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Weggen JB, Darling AM, Autler AS, Hogwood AC, Decker KP, Richardson J, Tuzzolo G, Garten RS. Lower vascular conductance responses to handgrip exercise are improved following acute antioxidant supplementation in young individuals with post-traumatic stress disorder. Exp Physiol 2024; 109:992-1003. [PMID: 38711207 PMCID: PMC11140166 DOI: 10.1113/ep091762] [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: 01/08/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
Young individuals with post-traumatic stress disorder (PTSD) display peripheral vascular and autonomic nervous system dysfunction, two factors potentially stemming from a redox imbalance. It is currently unclear if these aforementioned factors, observed at rest, alter peripheral haemodynamic responses to exercise in this population. This study examined haemodynamic responses to handgrip exercise in young individuals with PTSD following acute antioxidant (AO) supplementation. Thirteen young individuals with PTSD (age 23 ± 3 years), and 13 age- and sex-matched controls (CTRL) participated in the study. Exercise-induced changes to arm blood flow (BF), mean arterial pressure (MAP) and vascular conductance (VC) were evaluated across two workloads of rhythmic handgrip exercise (3 and 6 kg). The PTSD group participated in two visits, consuming either a placebo (PL) or AO prior to their visits. The PTSD group demonstrated significantly lower VC (P = 0.04) across all exercise workloads (vs. CTRL), which was significantly improved following AO supplementation. In the PTSD group, AO supplementation improved VC in participants possessing the lowest VC responses to handgrip exercise, with AO supplementation significantly improving VC responses (3 and 6 kg: P < 0.01) by blunting elevated exercise-induced MAP responses (3 kg: P = 0.01; 6 kg: P < 0.01). Lower VC responses during handgrip exercise were improved following AO supplementation in young individuals with PTSD. AO supplementation was associated with a blunting of exercise-induced MAP responses in individuals with PTSD displaying elevated MAP responses. This study revealed that young individuals with PTSD exhibit abnormal, peripherally mediated exercise responses that may be linked to a redox imbalance.
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Affiliation(s)
- Jennifer B. Weggen
- Department of Kinesiology and Health SciencesVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Ashley M. Darling
- Department of KinesiologyUniversity of Texas at ArlingtonArlingtonTexasUSA
| | - Aaron S. Autler
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelawareUSA
| | - Austin C. Hogwood
- Department of KinesiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Kevin P. Decker
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelawareUSA
| | - Jacob Richardson
- Department of Kinesiology and Health SciencesVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Gina Tuzzolo
- Department of Kinesiology and Health SciencesVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Ryan S. Garten
- Department of Kinesiology and Health SciencesVirginia Commonwealth UniversityRichmondVirginiaUSA
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2
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Fujita D, Kubo Y. Influence of blood lactate variations and passive exercise on cardiac responses. J Phys Ther Sci 2024; 36:69-73. [PMID: 38304152 PMCID: PMC10830155 DOI: 10.1589/jpts.36.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024] Open
Abstract
[Purpose] This study aimed to investigate cardiovascular responses, including heart rate (HR) and heart rate variability (HRV), to various hyperlactatemia-passive exercise interactions. [Participants and Methods] Nine healthy male participants performed upper limb passive cycling movement, and their HR and HRV were assessed while their blood lactate levels were manipulated by sustained handgrip exercise at control, 15% maximum voluntary contraction (MVC), and 30% MVC, followed by postexercise circulatory occlusion. [Results] HR and root mean squared standard difference (rMSSD) of HRV response remained constant at all blood lactate levels during passive exercise (HR: control, 75.8 ± 3.4 bpm; 15% MVC, 76.9 ± 2.7 bpm; and 30% MVC, 77.0 ± 3.7 bpm; rMSSD: control, 33.2 ± 6.9 ms; 15% MVC, 36.3 ± 7.3 ms; and 30% MVC, 37.3 ± 8.9 ms). [Conclusion] Manipulating metaboreflex activation did not significantly alter HR or HRV during passive exercise. These results suggest that, in healthy participants, the interactions between mechanical and metabolic stimuli do not affect HR and HRV responses, implying that passive exercise may be safely implemented.
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Affiliation(s)
- Daisuke Fujita
- Department of Physical Therapy, Faculty of Medical Science,
Fukuoka International University of Health and Welfare: 3-6-40 Momochihama, Sawara-ku,
Fukuoka-shi, Fukuoka 814-0001, Japan
| | - Yusuke Kubo
- Department of Rehabilitation, Kobori Orthopedic Clinic,
Japan
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Takeda R, Nojima H, Hirono T, Okudaira M, Nishikawa T, Watanabe K. Impact of subtetanic neuromuscular electrical stimulation on cardiac autonomic nervous system in young individuals. J Sports Med Phys Fitness 2024; 64:78-87. [PMID: 37902806 DOI: 10.23736/s0022-4707.23.15352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Although subtetanic neuromuscular electrical stimulation (NMES) has been proposed as an exercise training and/or rehabilitation tool, the impact of NMES on the autonomic nervous system (ANS) is unclear. Thus, we hypothesized that NMES would alter ANS, i.e., increase sympathetic activity and decrease parasympathetic activity, in young individuals. METHODS Eighteen healthy young individuals (16 males, mean age: 22 [SD: 4] years, Body Mass Index: 21.7 [2.2] kg/m2) volunteered. Blood pressure (BP), heart rate (HR), and R-R intervals were recorded during 6-minute resting, NMES, and recovery conditions. Short-term heart rate variability analysis of R-R intervals was performed for the frequency and time domains during each condition. Time domain indices included the root mean square of successive R-R interval differences (RMSSD), and the percentage of successive R-R intervals differing by more than 50ms (pRR50%). Frequency domain indices (fast Fourier transform) of R-R intervals included total power (TP), low-frequency (LF) power (0.04-0.15 Hz), and high-frequency (HF) power (0.15-0.4 Hz). RESULTS BP was not altered but HR was significantly increased during NMES (P<0.001), and it returned to the resting level at recovery. RMSSD and pRR50 decreased from resting to NMES and returned at recovery conditions (P<0.05, respectively). TP and HF decreased from resting to NMES and returned at recovery conditions (P<0.05, respectively). LF increased from NMES to recovery (P<0.05). The LF/HF ratio showed no significant differences between conditions (P=0.210). CONCLUSIONS Cardiac ANS fluctuated by subtetanic NMES without BP elevation in healthy young individuals. Parasympathetic but not sympathetic activity was affected by NMES stimulation.
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Affiliation(s)
- Ryosuke Takeda
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan -
| | - Hiroya Nojima
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
| | - Tetsuya Hirono
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masamichi Okudaira
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
| | - Taichi Nishikawa
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
- Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Japan
| | - Kohei Watanabe
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
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Cuspidi C, Gherbesi E, Faggiano A, Sala C, Grassi G, Carugo S, Tadic M. Targeting Hypertensive Response to Exercise and the Association of Masked Hypertension With Subclinical Organ Damage: A Mini-Review and Meta-Analysis. Am J Hypertens 2024; 37:53-59. [PMID: 37195645 DOI: 10.1093/ajh/hpad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/05/2023] [Accepted: 05/05/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Emerging evidence suggests that a hypertensive response to exercise (HRE) during dynamic or isometric stress tests assessing cardiac function is predictive of hypertension and cardiovascular events such coronary artery disease, heart failure and stroke. Whether HRE represents a marker of masked hypertension (MH) in individuals with no prior history of hypertension is still unclear. This is also the case for the association between MH and hypertension-mediated organ damage (HMOD) in the HRE setting. METHODS We addressed this issue through a review and a meta-analysis of studies providing data on this topic in normotensive individuals undergone both to dynamic or static exercise and to 24-h blood pressure monitoring (ABPM). A systematic search was performed using Pub-Med, OVID, EMBASE and Cochrane library databases from inception up to February 28th 2023. RESULTS Six studies including a total of 1,155 untreated clinically normotensive individuals were considered for the review. Data provided by the selected studies can be summarized as follows: (i) HRE is a BP phenotype linked to a high prevalence of MH (27.3% in the pooled population); (ii) MH is, in turn, associated with a greater, consistent likelihood of echocardiographic left ventricular hypertrophy (OR: 4.93, CI: 2.16-12.2, P < 0.0001) and vascular organ damage, as assessed by pulse wave velocity, (SMD: 0.34 ± 0.11, CI: 0.12-0.56, P = 0002). CONCLUSIONS On the basis of this, albeit limited, evidence, the diagnostic work-up in individuals with HRE should primarily be addressed to look for MH as well as for markers of HMOD, a highly prevalent alteration in MH.
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Affiliation(s)
- Cesare Cuspidi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Elisa Gherbesi
- Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggior Policlinico of Milano, Milano, Italy
| | - Andrea Faggiano
- Department of Clinical Sciences and Community Health, University of Milano, Milano, Italy
- Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggior Policlinico of Milano, Milano, Italy
| | - Carla Sala
- Department of Clinical Sciences and Community Health, University of Milano, Milano, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Stefano Carugo
- Department of Clinical Sciences and Community Health, University of Milano, Milano, Italy
- Department of Cardio-Thoraco-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggior Policlinico of Milano, Milano, Italy
| | - Marijana Tadic
- Department of Cardiology, University Hospital "Dr. DragisaMisovic-Dedinje", Heroja Milana Tepica 1,11000 Belgrade, Serbia
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Kallistratos M, Konstantinidis D, Dimitriadis K, Sanidas E, Katsi V, Androulakis E, Vlachopoulos C, Toutouzas K, Kanakakis J, Sideris S, Kafkas N, Mavrogianni AD, Papadopoulos CH, Stefanidis A, Patsourakos N, Kachrimanidis I, Papaioannou N, Tsioufis C, Kochiadakis G, Marketou M. Exercise and cardiac rehabilitation in hypertensive patients with heart failure with preserved ejection fraction: A position statement on behalf of the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology. Hellenic J Cardiol 2024; 75:82-92. [PMID: 37619947 DOI: 10.1016/j.hjc.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life. However, the instructions for the prescriptive or recommended exercise in hypertensive patients and, more specifically, in those with HFpEF are not well defined. Moreover, the evidence is based on observational or small randomized studies, while well-designed clinical trials are lacking. Despite the proven benefit and the guidelines' recommendations, exercise programs and cardiac rehabilitation in patients with hypertensive heart disease and HFpEF are grossly underutilized. This position statement provides a general framework for exercise and exercise-based rehabilitation in patients with hypertension and HFpEF, guides clinicians' rehabilitation strategies, and facilitates clinical practice. It has been endorsed by the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology and is focused on the Health Care System in Greece.
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Affiliation(s)
| | - Dimitriοs Konstantinidis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos Dimitriadis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Elias Sanidas
- Cardiology Department, LAIKO General Hospital, Athens, Greece
| | - Vasiliki Katsi
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Charalambos Vlachopoulos
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - John Kanakakis
- Department of Clinical Therapeutics, University of Athens Medical School, 11528 Athens, Greece
| | - Skevos Sideris
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | | | | | | | - Nikolaos Patsourakos
- Department of Cardiology, "Tzaneio" General Hospital of Piraeus, Piraeus, Greece
| | - Ioannis Kachrimanidis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Nikolaos Papaioannou
- Department of Cardiology, Asklepeion General Hospital Cardiology, Athens, Greece
| | - Costas Tsioufis
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - George Kochiadakis
- Cardiology Department, Heraklion University General Hospital, Crete, Greece
| | - Maria Marketou
- Cardiology Department, Heraklion University General Hospital, Crete, Greece.
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Hori A, Fukazawa A, Katanosaka K, Mizuno M, Hotta N. Mechanosensitive channels in the mechanical component of the exercise pressor reflex. Auton Neurosci 2023; 250:103128. [PMID: 37925831 DOI: 10.1016/j.autneu.2023.103128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
The cardiovascular response is appropriately regulated during exercise to meet the metabolic demands of the active muscles. The exercise pressor reflex is a neural feedback mechanism through thin-fiber muscle afferents activated by mechanical and metabolic stimuli in the active skeletal muscles. The mechanical component of this reflex is referred to as skeletal muscle mechanoreflex. Its initial step requires mechanotransduction mediated by mechanosensors, which convert mechanical stimuli into biological signals. Recently, various mechanosensors have been identified, and their contributions to muscle mechanoreflex have been actively investigated. Nevertheless, the mechanosensitive channels responsible for this muscular reflex remain largely unknown. This review discusses progress in our understanding of muscle mechanoreflex under healthy conditions, focusing on mechanosensitive channels.
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Affiliation(s)
- Amane Hori
- College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-8472, Japan; Department of Applied Clinical Research, UT Southwestern Medical Center, Dallas, TX 75390-9174, USA
| | - Ayumi Fukazawa
- Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-8472, Japan; Department of Applied Clinical Research, UT Southwestern Medical Center, Dallas, TX 75390-9174, USA
| | - Kimiaki Katanosaka
- College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan
| | - Masaki Mizuno
- Department of Applied Clinical Research, UT Southwestern Medical Center, Dallas, TX 75390-9174, USA
| | - Norio Hotta
- College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan.
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Joyner MJ, Wiggins CC, Baker SE, Klassen SA, Senefeld JW. Exercise and Experiments of Nature. Compr Physiol 2023; 13:4879-4907. [PMID: 37358508 PMCID: PMC10853940 DOI: 10.1002/cphy.c220027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
In this article, we highlight the contributions of passive experiments that address important exercise-related questions in integrative physiology and medicine. Passive experiments differ from active experiments in that passive experiments involve limited or no active intervention to generate observations and test hypotheses. Experiments of nature and natural experiments are two types of passive experiments. Experiments of nature include research participants with rare genetic or acquired conditions that facilitate exploration of specific physiological mechanisms. In this way, experiments of nature are parallel to classical "knockout" animal models among human research participants. Natural experiments are gleaned from data sets that allow population-based questions to be addressed. An advantage of both types of passive experiments is that more extreme and/or prolonged exposures to physiological and behavioral stimuli are possible in humans. In this article, we discuss a number of key passive experiments that have generated foundational medical knowledge or mechanistic physiological insights related to exercise. Both natural experiments and experiments of nature will be essential to generate and test hypotheses about the limits of human adaptability to stressors like exercise. © 2023 American Physiological Society. Compr Physiol 13:4879-4907, 2023.
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Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Chad C Wiggins
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah E Baker
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen A Klassen
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Jonathon W Senefeld
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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8
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Effect of Lower Limb Venous Dilation on the Autonomic Cardiac Response among Healthy Young Men. Healthcare (Basel) 2023; 11:healthcare11040548. [PMID: 36833082 PMCID: PMC9957185 DOI: 10.3390/healthcare11040548] [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: 12/07/2022] [Revised: 01/21/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Venous occlusion of the lower limbs, which simulates edema, can alter heart rate variability (HRV) by increasing feedback information from group III/IV sensory fibers. Our aim was to quantify this effect among healthy young men. The study group included 13 men (mean age, 20.4 years). Venous occlusion of the lower limbs was induced using a pressure cuff around both thighs. The effect of occlusion on autonomic cardiac response was quantified under occlusion pressures of 20, 60, and 100 mmHg. Compression was applied for 5 min. HRV was evaluated from changes in the low-frequency (LF) and high-frequency (HF) power of the electrocardiogram and the resulting LF/HF balance. Near-infrared spectroscopy of the leg was used to quantify the effects of occlusion on deoxyhemoglobin, measured as the area under the curve (HHb-AUC). The occlusion pressure of 100 mmHg induced a significant increase in the LF/HF ratio, compared to the baseline (p < 0.05). HHb-AUC was highest for the 100 mmHg occlusion pressure compared with the 20 and 60 mmHg pressures (p < 0.01). These findings indicate that venous dilation may elicit a shift towards sympathetic dominance in the autonomic balance.
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9
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Tan Z, Chen P, Zheng Y, Pan Y, Wang B, Zhao Y. Effect of blood flow-restricted resistance training on myocardial fibrosis in early spontaneously hypertensive rats. Front Cardiovasc Med 2023; 10:1101748. [PMID: 36818353 PMCID: PMC9928848 DOI: 10.3389/fcvm.2023.1101748] [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: 11/18/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Objective The purpose of this study was to explore the effect of blood flow-restricted resistance training on myocardial fibrosis in early spontaneously hypertensive rats (SHRs). Methods Four-week-old male Wistar-Kyoto rats and SHRs were randomly divided into the following groups: normal group (WKY), SHR control (SHR-SED) group, high-intensity resistance training (HIRT) group, low- and medium-intensity resistance training (LMIRT) group, and blood flow-restricted low- and medium-resistance training (BFRT) group. Body weight, hemodynamics, cardiac function, myocardial morphology and fibrosis, and the expression levels of transforming growth factor-beta1-Smad (TGFβ-1-Smad) pathway-related proteins in the myocardium were assessed. Results (1) BFRT lowered blood pressure significantly, decreased left ventricular wall thickness, and improved cardiac function. At the same time, BFRT was superior to traditional resistance training in lowering diastolic blood pressure, and was superior to HIRT in improving left ventricular compliance, reducing heart rate, and reducing left ventricular posterior wall and left ventricular mass (P < 0.05). (2) BFRT decreased collagen I and collagen fiber area in the myocardium, increased the collagen III area, and decreased the collagen I/III ratio (P < 0.05). BFRT produced a better proportion of myocardial collagen fibers than did traditional resistance training (P < 0.05). (3) In the myocardium of the BFRT group compared to the traditional resistance training group, the expression of TGFβ-1, Smad2/3/4, p-Smad2/3, CTGF, and TIMP1 was significantly downregulated, MMP2 and TIMP2 were significantly upregulated, the MMP/TIMP ratio significantly increased, and TGFβ-1 expression significantly decreased (P < 0.05). Conclusion BFRT inhibited the TGFβ-1-Smad pathway in the myocardium, downregulated the expression of CTGF, and regulated the balance between MMPs and TIMPs, thereby reducing myocardial fibrosis in SHR, and improving cardiac morphology and function. BFRT also lowered blood pressure, and achieved an effect of early prevention and treatment of hypertension. At the same time, BFRT was superior to traditional resistance training in reducing diastolic blood pressure and adjusting the proportion of myocardial collagen fibers.
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Affiliation(s)
- Zhaowen Tan
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Peiyou Chen
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yuchan Zheng
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Ying Pan
- Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Baolong Wang
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yan Zhao
- Nanjing Sport Institute, Nanjing, Jiangsu, China,*Correspondence: Yan Zhao,
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10
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Schultz MG, Otahal P, Kovacevic AM, Roberts-Thomson P, Stanton T, Hamilton-Craig C, Wahi S, La Gerche A, Hare JL, Selvanayagam J, Maiorana A, Venn AJ, Marwick TH, Sharman JE. Type-2 Diabetes and the Clinical Importance of Exaggerated Exercise Blood Pressure. Hypertension 2022; 79:2346-2354. [PMID: 35938406 DOI: 10.1161/hypertensionaha.122.19420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exaggerated exercise blood pressure (EEBP) during clinical exercise testing is associated with poor blood pressure (BP) control and cardiovascular disease (CVD). Type-2 diabetes (T2DM) is thought to be associated with increased prevalence of EEBP, but this has never been definitively determined and was the aim of this study. METHODS Clinical exercise test records were analyzed from 13 268 people (aged 53±13 years, 59% male) who completed the Bruce treadmill protocol (stages 1-4, and peak) at 4 Australian public hospitals. Records (including BP) were linked to administrative health datasets (hospital and emergency admissions) to define clinical characteristics and classify T2DM (n=1199) versus no T2DM (n=12 069). EEBP was defined as systolic BP ≥90th percentile at each test stage. Exercise BP was regressed on T2DM history and adjusted for CVD and risk factors. RESULTS Prevalence of EEBP (age, sex, preexercise BP, hypertension history, CVD history and aerobic capacity adjusted) was 12% to 51% greater in T2DM versus no T2DM (prevalence ratio [95% CI], stage 1, 1.12 [1.02-1.24]; stage 2, 1.51 [1.41-1.61]; stage 3, 1.25 [1.10-1.42]; peak, 1.18 [1.09-1.29]). At stages 1 to 3, 8.6% to 15.8% (4.8%-9.7% T2DM versus 3.5% to 6.1% no-T2DM) of people with 'normal' preexercise BP (<140/90 mm Hg) were identified with EEBP. Exercise systolic BP relative to aerobic capacity (stages 1-4 and peak) was higher in T2DM with adjustment for all CVD risk factors. CONCLUSIONS People with T2DM have higher prevalence of EEBP and exercise systolic BP independent of CVD and many of its known risk factors. Clinicians supervising exercise testing should be alerted to increased likelihood of EEBP and thus poor BP control warranting follow-up care in people with T2DM.
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Affiliation(s)
- Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (M.G.S., P.O., A.M.K., A.J.V., J.E.S.)
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (M.G.S., P.O., A.M.K., A.J.V., J.E.S.)
| | - Ann-Marie Kovacevic
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (M.G.S., P.O., A.M.K., A.J.V., J.E.S.)
| | | | - Tony Stanton
- Sunshine Coast University Hospital, Birtinya, Australia (T.S.)
| | | | - Sudhir Wahi
- Princess Alexandra Hospital, Brisbane, Australia (S.W.)
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia (A.L.G., J.L.H., T.H.M.)
| | - James L Hare
- Baker Heart and Diabetes Institute, Melbourne, Australia (A.L.G., J.L.H., T.H.M.).,Department of Cardiology, The Alfred Hospital, Melbourne, Australia (J.L.H.)
| | - Joseph Selvanayagam
- Cardiac Imaging Research, Flinders University, Adelaide, Australia (J.S.).,South Australian Health and Medical Research Institute, Adelaide, Australia (J.S.)
| | - Andrew Maiorana
- Curtin School of Allied Health, Curtin University, Perth, Australia (A.M.).,Allied Health Department, Fiona Stanley Hospital, Perth, Australia (A.M.)
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (M.G.S., P.O., A.M.K., A.J.V., J.E.S.)
| | - Thomas H Marwick
- Baker Heart and Diabetes Institute, Melbourne, Australia (A.L.G., J.L.H., T.H.M.)
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (M.G.S., P.O., A.M.K., A.J.V., J.E.S.)
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11
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Kominami K, Akino M. Prolonged mean response time in older adults with cardiovascular risk compared to healthy older adults. BMC Sports Sci Med Rehabil 2022; 14:173. [PMID: 36151572 PMCID: PMC9503204 DOI: 10.1186/s13102-022-00565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND During incremental exercise (Inc-Ex), the mean response time (MRT) of oxygen uptake (V̇O2) represents the time delay before changes in muscle V̇O2 reflect at the mouth level. MRT calculation by linear regression or monoexponential (τ') fitting of V̇O2 data are known to be highly variable, and a combination of incremental and constant load exercise (CL-Ex) is more reproducible. METHODS We evaluated MRT in older adults using linear regression and combination methods. We recruited 20 healthy adults (male: 9, 69.4 ± 6.8 years) and 10 cardiovascular risk subjects (male: 8, 73.0 ± 8.8 years). On day 1, they performed Inc-Ex using a 10W/min ramp protocol, for determination of the ventilatory anaerobic threshold (VAT) using the V-slope method. On day 2, they performed Inc-Ex to VAT exercise intensity and CL-Ex for 25min total. The MRT was calculated from the CL-Ex V̇O2 average and the time at equivalent V̇O2 in the Inc-Ex. We also assessed the amount of physical activity using the International Physical Activity Questionnaire short form (IPAQ-SF). RESULTS The MRT of healthy participants and those at cardiovascular risk were 49.2 ± 36.3 vs. 83.6 ± 45.4s (p = 0.033). Total physical activity in the IPAQ-SF was inversely correlated with MRT. CONCLUSION The MRT was significantly prolonged in cardiovascular risk participants compared to healthy participants, possibly related to the amount of daily physical activity. Individual MRT may be useful for adjustment of exercise intensity, but this should also be based on daily physical activity and individual condition during exercise.
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Affiliation(s)
- Kazuyuki Kominami
- Department of Rehabilitation, Sanseikai Kitano Hospital, 6-30, 1-chome, Kitano1-jyo, Kiyota-ku, 004–0861 Sapporo, Hokkaido Japan
| | - Masatoshi Akino
- Department of Rehabilitation, Sapporo Kiyota Orthopedic Hospital, 1-50, 4-chome, Kiyota1-jyo, Kiyota-ku, 004-0841 Sapporo, Hokkaido Japan
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12
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Teixeira AL, Vianna LC. The exercise pressor reflex: An update. Clin Auton Res 2022; 32:271-290. [PMID: 35727398 DOI: 10.1007/s10286-022-00872-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/25/2022] [Indexed: 02/07/2023]
Abstract
The exercise pressor reflex is a feedback mechanism engaged upon stimulation of mechano- and metabosensitive skeletal muscle afferents. Activation of these afferents elicits a reflex increase in heart rate, blood pressure, and ventilation in an intensity-dependent manner. Consequently, the exercise pressor reflex has been postulated to be one of the principal mediators of the cardiorespiratory responses to exercise. In this updated review, we will discuss classical and recent advancements in our understating of the exercise pressor reflex function in both human and animal models. Particular attention will be paid to the afferent mechanisms and pathways involved during its activation, its effects on different target organs, its potential role in the abnormal cardiovascular response to exercise in diseased states, and the impact of age and biological sex on these responses. Finally, we will highlight some unanswered questions in the literature that may inspire future investigations in the field.
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Affiliation(s)
- André L Teixeira
- NeuroV̇ASQ̇, Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, DF, Brasília, Brazil
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Lauro C Vianna
- NeuroV̇ASQ̇, Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, DF, Brasília, Brazil.
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13
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Tse R, Garland J, McCarthy S, Ondruschka B, Bardsley EN, Wong CX, Stables S, Paton JFR. Sudden cardiac deaths have higher proportion of left stellate ganglionitis. Forensic Sci Med Pathol 2022; 18:156-164. [PMID: 35349080 DOI: 10.1007/s12024-022-00466-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/25/2022]
Abstract
One of the hypothesized mechanisms of sudden cardiac death in humans is an arrhythmia precipitated by increased sympathetic outflow to a compromised heart. The stellate ganglia provide the main sympathetic innervation to the heart, where the left stellate ganglion appears to play a role in arrhythmogenesis. Case reports of sudden cardiac death have described left stellate ganglion inflammation but no larger studies have been performed. Thus, we have specifically assessed whether the left stellate ganglion was inflamed in those dying from sudden cardiac death versus other causes of death. Thirty-one left stellate ganglia were resected from cadavers diagnosed with sudden cardiac deaths and compared with 18 ganglia from cadavers diagnosed with non-sudden cardiac deaths. Ganglia were stained with hematoxylin and eosin and lymphocytic aggregates compared. The proportion of left stellate ganglion inflammation (77%) was significantly higher in deaths from sudden cardiac deaths than non-sudden cardiac deaths (33%). This study provides information on a previously recognized, but understudied, structure that may help understand sudden cardiac death. We found high prevalence of stellate ganglion inflammation and propose that this may trigger sympathetic storms.
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Affiliation(s)
- Rexson Tse
- Northern Forensic Pathology Service of New Zealand, Auckland City Hospital, LabPLUS, Auckland, New Zealand. .,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
| | - Jack Garland
- Forensic and Analytical Science Service, NSW Health Pathology, Sydney, NSW, Australia
| | - Sinead McCarthy
- Northern Forensic Pathology Service of New Zealand, Auckland City Hospital, LabPLUS, Auckland, New Zealand
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Emma N Bardsley
- Department of Physiology, Faculty of Medical & Health Sciences, Manaaki Mānawa, The Centre for Heart Research, University of Auckland, Auckland, New Zealand
| | - Christopher X Wong
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Simon Stables
- Northern Forensic Pathology Service of New Zealand, Auckland City Hospital, LabPLUS, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Julian F R Paton
- Department of Physiology, Faculty of Medical & Health Sciences, Manaaki Mānawa, The Centre for Heart Research, University of Auckland, Auckland, New Zealand
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14
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The association of elevated blood pressure during ischaemic exercise with sport performance in Master athletes with and without morbidity. Eur J Appl Physiol 2021; 122:211-221. [PMID: 34652528 PMCID: PMC8748359 DOI: 10.1007/s00421-021-04828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022]
Abstract
Background An exaggerated exercise blood pressure (BP) is associated with a reduced exercise capacity. However, its connection to physical performance during competition is unknown. Aim To examine BP responses to ischaemic handgrip exercise in Master athletes (MA) with and without underlying morbidities and to assess their association with athletic performance during the World Master Track Cycling Championships 2019. Methods Forty-eight Master cyclists [age 59 ± 13yrs; weekly training volume 10.4 ± 4.1 h/week; handgrip maximum voluntary contraction (MVC) 46.3 ± 11.5 kg] divided into 2 matched groups (24 healthy MA and 24 MA with morbidity) and 10 healthy middle-aged non-athlete controls (age 48.3 ± 8.3 years; MVC 40.4 ± 14.8 kg) performed 5 min of forearm occlusion including 1 min handgrip isometric contraction (40%MVC) followed by 5 min recovery. Continuous beat-by-beat BP was recorded using finger plethysmography. Age-graded performance (AGP) was calculated to compare race performances among MA. Healthy Master cyclists were further grouped into middle-age (age 46.2 ± 6.4 years; N:12) and old-age (age 65.0 ± 7.7 years; N:12) for comparison with middle-aged non-athlete controls. Results Healthy and morbidity MA groups showed similar BP responses during forearm occlusion and AGP (90.1 ± 4.3% and 91.0 ± 5.3%, p > 0.05, respectively). Healthy and morbidity MA showed modest correlation between the BP rising slope for 40%MVC ischaemic exercise and AGP (r = 0.5, p < 0.05). MA showed accelerated SBP recovery after cessation of ischaemic handgrip exercise compared to healthy non-athlete controls. Conclusion Our findings associate long-term athletic training with improved BP recovery following ischaemic exercise regardless of age or reported morbidity. Exaggerated BP in Master cyclists during ischaemic exercise was associated with lower AGP during the World Master Cycling Championships. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-021-04828-9.
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15
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Waclawovsky G, Boll LFC, Neto SG, Irigoyen MCC, Lehnen AM. Effects of autonomic nervous system activation on endothelial function in response to acute exercise in hypertensive individuals: study protocol for a randomized double-blind study. Trials 2021; 22:548. [PMID: 34412668 PMCID: PMC8374129 DOI: 10.1186/s13063-021-05516-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/06/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Arterial hypertension has a direct association with endothelial dysfunction and major cardiovascular events. There is evidence showing the benefits of aerobic exercise on flow-mediated dilation (FMD) in hypertensive individuals but little is known about the effect of autonomic nervous system (ANS) activation on FMD of the brachial artery in response to different types of exercise in this specific population. This study aims to examine the effects of ANS activation on FMD of the brachial artery in response to exercise in hypertensive individuals following a session of different types of exercise including aerobic exercise (AE), resistance exercise (RE), or combined exercise (CE). METHODS Thirty-nine hypertensive volunteers aged 35 to 55 years will be randomly assigned to two exercise sessions: AE (40 min on a cycle ergometer at 60% of HR reserve), RE (4 lower limb sets with 12 repetitions at 60% 1-RM for 40 min), or CE (RE for 20 min + AE for 20 min). Each exercise group will be randomized to receive either an α1-adrenergic blocker (doxazosin 0.05 mg/kg-1) or placebo. Ultrasound measurement of FMD is performed 10 min before and 10, 40, and 70 min after exercise. ANS activation is monitored using a Finometer and measurements are taken during 10 min before each FMD assessment. Arterial stiffness is assessed by pulse wave velocity (PWV) analysis using a Complior device. DISCUSSION We expect to demonstrate the effect of ANS activation on FMD of the brachial artery in hypertensive individuals in response to different types of exercise. This study may give some insight on how to improve exercise prescription for hypertension management. TRIAL REGISTRATION https://clinicaltrials.gov and ID "NCT04371757". Registered on May 1, 2020.
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Affiliation(s)
- Gustavo Waclawovsky
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | | | - Salvador Gomes Neto
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | - Maria Claudia Costa Irigoyen
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil
- Unidade de Hipertensão, Instituto do Coração de São Paulo, Universidade do Estado de São Paulo, São Paulo, Brazil
| | - Alexandre M Lehnen
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
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16
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Peterson RA, König C, Zimmermann K, Barry CM, Wiklendt L, Brookes SJH. Effects of Lactate on One Class of Group III (CT3) Muscle Afferents. Front Cell Neurosci 2020; 14:215. [PMID: 32848615 PMCID: PMC7424053 DOI: 10.3389/fncel.2020.00215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/17/2020] [Indexed: 12/18/2022] Open
Abstract
A class of Group III muscle afferent neurons has branching sensory terminals in the connective tissue between layers of mouse abdominal muscles (“CT3 muscle afferents”). These sensory endings are both mechanosensitive and metabosensitive. In the present study, responses of CT3 afferents to lactate ions and changes in temperature were recorded. Raising muscle temperature from 32.7°C to 37°C had no consistent effects on CT3 afferent basal firing rate or responses to either von Frey hair stimulation or to an applied load. Superfusion with lactate ions (15 mM, pH 7.4) was associated with an increase in firing from 6 ± 0.7 Hz to 11.7 ± 6.7 Hz (14 units, n = 13, P < 0.05, P = 0.0484) but with considerable variability in the nature and latency of response. Reducing the concentration of extracellular divalent cations, which mimicked the chelating effects of lactate, did not increase firing. Raised concentrations of divalent cations (to compensate for chelation) did not block excitatory effects of lactate on CT3 afferents, suggesting that effects via ASIC3 were not involved. Messenger RNA for the G-protein coupled receptor, hydroxyl carboxylic acid receptor 1 (HCAR1) was detected in dorsal root ganglia and HCAR1-like immunoreactivity was present in spinal afferent nerve cell bodies retrogradely labeled from mouse abdominal muscles. HCAR1-like immunoreactivity was also present in axons in mouse abdominal muscles. This raises the possibility that some effects of lactate on group III muscle afferents may be mediated by HCAR1.
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Affiliation(s)
- Rochelle A Peterson
- Neurogastroentrology Laboratory, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Christine König
- Klinik für Anästhesiologie am Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina Zimmermann
- Klinik für Anästhesiologie am Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christine M Barry
- Musculoskeletal Neurobiology Laboratory, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Lukasz Wiklendt
- Neurogastroentrology Laboratory, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Simon J H Brookes
- Neurogastroentrology Laboratory, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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17
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Grotle AK, Macefield VG, Farquhar WB, O'Leary DS, Stone AJ. Recent advances in exercise pressor reflex function in health and disease. Auton Neurosci 2020; 228:102698. [PMID: 32861944 DOI: 10.1016/j.autneu.2020.102698] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 01/11/2023]
Abstract
Autonomic alterations at the onset of exercise are critical to redistribute cardiac output towards the contracting muscles while preventing a fall in arterial pressure due to excessive vasodilation within the contracting muscles. Neural mechanisms responsible for these adjustments include central command, the exercise pressor reflex, and arterial and cardiopulmonary baroreflexes. The exercise pressor reflex evokes reflex increases in sympathetic activity to the heart and systemic vessels and decreases in parasympathetic activity to the heart, which increases blood pressure (BP), heart rate, and total peripheral resistance through vasoconstriction of systemic vessels. In this review, we discuss recent advancements in our understanding of exercise pressor reflex function in health and disease. Specifically, we discuss emerging evidence suggesting that sympathetic vasoconstrictor drive to the contracting and non-contracting skeletal muscle is differentially controlled by central command and the metaboreflex in healthy conditions. Further, we discuss evidence from animal and human studies showing that cardiovascular diseases, including hypertension, diabetes, and heart failure, lead to an altered exercise pressor reflex function. We also provide an update on the mechanisms thought to underlie this altered exercise pressor reflex function in each of these diseases. Although these mechanisms are complex, multifactorial, and dependent on the etiology of the disease, there is a clear consensus that several mechanisms are involved. Ultimately, approaches targeting these mechanisms are clinically significant as they provide alternative therapeutic strategies to prevent adverse cardiovascular events while also reducing symptoms of exercise intolerance.
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Affiliation(s)
- Ann-Katrin Grotle
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States of America
| | | | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States of America
| | - Audrey J Stone
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, United States of America.
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18
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Hotta N, Hori A, Okamura Y, Baba R, Watanabe H, Sugawara J, Vongpatanasin W, Wang J, Kim HK, Ishizawa R, Iwamoto GA, Mitchell JH, Smith SA, Mizuno M. Insulin resistance is associated with an exaggerated blood pressure response to ischemic rhythmic handgrip exercise in nondiabetic older adults. J Appl Physiol (1985) 2020; 129:144-151. [PMID: 32584663 DOI: 10.1152/japplphysiol.00247.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patients with type 2 diabetes display an exaggerated pressor response to exercise. However, evidence supporting the association between the magnitude of the pressor response to exercise and insulin resistance-related factors including hemoglobin A1c (HbA1c) or homeostatic model assessment of insulin resistance (HOMA-IR) in nondiabetic subjects has remained sparse and inconclusive. Thus we investigated the relationship between cardiovascular responses to exercise and insulin resistance-related factors in nondiabetic healthy men (n = 23) and women (n = 22) above 60 yr old. We measured heart rate (HR) and blood pressure (BP) responses during: isometric handgrip (IHG) exercise of 30% maximal voluntary contraction, a period of skeletal muscle ischemia (SMI) induced by tourniqueting the arm after IHG, and rhythmic dynamic handgrip (DHG) exercise during SMI. Greater diastolic BP (DBP) responses to DHG with SMI was associated with male sex (r = 0.44, P = 0.02) and higher HbA1c (r = 0.33, P = 0.03), heart-ankle pulse wave velocity (haPWV) (r = 0.45, P < 0.01), and resting systolic BP (SBP) (r = 0.36, P = 0.02). HbA1c persisted as a significant determinant explaining the variance in the DBP response to DHG with SMI in multivariate models despite adjustment for sex, haPWV, and resting SBP. It was also determined that the DBP response to DHG with SMI in a group in which HOMA-IR was abnormal (Δ33 ± 3 mmHg) was significantly higher than that of groups in which HOMA-IR was at intermediate (Δ20 ± 4 mmHg) and normal (Δ23 ± 2 mmHg) levels. These data suggest that even in nondiabetic older adults, insulin resistance is related to an exaggerated pressor response to exercise especially when performed under ischemic conditions.NEW & NOTEWORTHY The diastolic blood pressure response to rhythmic dynamic handgrip exercise under ischemic conditions was demonstrated to be correlated with insulin resistance-related factors in nondiabetic older adults. This finding provides important insight to the prescription of exercise in this particular patient population as the blood pressure response to exercise, especially under ischemic conditions, could be exaggerated to nonsafe levels.
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Affiliation(s)
- Norio Hotta
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Amane Hori
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Yukiko Okamura
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Reizo Baba
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Hidehiro Watanabe
- Department of Rehabilitation, Tokai Memorial Hospital, Kasugai, Japan
| | - Jun Sugawara
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Wanpen Vongpatanasin
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jijia Wang
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Han-Kyul Kim
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rie Ishizawa
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gary A Iwamoto
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jere H Mitchell
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Scott A Smith
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Masaki Mizuno
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
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19
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Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens 2020; 34:709-718. [DOI: 10.1038/s41371-020-0298-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/02/2019] [Accepted: 12/31/2019] [Indexed: 02/07/2023]
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20
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Yoo JK, Badrov MB, Parker RS, Anderson EH, Wiblin JL, North CS, Suris A, Fu Q. Early onset neurocirculatory response to static handgrip is associated with greater blood pressure variability in women with posttraumatic stress disorder. Am J Physiol Heart Circ Physiol 2020; 318:H49-H58. [PMID: 31756119 DOI: 10.1152/ajpheart.00490.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric illness that is more prevalent in women, and accumulating evidence suggests a link between PTSD and future development of cardiovascular disease. The underlying mechanisms are unclear, but augmented sympathetic reactivity to daily stressors may be involved. We measured muscle sympathetic nerve activity (MSNA), blood pressure (BP), and heart rate responses in 14 women with PTSD and 14 healthy women (controls) during static handgrip (SHG) exercise to fatigue at 40% of maximal voluntary contraction (MVC). Two minutes of postexercise circulatory arrest (PECA) was followed immediately after SHG to fatigue. MVC and the time to fatigue during SHG did not differ between groups (both P > 0.05). At the first 30 s of SHG, women with PTSD showed augmented sympathetic neural [mean ± SD, ∆MSNA burst frequency (BF): 5 ± 4 vs. 2 ± 3 bursts/30 s, P = 0.02 and ∆MSNA total activity (TA): 82 ± 58 vs. 25 ± 38 arbitrary units/30 s, P = 0.004] and pressor (∆systolic BP: 10 ± 5 vs. 4 ± 3 mmHg, P = 0.003) responses compared with controls. However, MSNA and BP responses at fatigue and during PECA were not different between groups. More interestingly, the augmented initial neural and pressor responses to SHG were associated with greater awake systolic BP variability during ambulation in women with PTSD (MSNA BF: r = 0.55, MSNA TA: r = 0.62, and SBP: r = 0.69, all P < 0.05). These results suggest that early onset exercise pressor response in women with PTSD may be attributed to enhanced mechano- rather than metaboreflexes, which might contribute to the mechanisms underlying the link between PTSD and cardiovascular risk.NEW & NOTEWORTHY The novel findings of the current study are that women with posttraumatic stress disorder (PTSD) exhibited augmented sympathetic neural and pressor responses at the first 30 s of submaximal isometric muscle contraction. More interestingly, exaggerated neurocirculatory responses at the onset of muscle contraction were associated with greater ambulatory awake systolic blood pressure fluctuations in women with PTSD. Our findings expand the knowledge on the physiological mechanisms that perhaps contribute to increased risk of cardiovascular disease in such a population.
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Affiliation(s)
- Jeung-Ki Yoo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Texas.,Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mark B Badrov
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Texas.,Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rosemary S Parker
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Texas
| | - Elizabeth H Anderson
- Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.,Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Jessica L Wiblin
- Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.,Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Carol S North
- Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.,Metrocare Services, Dallas, Texas
| | - Alina Suris
- Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.,Veterans Affairs North Texas Health Care System, Dallas, Texas
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Texas.,Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
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21
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Vianna LC, Fisher JP. Reflex control of the cardiovascular system during exercise in disease. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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22
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Roca F, Bellien J, Iacob M, Joannides R. Endothelium-dependent adaptation of arterial wall viscosity during blood flow increase is impaired in essential hypertension. Atherosclerosis 2019; 285:102-107. [PMID: 31051413 DOI: 10.1016/j.atherosclerosis.2019.04.208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/11/2019] [Accepted: 04/04/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Arterial wall viscosity (AWV) is regulated by endothelium-derived NO and epoxyeicosatrienoic acids (EETs) under baseline physiological conditions. Whether these factors regulate AWV during blood flow increase and whether this mechanism is affected in essential hypertensive patients (HT) remain unknown. METHODS The evolution of radial artery diameter, wall thickness and arterial pressure in response to an increase in flow induced by hand skin heating were measured in 18 untreated HT and 14 normotensive controls (NT) during local infusion of saline and the respective pharmacological inhibitors of NO-synthase and EETs synthesis by cytochrome P450, L-NMMA and/or fluconazole. AWV was estimated by the ratio of the viscous energy dissipated (WV) to the elastic energy stored (WE) obtained from the pressure-diameter relationship. Concomitant changes in operating conditions, which influence the AWV, were taken into account by calculating the midwall stress. RESULTS Baseline WV and WE were higher in HT than in NT but WV/WE was similar. In saline condition, WV/WE increased in HT during heating but not in NT. In the presence of L-NMMA and/or fluconazole, WV/WE increased during heating in NT. In contrast, these inhibitors did not modify the increase in WV/WE during heating in HT compared to saline. In all conditions, a larger increase in WV than WE was responsible for the increase in WV/WE. CONCLUSIONS The release of NO and EETs maintains a stable AWV during flow increase and this endothelial adaptive regulation is lost during essential hypertension, which may promote excessive viscous energy dissipation and cardiovascular uncoupling. Restoration of EETs availability with inhibitors of soluble epoxide hydrolase could thus constitute a promising pharmacological approach to restore the endothelial adaptive regulation of AWV.
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Affiliation(s)
- Frederic Roca
- Rouen University Hospital, Department of Pharmacology, F 76000, Rouen, France; Normandie Univ, UNIROUEN, Inserm U1096, F 76000, Rouen, France; University of Rouen, Institute for Research and Innovation in Biomedicine, Rouen, France; Clinical Investigation Center CIC-CRB 1404, Rouen University Hospital, Rouen, France.
| | - Jeremy Bellien
- Rouen University Hospital, Department of Pharmacology, F 76000, Rouen, France; Normandie Univ, UNIROUEN, Inserm U1096, F 76000, Rouen, France; University of Rouen, Institute for Research and Innovation in Biomedicine, Rouen, France; Clinical Investigation Center CIC-CRB 1404, Rouen University Hospital, Rouen, France
| | - Michele Iacob
- Rouen University Hospital, Department of Pharmacology, F 76000, Rouen, France; Normandie Univ, UNIROUEN, Inserm U1096, F 76000, Rouen, France
| | - Robinson Joannides
- Rouen University Hospital, Department of Pharmacology, F 76000, Rouen, France; Normandie Univ, UNIROUEN, Inserm U1096, F 76000, Rouen, France; University of Rouen, Institute for Research and Innovation in Biomedicine, Rouen, France; Clinical Investigation Center CIC-CRB 1404, Rouen University Hospital, Rouen, France
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23
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Koletsos N, Dipla K, Triantafyllou A, Gkaliagkousi E, Sachpekidis V, Zafeiridis A, Douma S. A brief submaximal isometric exercise test 'unmasks' systolic and diastolic masked hypertension. J Hypertens 2019; 37:710-719. [PMID: 30817451 DOI: 10.1097/hjh.0000000000001943] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES An exaggerated blood pressure (BP) response during dynamic exercise testing has been proposed as an additional screening tool to identify systolic masked hypertension (masked-HYP). However, masked-HYP in young people is often characterized by an elevated DBP. Static/isometric exercise elicits augmented sympathetic stimulation causing greater increases in both SBP and DBP than dynamic exercise. AIMS To examine whether individuals with masked-HYP exhibit exaggerated BP responses during a submaximal handgrip vs. normotensive individuals and individuals with sustained hypertension (true-HYP), and the possible associations of exercise BP with total peripheral resistance (TPR), central/aortic BP, and 24-h-ambulatory BP (24-h BP). METHODS Eighty-six participants [untreated, newly diagnosed, masked-HYP (n = 27), true-HYP (n = 31), and normotensive individuals (n = 28); 46.3 ± 10.7 years], following evaluation of office BP, central/aortic BP, pulse wave velocity, carotid intima-media thickness, echocardiocardiography, and 24-h BP, underwent a 3-min handgrip (30% maximal voluntary contraction) with beat-by-beat BP and hemodynamics assessment (Finapres Medical Systems). RESULTS Despite similar baseline-BP in masked-HYP and normotensive individuals, during exercise masked-HYP exhibited a markedly greater (P < 0.01) SBP and DBP vs. normotensive individuals, and similar BP to true-HYP. TPR significantly increased (P < 0.001) during exercise, in masked-HYP and true-HYP. The exaggerated BP responses in masked-HYP were evident from the 1st minute of exercise and correlated (P < 0.05) with central/aortic-BP, aortic stiffness, 24-h BP, day-BP, night-time-BP, and interventricular septum thickness. CONCLUSION During handgrip, masked-HYP exhibited exaggerated BP and TPR responses, similar to those of true-HYP. These responses were evident from the 1st minute of exercise and correlated with 24-h BP, suggesting that systolic and diastolic masked-HYP can be 'unmasked' during a brief, submaximal, handgrip test.
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Affiliation(s)
| | - Konstantina Dipla
- Department of Sports Science at Serres, Exercise Physiology and Biochemistry Laboratory, Aristotle University of Thessaloniki
| | | | | | | | - Andreas Zafeiridis
- Department of Sports Science at Serres, Exercise Physiology and Biochemistry Laboratory, Aristotle University of Thessaloniki
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital
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24
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Mongkhonsiri P, Tong-un T, Wyss JM, Roysommuti S. Blunted Nighttime Sympathetic Nervous System Response to Stress Among Thai Men with Positive Family History of Sudden Unexplained Nocturnal Death Syndrome. Int Heart J 2019; 60:55-62. [DOI: 10.1536/ihj.18-061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Pitsini Mongkhonsiri
- Department of Physiology, Faculty of Medicine, Khon Kaen University
- Research Division, Praboromarajchanok Institute for Health Workforce Development, Ministry of Public Health
| | - Terdthai Tong-un
- Department of Physiology, Faculty of Medicine, Khon Kaen University
| | - James Michael Wyss
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham
| | - Sanya Roysommuti
- Research Division, Praboromarajchanok Institute for Health Workforce Development, Ministry of Public Health
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25
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Caldwell JT, Sutterfield SL, Post HK, Craig JC, Baumfalk DR, Copp SW, Ade CJ. Impact of Acute Dietary Nitrate Supplementation during Exercise in Hypertensive Women. Med Sci Sports Exerc 2018; 51:1014-1021. [PMID: 30531488 DOI: 10.1249/mss.0000000000001857] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION the aim of the current investigation was to examine if dietary nitrate supplementation would improve vascular control in hypertensive postmenopausal women (PMW). We tested the hypotheses that acute dietary nitrate supplementation would 1) significantly decrease arterial blood pressure (BP) at rest and during exercise, 2) increase limb blood flow during steady-state (SS) exercise, and 3) improve functional sympatholysis during SS exercise. METHODS Ten hypertensive PMW underwent a randomized, double-blind, placebo-controlled trial with a nitrate-rich (NR) or nitrate-poor (NP) supplement. Beat-by-beat BP and heart rate were recorded throughout the trial on the nonexercising limb. Forearm blood flow was measured via ultrasonography on the brachial artery of the exercising limb. All patients performed a resting cold pressor test (CPT) (2 min) and then 7 min of submaximal handgrip exercise with a CPT applied during minutes 5-7. RESULTS SS systolic (NR, 170 ± 7; NP, 171 ± 37 mm Hg), diastolic (NR, 89 ± 2; NP, 92 ± 2 mm Hg), and mean arterial (NR, 121 ± 4; NP, 123 ± 2 mm Hg) pressures were not different between NP and NR treatment conditions (P > 0.05). During SS exercise, forearm blood flow (NR, 189 ± 8; NP, 218 ± 8 mL·min; P = 0.03) in the NR treatment was significantly lower compared with NP. When the CPT was applied during minutes 6-7 of exercise, forearm vascular conductance was reduced by 15% in the NR condition, but only 7% in the NR condition. CONCLUSIONS In summary, an acute NR supplement improved functional sympatholysis by ~50% versus an NP placebo condition. Improvements in functional sympatholysis may have important implications regarding exercise tolerance in hypertensive PMW.
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Affiliation(s)
- Jacob T Caldwell
- Department of Kinesiology, Kansas State University, Manhattan, KS
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26
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Raven PB. Antihypertensive Treatment Fails to Control Blood Pressure During Exercise. Hypertension 2018; 72:63-64. [PMID: 29895531 DOI: 10.1161/hypertensionaha.118.11173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Peter Bernard Raven
- From the Department of Integrative Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth.
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27
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Excessive SBP elevation during moderate exercise discriminates patients at high risk of developing left ventricular hypertrophy from hypertensive patients. J Hypertens 2018. [DOI: 10.1097/hjh.0000000000001700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Moralez G, Jouett NP, Tian J, Zimmerman MC, Bhella P, Raven PB. Effect of centrally acting angiotensin converting enzyme inhibitor on the exercise-induced increases in muscle sympathetic nerve activity. J Physiol 2018; 596:2315-2332. [PMID: 29635787 PMCID: PMC6002210 DOI: 10.1113/jp274697] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/21/2018] [Indexed: 01/01/2023] Open
Abstract
KEY POINTS The arterial baroreflex's operating point pressure is reset upwards and rightwards from rest in direct relation to the increases in dynamic exercise intensity. The intraneural pathways and signalling mechanisms that lead to upwards and rightwards resetting of the operating point pressure, and hence the increases in central sympathetic outflow during exercise, remain to be identified. We tested the hypothesis that the central production of angiotensin II during dynamic exercise mediates the increases in sympathetic outflow and, therefore, the arterial baroreflex operating point pressure resetting during acute and prolonged dynamic exercise. The results identify that perindopril, a centrally acting angiotensin converting enzyme inhibitor, markedly attenuates the central sympathetic outflow during acute and prolonged dynamic exercise. ABSTRACT We tested the hypothesis that the signalling mechanisms associated with the dynamic exercise intensity related increases in muscle sympathetic nerve activity (MSNA) and arterial baroreflex resetting during exercise are located within the central nervous system. Participants performed three randomly ordered trials of 70° upright back-supported dynamic leg cycling after ingestion of placebo and two different lipid soluble angiotensin converting enzyme inhibitors (ACEi): perindopril (high lipid solubility), captopril (low lipid solubility). Repeated measurements of whole venous blood (n = 8), MSNA (n = 7) and arterial blood pressures (n = 14) were obtained at rest and during an acute (SS1) and prolonged (SS2) bout of steady state dynamic exercise. Arterial baroreflex function curves were modelled at rest and during exercise. Peripheral venous superoxide concentrations measured by electron spin resonance spectroscopy were elevated during exercise and were not altered by ACEi at rest (P ≥ 0.4) or during exercise (P ≥ 0.3). Baseline MSNA and mean arterial pressure were unchanged at rest (P ≥ 0.1; P ≥ 0.8, respectively). However, during both SS1 and SS2, the centrally acting ACEi perindopril attenuated MSNA compared to captopril and the placebo (P < 0.05). Arterial pressures at the operating point and threshold pressures were decreased with perindopril from baseline to SS1 with no further changes in the operating point pressure during SS2 under all three conditions. These data suggest that centrally acting ACEi is significantly more effective at attenuating the increase in the acute and prolonged exercise-induced increases in MSNA.
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Affiliation(s)
- Gilbert Moralez
- Institute for Cardiovascular and Metabolic DiseaseUniversity of North Texas Health Science CenterFort WorthTXUSA
- Institute for Exercise and Environmental MedicineTexas Health Presbyterian Hospital Dallas and The University of Texas Southwestern Medical CenterDallasTXUSA
| | - Noah P. Jouett
- Institute for Cardiovascular and Metabolic DiseaseUniversity of North Texas Health Science CenterFort WorthTXUSA
| | - Jun Tian
- Department of Cellular and Integrative PhysiologyUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Matthew C. Zimmerman
- Department of Cellular and Integrative PhysiologyUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Paul Bhella
- Department of Cardiac Imaging at the John Peter Smith Health NetworkFort WorthTXUSA
- Department of Internal MedicineTCU and UNTHSC School of MedicineFort WorthTXUSA
| | - Peter B. Raven
- Institute for Cardiovascular and Metabolic DiseaseUniversity of North Texas Health Science CenterFort WorthTXUSA
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29
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Kruse NT, Hughes WE, Casey DP. Mechanistic insights into the modulatory role of the mechanoreflex on central hemodynamics using passive leg movement in humans. J Appl Physiol (1985) 2018; 125:545-552. [PMID: 29771607 DOI: 10.1152/japplphysiol.01085.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to examine the independent contributions of joint range of motion (ROM), muscle fascicle length (MFL), and joint angular velocity on mechanoreceptor-mediated central cardiovascular dynamics using passive leg movement (PLM) in humans. Twelve healthy men (age: 23 ± 2 yr, body mass index: 23.7 kg/m2) performed continuous PLM at various randomized joint angle ROMs (0°-50° vs. 50°-100° vs. 0°-100°) and joint angular velocities ("fast": 200°/s vs. "slow": 100°/s). Measures of heart rate (HR), cardiac output (CO), and mean arterial pressure (MAP) were recorded during baseline and during 60 s of PLM. MFL was calculated from muscle architectural measurements of fascicle pennation angle and tissue thickness (Doppler ultrasound). Percent change in MFL increased across the transition of PLM from 0° to 50° (15 ± 3%; P < 0.05) and from 0° to 100° knee flexion (27 ± 4%; P < 0.05). The average peak percent change in HR (increased, approx. +5 ± 2%; P < 0.05), CO (increased, approx. +5 ± 3%; P < 0.05), and MAP (decreased, approx. -2 ± 2%; P < 0.05) were similar between fast versus slow angular velocities when compared against shorter absolute joint ROMs (i.e., 0°-50° and 50°-100°). However, the condition that exhibited the greatest angular velocity in combination with ROM (0°-100° at 200°/s) elicited the greatest increases in HR (+13 ± 2%; P < 0.05) and CO (+12 ± 2%; P < 0.05) compared with all conditions. Additionally, there was a significant relationship between MFL and HR within 0°-100° at 200°/s condition ( r2 = 0.59; P < 0.05). These findings suggest that increasing MFL and joint ROM in combination with increased angular velocity via PLM are important components that activate mechanoreflex-mediated cardioacceleration and increased CO. NEW & NOTEWORTHY The mechanoreflex is an important autonomic feedback mechanism that serves to optimize skeletal muscle perfusion during exercise. The present study sought to explore the mechanistic contributions that initiate the mechanoreflex using passive leg movement (PLM). The novel findings show that progressively increasing joint angle range of motion and muscle fascicle length via PLM, in combination with increased angular velocity, are important components that activate mechanoreflex-mediated cardioacceleration and increase cardiac output in humans.
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Affiliation(s)
- Nicholas T Kruse
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa , Iowa City, Iowa
| | - William E Hughes
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa , Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research, University of Iowa , Iowa City, Iowa
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