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Martin TG, Leinwand LA. Hearts apart: sex differences in cardiac remodeling in health and disease. J Clin Invest 2024; 134:e180074. [PMID: 38949027 PMCID: PMC11213513 DOI: 10.1172/jci180074] [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: 07/02/2024] Open
Abstract
Biological sex is an important modifier of physiology and influences pathobiology in many diseases. While heart disease is the number one cause of death worldwide in both men and women, sex differences exist at the organ and cellular scales, affecting clinical presentation, diagnosis, and treatment. In this Review, we highlight baseline sex differences in cardiac structure, function, and cellular signaling and discuss the contribution of sex hormones and chromosomes to these characteristics. The heart is a remarkably plastic organ and rapidly responds to physiological and pathological cues by modifying form and function. The nature and extent of cardiac remodeling in response to these stimuli are often dependent on biological sex. We discuss organ- and molecular-level sex differences in adaptive physiological remodeling and pathological cardiac remodeling from pressure and volume overload, ischemia, and genetic heart disease. Finally, we offer a perspective on key future directions for research into cardiac sex differences.
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Affiliation(s)
- Thomas G. Martin
- Department of Molecular, Cellular, and Developmental Biology and
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
| | - Leslie A. Leinwand
- Department of Molecular, Cellular, and Developmental Biology and
- BioFrontiers Institute, University of Colorado Boulder, Boulder, Colorado, USA
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Jønck S, Løk M, Durrer C, Wedell‐Neergaard A, Lehrskov LL, Legaard GE, Krogh‐Madsen R, Rosenmeier J, Lund MAV, Pedersen BK, Ellingsgaard H, Berg RMG, Christensen RH. Exercise-induced changes in left ventricular strain are affected by interleukin-6 activity: An exploratory analysis of a randomised-controlled trial in humans with abdominal obesity. Exp Physiol 2024; 109:1134-1144. [PMID: 38803062 PMCID: PMC11215489 DOI: 10.1113/ep091800] [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: 02/07/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
Whilst the exercise-induced myokine interleukin-6 (IL-6) plays a beneficial role in cardiac structural adaptations, its influence on exercise-induced functional cardiac outcomes remains unknown. We hypothesised that IL-6 activity is required for exercise-induced improvements in left ventricular global longitudinal strain (LV GLS). In an exploratory study 52 individuals with abdominal obesity were randomised to 12 weeks' high-intensity exercise or no exercise in combination with IL-6 receptor inhibition (IL-6i) or placebo. LV strain and volume measurements were assessed by cardiac magnetic resonance. Exercise improved LV GLS by -5.4% [95% CI: -9.1% to -1.6%] (P = 0.007). Comparing the change from baseline in LV GLS in the exercise + placebo group (-4.8% [95% CI: -7.4% to -2.2%]; P < 0.0004) to the exercise + IL-6i group (-1.1% [95% CI: -3.8% to 1.6%]; P = 0.42), the exercise + placebo group changed -3.7% [95% CI: -7.4% to -0.02%] (P = 0.049) more than the exercise + IL6i group. However, the interaction effect between exercise and IL-6i was insignificant (4.5% [95% CI: -0.8% to 9.9%]; P = 0.09). Similarly, the exercise + placebo group improved LV global circumferential strain by -3.1% [95% CI: -6.0% to -0.1%] (P = 0.04) more compared to the exercise + IL-6i group, yet we found an insignificant interaction between exercise and IL-6i (4.2% [95% CI: -1.8% to 10.3%]; P = 0.16). There was no effect of IL-6i on exercise-induced changes to volume rates. This study underscores the importance of IL-6 in improving LV GLS in individuals with abdominal obesity suggesting a role for IL-6 in cardiac functional exercise adaptations.
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Affiliation(s)
- Simon Jønck
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Mathilde Løk
- Department of CardiologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Cody Durrer
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Anne‐Sophie Wedell‐Neergaard
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Dermatology and AllergyCopenhagen University Hospital ‐ Herlev and GentofteCopenhagenDenmark
| | - Louise Lang Lehrskov
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of OncologyCopenhagen University Hospital – Herlev and GentofteCopenhagenDenmark
| | - Grit Elster Legaard
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Rikke Krogh‐Madsen
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Infectious DiseasesCopenhagen University Hospital ‐ HvidovreCopenhagenDenmark
| | - Jaya Rosenmeier
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Morten Asp Vonsild Lund
- Department of CardiologyCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Bente Klarlund Pedersen
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Helga Ellingsgaard
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Ronan M. G. Berg
- Centre for Physical Activity ResearchCopenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of Clinical Physiology and Nuclear MedicineCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
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Spencer L, Wright L, Foulkes SJ, Rowe SJ, Dillon HT, Climie R, Bigaran A, Janssens K, Mitchell A, Wallace I, Lindqvist A, Burnham L, Prior DL, Howden EJ, La Gerche A. Characterizing the influence of cardiorespiratory fitness on left atrial size and function in the general population. Am J Physiol Heart Circ Physiol 2024; 326:H1269-H1278. [PMID: 38457351 DOI: 10.1152/ajpheart.00422.2023] [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: 07/11/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 03/10/2024]
Abstract
Increased left atrial (LA) size and reduced LA function have been associated with heart failure and atrial fibrillation (AF) in at-risk populations. However, atrial remodeling has also been associated with exercise training and the relationship between fitness, LA size, and function has not been defined across the fitness spectrum. In a cross-sectional study of 559 ostensibly healthy participants, comprising 304 males (mean age, 46 ± 20 yr) and 255 females (mean age, 47 ± 15 yr), we sought to define the relationship between cardiorespiratory fitness (CRF), LA size, and function. We also aimed to interrogate sex differences in atrial factors influencing CRF. Echocardiographic measures included biplane measures of LA volumes indexed to body surface area (LAVi) and atrial deformation using two-dimensional speckle tracking. CRF was measured as peak oxygen consumption (V̇o2peak) during cardiopulmonary exercise testing (CPET). Using multivariable regression, age, sex, weight, and LAVi (P < 0.001 for all) predicted V̇o2peak (P < 0.001, R2 = 0.66 for combined model). After accounting for these variables, heart rate reserve added strength to the model (P < 0.001, R2 = 0.74) but LA strain parameters did not predict V̇o2peak. These findings add important nuance to the perception that LA size is a marker of cardiac pathology. LA size should be considered in the context of fitness, and it is likely that the adverse prognostic associations of increased LA size may be confined to those with LA enlargement and low fitness.NEW & NOTEWORTHY Left atrial (LA) structure better predicts cardiorespiratory fitness (CRF) than LA function. LA function adds little statistical value to predictive models of peak oxygen uptake (V̇o2peak) in healthy individuals, suggesting limited discriminatory for CRF once LA size is factored. In the wider population of ostensibly healthy individuals, the association between increased LA volume and higher CRF provides an important counter to the association between atrial enlargement and heart failure symptoms in those with cardiac pathology.
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Affiliation(s)
- Luke Spencer
- St Vincent's Institute, Fitzroy, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
| | - Leah Wright
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Stephanie J Rowe
- St Vincent's Institute, Fitzroy, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
- Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Hayley T Dillon
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Deakin University, Geelong, Victoria, Australia
| | - Rachel Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | | | - Kristel Janssens
- St Vincent's Institute, Fitzroy, Victoria, Australia
- Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Amy Mitchell
- St Vincent's Institute, Fitzroy, Victoria, Australia
| | - Imogen Wallace
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Lauren Burnham
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - David L Prior
- Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Erin J Howden
- University of Melbourne, Parkville, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Andre La Gerche
- Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Victor Chang Cardiac Research Centre, Darlinghurst, New South Wales, Australia
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Green DJ, Marsh CE, Thomas HJ, Maslen BA, Collis J, Lester L, Naylor LH. Cardiac functional adaptation to resistance and endurance exercise training: a randomized crossover study. Am J Physiol Heart Circ Physiol 2024; 326:H929-H937. [PMID: 38334974 DOI: 10.1152/ajpheart.00579.2023] [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: 09/18/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/10/2024]
Abstract
Few training studies have assessed the impact of different modes of exercise on changes in cardiac function. This study investigated changes in left ventricular (LV) systolic and diastolic function following endurance (END) and resistance (RES) training in healthy participants. Sixty-four individuals participated in a randomized crossover design trial, involving 12 wk of END and RES training, separated by a 12-wk washout. Echocardiograms assessed systolic function [ejection fraction (EF) and global longitudinal strain (GLS)], diastolic function [mitral valve early velocity (E), tissue Doppler velocity (e'), their ratio (E/e')], and left atrial volume indexed to body surface area (LA ESVi). LV mass (LVM) increased with both RES (Δ5.3 ± 11.9, P = 0.001) and END (Δ7.5 ± 13.9, P < 0.001). Once adjusted for lean body mass (LVMi), changes remained significant following END. E/e' improved following END (Δ-0.35 ± 0.98, P = 0.011) not RES (Δ0.35 ± 1.11, P =0.157; P = 0.001 between modes). LA ESVi increased with END (Δ2.0 ± 6.1, P = 0.019) but not RES (Δ1.7 ± 5.7, P = 0.113). EF and GLS were not impacted significantly by either mode of training. Adaptation in LVM and LA volumes, as well as diastolic function, was exercise mode specific. Twelve weeks of intensive END increased LVM, LA volumes, and increased diastolic function. Following RES, LVM increased, although this was attenuated after accounting for changes in lean body mass. There were no changes in systolic function following either mode of exercise training.NEW & NOTEWORTHY Different types of exercise training induce distinct physiological adaptations however few exercise training studies have assessed the impact of different modes of exercise on cardiac function. This study investigated changes in left ventricular systolic and diastolic function following exercise training. Participants completed both endurance and resistance training separated by a 12-wk washout period so each participant is their own control. We present adaptations in cardiac structure and diastolic function are exercise mode specific.
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Affiliation(s)
- Daniel J Green
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Channa E Marsh
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Hannah J Thomas
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
- College of Sport and Exercise Science, Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - Barbara A Maslen
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Julie Collis
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Leanne Lester
- Business School, The University of Western Australia, Perth, Western Australia, Australia
| | - Louise H Naylor
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
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Massarotto RJ, Campbell AJ, Kreiter E, Claydon VE, Cote AT. Effects of detraining on left ventricular mass in endurance-trained individuals: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:415-424. [PMID: 37821393 DOI: 10.1093/eurjpc/zwad327] [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: 06/27/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
AIMS Detraining refers to a loss of training adaptations resulting from reductions in training stimulus due to illness, injury, or active recovery breaks in a training cycle and is associated with a reduction in left ventricular mass (LVM). The purpose of this study was to conduct a systematic review and meta-analysis to determine the influence of detraining on LVM in endurance-trained, healthy individuals. METHODS AND RESULTS Using electronic databases (e.g. EMBASE and MEDLINE), a literature search was performed looking for prospective detraining studies in humans. Inclusion criteria were adults, endurance-trained individuals with no known chronic disease, detraining intervention >1 week, and pre- and post-detraining LVM reported. A pooled statistic for random effects was used to assess changes in LVM with detraining. Fifteen investigations (19 analyses) with a total of 196 participants (ages 18-55 years, 15% female) met inclusion criteria, with detraining ranging between 1.4 and 15 weeks. The meta-analysis revealed a significant reduction in LVM with detraining (standardized mean difference = -0.586; 95% confidence interval = -0.817, -0.355; P < 0.001). Independently, length of detraining was not correlated with the change in LVM. However, a meta-regression model revealed length of the detraining, when training status was accounted for, was associated with the reduction of LVM (Q = 15.20, df = 3, P = 0.0017). Highly trained/elite athletes had greater reductions in LVM compared with recreational and newly trained individuals (P < 0.01). Limitations included relatively few female participants and inconsistent reporting of intervention details. CONCLUSION In summary, LVM is reduced following detraining of one week or more. Further research may provide a greater understanding of the effects of sex, age, and type of detraining on changes in LVM in endurance-trained individuals.
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Affiliation(s)
- Raffaele J Massarotto
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Allison J Campbell
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Elizabeth Kreiter
- Norma Marion Alloway Library, Trinity Western University, 25000 University Drive, Langley, V2Y 1Y1, Canada
| | - Victoria E Claydon
- Cardiovascular Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, V5A 1S6, Canada
| | - Anita T Cote
- Integrative Cardiovascular Physiology Laboratory, School of Human Kinetics, Trinity Western University, 25000 University Drive, Langley, BC V2Y 1Y1, Canada
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Huiberts RO, Wüst RCI, van der Zwaard S. Concurrent Strength and Endurance Training: A Systematic Review and Meta-Analysis on the Impact of Sex and Training Status. Sports Med 2024; 54:485-503. [PMID: 37847373 PMCID: PMC10933151 DOI: 10.1007/s40279-023-01943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Many sports require maximal strength and endurance performance. Concurrent strength and endurance training can lead to suboptimal training adaptations. However, how adaptations differ between males and females is currently unknown. Additionally, current training status may affect training adaptations. OBJECTIVE We aimed to assess sex-specific differences in adaptations in strength, power, muscle hypertrophy, and maximal oxygen consumption ( V ˙ O2max) to concurrent strength and endurance training in healthy adults. Second, we investigated how training adaptations are influenced by strength and endurance training status. METHODS A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and a Cochrane risk of bias was evaluated. ISI Web of science, PubMed/MEDLINE, and SPORTDiscus databases were searched using the following inclusion criteria: healthy adults aged 18-50 years, intervention period of ≥ 4 weeks, and outcome measures were defined as upper- and lower-body strength, power, hypertrophy, and/or V ˙ O2max. A meta-analysis was performed using a random-effects model and reported in standardized mean differences. RESULTS In total, 59 studies with 1346 participants were included. Concurrent training showed blunted lower-body strength adaptations in males, but not in females (male: - 0.43, 95% confidence interval [- 0.64 to - 0.22], female: 0.08 [- 0.34 to 0.49], group difference: P = 0.03). No sex differences were observed for changes in upper-body strength (P = 0.67), power (P = 0.37), or V ˙ O2max (P = 0.13). Data on muscle hypertrophy were insufficient to draw any conclusions. For training status, untrained but not trained or highly trained endurance athletes displayed lower V ˙ O2max gains with concurrent training (P = 0.04). For other outcomes, no differences were found between untrained and trained individuals, both for strength and endurance training status. CONCLUSIONS Concurrent training results in small interference for lower-body strength adaptations in males, but not in females. Untrained, but not trained or highly trained endurance athletes demonstrated impaired improvements in V ˙ O2max following concurrent training. More studies on females and highly strength-trained and endurance-trained athletes are warranted. CLINICAL TRIAL REGISTRATION PROSPERO: CRD42022370894.
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Affiliation(s)
- Raven O Huiberts
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Rob C I Wüst
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Stephan van der Zwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
- Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Altmäe S, Plaza-Florido A, Esteban FJ, Anguita-Ruiz A, Krjutškov K, Katayama S, Einarsdottir E, Kere J, Radom-Aizik S, Ortega FB. Effects of exercise on whole-blood transcriptome profile in children with overweight/obesity. Am J Hum Biol 2024; 36:e23983. [PMID: 37715654 DOI: 10.1002/ajhb.23983] [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] [Received: 05/31/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND The current knowledge about the molecular mechanisms underlying the health benefits of exercise is still limited, especially in childhood. We set out to investigate the effects of a 20-week exercise intervention on whole-blood transcriptome profile (RNA-seq) in children with overweight/obesity. METHODS Twenty-four children (10.21 ± 1.33 years, 46% girls) with overweight/obesity, were randomized to either a 20-week exercise program (intervention group; n = 10), or to a no-exercise control group (n = 14). Whole-blood transcriptome profile was analyzed using RNA-seq by STRT technique with GlobinLock technology. RESULTS Following the 20-week exercise intervention program, 161 genes were differentially expressed between the exercise and the control groups among boys, and 121 genes among girls (p-value <0.05), while after multiple correction, no significant difference between exercise and control groups persisted in gene expression profiles (FDR >0.05). Genes enriched in GO processes and molecular pathways showed different immune response in boys (antigen processing and presentation, infections, and T cell receptor complex) and in girls (Fc epsilon RI signaling pathway) (FDR <0.05). CONCLUSION These results suggest that 20-week exercise intervention program alters the molecular pathways involved in immune processes in children with overweight/obesity.
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Affiliation(s)
- Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Abel Plaza-Florido
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada Granada, Granada, Spain
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, California, USA
| | - Francisco J Esteban
- Systems Biology Unit, Department of Experimental Biology, Faculty of Experimental Sciences, University of Jaen, Jaen, Spain
| | - Augusto Anguita-Ruiz
- Barcelona Institute for Global Health, ISGlobal Barcelona, Barcelona, Spain
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada Granada, Granada, Spain
- Center of Biomedical Research, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
| | - Kaarel Krjutškov
- Competence Centre for Health Technologies, Tartu, Estonia
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Shintaro Katayama
- Folkhälsan Research Center, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Research Programs Unit, University of Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Elisabet Einarsdottir
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
- Science for Life Laboratory, Department of Gene Technology, KTH-Royal Institute of Technology, Solna, Sweden
| | - Juha Kere
- Folkhälsan Research Center, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Research Programs Unit, University of Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine, Irvine, California, USA
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada Granada, Granada, Spain
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- CIBERobn Physiopathology of Obesity and Nutrition, Granada, Spain
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8
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Coe LN, Astorino TA. Sex differences in hemodynamic response to high-intensity interval exercise. Scand J Med Sci Sports 2024; 34:e14495. [PMID: 37724816 DOI: 10.1111/sms.14495] [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: 05/21/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
Sex differences in the cardiorespiratory and hemodynamic response to exercise exist due to differences in heart size, blood volume, and hemoglobin mass, eliciting higher maximal oxygen uptake (VO2max ) in men versus women. Data are equivocal whether sex differences in training responsiveness occur. This study investigated potential sex differences in the hemodynamic response (stroke volume (SV) and cardiac output (CO)) to high-intensity interval exercise (HIIE). Habitually active men (n = 15) and women (n = 13) underwent VO2max testing, followed by three HIIE sessions consisting of the 4 × 4, 10 × 1, and reduced exertion high-intensity training (REHIT), whose order was randomized. During exercise, oxygen uptake (VO2 ) and hemodynamic responses were determined. Results showed no sex difference in peak relative VO2 (p = 0.263), CO (p = 0.277), or SV (p = 0.116), although absolute values were higher in men (p < 0.05). Peak absolute (127.3 ± 20.6 vs. 115.2 ± 16.6 mL/beat, p = 0.004, d = 0.66) and relative SV (111.0 ± 15.5 vs. 100.7 ± 11.1% max, p = 0.005, d = 0.78) were higher with REHIT versus 4 × 4. No sex differences in mean relative VO2 , CO, or SV occurred (p > 0.05). Data showed lower mean VO2 during REHIT versus 4 × 4 (59.3 ± 6.8 vs. 65.8 ± 5.8 %VO2max , p < 0.001, d = 1.05) and 10 × 1 (59.3 ± 6.8 vs. 69.1 ± 7.4 %VO2max , p < 0.001, d = 1.4). Mean CO was lower in REHIT than 10 × 1 (79.8 ± 8.6 vs. 84.0 ± 7.4% max, p = 0.012, d = 0.53). Previously reported differences in VO2max response to HIIE may not be due to unique hemodynamic responses.
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Affiliation(s)
- Leah Noël Coe
- Department of Kinesiology, California State University, San Marcos, California, USA
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9
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Lundby C, Mazza O, Nielsen J, Haubro M, Kvorning T, Ørtenblad N, Gejl KD. Eight weeks of heavy strength training increases hemoglobin mass and V̇o 2peak in well-trained to elite female and male rowers. J Appl Physiol (1985) 2024; 136:1-12. [PMID: 37942530 DOI: 10.1152/japplphysiol.00587.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023] Open
Abstract
O2-transport and endurance exercise performance are greatly influenced by hemoglobin mass (Hbmass), which largely depends on lean body mass (LBM). This study investigated the effects of 8 wk with three weekly sessions of conventional (3-SET: 3 × 10 reps) or high-volume strength training (10-SET: 5-10 × 10 reps) on LBM, Hbmass, muscle strength, and exercise performance in female and male rowers. Hematological parameters were obtained through CO rebreathing and body composition by dual-energy X-ray absorptiometry (DEXA) scans before and after the training period. Concomitantly, V̇o2peak was determined during 2-km ergometer rowing and muscle strength by isometric midthigh pull. There were no differences in training responses between groups for any of the parameters. Pooled data revealed overall increments for Hbmass (10-SET: 882 ± 199 g to 897 ± 213 g; 3-SET: 936 ± 245 g to 962 ± 247 g, P = 0.02) and V̇o2peak (10-SET: 4.3 ± 1.0 to 4.4 ± 0.9 L·min-1; 3-SET: 4.5 ± 0.9 to 4.6 ± 0.9 L·min-1, P = 0.03), whereas LBM remained unchanged (10-SET: 58.7 ± 10.5 to 58.7 ± 10.1 kg; 3-SET: 64.1 ± 10.8 to 64.5 ± 10.6 kg, P = 0.42). Maximal isometric midthigh pull strength increased (10-SET: 224 ± 47 kg to 237 ± 55 kg; 3-SET: 256 ± 77 kg to 281 ± 83 kg, P = 0.001). Strong associations were observed between LBM and Hbmass and V̇o2peak (r2 = 0.88-0.90), entailing sex differences in Hbmass and V̇o2peak. Normalizing V̇o2peak to LBM reduced the sex difference to ∼10%, aligning with the sex difference in Hbmass·LBM-1. Strength training successfully increased Hbmass and V̇o2peak in elite female and male rowers, without an additional effect from increased training volume. Moreover, sex differences in V̇o2peak were mainly explained by differences in LBM, but likely also by differences in Hbmass·LBM-1.NEW & NOTEWORTHY This study in female and male rowers demonstrates that hemoglobin mass (Hbmass), V̇o2peak, and muscle strength increases with 8 wk of heavy strength training and that this response is not different between conventional (3 × 10 repetitions) and high-volume strength training (10 × 10 repetitions). Moreover, female rowers exhibited less hemoglobin per kilogram of lean body mass compared with their male counterparts, which likely contributes to sex differences in V̇o2peak and rowing performance.
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Affiliation(s)
- Carsten Lundby
- Section for Health and Exercise Physiology, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Oscar Mazza
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Joachim Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mads Haubro
- The Danish Rowing Federation, Bagsvaerd, Denmark
| | - Thue Kvorning
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kasper Degn Gejl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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10
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Verdicchio CV, Mahajan R, Middeldorp ME, Gallagher C, Mishima RS, Lau DH, Sanders P, Elliott AD. Influence of sex on efficacy of exercise training for patients with symptomatic atrial fibrillation: insights from the ACTIVE-AF randomized controlled trial. Eur J Prev Cardiol 2023; 30:2006-2014. [PMID: 37486229 DOI: 10.1093/eurjpc/zwad242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/09/2023] [Accepted: 07/21/2023] [Indexed: 07/25/2023]
Abstract
AIMS Exercise training reduces recurrence of arrhythmia and symptom severity amongst patients with symptomatic, non-permanent atrial fibrillation (AF). However, there is little evidence on whether this effect is modified by patient sex. In a sub-analysis from the ACTIVE-AF (A Lifestyle-based, PhysiCal AcTIVity IntErvention for Patients With Symptomatic Atrial Fibrillation) randomized controlled trial, we compared the effects of exercise training on AF recurrence and symptom severity between men and women. METHODS AND RESULTS The ACTIVE-AF study randomized 120 patients (69 men, 51 women) with paroxysmal or persistent AF to receive an exercise intervention combining supervised and home-based aerobic exercise over 6 months or to continue standard medical care. Patients were followed over a 12-month period. The co-primary outcomes were recurrence of AF, off anti-arrhythmic medications and without catheter ablation, and AF symptom severity scores. By 12 months, recurrence of AF was observed in 50 (73%) men and 34 (67%) women. In an intention-to-treat analysis, there was a between-group difference in favour of the exercise group for both men [hazard ratio (HR) 0.52, 95% confidence interval (CI): 0.29-0.91, P = 0.022] and women (HR 0.47, 95% CI: 0.23-0.95, P = 0.035). At 12 months, symptom severity scores were lower in the exercise group compared with controls amongst women but not for men. CONCLUSION An exercise-based intervention reduced arrhythmia recurrence for both men and women with symptomatic AF. Symptom severity was reduced with exercise in women at 12 months. No difference was observed in symptom severity for men. REGISTRATION Australia and New Zealand Clinical Trials Registry: ACTRN12615000734561.
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Affiliation(s)
- Christian V Verdicchio
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Faculty of Medicine & Health, University of Sydney, Sydney, Australia
| | - Rajiv Mahajan
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Lyell McEwin Health Service, Adelaide, Australia
| | - Melissa E Middeldorp
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
| | - Celine Gallagher
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
| | - Ricardo S Mishima
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
| | - Dennis H Lau
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
| | - Adrian D Elliott
- Centre for Heart Rhythm Disorders, University of Adelaide and South Australian Health & Medical Research Institute, North Terrace, Adelaide 5000, South Australia, Australia
- Department of Cardiology, Royal Adelaide Hospital, Port Road, Adelaide 5000, South Australia, Australia
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11
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Carrick-Ranson G, Howden EJ, Brazile TL, Levine BD, Reading SA. Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women. J Appl Physiol (1985) 2023; 135:1215-1235. [PMID: 37855034 DOI: 10.1152/japplphysiol.00798.2022] [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: 01/03/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in women in developed societies. Unfavorable structural and functional adaptations within the heart and central blood vessels with sedentary aging in women can act as the substrate for the development of debilitating CVD conditions such as heart failure with preserved ejection fraction (HFpEF). The large decline in cardiorespiratory fitness, as indicated by maximal or peak oxygen uptake (V̇o2max and V̇o2peak, respectively), that occurs in women as they age significantly affects their health and chronic disease status, as well as the risk of cardiovascular and all-cause mortality. Midlife and older women who have performed structured endurance exercise training for several years or decades of their adult lives exhibit a V̇o2max and cardiac and vascular structure and function that are on par or even superior to much younger sedentary women. Therefore, regular endurance exercise training appears to be an effective preventative strategy for mitigating the adverse physiological cardiovascular adaptations associated with sedentary aging in women. Herein, we narratively describe the aging and short- and long-term endurance exercise training adaptations in V̇o2max, cardiac structure, and left ventricular systolic and diastolic function at rest and exercise in midlife and older women. The role of circulating estrogens on cardiac structure and function is described for consideration in the timing of exercise interventions to maximize beneficial adaptations. Current research gaps and potential areas for future investigation to advance our understanding in this critical knowledge area are highlighted.
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Affiliation(s)
- Graeme Carrick-Ranson
- Department of Surgery, the University of Auckland, Auckland, New Zealand
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| | - Erin J Howden
- Human Integrative Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Tiffany L Brazile
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stacey A Reading
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
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12
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Hunter SK, S Angadi S, Bhargava A, Harper J, Hirschberg AL, D Levine B, L Moreau K, J Nokoff N, Stachenfeld NS, Bermon S. The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine. Med Sci Sports Exerc 2023; 55:2328-2360. [PMID: 37772882 DOI: 10.1249/mss.0000000000003300] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
ABSTRACT Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, and Athletic and Human Performance Center, Marquette University, Milwaukee, WI
| | | | - Aditi Bhargava
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California, San Francisco, CA
| | - Joanna Harper
- Loughborough University, Loughborough, UNITED KINGDOM
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet, and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, SWEDEN
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and the Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kerrie L Moreau
- Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, and Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO
| | - Natalie J Nokoff
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory and Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
| | - Stéphane Bermon
- Health and Science Department, World Athletics, Monaco and the LAMHESS, University Côte d'Azur, Nice, FRANCE
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13
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Liu Y, Zhao X, Hu W, Ren Y, Wei Z, Ren X, Tang Z, Wang N, Chen H, Li Y, Shi Z, Qin S, Yang J. Neural habituation during acute stress signals a blunted endocrine response and poor resilience. Psychol Med 2023; 53:7735-7745. [PMID: 37309913 DOI: 10.1017/s0033291723001666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND A blunted hypothalamic-pituitary-adrenal (HPA) axis response to acute stress is associated with psychiatric symptoms. Although the prefrontal cortex and limbic areas are important regulators of the HPA axis, whether the neural habituation of these regions during stress signals both blunted HPA axis responses and psychiatric symptoms remains unclear. In this study, neural habituation during acute stress and its associations with the stress cortisol response, resilience, and depression were evaluated. METHODS Seventy-seven participants (17-22 years old, 37 women) were recruited for a ScanSTRESS brain imaging study, and the activation changes between the first and last stress blocks were used as the neural habituation index. Meanwhile, participants' salivary cortisol during test was collected. Individual-level resilience and depression were measured using questionnaires. Correlation and moderation analyses were conducted to investigate the association between neural habituation and endocrine data and mental symptoms. Validated analyses were conducted using a Montreal Image Stress Test dataset in another independent sample (48 participants; 17-22 years old, 24 women). RESULTS Neural habituation of the prefrontal cortex and limbic area was negatively correlated with cortisol responses in both datasets. In the ScanSTRESS paradigm, neural habituation was both positively correlated with depression and negatively correlated with resilience. Moreover, resilience moderated the relationship between neural habituation in the ventromedial prefrontal cortex and cortisol response. CONCLUSIONS This study suggested that neural habituation of the prefrontal cortex and limbic area could reflect motivation dysregulation during repeated failures and negative feedback, which might further lead to maladaptive mental states.
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Affiliation(s)
- Yadong Liu
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Weiyu Hu
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Yipeng Ren
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zhenni Wei
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xi Ren
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zihan Tang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Nan Wang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Haopeng Chen
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Yizhuo Li
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning, McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
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14
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Helgerud J, Hov H, Mehus H, Balto B, Boye A, Finsås L, Hoff J, Wang E. Aerobic high-intensity intervals improve V̇O 2max more than supramaximal sprint intervals in females, similar to males. Scand J Med Sci Sports 2023; 33:2193-2207. [PMID: 37608507 DOI: 10.1111/sms.14470] [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: 05/15/2023] [Revised: 07/09/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Maximal oxygen uptake (V̇O2max ) is a pivotal factor for aerobic endurance performance. Recently, aerobic high-intensity interval training (HIIT) was documented to be superior to sprint interval training (SIT) in improving V̇O2max in well-trained males. However, as mounting evidence suggests that physiological responses to training are sex-dependent, examining the effects of HIIT versus SIT on V̇O2max , anaerobic capacity, and endurance performance in females is warranted. METHODS We randomized 81 aerobically well-trained females (22 ± 2 years, 51.8 ± 3.6 mL∙kg-1 ∙min-1 V̇O2max ), training three times weekly for 8 weeks, to well-established protocols: (1) HIIT 4 × 4 min at ~95% of maximal aerobic speed (MAS), with 3 min active recovery (2) SIT 8 × 20 s at ~150% of MAS, with 10 s passive recovery (3) SIT 10 × 30 s at ~175% of MAS, with 3.5 min active recovery. RESULTS Only HIIT 4 × 4 min increased V̇O2max (7.3 ± 3.1%), different from both SIT groups (all p < 0.001). Anaerobic capacity (maximal accumulated oxygen deficit) increased following SIT 8 × 20 s (6.5 ± 10.5%, p < 0.05), SIT 10 × 30 s (14.4 ± 13.7%, p < 0.05; different from HIIT 4 × 4 min, p < 0.05). SIT 10 × 30 s resulted in eight training-induced injuries, different from no injuries following HIIT 4 × 4 min and SIT 8 × 20 s (p < 0.001). All groups improved long-distance (3000-meter) and sprint (300-meter) running performance (all p < 0.001). SIT protocols improved sprint performance more than HIIT 4 × 4 min (p < 0.05). Compared to previous male results, no increase in V̇O2max following SIT 8 × 20 s (p < 0.01), and a higher injury rate for SIT 10 × 30 s (p < 0.001), were evident. CONCLUSIONS In aerobically well-trained women, HIIT is superior to SIT in increasing V̇O2max while all-out treadmill running SIT is potentially more harmful.
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Affiliation(s)
- Jan Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Håkon Hov
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Håkon Mehus
- Physical Education, Sports Science and Outdoor Education, NORD University, Bodø, Norway
| | - Bård Balto
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anders Boye
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Finsås
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Hoff
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Eivind Wang
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
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15
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Rowe SJ, Paratz ED, Foulkes SJ, Janssens K, Spencer LW, Fahy L, D'Ambrosio P, Haykowsky MJ, La Gerche A. Understanding Exercise Capacity: From Elite Athlete to HFpEF. Can J Cardiol 2023; 39:S323-S334. [PMID: 37574129 DOI: 10.1016/j.cjca.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023] Open
Abstract
Exercise capacity is a spectrum that reflects an individual's functional capacity and the dynamic nature of cardiac remodelling along with respiratory and skeletal muscle systems. The relationship of increasing physical activity, increased cardiac mass and volumes, and improved cardiorespiratory fitness (CRF) is well established in the endurance athlete. However, less emphasis has been placed on the other end of the spectrum, which includes individuals with a more sedentary lifestyle and small hearts who are at increased risk of functional disability and poor clinical outcomes. Reduced CRF is an independent predictor of all-cause mortality and cardiovascular events determined by multiple inter-related exogenous and endogenous factors. In this review, we explore the relationship of physical activity, cardiac remodelling, and CRF across the exercise spectrum, emphasising the critical role of cardiac size in determining exercise capacity. In contrast to the large compliant left ventricle of the endurance athlete, an individual with a lifetime of physical inactivity is likely to have a small, stiff heart with reduced cardiac reserve. We propose that this might contribute to the development of heart failure with preserved ejection fraction in certain individuals, and is key to understanding the link between low CRF and increased risk of heart failure.
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Affiliation(s)
- Stephanie J Rowe
- Baker Heart and Diabetes Institute, Melbourne, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Elizabeth D Paratz
- Baker Heart and Diabetes Institute, Melbourne, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Stephen J Foulkes
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Kristel Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia; Exercise and Nutrition Research Program, The Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Luke W Spencer
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Louise Fahy
- Baker Heart and Diabetes Institute, Melbourne, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Paolo D'Ambrosio
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia; Cardiology Department, Royal Melbourne Hospital, Parkville, Australia
| | - Mark J Haykowsky
- Baker Heart and Diabetes Institute, Melbourne, Australia; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Andre La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Baker Department of Cardiometabolic Health, The University of Melbourne, Parkville, Victoria, Australia
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16
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Flanagan H, Cooper R, George KP, Augustine DX, Malhotra A, Paton MF, Robinson S, Oxborough D. The athlete's heart: insights from echocardiography. Echo Res Pract 2023; 10:15. [PMID: 37848973 PMCID: PMC10583359 DOI: 10.1186/s44156-023-00027-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/07/2023] [Indexed: 10/19/2023] Open
Abstract
The manifestations of the athlete's heart can create diagnostic challenges during an echocardiographic assessment. The classifications of the morphological and functional changes induced by sport participation are often beyond 'normal limits' making it imperative to identify any overlap between pathology and normal physiology. The phenotype of the athlete's heart is not exclusive to one chamber or function. Therefore, in this narrative review, we consider the effects of sporting discipline and training volume on the holistic athlete's heart, as well as demographic factors including ethnicity, body size, sex, and age.
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Affiliation(s)
- Harry Flanagan
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - Robert Cooper
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - Keith P George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - Daniel X Augustine
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- Department for Health, University of Bath, Bath, UK
| | - Aneil Malhotra
- Institute of Sport, Manchester Metropolitan University and University of Manchester, Manchester, UK
| | - Maria F Paton
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | | | - David Oxborough
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK.
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17
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Petek BJ, Chung EH, Kim JH, Lampert R, Levine BD, Phelan D, Danielian A, Dean PN, Dineen EH, Fernandez AB, Husaini M, Krishnan S, Shah AB, Stewart KM, Wasfy MM. Impact of Sex on Cardiovascular Adaptations to Exercise: JACC Review Topic of the Week. J Am Coll Cardiol 2023; 82:1030-1038. [PMID: 37648352 DOI: 10.1016/j.jacc.2023.05.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/22/2023] [Indexed: 09/01/2023]
Abstract
Routine exercise leads to cardiovascular adaptations that differ based on sex. Use of cardiac testing to screen athletes has driven research to define how these sex-based adaptations manifest on the electrocardiogram and cardiac imaging. Importantly, sex-based differences in cardiovascular structure and outcomes in athletes often parallel findings in the general population, underscoring the importance of understanding their mechanisms. Substantial gaps exist in the understanding of why cardiovascular adaptations and outcomes related to exercise differ by sex because of underrepresentation of female participants in research. As female sports participation rates have increased dramatically over several decades, it also remains unknown if differences observed in older athletes reflect biological mechanisms vs less lifetime access to sports in females. In this review, we will assess the effect of sex on cardiovascular adaptations and outcomes related to exercise, identify the impact of sex hormones on exercise performance, and highlight key areas for future research.
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Affiliation(s)
- Bradley J Petek
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Eugene H Chung
- Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan H Kim
- Emory University School of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Rachel Lampert
- Section of Cardiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Benjamin D Levine
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, USA
| | - Dermot Phelan
- Sports & Performance Cardiology Center, Atrium Health, Sanger Heart & Vascular Institute, Charlotte, North Carolina, USA
| | - Alfred Danielian
- Division of Sports Cardiology, Las Vegas Heart Associates, Las Vegas, Nevada, USA
| | - Peter N Dean
- Division of Pediatric Cardiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Elizabeth H Dineen
- Division of Cardiology, University of California Irvine, Irvine, California, USA
| | - Antonio B Fernandez
- Hartford Healthcare Heart and Vascular Institute, Hartford, Connecticut, USA
| | - Mustafa Husaini
- Division of Cardiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Sheela Krishnan
- Sports Cardiology & Fitness Program, Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ankit B Shah
- Sports & Performance Cardiology LLC, Chevy Chase, Maryland; Georgetown University School of Medicine, Washington DC
| | - Katie M Stewart
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Meagan M Wasfy
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
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Watso JC, Romero SA, Moralez G, Huang M, Cramer MN, Jaffery MF, Balmain BN, Wilhite DP, Babb TG, Crandall CG. Six Months of Exercise Training Improves Ventilatory Responses during Exercise in Adults with Well-Healed Burn Injuries. Med Sci Sports Exerc 2023; 55:765-776. [PMID: 36729937 PMCID: PMC10106361 DOI: 10.1249/mss.0000000000003099] [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: 02/03/2023]
Abstract
INTRODUCTION Pulmonary function is lower after a severe burn injury, which could influence ventilatory responses during exercise. It is unclear whether exercise training improves pulmonary function or ventilatory responses during exercise in adults with well-healed burn injuries. Therefore, we tested the hypothesis that exercise training improves pulmonary function and ventilatory responses during exercise in adults with well-healed burn injuries. METHODS Thirty-nine adults (28 with well-healed burn injuries and 11 non-burn-injured controls) completed 6 months of unsupervised, progressive exercise training including endurance, resistance, and high-intensity interval components. Before and after exercise training, we performed comprehensive pulmonary function testing and measured ventilatory responses during cycling exercise. We compared variables using two-way ANOVA (group-time; i.e., preexercise/postexercise training (repeated factor)). RESULTS Exercise training did not increase percent predicted spirometry, lung diffusing capacity, or airway resistance measures (time: P ≥ 0.14 for all variables). However, exercise training reduced minute ventilation ( V̇E ; time: P ≤ 0.05 for 50 and 75 W) and the ventilatory equivalent for oxygen ( V̇E /V̇O 2 ; time: P < 0.001 for 75 W) during fixed-load exercise for both groups. The ventilatory equivalent for carbon dioxide ( V̇E /V̇CO 2 ) during exercise at 75 W was reduced after exercise training (time: P = 0.04). The percentage of age-predicted maximum heart rate at the ventilatory threshold was lower in adults with well-healed burn injuries before ( P = 0.002), but not after ( P = 0.22), exercise training. Lastly, exercise training increased V̇E and reduced V̇E /V̇O 2 during maximal exercise (time: P = 0.005 for both variables). CONCLUSIONS These novel findings demonstrate that exercise training can improve ventilatory responses during exercise in adults with well-healed burn injuries.
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Affiliation(s)
- Joseph C. Watso
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX
| | - Steven A. Romero
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
- Department of Physiology & Anatomy, University of North Texas Health Science Center, Fort Worth, TX
| | - Gilbert Moralez
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mu Huang
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX
- Office of Science, Medicine, and Health, American Heart Association, Dallas, TX
| | - Matthew N. Cramer
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Manall F. Jaffery
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Bryce N. Balmain
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Daniel P. Wilhite
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Tony G. Babb
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
| | - Craig G. Crandall
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX
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Amateur Female Athletes Perform the Running Split of a Triathlon Race at Higher Relative Intensity than the Male Athletes: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11030418. [PMID: 36766993 PMCID: PMC9914054 DOI: 10.3390/healthcare11030418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Maximal oxygen uptake (V˙O2max), ventilatory threshold (VT) and respiratory compensation point (RCP) can be used to monitor the training intensity and the race strategy, and the elucidation of the specificities existing between the sexes can be interesting for coaches and athletes. The aim of the study was to compare ventilatory threshold (VT), respiratory compensation point (RCP), and the percentage of the maximal aerobic speed (MAS) that can be maintained in a triathlon race between sexes. Forty-one triathletes (22 men and 19 women), 42.1 ± 8.4 (26 to 60) years old, that raced the same Olympic triathlon underwent a cardiorespiratory maximal treadmill test to assess their VT, RPC, and MAS, and race speed. The maximal oxygen uptake (V˙O2max) (54.0 ± 5.1 vs. 49.8 ± 7.7 mL/kg/min, p < 0.001) and MAS (17 ± 2 vs. 15 ± 2 km/h, p = 0.001) were significantly higher in male than in female athletes. Conversely, there were no sex differences according to the percentage of V˙O2max reached at VT (74.4 ± 4.9 vs. 76.1 ± 5.4%, p = 0.298) and RCP (89.9 ± 3.6 vs. 90.6 ± 4.0%, p = 0.560). The mean speed during the race did not differ between sexes (12.1 ± 1.7 km/h and 11.7 ± 1.8 km/h, p = 0.506, respectively). Finally, men performed the running split at a lower percentage of speed at RCP than women (84.0 ± 8.7 vs. 91.2 ± 7.0%, respectively, p = 0.005). Therefore, male and female athletes accomplished the running split in an Olympic triathlon distance at distinct relative intensities, as female athletes run at a higher RCP percentage.
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20
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McKenna ZJ, Moralez G, Romero SA, Hieda M, Huang M, Cramer MN, Sarma S, MacNamara JP, Jaffery MF, Atkins WC, Foster J, Crandall CG. Cardiac remodeling in well-healed burn survivors after 6 months of unsupervised progressive exercise training. J Appl Physiol (1985) 2023; 134:405-414. [PMID: 36633867 PMCID: PMC9902219 DOI: 10.1152/japplphysiol.00630.2022] [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: 10/20/2022] [Revised: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
Aerobic exercise is important in the rehabilitation of individuals with prior burn injuries, but no studies have examined whether adult burn survivors demonstrate cardiac remodeling to long-term aerobic exercise training. In this study, we tested the hypothesis that 6 months of progressive exercise training improves cardiac magnetic resonance imaging-based measures of cardiac structure and function in well-healed burn survivors. Secondary analyses explored relations between burn surface area and changes in cardiac structure in the cohort of burn survivors. V̇o2peak assessments and cardiac magnetic resonance imaging were performed at baseline and following 6 months of progressive exercise training from 19 well-healed burn survivors and 10 nonburned control participants. V̇o2peak increased following 6 months of training in both groups (Control: Δ5.5 ± 5.8 mL/kg/min; Burn Survivors: Δ3.2 ± 3.6 mL/kg/min, main effect of training, P < 0.001). Left ventricle (LV) mass (Control: Δ1.7 ± 3.1 g/m2; Burn survivors: Δ1.8 ± 2.7 g/m2), stroke volume (Control: Δ5.8 ± 5.2 mL/m2; Burn Survivors: Δ2.8 ± 4.2 mL/m2), and ejection fraction (Control: Δ2.4 ± 4.0%; Burn Survivors: Δ2.2 ± 4.3%) similarly increased following 6 months of exercise training in both cohorts (main effect of training P < 0.05 for all indexes). LV end-diastolic volume increased in the control group (Δ6.5 ± 4.5 mL/m2) but not in the cohort of burn survivors (Δ1.9 ± 2.7 mL/m2, interaction, P = 0.040). Multiple linear regression analyses revealed that burn surface area had little to no effect on changes in ventricular mass or end-diastolic volumes in response to exercise training. Our findings provide initial evidence of physiological cardiac remodeling, which is not impacted by burn size, in response to exercise training in individuals with well-healed burn injuries.NEW & NOTEWORTHY Aerobic exercise is important in the rehabilitation of individuals with prior burn injuries, but no studies have examined whether adult burn survivors demonstrate cardiac remodeling to long-term aerobic exercise training. In this study, we tested the hypothesis that 6 months of progressive exercise training would improve cardiac magnetic resonance imaging-based measures of cardiac structure and function in well-healed burn survivors. Our findings highlight the ability of exercise training to modify cardiac structure and function in well-healed burn survivors and nonburned sedentary controls alike.
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Affiliation(s)
- Zachary J McKenna
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Gilbert Moralez
- Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Steven A Romero
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | | | - Mu Huang
- Office of Science, Medicine, and Health, American Heart Association, Dallas, Texas
| | - Matthew N Cramer
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Satyam Sarma
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - James P MacNamara
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Manall F Jaffery
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Whitley C Atkins
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Josh Foster
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Craig G Crandall
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
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La Gerche A, Howden EJ, Haykowsky MJ, Lewis GD, Levine BD, Kovacic JC. Heart Failure With Preserved Ejection Fraction as an Exercise Deficiency Syndrome: JACC Focus Seminar 2/4. J Am Coll Cardiol 2022; 80:1177-1191. [PMID: 36075837 DOI: 10.1016/j.jacc.2022.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 10/14/2022]
Abstract
Across differing spectrums of cardiac function and cardiac pathologies, there are strong associations between measures of cardiorespiratory fitness and burden of symptoms, quality of life, and prognosis. In this part 2 of a 4-part series, we contend that there is a strong association among physical activity, cardiorespiratory fitness, and cardiac function. We argue that a chronic lack of exercise is a major risk factor for heart failure with preserved ejection fraction in some patients. In support of this hypothesis, increasing physical activity is associated with greater cardiac mass, greater stroke volumes, greater cardiac output and peak oxygen consumption, and fewer clinical events. Conversely, physical inactivity results in cardiac atrophy, reduced output, reduced chamber size, and decreased ability to augment cardiac performance with exercise. Moreover, physical inactivity is a strong predictor of heart failure risk and death. In sum, exercise deficiency should be considered part of the broad heart failure with preserved ejection fraction phenotype.
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Affiliation(s)
- Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; National Centre for Sports Cardiology, Fitzroy, Victoria, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
| | - Erin J Howden
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Mark J Haykowsky
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jason C Kovacic
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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22
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O'Bryan SM, Connor KR, Drummer DJ, Lavin KM, Bamman MM. Considerations for Sex-Cognizant Research in Exercise Biology and Medicine. Front Sports Act Living 2022; 4:903992. [PMID: 35721874 PMCID: PMC9204149 DOI: 10.3389/fspor.2022.903992] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 12/15/2022] Open
Abstract
As the fields of kinesiology, exercise science, and human movement developed, the majority of the research focused on male physiology and extrapolated findings to females. In the medical sphere, basing practice on data developed in only males resulted in the removal of drugs from the market in the late 1990s due to severe side effects (some life-threatening) in females that were not observed in males. In response to substantial evidence demonstrating exercise-induced health benefits, exercise is often promoted as a key modality in disease prevention, management, and rehabilitation. However, much like the early days of drug development, a historical literature knowledge base of predominantly male studies may leave the exercise field vulnerable to overlooking potentially key biological differences in males and females that may be important to consider in prescribing exercise (e.g., how exercise responses may differ between sexes and whether there are optimal approaches to consider for females that differ from conventional approaches that are based on male physiology). Thus, this review will discuss anatomical, physiological, and skeletal muscle molecular differences that may contribute to sex differences in exercise responses, as well as clinical considerations based on this knowledge in athletic and general populations over the continuum of age. Finally, this review summarizes the current gaps in knowledge, highlights the areas ripe for future research, and considerations for sex-cognizant research in exercise fields.
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Affiliation(s)
- Samia M. O'Bryan
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kathleen R. Connor
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Devin J. Drummer
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kaleen M. Lavin
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
| | - Marcas M. Bamman
- Department of Cell, Developmental and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, United States
- UAB Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
- The Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
- *Correspondence: Marcas M. Bamman
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23
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Sex Differences in VO 2max and the Impact on Endurance-Exercise Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094946. [PMID: 35564339 PMCID: PMC9105160 DOI: 10.3390/ijerph19094946] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
It was not until 1984 that women were permitted to compete in the Olympic marathon. Today, more women than men participate in road racing in all distances except the marathon where participation is near equal. From the period of 1985 to 2004, the women’s marathon record improved at a rate three times greater than men’s. This has led many to question whether women are capable of surpassing men despite the fact that there remains a 10–12% performance gap in all distance events. The progressive developments in sports performance research and training, beginning with A.V. Hill’s establishment of the concept of VO2max, have allowed endurance athletes to continue performance feats previously thought to be impossible. However, even today women are significantly underrepresented in sports performance research. By focusing more research on the female physiology and sex differences between men and women, we can better define how women differ from men in adapting to training and potentially use this information to improve endurance-exercise performance in women. The male advantage in endurance-exercise performance has commonly been attributed to their higher VO2max, even when expressed as mL/kg/min. It is widely known that oxygen delivery is the primary limiting factor in elite athletes when it comes to improving VO2max, but little research has explored the sex differences in oxygen delivery. Thus, the purpose of this review is to highlight what is known about the sex differences in the physiological factors contributing to VO2max, more specifically oxygen delivery, and the impacts on performance.
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24
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Gelman R, Berg M, Ilan Y. A Subject-Tailored Variability-Based Platform for Overcoming the Plateau Effect in Sports Training: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031722. [PMID: 35162745 PMCID: PMC8834821 DOI: 10.3390/ijerph19031722] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 12/16/2022]
Abstract
The plateau effect in training is a significant obstacle for professional athletes and average subjects. It evolves from both the muscle-nerve-axis-associated performance and various cardiorespiratory parameters. Compensatory adaptation mechanisms contribute to a lack of continuous improvement with most exercise regimens. Attempts to overcome this plateau in exercise have been only partially successful, and it remains a significant unmet need in both healthy subjects and those suffering from chronic neuromuscular, cardiopulmonary, and metabolic diseases. Variability patterns characterize many biological processes, from cellular to organ levels. The present review discusses the significant obstacles in overcoming the plateau in training and establishes a platform to implement subject-tailored variability patterns to prevent and overcome this plateau in muscle and cardiorespiratory performance.
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Affiliation(s)
- Ram Gelman
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem 9103401, Israel;
| | - Marc Berg
- Department of Pediatrics, Lucile Packard Children’s Hospital, Stanford University, Palo Alto, CA 94304, USA;
| | - Yaron Ilan
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem 9103401, Israel;
- Correspondence: ; Tel.: +972-2-6778231; Fax: +972-2-6431021
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Perkins DR, Talbot JS, Lord RN, Dawkins TG, Baggish AL, Zaidi A, Uzun O, Mackintosh KA, McNarry MA, Cooper SM, Lloyd RS, Oliver JL, Shave RE, Stembridge M. The influence of maturation on exercise-induced cardiac remodelling and haematological adaptation. J Physiol 2021; 600:583-601. [PMID: 34935156 DOI: 10.1113/jp282282] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/15/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS It has long been hypothesised that cardiovascular adaptation to endurance training is augmented following puberty. We investigated whether differences in cardiac and haematological variables exist, and to what extent, between endurance-trained vs. untrained, pre- and post-peak height velocity (PHV) children, and how these central factors relate to maximal oxygen consumption. Using echocardiography to quantify left ventricular (LV) morphology and carbon monoxide rebreathing to determine blood volume and haemoglobin mass, we identified that training-related differences in LV morphology are evident in pre-PHV children, with haematological differences also observed between pre-PHV girls. However, the breadth and magnitude of cardiovascular remodelling was more pronounced post-PHV. Cardiac and haematological measures provide significant predictive models for maximal oxygen consumption in children that are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in before puberty. ABSTRACT Cardiovascular and haematological adaptations to endurance training facilitate greater maximal oxygen consumption, and such adaptations maybe augmented following puberty. Therefore, we compared left ventricular (LV) morphology (echocardiography), blood volume, haemoglobin (Hb) mass (CO-rebreathe) and in endurance-trained and untrained boys (n = 42, age = 9.0-17.1 years, = 61.6±7.2 mL∙kg∙min, and n = 31, age = 8.0-17.7 years, O2max = 46.5±6.1 mL∙kg∙min, respectively) and girls (n = 45, age = 8.2-17.0 years, O2max = 51.4±5.7 mL∙kg∙min and n = 36, age = 8.0-17.6 years, O2max = 39.8±5.7 mL∙kg∙min, respectively). Pubertal stage was estimated via maturity offset, with participants classified as pre- or post-peak height velocity (PHV). Pre-PHV, only a larger LV end-diastolic volume/lean body mass (EDV/LBM) for trained boys (+0.28 mL∙kgLBM , P = 0.007) and a higher Hb mass/LBM for trained girls (+1.65 g∙kgLBM , P = 0.007) were evident compared to untrained controls. Post-PHV, LV mass/LBM (boys:+0.50 g∙kgLBM , P = 0.0003; girls:+0.35 g∙kgLBM , P = 0.003), EDV/LBM (boys:+0.35 mL∙kgLBM , P<0.0001; girls:+0.31 mL∙kgLBM, P = 0.0004), blood volume/LBM (boys:+12.47 mL∙kgLBM , P = 0.004; girls:+13.48 mL∙kgLBM , P = 0.0002.) and Hb mass/LBM (boys:+1.29 g∙kgLBM , P = 0.015; girls:+1.47 g∙kgLBM , P = 0.002) were all greater in trained vs. untrained groups. Pre-PHV, EDV (R2 adj = 0.224, P = 0.001) in boys, and Hb mass and interventricular septal thickness (R2 adj = 0.317, P = 0.002) in girls partially accounted for the variance in O2max . Post-PHV, stronger predictive models were evident via the inclusion of LV wall thickness and EDV in boys (R2 adj = 0.608, P<0.0001), and posterior wall thickness and Hb mass in girls (R2 adj = 0.490, P<0.0001). In conclusion, cardiovascular adaptation to exercise training is more pronounced post-PHV, with evidence for a greater role of central components for oxygen delivery. Abstract figure legend: Schematic diagram depicting cardiac structural and haematological differences between trained and untrained boys and girls, pre-peak height velocity (PHV) and post-PHV alongside cardiac and haematological variables contributions to the variance in O2max . Cardiac and haematological variables are greater in trained vs. untrained pre-pubertal children, and a greater number and magnitude of differences are observed at post-PHV. These variables provide significant predictive models for maximal oxygen consumption in children and are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in O2max before puberty. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dean R Perkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jack S Talbot
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom.,Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Abbas Zaidi
- University Hospital of Wales, Cardiff, United Kingdom
| | - Orhan Uzun
- University Hospital of Wales, Cardiff, United Kingdom
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, United Kingdom
| | - Stephen-Mark Cooper
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rhodri S Lloyd
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom.,Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand.,Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand
| | - Jon L Oliver
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom.,Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Rob E Shave
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Mike Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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26
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Marsh CE, Thomas HJ, Naylor LH, Dembo LG, Green DJ. Sex Differences in Cardiac Adaptation to Distinct Modalities of Exercise: A Cardiac Magnetic Resonance Study. Med Sci Sports Exerc 2021; 53:2543-2552. [PMID: 34138817 DOI: 10.1249/mss.0000000000002729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE No previous study has described sex differences in chronic cardiac adaptation in response to distinct modalities of exercise training in humans. METHODS Cardiac magnetic resonance imaging (1.5 T) was used to assess left ventricular (LV) outcomes in 78 untrained subjects (46F, 26 M; 26.1 ± 5.4 yr). Subjects underwent 3 months of closely supervised and monitored resistance (RES) and endurance (END) training, separated by a 3-month washout period. RESULTS LV mass (LVM) increased in response to END in both sexes (females △3.98 ± 7.98 g, P = 0.002; males △5.99 ± 10.67 g, P = 0.005), whereas LV end-diastolic volume (EDV) increased in males (△7.48 ± 11.91 mL, P = 0.002) but not females (△1.54 ± 10.49 mL, P = 0.373). In response to RES, LVM and EDV did not increase in either sex. The proportion of subjects exhibiting a positive response to training (i.e., a change >0) for LVM and EDV did not differ between sexes for either training modality. CONCLUSION Eccentric hypertrophy in response to END training was more apparent in males than females, whereas there were no notable cardiac changes between sexes for RES training. The proportion of low versus high responders to training was not sex specific for LVM or EDV in response to either commonly prescribed exercise training modality.
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Affiliation(s)
- Channa E Marsh
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA
| | - Hannah J Thomas
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA
| | | | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA
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Petek BJ, Groezinger EY, Pedlar CR, Baggish AL. Cardiac effects of detraining in athletes: A narrative review. Ann Phys Rehabil Med 2021; 65:101581. [PMID: 34624549 DOI: 10.1016/j.rehab.2021.101581] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/12/2021] [Accepted: 08/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Routine physical activity stimulates numerous morphologic and functional adaptations of the cardiac system, which are commonly referred to as exercise-induced cardiac remodeling (EICR). EICR has been well documented in elite and recreational athletes, but comparatively little is known about the "reverse" cardiac adaptations during detraining in an athletic population. OBJECTIVE To assess the morphologic and functional cardiac effects of detraining in athletes. METHODS Eligible studies were identified in PubMed from inception to May 2020. Studies were included if they assessed the cardiac effects of detraining periods in athletes. RESULTS A total of 16 studies from the literature search were identified and included in this review. These studies included athletes from multiple different sporting disciplines and detraining periods ranged from 3 weeks to 13 years. Detraining periods led to significantly decreased right ventricular and left (LV) ventricular dimensions, LV mass, and LV wall thickness, but only limited changes in systolic and diastolic functional parameters were observed. CONCLUSIONS From the limited data available in this population, cardiac atrophy has been observed with short periods of detraining (1-8 weeks) but often spares systolic and diastolic heart function. Supplemental exercise training during times of rehabilitation to combat cardiac regression has not been vigorously studied in athletes, so the ideal frequency, intensity, and modality of exercise needed to maintain EICR remains unclear.
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Affiliation(s)
- Bradley J Petek
- Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States
| | - Erich Y Groezinger
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, United States
| | - Charles R Pedlar
- Faculty of Sport, Health and Applied Science, St. Mary's University, Twickenham, United Kingdom
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Yawkey Suite 5B, 55 Fruit Street, Boston, MA 02114, United States.
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Petek BJ, Baggish AL. Valvular Heart Disease in Athletes. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23. [DOI: 10.1007/s11936-021-00950-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Augustine JA, Lefferts WK, DeBlois JP, Barreira TV, Taylor BA, Liu K, Heffernan KS. Sex differences in cardiovascular adaptations in recreational marathon runners. Eur J Appl Physiol 2021; 121:3459-3472. [PMID: 34515867 DOI: 10.1007/s00421-021-04806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION There are well-established sex differences in central hemodynamic and cardiac adaptations to endurance exercise; however, controversial evidence suggests that excessive endurance exercise may be related to detrimental cardiovascular adaptations in marathoners. PURPOSE To examine left ventricle (LV) structure, LV function, 24-h central hemodynamics and ventricular-vascular coupling in male and female marathoners and recreationally active adults. METHODS 52 marathoners (41 ± 5 years, n = 28 female, completed 6 ± 1 marathons/3 years) and 49 recreationally active controls (42 ± 5 years, n = 25 female) participated in the study. Three-Dimensional Echocardiography (3DE) was used to measure LV mass index and LV longitudinal (LS) circumferential (CS), area (AS), and radial strain (RS). An ambulatory blood pressure (BP) cuff was used to measure 24-h central hemodynamics (BP, pulse wave velocity, PWV, wave reflection index, RIx). Hemodynamic and 3DE measures were combined to derive the ratio of arterial elastance (Ea) to ventricular elastance (Elv) as a global measure of ventricular-vascular coupling. RESULTS There were no sex or group differences in LS, CS, AS, and RS (p > 0.05). Females marathoners had similar aortic BP (116 ± 9 vs. 113 ± 1 mmHg), and PWV (5.9 ± 0.5 vs. 5.9 ± 1.1 m/s) compared to female controls but lower aSBP (116 ± 9 vs. 131 ± 10 mmHg) and PWV (5.9 ± 0.5 vs. 6.2 ± 0.5 m/s) compared to male marathoners (p < 0.05). Female marathoners had lower Ea/Elv than female controls (0.67 ± 0.20 vs. 0.93 ± 0.36) and male marathoners (0.67 ± 0.20 vs. 0.85 ± 0.42, p < 0.05). CONCLUSIONS Women that have completed multiple marathons do not have reduced LV function or increased aortic stiffness and may have better ventricular-vascular coupling compared to male marathoners and their female untrained counterparts.
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Affiliation(s)
- Jacqueline A Augustine
- Kinesiology Department, School of Professional Studies, State University of New York at Cortland, Office 1149, Cortland, NY, 13045, USA. .,Department of Exercise Science, Syracuse University, Syracuse, NY, USA.
| | - Wesley K Lefferts
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA.,Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Jacob P DeBlois
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - Tiago V Barreira
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Kan Liu
- Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.,State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
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Alaasam VJ, Liu X, Niu Y, Habibian JS, Pieraut S, Ferguson BS, Zhang Y, Ouyang JQ. Effects of dim artificial light at night on locomotor activity, cardiovascular physiology, and circadian clock genes in a diurnal songbird. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 282:117036. [PMID: 33838441 PMCID: PMC8184626 DOI: 10.1016/j.envpol.2021.117036] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/04/2021] [Accepted: 03/28/2021] [Indexed: 05/17/2023]
Abstract
Artificial light is transforming the nighttime environment and quickly becoming one of the most pervasive pollutants on earth. Across taxa, light entrains endogenous circadian clocks that function to synchronize behavioral and physiological rhythms with natural photoperiod. Artificial light at night (ALAN) disrupts these photoperiodic cues and has consequences for humans and wildlife including sleep disruption, physiological stress and increased risk of cardiovascular disease. However, the mechanisms underlying organismal responses to dim ALAN, resembling light pollution, remain elusive. Light pollution exists in the environment at lower levels (<5 lux) than tested in many laboratory studies that link ALAN to circadian rhythm disruption. Few studies have linked dim ALAN to both the upstream regulators of circadian rhythms and downstream behavioral and physiological consequences. We exposed zebra finches (Taeniopygia gutatta) to dim ALAN (1.5 lux) and measured circadian expression of five pacemaker genes in central and peripheral tissues, plasma melatonin, locomotor activity, and biomarkers of cardiovascular health. ALAN caused an increase in nighttime activity and, for males, cardiac hypertrophy. Moreover, downstream effects were detectable after just short duration exposure (10 days) and at dim levels that mimic the intensity of environmental light pollution. However, ALAN did not affect circulating melatonin nor oscillations of circadian gene expression in the central clock (brain) or liver. These findings suggest that dim ALAN can alter behavior and physiology without strong shifts in the rhythmic expression of molecular circadian pacemakers. Approaches that focus on ecologically-relevant ALAN and link complex biological pathways are necessary to understand the mechanisms underlying vertebrate responses to light pollution.
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Affiliation(s)
- Valentina J Alaasam
- Department of Biology, University of Nevada, Reno, Reno, NV, USA; Program of Ecology, Evolution, and Conservation Biology, University of Nevada, Reno, Reno, NV, USA.
| | - Xu Liu
- Department of Biology, University of Nevada, Reno, Reno, NV, USA
| | - Ye Niu
- Department of Biology, University of Nevada, Reno, Reno, NV, USA
| | - Justine S Habibian
- Department of Nutrition, University of Nevada, Reno, Reno, NV, USA; Program of Cellular and Molecular Biology, University of Nevada, Reno, Reno, NV, USA
| | - Simon Pieraut
- Department of Biology, University of Nevada, Reno, Reno, NV, USA
| | - Brad S Ferguson
- Department of Nutrition, University of Nevada, Reno, Reno, NV, USA; Center for Biomedical Research Excellence in Molecular and Cellular Signal Transduction in the Cardiovascular System, School of Medicine, University of Nevada, Reno, Reno, NV, USA
| | - Yong Zhang
- Department of Biology, University of Nevada, Reno, Reno, NV, USA
| | - Jenny Q Ouyang
- Department of Biology, University of Nevada, Reno, Reno, NV, USA
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Jenkins NDM, Rogers EM, Banks NF, Tomko PM, Sciarrillo CM, Emerson SR, Taylor A, Teague TK. Childhood psychosocial stress is linked with impaired vascular endothelial function, lower SIRT1, and oxidative stress in young adulthood. Am J Physiol Heart Circ Physiol 2021; 321:H532-H541. [PMID: 34328346 DOI: 10.1152/ajpheart.00123.2021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Adverse childhood experiences (ACEs) are psychosocial stressors that occur during sensitive developmental windows and are associated with increased lifetime cardiovascular disease (CVD) risk in a dose-dependent manner. Vascular endothelial dysfunction is a pathophysiological mechanism that promotes hypertension and CVD and may be a mechanism by which ACEs contribute to lifetime CVD risk. We examined whether exposure to ACEs is associated with reduced vascular endothelial function (VEF) in otherwise healthy, young adult women (20.7 ± 3 yr) with (ACE+) versus without (ACE-) ACEs, explored whether differences in circulating sirtuin 1 (SIRT1) or systemic oxidative stress could explain ACEs-related differences in VEF, and examined the ability of a pilot, 8-wk exercise intervention to augment VEF and SIRT1 or reduce oxidized LDL cholesterol (oxLDL) in ACE+ young adult women. Forty-two otherwise healthy young adults completed this study. Prior to the intervention, VEF (P = 0.002) and SIRT1 (P = 0.004) were lower in the ACE+ than ACE- group, but oxLDL concentrations were not different (P = 0.77). There were also significant relationships (P ≤ 0.04) among flow-mediated dilation (FMD), SIRT1, and oxLDL in the ACE+, but not ACE- group. Adjusting for circulating SIRT1 and oxLDL reduced the differences in FMD observed between groups (P = 0.10), but only SIRT1 was a significant adjuster of the means (P < 0.05). Finally, the exercise intervention employed was unable to enhance VEF or SIRT1 in the ACE+ exercise group. Our data suggest that ACEs likely increase susceptibility to hypertension and CVD by causing endothelial dysfunction, perhaps through a SIRT1 pathway-related mechanism.NEW & NOTEWORTHY Our study provides novel evidence that young adult women with moderate-to-severe adverse childhood experience (ACE) exposure present impaired endothelial function and lower circulating sirtuin 1 (SIRT1) concentrations than age-matched controls. However, an 8-wk exercise intervention was unable to augment endothelial function or SIRT1 concentrations in a subset of those with ACEs. Our data suggest that ACEs-related impairments in endothelial function may be secondary to decreased NO bioavailability via SIRT1 and/or oxidative stress-related mechanisms.
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Affiliation(s)
- Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
| | - Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, University of Iowa, Iowa City, Iowa
| | - Patrick M Tomko
- School of Health Sciences, Kent State University, Kent, Ohio
| | - Christina M Sciarrillo
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Sam R Emerson
- Laboratory of Applied Nutrition and Exercise Science, Oklahoma State University, Tulsa, Oklahoma
| | - Ashlee Taylor
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma
| | - T Kent Teague
- Integrative Immunology Center, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.,Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
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The impact of repeated, local heating-induced increases in blood flow on lower limb endothelial function in young, healthy females. Eur J Appl Physiol 2021; 121:3017-3030. [PMID: 34251539 DOI: 10.1007/s00421-021-04749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the present study was to examine the effect of repeated, single leg heating on lower limb endothelial function. METHODS Macrovascular function was assessed with superficial femoral artery (SFA) reactive hyperemia flow-mediated dilation (RH-FMD) and sustained stimulus FMD (SS-FMD). Calf microvascular function was assessed as the peak and area under the curve of SFA reactive hyperemia (RH). Participants (n = 13 females, 23 ± 2 yrs) had one leg randomized to the single leg heating intervention (EXP; other leg: control (CON)). The EXP leg underwent 8 weeks of single leg heating via immersion in 42.5 ℃ water for five 35-min sessions/week. At weeks 0, 2, 4, 6, and 8, SFA RH-FMD, SS-FMD (shear stress increased via plantar flexion exercise), and SFA RH flow were measured. RESULTS None of the variables changed with repeated, single leg heating (interaction week*limb RH-FMD: p = 0.076; SS-FMD: p = 0.958; RH flow p = 0.955). Covariation for the shear stress stimulus did not alter the FMD results. CONCLUSION Eight weeks of single leg heating did not change SFA endothelial or calf microvascular function. These results are in contrast with previous findings that limb heating improves upper limb endothelial function.
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Meyler S, Bottoms L, Muniz-Pumares D. Biological and methodological factors affecting V ̇ O 2 max response variability to endurance training and the influence of exercise intensity prescription. Exp Physiol 2021; 106:1410-1424. [PMID: 34036650 DOI: 10.1113/ep089565] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022]
Abstract
NEW FINDINGS What is the topic of this review? Biological and methodological factors associated with the variable changes in cardiorespiratory fitness in response to endurance training. What advances does it highlight? Several biological and methodological factors exist that each contribute, to a given extent, to response variability. Notably, prescribing exercise intensity relative to physiological thresholds reportedly increases cardiorespiratory fitness response rates compared to when prescribed relative to maximum physiological values. As threshold-based approaches elicit more homogeneous acute physiological responses among individuals, when repeated over time, these uniform responses may manifest as more homogeneous chronic adaptations thereby reducing response variability. ABSTRACT Changes in cardiorespiratory fitness (CRF) in response to endurance training (ET) exhibit large variations, possibly due to a multitude of biological and methodological factors. It is acknowledged that ∼20% of individuals may not achieve meaningful increases in CRF in response to ET. Genetics, the most potent biological contributor, has been shown to explain ∼50% of response variability, whilst age, sex and baseline CRF appear to explain a smaller proportion. Methodological factors represent the characteristics of the ET itself, including the type, volume and intensity of exercise, as well as the method used to prescribe and control exercise intensity. Notably, methodological factors are modifiable and, upon manipulation, alter response rates to ET, eliciting increases in CRF regardless of an individual's biological predisposition. Particularly, prescribing exercise intensity relative to a physiological threshold (e.g., ventilatory threshold) is shown to increase CRF response rates compared to when intensity is anchored relative to a maximum physiological value (e.g., maximum heart rate). It is, however, uncertain whether the increased response rates are primarily attributable to reduced response variability, greater mean changes in CRF or both. Future research is warranted to elucidate whether more homogeneous chronic adaptations manifest over time among individuals, as a result of exposure to more homogeneous exercise stimuli elicited by threshold-based practices.
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Affiliation(s)
- Samuel Meyler
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Lindsay Bottoms
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Bostad W, Valentino SE, McCarthy DG, Richards DL, MacInnis MJ, MacDonald MJ, Gibala MJ. Twelve weeks of sprint interval training increases peak cardiac output in previously untrained individuals. Eur J Appl Physiol 2021; 121:2449-2458. [PMID: 34014402 DOI: 10.1007/s00421-021-04714-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Sprint interval training (SIT), characterized by brief bouts of 'supramaximal' exercise interspersed with recovery periods, increases peak oxygen uptake ([Formula: see text]) despite a low total exercise volume. Per the Fick principle, increased [Formula: see text] is attributable to increased peak cardiac output ([Formula: see text]) and/or peak arterio-venous oxygen difference (a-vO2diff). There are limited and equivocal data regarding the physiological basis for SIT-induced increases in [Formula: see text], with most studies lasting ≤ 6 weeks. PURPOSE To determine the effect of 12 weeks of SIT on [Formula: see text], measured using inert gas rebreathing, and the relationship between changes in [Formula: see text] and [Formula: see text]. METHODS 15 healthy untrained adults [6 males, 9 females; 21 ± 2 y (mean ± SD)] performed 28 ± 3 training sessions. Each session involved a 2-min warm-up at 50 W, 3 × 20-s 'all-out' cycling bouts (581 ± 221 W) interspersed with 2-min of recovery, and a 3-min cool-down at 50 W. RESULTS Measurements performed before and after training showed that 12 weeks of SIT increased [Formula: see text] (17.0 ± 3.7 vs 18.1 ± 4.6 L/min, p = 0.01, partial η2 = 0.28) and [Formula: see text] (2.63 ± 0.78 vs 3.18 ± 1.1 L/min, p < 0.01, partial η2 = 0.58). The changes in these two variables were correlated (r2 = 0.46, p < 0.01). Calculated peak a-vO2diff also increased after training (154 ± 22 vs 174 ± 23 ml O2/L; p < 0.01) and was correlated with the change in [Formula: see text] (r2 = 0.33, p = 0.03). Exploratory analyses revealed an interaction (p < 0.01) such that [Formula: see text] increased in male (+ 10%, p < 0.01) but not female participants (+ 0.6%, p = 0.96), suggesting potential sex-specific differences. CONCLUSION Twelve weeks of SIT increased [Formula: see text] by 6% in previously untrained participants and the change was correlated with the larger 21% increase in [Formula: see text].
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Affiliation(s)
- William Bostad
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Sydney E Valentino
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Devin G McCarthy
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | | | | | - Maureen J MacDonald
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada.
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Dawkins TG, Curry BA, Wright SP, Meah VL, Yousef Z, Eves ND, Shave RE, Stembridge M. Right Ventricular Function and Region-Specific Adaptation in Athletes Engaged in High-Dynamic Sports: A Meta-Analysis. Circ Cardiovasc Imaging 2021; 14:e012315. [PMID: 33993732 DOI: 10.1161/circimaging.120.012315] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Structural remodeling of the right ventricle (RV) is widely documented in athletes. However, functional adaptation, including RV pressure generation and systolic free-wall longitudinal mechanics, remains equivocal. This meta-analysis compared RV pressure and function in athletes and controls. METHODS A systematic review of online databases was conducted up to June 4, 2020. Meta-analyses were performed on RV systolic pressures, at rest and during exercise, tricuspid annular plane systolic displacement, myocardial velocity (S'), and global and regional longitudinal strain. Bias was assessed using Egger regression for asymmetry. Data were analyzed using random-effects models with weighted mean difference and 95% CI. RESULTS Fifty-three studies were eligible for inclusion. RV systolic pressure was obtained from 21 studies at rest (n=1043:1651; controls:athletes) and 8 studies during exercise (n=240:495) and was significantly greater in athletes at rest (weighted mean difference, 2.9 mmHg [CI, 1.3-4.5 mmHg]; P=0.0005) and during exercise (11.0 [6.5-15.6 mm Hg]; P<0.0001) versus controls. Resting tricuspid annular plane systolic displacement (P<0.0001) and S' (P=0.001) were greater in athletes. In contrast, athletes had similar RV free-wall longitudinal strain (17 studies; n=450:605), compared with controls but showed greater longitudinal apical strain (16 studies; n=455:669; 0.9%, 0.1%-1.8%; P=0.03) and lower basal strain (-2.5% [-1.4 to -3.5%]; P<0.0001). CONCLUSIONS Functional RV adaptation, characterized by increased tricuspid annular displacement and velocity and a greater base-to-apex strain gradient, is a normal feature of the athlete's heart, together with a slightly elevated RV systolic pressure. These findings contribute to our understanding of RV in athletes and highlight the importance of considering RV function in combination with structure in the clinical interpretation of the athlete's heart.
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Affiliation(s)
- Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom (T.G.D., B.A.C., M.S.)
| | - Bryony A Curry
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom (T.G.D., B.A.C., M.S.).,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada (B.A.C., S.P.W., N.D.E., R.E.S.)
| | - Stephen P Wright
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada (B.A.C., S.P.W., N.D.E., R.E.S.)
| | - Victoria L Meah
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Canada (V.L.M.).,Women and Children's Health Research Institute, University of Alberta, Canada (V.L.M.).,Alberta Diabetes Institute, University of Alberta, Canada (V.L.M.)
| | - Zaheer Yousef
- Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom (Z.Y.)
| | - Neil D Eves
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada (B.A.C., S.P.W., N.D.E., R.E.S.)
| | - Rob E Shave
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada (B.A.C., S.P.W., N.D.E., R.E.S.)
| | - Michael Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, United Kingdom (T.G.D., B.A.C., M.S.)
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Senefeld JW, Shepherd JRA, Baker SE, Joyner MJ. Sex-based limits to running speed in the human, horse and dog: The role of sexual dimorphisms. FASEB J 2021; 35:e21562. [PMID: 33913189 PMCID: PMC8444096 DOI: 10.1096/fj.202100161r] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 01/27/2023]
Abstract
Elite performing men continue to record faster record times in running events compared to women. These sex-based differences in running speed and endurance in humans are expected based on sexual dimorphisms that contribute to differences in the determinants of aerobic performance. Comparatively, the sexual dimorphisms contributing to sex-based differences in elite aerobic performance are not ubiquitous across other species that compete in running events. The purpose of this review is to offer a framework and model for ongoing discussions of the physiological determinants and ultimately limits of physical performance. The records for average running speed of champion athletes were delineated by sex for thoroughbred horses, greyhound dogs, and humans. Male and female performances within each of these species are being optimized by training, nutrition, and financial incentives, and are approaching a performance maximum. For horses and greyhounds breeding also plays a role. Analysis of athletic records shows that there is a sex-related difference of ~10% or more in elite athletic performance for humans; however, the upper limit of performance does not appear to be different between sexes for thoroughbred horses and greyhound dogs. In the context of the nil sex differences in running performance in thoroughbreds and greyhounds, we discuss the physiological role of sexual dimorphisms on sex-specific limits to running performance. We highlight that studies on both human and animal performance in athletic events stimulate critical physiological questions and drive novel research.
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Affiliation(s)
- Jonathon W Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - John R A Shepherd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
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Archiza B, Leahy MG, Kipp S, Sheel AW. An integrative approach to the pulmonary physiology of exercise: when does biological sex matter? Eur J Appl Physiol 2021; 121:2377-2391. [PMID: 33903937 DOI: 10.1007/s00421-021-04690-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
Historically, many studies investigating the pulmonary physiology of exercise (and biomedical research in general) were performed exclusively or predominantly with male research participants. This has led to an incomplete understanding of the pulmonary response to exercise. More recently, important sex-based differences with respect to the human respiratory system have been identified. The purpose of this review is to summarize current findings related to sex-based differences in the pulmonary physiology of exercise. To that end, we will discuss how morphological sex-based differences of the respiratory system affect the respiratory response to exercise. Moreover, we will discuss sex-based differences of the physiological integrative responses to exercise, and how all these differences can influence the regulation of breathing. We end with a brief discussion of pregnancy and menopause and the accompanying ventilatory changes observed during exercise.
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Affiliation(s)
- Bruno Archiza
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada.
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - Shalaya Kipp
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
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Evaluating the Accuracy of Using Fixed Ranges of METs to Categorize Exertional Intensity in a Heterogeneous Group of Healthy Individuals: Implications for Cardiorespiratory Fitness and Health Outcomes. Sports Med 2021; 51:2411-2421. [PMID: 33900580 DOI: 10.1007/s40279-021-01476-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Appropriate quantification of exertional intensity remains elusive. OBJECTIVE To compare, in a large and heterogeneous cohort of healthy females and males, the commonly used intensity classification system (i.e., light, moderate, vigorous, near-maximal) based on fixed ranges of metabolic equivalents (METs) to an individualized schema based on the exercise intensity domains (i.e., moderate, heavy, severe). METHODS A heterogenous sample of 565 individuals (females 165; males 400; age range 18-83 years old) were included in the study. Individuals performed a ramp-incremental exercise test from which gas exchange threshold (GET), respiratory compensation point (RCP) and maximum oxygen uptake (VO2max) were determined to build the exercise intensity domain schema (moderate = METs ≤ GET; heavy = METs > GET but ≤ RCP; severe = METs > RCP) for each individual. Pearson's chi-square tests over contingency tables were used to evaluate frequency distribution within intensity domains at each MET value. A multi-level regression model was performed to identify predictors of the amplitude of the exercise intensity domains. RESULTS A critical discrepancy existed between the confines of the exercise intensity domains and the commonly used fixed MET classification system. Overall, the upper limit of the moderate-intensity domain ranged between 2 and 13 METs and of the heavy-intensity domain between 3 and 18 METs, whereas the severe-intensity domain included METs from 4 onward. CONCLUSIONS Findings show that the common practice of assigning fixed values of METs to relative categories of intensity risks misclassifications of the physiological stress imposed by exercise and physical activity. These misclassifications can lead to erroneous interpretations of the dose-response relationship of exercise and physical activity.
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Lifelong Endurance Exercise as a Countermeasure Against Age-Related [Formula: see text] Decline: Physiological Overview and Insights from Masters Athletes. Sports Med 2021; 50:703-716. [PMID: 31873927 DOI: 10.1007/s40279-019-01252-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Maximum oxygen consumption ([Formula: see text]) is not only an indicator of endurance performance, but also a strong predictor of cardiovascular disease and mortality. This physiological parameter is known to decrease with aging. In turn, physical exercise might attenuate the rate of aging-related decline in [Formula: see text], which in light of the global population aging is of major clinical relevance, especially at advanced ages. In this narrative review, we summarize the evidence available from masters athletes about the role of lifelong endurance exercise on aging-related [Formula: see text] decline, with examples of the highest [Formula: see text] values reported in the scientific literature for athletes across different ages (e.g., 35 ml·kg-1·min-1 in a centenarian cyclist). These data suggest that a linear decrease in [Formula: see text] might be possible if physical exercise loads are kept consistently high through the entire life span, with [Formula: see text] values remaining higher than those of the general population across all ages. We also summarize the main physiological changes that occur with inactive aging at different system levels-pulmonary and cardiovascular function, blood O2 carrying capacity, skeletal muscle capillary density and oxidative capacity-and negatively influence [Formula: see text], and review how lifelong exercise can attenuate or even prevent most-but apparently not all (e.g., maximum heart rate decline)-of them. In summary, although aging seems to be invariably associated with a progressive decline in [Formula: see text], maintaining high levels of physical exercise along the life span slows the multi-systemic deterioration that is commonly observed in inactive individuals, thereby attenuating age-related [Formula: see text] decline.
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Diaz-Canestro C, Pentz B, Sehgal A, Montero D. Sex Differences In Cardiorespiratory Fitness Are Explained By Blood Volume And Oxygen Carrying Capacity. Cardiovasc Res 2021; 118:334-343. [PMID: 33538810 DOI: 10.1093/cvr/cvab028] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/26/2021] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Intrinsic sex differences in fundamental blood attributes have long been hypothesized to contribute to the gap in cardiorespiratory fitness between men and women. This study experimentally assessed the role of blood volume and oxygen (O2) carrying capacity on sex differences in cardiac function and aerobic power. METHODS AND RESULTS Healthy women and men (n = 60) throughout the mature adult lifespan (42-88 yr) were matched by age and physical activity levels. Transthoracic echocardiography, central blood pressure and O2 uptake were assessed throughout incremental exercise (cycle ergometry). Main outcomes such as left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac output (Q), and peak O2 uptake (VO2peak), as well as blood volume (BV) were determined with established methods. Measurements were repeated in men following blood withdrawal and O2 carrying capacity reduction matching women's levels. Prior to blood normalization, BV and O2 carrying capacity were markedly reduced in women compared with men (P < 0.001). Blood normalization resulted in a precise match of BV (82.36 ± 9.83 vs. 82.34 ± 7.70 ml·kg-1, P = 0.993) and O2 carrying capacity (12.0 ± 0.6 vs. 12.0 ± 0.7 g·dl-1, P = 0.562) between women and men. Body size-adjusted cardiac filling and output (LVEDV, SV, Q) during exercise as well as VO2peak (30.8 ± 7.5 vs. 35.6 ± 8.7 ml·min-1·kg-1, P < 0.001) were lower in women compared with men prior to blood normalization. VO2peak did not differ between women and men after blood normalization (30.8 ± 7.5 vs. 29.7 ± 7.4 ml·min-1·kg-1, P = 0.551). CONCLUSIONS Sex differences in cardiorespiratory fitness are abolished when blood attributes determining O2 delivery are experimentally matched between adult women and men. TRANSLATIONAL PERSPECTIVE Low cardiorespiratory fitness is strongly associated with all-cause and cardiovascular mortality in asymptomatic adults independently of traditional risk factors, relationships seemingly enhanced in middle-aged and older women. Yet, whether the primary hematological determinants of cardiorespiratory fitness that were established in studies comprising men explain the difference between sexes remains uncertain. Importantly, blood attributes are amenable to modification and thus potentially translated into effective targets to improve or preserve cardiovascular health in the general population. The present experimental study demonstrates that blood normalization between men and women eliminate sex differences in cardiorespiratory fitness.
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Affiliation(s)
- Candela Diaz-Canestro
- Faculty of Kinesiology, University of Calgary, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Canada
| | - Brandon Pentz
- Faculty of Kinesiology, University of Calgary, Canada
| | - Arshia Sehgal
- Faculty of Kinesiology, University of Calgary, Canada
| | - David Montero
- Faculty of Kinesiology, University of Calgary, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Canada.,Cumming School of Medicine, Calgary, Canada
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Cooper IR, Liu S, DeLorey DS. Effects of sex and exercise training on β-adrenoreceptor-mediated opposition of evoked sympathetic vasoconstriction in resting and contracting muscle of rats. J Appl Physiol (1985) 2020; 130:114-123. [PMID: 33090912 DOI: 10.1152/japplphysiol.00726.2020] [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: 11/22/2022] Open
Abstract
This study investigated the hypothesis that β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction would be enhanced in female compared with male rats, and that endurance exercise training would augment β-adrenoreceptor-mediated inhibition of sympathetic vasoconstriction in male and female rats. Sprague-Dawley rats were randomized into sedentary (male: n = 7; female: n = 8) and exercise-trained (male: n = 9; female: n = 9) groups. Following 4 wk of exercise training or being sedentary, rats were anesthetized and surgically instrumented for stimulation of the lumbar sympathetic chain, muscle contraction and measurement of arterial blood pressure and femoral artery blood flow (FBF). Femoral vascular conductance (FVC) was calculated as FBF/mean arterial pressure. The percentage change of FVC in response to sympathetic stimulation delivered at 2 and 5 Hz was measured at rest and during contraction of the triceps surae muscles before and after β-adrenoreceptor blockade (propranolol: 0.075 mg·kg-1 iv). We found that, at rest, β-adrenoreceptor blockade decreased (main effect of drug, 2 Hz: P < 0.001; 5 Hz: P < 0.001) sympathetic vasoconstriction. During contraction, sympathetic vasoconstrictor responsiveness was lower (main effect of sex, 2 Hz: P = 0.001; 5 Hz: P = 0.023) in female compared with male rats, and sympatholysis was enhanced (main effect of sex, 2 Hz: P = 0.001; 5 Hz: P < 0.001) in female rats. β-adrenoreceptor blockade decreased (main effect of drug, 2 Hz: P = 0.049; 5 Hz: P < 0.001) evoked sympathetic vasoconstriction in contracting muscle. The present study demonstrated that β-adrenoreceptors do not blunt sympathetic vasoconstriction in resting or contracting skeletal muscle of male or female rats. Sympatholysis was enhanced in female rats; however, this was not attributable to β-adrenoreceptor-mediated blunting of sympathetic vasoconstriction.NEW & NOTEWORTHY β-adrenoreceptors do not inhibit sympathetic vasoconstriction in resting or contracting muscle of male or female rats, regardless of training status. Sympatholysis was enhanced in female, compared to male rats; however, β-adrenoreceptors were not responsible for the enhanced sympatholysis. These findings indicate that β-adrenoreceptors do not contribute to the regulation of sympathetic vasoconstriction in resting and contracting skeletal muscle and suggest that β-adrenoreceptors do not underlie sex differences in the neural control of the circulation.
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Affiliation(s)
- Ian R Cooper
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Sixue Liu
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Darren S DeLorey
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Ansdell P, Thomas K, Hicks KM, Hunter SK, Howatson G, Goodall S. Physiological sex differences affect the integrative response to exercise: acute and chronic implications. Exp Physiol 2020; 105:2007-2021. [PMID: 33002256 DOI: 10.1113/ep088548] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022]
Abstract
NEW FINDINGS What is the topic of this review? We review sex differences within physiological systems implicated in exercise performance; specifically, how they integrate to determine metabolic thresholds and fatigability. Thereafter, we discuss the implications that these sex differences might have for long-term adaptation to exercise. What advances does it highlight? The review collates evidence from recent physiological studies that have investigated sex as a biological variable, demonstrating that the physiological response to equivalent 'dosages' of exercise is not the same in males and females; thus, highlighting the need to research diversity in physiological responses to interventions. ABSTRACT The anatomical and physiological differences between males and females are thought to determine differences in the limits of human performance. The notion of studying sex as a biological variable has recently been emphasized in the biosciences as a vital step in enhancing human health. In this review, we contend that the effects of biological sex on acute and chronic responses must be studied and accounted for when prescribing aerobic exercise, much like any intervention targeting the optimization of physiological function. Emerging evidence suggests that the response of physiological systems to exercise differs between males and females, potentially mediating the beneficial effects in healthy and clinical populations. We highlight evidence that integrative metabolic thresholds during exercise are influenced by phenotypical sex differences throughout many physiological systems. Furthermore, we discuss evidence that female skeletal muscle is more resistant to fatigue elicited by equivalent dosages of high-intensity exercise. How the different acute responses affect the long-term trainability of males and females is considered, with discussion about tailoring exercise to the characteristics of the individual presented within the context of biological sex. Finally, we highlight the influence of endogenous and exogenous sex hormones on physiological responses to exercise in females. Sex is one of many mediating influences on the outcomes of exercise, and with careful experimental designs, physiologists can advance the collective understanding of diversity in physiology and optimize outcomes for both sexes.
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Affiliation(s)
- Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kevin Thomas
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Kirsty M Hicks
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Sandra K Hunter
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.,Water Research Group, School of Environmental Sciences and Development, North-West University, Potchefstroom, South Africa
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Dawkins TG, Curry BA, Drane AL, Lord RN, Richards C, Brown M, Pugh CJA, Lodge F, Yousef Z, Stembridge M, Shave RE. Stimulus-specific functional remodeling of the left ventricle in endurance and resistance-trained men. Am J Physiol Heart Circ Physiol 2020; 319:H632-H641. [PMID: 32772543 DOI: 10.1152/ajpheart.00233.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Left ventricular (LV) structural remodeling following athletic training has been evidenced through training-specific changes in wall thickness and geometry. Whether the LV response to changes in hemodynamic load also adapts in a training-specific manner is unknown. Using echocardiography, we examined LV responses of endurance-trained (n = 15), resistance-trained (n = 14), and nonathletic men (n = 13) to 1) 20, 40, and 60% one repetition-maximum (1RM), leg-press exercise and 2) intravascular Gelofusine infusion (7 mL/kg) with passive leg raise. While resting heart rate was lower in endurance-trained participants versus controls (P = 0.001), blood pressure was similar between groups. Endurance-trained individuals had lower wall thickness but greater LV mass relative to body surface area versus controls, with no difference between resistance-trained individuals and controls. Leg press evoked a similar increase in blood pressure; however, resistance-trained participants preserved stroke volume (SV; -3 ± 8%) versus controls at 60% 1RM (-15 ± 7%, P = 0.001). While the maintenance of SV was related to the change in longitudinal strain across all groups (R = 0.537; P = 0.007), time-to-peak strain was maintained in resistance-trained but delayed in endurance-trained individuals (1 vs. 12% delay; P = 0.021). Volume infusion caused a similar increase in end-diastolic volume (EDV) and SV across groups, but leg raise further increased EDV only in endurance-trained individuals (5 ± 5 to 8 ± 5%; P = 0.018). Correlation analysis revealed a relationship between SV and longitudinal strain following infusion and leg raise (R = 0.334, P = 0.054); however, we observed no between-group differences in longitudinal myocardial mechanics. In conclusion, resistance-trained individuals better maintained SV during pressure loading, whereas endurance-trained individuals demonstrated greater EDV reserve during volume loading. These data provide novel evidence of training-specific LV functional remodeling.NEW & NOTEWORTHY Training-specific functional remodeling of the LV in response to different loading conditions has been recently suggested, but not experimentally tested in the same group of individuals. Our data provide novel evidence of a dichotomous, training-specific LV adaptive response to hemodynamic pressure or volume loading.
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Affiliation(s)
- Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Bryony A Curry
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Aimee L Drane
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Cory Richards
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Megan Brown
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Christopher J A Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Freya Lodge
- Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom
| | - Zaheer Yousef
- Department of Cardiology, University Hospital of Wales, Cardiff, United Kingdom
| | - Michael Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rob E Shave
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
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Autio J, Stenbäck V, Gagnon DD, Leppäluoto J, Herzig KH. (Neuro) Peptides, Physical Activity, and Cognition. J Clin Med 2020; 9:jcm9082592. [PMID: 32785144 PMCID: PMC7464334 DOI: 10.3390/jcm9082592] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
Regular physical activity (PA) improves cognitive functions, prevents brain atrophy, and delays the onset of cognitive decline, dementia, and Alzheimer’s disease. Presently, there are no specific recommendations for PA producing positive effects on brain health and little is known on its mediators. PA affects production and release of several peptides secreted from peripheral and central tissues, targeting receptors located in the central nervous system (CNS). This review will provide a summary of the current knowledge on the association between PA and cognition with a focus on the role of (neuro)peptides. For the review we define peptides as molecules with less than 100 amino acids and exclude myokines. Tachykinins, somatostatin, and opioid peptides were excluded from this review since they were not affected by PA. There is evidence suggesting that PA increases peripheral insulin growth factor 1 (IGF-1) levels and elevated serum IGF-1 levels are associated with improved cognitive performance. It is therefore likely that IGF-1 plays a role in PA induced improvement of cognition. Other neuropeptides such as neuropeptide Y (NPY), ghrelin, galanin, and vasoactive intestinal peptide (VIP) could mediate the beneficial effects of PA on cognition, but the current literature regarding these (neuro)peptides is limited.
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Affiliation(s)
- Juho Autio
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
| | - Ville Stenbäck
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Biocenter Oulu, 90220 Oulu, Finland
| | - Dominique D. Gagnon
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Laboratory of Environmental Exercise Physiology, School of Human Kinetics, Laurentian University, Sudbury, ON P3E 2C6, Canada
- Center of Research in Occupational Safety and Health, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Juhani Leppäluoto
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
| | - Karl-Heinz Herzig
- Institute of Biomedicine, Medical Research Center, Faculty of Medicine, University of Oulu, Oulu University Hospital, 90220 Oulu, Finland; (J.A.); (V.S.); (D.D.G.); (J.L.)
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Correspondence:
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Barha CK, Liu-Ambrose T. Sex differences in exercise efficacy: Is midlife a critical window for promoting healthy cognitive aging? FASEB J 2020; 34:11329-11336. [PMID: 32761860 DOI: 10.1096/fj.202000857r] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 01/17/2023]
Abstract
Dementia is one of the most pressing health care issues of this century. As no curative treatment for dementia exists, research efforts are growing to identify effective lifestyle interventions to prevent or delay onset. One such promising strategy that promotes cognitive and brain health is engaging in physical exercise. However, current exercise recommendations are imprecise. To advance the potential of exercise as a preventative and treatment strategy, important questions regarding moderators (ie, biological sex and age) are being addressed in the literature. Biological sex is recognized as an important variable to consider in exercise efficacy on brain health, with females showing greater cognitive gains. This may be related to sex differences in underlying mechanisms. Here, we argue to better understand the sex differences in exercise efficacy, the timing of exercise intervention should also be considered. Specifically, we present the hypothesis that midlife in females is a critical window for the implementation of exercise as an early intervention to promote brain health and prevent dementia. Further, we speculate that exercise interventions targeting midlife will be of critical importance for the female brain, as females exit this period of the lifespan at greater risk for cognitive impairment. Given the potential sex differences in dementia risk and prevalence, it is imperative to assess potential sex differences in exercise efficacy as an early intervention during midlife.
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Affiliation(s)
- Cindy K Barha
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Aging, Mobility, and Cognitive Neuroscience Lab, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Physical Activity for Precision Health Research Cluster, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Aging, Mobility, and Cognitive Neuroscience Lab, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Physical Activity for Precision Health Research Cluster, University of British Columbia, Vancouver, BC, Canada
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Schaumberg MA, Stanley J, Jenkins DG, Hume EA, Janse de Jonge XAK, Emmerton LM, Skinner TL. Oral Contraceptive Use Influences On-Kinetic Adaptations to Sprint Interval Training in Recreationally-Active Women. Front Physiol 2020; 11:629. [PMID: 32595523 PMCID: PMC7303366 DOI: 10.3389/fphys.2020.00629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Oral contraceptive (OC) use influences peak exercise responses to training, however, the influence of OC on central and peripheral adaptations to exercise training are unknown. This study investigated the influence of OC use on changes in time-to-fatigue, pulmonary oxygen uptake, cardiac output, and heart rate on-kinetics, as well as tissue saturation index to 4 weeks of sprint interval training in recreationally active women. METHODS Women taking an oral contraceptive (OC; n = 25) or experiencing natural menstrual cycles (MC; n = 22) completed an incremental exercise test to volitional exhaustion followed by a square-wave step-transition protocol to moderate (90% of power output at ventilatory threshold) and high intensity (Δ50% of power output at ventilatory threshold) exercise on two separate occasions. Time-to-fatigue, pulmonary oxygen uptake on-kinetics, cardiac output, and heart rate on-kinetics, and tissue saturation index responses were assessed prior to, and following 12 sessions of sprint interval training (10 min × 1 min efforts at 100-120% PPO in a 1:2 work:rest ratio) completed over 4 weeks. RESULTS Time-to-fatigue increased in both groups following training (p < 0.001), with no difference between groups. All cardiovascular on-kinetic parameters improved to the same extent following training in both groups. Greater improvements in pulmonary oxygen up-take kinetics were seen at both intensities in the MC group (p < 0.05 from pre-training) but were blunted in the OC group (p > 0.05 from pre-training). In contrast, changes in tissue saturation index were greater in the OC group at both intensities (p < 0.05); with the MC group showing no changes at either intensity. DISCUSSION Oral contraceptive use may reduce central adaptations to sprint interval training in women without influencing improvements in exercise performance - potentially due to greater peripheral adaptation. This may be due to the influence of exogenous oestradiol and progestogen on cardiovascular function and skeletal muscle blood flow. Further investigation into female-specific influences on training adaptation and exercise performance is warranted.
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Affiliation(s)
- Mia Annalies Schaumberg
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Sunshine Coast Health Institute, Birtinya, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Jamie Stanley
- South Australian Sports Institute, Kidman Park, SA, Australia
- Australian Cycling Team, Gepps Cross, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David G. Jenkins
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Emily A. Hume
- School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Lynne M. Emmerton
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Abstract
BACKGROUND Increases in maximal oxygen uptake (VO2max) are strongly associated with improved cardiovascular health. OBJECTIVE The aim was to perform a systematic review and meta-analysis to determine whether VO2max responses to endurance training (ET), the most effective intervention to improve VO2max, are influenced by sex. METHODS We conducted a systematic search of MEDLINE and Web of Science since their inceptions until February 2019 for articles assessing the VO2max response to a given sex-matched dose of ET in healthy age-matched men and women. Meta-analyses were performed to determine the mean difference between VO2max responses in men versus women. Subgroup and meta-regression analyses were used to assess potential moderating factors. RESULTS After systematic review, eight studies met the inclusion criteria. All studies implemented common modalities of ET in healthy untrained individuals, comprising a total of 175 men and women (90 ♂, 85 ♀). ET duration and intensity were sex-matched in all studies. After data pooling, ET induced substantially larger increases in absolute VO2max in men compared with women (mean difference = + 191 ml·min-1, 95% CI 99, 283; P < 0.001). A greater effect of ET on relative VO2max was also observed in men versus women (mean difference = + 1.95 ml·min-1·kg-1, 95% CI 0.76, 3.15; P = 0.001). No heterogeneity was detected among studies (I2 = 0%, P ≥ 0.59); the meta-analytical results were robust to potential moderating factors. CONCLUSION Pooled evidence demonstrates greater improvements in VO2max in healthy men compared with women in response to a given dose of ET, suggesting the presence of sexual dimorphism in the trainability of aerobic capacity.
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Carrick-Ranson G, Sloane NM, Howden EJ, Bhella PS, Sarma S, Shibata S, Fujimoto N, Hastings JL, Levine BD. The effect of lifelong endurance exercise on cardiovascular structure and exercise function in women. J Physiol 2020; 598:2589-2605. [PMID: 32347540 DOI: 10.1113/jp278503] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 04/17/2020] [Indexed: 01/08/2023] Open
Abstract
KEY POINTS The beneficial effects of sustained or lifelong (>25 years) endurance exercise on cardiovascular structure and exercise function have been largely established in men. The current findings indicate that committed (≥4 weekly exercise sessions) lifelong exercise results in substantial benefits in exercise capacity ( V ̇ O 2 max ), cardiovascular function at submaximal and maximal exercise, left ventricular mass and compliance, and blood volume compared to similarly aged or even younger (middle-age) untrained women. Endurance exercise training should be considered a key strategy to prevent cardiovascular disease with ageing in women as well as men. ABSTRACT This study was a retrospective, cross-sectional analysis of exercise performance and left ventricular (LV) morphology in 70 women to examine whether women who have performed regular, lifelong endurance exercise acquire the same beneficial adaptations in cardiovascular structure and function and exercise performance that have been reported previously in men. Three groups of women were examined: (1) 35 older (>60 years) untrained women (older untrained, OU), (2) 13 older women who had consistently performed four or more endurance exercise sessions weekly for at least 25 years (older trained, OT), and (3) 22 middle-aged (range 35-59 years) untrained women (middle-aged untrained, MU) as a reference control for the appropriate age-related changes. Oxygen uptake ( V ̇ O 2 ) and cardiovascular function (cardiac output ( Q ̇ ); stroke volume (SV) acetylene rebreathing) were examined at rest, steady-state submaximal exercise and maximal exercise (maximal oxygen uptake, V ̇ O 2 max ). Blood volume (CO rebreathing) and LV mass (cardiac magnetic resonance imaging), plus invasive measures of static and dynamic chamber compliance were also examined. V ̇ O 2 max (p < 0.001) and maximal exercise Q ̇ and SV were larger in older trained women compared to the two untrained groups (∼17% and ∼27% for Q ̇ and SV, respectively, versus MU; ∼40% and ∼38% versus OU, all p < 0.001). Blood volume (mL kg-1 ) and LV mass index (g m-2 ) were larger in OT versus OU (∼11% and ∼16%, respectively, both P ≤ 0.015) Static LV chamber compliance was greater in OT compared to both untrained groups (median (25-75%): MU: 0.065 (0.049-0.080); OU: 0.085 (0.061-0.138); OT: 0.047 (0.031-0.054), P ≤ 0.053). Collectively, these findings indicate that lifetime endurance exercise appears to be extremely effective at preserving or even enhancing cardiovascular structure and function with advanced age in women.
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Affiliation(s)
- Graeme Carrick-Ranson
- The University of South Australia, Adelaide, Australia.,Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nikita M Sloane
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| | - Erin J Howden
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA.,Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Paul S Bhella
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Cardiology, John Peter Smith Health Network, Fort Worth, TX, USA.,Department of Internal Medicine, TCU and UNT School of Medicine, Fort Worth, TX, USA
| | - Satyam Sarma
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shigeki Shibata
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Naoki Fujimoto
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey L Hastings
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin D Levine
- Texas Health Presbyterian Dallas, Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
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49
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The Impact of Sex on Left Ventricular Cardiac Adaptations to Endurance Training: a Systematic Review and Meta-analysis. Sports Med 2020; 50:1501-1513. [DOI: 10.1007/s40279-020-01294-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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50
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Baggish AL, Battle RW, Beaver TA, Border WL, Douglas PS, Kramer CM, Martinez MW, Mercandetti JH, Phelan D, Singh TK, Weiner RB, Williamson E. Recommendations on the Use of Multimodality Cardiovascular Imaging in Young Adult Competitive Athletes: A Report from the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Computed Tomography and the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr 2020; 33:523-549. [PMID: 32362332 DOI: 10.1016/j.echo.2020.02.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Robert W Battle
- University of Virginia Health System, Charlottesville, Virginia
| | | | - William L Border
- Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | | | | | | | | | - Dermot Phelan
- Sanger Heart and Vascular Institute in Atrium Health, Charlotte, North Carolina
| | | | - Rory B Weiner
- Massachusetts General Hospital, Boston, Massachusetts
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