment of vascular function utilizes the blood flow response in the common femoral artery (CFA): what is the impact of baseline CFA blood flow on the PLM response? What is the main finding and its importance? Although an attenuated PLM response is not an obligatory consequence of increased baseline CFA blood flow, increased blood flow through the deep femoral artery will diminish the response. Care should be taken to ensure that a genuine baseline leg blood flow is obtained prior to performing a PLM vascular function assessment. ABSTRACT The passive leg movement (PLM) assessment of vascular function utilizes the blood flow response in the common femoral artery (CFA). This response is primarily driven by vasodilation of the microvasculature downstream from the deep (DFA) and, to a lesser extent, the superficial (SFA) femoral artery, which facilitate blood flow to the upper and lower leg, respectively. However, the impact of baseline CFA blood flow on the PLM response is unknown. Therefore, to manipulate baseline CFA blood flow, PLM was performed with and without upper and lower leg cutaneous heating in 10 healthy subjects, with blood flow (ultrasound Doppler) and blood pressure (finometer) assessed. Baseline blood flow was significantly increased in the CFA (∼97%), DFA (∼109%) and SFA (∼78%) by upper leg heating. This increase in baseline CFA blood flow significantly attenuated the PLM-induced total blood flow in the DFA (∼62%), which was reflected by a significant fall in blood flow in the CFA (∼49%), but not in the SFA. Conversely, lower leg heating increased blood flow in the CFA (∼68%) and SFA (∼160%), but not in the DFA. Interestingly, this increase in baseline CFA blood flow only significantly attenuated the PLM-induced total blood flow in the SFA (∼60%), and not in the CFA or DFA. Thus, although an attenuated PLM response is not an obligatory consequence of an increase in baseline CFA blood flow, an increase in baseline blood flow through the DFA will diminish the PLM response. Therefore, care should be taken to ensure that a genuine baseline leg blood flow is obtained prior to performance of a PLM vascular function assessment.
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Affiliation(s)
- Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Angela V Bisconti
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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16
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Lew LA, Liu KR, Pyke KE. Reliability of the hyperaemic response to passive leg movement in young, healthy women. Exp Physiol 2021; 106:2013-2023. [PMID: 34216162 DOI: 10.1113/ep089629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/01/2021] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? This is the first study to assess the day-to-day reliability of passive leg movement-induced hyperaemia (PLM-H), an index of lower-limb microvascular function, in young, healthy women. What is the main finding and its importance? Passive leg movement-induced hyperaemia demonstrated good day-to-day reliability, comparable to other common indices of endothelial function, supporting the use of PLM-H to assess lower-limb microvascular function in women. ABSTRACT Passive leg movement-elicited hyperaemia (PLM-H) provides an index of lower-limb microvascular function. However, there is currently limited information regarding the reliability of PLM-H and no reliability information specific to women. The purpose of this study was to determine the reliability of PLM-H in women on two separate days. Seventeen young, healthy women [22 ± 3 years old (mean ± SD)] participated in two identical visits including three trials of PLM. Using duplex ultrasound, PLM-H was characterized by six indices: peak leg blood flow (LBF) and vascular conductance (LVC), peak change above baseline (Δpeak) for LBF and LVC, and area under the curve above baseline (AUC) during the first 60 s of PLM for LBF and LVC. The results demonstrated good day-to-day reliability of PLM-H characterized as peak LBF [r = 0.84, P < 0.001; intraclass correlation coefficient (ICC) = 0.84; coefficient of variation (CV) = 13.2%], peak LVC (r = 0.82, P < 0.001; ICC = 0.79; CV = 14.4%), Δpeak LBF (r = 0.83, P < 0.001; ICC = 0.82; CV = 17.8%) and Δpeak LVC (r = 0.83, P < 0.001; ICC = 0.80; CV = 16.5%). Characterization of PLM as AUC demonstrated moderate day-to-day reliability: AUC LBF (r = 0.71, P < 0.05; ICC = 0.70; CV = 31.2%) and AUC LVC (r = 0.78, P < 0.001; ICC = 0.74; CV = 27.1%). In conclusion, this study demonstrates that PLM-H has good reliability as an index of microvascular function; however, characterization of PLM-H as peak, Δpeak LBF and LVC is more reliable than AUC.
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Affiliation(s)
- Lindsay A Lew
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kaitlyn R Liu
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kyra E Pyke
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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17
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Weggen JB, Darling AM, Autler AS, Hogwood AC, Decker KP, Imthurn B, Tuzzolo GM, Garten RS. Impact of acute antioxidant supplementation on vascular function and autonomic nervous system modulation in young adults with PTSD. Am J Physiol Regul Integr Comp Physiol 2021; 321:R49-R61. [PMID: 34075811 DOI: 10.1152/ajpregu.00054.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Posttraumatic stress disorder (PTSD) has been associated with an increase in risk of cardiovascular disease (CVD). The goal of this study was to determine if peripheral vascular dysfunction, a precursor to CVD, was present in young adults with PTSD, and if an acute antioxidant (AO) supplementation could modify this potential PTSD-induced vascular dysfunction. Thirteen individuals with PTSD were recruited for this investigation and were compared with 35 age- and sex-matched controls (CTRL). The PTSD group participated in two visits, consuming either a placebo (PTSD-PL) or antioxidants (PTSD-AO; vitamins C and E; α-lipoic acid) before their visits, whereas the CTRL subjects only participated in one visit. Upper and lower limb vascular functions were assessed via flow-mediated dilation and passive leg movement technique. Heart rate variability was utilized to assess autonomic nervous system modulation. The PTSD-PL condition, when compared with the CTRL group, reported lower arm and leg microvascular function as well as sympathetic nervous system (SNS) predominance. After acute AO supplementation, arm, but not leg, microvascular function was improved and SNS predominance was lowered to which the prior difference between PTSD group and CTRL was no longer significant. Young individuals with PTSD demonstrated lower arm and leg microvascular function as well as greater SNS predominance when compared with age- and sex-matched controls. Furthermore, this lower vascular/autonomic function was augmented by an acute AO supplementation to the level of the healthy controls, potentially implicating oxidative stress as a contributor to this blunted vascular/autonomic function.
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Affiliation(s)
- Jennifer B Weggen
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Ashley M Darling
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Aaron S Autler
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Austin C Hogwood
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Kevin P Decker
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Brandon Imthurn
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Gina M Tuzzolo
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
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18
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Pedrinolla A, Magliozzi R, Colosio AL, Danese E, Gelati M, Rossi S, Pogliaghi S, Calabrese M, Muti E, Cè E, Longo S, Esposito F, Lippi G, Schena F, Venturelli M. Repeated passive mobilization to stimulate vascular function in individuals of advanced age who are chronically bedridden. A randomized controlled trial. J Gerontol A Biol Sci Med Sci 2021; 77:588-596. [PMID: 34036337 DOI: 10.1093/gerona/glab148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vascular dysfunction and associated disorders are major side effects of chronic bed rest, yet passive mobilization as a potential treatment has only been theorized so far. This study investigated the effects of passive mobilization treatment on vascular function in older, chronically bedridden people. METHODS The study sample was 45 chronically bedridden people of advanced age (mean age 87 years; 56% female; mean bed rest 4 years) randomly assigned to a treatment (n=23) or a control group (CTRL, n=22). The treatment group received passive mobilization twice daily (30 min, 5 times/week) for 4 weeks. A kinesiologist performed passive mobilization by passive knee flexion/extension at 1 Hz in one leg (treated leg, T-leg vs ctrl-leg). The CTRL group received routine treatment. The primary outcome was changes in peak blood flow (∆Peak) as measured with the single passive leg movement test (sPLM) at the common femoral artery. RESULTS ∆Peak was increased in both legs in the Treatment group (+90.9 ml/min, p<0.001, in T-leg and +25.7 ml/min, p=0.039 in ctrl-leg). No difference in peak blood flow after routine treatment was found in the CTRL group. CONCLUSION Improvement in vascular function after 4 weeks of passive mobilization was recorded in the treatment group. Passive mobilization may be advantageously included in standard clinical practice as an effective strategy to treat vascular dysfunction in persons with severely limited mobility.
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Affiliation(s)
- Anna Pedrinolla
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Roberta Magliozzi
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Alessandro L Colosio
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Elisa Danese
- Department of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Matteo Gelati
- Department of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Stefania Rossi
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Silvia Pogliaghi
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Massimiliano Calabrese
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | | | - Emiliano Cè
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,IRCSS Galeazzi Orthopaedic Institute, Milano, Italy
| | - Stefano Longo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,IRCSS Galeazzi Orthopaedic Institute, Milano, Italy
| | - Giuseppe Lippi
- Department of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy
| | - Massimo Venturelli
- Department of Neuroscience, Biomedicine, and Movement Science, Section of Movement Science, University of Verona, Verona, Italy.,Department of Internal Medicine section of Geriatrics, University of Utah, Salt Lake City, UT, USA
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19
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Hoopes EK, Berube FR, D'Agata MN, Patterson F, Farquhar WB, Edwards DG, Witman MAH. Sleep duration regularity, but not sleep duration, is associated with microvascular function in college students. Sleep 2021; 44:5903410. [PMID: 32905591 DOI: 10.1093/sleep/zsaa175] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/28/2020] [Indexed: 12/16/2022] Open
Abstract
STUDY OBJECTIVES Vascular dysfunction is a hypothesized mechanism linking poor sleep habits to an increased incidence of cardiovascular diseases (CVDs). However, the vascular profile associated with free-living sleep duration and sleep regularity has not been well elucidated, particularly in young adults. Thus, this study aimed to evaluate the associations between mean sleep duration, regularity in sleep duration, and peripheral vascular function in young adult college students. METHODS Fifty-one healthy undergraduate students (20 ± 1 years) completed 14 days of 24-hour wrist actigraphy and subsequent vascular assessments. Macrovascular function was measured using brachial artery flow-mediated dilation (FMD) while microvascular function was measured via passive leg movement (PLM). RESULTS Mean sleep duration was unrelated to FMD and PLM. Conversely, more irregular sleep duration (14-day sleep duration standard deviation [SD]) was unfavorably associated with all three measures of PLM-induced hyperemia (peak leg blood flow [LBF], p = 0.01; change in LBF from baseline to peak, p < 0.01; LBF area under the curve, p < 0.01), and remained significant in regression models which adjusted for sex, body mass index, blood pressure, physical activity, alcohol and caffeine consumption, and sleep duration (all p < 0.05). When using a median split to dichotomize "low" and "high" sleep duration SD groups, those demonstrating high variability in sleep duration exhibited ~45% lower PLM responses compared with those demonstrating low variability. CONCLUSIONS Irregular sleep duration is associated with poorer microvascular function as early as young adulthood. These findings support the growing body of evidence that irregular sleep patterns may be an independent and modifiable risk factor for CVD.
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Affiliation(s)
- Elissa K Hoopes
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Felicia R Berube
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Michele N D'Agata
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Melissa A H Witman
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
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20
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Adams JA, Uryash A, Lopez JR, Sackner MA. The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective. Front Physiol 2021; 12:638491. [PMID: 33708143 PMCID: PMC7940370 DOI: 10.3389/fphys.2021.638491] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
Diabetes has reached worldwide epidemic proportions, and threatens to be a significant economic burden to both patients and healthcare systems, and an important driver of cardiovascular mortality and morbidity. Improvement in lifestyle interventions (which includes increase in physical activity via exercise) can reduce diabetes and cardiovascular disease mortality and morbidity. Encouraging a population to increase physical activity and exercise is not a simple feat particularly in individuals with co-morbidities (obesity, heart disease, stroke, peripheral vascular disease, and those with cognitive and physical limitations). Translation of the physiological benefits of exercise within that vulnerable population would be an important step for improving physical activity goals and a stopgap measure to exercise. In large part many of the beneficial effects of exercise are due to the introduction of pulsatile shear stress (PSS) to the vascular endothelium. PSS is a well-known stimulus for endothelial homeostasis, and induction of a myriad of pathways which include vasoreactivity, paracrine/endocrine function, fibrinolysis, inflammation, barrier function, and vessel growth and formation. The endothelial cell mediates the balance between vasoconstriction and relaxation via the major vasodilator endothelial derived nitric oxide (eNO). eNO is critical for vasorelaxation, increasing blood flow, and an important signaling molecule that downregulates the inflammatory cascade. A salient feature of diabetes, is endothelial dysfunction which is characterized by a reduction of the bioavailability of vasodilators, particularly nitric oxide (NO). Cellular derangements in diabetes are also related to dysregulation in Ca2+ handling with increased intracellular Ca2+overload, and oxidative stress. PSS increases eNO bioavailability, reduces inflammatory phenotype, decreases intracellular Ca2+ overload, and increases antioxidant capacity. This narrative review and perspective will outline four methods to non-invasively increase PSS; Exercise (the prototype for increasing PSS), Enhanced External Counterpulsation (EECP), Whole Body Vibration (WBV), Passive Simulated Jogging and its predicate device Whole Body Periodic Acceleration, and will discuss current knowledge on their use in diabetes.
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Affiliation(s)
- Jose A Adams
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Arkady Uryash
- Division of Neonatology, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Jose R Lopez
- Department of Research, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Marvin A Sackner
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL, United States
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21
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Trinity JD, Kwon OS, Broxterman RM, Gifford JR, Kithas AC, Hydren JR, Jarrett CL, Shields KL, Bisconti AV, Park SH, Craig JC, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. The role of the endothelium in the hyperemic response to passive leg movement: looking beyond nitric oxide. Am J Physiol Heart Circ Physiol 2020; 320:H668-H678. [PMID: 33306447 DOI: 10.1152/ajpheart.00784.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Passive leg movement (PLM) evokes a robust and predominantly nitric oxide (NO)-mediated increase in blood flow that declines with age and disease. Consequently, PLM is becoming increasingly accepted as a sensitive assessment of endothelium-mediated vascular function. However, a substantial PLM-induced hyperemic response is still evoked despite nitric oxide synthase (NOS) inhibition. Therefore, in nine young healthy men (25 ± 4 yr), this investigation aimed to determine whether the combination of two potent endothelium-dependent vasodilators, specifically prostaglandin (PG) and endothelium-derived hyperpolarizing factor (EDHF), account for the remaining hyperemic response to the two variants of PLM, PLM (60 movements) and single PLM (sPLM, 1 movement), when NOS is inhibited. The leg blood flow (LBF, Doppler ultrasound) response to PLM and sPLM following the intra-arterial infusion of NG-monomethyl-l-arginine (l-NMMA), to inhibit NOS, was compared to the combined inhibition of NOS, cyclooxygenase (COX), and cytochrome P-450 (CYP450) by l-NMMA, ketorolac tromethamine (KET), and fluconazole (FLUC), respectively. NOS inhibition attenuated the overall LBF [area under the curve (LBFAUC)] response to both PLM (control: 456 ± 194, l-NMMA: 168 ± 127 mL, P < 0.01) and sPLM (control: 185 ± 171, l-NMMA: 62 ± 31 mL, P = 0.03). The combined inhibition of NOS, COX, and CYP450 (i.e., l-NMMA+KET+FLUC) did not further attenuate the hyperemic responses to PLM (LBFAUC: 271 ± 97 mL, P > 0.05) or sPLM (LBFAUC: 72 ± 45 mL, P > 0.05). Therefore, PG and EDHF do not collectively contribute to the non-NOS-derived NO-mediated, endothelium-dependent hyperemic response to either PLM or sPLM in healthy young men. These findings add to the mounting evidence and understanding of the vasodilatory pathways assessed by the PLM and sPLM vascular function tests.NEW & NOTEWORTHY Passive leg movement (PLM) evokes a highly nitric oxide (NO)-mediated hyperemic response and may provide a novel evaluation of vascular function. The contributions of endothelium-dependent vasodilatory pathways, beyond NO and including prostaglandins and endothelium-derived hyperpolarizing factor, to the PLM-induced hyperemic response to PLM have not been evaluated. With intra-arterial drug infusion, the combined inhibition of nitric oxide synthase (NOS), cyclooxygenase, and cytochrome P-450 (CYP450) pathways did not further diminish the hyperemic response to PLM compared with NOS inhibition alone.
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Affiliation(s)
- Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Oh Sung Kwon
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Exercise Science, Brigham Young University, Provo, Utah
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Angela V Bisconti
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jesse C Craig
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - David E Morgan
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Jacob E Jessop
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Amber D Bledsoe
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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22
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Sackner MA, Lopez JR, Banderas V, Adams JA. Can Physical Activity While Sedentary Produce Health Benefits? A Single-Arm Randomized Trial. SPORTS MEDICINE-OPEN 2020; 6:47. [PMID: 33006749 PMCID: PMC7532252 DOI: 10.1186/s40798-020-00278-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/24/2020] [Indexed: 12/17/2022]
Abstract
Background Sedentary time poses a risk to health. Substituting physical activity for inactivity is obvious but this requires a behavior change. Interventions advocated to decrease uninterrupted physical inactivity (defined as Metabolic Equivalent of Task (METS) less than 1.5) are important. One such intervention is accomplished with the Gentle Jogger (GJ), a low risk motorized wellness device which produces effortless, rapid motion of the lower extremities simulating locomotion or fidgeting. GJ produces health benefits in type 2 diabetes, heart disease, and high blood pressure. The purpose of this trial was to ascertain whether GJ increases METS above 1.5 to explain its effectiveness despite sedentary behavior or whether tapping is responsible. Methods A randomized single-arm trial was conducted. Subjects were randomized to begin the study in either the supine or seated postures and on the same day crossed over with the starting posture reversed. Oxygen consumption was measured at rest and during GJ. Results Twenty-six subjects were studied (15 women and 11 men) with a mean age of 44 ± 15 years and BMI 27.9 ± 5.0, 19 were overweight or obese, and 7 had normal BMI. GJ increased oxygen consumption and METS 15% in the seated posture and 13% in the supine posture. No individual receiving GJ achieved METS exceeding 1.5. Conclusions In a moderately obese population, GJ in seated or supine posture did not exceed 1.5 METS. The values are comparable to those reported for sit-stand interventions and cannot explain the health benefits of GJ. Trial registration ClinicalTrials.gov, NCT03602365. Registered on July 26, 2018
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Affiliation(s)
| | - Jose R Lopez
- Mt. Sinai Medical Center of Greater Miami, Miami Beach, FL, USA
| | | | - Jose A Adams
- Mt. Sinai Medical Center of Greater Miami, Miami Beach, FL, USA.
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23
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Kithas AC, Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Hydren JR, Nelson AD, Jessop JE, Bledsoe AD, Morgan DE, Richardson RS. Nitric oxide synthase inhibition with N(G)-monomethyl-l-arginine: Determining the window of effect in the human vasculature. Nitric Oxide 2020; 104-105:51-60. [PMID: 32979497 DOI: 10.1016/j.niox.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/07/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
Nitric oxide synthase (NOS) inhibition with N(G)-monomethyl-l-arginine (L-NMMA) is often used to assess the role of NO in human cardiovascular function. However, the window of effect for L-NMMA on human vascular function is unknown, which is critical for designing and interpreting human-based studies. This study utilized the passive leg movement (PLM) assessment of vascular function, which is predominantly NO-mediated, in 7 young male subjects under control conditions, immediately following intra-arterial L-NMMA infusion (0.24 mg⋅dl-1⋅min-1), and at 45-60 and 90-105 min post L-NMMA infusion. The leg blood flow (LBF) and leg vascular conductance (LVC) responses to PLM, measured with Doppler ultrasound and expressed as the change from baseline to peak (ΔLBFpeak and ΔLVCpeak) and area under the curve (LBFAUC and LVCACU), were assessed. PLM-induced robust control ΔLBFpeak (1135 ± 324 ml⋅min-1) and ΔLVCpeak (10.7 ± 3.6 ml⋅min-1⋅mmHg-1) responses that were significantly attenuated (704 ± 196 ml⋅min-1 and 6.7 ± 2 ml⋅min-1⋅mmHg-1) immediately following L-NMMA infusion. Likewise, control condition PLM ΔLBFAUC (455 ± 202 ml) and ΔLVCAUC (4.0 ± 1.4 ml⋅mmHg-1) were significantly attenuated (141 ± 130 ml and 1.3 ± 1.2 ml⋅mmHg-1) immediately following L-NMMA infusion. However, by 45-60 min post L-NMMA infusion all PLM variables were not significantly different from control, and this was still the case at 90-105 min post L-NMMA infusion. These findings reveal that the potent reduction in NO bioavailability afforded by NOS inhibition with L-NMMA has a window of effect of less than 45-60 min in the human vasculature. These data are particularly important for the commonly employed approach of pharmacologically inhibiting NOS with L-NMMA in the human vasculature.
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Affiliation(s)
- Andrew C Kithas
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ryan M Broxterman
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Geriatric Research, Education, and Clinical Center, Salt Lake City, VAMC, UT, USA
| | - Joel D Trinity
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Nutrition and Integrative Physiology, USA; Geriatric Research, Education, and Clinical Center, Salt Lake City, VAMC, UT, USA
| | - Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Jay R Hydren
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Nutrition and Integrative Physiology, USA; Geriatric Research, Education, and Clinical Center, Salt Lake City, VAMC, UT, USA
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jacob E Jessop
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Amber D Bledsoe
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - David E Morgan
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA; Department of Nutrition and Integrative Physiology, USA; Geriatric Research, Education, and Clinical Center, Salt Lake City, VAMC, UT, USA.
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24
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Gifford JR, Bloomfield T, Davis T, Addington A, McMullin E, Wallace T, Proffit M, Hanson B. The effect of the speed and range of motion of movement on the hyperemic response to passive leg movement. Physiol Rep 2020; 7:e14064. [PMID: 31004411 PMCID: PMC6474844 DOI: 10.14814/phy2.14064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 03/27/2019] [Indexed: 11/24/2022] Open
Abstract
Passive leg movement (PLM)-induced hyperemia is used to assess the function of the vascular endothelium. This study sought to determine the impact of movement speed and range of motion (ROM) on the hyperemic response to PLM and determine if the currently recommended protocol of moving the leg through a 90° ROM at 180°/sec provides a peak hyperemic response to PLM. 11 healthy adults underwent multiple bouts of PLM, in which either movement speed (60-240°/sec) or ROM (30-120° knee flexion) were varied. Femoral artery blood flow (Doppler Ultrasound) and mean arterial pressure (MAP; photoplethysmography) were measured throughout. Movement speed generally exhibited positive linear relationships with the hyperemic response to PLM, eliciting ~15-20% increase in hyperemia and conductance for each 30°/sec increase in speed (P < 0.05). However, increasing the movement speed above 180°/sec was physically difficult and seemingly impractical to implement. ROM exhibited curvilinear relationships (P<0.05) with hyperemia and conductance, which peaked at 90°, such that a 30° increase or decrease in ROM from 90° resulted in a 10-40% attenuation (P < 0.05) in the hyperemic response. Alterations in the balance of antegrade and retrograde flow appear to play a role in this attenuation. Movement speed and ROM have a profound impact on PLM-induced hyperemia. When using PLM to assess vascular endothelial function, it is recommended to perform the test at the traditional 180°/sec with 90° ROM, which offers a near peak hyperemic response, while maintaining test feasibility.
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Affiliation(s)
- Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, Utah.,Program of Gerontology, Brigham Young University, Provo, Utah
| | - Travis Bloomfield
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Trevor Davis
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Amy Addington
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Erin McMullin
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Taysom Wallace
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Meagan Proffit
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Brady Hanson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
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25
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Ives SJ, Layec G, Hart CR, Trinity JD, Gifford JR, Garten RS, Witman MAH, Sorensen JR, Richardson RS. Passive leg movement in chronic obstructive pulmonary disease: evidence of locomotor muscle vascular dysfunction. J Appl Physiol (1985) 2020; 128:1402-1411. [PMID: 32324478 DOI: 10.1152/japplphysiol.00568.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD), characterized by pulmonary dysfunction, is now also recognized to be associated with free radical-mediated vascular dysfunction. However, as previous investigations have utilized the brachial artery flow-mediated dilation technique, whether such vascular dysfunction exists in the locomotor muscle of patients with COPD remains unclear. Therefore, in patients with COPD (n = 13, 66 ± 6 yr) and healthy age- and sex-matched control subjects (n = 12, 68 ± 6 yr), second-by-second measurements of leg blood flow (LBF) (ultrasound Doppler), mean arterial pressure (MAP) (Finapres), and leg vascular conductance (LVC) were recorded before and during both 2 min of continuous upright seated continuous-movement passive leg movement (PLM) and a single-movement PLM (sPLM). In response to PLM, both peak change in LBF (COPD 321 ± 54, Control 470 ± 55 ∆mL/min) and LVC (COPD 3.0 ± 0.5, Control 5.4 ± 0.5 ∆mL·min-1·mmHg-1) were significantly attenuated in patients with COPD compared with control subjects (P < 0.05). This attenuation in the patients with COPD was also evident in response to sPLM, with peak change in LBF tending to be lower (COPD 142 ± 26, Control 169 ± 14 ∆mL/min) and LVC being significantly lower (P < 0.05) in the patients than the control subjects (COPD 1.6 ± 0.4, Control 2.5 ± 0.3 ∆mL·min-1·mmHg-1). Therefore, utilizing both PLM and sPLM, this study provides evidence of locomotor muscle vascular dysfunction in patients with COPD, perhaps due to redox imbalance and reduced nitric oxide bioavailability, which is in agreement with an increased cardiovascular disease risk in this population. This locomotor muscle vascular dysfunction, in combination with the clearly dysfunctional lungs, may contribute to the exercise intolerance associated with COPD.NEW & NOTEWORTHY Utilizing both the single and continuous passive leg movement (PLM) models, which induce nitric oxide (NO)-dependent hyperemia, this study provides evidence of vascular dysfunction in the locomotor muscle of patients with chronic obstructive pulmonary disease (COPD), independent of central hemodynamics. This impaired hyperemia may be the result of an oxidant-mediated attenuation in NO bioavailability. In addition to clearly dysfunctional lungs, vascular dysfunction in locomotor muscle may contribute to the exercise intolerance associated with COPD and increased cardiovascular disease risk.
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Affiliation(s)
- Stephen J Ives
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Health and Human Physiological Sciences Department, Skidmore College, Saratoga Springs, New York
| | - Gwenael Layec
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Corey R Hart
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Ryan S Garten
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Melissa A H Witman
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Kinesiology and Applied Physiology, University of Delaware, Wilmington, Delaware
| | - Jacob R Sorensen
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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26
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Hanson BE, Proffit M, Gifford JR. Vascular function is related to blood flow during high-intensity, but not low-intensity, knee extension exercise. J Appl Physiol (1985) 2020; 128:698-708. [DOI: 10.1152/japplphysiol.00671.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
While vascular function, assessed as the ability of the vasculature to dilate in response to a stimulus, is related to cardiovascular health, its relationship to exercise hyperemia is unclear. This study sought to determine if blood flow during submaximal and maximal exercise is related to vascular function. Nineteen healthy adults completed multiple assessments of vascular function specific to the leg, including passive leg movement (PLM), rapid onset vasodilation (ROV), reactive hyperemia (RH), and flow-mediated dilation (FMD). On a separate day, exercise blood flow (Doppler ultrasound) was assessed in the same leg during various intensities of single-leg, knee-extension (KE) exercise. Vascular function, determined by PLM, ROV, and RH, was related to exercise blood flow at high intensities, including maximum work rate (WRmax) ( r = 0.58–0.77, P < 0.001), but not low intensities, like ~21% WRmax ( r = 0.12–0.34, P = 0.12–0.62). Relationships between multiple indices of vascular function and peak exercise blood flow persisted when controlling for quadriceps mass and exercise work rate ( P < 0.05), indicating vascular function is independently related to the blood flow response to intense exercise. When divided into two groups based upon the magnitude of the PLM response, subjects with a lower PLM response exhibited lower exercise flow at several absolute work rates, as well as lower peak flow ( P < 0.05). In conclusion, leg flow during dynamic exercise is independently correlated with multiple different indices of microvascular function. Thus microvascular function appears to modulate the hyperemic response to high-intensity, but not low-intensity, exercise. NEW & NOTEWORTHY While substantial evidence indicates that individuals with lower vascular function are at greater risk for cardiovascular disease, with many redundant vasodilator pathways present during exercise, it has been unclear if low vascular function actually impacts blood flow during exercise. This study provides evidence that vascular function, assessed by multiple noninvasive methods, is related to the blood flow response to high-intensity leg exercise in healthy young adults. Importantly, healthy young adults with lower levels of vascular function, particularly microvascular function, exhibit lower blood flow during high-intensity, and maximal knee extension exercise. Thus it appears that in addition to increasing one’s risk of cardiovascular disease, lower vascular function is also related to a blunted blood flow response during high-intensity exercise.
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Affiliation(s)
- Brady E. Hanson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Meagan Proffit
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Jayson R. Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
- Program of Gerontology, Brigham Young University, Provo, Utah
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27
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Limberg JK, Casey DP, Trinity JD, Nicholson WT, Wray DW, Tschakovsky ME, Green DJ, Hellsten Y, Fadel PJ, Joyner MJ, Padilla J. Assessment of resistance vessel function in human skeletal muscle: guidelines for experimental design, Doppler ultrasound, and pharmacology. Am J Physiol Heart Circ Physiol 2019; 318:H301-H325. [PMID: 31886718 DOI: 10.1152/ajpheart.00649.2019] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The introduction of duplex Doppler ultrasound almost half a century ago signified a revolutionary advance in the ability to assess limb blood flow in humans. It is now widely used to assess blood flow under a variety of experimental conditions to study skeletal muscle resistance vessel function. Despite its pervasive adoption, there is substantial variability between studies in relation to experimental protocols, procedures for data analysis, and interpretation of findings. This guideline results from a collegial discussion among physiologists and pharmacologists, with the goal of providing general as well as specific recommendations regarding the conduct of human studies involving Doppler ultrasound-based measures of resistance vessel function in skeletal muscle. Indeed, the focus is on methods used to assess resistance vessel function and not upstream conduit artery function (i.e., macrovasculature), which has been expertly reviewed elsewhere. In particular, we address topics related to experimental design, data collection, and signal processing as well as review common procedures used to assess resistance vessel function, including postocclusive reactive hyperemia, passive limb movement, acute single limb exercise, and pharmacological interventions.
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Affiliation(s)
- Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,François M. Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | | | - D Walter Wray
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Michael E Tschakovsky
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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28
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Abstract
Passive exercise/movement has a long history in both medicine and physiology. Early clinical applications of passive exercise/movement utilized pneumatic and direct limb compression to stimulate the vasculature and evoke changes in blood flow to avoid complications brought about by stasis and vascular disease. Over the last 50 years, passive exercise/movement has continued to progress and has provided physiologists with a reductionist approach to mechanistically examine the cardiorespiratory, hyperemic, and afferent responses to movement without the confounding influence of metabolism that accompanies active exercise. This review, in addition to providing an historical perspective, focuses on the recent advancements utilizing passive leg movement, and how the hyperemic response at the onset of this passive movement has evolved from a method to evaluate the central and peripheral regulation of blood flow during exercise to an innovative and promising tool to assess vascular function. As an assessment of vascular function, passive leg movement is relatively simple to perform and provides a nitric oxide-dependent evaluation of endothelial function across the lifespan that is sensitive to changes in activity/fitness and disease state (heart failure, peripheral artery disease, sepsis). The continual refinement and characterization of passive leg movement are aimed at improving our understanding of blood flow regulation and the development of a clinically ready approach to predict and monitor the progression of cardiovascular disease.
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Affiliation(s)
- Joel D Trinity
- George E Wahlen Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Bldg 2, RM 1D29A, 500 Foothill Dr., Salt Lake City, UT, 84148, USA.
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
| | - Russell S Richardson
- George E Wahlen Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Bldg 2, RM 1D29A, 500 Foothill Dr., Salt Lake City, UT, 84148, USA
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
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29
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Shields KL, Broxterman RM, Jarrett CL, Bisconti AV, Park SH, Richardson RS. The passive leg movement technique for assessing vascular function: defining the distribution of blood flow and the impact of occluding the lower leg. Exp Physiol 2019; 104:1575-1584. [PMID: 31400019 DOI: 10.1113/ep087845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/08/2019] [Indexed: 01/19/2023]
Abstract
NEW FINDINGS What is the central question of this study? What is the distribution of the hyperaemic response to passive leg movement (PLM) in the common (CFA), deep (DFA) and superficial (SFA) femoral arteries? What is the impact of lower leg cuff-induced blood flow occlusion on this response? What is the main finding and its importance? Of the total blood that passed through the CFA, the majority was directed to the DFA and this was unaffected by cuffing. As a small fraction does pass through the SFA to the lower leg, cuffing during PLM should be considered to emphasize the thigh-specific hyperaemia. ABSTRACT It has yet to be quantified how passive leg movement (PLM)-induced hyperaemia, an index of vascular function, is distributed beyond the common femoral artery (CFA), into the deep femoral (DFA) and the superficial femoral (SFA) arteries, which supply blood to the thigh and lower leg, respectively. Furthermore, the impact of cuffing the lower leg, a common practice, especially with drug infusions during PLM, on the hyperaemic response is, also, unknown. Therefore, PLM was performed with and without cuff-induced blood flow (BF) occlusion to the lower leg in 10 healthy subjects, with BF assessed by Doppler ultrasound. In terms of BF distribution during PLM, of the 380 ± 191 ml of blood that passed through the CFA, 69 ± 8% was directed to the DFA, while only 31 ± 8% passed through the SFA. Cuff occlusion of the lower leg significantly attenuated the PLM-induced hyperaemia through the SFA (∼30%), which was reflected by a fall in BF through the CFA (∼20%), but not through the DFA. Additionally, cuff occlusion significantly attenuated the PLM-induced peak change in BF (BFΔpeak ) in the SFA (324 ± 159 to 214 ± 114 ml min-1 ), which was, again, reflected in the CFA (1019 ± 438 to 833 ± 476 ml min-1 ), but not in the DFA. Thus, the PLM-induced hyperaemia predominantly passes through the DFA and this was unaltered by cuffing. However, as a small fraction of the PLM-induced hyperaemia does pass through the SFA to the lower leg, cuffing the lower leg during PLM should be considered to emphasize thigh-specific hyperaemia in the PLM assessment of vascular function.
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Affiliation(s)
- Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Angela V Bisconti
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Biomedical Sciences for Health, University of Milan, Milan, MI, Italy
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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30
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Broxterman RM, La Salle DT, Zhao J, Reese VR, Richardson RS, Trinity JD. Influence of dietary inorganic nitrate on blood pressure and vascular function in hypertension: prospective implications for adjunctive treatment. J Appl Physiol (1985) 2019; 127:1085-1094. [PMID: 31414959 DOI: 10.1152/japplphysiol.00371.2019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Dietary inorganic nitrate (nitrate) is a promising adjunctive treatment to reduce blood pressure and improve vascular function in hypertension. However, it remains unknown if the efficacy of nitrate is dependent upon an elevated blood pressure or altered by medication in patients with hypertension. Therefore, blood pressure and vascular function, measured by passive leg movement (PLM) and flow-mediated dilation (FMD), were assessed following 3 days of placebo (nitrate-free beetroot juice) and nitrate (nitrate-rich beetroot juice) administration in 13 patients (age: 53 ± 12 yr) with hypertension taking antihypertensive medications (study 1) and in 14 patients (49 ± 13 yr) with hypertension not taking antihypertensive medications (study 2). In study 1, plasma nitrite concentration was greater for nitrate than placebo (341 ± 118 vs. 308 ± 123 nmol/L, P < 0.05), yet blood pressure and vascular function were unaltered. In study 2, plasma nitrite concentration was greater for nitrate than placebo (340 ± 102 vs. 295 ± 93 nmol/L, P < 0.01). Systolic (136 ± 16 vs. 141 ± 19 mmHg), diastolic (84 ± 13 vs. 88 ± 12 mmHg), and mean (101 ± 12 vs. 106 ± 13 mmHg) blood pressures were lower (P < 0.05), whereas the PLM change in leg vascular conductance (6.0 ± 3.0 vs. 5.1 ± 2.6 mL·min-1·mmHg-1) and FMD (6.1 ± 2.4% vs. 4.1 ± 2.7%) were greater (P < 0.05) for nitrate than placebo. The changes in systolic blood pressure (r = -0.60) and FMD (r = -0.48) induced by nitrate were inversely correlated (P < 0.05) to the respective baseline values obtained in the placebo condition. Thus, the efficacy of nitrate to improve blood pressure and vascular function in hypertension appears to be dependent on the degree of blood pressure elevation and vascular dysfunction and not antihypertensive medication status, per se.NEW & NOTEWORTHY Dietary nitrate (nitrate) is a promising intervention to improve blood pressure and vascular function in hypertension. We demonstrate that these beneficial effects of nitrate are inversely related to the baseline value in a continuous manner with no distinction between antihypertensive medication status. Thus, the efficacy of nitrate to improve blood pressure and vascular function in hypertension appears to be dependent on the degree of blood pressure elevation and vascular dysfunction and not antihypertensive mediation status.
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Affiliation(s)
- Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - D Taylor La Salle
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jia Zhao
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Van R Reese
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.,Center on Aging, University of Utah, Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.,Center on Aging, University of Utah, Salt Lake City, Utah
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31
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Bisconti AV, Cè E, Longo S, Venturelli M, Coratella G, Shokohyar S, Ghahremani R, Rampichini S, Limonta E, Esposito F. Evidence of Improved Vascular Function in the Arteries of Trained but Not Untrained Limbs After Isolated Knee-Extension Training. Front Physiol 2019; 10:727. [PMID: 31244682 PMCID: PMC6581732 DOI: 10.3389/fphys.2019.00727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2019] [Indexed: 01/22/2023] Open
Abstract
Vascular endothelial function is a strong marker of cardiovascular health and it refers to the ability of the body to maintain the homeostasis of vascular tone. The endothelial cells react to mechanical and chemical stimuli modulating the smooth muscle cells relaxation. The extent of the induced vasodilation depends on the magnitude of the stimulus. During exercise, the peripheral circulation is mostly controlled by the endothelial cells response that increases the peripheral blood flow in body districts involved but also not involved with exercise. However, whether vascular adaptations occur also in the brachial artery as a result of isolated leg extension muscles (KE) training is still an open question. Repetitive changes in blood flow occurring during exercise may act as vascular training for vessels supplying the active muscle bed as well as for the vessels of body districts not directly involved with exercise. This study sought to evaluate whether small muscle mass (KE) training would induce improvements in endothelial function not only in the vasculature of the lower limb (measured at the femoral artery level in the limb directly involved with training), but also in the upper limb (measured at the brachial artery level in the limb not directly involved with training) as an effect of repetitive increments in the peripheral blood flow during training sessions. Ten young healthy participants (five females, and five males; age: 23 ± 3 years; stature: 1.70 ± 0.11 m; body mass: 66 ± 11 kg; BMI: 23 ± 1 kg ⋅ m-2) underwent an 8-week KE training study. Maximum work rate (MWR), vascular function and peripheral blood flow were assessed pre- and post-KE training by KE ergometer, flow mediated dilatation (FMD) in the brachial artery (non-trained limb), and by passive limb movement (PLM) in femoral artery (trained limb), respectively. After 8 weeks of KE training, MWR and PLM increased by 44% (p = 0.015) and 153% (p = 0.003), respectively. Despite acute increase in brachial artery blood flow during exercise occurred (+25%; p < 0.001), endothelial function did not change after training. Eight weeks of KE training improved endothelial cells response only in the lower limb (measured at the femoral artery level) directly involved with training, likely without affecting the endothelial response of the upper limb (measured at the brachial artery level) not involved with training.
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Affiliation(s)
- Angela Valentina Bisconti
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States.,Geriatric Research, Education, and Clinical Centre, Veterans Affairs Medical Centre, Salt Lake City, UT, United States
| | - Emiliano Cè
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Stefano Longo
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Venturelli
- Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Coratella
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Sheida Shokohyar
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy
| | - Reza Ghahremani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
| | - Susanna Rampichini
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Science for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS, Istituto Ortopedico Galeazzi, Milan, Italy
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32
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Kim MS, Park DG, Yoon JH. Impaired endothelial function may predict treatment response in restless legs syndrome. J Neural Transm (Vienna) 2019; 126:1051-1059. [PMID: 31218470 DOI: 10.1007/s00702-019-02031-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/14/2019] [Indexed: 12/17/2022]
Abstract
While dopaminergic dysfunction is believed to be a crucial role in restless legs syndrome (RLS), changes in peripheral microvasculature system such as peripheral hypoxia and altered skin temperature, have been found. This study aimed to investigate whether patients with RLS would have a cerebral and peripheral endothelial dysfunction, and this may have association with treatment responsiveness. We evaluated cerebral endothelial function using breath-holding index (BHI) on transcranial Doppler in bilateral middle cerebral artery (MCA), posterior cerebral artery (PCA) and basilar artery (BA) and peripheral endothelial function using brachial flow-mediated dilation (FMD) in 34 patients with RLS compared with age and sex-matched controls. The values of BHI in both MCA and BA were significantly lower in RLS group than control group. The values of FMD also were significantly lower in RLS patients. There was a weak correlation between BHI and FMD (p = 0.038 in Rt MCA, p = 0.032 in Lt MCA, p = 0.362 in BA) in RLS, but not in controls. BHI differed according to treatment responsiveness. (p < 0.005). Our study suggests that RLS patients have poorer cerebral and peripheral endothelial function than controls, showing an underlying mechanism of RLS and further evidence of a possible association between RLS and cardiovascular disease.
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Affiliation(s)
- Min Seung Kim
- Department of Neurology, Ajou University School of Medicine, 5 San,Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, South Korea
| | - Dong Gyu Park
- Department of Neurology, Ajou University School of Medicine, 5 San,Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, South Korea
| | - Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, 5 San,Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, South Korea.
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33
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New fluoroquinolones/nitric oxide donor hybrids: design, synthesis and antitubercular activity. Med Chem Res 2019. [DOI: 10.1007/s00044-019-02372-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Walker MA, Bailey TG, McIlvenna L, Allen JD, Green DJ, Askew CD. Acute Dietary Nitrate Supplementation Improves Flow Mediated Dilatation of the Superficial Femoral Artery in Healthy Older Males. Nutrients 2019; 11:E954. [PMID: 31035478 PMCID: PMC6566150 DOI: 10.3390/nu11050954] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/15/2022] Open
Abstract
Aging is often associated with reduced leg blood flow, increased arterial stiffness, and endothelial dysfunction, all of which are related to declining nitric oxide (NO) bioavailability. Flow mediated dilatation (FMD) and passive leg movement (PLM) hyperaemia are two techniques used to measure NO-dependent vascular function. We hypothesised that acute dietary nitrate (NO3-) supplementation would improve NO bioavailability, leg FMD, and PLM hyperaemia. Fifteen healthy older men (69 ± 4 years) attended two experiment sessions and consumed either 140 mL of concentrated beetroot juice (800 mg NO3-) or placebo (NO3--depleted beetroot juice) in a randomised, double blind, cross-over design study. Plasma nitrite (NO2-) and NO3-, blood pressure (BP), augmentation index (AIx75), pulse wave velocity (PWV), FMD of the superficial femoral artery, and PLM hyperaemia were measured immediately before and 2.5 h after consuming NO3- and placebo. Placebo had no effect but NO3- led to an 8.6-fold increase in plasma NO2-, which was accompanied by an increase in FMD (NO3-: +1.18 ± 0.94% vs. placebo: 0.23 ± 1.13%, p = 0.002), and a reduction in AIx75 (NO3-: -8.7 ± 11.6% vs. placebo: -4.6 ± 5.5%, p = 0.027). PLM hyperaemia, BP, and PWV were unchanged during both trials. This study showed that a dose of dietary NO3- improved NO bioavailability and enhanced endothelial function as measured by femoral artery FMD. These findings provide insight into the specific central and peripheral vascular responses to dietary NO3- supplementation in older adults.
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Affiliation(s)
- Meegan A Walker
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia.
| | - Tom G Bailey
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia.
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, Australia.
| | - Luke McIlvenna
- Institute for Health and Sport, College of Sport and Exercise Science, Victoria University, Melbourne, VIC 3031, Australia.
| | - Jason D Allen
- Institute for Health and Sport, College of Sport and Exercise Science, Victoria University, Melbourne, VIC 3031, Australia.
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22903, USA.
| | - Daniel J Green
- School of Sport Sciences, Exercise and Health, University of Western Australia, West Perth, WA 6872, Australia.
| | - Christopher D Askew
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia.
- Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia.
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35
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Nakamura A, Kajitani S, Sato K, Kanazawa M, Kondo M, Endo H, Nozaki E. Decline of popliteal artery flow-mediated dilation with aging and possible involvement of asymmetric dimethylarginine in healthy men. J Med Ultrason (2001) 2019; 46:503-511. [PMID: 31011935 PMCID: PMC6765476 DOI: 10.1007/s10396-019-00946-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/05/2019] [Indexed: 12/17/2022]
Abstract
Purpose We examined the influences of age and gender on flow-mediated endothelial function and the involvement of the competitive inhibition of l-arginine in endothelial function. Methods We measured brachial and popliteal flow-mediated vasodilation (FMD) responses, nitrate/nitrite (NOx) concentrations, and plasma levels of asymmetric dimethylarginine (ADMA) in four healthy, nonsmoking groups: young men (mean 26 ± 2 years, n = 17), middle-aged men (mean 50 ± 3 years, n = 19), young women (mean 27 ± 2 years, n = 16), and middle-aged women (mean 51 ± 2 years, n = 18). Results In young men, we found no significant differences between brachial and popliteal artery FMDs (10.6 ± 1.5 vs 8.7 ± 1.6%, p = 0.06). However, the popliteal artery FMD was significantly lower than the brachial artery FMD in middle-aged men (11.4 ± 1.5 vs 6.4 ± 1.0%, p < 0.001). In women, we found no significant differences between brachial and popliteal artery FMDs in young and middle-aged individuals (young, p = 0.17; middle-aged, p = 0.08). Popliteal artery FMD correlated with plasma NOx and ADMA levels as well as with the NOx/ADMA ratio in men but not in women (r = 0.485, − 0.544, and 0.672, respectively). Conclusion We concluded that a decrease in flow-mediated endothelial function in arteries of the lower extremities was evident in healthy middle-aged men, but not in middle-aged women. The competitive inhibition of l-arginine may contribute to this decrease in men.
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Affiliation(s)
- Akihiro Nakamura
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan.
| | - Shoko Kajitani
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenjiro Sato
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan
| | - Masanori Kanazawa
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan
| | - Masateru Kondo
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan
| | - Hideaki Endo
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan
| | - Eiji Nozaki
- Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 020-0066, Japan
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36
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Gliemann L, Rytter N, Piil P, Nilton J, Lind T, Nyberg M, Cocks M, Hellsten Y. The Endothelial Mechanotransduction Protein Platelet Endothelial Cell Adhesion Molecule-1 Is Influenced by Aging and Exercise Training in Human Skeletal Muscle. Front Physiol 2018; 9:1807. [PMID: 30618819 PMCID: PMC6305393 DOI: 10.3389/fphys.2018.01807] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022] Open
Abstract
Aim: The aim was to determine the role of aging and exercise training on endothelial mechanosensor proteins and the hyperemic response to shear stress by passive leg movement. Methods: We examined the expression of mechanosensor proteins and vascular function in young (n = 14, 25 ± 3 years) and old (n = 14, 72 ± 5 years) healthy male subjects with eight weeks of aerobic exercise training. Before and after training, the hyperaemic response to passive leg movement was determined and a thigh muscle biopsy was obtained before and after passive leg movement to assess the acute effect of increased shear stress. Biopsies were analyzed for protein amount and phosphorylation of mechanosensor proteins; Platelet endothelial cell adhesion molecule-1 (PECAM-1), Vascular endothelial cadherin, Vascular endothelial growth factor receptor-2 and endothelial nitric oxide synthase (eNOS). Results: Before training, the old group presented a lower hyperaemic response to passive leg movement and a 35% lower (P < 0.05) relative basal phosphorylation level of PECAM-1 whereas there was no difference for the other mechanosensor proteins. After training, the eNOS protein amount, the amount of PECAM-1 protein and the passive leg movement-induced phosphorylation of PECAM-1 were higher in both groups. The hyperaemic response to passive leg movement was higher after training in the young group only. Conclusion: Aged individuals have a lower hyperaemic response to passive leg movement and a lower relative basal phosphorylation of PECAM-1 than young. The higher PECAM-1 phosphorylation despite a similar hyperemic level in the aged observed after training, suggests that training improved shear stress responsiveness of this mechanotransduction protein.
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Affiliation(s)
- Lasse Gliemann
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Peter Piil
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Jannik Nilton
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Lind
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Matthew Cocks
- Exercise Metabolism Research Group, School of Sport and Exercise Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
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Garten RS, Hogwood AC, Weggen JB, Fralin RC, LaRosa K, Lee D, Michael A, Scott M. Aerobic training status does not attenuate prolonged sitting-induced lower limb vascular dysfunction. Appl Physiol Nutr Metab 2018; 44:425-433. [PMID: 30257099 DOI: 10.1139/apnm-2018-0420] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study examined if the degree of aerobic training protects against the lower limb vascular dysfunction associated with a prolonged sitting bout. Ten young, aerobically trained (AT) and 10 young, untrained (UT) individuals completed a prolonged (3 h) sitting bout. Leg vascular function was measured prior to and at 1.5 and 3 h into the prolonged sitting bout using the passive leg movement (PLM) technique. PLM-induced hyperemia was significantly reduced from baseline at 1.5 and 3 h into the prolonged sitting bout in both groups when evaluated as peak change in leg blood flow from baseline (Δ LBF) (UT: 956 ± 140, 586 ± 80, and 599 ± 96 mL·min-1 at baseline, 1.5 h, and 3 h, respectively; AT: 955 ± 183, 789 ± 193, and 712 ± 131 mL·min-1 at baseline, 1.5 h, and 3 h, respectively) and LBF area under the curve (UT: 283 ± 73, 134 ± 31, and 164 ± 42 mL·min-1 at baseline, 1.5 h, and 3 h, respectively; AT: 336 ± 86, 242 ± 86, and 245 ± 73 mL·min-1 at baseline, 1.5 h, and 3 h, respectively), but no significant differences between groups were revealed. No significant correlations were observed when examining the relationship between maximal oxygen uptake (relative and absolute) and reductions in leg vascular function at 1.5 and 3 h into the prolonged sitting bout. This study revealed that aerobic training did not provide a protective effect against prolonged sitting-induced lower limb vascular dysfunction and further highlights the importance of reducing excessive sitting in all populations.
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Affiliation(s)
- Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Austin C Hogwood
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Jennifer B Weggen
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - R Carson Fralin
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Kathryn LaRosa
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - David Lee
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Austin Michael
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
| | - Matthew Scott
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.,Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA 23284-2020, USA
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Passive limb movement intervals results in repeated hyperemic responses in those with paraplegia. Spinal Cord 2018; 56:940-948. [PMID: 29686256 PMCID: PMC6173639 DOI: 10.1038/s41393-018-0099-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/16/2018] [Accepted: 03/18/2018] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Repeated measures. OBJECTIVES Reports suggest passive limb movement (PLM) could be used as a therapy to increase blood flow and tissue perfusion in the paralyzed lower limbs of those with spinal cord injuries. However, the hyperemic response to PLM appears to be transient, lasting only 30-45 s despite continued limb movement. The purpose of this investigation was to determine whether the hyperemic response is repeatable across multiple short bouts of passive limb movement. SETTING Cleveland Veterans Affairs Medical Center. METHODS Nine individuals with paraplegia 46 ± 6 years of age, 17 ± 12 years post injury (range: 3-33 years) with complete T3-T11 injuries were subject to 5 × 1 min bouts of passive knee extension/flexion at 1 Hz with a 1 min recovery period between each bout. Heart rate (HR), mean arterial pressure (MAP), femoral artery blood flow (FABF), skin blood flow (SBF), and tissue perfusion in the lower limb were recorded during baseline and throughout each bout of PLM. RESULTS Despite no increase in HR (p ≥ 0.8) or MAP (p ≥ 0.40) across all four bouts of PLM, the average increase in FABF during each bout ranged from 71 ± 87% to 88 ± 93% greater than baseline (p ≤ 0.043). SBF also increased between 465 ± 302% and 582 ± 309% across the five bouts of PLM (p ≤ 0.005). CONCLUSIONS Repeated bouts of PLM in those with SCI while in an upright position resulted in a robust and steady increase in FABF and SBF which could have implications for improving vascular health and tissue perfusion in the lower limbs of those with paraplegia.
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Piil P, Jørgensen TS, Egelund J, Rytter N, Gliemann L, Bangsbo J, Hellsten Y, Nyberg M. Effects of aging and exercise training on leg hemodynamics and oxidative metabolism in the transition from rest to steady-state exercise: role of cGMP signaling. Am J Physiol Regul Integr Comp Physiol 2018; 315:R274-R283. [PMID: 29668326 DOI: 10.1152/ajpregu.00446.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aging is associated with slower skeletal muscle O2 uptake (V̇o2) kinetics; however, the mechanisms underlying this effect of age are unclear. Also, the effects of exercise training in elderly on the initial vascular and metabolic response to exercise remain to be elucidated. We measured leg hemodynamics and oxidative metabolism in the transition from rest to steady-state exercise engaging the knee-extensor muscles in young ( n = 15, 25 ± 1 yr) and older ( n = 15, 72 ± 1 yr) subjects before and after a period of aerobic high-intensity exercise training. To enhance cGMP signaling, pharmacological inhibition of phosphodiesterase 5 (PDE5) was performed. Before training, the older group had a slower ( P <0.05) increase in femoral arterial blood flow and leg vascular conductance in the transition from rest to steady-state exercise at low- and moderate-intensity compared with the young group. The rate of increase in leg V̇o2 was, however, similar in the two groups as a result of higher ( P < 0.05) arteriovenous O2 difference in the older group. Potentiation of cGMP signaling did not affect the rate of increase in blood flow or V̇o2 in either group. Exercise training augmented ( P < 0.05) the increase in leg vascular conductance and blood flow during the onset of moderate-intensity exercise in both groups without altering V̇o2. These findings suggest that an age-related reduction in the initial vascular response to low- and moderate-intensity knee-extensor exercise is not limiting for V̇o2 in older individuals. A lower blood flow response in aging does not appear to be a result of reduced cGMP signaling.
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Affiliation(s)
- Peter Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark.,Department of Orthopedics, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Jon Egelund
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
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Wray DW, Amann M, Richardson RS. Peripheral vascular function, oxygen delivery and utilization: the impact of oxidative stress in aging and heart failure with reduced ejection fraction. Heart Fail Rev 2018; 22:149-166. [PMID: 27392715 DOI: 10.1007/s10741-016-9573-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The aging process appears to be a precursor to many age-related diseases, perhaps the most impactful of which is cardiovascular disease (CVD). Heart disease, a manifestation of CVD, is the leading cause of death in the USA, and heart failure (HF), a syndrome that develops as a consequence of heart disease, now affects almost six million American. Importantly, as this is an age-related disease, this number is likely to grow along with the ever-increasing elderly population. Hallmarks of the aging process and HF patients with a reduced ejection fraction (HFrEF) include exercise intolerance, premature fatigue, and limited oxygen delivery and utilization, perhaps as a consequence of diminished peripheral vascular function. Free radicals and oxidative stress have been implicated in this peripheral vascular dysfunction, as a redox imbalance may directly impact the function of the vascular endothelium. This review aims to bring together studies that have examined the impact of oxidative stress on peripheral vascular function and oxygen delivery and utilization with both healthy aging and HFrEF.
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Affiliation(s)
- D Walter Wray
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA
| | - Markus Amann
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA.
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Evidence of a metabolic reserve in the skeletal muscle of elderly people. Aging (Albany NY) 2017; 9:52-67. [PMID: 27824313 PMCID: PMC5310656 DOI: 10.18632/aging.101079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
Abstract
The purpose of the present study was to determine whether mitochondrial function is limited by O2 availability or the intrinsic capacity of mitochondria to synthesize ATP in elderly individuals. To this aim, we examined, in comparison to free-flow conditions (FF), the effect of superimposing reactive hyperemia (RH), induced by a period of brief ischemia during the last min of exercise, on O2 availability and mitochondrial function in the calf muscle. 12 healthy, untrained, elderly subjects performed dynamic plantar flexion exercise and phosphorus magnetic resonance spectroscopy (31P-MRS), near-infrared spectroscopy (NIRS), and Doppler ultrasound were used to assess muscle metabolism and peripheral hemodynamics. Limb blood flow [area under the curve (AUC), FF: 1.5±0.5L; RH: 3.2±1.1L, P<0.01] and convective O2 delivery (AUC, FF: 0.30±0.13L; RH: 0.64±0.29L, P<0.01) were significantly increased in RH in comparison to FF. RH was also associated with significantly higher capillary blood flow (P<0.05) and this resulted in a 33% increase in estimated peak mitochondrial ATP synthesis rate (FF: 24±11 mM.min−1; RH: 31±7 mM.min−1, P<0.05). These results document a hemodynamic reserve in the contracting calf muscle of the elderly accessible by superimposing reactive hyperemia. Furthermore, this increase in O2 availability enhanced mitochondrial function thus indicating a skeletal muscle metabolic reserve despite advancing age and low level of physical activity.
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Groot HJ, Rossman MJ, Garten RS, Wang E, Hoff J, Helgerud J, Richardson RS. The Effect of Physical Activity on Passive Leg Movement-Induced Vasodilation with Age. Med Sci Sports Exerc 2017; 48:1548-57. [PMID: 27031748 DOI: 10.1249/mss.0000000000000936] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Because of reduced nitric oxide (NO) bioavailability with age, passive leg movement (PLM)-induced vasodilation is attenuated in older sedentary subjects and, unlike the young subjects, cannot be augmented by posture-induced elevations in femoral perfusion pressure. However, whether vasodilator function assessed with PLM, and therefore NO bioavailability, is preserved in older individuals with greater physical activity and fitness is unknown. METHODS PLM was performed on four subject groups: young sedentary (Y, 23 ± 1 yr, n = 12), old sedentary (OS, 73 ± 2 yr, n = 12), old active (OA, 71 ± 2 yr, n = 10), and old endurance trained (OT, 72 ± 1 yr, n = 10) in the supine and upright-seated posture. Hemodynamics were measured using ultrasound Doppler and finger photoplethysmography. RESULTS In the supine posture, PLM-induced peak change in leg vascular conductance was significantly attenuated in the OS compared with the young subjects (OS = 4.9 ± 0.5, Y = 6.9 ± 0.7 mL·min·mm Hg) but was not different from the young in the OA and OT (OA = 5.9 ± 1.0, OT = 5.4 ± 0.4 mL·min·mm Hg). The upright-seated posture significantly augmented peak change in leg vascular conductance in all but the OS (OS = 4.9 ± 0.5, Y = 11.8 ± 1.3, OA = 7.3 ± 0.8, OT = 8.1 ± 0.8 mL·min·mm Hg), revealing a significant vasodilatory reserve capacity in the other groups (Y = 4.92 ± 1.18, OA = 1.37 ± 0.55, OT = 2.76 ± 0.95 mL·min·mm Hg). CONCLUSIONS As PLM predominantly reflects NO-mediated vasodilation, these findings support the idea that augmenting physical activity and fitness can protect NO bioavailability, attenuating the deleterious effects of advancing age on vascular function.
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Affiliation(s)
- H Jonathan Groot
- 1Geriatric Research, Education, and Clinical Center Salt Lake City VAMC, UT; 2Department of Exercise and Sport Science University of Utah, Salt Lake City, UT; 3Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA; 4Department of Internal Medicine, University of Utah, Salt Lake City, UT; 5Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, NORWAY; 6Department of Physical Medicine and Rehabilitation, St. Olavs University Hospital, Trondheim, NORWAY; 7Hokksund Medical Rehabilitation Center, Hokksund, NORWAY; and 8Department of Sports and Outdoor Life Studies, Telemark University College, Bø, NORWAY
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Gifford JR, Richardson RS. CORP: Ultrasound assessment of vascular function with the passive leg movement technique. J Appl Physiol (1985) 2017; 123:1708-1720. [PMID: 28883048 DOI: 10.1152/japplphysiol.00557.2017] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As dysfunction of the vascular system is an early, modifiable step in the progression of many cardiovascular diseases, there is demand for methods to monitor the health of the vascular system noninvasively in clinical and research settings. Validated by very good agreement with more technical assessments of vascular function, like intra-arterial drug infusions and flow-mediated dilation, the passive leg movement (PLM) technique has emerged as a powerful, yet relatively simple, test of peripheral vascular function. In the PLM technique, the change in leg blood flow elicited by the passive movement of the leg through a 90° range of motion is quantified with Doppler ultrasound. This relatively easy-to-learn test has proven to be ≤80% dependent on nitric oxide bioavailability and is especially adept at determining peripheral vascular function across the spectrum of cardiovascular health. Indeed, multiple reports have documented that individuals with decreased cardiovascular health such as the elderly and those with heart failure tend to exhibit a substantially blunted PLM-induced hyperemic response (~50 and ~85% reduction, respectively) compared with populations with good cardiovascular health such as young individuals. As specific guidelines have not yet been put forth, the purpose of this Cores of Reproducibility in Physiology (CORP) article is to provide a comprehensive reference for the assessment and interpretation of vascular function with PLM with the aim to increase reproducibility and consistency among studies and facilitate the use of PLM as a research tool with clinical relevance.
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Affiliation(s)
- Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University , Provo, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Kithas AC, Hydren JR, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. Single passive leg movement assessment of vascular function: contribution of nitric oxide. J Appl Physiol (1985) 2017; 123:1468-1476. [PMID: 28860173 DOI: 10.1152/japplphysiol.00533.2017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Kithas AC, Hydren JR, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. Single passive leg movement assessment of vascular function: contribution of nitric oxide. J Appl Physiol 123: 1468-1476, 2017. First published August 31, 2017; doi:10.1152/japplphysiol.00533.2017.-The assessment of passive leg movement (PLM)-induced leg blood flow (LBF) and vascular conductance (LVC) is a novel approach to assess vascular function that has recently been simplified to only a single PLM (sPLM), thereby increasing the clinical utility of this technique. As the physiological mechanisms mediating the robust increase in LBF and LVC with sPLM are unknown, we tested the hypothesis that nitric oxide (NO) is a major contributor to the sPLM-induced LBF and LVC response. In nine healthy men, sPLM was performed with and without NO synthase inhibition by intra-arterial infusion of NG-monomethyl-l-arginine (l-NMMA). Doppler ultrasound and femoral arterial pressure were used to determine LBF and LVC, which were characterized by the peak change (ΔLBFpeak and ΔLVCpeak) and area under the curve (LBFAUC and LVCAUC). l-NMMA significantly attenuated ΔLBFpeak [492 ± 153 (l-NMMA) vs. 719 ± 238 (control) ml/min], LBFAUC [57 ± 34 (l NMMA) vs. 147 ± 63 (control) ml], ΔLVCpeak [4.7 ± 1.1 (l-NMMA) vs. 8.0 ± 3.0 (control) ml·min-1·mmHg-1], and LVCAUC [0.5 ± 0.3 (l-NMMA) vs. 1.6 ± 0.9 (control) ml/mmHg]. The magnitude of the NO contribution to LBF and LVC was significantly correlated with the magnitude of the control responses ( r = 0.94 for ΔLBFpeak, r = 0.85 for LBFAUC, r = 0.94 for ΔLVCpeak, and r = 0.95 for LVCAUC). These data establish that the sPLM-induced hyperemic and vasodilatory response is predominantly (~65%) NO-mediated. As such, sPLM appears to be a promising, simple, in vivo assessment of NO-mediated vascular function and NO bioavailability. NEW & NOTEWORTHY Passive leg movement (PLM), a novel assessment of vascular function, has been simplified to a single PLM (sPLM), thereby increasing the clinical utility of this technique. However, the role of nitric oxide (NO) in mediating the robust sPLM hemodynamic responses is unknown. This study revealed that sPLM induces a hyperemic and vasodilatory response that is predominantly NO-mediated and, as such, appears to be a promising simple, in vivo, clinical assessment of NO-mediated vascular function and, therefore, NO bioavailability.
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Affiliation(s)
- Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Oh Sung Kwon
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - David E Morgan
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Jacob E Jessop
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Amber D Bledsoe
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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Roman MA, Rossiter HB, Casaburi R. Exercise, ageing and the lung. Eur Respir J 2016; 48:1471-1486. [PMID: 27799391 DOI: 10.1183/13993003.00347-2016] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/27/2016] [Indexed: 02/07/2023]
Abstract
This review provides a pulmonary-focused description of the age-associated changes in the integrative physiology of exercise, including how declining lung function plays a role in promoting multimorbidity in the elderly through limitation of physical function. We outline the ageing of physiological systems supporting endurance activity: 1) coupling of muscle metabolism to mechanical power output; 2) gas transport between muscle capillary and mitochondria; 3) matching of muscle blood flow to its requirement; 4) oxygen and carbon dioxide carrying capacity of the blood; 5) cardiac output; 6) pulmonary vascular function; 7) pulmonary oxygen transport; 8) control of ventilation; and 9) pulmonary mechanics and respiratory muscle function. Deterioration in function occurs in many of these systems in healthy ageing. Between the ages of 25 and 80 years pulmonary function and aerobic capacity each decline by ∼40%. While the predominant factor limiting exercise in the elderly likely resides within the function of the muscles of ambulation, muscle function is (at least partially) rescued by exercise training. The age-associated decline in pulmonary function, however, is not recovered by training. Thus, loss in pulmonary function may lead to ventilatory limitation in exercise in the active elderly, limiting the ability to accrue the health benefits of physical activity into senescence.
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Affiliation(s)
- Michael A Roman
- Division of Respiratory Medicine, Rockyview Hospital, University of Calgary, Calgary, AB, Canada
| | - Harry B Rossiter
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA.,Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Burns KJ, Pollock BS, McDaniel J. The cardiovascular response to passive movement is joint dependent. Physiol Rep 2016; 4:4/5/e12721. [PMID: 26997626 PMCID: PMC4823599 DOI: 10.14814/phy2.12721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The cardiovascular responses to passive limb movement (PLM) at the knee are well established, however, responses to PLM at other joints involving smaller muscle volume are unknown. To compare the cardiovascular responses to passive movement at other joints, 10 participants underwent a PLM protocol in which the wrist, elbow, ankle, and knee joints were passively extended and flexed at 1 Hz for 1 min. Heart rate (HR), mean arterial blood pressure (MAP), and arterial blood flow to that limb segment (BF) were measured and vascular conductance (VC) was calculated for a 30‐sec baseline period and for 3‐sec intervals throughout PLM protocols. PLM of the knee and elbow resulted in significant increases in BF and VC from baseline values with peak values 180% (P < 0.001) greater than baseline. PLM of the elbow resulted in significant increases in BF and VC from baseline values with peak values 109% and 115% (P < 0.001) greater than baseline, respectively. No changes in BF and VC were observed in the ankle and wrist. Furthermore, the greater increase in blood flow per limb segment volume in the thigh and upper arm (62.8 ± 36.5 and 55.5 ± 30.3 mL min−1 L−1, respectively) compared to the forearm and lower leg (23.6 ± 16.7 and 19.1 ± 10.3 mL min−1 L−1, respectively) indicates the limb volume is not solely responsible for the differences in the hyperemic responses. These data indicate that the use of PLM to assess vascular function or as a rehabilitation modality to maintain vascular health may be most appropriate for the muscles that span the elbow and knee.
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Affiliation(s)
- Keith J Burns
- Department of Exercise Physiology, Kent State University, Kent, Ohio
| | - Brandon S Pollock
- Department of Exercise Physiology, Kent State University, Kent, Ohio
| | - John McDaniel
- Department of Exercise Physiology, Kent State University, Kent, Ohio Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio
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Rossman MJ, Groot HJ, Garten RS, Witman MAH, Richardson RS. Vascular function assessed by passive leg movement and flow-mediated dilation: initial evidence of construct validity. Am J Physiol Heart Circ Physiol 2016; 311:H1277-H1286. [PMID: 27638879 DOI: 10.1152/ajpheart.00421.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/08/2016] [Indexed: 12/11/2022]
Abstract
The vasodilatory response to passive leg movement (PLM) appears to provide a novel, noninvasive assessment of vascular function. However, PLM has yet to be compared with the established noninvasive assessment of vascular health, flow-mediated dilation (FMD). Therefore, as an initial evaluation of the construct validity of PLM and upright seated and supine PLM as well as brachial (BA) and superficial femoral (SFA) artery FMDs were performed in 10 young (22 ± 1) and 30 old (73 ± 2) subjects. During upright seated PLM, the peak change in leg blood flow (ΔLBF) and leg vascular conductance (ΔLVC) was significantly correlated with BA (r = 0.57 and r = 0.66) and SFA (r = 0.44 and r = 0.41, ΔLBF and ΔLVC, respectively) FMD. Furthermore, although the relationships were not as strong, the supine PLM response was also significantly correlated with BA (r = 0.38 and r = 0.35) and SFA (r = 0.39 and r = 0.35, ΔLBF and ΔLVC, respectively) FMD. Examination of the young and old separately, however, revealed that significant relationships persisted in both groups only for the upright seated PLM response and BA FMD (young: r = 0.73 and r = 0.77; old: r = 0.35 and r = 0.45, ΔLBF and ΔLVC, respectively). Normalizing FMD for shear rate during PLM abrogated all significant relationships between the PLM and FMD response, suggesting a role for nitric oxide (NO) in these associations. Collectively, these data indicate that PLM, particularly upright seated PLM, likely provides an index of vascular health analogous to the traditional FMD test. Given the relative ease of PLM implementation, these data have important positive implications for PLM as a clinical vascular health assessment.
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Affiliation(s)
- Matthew J Rossman
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
| | - H Jonathan Groot
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
| | - Ryan S Garten
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Melissa A H Witman
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah; .,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah; and.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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Hughes WE, Kruse NT. A 'passive' movement into the future of assessing endothelial dysfunction? J Physiol 2016; 594:1525-6. [PMID: 26995261 DOI: 10.1113/jp271888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- William E Hughes
- Human Integrative and Cardiovascular Physiology Laboratory, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Nicholas T Kruse
- Human Integrative and Cardiovascular Physiology Laboratory, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Angulo J, El Assar M, Rodríguez-Mañas L. Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults. Mol Aspects Med 2016; 50:1-32. [PMID: 27370407 DOI: 10.1016/j.mam.2016.06.001] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/18/2016] [Indexed: 12/13/2022]
Abstract
Frailty is a functional status that precedes disability and is characterized by decreased functional reserve and increased vulnerability. In addition to disability, the frailty phenotype predicts falls, institutionalization, hospitalization and mortality. Frailty is the consequence of the interaction between the aging process and some chronic diseases and conditions that compromise functional systems and finally produce sarcopenia. Many of the clinical manifestations of frailty are explained by sarcopenia which is closely related to poor physical performance. Reduced regenerative capacity, malperfusion, oxidative stress, mitochondrial dysfunction and inflammation compose the sarcopenic skeletal muscle alterations associated to the frailty phenotype. Inflammation appears as a common determinant for chronic diseases, sarcopenia and frailty. The strategies to prevent the frailty phenotype include an adequate amount of physical activity and exercise as well as pharmacological interventions such as myostatin inhibitors and specific androgen receptor modulators. Cell response to stress pathways such as Nrf2, sirtuins and klotho could be considered as future therapeutic interventions for the management of frailty phenotype and aging-related chronic diseases.
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Affiliation(s)
- Javier Angulo
- Unidad de Investigación Cardiovascular (IRYCIS/UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mariam El Assar
- Instituto de Investigación Sanitaria de Getafe, Getafe, Madrid, Spain
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Liu L, Chen L, Zhang YH, Wei L, Cheng S, Kong X, Zheng M, Huang T, Cai YD. Analysis and prediction of drug-drug interaction by minimum redundancy maximum relevance and incremental feature selection. J Biomol Struct Dyn 2016; 35:312-329. [PMID: 26750516 DOI: 10.1080/07391102.2016.1138142] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Drug-drug interaction (DDI) defines a situation in which one drug affects the activity of another when both are administered together. DDI is a common cause of adverse drug reactions and sometimes also leads to improved therapeutic effects. Therefore, it is of great interest to discover novel DDIs according to their molecular properties and mechanisms in a robust and rigorous way. This paper attempts to predict effective DDIs using the following properties: (1) chemical interaction between drugs; (2) protein interactions between the targets of drugs; and (3) target enrichment of KEGG pathways. The data consisted of 7323 pairs of DDIs collected from the DrugBank and 36,615 pairs of drugs constructed by randomly combining two drugs. Each drug pair was represented by 465 features derived from the aforementioned three categories of properties. The random forest algorithm was adopted to train the prediction model. Some feature selection techniques, including minimum redundancy maximum relevance and incremental feature selection, were used to extract key features as the optimal input for the prediction model. The extracted key features may help to gain insights into the mechanisms of DDIs and provide some guidelines for the relevant clinical medication developments, and the prediction model can give new clues for identification of novel DDIs.
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Affiliation(s)
- Lili Liu
- a Intelligence Research Department, Information Center , Shanghai Institute of Materia Medica, Chinese Academy of Sciences , Shanghai 201203 , P. R. China
| | - Lei Chen
- b College of Information Engineering, Shanghai Maritime University , Shanghai 201306 , P. R. China
| | - Yu-Hang Zhang
- c Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences , Shanghai 200031 , P. R. China
| | - Lai Wei
- b College of Information Engineering, Shanghai Maritime University , Shanghai 201306 , P. R. China
| | - Shiwen Cheng
- b College of Information Engineering, Shanghai Maritime University , Shanghai 201306 , P. R. China
| | - Xiangyin Kong
- c Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences , Shanghai 200031 , P. R. China
| | - Mingyue Zheng
- d State Key Laboratory of Drug Research, Drug Discovery and Design Center , Shanghai Institute of Materia Medica, Chinese Academy of Sciences , Shanghai 201203 , P. R. China
| | - Tao Huang
- c Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences , Shanghai 200031 , P. R. China
| | - Yu-Dong Cai
- e School of Life Sciences, Shanghai University , Shanghai 200444 , P. R. China
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