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Guo M, Diaz‐Canestro C, Pugliese NR, Paneni F, Montero D. Lean body mass and the cardiorespiratory phenotype: An ethnic-specific relationship in Hans Chinese women and men. J Cachexia Sarcopenia Muscle 2024; 15:963-974. [PMID: 38632694 PMCID: PMC11154775 DOI: 10.1002/jcsm.13464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/27/2023] [Accepted: 01/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Lean body mass (LBM) and the functional capacity of cardiovascular (CV) and respiratory systems constitute a female-specific relationship in European-American individuals. Whether this recent finding be extrapolated to the world's largest ethnic group, that is, Hans Chinese (HC, a population characterized by low LBM), is unknown. METHODS Healthy HC adults (n = 144, 50% ♀) closely matched by sex, age and physical activity were included. Total and regional (leg, arm and trunk) LBM and body composition were measured via dual-energy X-ray absorptiometry. Cardiac structure, stiffness, central/peripheral haemodynamics and peak O2 consumption (VO2peak) were assessed via transthoracic echocardiography and pulmonary gas analyses at rest and during exercise up to peak effort. Regression analyses determined the sex-specific relationship of LBM with cardiac and aerobic phenotypes. RESULTS Total and regional LBM were lower and body fat percentage higher in women compared with men (P < 0.001). In both sexes, total LBM positively associated with left ventricular (LV) mass and peak volumes (r ≥ 0.33, P ≤ 0.005) and negatively with LV end-systolic and central arterial stiffness (r ≥ -0.34, P ≤ 0.004). Total LBM strongly associated with VO2peak (r ≥ 0.60, P < 0.001) and peak cardiac output (r ≥ 0.40, P < 0.001) in women and men. Among regional LBM, leg LBM prominently associated with the arterio-venous O2 difference at peak exercise in both sexes (r ≥ 0.43, P < 0.001). Adjustment by adiposity or CV risk factors did not modify the results. CONCLUSIONS LBM independently determines internal cardiac dimensions, ventricular mass, distensibility and the capacity to deliver and consume O2 in HC adults irrespective of sex.
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Affiliation(s)
- Meihan Guo
- Faculty of MedicineHong Kong UniversityHong Kong
| | - Candela Diaz‐Canestro
- Faculty of MedicineHong Kong UniversityHong Kong
- Department of Medicine, School of Clinical MedicineHong Kong UniversityHong Kong
| | | | - Francesco Paneni
- Center for Translational and Experimental Cardiology (CTEC), Zurich University HospitalUniversity of ZurichZurichSwitzerland
- University Heart Center, University Hospital ZurichUniversity of ZurichZurichSwitzerland
| | - David Montero
- Faculty of MedicineHong Kong UniversityHong Kong
- Department of Medicine, School of Clinical MedicineHong Kong UniversityHong Kong
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Raffin J, Rolland Y, Aubertin‐Leheudre M, Aragoni da Silva J, Guyonnet S, Pillard F, Vellas B, de Souto Barreto P. Cross-sectional interactive associations of physical activity and sedentary behaviour with physical capacity across adulthood. J Cachexia Sarcopenia Muscle 2024; 15:1134-1145. [PMID: 38638004 PMCID: PMC11154759 DOI: 10.1002/jcsm.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/22/2024] [Accepted: 02/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The way physical activity (PA) and sedentary behaviour (SB) independently and interactively modify the age-related decline in physical capacity remains poorly understood. This cross-sectional study investigated the independent and interactive associations of PA and SB with physical function and performance throughout the adult life course. METHODS Data from 499 community-dwelling adults (63% female) aged 20-92 years, involved in the INSPIRE Human Translational Cohort, were used in this cross-sectional study. Daily time spent on moderate-to-vigorous PA (MVPA, min/day) and SB (h/day) was measured with activPAL triaxial accelerometers. Physical function and performance were assessed through the measurement of the 4-m usual gait speed (m/s), handgrip strength (kg), lower-limb strength (isokinetic knee extension torque, N·m), estimated lower-limb power (five-time chair-rise test performance, s) and cardiorespiratory fitness (V̇O2max, mL/kg/min). Confounder-adjusted multiple linear and curvilinear regressions were performed to investigate how MVPA, SB and their interactions were associated with the physical outcomes (all square root-transformed except gait speed) throughout the adulthood spectrum. RESULTS Interaction analyses revealed that the combination of higher levels of MVPA with lower levels of SB favourably reshaped the negative relationship between handgrip strength and age (age2 × SB × MVPA: B = -7E-08, SE = 3E-08, P < 0.05). In addition, higher levels of MVPA were independently associated with an improved age-related profile in gait speed (age2 × MVPA: B = 3E-06, SE = 1E-06, P < 0.05), chair-rise performance (age × MVPA: B = -9E-05, SE = 4E-05, P < 0.05) and V̇O2max (MVPA at 21 years: B = 3E-02, SE = 7E-03, P < 0.05; age × MVPA: B = -5E-04, SE = 2E-04, P < 0.05). Conversely, the detrimental association of age with lower-limb muscle strength (age × SB: B = -1E-04, SE = 6E-05, P < 0.05) and chair-rise performance (age × SB: B = 1E-05, SE = 7E-06, P < 0.05) was exacerbated with increasing duration of SB, independently of MVPA. Supplementary analyses further revealed that some of these associations were age and sex specific. CONCLUSIONS This cross-sectional study demonstrated that reduced sedentary time and increased activity duration were independently and synergistically associated with an attenuated age-related loss in physical capacity. These findings need to be confirmed with longitudinal data but encourage both adopting an active lifestyle and reducing sedentary time as preventive measures against physical aging.
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Affiliation(s)
- Jérémy Raffin
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
| | - Yves Rolland
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Mylène Aubertin‐Leheudre
- Département des Sciences de l'activité physique, Faculté des sciencesUniversité du Québec à MontréalMontréalCanada
- Centre de recherche, Institut universitaire de gériatrie de Montréal (IUGM), CIUSSS du Centre‐Sud‐de‐l'Île‐de‐MontréalMontréalCanada
| | - Jaqueline Aragoni da Silva
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
| | - Sophie Guyonnet
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Fabien Pillard
- Unité de Médecine du Sport, Clinique Universitaire du Sport, Hôpital Pierre Paul RIQUET (Centre Hospitalo‐Universitaire)ToulouseFrance
- Centre RESTORE (Geroscience and Rejuvenation Center), UMR 1301 (INSERM)/UMR 5070 (CNRS)ToulouseFrance
| | - Bruno Vellas
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
| | - Philipe de Souto Barreto
- Institut Hospitalo‐Universitaire (IHU) HealthAgeToulouseFrance
- Institut du Vieillissement, Gérontopôle de ToulouseCentre Hospitalo‐Universitaire de ToulouseToulouseFrance
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPSToulouseFrance
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Haddad T, Spence AL, Peiffer J, Blain GM, Brisswalter J, Abbiss CR. The Improvement in Exercise Performance during Reduced Muscle Mass Exercise is Associated with an Increase in Femoral Blood Flow in Older and Younger Endurance-Trained Athletes. J Sports Sci Med 2024; 23:46-55. [PMID: 38455445 PMCID: PMC10915611 DOI: 10.52082/jssm.2024.46] [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: 10/09/2023] [Accepted: 12/01/2023] [Indexed: 03/09/2024]
Abstract
This study investigated whether the improved performance observed with maximal self-paced single-leg (SL), compared with double-leg (DL) cycling, is associated with enhanced femoral blood flow and/or altered tissue oxygenation. The hyperaemic response to exercise was assessed in younger and older athletes. Power output was measured in 12 older (65 ± 4 y) and 12 younger (35 ± 5 y) endurance-trained individuals performing 2 x 3 min maximal self-paced exercise using SL and DL cycling. Blood flow (BF) in the femoral artery was assessed using Doppler ultrasound and muscle oxygenation was measured using near-infrared spectroscopy on the vastus lateralis. SL cycling elicited a greater power output (295 ± 83 vs 265 ± 70 W, P < 0.001) and peak femoral BF (1749.1 ± 533.3 vs 1329.7 ± 391.7 ml/min, P < 0.001) compared with DL cycling. Older individuals had a lower peak BF in response to exercise (1355.4 ± 385.8 vs 1765.2 ± 559.6 ml/min, P = 0.019) compared with younger individuals. Peak BF in response to exercise was correlated with power output during SL (r = 0.655, P = 0.002) and DL (r = 0.666, P = 0.001) cycling. The greater exercise performance during SL compared with DL cycling may be partly explained by a greater hyperaemic response when reducing active muscle mass. Despite regular endurance training, older athletes had a lower femoral BF in response to maximal self-paced exercise compared with younger athletes.
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Affiliation(s)
- Toni Haddad
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Université Côte d'Azur, LAMHESS, France
| | - Angela L Spence
- Curtin School of Allied Health, Exercise and Sport Science Discipline, Curtin University, WA, Australia
- Curtin Health Innovation Research Institute, Curtin University, WA, Australia
| | - Jeremiah Peiffer
- Centre for Healthy Ageing, Murdoch University, Murdoch, WA, Australia
| | | | | | - Chris R Abbiss
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Ashcroft SP, Stocks B, Egan B, Zierath JR. Exercise induces tissue-specific adaptations to enhance cardiometabolic health. Cell Metab 2024; 36:278-300. [PMID: 38183980 DOI: 10.1016/j.cmet.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
The risk associated with multiple cancers, cardiovascular disease, diabetes, and all-cause mortality is decreased in individuals who meet the current recommendations for physical activity. Therefore, regular exercise remains a cornerstone in the prevention and treatment of non-communicable diseases. An acute bout of exercise results in the coordinated interaction between multiple tissues to meet the increased energy demand of exercise. Over time, the associated metabolic stress of each individual exercise bout provides the basis for long-term adaptations across tissues, including the cardiovascular system, skeletal muscle, adipose tissue, liver, pancreas, gut, and brain. Therefore, regular exercise is associated with a plethora of benefits throughout the whole body, including improved cardiorespiratory fitness, physical function, and glycemic control. Overall, we summarize the exercise-induced adaptations that occur within multiple tissues and how they converge to ultimately improve cardiometabolic health.
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Affiliation(s)
- Stephen P Ashcroft
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ben Stocks
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Juleen R Zierath
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Integrative Physiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Integrative Physiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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Guo M, Diaz-Canestro C, Ng MY, Yiu KH, Montero D. The Chinese cardiorespiratory and circulatory system at work in women and men: a case-control study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100975. [PMID: 38058739 PMCID: PMC10696127 DOI: 10.1016/j.lanwpc.2023.100975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 12/08/2023]
Abstract
Background The physiology of prominent prognostic factors in the cardiorespiratory system remains unchartered in the world's largest ethnic group: Hans Chinese (HC). This study assessed and contrasted the fundamental variables in HC and European-American (EA) individuals. Methods Healthy HC and EA adults (n = 140, 43% ♀) closely matched by age, sex and physical activity were included. Body composition (DXA) and haematological variables (haemoglobin mass, blood volume (BV)) were measured at rest. Pulmonary O2 uptake (VO2) measurements along with cycle ergometry designed for accurate transthoracic echocardiography were implemented to assess cardiorespiratory structure/function up to peak effort. Findings HC presented with higher body fat and lower lean body mass (LBM) percentage than EA irrespective of sex (P ≤ 0.014). BV did not differ whereas blood haemoglobin concentration was lower in HC compared with EA, particularly in females (P = 0.009). Myocardial diastolic and overall function at rest was enhanced in HC versus EA (P < 0.001). During exercise, heart volumes and output per unit of body size did not differ between ethnicities, whereas larger heart volumes per unit of LBM were found in HC versus EA in females (P ≤ 0.003). At high exercise intensities, VO2 (-16%) and the arteriovenous O2 difference (-28%) were markedly reduced in HC compared with EA in females (P ≤ 0.024). In males, no physiological difference between HC and EA was observed during exercise. Interpretation Notwithstanding lower LBM, HC are characterised by similar BV and cardiac capacity but reduced peak VO2 than EA in females, partly explained by low ethnic-specific blood O2 carrying capacity. Funding Early Career Scheme (106210224, to D.M.) and Seed Fund (104006024, to D.M.).
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Affiliation(s)
- Meihan Guo
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Ming-Yen Ng
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Diagnostic Radiology, HKU-Shenzhen Hospital and Li Ka Shing Faculty of Medicine, The University of Hong Kong, Shenzhen, Hong Kong, China
| | - Kai Hang Yiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - David Montero
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
- Libin Cardiovascular Institute of Alberta, University of Calgary, Canada
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Koch Esteves N, Khir AW, González‐Alonso J. Lower limb hyperthermia augments functional hyperaemia during small muscle mass exercise similarly in trained elderly and young humans. Exp Physiol 2023; 108:1154-1171. [PMID: 37409754 PMCID: PMC10988472 DOI: 10.1113/ep091275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
NEW FINDINGS What is the central question of the study? Ageing is postulated to lead to underperfusion of human limb tissues during passive and exertional hyperthermia, but findings to date have been equivocal. Thus, does age have an independent adverse effect on local haemodynamics during passive single-leg hyperthermia, single-leg knee-extensor exercise and their combination? What is the main finding and its importance? Local hyperthermia increased leg blood flow over three-fold and had an additive effect during knee-extensor exercise with no absolute differences in leg perfusion between the healthy, exercise-trained elderly and the young groups. Our findings indicate that age per se does not compromise lower limb hyperaemia during local hyperthermia and/or small muscle mass exercise. ABSTRACT Heat and exercise therapies are recommended to improve vascular health across the lifespan. However, the haemodynamic effects of hyperthermia, exercise and their combination are inconsistent in young and elderly people. Here we investigated the acute effects of local-limb hyperthermia and exercise on limb haemodynamics in nine healthy, trained elderly (69 ± 5 years) and 10 young (26 ± 7 years) adults, hypothesising that the combination of local hyperthermia and exercise interact to increase leg perfusion, albeit to a lesser extent in the elderly. Participants underwent 90 min of single whole-leg heating, with the contralateral leg remaining as control, followed by 10 min of low-intensity incremental single-leg knee-extensor exercise with both the heated and control legs. Temperature profiles and leg haemodynamics at the femoral and popliteal arteries were measured. In both groups, heating increased whole-leg skin temperature and blood flow by 9.5 ± 1.2°C and 0.7 ± 0.2 L min-1 (>3-fold), respectively (P < 0.0001). Blood flow in the heated leg remained 0.7 ± 0.6 and 1.0 ± 0.8 L min-1 higher during exercise at 6 and 12 W, respectively (P < 0.0001). However, there were no differences in limb haemodynamics between cohorts, other than the elderly group exhibiting a 16 ± 6% larger arterial diameter and a 51 ± 6% lower blood velocity following heating (P < 0.0001). In conclusion, local hyperthermia-induced limb hyperperfusion and/or small muscle mass exercise hyperaemia are preserved in trained older people despite evident age-related structural and functional alterations in their leg conduit arteries.
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Affiliation(s)
- Nuno Koch Esteves
- Division of Sport, Health, and Exercise Sciences, Department of Life SciencesBrunel University LondonUxbridgeUK
| | | | - José González‐Alonso
- Division of Sport, Health, and Exercise Sciences, Department of Life SciencesBrunel University LondonUxbridgeUK
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Effects of Concurrent Strength and Endurance Training on Measures of Physical Fitness in Healthy Middle-Aged and Older Adults: A Systematic Review with Meta-Analysis. Sports Med 2023; 53:437-455. [PMID: 36222981 PMCID: PMC9876872 DOI: 10.1007/s40279-022-01764-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is evidence that in older adults the combination of strength training (ST) and endurance training (ET) (i.e., concurrent training [CT]) has similar effects on measures of muscle strength and cardiorespiratory endurance (CRE) compared with single-mode ST or ET, respectively. Therefore, CT seems to be an effective method to target broad aspects of physical fitness in older adults. OBJECTIVES The aim was to examine the effects of CT on measures of physical fitness (i.e., muscle strength, power, balance and CRE) in healthy middle-aged and older adults aged between 50 and 73 years. We also aimed to identify key moderating variables to guide training prescription. STUDY DESIGN We conducted a systematic review with meta-analysis of randomized controlled trials. DATA SOURCES The electronic databases PubMed, Web of Science Core Collection, MEDLINE and Google Scholar were systematically searched until February 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomized controlled trials that examined the effects of CT versus passive controls on measures of physical fitness in healthy middle-aged and older adults aged between 50 and 73 years. RESULTS Fifteen studies were eligible, including a total of 566 participants. CT induced moderate positive effects on muscle strength (standardized mean difference [SMD] = 0.74) and power (SMD = 0.50), with a small effect on CRE (SMD = 0.48). However, no significant effects were detected for balance (p > 0.05). Older adults > 65 years (SMD = 1.04) and females (SMD = 1.05) displayed larger improvements in muscle strength compared with adults ≤ 65 years old (SMD = 0.60) and males (SMD = 0.38), respectively. For CRE, moderate positive effects (SMD = 0.52) were reported in those ≤ 65 years old only, with relatively larger gains in females (SMD = 0.55) compared with males (SMD = 0.45). However, no significant differences between all subgroups were detected. Independent single training factor analysis indicated larger positive effects of 12 weeks (SMD = 0.87 and 0.88) compared with 21 weeks (SMD = 0.47 and 0.29) of CT on muscle strength and power, respectively, while for CRE, 21 weeks of CT resulted in larger gains (SMD = 0.62) than 12 weeks (SMD = 0.40). For CT frequency, three sessions per week produced larger beneficial effects (SMD = 0.91) on muscle strength compared with four sessions (SMD = 0.55), whereas for CRE, moderate positive effects were only noted after four sessions per week (SMD = 0.58). A session duration of > 30-60 min generated larger improvements in muscle strength (SMD = 0.99) and power (SMD = 0.88) compared with > 60-90 min (SMD = 0.40 and 0.29, respectively). However, for CRE, longer session durations (i.e., > 60-90 min) seem to be more effective (SMD = 0.61) than shorter ones (i.e., > 30-60 min) (SMD = 0.34). ET at moderate-to-near maximal intensities produced moderate (SMD = 0.64) and small positive effects (SMD = 0.49) on muscle strength and CRE, respectively, with no effects at low intensity ET (p > 0.05). Finally, intra-session ST before ET produced larger gains in muscle strength (SMD = 1.00) compared with separate sessions (SMD = 0.55), whereas ET and ST carried out separately induced larger improvements in CRE (SMD = 0.58) compared with intra-session ET before ST (SMD = 0.49). CONCLUSIONS CT is an effective method to improve measures of physical fitness (i.e., muscle strength, power, and CRE) in healthy middle-aged and older adults aged between 50 and 73 years, regardless of sex. Results of independent single training factor analysis indicated that the largest effects on muscle strength were observed after 12 weeks of training, > 30-60 min per session, three sessions per week, higher ET intensities and when ST preceded ET within the same session. For CRE, the largest effects were noted after 21 weeks of training, four sessions per week, > 60-90 min per session, higher ET intensities and when ET and ST sessions were performed separately. Regarding muscle power, the largest effects were observed after 12 weeks of training and > 30-60 min per session.
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Md MA, Parrott CF, Ph D MJH, Ph D PHB, Md FY, Md BU. Skeletal muscle abnormalities in heart failure with preserved ejection fraction. Heart Fail Rev 2023; 28:157-168. [PMID: 35353269 DOI: 10.1007/s10741-022-10219-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 02/07/2023]
Abstract
Almost half of all heart failure (HF) disease burden is due to HF with preserved ejection fraction (HFpEF). The primary symptom in patients with HFpEF, even when well compensated, is severe exercise intolerance and is associated with their reduced quality of life. Recently, studies showed that HFpEF patients have multiple skeletal muscle (SM) abnormalities, and these are associated with decreased exercise intolerance. The SM abnormalities are likely intrinsic to the HFpEF syndrome, not a secondary consequence of an epiphenomenon. These abnormalities are decreased muscle mass, reduced type I (oxidative) muscle fibers, and reduced type I-to-type II fiber ratio as well as a reduced capillary-to-fiber ratio, abnormal fat infiltration into the thigh SM, increased levels of atrophy genes and proteins, reduction in mitochondrial content, and rapid depletion of high-energy phosphate during exercise with markedly delayed repletion of high-energy phosphate during recovery in mitochondria. In addition, patients with HFpEF have impaired nitric oxide bioavailability, particularly in the microvasculature. These SM abnormalities may be responsible for impaired diffusive oxygen transport and/or impaired SM oxygen extraction. To date, exercise training (ET) and caloric restriction are some of the interventions shown to improve outcomes in HFpEF patients. Improvements in exercise tolerance following aerobic ET are largely mediated through peripheral SM adaptations with minimal change in central hemodynamics and highlight the importance of targeting SM to improve exercise intolerance in HFpEF. Focusing on the abnormalities mentioned above may improve the clinical condition of patients with HFpEF.
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Affiliation(s)
- Matthew Anderson Md
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA
| | - Clifton Forrest Parrott
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA
| | - Mark J Haykowsky Ph D
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Peter H Brubaker Ph D
- Department of Health and Exercise Science, Wake Forest School of Medicine, Winston-Salem, USA
| | - Fan Ye Md
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA
| | - Bharathi Upadhya Md
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA.
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Gong X, Hu M, Li M. Relationship of arterial tonometry and exercise in patients with chronic heart failure: a systematic review with meta-analysis and trial sequential analysis. BMC Cardiovasc Disord 2022; 22:345. [PMID: 35909113 PMCID: PMC9341099 DOI: 10.1186/s12872-022-02792-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Arterial stiffness is a common characteristic in patients with chronic heart failure (CHF), and arterial tonometric technologies related to arterial stiffness are novel and effective methods and have an important value in the diagnosis and prognosis of CHF. In terms of ameliorating arterial stiffness in patients with CHF, exercise training is considered an adjuvant treatment and also an effective means in the diagnosis and judgment of prognosis. However, there are huge controversies and inconsistencies in these aspects. The objective of this meta-analysis was to systematically test the connection of arterial tonometry and exercise in patients with CHF. METHODS Databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, were accessed from inception to 7 March 2022. The meta-analysis was then conducted, and trial sequential analysis (TSA) was performed jointly to further verify our tests and reach more convincing conclusions by using RevMan version 5.4 software, STATA version 16.0 software, and TSA version 0.9.5.10 Beta software. RESULTS Eighteen articles were included, with a total of 876 participants satisfying the inclusion criteria. The pooling revealed that flow-mediated dilation (FMD) was lower in basal condition [standardized mean difference (SMD): - 2.28%, 95% confidence interval (CI) - 3.47 to - 1.08, P < 0.001] and improved significantly after exercise (SMD: 5.96%, 95% CI 2.81 to 9.05, P < 0.001) in patients with heart failure with reduced ejection fraction (HFrEF) compared with healthy participants. The high-intensity training exercise was more beneficial (SMD: 2.88%, 95% CI 1.78 to 3.97, P < 0.001) than the moderate-intensity training exercise to improve FMD in patients with CHF. For augmentation index (AIx), our study indicated no significant differences (SMD: 0.50%, 95% CI - 0.05 to 1.05, P = 0.074) in patients with heart failure with preserved ejection fraction (HFpEF) compared with healthy participants. However, other outcomes of our study were not identified after further verification using TSA, and more high-quality studies are needed to reach definitive conclusions in the future. CONCLUSIONS This review shows that FMD is lower in basal condition and improves significantly after exercise in patients with HFrEF compared with healthy population; high-intensity training exercise is more beneficial than moderate-intensity training exercise to improve FMD in patients with CHF; besides, there are no significant differences in AIx in patients with HFpEF compared with the healthy population. More high-quality studies on this topic are warranted.
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Affiliation(s)
- Xiaodan Gong
- Department of Cardiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Mengwen Hu
- Department of Experimental Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Mei Li
- Institute of Physiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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10
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Balci GA, As H, Ozkaya O, Colakoglu M. Development potentials of commonly used high-intensity training strategies on central and peripheral components of maximal oxygen consumption. Respir Physiol Neurobiol 2022; 302:103910. [PMID: 35405332 DOI: 10.1016/j.resp.2022.103910] [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: 01/22/2022] [Revised: 03/16/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
The aim of this study was to reveal the development potentials of five high-intensity training models on central and peripheral components of maximal oxygen consumption (VO2max). Following VO2max determination, maximal cardiac output (Qmax), maximal stroke volume (SVmax), and maximal arteriovenous O2 difference (a-vO2diff_max) were analysed. Short-interval- (short-HIIT), long-interval (long-HIIT), alternating work-rate continuous (alter-HIT), constant work-rate continuous (const-HIT), and sprint interval (SIT) sessions were performed on separate days with iso-effort and iso-time methods. Time spent (tspent) at > 95% of VO2max was the highest in long-HIIT (p < 0.05). The tspent at > 90% of Qmax was higher in alter-HIT than long-HIIT and SIT (p < 0.05), while there was no significant difference for tspent at > 90% of SVmax amongst high-intensity trainings. The tspent at > 90% of a-vO2diff_max was higher in short-HIIT and long-HIIT than other modalities (p < 0.05). It can be said that continuous modalities seem to have a higher potential to improve central part of VO2max, while interval modalities may be better to develop peripheral component.
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Affiliation(s)
- Gorkem Aybars Balci
- Department of Coaching Education, Faculty of Sports Sciences, Ege University, Turkey
| | - Hakan As
- Department of Sports Health Sciences, Institution of Health Sciences, Ege University, Turkey
| | - Ozgur Ozkaya
- Department of Coaching Education, Faculty of Sports Sciences, Ege University, Turkey
| | - Muzaffer Colakoglu
- Department of Coaching Education, Faculty of Sports Sciences, Ege University, Turkey.
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11
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Nyberg M, Jones AM. Matching of O2 Utilization and O2 Delivery in Contracting Skeletal Muscle in Health, Aging, and Heart Failure. Front Physiol 2022; 13:898395. [PMID: 35774284 PMCID: PMC9237395 DOI: 10.3389/fphys.2022.898395] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/05/2022] [Indexed: 12/12/2022] Open
Abstract
Skeletal muscle is one of the most dynamic metabolic organs as evidenced by increases in metabolic rate of >150-fold from rest to maximal contractile activity. Because of limited intracellular stores of ATP, activation of metabolic pathways is required to maintain the necessary rates of ATP re-synthesis during sustained contractions. During the very early phase, phosphocreatine hydrolysis and anaerobic glycolysis prevails but as activity extends beyond ∼1 min, oxidative phosphorylation becomes the major ATP-generating pathway. Oxidative metabolism of macronutrients is highly dependent on the cardiovascular system to deliver O2 to the contracting muscle fibres, which is ensured through a tight coupling between skeletal muscle O2 utilization and O2 delivery. However, to what extent O2 delivery is ideal in terms of enabling optimal metabolic and contractile function is context-dependent and determined by a complex interaction of several regulatory systems. The first part of the review focuses on local and systemic mechanisms involved in the regulation of O2 delivery and how integration of these influences the matching of skeletal muscle O2 demand and O2 delivery. In the second part, alterations in cardiovascular function and structure associated with aging and heart failure, and how these impact metabolic and contractile function, will be addressed. Where applicable, the potential of exercise training to offset/reverse age- and disease-related cardiovascular declines will be highlighted in the context of skeletal muscle metabolic function. The review focuses on human data but also covers animal observations.
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Affiliation(s)
- Michael Nyberg
- Vascular Biology, Global Drug Discovery, Novo Nordisk A/S, Maaloev, Denmark
- *Correspondence: Michael Nyberg,
| | - Andrew M. Jones
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
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12
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Roh J, Hill JA, Singh A, Valero-Muñoz M, Sam F. Heart Failure With Preserved Ejection Fraction: Heterogeneous Syndrome, Diverse Preclinical Models. Circ Res 2022; 130:1906-1925. [PMID: 35679364 PMCID: PMC10035274 DOI: 10.1161/circresaha.122.320257] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) represents one of the greatest challenges facing cardiovascular medicine today. Despite being the most common form of heart failure worldwide, there has been limited success in developing therapeutics for this syndrome. This is largely due to our incomplete understanding of the biology driving its systemic pathophysiology and the heterogeneity of clinical phenotypes, which are increasingly being recognized as distinct HFpEF phenogroups. Development of efficacious therapeutics fundamentally relies on robust preclinical models that not only faithfully recapitulate key features of the clinical syndrome but also enable rigorous investigation of putative mechanisms of disease in the context of clinically relevant phenotypes. In this review, we propose a preclinical research strategy that is conceptually grounded in model diversification and aims to better align with our evolving understanding of the heterogeneity of clinical HFpEF. Although heterogeneity is often viewed as a major obstacle in preclinical HFpEF research, we challenge this notion and argue that embracing it may be the key to demystifying its pathobiology. Here, we first provide an overarching guideline for developing HFpEF models through a stepwise approach of comprehensive cardiac and extra-cardiac phenotyping. We then present an overview of currently available models, focused on the 3 leading phenogroups, which are primarily based on aging, cardiometabolic stress, and chronic hypertension. We discuss how well these models reflect their clinically relevant phenogroup and highlight some of the more recent mechanistic insights they are providing into the complex pathophysiology underlying HFpEF.
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Affiliation(s)
- Jason Roh
- Cardiovascular Research Center, Massachusetts General Hospital, Boston (J.R., A.S.)
| | - Joseph A Hill
- Department of Internal Medicine (Cardiology) (J.A.H.), University of Texas Southwestern Medical Center, Dallas
- Department of Molecular Biology (J.A.H.), University of Texas Southwestern Medical Center, Dallas
| | - Abhilasha Singh
- Cardiovascular Research Center, Massachusetts General Hospital, Boston (J.R., A.S.)
| | - María Valero-Muñoz
- Whitaker Cardiovascular Institute, Boston University School of Medicine, MA (M.V.-M., F.S.)
| | - Flora Sam
- Whitaker Cardiovascular Institute, Boston University School of Medicine, MA (M.V.-M., F.S.)
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13
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DeLorey DS. Sympathetic vasoconstriction in skeletal muscle: Modulatory effects of aging, exercise training, and sex. Appl Physiol Nutr Metab 2021; 46:1437-1447. [PMID: 34348066 DOI: 10.1139/apnm-2021-0399] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as peripheral vascular resistance and blood pressure at rest and during exercise. Aging is associated with increased blood pressure and decreased skeletal muscle blood flow at rest and in response to exercise. The mechanisms responsible for the blunted skeletal muscle blood flow response to dynamic exercise with aging have not been fully elucidated; however, increased muscle sympathetic nerve activity (MSNA), elevated vascular resistance and a decline in endothelium-dependent vasodilation are commonly reported in older adults. In contrast to aging, exercise training has been shown to reduce blood pressure and enhance skeletal muscle vascular function. Exercise training has been shown to enhance nitric oxide-dependent vascular function and may improve the vasodilatory capacity of the skeletal muscle vasculature; however, surprisingly little is known about the effect of exercise training on the neural control of circulation. The control of blood pressure and skeletal muscle blood flow also differs between males and females. Blood pressure and MSNA appear to be lower in young females compared to males. However, females experience a larger increase in MSNA with aging compared to males. The mechanism(s) for the altered SNS control of vascular function in females remain to be determined. Novelty: • This review will summarize our current understanding of the effects of aging, exercise training and sex on sympathetic vasoconstriction at rest and during exercise. • Areas where additional research is needed are also identified.
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Affiliation(s)
- Darren S DeLorey
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
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14
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Langan SP, Grosicki GJ. Exercise Is Medicine…and the Dose Matters. Front Physiol 2021; 12:660818. [PMID: 34054576 PMCID: PMC8149792 DOI: 10.3389/fphys.2021.660818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Affiliation(s)
- Sean P Langan
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, United States
| | - Gregory J Grosicki
- Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, GA, United States
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15
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Yang G, Qian T, Sun H, Xu Q, Hou X, Hu W, Zhang G, Drummond GR, Sobey CG, Witting PK, Denton KM, Charchar FJ, Golledge J, Wang Y. Adjustment for body mass index changes inverse associations of HDL-cholesterol with blood pressure and hypertension to positive associations. J Hum Hypertens 2021; 36:570-579. [PMID: 33976343 DOI: 10.1038/s41371-021-00548-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 11/09/2022]
Abstract
The associations between high-density lipoprotein cholesterol (HDL-C) and blood pressure (BP) or hypertension are inconsistent in previous studies. This study aimed to assess these associations in a large cohort of Chinese adults and across different age groups. This cross-sectional association study included 22,081 Chinese adults. Associations of HDL-C with BP and hypertension were analyzed using linear or logistic regression, with or without adjustment for confounding factors. HDL-C was inversely associated with BP and hypertension. These associations were still apparent after adjustment for age, sex, fasting plasma glucose, and low-density lipoprotein cholesterol. Sub-analyses revealed: (1) in the whole cohort and females alone, HDL-C was inversely associated with BP and hypertension in young and middle-aged but not older participants; (2) in males alone, HDL-C was not associated with systolic BP or hypertension. However, HDL-C was either inversely, or not, or positively associated with BP in young, middle-aged, and older males, respectively. After further adjustment for body mass index (BMI), the negative associations of HDL-C with BP and hypertension in the whole cohort became positive ones, and the positive associations only presented in males. These findings suggest that further adjustment for BMI changes inverse associations of HDL-cholesterol with BP and hypertension to positive associations in a cohort of Chinese adults.
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Affiliation(s)
- Guang Yang
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China.
| | - Tingting Qian
- Department of Geriatric Medicine, School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Hui Sun
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Qun Xu
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Xujuan Hou
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Wenqi Hu
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Guang Zhang
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Grant R Drummond
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Christopher G Sobey
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Paul K Witting
- Discipline of Pathology, School of Medical Sciences, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Kate M Denton
- Department of Physiology, Monash University, Melbourne, VIC, Australia.,Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Fadi J Charchar
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.,Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, QLD, Australia
| | - Yutang Wang
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia.
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16
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Williams JS, Dunford EC, Cheng JL, Moncion K, Valentino SE, Droog CA, Cherubini JM, King TJ, Noguchi KS, Wiley E, Turner JR, Tang A, Al-Khazraji BK, MacDonald MJ. The impact of the 24-h movement spectrum on vascular remodeling in older men and women: a review. Am J Physiol Heart Circ Physiol 2021; 320:H1136-H1155. [PMID: 33449851 DOI: 10.1152/ajpheart.00754.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Aging is associated with increased risk of cardiovascular and cerebrovascular events, which are preceded by early, negative remodeling of the vasculature. Low physical activity is a well-established risk factor associated with the incidence and development of disease. However, recent physical activity literature indicates the importance of considering the 24-h movement spectrum. Therefore, the purpose of this review was to examine the impact of the 24-h movement spectrum, specifically physical activity (aerobic and resistance training), sedentary behavior, and sleep, on cardiovascular and cerebrovascular outcomes in older adults, with a focus on recent evidence (<10 yr) and sex-based considerations. The review identifies that both aerobic training and being physically active (compared with sedentary) are associated with improvements in endothelial function, arterial stiffness, and cerebrovascular function. Additionally, there is evidence of sex-based differences in endothelial function: a blunted improvement in aerobic training in postmenopausal women compared with men. While minimal research has been conducted in older adults, resistance training does not appear to influence arterial stiffness. Poor sleep quantity or quality are associated with both impaired endothelial function and increased arterial stiffness. Finally, the review highlights mechanistic pathways involved in the regulation of vascular and cerebrovascular function, specifically the balance between pro- and antiatherogenic factors, which mediate the relationship between the 24-h movement spectrum and vascular outcomes. Finally, this review proposes future research directions: examining the role of duration and intensity of training, combining aerobic and resistance training, and exploration of sex-based differences in cardiovascular and cerebrovascular outcomes.
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Affiliation(s)
- Jennifer S Williams
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Emily C Dunford
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Jem L Cheng
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Kevin Moncion
- MacStroke Canada, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sydney E Valentino
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Connor A Droog
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Joshua M Cherubini
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Trevor J King
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Kenneth S Noguchi
- MacStroke Canada, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Elise Wiley
- MacStroke Canada, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joshua R Turner
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Ada Tang
- MacStroke Canada, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Maureen J MacDonald
- Vascular Dynamics Lab, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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17
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Skattebo Ø, Calbet JAL, Rud B, Capelli C, Hallén J. Contribution of oxygen extraction fraction to maximal oxygen uptake in healthy young men. Acta Physiol (Oxf) 2020; 230:e13486. [PMID: 32365270 PMCID: PMC7540168 DOI: 10.1111/apha.13486] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/16/2022]
Abstract
We analysed the importance of systemic and peripheral arteriovenous O2 difference (
a-v¯O2 difference and a‐vfO2 difference, respectively) and O2 extraction fraction for maximal oxygen uptake (
V˙O2max). Fick law of diffusion and the Piiper and Scheid model were applied to investigate whether diffusion versus perfusion limitations vary with
V˙O2max. Articles (n = 17) publishing individual data (n = 154) on
V˙O2max, maximal cardiac output (
Q˙max; indicator‐dilution or the Fick method),
a-v¯O2 difference (catheters or the Fick equation) and systemic O2 extraction fraction were identified. For the peripheral responses, group‐mean data (articles: n = 27; subjects: n = 234) on leg blood flow (LBF; thermodilution), a‐vfO2 difference and O2 extraction fraction (arterial and femoral venous catheters) were obtained.
Q˙max and two‐LBF increased linearly by 4.9‐6.0 L · min–1 per 1 L · min–1 increase in
V˙O2max (R2 = .73 and R2 = .67, respectively; both P < .001). The
a-v¯O2 difference increased from 118‐168 mL · L–1 from a
V˙O2max of 2‐4.5 L · min–1 followed by a reduction (second‐order polynomial: R2 = .27). After accounting for a hypoxemia‐induced decrease in arterial O2 content with increasing
V˙O2max (R2 = .17; P < .001), systemic O2 extraction fraction increased up to ~90% (
V˙O2max: 4.5 L · min–1) with no further change (exponential decay model: R2 = .42). Likewise, leg O2 extraction fraction increased with
V˙O2max to approach a maximal value of ~90‐95% (R2 = .83). Muscle O2 diffusing capacity and the equilibration index Y increased linearly with
V˙O2max (R2 = .77 and R2 = .31, respectively; both P < .01), reflecting decreasing O2 diffusional limitations and accentuating O2 delivery limitations. In conclusion, although O2 delivery is the main limiting factor to
V˙O2max, enhanced O2 extraction fraction (≥90%) contributes to the remarkably high
V˙O2max in endurance‐trained individuals.
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Affiliation(s)
- Øyvind Skattebo
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
| | - Jose A. L. Calbet
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS) University of Las Palmas de Gran Canaria Gran Canaria Spain
| | - Bjarne Rud
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
| | - Carlo Capelli
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
- Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Jostein Hallén
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
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18
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Skattebo Ø, Capelli C, Rud B, Auensen M, Calbet JAL, Hallén J. Increased oxygen extraction and mitochondrial protein expression after small muscle mass endurance training. Scand J Med Sci Sports 2020; 30:1615-1631. [PMID: 32403173 DOI: 10.1111/sms.13707] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/06/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
When exercising with a small muscle mass, the mass-specific O2 delivery exceeds the muscle oxidative capacity resulting in a lower O2 extraction compared with whole-body exercise. We elevated the muscle oxidative capacity and tested its impact on O2 extraction during small muscle mass exercise. Nine individuals conducted six weeks of one-legged knee extension (1L-KE) endurance training. After training, the trained leg (TL) displayed 45% higher citrate synthase and COX-IV protein content in vastus lateralis and 15%-22% higher pulmonary oxygen uptake ( V ˙ O 2 peak ) and peak power output ( W ˙ peak ) during 1L-KE than the control leg (CON; all P < .05). Leg O2 extraction (catheters) and blood flow (ultrasound Doppler) were measured while both legs exercised simultaneously during 2L-KE at the same submaximal power outputs (real-time feedback-controlled). TL displayed higher O2 extraction than CON (main effect: 1.7 ± 1.6% points; P = .010; 40%-83% of W ˙ peak ) with the largest between-leg difference at 83% of W ˙ peak (O2 extraction: 3.2 ± 2.2% points; arteriovenous O2 difference: 7.1 ± 4.8 mL· L-1 ; P < .001). At 83% of W ˙ peak , muscle O2 conductance (DM O2 ; Fick law of diffusion) and the equilibration index Y were higher in TL (P < .01), indicating reduced diffusion limitations. The between-leg difference in O2 extraction correlated with the between-leg ratio of citrate synthase and COX-IV (r = .72-.73; P = .03), but not with the difference in the capillary-to-fiber ratio (P = .965). In conclusion, endurance training improves O2 extraction during small muscle mass exercise by elevating the muscle oxidative capacity and the recruitment of DM O2, especially evident during high-intensity exercise exploiting a larger fraction of the muscle oxidative capacity.
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Affiliation(s)
- Øyvind Skattebo
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Carlo Capelli
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bjarne Rud
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Marius Auensen
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jose A L Calbet
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Physical Education, University of Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Jostein Hallén
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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19
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Guirgis L, Khraiche D, Ladouceur M, Iserin L, Bonnet D, Legendre A. Cardiac performance assessment during cardiopulmonary exercise test can improve the management of children with repaired congenital heart disease. Int J Cardiol 2020; 300:121-126. [DOI: 10.1016/j.ijcard.2019.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 11/30/2022]
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20
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Pandey A, Kraus WE, Brubaker PH, Kitzman DW. Healthy Aging and Cardiovascular Function: Invasive Hemodynamics During Rest and Exercise in 104 Healthy Volunteers. JACC-HEART FAILURE 2019; 8:111-121. [PMID: 31706837 PMCID: PMC10367061 DOI: 10.1016/j.jchf.2019.08.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the association between age and invasive cardiovascular hemodynamics during upright exercise among healthy adults. BACKGROUND The marked age-related decline in maximal exercise oxygen uptake (peak VO2) may contribute to the high burden of heart failure among older individuals and their greater severity of exertional symptoms. However, the mechanisms underlying this decline are not well understood. METHODS A total of 104 healthy community-dwelling volunteers age 20 to 76 years well screened for cardiovascular disease underwent exhaustive upright exercise with brachial and pulmonary artery catheters; radionuclide ventriculography; and expired gas analysis for the measurement of peak VO2, cardiac output, left ventricular stroke volume, end-diastolic volume, end-systolic volume, ejection fraction, pulmonary capillary wedge pressure, and arteriovenous oxygen difference. RESULTS Over a 5.5-decade age range, there was a 40% decline in peak VO2 due primarily to reduced peak exercise cardiac output; peak arteriovenous oxygen difference was unaffected by age. The lower age-related exercise cardiac output was related to lower peak exercise heart rate and stroke volume. Aging was also associated with lower peak exercise ejection fraction, indicating reduced inotropic reserve. Peak exercise end-diastolic volume was lower with aging despite similar left ventricular filling pressure, suggesting age-related reduced diastolic compliance limiting the use of the Frank-Starling mechanism to compensate for reduced chronotropic and inotropic reserves. These age relationships were unaffected by sex. CONCLUSIONS The age-related decline in exercise capacity among healthy persons is due predominantly to cardiac mechanisms, including reduced chronotropic and inotropic reserve and possibly reduced Frank-Starling reserve. Peak exercise left ventricular filling pressure and arteriovenous oxygen difference are unchanged with healthy aging.
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Affiliation(s)
- Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - William E Kraus
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Peter H Brubaker
- Department of Exercise and Health Science, Wake Forest University, Winston-Salem, North Carolina
| | - Dalane W Kitzman
- Sections on Cardiovascular Medicine and Gerontology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
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21
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Buzza G, Lovell GP, Askew CD, Solomon C. The Effect of Short- and Long-Term Aerobic Training Years on Systemic O2 Utilization, and Muscle and Prefrontal Cortex Tissue Oxygen Extraction in Young Women. J Strength Cond Res 2019; 33:2128-2137. [DOI: 10.1519/jsc.0000000000002512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Socha MJ, Segal SS. Microvascular mechanisms limiting skeletal muscle blood flow with advancing age. J Appl Physiol (1985) 2018; 125:1851-1859. [PMID: 30412030 PMCID: PMC6737458 DOI: 10.1152/japplphysiol.00113.2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 10/22/2018] [Accepted: 11/06/2018] [Indexed: 02/08/2023] Open
Abstract
Effective oxygen delivery to active muscle fibers requires that vasodilation initiated in distal arterioles, which control flow distribution and capillary perfusion, ascends the resistance network into proximal arterioles and feed arteries, which govern total blood flow into the muscle. With exercise onset, ascending vasodilation reflects initiation and conduction of hyperpolarization along endothelium from arterioles into feed arteries. Electrical coupling of endothelial cells to smooth muscle cells evokes the rapid component of ascending vasodilation, which is sustained by ensuing release of nitric oxide during elevated luminal shear stress. Concomitant sympathetic neural activation inhibits ascending vasodilation by stimulating α-adrenoreceptors on smooth muscle cells to constrict the resistance vasculature. We hypothesized that compromised muscle blood flow in advanced age reflects impaired ascending vasodilation through actions on both cell layers of the resistance network. In the gluteus maximus muscle of old (24 mo) vs. young (4 mo) male mice (corresponding to mid-60s vs. early 20s in humans) inhibition of α-adrenoreceptors in old mice restored ascending vasodilation, whereas even minimal activation of α-adrenoreceptors in young mice attenuated ascending vasodilation in the manner seen with aging. Conduction of hyperpolarization along the endothelium is impaired in old vs. young mice because of "leaky" membranes resulting from the activation of potassium channels by hydrogen peroxide released from endothelial cells. Exposing the endothelium of young mice to hydrogen peroxide recapitulates this effect of aging. Thus enhanced α-adrenoreceptor activation of smooth muscle in concert with electrically leaky endothelium restricts muscle blood flow by impairing ascending vasodilation in advanced age.
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Affiliation(s)
- Matthew J Socha
- Biology Department, University of Scranton , Scranton, Pennsylvania
| | - Steven S Segal
- Department of Medical Pharmacology and Physiology, University of Missouri , Columbia, Missouri
- Dalton Cardiovascular Research Center , Columbia, Missouri
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Wezenbeek E, De Clercq D, Mahieu N, Willems T, Witvrouw E. Activity-Induced Increase in Achilles Tendon Blood Flow Is Age and Sex Dependent. Am J Sports Med 2018; 46:2678-2686. [PMID: 30067065 DOI: 10.1177/0363546518786259] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous research of a young adult population identified a lower increase in Achilles tendon blood flow immediately after a running activity as a significant predictor for the development of Achilles tendinopathy (AT). Furthermore, advancing age is often mentioned as a risk factor for the development of AT, and the highest incidence for AT is reported to occur in middle-aged recreational male athletes. PURPOSE To investigate the effect of age, sex, and type of physical activity on the increase in Achilles tendon blood flow. STUDY DESIGN Controlled laboratory study. METHODS Blood flow measurements of 33 subjects aged 18 to 25 years and 30 subjects aged 40 to 55 years were obtained before and after 4 physical activities performed in randomized order: running, cycling, dynamic stretching, and rope skipping. Blood flow measurements of the Achilles tendon were performed before, immediately after, 5 minutes after, and 10 minutes after the physical activities. The effect of age, sex, and physical activities on the increase in blood flow was investigated with linear mixed models. RESULTS The results of this study identified that running, rope skipping, and cycling resulted in a significant increase in tendon blood flow ( P ≤ .001), whereas stretching did not. Prominent was the finding that the increase in blood flow after activity was significantly lower in the older population as compared with the younger population ( P < .001). Furthermore, male participants in the older group showed a significantly lower increase in tendon blood flow than did their female counterparts ( P = .019). CONCLUSION This study identified that sex and age significantly influence the increase in blood flow after activity, possibly explaining the increased risk for AT among middle-aged recreational athletes. CLINICAL RELEVANCE This study possibly identified one of the mechanisms explaining why an older male population is at increased risk for developing AT. Given that the lower increase in blood flow is an identified risk factor according to previous research, preventative measures should focus on improving this blood flow during physical activity in the physically active older male population. Registration: NCT03218605 ( ClinicalTrials.gov identifier).
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Affiliation(s)
- Evi Wezenbeek
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Dirk De Clercq
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Nele Mahieu
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Tine Willems
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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24
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Hughes WE, Kruse NT, Ueda K, Casey DP. Habitual exercise training in older adults offsets the age-related prolongation in leg vasodilator kinetics during single-limb lower body exercise. J Appl Physiol (1985) 2018; 125:746-754. [PMID: 29856264 DOI: 10.1152/japplphysiol.00235.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We tested the hypothesis that aging is associated with prolonged leg vasodilator kinetics and habitual exercise training in older adults improves these responses relative to untrained older adults. Additionally, we examined the relationship between contraction-induced rapid onset vasodilation (ROV) and vasodilator kinetics. Young ( n = 10), older untrained ( n = 13), and older trained ( n = 14) adults performed single and rhythmic knee-extension contractions at 20% and 40% work-rate maximum (WRmax). Femoral artery diameter and mean blood velocity were measured by Doppler ultrasound. Vascular conductance (VC; ml·min-1·mmHg-1) was calculated using blood flow (ml/min) and mean arterial pressure (mmHg). The primary outcome was the kinetic response (mean response time; MRT), modeled using an exponential model, expressed as the number of duty cycles to change 63% of the steady-state amplitude. There were no age- or training-related differences in VC MRT between the groups at 20% WRmax. Older untrained adults exhibited prolonged VC MRT at 40% WRmax relative to young (37 ± 16 vs. 24 ± 10 duty-cycles; P < 0.05) and older trained adults (37 ± 16 vs. 23 ± 14 duty-cycles; P < 0.05). There were no differences in VC MRT between young and older trained adults at 40% WRmax ( P = 0.96). There were no associations between peak ROV and VC MRT at 20% or 40% WRmax ( r = -0.08 and 0.22; P = 0.67 and 0.20, respectively) in the group as a whole. Our data suggest 1) advancing age prolongs leg vasodilator kinetics; 2) habitual exercise training in older adults offsets this age-related prolongation; and 3) contraction-induced ROV is not related to vasodilator kinetics within a group of young and older adults. NEW & NOTEWORTHY Aging is associated with reductions in exercise hyperemia and vasodilation at the onset of exercise, as well as during steady-state exercise. Habitual endurance exercise training offsets these age-related reductions. We found that aging prolongs vasodilator kinetics in the leg of older untrained but not older trained adults. Finally, our results demonstrate that contraction-induced rapid vasodilation is not associated with vasodilator kinetics within the leg of young and older adults.
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Affiliation(s)
- William E Hughes
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa
| | - Nicholas T Kruse
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa.,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa , Iowa City, Iowa
| | - Kenichi Ueda
- Department of Anesthesia, Carver College of Medicine, University of Iowa , Iowa City, Iowa
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa , Iowa City, Iowa.,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa , Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research, Carver College of Medicine, University of Iowa , Iowa City, Iowa
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25
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Bouaziz W, Kanagaratnam L, Vogel T, Schmitt E, Dramé M, Kaltenbach G, Geny B, Lang PO. Effect of Aerobic Training on Peak Oxygen Uptake Among Seniors Aged 70 or Older: A Meta-Analysis of Randomized Controlled Trials. Rejuvenation Res 2018; 21:341-349. [DOI: 10.1089/rej.2017.1988] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Walid Bouaziz
- Geriatric Department, Medical School, University Hospitals of Strasbourg, Strasbourg, France
- Department of Physiology and EA-3072, Medical School, Strasbourg University, Strasbourg, France
- Research Unit of the University of Rouen (EA-3832), UFR STAPS, CETAPS, Mont Saint Aignan, France
| | - Lukshe Kanagaratnam
- Department of Research and Innovation, University Hospitals of Reims, Reims, France
| | - Thomas Vogel
- Geriatric Department, Medical School, University Hospitals of Strasbourg, Strasbourg, France
- Department of Physiology and EA-3072, Medical School, Strasbourg University, Strasbourg, France
| | - Elise Schmitt
- Geriatric Department, Medical School, University Hospitals of Strasbourg, Strasbourg, France
- Department of Physiology and EA-3072, Medical School, Strasbourg University, Strasbourg, France
| | - Moustapha Dramé
- Department of Research and Innovation, University Hospitals of Reims, Reims, France
- EA-3797, Faculty of Medicine, University of Reims-Champagne-Ardenne, Reims, France
| | - Georges Kaltenbach
- Geriatric Department, Medical School, University Hospitals of Strasbourg, Strasbourg, France
| | - Bernard Geny
- Department of Physiology and EA-3072, Medical School, Strasbourg University, Strasbourg, France
- Functional Explorations Department, Medical School, University Hospitals of Strasbourg, Strasbourg, France
| | - Pierre Olivier Lang
- Health and Wellbeing Academy, Anglia Ruskin University, Cambridge, United Kingdom
- Geriatric and Rehabilitation Geriatric Division, University Hospital of Lausanne, Lausanne, Switzerland
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Weavil JC, Hureau TJ, Thurston TS, Sidhu SK, Garten RS, Nelson AD, McNeil CJ, Richardson RS, Amann M. Impact of age on the development of fatigue during large and small muscle mass exercise. Am J Physiol Regul Integr Comp Physiol 2018; 315:R741-R750. [PMID: 29995457 DOI: 10.1152/ajpregu.00156.2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To examine the impact of aging on neuromuscular fatigue following cycling (CYC; large active muscle mass) and single-leg knee-extension (KE; small active muscle mass) exercise, 8 young (25 ± 4 years) and older (72 ± 6 years) participants performed CYC and KE to task failure at a given relative intensity (80% of peak power output). The young also matched CYC and KE workload and duration of the old (iso-work comparison). Peripheral and central fatigue were quantified via pre-/postexercise decreases in quadriceps twitch torque (∆Qtw, electrical femoral nerve stimulation) and voluntary activation (∆VA). Although young performed 77% and 33% more work during CYC and KE, respectively, time to task failure in both modalities was similar to the old (~9.5 min; P > 0.2). The resulting ΔQtw was also similar between groups (CYC ~40%, KE ~55%; P > 0.3); however, ∆VA was, in both modalities, approximately double in the young (CYC ~6%, KE ~9%; P < 0.05). While causing substantial peripheral and central fatigue in both exercise modalities in the old, ∆Qtw in the iso-work comparison was not significant (CYC; P = 0.2), or ~50% lower (KE; P < 0.05) in the young, with no central fatigue in either modality ( P > 0.4). Based on iso-work comparisons, healthy aging impairs fatigue resistance during aerobic exercise. Furthermore, comparisons of fatigue following exercise at a given relative intensity mask the age-related difference observed following exercise performed at the same workload. Finally, although active muscle mass has little influence on the age-related difference in the rate of fatigue at a given relative intensity, it substantially impacts the comparison during exercise at a given absolute intensity.
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Affiliation(s)
- Joshua C Weavil
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center , Salt Lake City, Utah
| | - Thomas J Hureau
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Taylor S Thurston
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Simranjit K Sidhu
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Ryan S Garten
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center , Salt Lake City, Utah
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Chris J McNeil
- School of Health and Exercise Sciences, University of British Columbia , Kelowna , Canada
| | - Russell S Richardson
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center , Salt Lake City, Utah
| | - Markus Amann
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Anesthesiology, University of Utah , Salt Lake City, Utah
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27
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Piil P, Jørgensen TS, Egelund J, Rytter N, Gliemann L, Bangsbo J, Hellsten Y, Nyberg M. Effects of aging and exercise training on leg hemodynamics and oxidative metabolism in the transition from rest to steady-state exercise: role of cGMP signaling. Am J Physiol Regul Integr Comp Physiol 2018; 315:R274-R283. [PMID: 29668326 DOI: 10.1152/ajpregu.00446.2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aging is associated with slower skeletal muscle O2 uptake (V̇o2) kinetics; however, the mechanisms underlying this effect of age are unclear. Also, the effects of exercise training in elderly on the initial vascular and metabolic response to exercise remain to be elucidated. We measured leg hemodynamics and oxidative metabolism in the transition from rest to steady-state exercise engaging the knee-extensor muscles in young ( n = 15, 25 ± 1 yr) and older ( n = 15, 72 ± 1 yr) subjects before and after a period of aerobic high-intensity exercise training. To enhance cGMP signaling, pharmacological inhibition of phosphodiesterase 5 (PDE5) was performed. Before training, the older group had a slower ( P <0.05) increase in femoral arterial blood flow and leg vascular conductance in the transition from rest to steady-state exercise at low- and moderate-intensity compared with the young group. The rate of increase in leg V̇o2 was, however, similar in the two groups as a result of higher ( P < 0.05) arteriovenous O2 difference in the older group. Potentiation of cGMP signaling did not affect the rate of increase in blood flow or V̇o2 in either group. Exercise training augmented ( P < 0.05) the increase in leg vascular conductance and blood flow during the onset of moderate-intensity exercise in both groups without altering V̇o2. These findings suggest that an age-related reduction in the initial vascular response to low- and moderate-intensity knee-extensor exercise is not limiting for V̇o2 in older individuals. A lower blood flow response in aging does not appear to be a result of reduced cGMP signaling.
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Affiliation(s)
- Peter Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark.,Department of Orthopedics, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Jon Egelund
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
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28
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Distefano G, Standley RA, Zhang X, Carnero EA, Yi F, Cornnell HH, Coen PM. Physical activity unveils the relationship between mitochondrial energetics, muscle quality, and physical function in older adults. J Cachexia Sarcopenia Muscle 2018; 9:279-294. [PMID: 29368427 PMCID: PMC5879963 DOI: 10.1002/jcsm.12272] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/01/2017] [Accepted: 10/24/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The concept of mitochondrial dysfunction in ageing muscle is highly controversial. In addition, emerging evidence suggests that reduced muscle oxidative capacity and efficiency underlie the aetiology of mobility loss in older adults. Here, we hypothesized that studying well-phenotyped older cohorts across a wide range of physical activity would unveil a range of mitochondrial function in skeletal muscle and in turn allow us to more clearly examine the impact of age per se on mitochondrial energetics. This also enabled us to more clearly define the relationships between mitochondrial energetics and muscle lipid content with clinically relevant assessments of muscle and physical function. METHODS Thirty-nine volunteers were recruited to the following study groups: young active (YA, n = 2 women/8 men, age = 31.2 ± 5.4 years), older active (OA, n = 2 women/8 men, age = 67.5 ± 2.7 years), and older sedentary (OS, n = 8 women/11 men, age = 70.7 ± 4.7 years). Participants completed a graded exercise test to determine fitness (VO2 peak), a submaximal exercise test to determine exercise efficiency, and daily physical activity was recorded using a tri-axial armband accelerometer. Mitochondrial energetics were determined by (i) 31 P magnetic resonance spectroscopy and (ii) respirometry of fibre bundles from vastus lateralis biopsies. Quadriceps function was assessed by isokinetic dynamometry and physical function by the short physical performance battery and stair climb test. RESULTS Daily physical activity energy expenditure was significantly lower in OS, compared with YA and OA groups. Despite fitness being higher in YA compared with OA and OS, mitochondrial respiration, maximum mitochondrial capacity, Maximal ATP production/Oxygen consumption (P/O) ratio, and exercise efficiency were similar in YA and OA groups and were significantly lower in OS. P/O ratio was correlated with exercise efficiency. Time to complete the stair climb and repeated chair stand tests were significantly greater for OS. Interestingly, maximum mitochondrial capacity was related to muscle contractile performance and physical function. CONCLUSIONS Older adults who maintain a high amount of physical activity have better mitochondrial capacity, similar to highly active younger adults, and this is related to their better muscle quality, exercise efficiency, and physical performance. This suggests that mitochondria could be an important therapeutic target for sedentary ageing associated conditions including sarcopenia, dynapenia, and loss of physical function.
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Affiliation(s)
- Giovanna Distefano
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Robert A Standley
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Xiaolei Zhang
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Elvis A Carnero
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Fanchao Yi
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Heather H Cornnell
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA
| | - Paul M Coen
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 East Princeton Street, Orlando, FL, 32804, USA.,Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, 6400 Sanger Rd, Orlando, FL, 32827, USA
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29
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Reilly H, Lane LM, Egaña M. Lack of age-specific influence on leg blood flow during incremental calf plantar-flexion exercise in men and women. Eur J Appl Physiol 2018; 118:989-1001. [PMID: 29502172 DOI: 10.1007/s00421-018-3833-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/21/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Age-related exercising leg blood flow (LBF) responses during dynamic knee-extension exercise and forearm blood flow responses during handgrip exercise are preserved in normally active men but attenuated in activity-matched women. We explored whether these age- and sex-specific effects are also apparent during isometric calf plantar-flexion incremental exercise. METHODS Normally active young men (YM, n = 15, 24 ± 2 years), young women (YW, n = 8, 22 ± 1 years), older men (OM, n = 13, 70 ± 7 years) and older women (OW, n = 10, 64 ± 7 years) were tested. LBF was measured between contractions using venous occlusion plethysmography. RESULTS Peak force obtained was higher (P < 0.05) in men compared with women and in young compared with older individuals. However, peak LBF (YM; 971 ± 328 ml min-1, OM; 985 ± 504 ml min-1, YW; 844 ± 366 ml min-1, OW; 960 ± 244 ml min-1) and peak leg vascular conductance [LVC = LBF/(MAP + hydrostatic pressure)] responses (YM; 6.0 ± 1.8 ml min-1 mmHg-1, OM; 5.5 ± 2.8 ml min-1 mmHg-1, YW; 5.3 ± 2.1 ml min-1 mmHg-1, OW; 5.5 ± 1.6 ml min-1 mmHg-1) were similar among the four groups. Furthermore, the hyperaemic (YM; 8.8 ± 3.7 ml min-1 %Fpeak-1 OM; 8.3 ± 5.4 ml min-1 %Fpeak-1, YW; 8.2 ± 3.5 ml min-1 %Fpeak-1, OW; 9.6 ± 2.2 ml min-1 %Fpeak-1) and vasodilatory responses (YM; 0.053 ± 0.020 ml min-1 mmHg-1 %Fpeak-1, OM; 0.048 ± 0.028 ml min-1 mmHg-1 %Fpeak-1, YW; 0.051 ± 0.019 ml min-1 mmHg-1 %Fpeak-1, OW; 0.055 ± 0.014 ml min-1 mmHg-1 %Fpeak-1) were not different among the four groups. These results were accompanied by similar resting LBF responses among groups and were not affected when data were normalised to estimated leg muscle mass. CONCLUSIONS Our results demonstrate that exercising LBF responses during isometric incremental calf muscle exercise are preserved in older men and women, suggesting that the previously observed age-related attenuations in leg and forearm hyperaemia among women may be muscle-group specific.
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Affiliation(s)
- Heather Reilly
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Louise M Lane
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Mikel Egaña
- Department of Physiology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
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30
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Wray DW, Amann M, Richardson RS. Peripheral vascular function, oxygen delivery and utilization: the impact of oxidative stress in aging and heart failure with reduced ejection fraction. Heart Fail Rev 2018; 22:149-166. [PMID: 27392715 DOI: 10.1007/s10741-016-9573-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The aging process appears to be a precursor to many age-related diseases, perhaps the most impactful of which is cardiovascular disease (CVD). Heart disease, a manifestation of CVD, is the leading cause of death in the USA, and heart failure (HF), a syndrome that develops as a consequence of heart disease, now affects almost six million American. Importantly, as this is an age-related disease, this number is likely to grow along with the ever-increasing elderly population. Hallmarks of the aging process and HF patients with a reduced ejection fraction (HFrEF) include exercise intolerance, premature fatigue, and limited oxygen delivery and utilization, perhaps as a consequence of diminished peripheral vascular function. Free radicals and oxidative stress have been implicated in this peripheral vascular dysfunction, as a redox imbalance may directly impact the function of the vascular endothelium. This review aims to bring together studies that have examined the impact of oxidative stress on peripheral vascular function and oxygen delivery and utilization with both healthy aging and HFrEF.
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Affiliation(s)
- D Walter Wray
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA
| | - Markus Amann
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
- Geriatric Research, Education, and Clinical Center, VA Medical Center, Bldg 2, Rm 1D25, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA.
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HOWDEN ERINJ, CARRICK-RANSON GRAEME, SARMA SATYAM, HIEDA MICHINARI, FUJIMOTO NAOKI, LEVINE BENJAMIND. Effects of Sedentary Aging and Lifelong Exercise on Left Ventricular Systolic Function. Med Sci Sports Exerc 2018; 50:494-501. [DOI: 10.1249/mss.0000000000001464] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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32
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Chantler PD. Arterial Ventricular Uncoupling With Age and Disease and Recoupling With Exercise. Exerc Sport Sci Rev 2018; 45:70-79. [PMID: 28072585 DOI: 10.1249/jes.0000000000000100] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Paul D Chantler
- 1Division of Exercise Physiology, School of Medicine; and 2Center for Cardiovascular and Respiratory Sciences, Health Sciences Center, West Virginia University, Morgantown, WV
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Okushima D, Poole DC, Barstow TJ, Rossiter HB, Kondo N, Bowen TS, Amano T, Koga S. Greater V˙O2peak is correlated with greater skeletal muscle deoxygenation amplitude and hemoglobin concentration within individual muscles during ramp-incremental cycle exercise. Physiol Rep 2018; 4:4/23/e13065. [PMID: 27986837 PMCID: PMC5260088 DOI: 10.14814/phy2.13065] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/03/2016] [Indexed: 11/24/2022] Open
Abstract
It is axiomatic that greater aerobic fitness (V˙O2peak) derives from enhanced perfusive and diffusive O2 conductances across active muscles. However, it remains unknown how these conductances might be reflected by regional differences in fractional O2 extraction (i.e., deoxy [Hb+Mb] and tissue O2 saturation [StO2]) and diffusive O2 potential (i.e., total[Hb+Mb]) among muscles spatially heterogeneous in blood flow, fiber type, and recruitment (vastus lateralis, VL; rectus femoris, RF). Using quantitative time‐resolved near‐infrared spectroscopy during ramp cycling in 24 young participants (V˙O2peak range: ~37.4–66.4 mL kg−1 min−1), we tested the hypotheses that (1) deoxy[Hb+Mb] and total[Hb+Mb] at V˙O2peak would be positively correlated with V˙O2peak in both VL and RF muscles; (2) the pattern of deoxygenation (the deoxy[Hb+Mb] slopes) during submaximal exercise would not differ among subjects differing in V˙O2peak. Peak deoxy [Hb+Mb] and StO2 correlated with V˙O2peak for both VL (r = 0.44 and −0.51) and RF (r = 0.49 and −0.49), whereas for total[Hb+Mb] this was true only for RF (r = 0.45). Baseline deoxy[Hb+Mb] and StO2 correlated with V˙O2peak only for RF (r = −0.50 and 0.54). In addition, the deoxy[Hb+Mb] slopes were not affected by aerobic fitness. In conclusion, while the pattern of deoxygenation (the deoxy[Hb+Mb] slopes) did not differ between fitness groups the capacity to deoxygenate [Hb+Mb] (index of maximal fractional O2 extraction) correlated significantly with V˙O2peak in both RF and VL muscles. However, only in the RF did total[Hb+Mb] (index of diffusive O2 potential) relate to fitness.
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Affiliation(s)
- Dai Okushima
- Applied Physiology Laboratory, Kobe Design University, Kobe, Japan
| | - David C Poole
- Departments of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Thomas J Barstow
- Departments of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Harry B Rossiter
- Rehabilitation Clinical Trials Center, Division of Respiratory & Critical Care Physiology & Medicine Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment Kobe University, Kobe, Japan
| | - T Scott Bowen
- Department of Internal Medicine & Cardiology, Heart Center, Leipzig University, Leipzig, Germany
| | - Tatsuro Amano
- Faculty of Education Niigata University, Niigata, Japan
| | - Shunsaku Koga
- Applied Physiology Laboratory, Kobe Design University, Kobe, Japan
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Montero D, Diaz-Cañestro C. Determinants of exercise intolerance in heart failure with preserved ejection fraction: A systematic review and meta-analysis. Int J Cardiol 2018; 254:224-229. [PMID: 29407095 DOI: 10.1016/j.ijcard.2017.10.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/08/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Severe exercise intolerance (EI), demonstrated by impaired peak oxygen consumption, intrinsically characterizes heart failure with preserved ejection fraction (HFpEF). Controversy exists on the determinants of EI in patients with HFpEF according to case-control studies. The purpose of this study is to systematically review and clarify the main (Fick) determinants of EI in HFpEF. METHODS We conducted a systematic search of MEDLINE, Scopus and Web of Science since their inceptions until January 2017 for articles assessing peak cardiac output and/or arteriovenous oxygen difference (a-vO2diffpeak) with incremental exercise in patients diagnosed with HFpEF and age-matched control individuals. Meta-analyses were performed to determine the standardized mean difference (SMD) in peak cardiac index (CIpeak) and a-vO2diffpeak between HFpEF and control groups. Subgroup and meta-regression analyses were used to evaluate potential moderating factors. RESULTS Ten studies were included after systematic review, comprising a total of 213 HFpEF patients and 179 age-matched control individuals (mean age=51-73years). After data pooling, CIpeak (n=392, SMD=-1.42; P<0.001) and a-vO2diffpeak (n=228, SMD=-0.52; P=0.002) were impaired in HFpEF patients. In subgroup analyses, a-vO2diffpeak was reduced in HFpEF versus healthy individuals (n=114, SMD=-0.85; P<0.001) but not compared with control patients without heart failure (n=92, SMD=-0.12; P=0.57). The SMD in a-vO2diffpeak was negatively associated with age (B=-0.05, P=0.046), difference in % females (B=-0.01, P=0.026) and prevalence of hypertension (B=-0.01, P=0.015) between HFpEF and control groups. CONCLUSIONS HFpEF is associated with a predominant impairment of CIpeak, accompanied by sex- and comorbidity-dependent reduced oxygen extraction at peak exercise.
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Affiliation(s)
- David Montero
- Department of Cardiology, University Hospital Zurich, Switzerland.
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35
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Kong HH, Bang HJ, Ko JU, Lee GJ. The Differences in Cardiac Rehabilitation Outcomes by Age in Myocardial Infarction: A Preliminary Study. Ann Rehabil Med 2018; 41:1047-1054. [PMID: 29354582 PMCID: PMC5773425 DOI: 10.5535/arm.2017.41.6.1047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/11/2017] [Indexed: 12/12/2022] Open
Abstract
Objective To determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI). Methods CR was administered for 8 weeks to 32 men (mean age, 54.0±8.8 years) who underwent percutaneous coronary intervention for acute MI between July 2012 and January 2016. The exercise tolerance tests were performed before and after the CR. The results were stratified based on a cut-off age of 55 years. Results In the whole patient group, the hemodynamic variables such as the resting heart rate (HRrest), systolic blood pressure (SBPrest), submaximal HR (HRsubmax), SBP (SBPsubmax), and rate pressure product (RPPsubmax) significantly decreased and the maximal HR (HRmax) and RPP (RPPmax) significantly increased. All metabolic variables displayed significant improvement, to include maximal oxygen consumption (VO2max) and ventilation (VEmax), anaerobic threshold (AT), and the maximal oxygen pulse (O2pulsemax). However, upon stratification by age, those who were younger than 55 years of age exhibited significant changes only in the HRrest and RPPsubmax and those aged 55 years old or greater displayed significant changes in all hemodynamic variables except diastolic BP. Both groups displayed significant increases in the VO2max, VEmax, and AT; the older group also exhibited a significant increase in O2pulsemax. The magnitude of the changes in the hemodynamic and metabolic variables before and after CR, based on age, did not differ between the groups; although, it tended to be greater among the older participants of this study's sample. Conclusion Because the older participants tended to show greater hemodynamic and metabolic changes due to CR, a more aggressive CR program must be administered to elderly patients with MI.
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Affiliation(s)
- Hyun Ho Kong
- Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.,Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.,Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jae Ung Ko
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
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36
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Piil P, Smith Jørgensen T, Egelund J, Damsgaard R, Gliemann L, Hellsten Y, Nyberg M. Exercise training improves blood flow to contracting skeletal muscle of older men via enhanced cGMP signaling. J Appl Physiol (1985) 2017; 124:109-117. [PMID: 28982945 DOI: 10.1152/japplphysiol.00634.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Physical activity has the potential to offset age-related impairments in the regulation of blood flow and O2 delivery to the exercising muscles; however, the mechanisms underlying this effect of physical activity remain poorly understood. The present study examined the role of cGMP in training-induced adaptations in the regulation of skeletal muscle blood flow and oxidative metabolism during exercise in aging humans. We measured leg hemodynamics and oxidative metabolism during exercise engaging the knee extensor muscles in young [ n = 15, 25 ± 1 (SE) yr] and older ( n = 15, 72 ± 1 yr) subjects before and after a period of aerobic high-intensity exercise training. To determine the role of cGMP signaling, pharmacological inhibition of phosphodiesterase 5 (PDE5) was performed. Before training, inhibition of PDE5 increased ( P < 0.05) skeletal muscle blood flow and O2 uptake during moderate-intensity exercise in the older group; however, these effects of PDE5 inhibition were not detected after training. These findings suggest a role for enhanced cGMP signaling in the training-induced improvement of regulation of blood flow in contracting skeletal muscle of older men. NEW & NOTEWORTHY The present study provides evidence for enhanced cyclic GMP signaling playing an essential role in the improved regulation of blood flow in contracting skeletal muscle of older men with aerobic exercise training.
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Affiliation(s)
- Peter Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark.,Department of Orthopedics, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Jon Egelund
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Rasmus Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen , Copenhagen , Denmark
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Lundby C, Montero D, Joyner M. Biology of VO 2 max: looking under the physiology lamp. Acta Physiol (Oxf) 2017; 220:218-228. [PMID: 27888580 DOI: 10.1111/apha.12827] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 08/26/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022]
Abstract
In this review, we argue that several key features of maximal oxygen uptake (VO2 max) should underpin discussions about the biological and reductionist determinants of its interindividual variability: (i) training-induced increases in VO2 max are largely facilitated by expansion of red blood cell volume and an associated improvement in stroke volume, which also adapts independent of changes in red blood cell volume. These general concepts are also informed by cross-sectional studies in athletes that have very high values for VO2 max. Therefore, (ii) variations in VO2 max improvements with exercise training are also likely related to variations in these physiological determinants. (iii) All previously untrained individuals will respond to endurance exercise training in terms of improvements in VO2 max provided the stimulus exceeds a certain volume and/or intensity. Thus, genetic analysis and/or reductionist studies performed to understand or predict such variations might focus specifically on DNA variants or other molecular phenomena of relevance to these physiological pathways.
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Affiliation(s)
- C. Lundby
- Zürich Center for Integrative Human Physiology; Institute of Physiology; University of Zürich; Zürich Switzerland
| | - D. Montero
- Department of Cardiology; University Hospital Zürich; Zürich Switzerland
| | - M. Joyner
- Department of Anesthesiology; Mayo Clinic; Rochester MN USA
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Montero D, Lundby C. Reduced arteriovenous oxygen difference in heart failure with preserved ejection fraction patients: Is the muscle oxidative phenotype certainly involved? Eur J Prev Cardiol 2017; 24:1157-1160. [DOI: 10.1177/2047487317706587] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David Montero
- Department of Cardiology, University Hospital Zurich, Switzerland
| | - Carsten Lundby
- Centre for Physical Activity Research, Rigshospitalet, Denmark
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Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK. Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation 2017; 135:e894-e918. [PMID: 28336790 PMCID: PMC7252210 DOI: 10.1161/cir.0000000000000483] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.
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Nyberg M, Egelund J, Mandrup CM, Andersen CB, Hansen KMBE, Hergel IMF, Valbak-Andersen N, Frikke-Schmidt R, Stallknecht B, Bangsbo J, Hellsten Y. Leg vascular and skeletal muscle mitochondrial adaptations to aerobic high-intensity exercise training are enhanced in the early postmenopausal phase. J Physiol 2017; 595:2969-2983. [PMID: 28231611 DOI: 10.1113/jp273871] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/08/2017] [Indexed: 12/15/2022] Open
Abstract
KEY POINTS Exercise training effectively improves vascular and skeletal muscle function; however, these effects of training may be blunted in postmenopausal women as a result of the loss of oestrogens. Accordingly, the capacity to deliver oxygen to the active muscles may also be impaired in postmenopausal women. In both premenopausal and recent postmenopausal women, exercise training was shown to improve leg vascular and skeletal muscle mitochondrial function. Interestingly, these effects were more pronounced in postmenopausal women. Skeletal muscle oxygen supply and utilization were similar in the two groups of women. These findings suggest that the early postmenopausal phase is associated with an enhanced capacity of the leg vasculature and skeletal muscle mitochondria to adapt to exercise training and that the ability to deliver oxygen to match the demand of the active muscles is preserved in the early phase following the menopausal transition. ABSTRACT Exercise training leads to favourable adaptations within skeletal muscle; however, this effect of exercise training may be blunted in postmenopausal women as a result of the loss of oestrogens. Furthermore, postmenopausal women may have an impaired vascular response to acute exercise. We examined the haemodynamic response to acute exercise in matched pre- and postmenopausal women before and after 12 weeks of aerobic high intensity exercise training. Twenty premenopausal and 16 early postmenopausal (mean ± SEM: 3.1 ± 0.5 years after final menstrual period) women only separated by 4 years of age (mean ± SEM: 50 ± 0 years vs. 54 ± 1 years) were included. Before training, leg blood flow, O2 delivery, O2 uptake and lactate release during knee-extensor exercise were similar in pre- and postmenopausal women. Exercise training reduced (P < 0.05) leg blood flow, O2 delivery, O2 uptake, lactate release, blood pressure and heart rate during the same absolute workloads in postmenopausal women. These effects were not detected in premenopausal women. Quadriceps muscle protein contents of mitochondrial complex II, III and IV; endothelial nitric oxide synthase (eNOS); cyclooxygenase (COX)-1; COX-2; and oestrogen-related receptor α (ERRα) were increased (P < 0.05) with training in postmenopausal women, whereas only the levels of mitochondrial complex V, eNOS and COX-2 were increased (P < 0.05) in premenopausal women. These findings demonstrate that vascular and skeletal muscle mitochondrial adaptations to aerobic high intensity exercise training are more pronounced in recent post- compared to premenopausal women, possibly as an effect of enhanced ERRα signalling. Also, the hyperaemic response to acute exercise appears to be preserved in the early postmenopausal phase.
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Affiliation(s)
- Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jon Egelund
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Camilla M Mandrup
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Caroline B Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karen M B E Hansen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ida-Marie F Hergel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Hildebrandt W, Schwarzbach H, Pardun A, Hannemann L, Bogs B, König AM, Mahnken AH, Hildebrandt O, Koehler U, Kinscherf R. Age-related differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound (CEUS). PLoS One 2017; 12:e0172771. [PMID: 28273102 PMCID: PMC5342194 DOI: 10.1371/journal.pone.0172771] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 12/21/2016] [Indexed: 12/20/2022] Open
Abstract
Background Aging involves reductions in exercise total limb blood flow and exercise capacity. We hypothesized that this may involve early age-related impairments of skeletal muscle microvascular responsiveness as previously reported for insulin but not for exercise stimuli in humans. Methods Using an isometric exercise model, we studied the effect of age on contrast-enhanced ultrasound (CEUS) parameters, i.e. microvascular blood volume (MBV), flow velocity (MFV) and blood flow (MBF) calculated from replenishment of Sonovue contrast-agent microbubbles after their destruction. CEUS was applied to the vastus lateralis (VLat) and intermedius (VInt) muscle in 15 middle-aged (MA, 43.6±1.5 years) and 11 young (YG, 24.1±0.6 years) healthy males before, during, and after 2 min of isometric knee extension at 15% of peak torque (PT). In addition, total leg blood flow as recorded by femoral artery Doppler-flow. Moreover, fiber-type-specific and overall capillarisation as well as fiber composition were additionally assessed in Vlat biopsies obtained from CEUS site. MA and YG had similar quadriceps muscle MRT-volume or PT and maximal oxygen uptake as well as a normal cardiovascular risk factors and intima-media-thickness. Results During isometric exercise MA compared to YG reached significantly lower levels in MFV (0.123±0.016 vs. 0.208±0.036 a.u.) and MBF (0.007±0.001 vs. 0.012±0.002 a.u.). In the VInt the (post-occlusive hyperemia) post-exercise peaks in MBV and MBF were significantly lower in MA vs. YG. Capillary density, capillary fiber contacts and femoral artery Doppler were similar between MA and YG. Conclusions In the absence of significant age-related reductions in capillarisation, total leg blood flow or muscle mass, healthy middle-aged males reveal impaired skeletal muscle microcirculatory responses to isometric exercise. Whether this limits isometric muscle performance remains to be assessed.
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Affiliation(s)
- Wulf Hildebrandt
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
- * E-mail:
| | - Hans Schwarzbach
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Anita Pardun
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Lena Hannemann
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Björn Bogs
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
| | - Alexander M. König
- Department of Diagnostic and Interventional Radiology, University Hospital of Giessen and Marburg (UKGM) University, Baldingerstraße, Marburg, Germany
| | - Andreas H. Mahnken
- Department of Diagnostic and Interventional Radiology, University Hospital of Giessen and Marburg (UKGM) University, Baldingerstraße, Marburg, Germany
| | - Olaf Hildebrandt
- Department of Sleep Medicine, Division of Pneumology, Internal Medicine, University Hospital of Giessen and Marburg (UKGM) Baldingerstraße, Marburg, Germany
| | - Ulrich Koehler
- Department of Sleep Medicine, Division of Pneumology, Internal Medicine, University Hospital of Giessen and Marburg (UKGM) Baldingerstraße, Marburg, Germany
| | - Ralf Kinscherf
- Department of Medical Cell Biology, Institute of Anatomy and Cell Biology, University of Marburg, Marburg, Germany
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Carrick-Ranson G, Fujimoto N, Shafer KM, Hastings JL, Shibata S, Palmer MD, Boyd K, Levine BD. The effect of 1 year of Alagebrium and moderate-intensity exercise training on left ventricular function during exercise in seniors: a randomized controlled trial. J Appl Physiol (1985) 2016; 121:528-36. [PMID: 27402556 DOI: 10.1152/japplphysiol.00021.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 07/05/2016] [Indexed: 02/02/2023] Open
Abstract
Sedentary aging leads to left ventricular (LV) and vascular stiffening due in part to advanced glycation end-products (AGEs) cross-linking of extracellular matrix proteins. Vigorous lifelong exercise ameliorates age-related cardiovascular (CV) stiffening and enhances exercise LV function, although this effect is limited when exercise is initiated later in life. We hypothesized that exercise training might be more effective at improving the impact of age-related CV stiffening during exercise when combined with an AGE cross-link breaker (Alagebrium). Sixty-two seniors (≥60 yr) were randomized into four groups: sedentary + placebo, sedentary + Alagebrium, exercise + placebo, and exercise + Alagebrium for 1 yr. Moderate-intensity aerobic exercise was performed 3-4 sessions/wk; controls underwent similar frequency of yoga/balance training. Twenty-four similarly-aged, lifelong exercisers (4-5 sessions/wk) served as a comparator for the effect of lifelong exercise on exercising LV function. Oxygen uptake (Douglas bags), stroke index (SI; acetylene rebreathing), and effective arterial elastance (Ea) were collected at rest and submaximal and maximal exercise. Maximum O2 uptake (23 ± 5 to 25 ± 6 ml·kg(-1)·min(-1)) increased, while SI (35 ± 11 to 39 ± 12 ml/m(2)) and Ea (4.0 ± 1.1 to 3.7 ± 1.2 mmHg·ml(-1)·m(-2)) were improved across all conditions with exercise, but remained unchanged in controls (exercise × time, P ≤ 0.018). SI or Ea were not affected by Alagebrium (medication × time, P ≥ 0.468) or its combination with exercise (interaction P ≥ 0.252). After 1 yr of exercise plus Alagebrium, exercise SI and Ea remained substantially below that of lifelong exercisers (15-24 and 9-22%, respectively, P ≤ 0.415). In conclusion, Alagebrium plus exercise had no synergistic effect on exercise LV function and failed to achieve levels associated with lifelong exercise, despite a similar exercise frequency.
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Affiliation(s)
- Graeme Carrick-Ranson
- University of Auckland, Auckland, New Zealand; University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas
| | - Naoki Fujimoto
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas
| | - Keri M Shafer
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
| | - Jeffrey L Hastings
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas; Veteran Affairs North Texas Health Care System, Dallas, Texas
| | - Shigeki Shibata
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas
| | - M Dean Palmer
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas
| | - Kara Boyd
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas
| | - Benjamin D Levine
- University of Texas Southwestern Medical Center at Dallas, Dallas, Texas; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian, Dallas, Texas;
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Perkisas S, De Cock A, Verhoeven V, Vandewoude M. Physiological and architectural changes in the ageing muscle and their relation to strength and function in sarcopenia. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.12.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Hughes WE, Ueda K, Casey DP. Chronic endurance exercise training offsets the age-related attenuation in contraction-induced rapid vasodilation. J Appl Physiol (1985) 2016; 120:1335-42. [PMID: 27032899 DOI: 10.1152/japplphysiol.00057.2016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/25/2016] [Indexed: 01/25/2023] Open
Abstract
Aging is associated with attenuated contraction-induced rapid onset vasodilation (ROV). We sought to examine whether chronic exercise training would improve ROV in older adults. Additionally, we examined whether a relationship between cardiorespiratory fitness and ROV exists in young and older adults. Chronically exercise-trained older adults (n = 16; 66 ± 2 yr, mean ± SE) performed single muscle contractions in the forearm and leg at various intensities. Brachial and femoral artery diameter and blood velocity were measured using Doppler ultrasound. Vascular conductance (VC) was calculated as the quotient of blood flow (ml/min) and mean arterial pressure (mmHg). These data were compared with our previously published work from an identical protocol in 16 older untrained (66 ± 1 yr, mean ± SE) and 14 young (23 ± 1 yr) adults. Peak (ΔVCpeak) and total vasodilator (VCtotal) responses were greater in trained compared with untrained older adults across leg exercise intensities (P < 0.05). There were no differences in responses between trained older and young adults in the arm or leg at any exercise intensity (P > 0.05). Comparison of ΔVCpeak in a subset of subjects at an absolute workload in the leg revealed that trained older adults exhibited augmented responses relative to untrained older adults. Exercise capacity (V̇o2 peak) was associated with ΔVCpeak and VCtotal across arm (r = 0.59-0.64) and leg exercise intensities (r = 0.55-0.68, P < 0.05) in older adults. Our data demonstrate that 1) chronic exercise training improves ROV in the arm and leg of trained older adults, such that age-related differences in ROV are abolished, and 2) VO2peak is associated with ΔVCpeak responses in both limbs of older adults.
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Affiliation(s)
| | - Kenichi Ueda
- Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science; Abboud Cardiovascular Research Center; Fraternal Order of Eagles Diabetes Research; and
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Poole DC, Kelley GA, Musch TI. Training Increases Muscle O₂ Diffusing Capacity Intrinsic to the Elevated V˙O2max. Med Sci Sports Exerc 2016; 48:762-3. [PMID: 26986243 DOI: 10.1249/mss.0000000000000853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- David C Poole
- Departments of Kinesiology Anatomy & Physiology Kansas State University Manhattan, KS School of Public Health West Virginia University Morgantown, WV Departments of Kinesiology Anatomy & Physiology Kansas State University Manhattan, KS
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Fournier SB, Donley DA, Bonner DE, Devallance E, Olfert IM, Chantler PD. Improved arterial-ventricular coupling in metabolic syndrome after exercise training: a pilot study. Med Sci Sports Exerc 2016; 47:2-11. [PMID: 24870568 DOI: 10.1249/mss.0000000000000388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The metabolic syndrome (MetS) is associated with threefold increased risk of cardiovascular (CV) morbidity and mortality, which is partly due to a blunted CV reserve capacity, reflected by a reduced peak exercise left ventricular (LV) contractility and aerobic capacity and a blunted peak arterial-ventricular coupling. To date, no study has examined whether aerobic exercise training in MetS can reverse peak exercise CV dysfunction. Furthermore, examining how exercise training alters CV function in a group of individuals with MetS before the development of diabetes and/or overt CV disease can provide insights into whether some of the pathophysiological CV changes can be delayed/reversed, lowering their CV risk. The objective of this study was to examine the effects of 8 wk of aerobic exercise training in individuals with MetS on resting and peak exercise CV function. METHODS Twenty participants with MetS underwent either 8 wk of aerobic exercise training (MetS-ExT, n = 10) or remained sedentary (MetS-NonT, n = 10) during this period. Resting and peak exercise CV function was characterized using Doppler echocardiography and gas exchange. RESULTS Exercise training did not alter resting LV diastolic or systolic function and arterial-ventricular coupling in MetS. In contrast, at peak exercise, an increase in LV contractility (40%, P < 0.01), cardiac output (28%, P < 0.05), and aerobic capacity (20%, P < 0.01), but a reduction in vascular resistance (30%, P < 0.05) and arterial-ventricular coupling (27%, P < 0.01), were noted in the MetS-ExT but not in the MetS-NonT group. Furthermore, an improvement in lifetime risk score was also noted in the MetS-ExT group. CONCLUSIONS These findings have clinical importance because they provide insight that some of the pathophysiological changes associated with MetS can be improved and can lower the risk of CV disease.
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Affiliation(s)
- Sara B Fournier
- 1Department of Human Performance and Applied Sciences, Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV; and 2Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV
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Heinonen I, Koga S, Kalliokoski KK, Musch TI, Poole DC. Heterogeneity of Muscle Blood Flow and Metabolism: Influence of Exercise, Aging, and Disease States. Exerc Sport Sci Rev 2015; 43:117-24. [PMID: 25688763 DOI: 10.1249/jes.0000000000000044] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The systematic increase in V˙O2 uptake and O2 extraction with increasing work rates conceals a substantial heterogeneity of O2 delivery (Q˙O2)-to- V˙O2 matching across and within muscles and other organs. We hypothesize that whether increased/decreased Q˙O2/V˙O2 heterogeneity can be judged as "good" or "bad," for example, after exercise training or in aged individuals or with disease (heart failure, diabetes) depends on the resultant effects on O2 transport and contractile performance.
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Affiliation(s)
- Ilkka Heinonen
- 1Turku PET Centre, University of Turku, Turku, Finland; 2Division of Experimental Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; 3School of Sport Science, Exercise and Health, University Of Western Australia, Crawley, Western Australia, Australia; 4Applied Physiology Laboratory, Kobe Design University, Kobe, Japan; and 5Departments of Kinesiology, Anatomy and Physiology, Kansas State University, Manhattan, KS
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Abstract
Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved contractility, and an increase in blood volume, allowing for greater filling of the ventricles and a consequent larger stroke volume. In parallel with the greater maximal cardiac output, the perfusion capacity of the muscle is increased, permitting for greater oxygen delivery. To accommodate the higher aerobic demands and perfusion levels, arteries, arterioles, and capillaries adapt in structure and number. The diameters of the larger conduit and resistance arteries are increased minimizing resistance to flow as the cardiac output is distributed in the body and the wall thickness of the conduit and resistance arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle allowing for an improved capacity for oxygen extraction by the muscle through a greater area for diffusion, a shorter diffusion distance, and a longer mean transit time for the erythrocyte to pass through the smallest blood vessels. The present article addresses the effect of endurance training on systemic and peripheral cardiovascular adaptations with a focus on humans, but also covers animal data.
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Affiliation(s)
- Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Houghton D, Jones TW, Cassidy S, Siervo M, MacGowan GA, Trenell MI, Jakovljevic DG. The effect of age on the relationship between cardiac and vascular function. Mech Ageing Dev 2015; 153:1-6. [PMID: 26590322 PMCID: PMC4762231 DOI: 10.1016/j.mad.2015.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/06/2015] [Accepted: 11/05/2015] [Indexed: 11/27/2022]
Abstract
Age-related changes in cardiac and vascular function are associated with increased risk of cardiovascular mortality and morbidity. The aim of the present study was to define the effect of age on the relationship between cardiac and vascular function. Haemodynamic and gas exchange measurements were performed at rest and peak exercise in healthy individuals. Augmentation index was measured at rest. Cardiac power output, a measure of overall cardiac function, was calculated as the product of cardiac output and mean arterial blood pressure. Augmentation index was significantly higher in older than younger participants (27.7 ± 10.1 vs. 2.5 ± 10.1%, P<0.01). Older people demonstrated significantly higher stroke volume and mean arterial blood pressure (P<0.05), but lower heart rate (145 ± 13 vs. 172 ± 10 beats/min, P<0.01) and peak oxygen consumption (22.5 ± 5.2 vs. 41.2 ± 8.4 ml/kg/min, P<0.01). There was a significant negative relationship between augmentation index and peak exercise cardiac power output (r=-0.73, P=0.02) and cardiac output (r=-0.69, P=0.03) in older participants. Older people maintain maximal cardiac function due to increased stroke volume. Vascular function is a strong predictor of overall cardiac function in older but in not younger people.
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Affiliation(s)
- David Houghton
- Institute of Cellular Medicine, MoveLab, Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas W Jones
- Institute of Neurosciences and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
| | - Sophie Cassidy
- Institute of Cellular Medicine, MoveLab, Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Guy A MacGowan
- Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, UK; Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Michael I Trenell
- Institute of Cellular Medicine, MoveLab, Medical School, Newcastle University, Newcastle upon Tyne, UK; RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Djordje G Jakovljevic
- Institute of Cellular Medicine, MoveLab, Medical School, Newcastle University, Newcastle upon Tyne, UK; RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
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Montero D, Díaz-Cañestro C. Endurance training and maximal oxygen consumption with ageing: Role of maximal cardiac output and oxygen extraction. Eur J Prev Cardiol 2015; 23:733-43. [PMID: 26553969 DOI: 10.1177/2047487315617118] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/21/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND The increase in maximal oxygen consumption (VO2max) with endurance training is associated with that of maximal cardiac output (Qmax), but not oxygen extraction, in young individuals. Whether such a relationship is altered with ageing remains unclear. Therefore, we sought systematically to review and determine the effect of endurance training on and the associations among VO2max, Qmax and arteriovenous oxygen difference at maximal exercise (Ca-vO2max) in healthy aged individuals. DESIGN AND METHODS We conducted a systematic search of MEDLINE, Scopus and Web of Science, from their inceptions until May 2015 for articles assessing the effect of endurance training lasting 3 weeks or longer on VO2max and Qmax and/or Ca-vO2max in healthy middle-aged and/or older individuals (mean age ≥40 years). Meta-analyses were performed to determine the standardised mean difference (SMD) in VO2max, Qmax and Ca-vO2max between post and pre-training measurements. Subgroup and meta-regression analyses were used to evaluate the associations among SMDs and potential moderating factors. RESULTS Sixteen studies were included after systematic review, comprising a total of 153 primarily untrained healthy middle-aged and older subjects (mean age 42-71 years). Endurance training programmes ranged from 8 to 52 weeks of duration. After data pooling, VO2max (SMD 0.89; P < 0.0001) and Qmax (SMD 0.61; P < 0.0001) were increased after endurance training; no heterogeneity among studies was detected. Ca-vO2max was only increased with endurance training interventions lasting more than 12 weeks (SMD 0.62; P = 0.001). In meta-regression, the SMD in Qmax was positively associated with the SMD in VO2max (B = 0.79, P = 0.04). The SMD in Ca-vO2max was not associated with the SMD in VO2max (B = 0.09, P = 0.84). CONCLUSIONS The improvement in VO2max following endurance training is a linear function of Qmax, but not Ca-vO2max, through healthy ageing.
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Affiliation(s)
- David Montero
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Switzerland
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