1
|
Mueller K, Allstrom H, Smith DJ, Downes E, Modly LA. Climate change's implications for practice: Pharmacologic considerations of heat-related illness. Nurse Pract 2024; 49:30-38. [PMID: 39248594 DOI: 10.1097/01.npr.0000000000000230] [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: 09/10/2024]
Abstract
ABSTRACT Climate change is the greatest threat to global health. As climate change worsens, heat waves will be longer, more intense, and more frequent. Increased health risks from climate change and heat waves include heat-related illness (HRI). HRI increases ED visits, hospitalizations, and mortality. Healthcare providers should be aware of the impact of medications on risk for HRI. This article elucidates signs and symptoms, populations at risk, drugs and mechanisms that increase risk, and patient education to reduce risk.
Collapse
|
2
|
Chen SJ, Lee M, Wu BC, Muo CH, Sung FC, Chen PC. Meteorological factors and risk of ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage: A time-stratified case-crossover study. Int J Stroke 2024:17474930241270483. [PMID: 39075752 DOI: 10.1177/17474930241270483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
BACKGROUND Stroke risks associated with rapid climate change remain controversial due to a paucity of evidence. AIMS To examine the risk of subarachnoid hemorrhage (SAH), intracranial hemorrhage (ICH), and ischemic stroke (IS) associated with meteorological parameters. METHODS In this time-stratified case-crossover study, adult patients hospitalized for their first stroke between 2011 and 2020 from the insurance claims data in Taiwan were identified. The hospitalization day was designated as the case period, and three or four control periods were matched by the same day of the week and month of each case period. Daily mean and 24-h variations in ambient temperature, relative humidity, air pressure, and apparent temperature were measured. Conditional logistic regression models were applied to assess the risk of stroke associated with exposure to weather variables, using the third quintile as a reference, controlling for air pollutant levels. RESULTS There were 7161 patients with SAH, 40,426 patients with ICH, and 107,550 patients with IS. There was an inverse linear relationship between mean daily temperature and apparent temperature with ICH. Elevated mean daily atmospheric pressure was associated with an increased risk of ICH. A greater decrease in apparent temperature over a 24-h period was associated with increased risk of ICH but decreased risk of IS (odds ratio (95% confidence interval) for the first vs. third quintile of changes in apparent temperature, 1.141 (1.053-1.237) and 0.946 (0.899-0.996), respectively). CONCLUSIONS There were considerable differences in short-term associations between meteorological parameters and three main pathological types of strokes. DATA ACCESS STATEMENT The authors have no permission to share the data.
Collapse
Affiliation(s)
- Sheng-Jen Chen
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi
| | - Bing-Chen Wu
- Department of Public Health, China Medical University, Taichung
| | - Chih-Hsin Muo
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, Taichung
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung
| | - Pei-Chun Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli
- Big Data Center, China Medical University Hospital, Taichung
| |
Collapse
|
3
|
Parapanov R, Debonneville A, Allouche M, Lugrin J, Rodriguez-Caro H, Liaudet L, Krueger T. Transient heat stress protects from severe endothelial damage and dysfunction during prolonged experimental ex-vivo lung perfusion. Front Immunol 2024; 15:1390026. [PMID: 38807604 PMCID: PMC11130382 DOI: 10.3389/fimmu.2024.1390026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction The pulmonary endothelium is the primary target of lung ischemia-reperfusion injury leading to primary graft dysfunction after lung transplantation. We hypothesized that treating damaged rat lungs by a transient heat stress during ex-vivo lung perfusion (EVLP) to elicit a pulmonary heat shock response could protect the endothelium from severe reperfusion injury. Methods Rat lungs damaged by 1h warm ischemia were reperfused on an EVLP platform for up to 6h at a constant temperature (T°) of 37°C (EVLP37°C group), or following a transient heat stress (HS) at 41.5°C from 1 to 1.5h of EVLP (EVLPHS group). A group of lungs exposed to 1h EVLP only (pre-heating conditions) was added as control (Baseline group). In a first protocol, we measured lung heat sock protein expression (HSP70, HSP27 and Hsc70) at selected time-points (n=5/group at each time). In a second protocol, we determined (n=5/group) lung weight gain (edema), pulmonary compliance, oxygenation capacity, pulmonary artery pressure (PAP) and vascular resistance (PVR), the expression of PECAM-1 (CD31) and phosphorylation status of Src-kinase and VE-cadherin in lung tissue, as well as the release in perfusate of cytokines (TNFα, IL-1β) and endothelial biomarkers (sPECAM, von Willebrand Factor -vWF-, sE-selectin and sICAM-1). Histological and immunofluorescent studies assessed perivascular edema and formation of 3-nitrotyrosine (a marker of peroxinitrite) in CD31 lung endothelium. Results HS induced an early (3h) and persisting expression of HSP70 and HSP27, without influencing Hsc70. Lungs from the EVLP37°C group developed massive edema, low compliance and oxygenation, elevated PAP and PVR, substantial release of TNFα, IL-1β, s-PECAM, vWF, E-selectin and s-ICAM, as well as significant Src-kinase activation, VE-cadherin phosphorylation, endothelial 3-NT formation and reduced CD31 expression. In marked contrast, all these alterations were either abrogated or significantly attenuated by HS treatment. Conclusion The therapeutic application of a transient heat stress during EVLP of damaged rat lungs reduces endothelial permeability, attenuates pulmonary vasoconstriction, prevents src-kinase activation and VE-cadherin phosphorylation, while reducing endothelial peroxinitrite generation and the release of cytokines and endothelial biomarkers. Collectively, these data demonstrate that therapeutic heat stress may represent a promising strategy to protect the lung endothelium from severe reperfusion injury.
Collapse
Affiliation(s)
- Roumen Parapanov
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Service of Adult Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Anne Debonneville
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Service of Adult Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Manon Allouche
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Service of Adult Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Jérôme Lugrin
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Service of Adult Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Helena Rodriguez-Caro
- Department of Oncology, University of Lausanne and Ludwig Institute for Cancer Research, Lausanne, Switzerland
| | - Lucas Liaudet
- Service of Adult Intensive Care Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Thorsten Krueger
- Service of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
4
|
Li L, Wang YW, Chang X, Chen JL, Wang M, Zhu JQ, Li JF, Ren LJ, Dai XY, Yan L, Fan XC, Song Q, Zhu JB, Chen JK, Xu SG. DNAJA1‑knockout alleviates heat stroke‑induced endothelial barrier disruption via improving thermal tolerance and suppressing the MLCK‑MLC signaling pathway. Mol Med Rep 2024; 29:87. [PMID: 38551163 PMCID: PMC10995657 DOI: 10.3892/mmr.2024.13211] [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: 09/06/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
Endothelial barrier disruption plays a key role in the pathophysiology of heat stroke (HS). Knockout of DNAJA1 (DNAJA1‑KO) is thought to be protective against HS based on a genome‑wide CRISPR‑Cas9 screen experiment. The present study aimed to illustrate the function of DNAJA1‑KO against HS in human umbilical vein endothelial cells. DNAJA1‑KO cells were infected using a lentivirus to investigate the role of DNAJA1‑KO in HS‑induced endothelial barrier disruption. It was shown that DNAJA1‑KO could ameliorate decreased cell viability and increased cell injury, according to the results of Cell Counting Kit‑8 and lactate dehydrogenase assays. Moreover, HS‑induced endothelial cell apoptosis was inhibited by DNAJA1‑KO, as indicated by Annexin V‑FITC/PI staining and cleaved‑caspase‑3 expression using flow cytometry and western blotting, respectively. Furthermore, the endothelial barrier function, as measured by transepithelial electrical resistance and FITC‑Dextran, was sustained during HS. DNAJA1‑KO was not found to have a significant effect on the expression and distribution of cell junction proteins under normal conditions without HS. However, DNAJA1‑KO could effectively protect the HS‑induced decrease in the expression and distribution of cell junction proteins, including zonula occludens‑1, claudin‑5, junctional adhesion molecule A and occludin. A total of 4,394 proteins were identified using proteomic analysis, of which 102 differentially expressed proteins (DEPs) were activated in HS‑induced wild‑type cells and inhibited by DNAJA1‑KO. DEPs were investigated by enrichment analysis, which demonstrated significant enrichment in the 'calcium signaling pathway' and associations with vascular‑barrier regulation. Furthermore, the 'myosin light‑chain kinase (MLCK)‑MLC signaling pathway' was proven to be activated by HS and inhibited by DNAJA1‑KO, as expected. Moreover, DNAJA1‑KO mice and a HS mouse model were established to demonstrate the protective effects on endothelial barrier in vivo. In conclusion, the results of the present study suggested that DNAJA1‑KO alleviates HS‑induced endothelial barrier disruption by improving thermal tolerance and suppressing the MLCK‑MLC signaling pathway.
Collapse
Affiliation(s)
- Lei Li
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai 200433, P.R. China
- Department of Emergency, The Second Naval Hospital of Southern Theater Command of The People's Liberation Army, Sanya, Hainan 572022, P.R. China
- Heatstroke Treatment and Research Center, Hainan Hospital, Chinese People's Liberation Army General Hospital, Sanya, Hainan 572022, P.R. China
| | - Ya-Wei Wang
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai 200433, P.R. China
- Department of Orthopedics Trauma, Changhai Hospital, Shanghai 200433, P.R. China
| | - Xin Chang
- Department of Gastroenterology, Changhai Hospital, Shanghai 200433, P.R. China
| | - Jue-Lin Chen
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai 200433, P.R. China
| | - Man Wang
- Department of Rehabilitation, Changhai Hospital, Shanghai 200433, P.R. China
| | - Jia-Qi Zhu
- Department of Cardiology, Changhai Hospital, Shanghai 200433, P.R. China
| | - Jin-Feng Li
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Li-Jun Ren
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Xiao-Yu Dai
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Lang Yan
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Xin-Chen Fan
- College of Basic Medical Sciences, Naval Medical University, Shanghai 200433, P.R. China
| | - Qing Song
- Heatstroke Treatment and Research Center, Hainan Hospital, Chinese People's Liberation Army General Hospital, Sanya, Hainan 572022, P.R. China
- Department of Critical Care Medicine, First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100039, P.R. China
- Department of Critical Care Medicine, Hainan Hospital, Chinese People's Liberation Army General Hospital, Sanya, Hainan 572022, P.R. China
| | - Jiang-Bo Zhu
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Ji-Kuai Chen
- Department of Health Toxicology, Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, P.R. China
| | - Shuo-Gui Xu
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai 200433, P.R. China
- Department of Orthopedics Trauma, Changhai Hospital, Shanghai 200433, P.R. China
| |
Collapse
|
5
|
Debray A, Gravel H, Garceau L, Bartlett AA, Chaseling GK, Barry H, Behzadi P, Ravanelli N, Iglesies-Grau J, Nigam A, Juneau M, Gagnon D. Finnish sauna bathing and vascular health of adults with coronary artery disease: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:795-804. [PMID: 37650138 DOI: 10.1152/japplphysiol.00322.2023] [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: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023] Open
Abstract
Regular Finnish sauna use is associated with a reduced risk of cardiovascular mortality. However, physiological mechanisms underlying this association remain unknown. This study determined if an 8-wk Finnish sauna intervention improves peripheral endothelial function, microvascular function, central arterial stiffness, and blood pressure in adults with coronary artery disease (CAD). Forty-one adults (62 ± 6 yr, 33 men/8 women) with stable CAD were randomized to 8 wk of Finnish sauna use (n = 21, 4 sessions/wk, 20-30 min/session, 79°C, 13% relative humidity) or a control intervention (n = 20, lifestyle maintenance). Brachial artery flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cf-PWV), total (area under the curve) and peak postocclusion forearm reactive hyperemia, and blood pressure (automated auscultation) were measured before and after the intervention. After the sauna intervention, resting core temperature was lower (-0.27°C [-0.54, -0.01], P = 0.046) and sweat rate during sauna exposure was greater (0.3 L/h [0.1, 0.5], P = 0.003). The change in brachial artery FMD did not differ between interventions (control: 0.07% [-0.99, +1.14] vs. sauna: 0.15% [-0.89, +1.19], interaction P = 0.909). The change in total (P = 0.031) and peak (P = 0.024) reactive hyperemia differed between interventions due to a nonsignificant decrease in response to the sauna intervention and an increase in response to control. The change in cf-PWV (P = 0.816), systolic (P = 0.951), and diastolic (P = 0.292) blood pressure did not differ between interventions. These results demonstrate that four sessions of Finnish sauna bathing per week for 8 wk does not improve markers of vascular health in adults with stable CAD.NEW & NOTEWORTHY This study determined if unsupervised Finnish sauna bathing for 8 wk improves markers of vascular health in adults with coronary artery disease. Finnish sauna bathing reduced resting core temperature and improved sweating capacity, indicative of heat acclimation. Despite evidence of heat acclimation, Finnish sauna bathing did not improve markers of endothelial function, microvascular function, arterial stiffness, or blood pressure.
Collapse
Affiliation(s)
- Amélie Debray
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Hugo Gravel
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Audrey-Ann Bartlett
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Nicholas Ravanelli
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
6
|
Zhang S, Breitner S, Rai M, Nikolaou N, Stafoggia M, De' Donato F, Samoli E, Zafeiratou S, Katsouyanni K, Rao S, Palomares ADL, Gasparrini A, Masselot P, Aunan K, Peters A, Schneider A. Assessment of short-term heat effects on cardiovascular mortality and vulnerability factors using small area data in Europe. ENVIRONMENT INTERNATIONAL 2023; 179:108154. [PMID: 37603993 DOI: 10.1016/j.envint.2023.108154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Short-term associations between heat and cardiovascular disease (CVD) mortality have been examined mostly in large cities. However, different vulnerability and exposure levels may contribute to spatial heterogeneity. This study assessed heat effects on CVD mortality and potential vulnerability factors using data from three European countries, including urban and rural settings. METHODS We collected daily counts of CVD deaths aggregated at the small-area level in Norway (small-area level: municipality), England and Wales (lower super output areas), and Germany (district) during the warm season (May-September) from 1996 to 2018. Daily mean air temperatures estimated by spatial-temporal models were assigned to each small area. Within each country, we applied area-specific Quasi-Poisson regression using distributed lag nonlinear models to examine the heat effects at lag 0-1 days. The area-specific estimates were pooled by random-effects meta-analysis to derive country-specific and overall heat effects. We examined individual- and area-level heat vulnerability factors by subgroup analyses and meta-regression, respectively. RESULTS We included 2.84 million CVD deaths in analyses. For an increase in temperature from the 75th to the 99th percentile, the pooled relative risk (RR) for CVD mortality was 1.14 (95% CI: 1.03, 1.26), with the country-specific RRs ranging from 1.04 (1.00, 1.09) in Norway to 1.24 (1.23, 1.26) in Germany. Heat effects were stronger among women [RRs (95% CIs) for women and men: 1.18 (1.08, 1.28) vs. 1.12 (1.00, 1.24)]. Greater heat vulnerability was observed in areas with high population density, high degree of urbanization, low green coverage, and high levels of fine particulate matter. CONCLUSION This study provides evidence for the heat effects on CVD mortality in European countries using high-resolution data from both urban and rural areas. Besides, we identified individual- and area-level heat vulnerability factors. Our findings may facilitate the development of heat-health action plans to increase resilience to climate change.
Collapse
Affiliation(s)
- Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Nikolaos Nikolaou
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy
| | - Francesca De' Donato
- Department of Epidemiology, Lazio Regional Health Service - ASL ROMA 1, Rome, Italy
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kristin Aunan
- CICERO Center for International Climate Research, Norway
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, LMU, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | | |
Collapse
|
7
|
Martin ZT, Akins JD, Merlau ER, Kolade JO, Al-Daas IO, Cardenas N, Vu JK, Brown KK, Brothers RM. The acute effect of whole-body heat therapy on peripheral and cerebral vascular reactivity in Black and White females. Microvasc Res 2023; 148:104536. [PMID: 37024072 PMCID: PMC10908357 DOI: 10.1016/j.mvr.2023.104536] [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: 01/04/2023] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023]
Abstract
Among females in the U.S., Black females suffer the most from cardiovascular disease and stroke. While the reasons for this disparity are multifactorial, vascular dysfunction likely contributes. Chronic whole-body heat therapy (WBHT) improves vascular function, but few studies have examined its acute effect on peripheral or cerebral vascular function, which may help elucidate chronic adaptative mechanisms. Furthermore, no studies have investigated this effect in Black females. We hypothesized that Black females would have lower peripheral and cerebral vascular function relative to White females and that one session of WBHT would mitigate these differences. Eighteen young, healthy Black (n = 9; 21 ± 3 yr; BMI: 24.7 ± 4.5 kg/m2) and White (n = 9; 27 ± 3 yr; BMI: 24.8 ± 4.1 kg/m2) females underwent one 60 min session of WBHT (49 °C water via a tube-lined suit). Pre- and 45 min post-testing measures included post-occlusive forearm reactive hyperemia (peripheral microvascular function, RH), brachial artery flow-mediated dilation (peripheral macrovascular function, FMD), and cerebrovascular reactivity (CVR) to hypercapnia. Prior to WBHT, there were no differences in RH, FMD, or CVR (p > 0.05 for all). WBHT improved peak RH in both groups (main effect of WBHT: 79.6 ± 20.1 cm/s to 95.9 ± 30.0 cm/s; p = 0.004, g = 0.787) but not Δ blood velocity (p > 0.05 for both groups). WBHT improved FMD in both groups (6.2 ± 3.4 % to 8.8 ± 3.7 %; p = 0.016, g = 0.618) but had no effect on CVR in either group (p = 0.077). These data indicate that one session of WBHT acutely improves peripheral micro- and macrovascular but not cerebral vascular function in Black and White females.
Collapse
Affiliation(s)
- Zachary T Martin
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - John D Akins
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Emily R Merlau
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - John O Kolade
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Iman O Al-Daas
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Natalia Cardenas
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Joshua K Vu
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - Kyrah K Brown
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX, USA.
| |
Collapse
|
8
|
Wang PC, Song QC, Chen CY, Su TC. Cardiovascular physiological effects of balneotherapy: focused on seasonal differences. Hypertens Res 2023; 46:1650-1661. [PMID: 36991066 PMCID: PMC10052248 DOI: 10.1038/s41440-023-01248-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023]
Abstract
Hot water bathing has been demonstrated to be an effective way to improve people's cardiovascular health in many studies. This study focused on seasonal physiological changes to provide suggestions on bathing methods based on season for hot spring bathing. Volunteers were recruited to the program of hot spring bathing at 38-40 °C in New Taipei City. Cardiovascular function, blood oxygen, and ear temperature were observed. There were five assessments for each participant during the study process: baseline, bathing for 20 min and 2 cycles *20 (2*20) min, resting for 20 min and 2*20 min after bathing, respectively. Lower blood pressure (p < 0.001), pulse pressure (p < 0.001), left ventricular dP/dt Max (p < 0.001), and cardiac output (p < 0.05) were identified after bathing then rested for 2*20 min in four seasons, compared to baseline by paired T test. However, in multivariate linear regression model, potential risk for bathing in summer was assumed by higher heart rate (+28.4%, p < 0.001), cardiac output (+54.9%, p < 0.001) and left ventricular dP/dt Max (+27.6%, p < 0.05) during bathing at 2*20 min in summer. Potential risk for bathing in winter was postulated by blood pressure lowering (cSBP -10.0%; cDBP -22.1%, p < 0.001) during bathing at 2*20 min in winter. Hot spring bathing is shown to potentially improve cardiovascular function via reducing cardiac workload and vasodilation effects. Prolonged hot spring bathing in summer is not suggested due to significantly increased cardiac stress. In winter, prominent drop of blood pressure should be concerned. We demonstrated the study enrollment, the hot-spring contents and location, and physiological changes of general trends or seasonal variations, which may indicate potential benefits and risks during and after bathing. (Abbreviations: BP, blood pressure; PP, pulse pressure; LV, left ventricular; CO, cardiac output; HR, heart rate; cSBP, central systolic blood pressure; cDBP, central diastolic blood pressure).
Collapse
Affiliation(s)
- Po-Chun Wang
- Department of Family Medicine, Linkou Chang-Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Qiao-Chu Song
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan, ROC
| | - Chung-Yen Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan, ROC
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan, ROC
| | - Ta-Chen Su
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan, ROC.
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
- Department of Internal Medicine (Cardiovascular Division and General Internal Medicine), National Taiwan University Hospital, Taipei, Taiwan, ROC.
- The Experimental Forest, National Taiwan University, Nantou, Taiwan, ROC.
| |
Collapse
|
9
|
Chaseling GK, Debray A, Gravel H, Ravanelli N, Bartlett A, Gagnon D. The acute effect of heat exposure on forearm macro- and microvascular function: Impact of measurement timing, heating modality and biological sex. Exp Physiol 2023; 108:221-239. [PMID: 36533971 PMCID: PMC10103856 DOI: 10.1113/ep090732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do measurement timing, heating modality and biological sex modulate the acute effect of heat exposure on brachial artery flow-mediated dilatation and postocclusion reactive hyperaemia? What is the main finding and its importance? The acute effect of heat exposure on brachial artery flow-mediated dilatation and postocclusion reactive hyperaemia is: (1) transient and short lasting; (2) different between forearm and whole-body heating; (3) unaffected by forearm heating during whole-body heating; and (4) not different but not always equivalent between males and females. These findings provide a useful basis for future studies to investigate the acute effect of heat exposure on vascular function. ABSTRACT The aim of this study was to gain a better understanding of the acute effect of heat exposure on brachial artery flow-mediated dilatation (FMD) and postocclusion reactive hyperaemia (PORH) by: characterizing the time course of changes post-heating; comparing forearm and whole-body heating; determining the impact of forearm heating during whole-body heating; and comparing males and females. Twenty adults (11 males and nine females; 28 ± 6 years of age) underwent two forearm [10 min electric blanket (EB) or 30 min hot water immersion (WI)] and two whole-body [60 min water-perfused suit with forearm covered (WBH-C) or uncovered (WBH-U)] heating modalities. The FMD and PORH were measured before and after (≤5, 30, 60, 90 and 120 min) heating. The FMD increased from baseline 30 min after EB, and 30 and 90 min after WI. In contrast, FMD decreased from baseline immediately after both WBH modalities. Peak PORH increased immediately after WI and both WBH modalities. Total PORH did not differ after WI, whereas it decreased immediately after both WBH modalities. Covering the forearm during WBH did not alter acute changes in FMD or PORH. Changes in FMD and PORH did not differ statistically between males and females during each heating modality, although the observed differences could not always be considered equivalent. These results demonstrate that the acute effect of heat exposure on brachial artery FMD and PORH is: (1) transient and short lasting; (2) different between forearm heating and WBH; (3) unaffected by direct forearm heating during WBH; and (4) not different but not always equivalent between males and females.
Collapse
Affiliation(s)
- Georgia K. Chaseling
- Montreal Heart InstituteMontréalQuébecCanada
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | - Amélie Debray
- Montreal Heart InstituteMontréalQuébecCanada
- Department of MedicineFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | - Hugo Gravel
- School of Kinesiology and Exercise ScienceFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | | | - Audrey‐Ann Bartlett
- Montreal Heart InstituteMontréalQuébecCanada
- School of Kinesiology and Exercise ScienceFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
| | - Daniel Gagnon
- Montreal Heart InstituteMontréalQuébecCanada
- Department of Pharmacology and PhysiologyFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
- School of Kinesiology and Exercise ScienceFaculty of MedicineUniversité de MontréalMontréalQuébecCanada
| |
Collapse
|
10
|
Gibson OR, Astin R, Puthucheary Z, Yadav S, Preston S, Gavins FNE, González-Alonso J. Skeletal muscle angiogenic, regulatory, and heat shock protein responses to prolonged passive hyperthermia of the human lower limb. Am J Physiol Regul Integr Comp Physiol 2023; 324:R1-R14. [PMID: 36409025 DOI: 10.1152/ajpregu.00320.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Passive hyperthermia induces a range of physiological responses including augmenting skeletal muscle mRNA expression. This experiment aimed to examine gene and protein responses to prolonged passive leg hyperthermia. Seven young participants underwent 3 h of resting unilateral leg heating (HEAT) followed by a further 3 h of rest, with the contralateral leg serving as an unheated control (CONT). Muscle biopsies were taken at baseline (0 h), and at 1.5, 3, 4, and 6 h in HEAT and 0 and 6 h in CONT to assess changes in selected mRNA expression via qRT-PCR, and HSP72 and VEGFα concentration via ELISA. Muscle temperature (Tm) increased in HEAT plateauing from 1.5 to 3 h (+3.5 ± 1.5°C from 34.2 ± 1.2°C baseline value; P < 0.001), returning to baseline at 6 h. No change occurred in CONT. Endothelial nitric oxide synthase (eNOS), Forkhead box O1 (FOXO-1), Hsp72, and VEGFα mRNA increased in HEAT (P < 0.05); however, post hoc analysis identified that only Hsp72 mRNA statistically increased (at 4 h vs. baseline). When peak change during HEAT was calculated angiopoietin 2 (ANGPT-2) decreased (-0.4 ± 0.2-fold), and C-C motif chemokine ligand 2 (CCL2) (+2.9 ± 1.6-fold), FOXO-1 (+6.2 ± 4.4-fold), Hsp27 (+2.9 ± 1.7-fold), Hsp72 (+8.5 ± 3.5-fold), Hsp90α (+4.6 ± 3.7-fold), and VEGFα (+5.9 ± 3.1-fold) increased from baseline (all P < 0.05). At 6 h Tm were not different between limbs (P = 0.582; CONT = 32.5 ± 1.6°C, HEAT = 34.3 ± 1.2°C), and only ANGPT-2 (P = 0.031; -1.3 ± 1.4-fold) and VEGFα (P = 0.030; 1.1 ± 1.2-fold) differed between HEAT and CONT. No change in VEGFα or HSP72 protein concentration were observed over time; however, peak change in VEGFα did increase (P < 0.05) in HEAT (+140 ± 184 pg·mL-1) versus CONT (+7 ± 86 pg·mL-1). Passive hyperthermia transiently augmented ANGPT-2, CCL2, eNOS, FOXO-1, Hsp27, Hsp72, Hsp90α and VEGFα mRNA, and VEGFα protein.
Collapse
Affiliation(s)
- Oliver R Gibson
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom.,Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Rónan Astin
- Department of Medicine, Centre for Human Health and Performance, University College London, London, United Kingdom
| | - Zudin Puthucheary
- Adult Critical Care Unit, Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Shreya Yadav
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - Sophie Preston
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - Felicity N E Gavins
- Centre for Inflammation Research and Translational Medicine, Brunel University London, Uxbridge, United Kingdom.,Division of Biosciences, Brunel University London, Uxbridge, United Kingdom
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom.,Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, United Kingdom
| |
Collapse
|
11
|
Weaver SRC, Rendeiro C, Lucas RAI, Cable NT, Nightingale TE, McGettrick HM, Lucas SJE. Non-pharmacological interventions for vascular health and the role of the endothelium. Eur J Appl Physiol 2022. [PMID: 36149520 DOI: 10.1007/s00421-022-05041-y.pmid:36149520;pmcid:pmc9613570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
The most common non-pharmacological intervention for both peripheral and cerebral vascular health is regular physical activity (e.g., exercise training), which improves function across a range of exercise intensities and modalities. Numerous non-exercising approaches have also been suggested to improved vascular function, including repeated ischemic preconditioning (IPC); heat therapy such as hot water bathing and sauna; and pneumatic compression. Chronic adaptive responses have been observed across a number of these approaches, yet the precise mechanisms that underlie these effects in humans are not fully understood. Acute increases in blood flow and circulating signalling factors that induce responses in endothelial function are likely to be key moderators driving these adaptations. While the impact on circulating factors and environmental mechanisms for adaptation may vary between approaches, in essence, they all centre around acutely elevating blood flow throughout the circulation and stimulating improved endothelium-dependent vascular function and ultimately vascular health. Here, we review our current understanding of the mechanisms driving endothelial adaptation to repeated exposure to elevated blood flow, and the interplay between this response and changes in circulating factors. In addition, we will consider the limitations in our current knowledge base and how these may be best addressed through the selection of more physiologically relevant experimental models and research. Ultimately, improving our understanding of the unique impact that non-pharmacological interventions have on the vasculature will allow us to develop superior strategies to tackle declining vascular function across the lifespan, prevent avoidable vascular-related disease, and alleviate dependency on drug-based interventions.
Collapse
Affiliation(s)
- Samuel R C Weaver
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - N Timothy Cable
- Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Helen M McGettrick
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
12
|
Weaver SRC, Rendeiro C, Lucas RAI, Cable NT, Nightingale TE, McGettrick HM, Lucas SJE. Non-pharmacological interventions for vascular health and the role of the endothelium. Eur J Appl Physiol 2022; 122:2493-2514. [PMID: 36149520 PMCID: PMC9613570 DOI: 10.1007/s00421-022-05041-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/05/2022] [Indexed: 12/11/2022]
Abstract
The most common non-pharmacological intervention for both peripheral and cerebral vascular health is regular physical activity (e.g., exercise training), which improves function across a range of exercise intensities and modalities. Numerous non-exercising approaches have also been suggested to improved vascular function, including repeated ischemic preconditioning (IPC); heat therapy such as hot water bathing and sauna; and pneumatic compression. Chronic adaptive responses have been observed across a number of these approaches, yet the precise mechanisms that underlie these effects in humans are not fully understood. Acute increases in blood flow and circulating signalling factors that induce responses in endothelial function are likely to be key moderators driving these adaptations. While the impact on circulating factors and environmental mechanisms for adaptation may vary between approaches, in essence, they all centre around acutely elevating blood flow throughout the circulation and stimulating improved endothelium-dependent vascular function and ultimately vascular health. Here, we review our current understanding of the mechanisms driving endothelial adaptation to repeated exposure to elevated blood flow, and the interplay between this response and changes in circulating factors. In addition, we will consider the limitations in our current knowledge base and how these may be best addressed through the selection of more physiologically relevant experimental models and research. Ultimately, improving our understanding of the unique impact that non-pharmacological interventions have on the vasculature will allow us to develop superior strategies to tackle declining vascular function across the lifespan, prevent avoidable vascular-related disease, and alleviate dependency on drug-based interventions.
Collapse
Affiliation(s)
- Samuel R C Weaver
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - N Timothy Cable
- Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Helen M McGettrick
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
13
|
Cho MJ, Choi HI, Kim HJ, Bunsawat K, Kunutsor SK, Jae SY. Comparison of the acute effects of ankle bathing versus moderate-intensity aerobic exercise on vascular function in young adults. Appl Physiol Nutr Metab 2022; 47:469-481. [PMID: 35380875 DOI: 10.1139/apnm-2021-0272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the efficacy of ankle bathing versus aerobic exercise to improve vascular function in young adults who were randomized to aerobic exercise (AE) (n = 13, 40%-60% of heart rate reserve), ankle bathing (AB) (n = 15, 43 °C), or a control condition (CON) (n = 14, ankle bathing, 36 °C) for 40 min. Conduit vessel function [brachial artery flow-mediated dilation (FMD)], carotid and femoral artery blood flow and shear rate (SR), and arterial stiffness [carotid-to-femoral pulse wave velocity (cf-PWV), augmentation index (AIx@75), β-stiffness index, and arterial compliance] were evaluated. Compared with CON, AE and AB increased FMD at 30 min and 90 min (interaction: p < 0.05); AB decreased carotid artery blood flow and SR at 30 min, while both AE and AB increased femoral artery blood flow and SR at 30 min and 90 min (interaction: p < 0.05); AE and AB decreased cf-PWV and AIx@75 at 30 min and 90 min (interaction: p < 0.05); and AE improved both carotid and femoral β-stiffness index and arterial compliance, while AB reduced β-stiffness index and increased arterial compliance only in the femoral artery (interaction: p < 0.05). These findings suggest that ankle bathing may serve as an alternative strategy for enhancing vascular function. Novelty: We observed similar improvements in conduit vessel function, femoral artery blood flow and shear rate, and arterial stiffness following ankle bathing and acute aerobic exercise in young adults. These findings have identified ankle bathing as a potential therapeutic strategy for enhancing vascular function, which may be particularly relevant for those with limited ability to engage in regular aerobic exercise.
Collapse
Affiliation(s)
- Min Jeong Cho
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Ho Il Choi
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Hyun Jeong Kim
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Kanokwan Bunsawat
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah, USA
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.,Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK
| | - Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea.,Division of Urban Social Health, Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea
| |
Collapse
|
14
|
Pettit-Mee RJ, Power G, Cabral-Amador FJ, Ramirez-Perez FI, Nogueira Soares R, Sharma N, Liu Y, Christou DD, Kanaley JA, Martinez-Lemus LA, Manrique-Acevedo CM, Padilla J. Endothelial HSP72 is not reduced in type 2 diabetes nor is it a key determinant of endothelial insulin sensitivity. Am J Physiol Regul Integr Comp Physiol 2022; 323:R43-R58. [PMID: 35470695 DOI: 10.1152/ajpregu.00006.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Impaired endothelial insulin signaling and consequent blunting of insulin-induced vasodilation is a feature of type 2 diabetes (T2D) that contributes to vascular disease and glycemic dysregulation. However, the molecular mechanisms underlying endothelial insulin resistance remain poorly known. Herein, we tested the hypothesis that endothelial insulin resistance in T2D is attributed to reduced expression of heat shock protein 72(HSP72). HSP72 is a cytoprotective chaperone protein that can be upregulated with heating and is reported to promote insulin sensitivity in metabolically active tissues, in part via inhibition of JNK activity. Accordingly, we further hypothesized that, in T2D individuals, seven days of passive heat treatment via hot water immersion to waist-level would improve leg blood flow responses to an oral glucose load (i.e., endogenous insulin stimulation) via induction of endothelial HSP72. In contrast, we found that: 1) endothelial insulin resistance in T2D mice and humans was not associated with reduced HSP72 in aortas and venous endothelial cells, respectively; 2) after passive heat treatment, improved leg blood flow responses to an oral glucose load did not parallel with increased endothelial HSP72; 3) downregulation of HSP72 (via small-interfering RNA) or upregulation of HSP72 (via heating) in cultured endothelial cells did not impair or enhance insulin signaling, respectively, nor was JNK activity altered. Collectively, these findings do not support the hypothesis that reduced HSP72 is a key driver of endothelial insulin resistance in T2D but provide novel evidence that lower-body heating may be an effective strategy for improving leg blood flow responses to glucose ingestion-induced hyperinsulinemia.
Collapse
Affiliation(s)
- Ryan J Pettit-Mee
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Gavin Power
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | | | | | | | - Neekun Sharma
- Department of Medicine, University of Missouri, Columbia, MO, United States
| | - Ying Liu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Luis A Martinez-Lemus
- Department of Medicine, University of Missouri, Columbia, MO, United States.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
| | - Camila M Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Missouri, Columbia, MO, United States.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
| |
Collapse
|
15
|
Behzadi P, Ravanelli N, Gravel H, Barry H, Debray A, Chaseling GK, Jacquemet V, Neagoe PE, Nigam A, Carpentier AC, Sirois MG, Gagnon D. Acute effect of passive heat exposure on markers of cardiometabolic function in adults with type 2 diabetes mellitus. J Appl Physiol (1985) 2022; 132:1154-1166. [PMID: 35323077 DOI: 10.1152/japplphysiol.00800.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM Heat therapy is a promising strategy to improve cardiometabolic health. This study evaluated the acute physiological responses to hot water immersion in adults with type 2 diabetes mellitus (T2DM). METHODS On separate days in randomized order, 13 adults with T2DM (8 males/5 females, 62 ± 12 yrs, BMI: 30.1 ± 4.6 kg/m2) were immersed in thermoneutral (34°C, 90 minutes) or hot (41°C, core temperature ≥38.5°C for 60 minutes) water. Insulin sensitivity was quantified via the minimal oral model during an oral glucose tolerance test (OGTT) performed 60 minutes after immersion. Brachial artery flow-mediated dilation (FMD) and reactive hyperemia were evaluated before and 40 minutes after immersion. Blood samples were drawn to quantify protein concentrations and mRNA levels of HSP70 and 90, and circulating concentrations of cytokines. RESULTS Relative to thermoneutral water immersion, hot water immersion increased core temperature (+1.66°C [+1.47, +1.87], P<0.01), heart rate (+34 bpm [+24, +44], P<0.01), antegrade shear rate (+96 s-1 [+57, +134], P<0.01), and IL-6 (+1.38 pg/mL [+0.31, +2.45], P=0.01). Hot water immersion did not exert an acute change in insulin sensitivity (-0.3 dl/kg/min/μU/ml [-0.9, +0.2], P=0.18), FMD (-1.0% [-3.6, +1.6], P=0.56), peak (+0.36 mL/min/mmHg [-0.71, +1.43], P=0.64) and total (+0.11 mL/min/mmHg x min [-0.46, +0.68], P=0.87) reactive hyperemia. There was also no change in eHSP70 (P=0.64), iHSP70 (P=0.06), eHSP90 (P=0.80), iHSP90 (P=0.51), IL1-RA (P=0.11), GLP-1 (P=0.59) and NFkB (P=0.56) after hot water immersion. CONCLUSION The physiological responses elicited by hot water immersion do not acutely improve markers of cardiometabolic function in adults with T2DM.
Collapse
Affiliation(s)
- Parya Behzadi
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Hugo Gravel
- Montreal Heart Institute, Montreal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Amelie Debray
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - Georgia K Chaseling
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Vincent Jacquemet
- Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - André C Carpentier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - Martin G Sirois
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
| |
Collapse
|
16
|
Larson EA, Ely BR, Brunt VE, Francisco MA, Harris SM, Halliwill JR, Minson CT. Brachial and carotid hemodynamic response to hot water immersion in men and women. Am J Physiol Regul Integr Comp Physiol 2021; 321:R823-R832. [PMID: 34643115 DOI: 10.1152/ajpregu.00110.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M) (24 ± 4 yr) completed a 60-min HWI session immersed to the level of the sternum in 40°C water. Brachial and carotid artery hemodynamics (Doppler ultrasound) were measured at baseline (seated rest) and every 15 min throughout HWI. Within the brachial artery, total shear rate was elevated to a greater extent in women [+479 (+364, +594) s-1] than in men [+292 (+222, +361) s-1] during HWI (P = 0.005). As shear rate is inversely proportional to blood vessel diameter and directly proportional to blood flow velocity, the sex difference in brachial shear response to HWI was the result of a smaller brachial diameter among women at baseline (P < 0.0001) and throughout HWI (main effect of sex, P < 0.0001) and a greater increase in brachial velocity seen in women [+48 (+36, +61) cm/s] compared with men [+35 (+27, +43) cm/s] with HWI (P = 0.047) which allowed for a similar increase in brachial blood flow between sexes [M: +369 (+287, +451) mL/min, W: +364 (+243, +486) mL/min, P = 0.943]. In contrast, no differences were seen between sexes in carotid total shear rate, flow, velocity, or diameter at baseline or throughout HWI. These data indicate the presence of an artery-specific sex difference in the hemodynamic response to a single bout of HWI.
Collapse
Affiliation(s)
- Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Sarianne M Harris
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | |
Collapse
|
17
|
Wang S, Cheng F, Ji Q, Song M, Wu Z, Zhang Y, Ji Z, Feng H, Belmonte JCI, Zhou Q, Qu J, Li W, Liu GH, Zhang W. Hyperthermia differentially affects specific human stem cells and their differentiated derivatives. Protein Cell 2021; 13:615-622. [PMID: 34719769 PMCID: PMC9232687 DOI: 10.1007/s13238-021-00887-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Si Wang
- Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.,Aging Translational Medicine Center, International Center for Aging and Cancer, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.,Chongqing Renji Hospital, University of Chinese Academy of Sciences, Chongqing, 400062, China
| | - Fang Cheng
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qianzhao Ji
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Moshi Song
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Zeming Wu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Yiyuan Zhang
- National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China
| | - Zhejun Ji
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Huyi Feng
- Chongqing Renji Hospital, University of Chinese Academy of Sciences, Chongqing, 400062, China
| | | | - Qi Zhou
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China
| | - Jing Qu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. .,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China. .,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. .,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China. .,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
| | - Guang-Hui Liu
- Advanced Innovation Center for Human Brain Protection, National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital Capital Medical University, Beijing, 100053, China. .,State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. .,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China. .,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
| | - Weiqi Zhang
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China. .,Aging Translational Medicine Center, International Center for Aging and Cancer, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. .,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, 100101, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China. .,China National Center for Bioinformation, Beijing, 100101, China.
| |
Collapse
|
18
|
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.
Collapse
|
19
|
Cheng JL, Williams JS, Hoekstra SP, MacDonald MJ. Improvements in vascular function in response to acute lower limb heating in young healthy males and females. J Appl Physiol (1985) 2021; 131:277-289. [PMID: 34013754 DOI: 10.1152/japplphysiol.00630.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Regular exposure to passive heat stress improves vascular function, but the optimal heating prescription remains undefined. Local limb heating is more feasible than whole body heating, but the evidence demonstrating its efficacy is lacking. The purpose of this study was to determine whether acute improvements in vascular function can be achieved with lower limb heating in 16 young healthy individuals (8 female, 8 male). In separate visits, participants underwent 45 min of ankle- and knee-level hot water immersion (45°C). A subset of seven participants also participated in a time-control visit. Endothelial function was assessed through simultaneous brachial and superficial femoral artery flow-mediated dilation (FMD) tests. Macrovascular function was quantified by %FMD, whereas microvascular function was quantified by vascular conductance during reactive hyperemia. Arterial stiffness was assessed through carotid-femoral and femoral-foot pulse wave velocity (PWV). Plasma concentrations of interleukin-6 and extracellular heat shock protein-72 (eHSP72) were used as indicators of inflammation. Our findings showed that 45 min of lower limb heating-regardless of condition-acutely improved upper limb macrovascular endothelial function (i.e., brachial %FMD; Pre: 4.6 ± 1.7 vs. Post: 5.4 ± 2.0%; P = 0.004) and lower limb arterial stiffness (i.e., femoral-foot PWV; Pre: 8.4 ± 1.2 vs. Post: 7.7 ± 1.1 m/s; P = 0.011). However, only knee-level heating increased upper limb microvascular function (i.e., brachial peak vascular conductance; Pre: 6.3 ± 2.7 vs. Post: 7.8 ± 3.5 mL/min ⋅ mmHg; P ≤ 0.050) and plasma eHSP72 concentration (Pre: 12.4 ± 9.4 vs. Post: 14.8 ± 9.8 ng/mL; P ≤ 0.050). These findings show that local lower limb heating acutely improves vascular function in younger individuals, with knee-level heating improving more outcome measures.NEW & NOTEWORTHY This study demonstrates that lower limb hot water immersion is an effective strategy for acutely improving vascular function in young, healthy males and females, thereby encouraging the development of accessible modes of heat therapy for vascular health.
Collapse
Affiliation(s)
- Jem L Cheng
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Sven P Hoekstra
- The Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | | |
Collapse
|
20
|
Pizzey FK, Smith EC, Ruediger SL, Keating SE, Askew CD, Coombes JS, Bailey TG. The effect of heat therapy on blood pressure and peripheral vascular function: A systematic review and meta-analysis. Exp Physiol 2021; 106:1317-1334. [PMID: 33866630 DOI: 10.1113/ep089424] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/08/2021] [Indexed: 01/09/2023]
Abstract
NEW FINDINGS What is the topic of this review? We have conducted a systematic review and meta-analysis on the current evidence for the effect of heat therapy on blood pressure and vascular function. What advances does it highlight? We found that heat therapy reduced mean arterial, systolic and diastolic blood pressure. We also observed that heat therapy improved vascular function, as assessed via brachial artery flow-mediated dilatation. Our results suggest that heat therapy is a promising therapeutic tool that should be optimized further, via mode and dose, for the prevention and treatment of cardiovascular disease risk factors. ABSTRACT Lifelong sauna exposure is associated with reduced cardiovascular disease risk. Recent studies have investigated the effect of heat therapy on markers of cardiovascular health. We aimed to conduct a systematic review with meta-analysis to determine the effects of heat therapy on blood pressure and indices of vascular function in healthy and clinical populations. Four databases were searched up to September 2020 for studies investigating heat therapy on outcomes including blood pressure and vascular function. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess the certainty of evidence. A total of 4522 titles were screened, and 15 studies were included. Healthy and clinical populations were included. Heat exposure was for 30-90 min, over 10-36 sessions. Compared with control conditions, heat therapy reduced mean arterial pressure [n = 4 studies; mean difference (MD): -5.86 mmHg, 95% confidence interval (CI): -8.63, -3.10; P < 0.0001], systolic blood pressure (n = 10; MD: -3.94 mmHg, 95% CI: -7.22, -0.67; P = 0.02) and diastolic blood pressure (n = 9; MD: -3.88 mmHg, 95% CI: -6.13, -1.63; P = 0.0007) and improved flow-mediated dilatation (n = 5; MD: 1.95%, 95% CI: 0.14, 3.76; P = 0.03). Resting heart rate was unchanged (n = 10; MD: -1.25 beats/min; 95% CI: -3.20, 0.70; P = 0.21). Early evidence also suggests benefits for arterial stiffness and cutaneous microvascular function. The certainty of evidence was moderate for the effect of heat therapy on systolic and diastolic blood pressure and heart rate and low for the effect of heat therapy on mean arterial pressure and flow-mediated dilatation. Heat therapy is an effective therapeutic tool to reduce blood pressure and improve macrovascular function. Future research should aim to optimize heat therapy, including the mode and dose, for the prevention and management of cardiovascular disease.
Collapse
Affiliation(s)
- Faith K Pizzey
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Emily C Smith
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Shelley E Keating
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Christopher D Askew
- VasoActive Research Group, School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health (CRExPAH), School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia
| |
Collapse
|
21
|
Brunt VE, Minson CT. Heat therapy: mechanistic underpinnings and applications to cardiovascular health. J Appl Physiol (1985) 2021; 130:1684-1704. [PMID: 33792402 DOI: 10.1152/japplphysiol.00141.2020] [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] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide, and novel therapies are drastically needed to prevent or delay the onset of CVD to reduce the societal and healthcare burdens associated with these chronic diseases. One such therapy is "heat therapy," or chronic, repeated use of hot baths or saunas. Although using heat exposure to improve health is not a new concept, it has received renewed attention in recent years as a growing number of studies have demonstrated robust and widespread beneficial effects of heat therapy on cardiovascular health. Here, we review the existing literature, with particular focus on the molecular mechanisms that underscore the cardiovascular benefits of this practice.
Collapse
Affiliation(s)
- Vienna E Brunt
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado.,Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | |
Collapse
|
22
|
Gravel H, Behzadi P, Cardinal S, Barry H, Neagoe PE, Juneau M, Nigam A, Sirois MG, Gagnon D. Acute Vascular Benefits of Finnish Sauna Bathing in Patients With Stable Coronary Artery Disease. Can J Cardiol 2021; 37:493-499. [DOI: 10.1016/j.cjca.2020.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 01/20/2023] Open
|
23
|
The Cardiometabolic Health Benefits of Sauna Exposure in Individuals with High-Stress Occupations. A Mechanistic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031105. [PMID: 33513711 PMCID: PMC7908414 DOI: 10.3390/ijerph18031105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 01/11/2023]
Abstract
Components of the metabolic syndrome (i.e., hypertension, insulin resistance, obesity, atherosclerosis) are a leading cause of death in the United States and result in low-grade chronic inflammation, excessive oxidative stress, and the eventual development of cardiometabolic diseases (CMD). High-stress occupations (HSO: firefighters, police, military personnel, first responders, etc.) increase the risk of developing CMD because they expose individuals to chronic and multiple stressors (i.e., sleep deprivation, poor nutrition habits, lack of physical activity, psychological stress). Interestingly, heat exposure and, more specifically, sauna bathing have been shown to improve multiple markers of CMD, potentially acting as hormetic stressors, at the cellular level and in the whole organism. Therefore, sauna bathing might be a practical and alternative intervention for disease prevention for individuals with HSO. The purpose of this review is to detail the mechanisms and pathways involved in the response to both acute and chronic sauna bathing and collectively present sauna bathing as a potential treatment, in addition to current standard of care, for mitigating CMD to both clinicians and individuals serving in HSO.
Collapse
|
24
|
Shepley BR, Ainslie PN, Hoiland RL, Donnelly J, Sekhon MS, Zetterberg H, Blennow K, Bain AR. Negligible influence of moderate to severe hyperthermia on blood-brain barrier permeability and neuronal parenchymal integrity in healthy men. J Appl Physiol (1985) 2021; 130:792-800. [PMID: 33444119 DOI: 10.1152/japplphysiol.00645.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With growing use for hyperthermia as a cardiovascular therapeutic, there is surprisingly little information regarding the acute effects it may have on the integrity of the neurovascular unit (NVU). Indeed, relying on animal data would suggest hyperthermia comparable to levels attained in thermal therapy will disrupt the blood-brain barrier (BBB) and damage the cerebral parenchymal cells. We sought to address the hypothesis that controlled passive hyperthermia is not sufficient to damage the NVU in healthy humans. Young men (n = 11) underwent acute passive heating until +2°C or absolute esophageal temperature of 39.5°C. The presence of BBB opening was determined by trans-cerebral exchange kinetics (radial-arterial and jugular venous cannulation) of S100B. Neuronal parenchymal damage was determined by the trans-cerebral exchange of tau protein, neuron-specific enolase (NSE), and neurofilament-light protein (NF-L). Cerebral blood flow to calculate exchange kinetics was measured by duplex ultrasound of the right internal carotid and left vertebral artery. Passive heating was performed via a warm-water perfused suit. In hyperthermia, there was no increase in the cerebral exchange of S100B (P = 0.327), tau protein (P = 0.626), NF-L (P = 0.447), or NSE (P = 0.908) suggesting the +2°C core temperature is not sufficient to acutely stress the NVU in healthy men. However, there was a significant condition effect (P = 0.028) of NSE, corresponding to a significant increase in arterial (P = 0.023) but not venous (P = 0.173) concentrations in hyperthermia, potentially indicating extra-cerebral release of NSE. Collectively, results from the present study support the notion that in young men there is little concern for NVU damage with acute hyperthermia of +2 °C.NEW & NOTEWORTHY The acute effects of passive whole-body hyperthermia on the integrity of the neurovascular unit (NVU) in humans have remained unclear. We demonstrate that passive heating for ∼1 h until an increase of +2°C esophageal temperature in healthy men does not increase the cerebral release of neuronal parenchymal stress biomarkers, suggesting the NVU integrity is maintained. This preliminary study indicates passive heating is safe for the brain, at least in young healthy men.
Collapse
Affiliation(s)
- Brooke R Shepley
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
| | - Philip N Ainslie
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada
| | - Ryan L Hoiland
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology, and Therapeutics, Vancouver General Hospital, Vancouver, BC, Canada
| | - Joseph Donnelly
- Brain Physics Laboratory, Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrookes Hospital, University of Cambridge, Cambridge, UK
| | - Mypinder S Sekhon
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Division of Critical Care Medicine and Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Anthony R Bain
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
| |
Collapse
|
25
|
Coombs GB, Tremblay JC, Shkredova DA, Carr JMJR, Wakeham DJ, Patrician A, Ainslie PN. Distinct contributions of skin and core temperatures to flow-mediated dilation of the brachial artery following passive heating. J Appl Physiol (1985) 2021; 130:149-159. [DOI: 10.1152/japplphysiol.00502.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The primary determinant of vascular adaptations to lifestyle interventions, such as exercise and heat therapy, is repeated elevations in vascular shear stress. Whether skin or core temperatures also modulate the vascular adaptation to acute heat exposure is unknown, likely due to difficulty in dissociating the thermal and hemodynamic responses to heat. We found that skin and core temperatures modify the acute vascular responses to passive heating irrespective of the magnitude of increase in shear stress.
Collapse
Affiliation(s)
- Geoff B. Coombs
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Joshua C. Tremblay
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Daria A. Shkredova
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jay M. J. R Carr
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Denis J. Wakeham
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Alexander Patrician
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Philip N. Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| |
Collapse
|
26
|
Cullen T, Clarke ND, Hill M, Menzies C, Pugh CJA, Steward CJ, Thake CD. The health benefits of passive heating and aerobic exercise: To what extent do the mechanisms overlap? J Appl Physiol (1985) 2020; 129:1304-1309. [DOI: 10.1152/japplphysiol.00608.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Exercise can induce numerous health benefits that can reduce the risk of chronic diseases and all-cause mortality, yet a significant percentage of the population do not meet minimal physical activity guidelines. Several recent studies have shown that passive heating can induce numerous health benefits, many of which are comparable with exercise, such as improvements to cardiorespiratory fitness, vascular health, glycemic control, and chronic low-grade inflammation. As such, passive heating is emerging as a promising therapy for populations who cannot perform sustained exercise or display poor exercise adherence. There appears to be some overlap between the cellular signaling responses that are regulated by temperature and the mechanisms that underpin beneficial adaptations to exercise, but detailed comparisons have not yet been made. Therefore, the purpose of this mini review is to assess the similarities and distinctions between adaptations to passive heating and exercise. Understanding the potential shared mechanisms of action between passive heating and exercise may help to direct future studies to implement passive heating more effectively and identify differences between passive heating and exercise-induced adaptations.
Collapse
Affiliation(s)
- Tom Cullen
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Neil D. Clarke
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Mathew Hill
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Campbell Menzies
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Christopher J. A. Pugh
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Charles J. Steward
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - C. Douglas Thake
- Centre for Sport Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| |
Collapse
|
27
|
Gravel H, Coombs GB, Behzadi P, Marcoux-Clément V, Barry H, Juneau M, Nigam A, Gagnon D. Acute effect of Finnish sauna bathing on brachial artery flow-mediated dilation and reactive hyperemia in healthy middle-aged and older adults. Physiol Rep 2020; 7:e14166. [PMID: 31293098 PMCID: PMC6640592 DOI: 10.14814/phy2.14166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022] Open
Abstract
Regular Finnish sauna bathing is associated with a reduced risk of all‐cause and cardiovascular mortality in middle‐aged and older adults. Potential acute physiological adaptations induced by sauna bathing that underlie this relationship remain to be fully elucidated. The purpose of this study was to determine if typical Finnish sauna sessions acutely improve brachial artery flow‐mediated dilation (FMD) and reactive hyperemia (RH) in healthy middle‐aged and older adults. Using a randomized crossover design, FMD and RH were evaluated in 21 healthy adults (66 ± 6 years, 10 men/11 women) before and after each of the following conditions: (1) 1 × 10 min of Finnish sauna bathing (80.2 ± 3.2°C, 23 ± 2% humidity); (2) 2 × 10 min of sauna bathing separated by 10 min of rest outside the sauna; (3) a time control period (10 min of seated rest outside the sauna). FMD was taken as the peak change from baseline in brachial artery diameter following 5 min of forearm ischemia, whereas RH was quantified as both peak and area‐under‐the‐curve forearm vascular conductance postischemia. FMD was statistically similar pre to post 1 × 10 min (4.69 ± 2.46 to 5.41 ± 2.64%, P = 0.20) and 2 × 10 min of sauna bathing (4.16 ± 1.79 to 4.55 ± 2.14%, P = 0.58). Peak and area‐under‐the‐curve forearm vascular conductance were also similar following both sauna interventions. These results suggest that typical Finnish sauna bathing sessions do not acutely improve brachial artery FMD and RH in healthy middle‐aged and older adults.
Collapse
Affiliation(s)
- Hugo Gravel
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Geoff B Coombs
- School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, Canada
| | - Parya Behzadi
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Virginie Marcoux-Clément
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Daniel Gagnon
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| |
Collapse
|
28
|
Wei J, Hollabaugh C, Miller J, Geiger PC, Flynn BC. Molecular Cardioprotection and the Role of Exosomes: The Future Is Not Far Away. J Cardiothorac Vasc Anesth 2020; 35:780-785. [PMID: 32571657 DOI: 10.1053/j.jvca.2020.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/20/2023]
Abstract
Heart disease is the leading cause of death in men and women in the United States. During the past several decades, research into the role of specific intracellular mediators, called exosomes, has advanced the understanding of molecular cardioprotection. Exosomes and the micro-RNAs within them may be potential targets for the development of genetically engineered or biosimilar medications for patients in heart failure or with ischemic cardiac disease. This review discusses anesthetic implications of exosome production and the future micro-RNA applications for cardioprotection.
Collapse
Affiliation(s)
- Johnny Wei
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS
| | | | - Joshua Miller
- University of Kansas Medical Center, Kansas City, KS
| | - Paige C Geiger
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS
| | - Brigid C Flynn
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS.
| |
Collapse
|
29
|
Sars B, van der Sande FM, Kooman JP. Intradialytic Hypotension: Mechanisms and Outcome. Blood Purif 2019; 49:158-167. [PMID: 31851975 DOI: 10.1159/000503776] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022]
Abstract
Intradialytic hypotension (IDH) occurs in approximately 10-12% of treatments. Whereas several definitions for IDH are available, a nadir systolic blood pressure carries the strongest relation with outcome. Whereas the relation between IDH may partly be based on patient characteristics, it is likely that also impaired organ perfusion leading to permanent damage, plays a role in this relationship. The pathogenesis of IDH is multifactorial and is based on a combination of a decline in blood volume (BV) and impaired vascular resistance at a background of a reduced cardiovascular reserve. Measurements of absolute BV based on an on-line dilution method appear more promising than relative BV measurements in the prediction of IDH. Also, feedback treatments in which ultrafiltration rate is automatically adjusted based on changes in relative BV have not yet resulted in improvement. Frequent assessment of dry weight, attempting to reduce interdialytic weight gain and prescribing more frequent or longer dialysis treatments may aid in preventing IDH. The impaired vascular response can be improved using isothermic or cool dialysis treatment which has also been associated with a reduction in end organ damage, although their effect on mortality has not yet been assessed. For the future, identification of vulnerable patients based on artificial intelligence and on-line assessment of markers of organ perfusion may aid in individualizing treatment prescription, which will always remain dependent on the clinical context of the patient.
Collapse
Affiliation(s)
- Benedict Sars
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frank M van der Sande
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jeroen P Kooman
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands,
| |
Collapse
|
30
|
Engelland RE, Hemingway HW, Tomasco OG, Olivencia-Yurvati AH, Romero SA. Acute lower leg hot water immersion protects macrovascular dilator function following ischaemia-reperfusion injury in humans. Exp Physiol 2019; 105:302-311. [PMID: 31707732 DOI: 10.1113/ep088154] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS • What is the central question of this study? What is the effect of lower leg hot water immersion on vascular ischaemia-reperfusion injury induced in the arm of young healthy humans? • What is the main finding and its importance? Lower leg hot water immersion successfully protects against vascular ischaemia-reperfusion injury in humans. This raises the possibility that targeted heating of the lower legs may be an alternative therapeutic approach to whole-body heating that is equally efficacious at protecting against vascular ischaemia-reperfusion injury. ABSTRACT Reperfusion that follows a period of ischaemia paradoxically reduces vasodilator function in humans and contributes to the tissue damage associated with an ischaemic event. Acute whole-body hot water immersion protects against vascular ischaemia-reperfusion (I-R) injury in young healthy humans. However, the effect of acute lower leg heating on I-R injury is unclear. Therefore, the purpose of this study was to test the hypothesis that, compared with thermoneutral control immersion, acute lower leg hot water immersion would prevent the decrease in macro- and microvascular dilator functions following I-R injury in young healthy humans. Ten young healthy subjects (5 female) immersed their lower legs into a circulated water bath for 60 min under two randomized conditions: (1) thermoneutral control immersion (∼33°C) and (2) hot water immersion (∼42°C). Macrovascular (brachial artery flow-mediated dilatation) and microvascular (forearm reactive hyperaemia) dilator functions were assessed using Doppler ultrasound at three time points: (1) pre-immersion, (2) 60 min post-immersion, and (3) post-I/R (20 min of arm ischaemia followed by 20 min of reperfusion). Ischaemia-reperfusion injury reduced macrovascular dilator function following control immersion (pre-immersion 6.0 ± 2.1% vs. post-I/R 3.6 ± 2.1%; P < 0.05), but was well-maintained with prior hot water immersion (pre-immersion 5.8 ± 2.1% vs. post-I/R 5.3 ± 2.1%; P = 0.8). Microvascular dilator function did not differ between conditions or across time. Taken together, acute lower leg hot water immersion prevents the decrease in macrovascular dilator function that occurs following I-R injury in young healthy humans.
Collapse
Affiliation(s)
- Rachel E Engelland
- Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Holden W Hemingway
- Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Olivia G Tomasco
- Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Albert H Olivencia-Yurvati
- Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA.,Department of Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Steven A Romero
- Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
| |
Collapse
|