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Nguyen CH, Thomas SH, Bentley DC. A brief experimental examination of post-exercise hypotension and the impact of calculation method. Blood Press Monit 2021; 26:279-283. [PMID: 33734124 DOI: 10.1097/mbp.0000000000000533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE There is great variability in the reported values of post-exercise hypotension (PEH), with inconsistent calculation methods employed across primary research. This study aimed to explore the influence of the mathematical calculation method on PEH variability, with the hypothesis that the method of identifying the lowest single reduction point (LSRP) would yield false-positive results. METHODS Young, normotensive (108 ± 7/69 ± 5 mmHg), apparently healthy, male (n = 20) were included in this study. Participants completed three random-order experimental sessions, with blood pressure and heart rate measured before (10 min) and after (30 min) an acute bout of either isometric handgrip exercise, aerobic cycling, or a nonexercise control. Three PEH calculation methods were analyzed: LSRP, 30-min average across the full post-exercise recovery, and 15-min binned averages with two recovery windows (0-15 min, 15-30 min). RESULTS The only calculation method to consistently identify PEH was the LSRP method, which identified PEH for SBP, DBP, and mean arterial pressure, across handgrip exercise, aerobic cycling, and even nonexercise control (P < 0.001). All other calculation methods inconsistently identified PEH across experimental sessions, supporting the hypothesis that LSRP inaccurately overreports PEH. CONCLUSION Mathematical calculation method appears to be one source of variability contributing to the inconsistency in reported PEH among young, healthy males. This brief experimental examination reveals that the LSRP method should be avoided as it inaccurately overreports PEH. Alternatively, binned averages of smaller time windows across the recovery period may be a potentially advantageous approach and require further examination to determine to ideal level of granularity.
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Affiliation(s)
- Cindy H Nguyen
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario
- Faculty of Kinesiology and Physical Education
| | | | - Danielle C Bentley
- Faculty of Kinesiology and Physical Education
- Division of Anatomy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Patik JC, Stock JM, Shenouda N, Chouramanis NV, Mehrer JD, Chirinos JA, Edwards DG. Pulsatile load and wasted pressure effort are reduced following an acute bout of aerobic exercise. J Appl Physiol (1985) 2021; 131:184-191. [PMID: 33982596 DOI: 10.1152/japplphysiol.00946.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Following aerobic exercise, sustained vasodilation and concomitant reductions in total peripheral resistance (TPR) result in a reduction in blood pressure that is maintained for two or more hours. However, the time course for postexercise changes in reflected wave amplitude and other indices of pulsatile load on the left ventricle have not been thoroughly described. Therefore, we tested the hypothesis that reflected wave amplitude is reduced beyond an hour after cycling at 60% V̇o2peak for 60 min. Aortic pressure waveforms were derived in 14 healthy adults (7 men, 7 women; 26 ± 3 yr) from radial pulse waves acquired via high-fidelity applanation tonometry at baseline and every 20 min for 120 min postexercise. Concurrently, left ventricle outflow velocities were acquired via Doppler echocardiography and pressure-flow analyses were performed. Aortic characteristic impedance (Zc), forward (Pf) and backward (Pb) pulse wave amplitude, reflected wave travel time (RWTT), and wasted pressure effort (WPE) were derived. Reductions in aortic blood pressure, Zc, Pf, and Pb were all sustained postexercise whereas increases in RWTT emerged from 60 to 100 min post exercise (all P < 0.05). WPE was reduced by ∼40% from 40 to 100 min post exercise (all P < 0.02). Stepwise multiple regression analysis revealed that the peak ΔWPE was associated with ΔRWTT (β = -0.57, P = 0.003) and ΔPb (β = 0.52, P = 0.006), but not Δcardiac output, ΔTPR, ΔZc, or ΔPf. These results suggest that changes in pulsatile hemodynamics are sustained for ≥100 min following moderate intensity aerobic exercise. Moreover, decreased and delayed reflected pressure waves are associated with decreased left ventricular wasted effort after exercise.NEW & NOTEWORTHY We demonstrate that pulsatile load on the left ventricle is diminished following 60 min of moderate intensity aerobic exercise. During recovery from exercise, the amplitude of the forward and backward traveling pressure waves are attenuated and the arrival of reflected waves is delayed. Thus, the work imposed upon the left ventricle by reflected pressure waves, wasted pressure effort, is decreased after exercise.
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Affiliation(s)
- Jordan C Patik
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Joseph M Stock
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Ninette Shenouda
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Nicholas V Chouramanis
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Justin D Mehrer
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
| | - Julio A Chirinos
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware
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A Novel mHealth Monitoring System during Cycling in Elite Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094788. [PMID: 33946166 PMCID: PMC8124243 DOI: 10.3390/ijerph18094788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
Background: Cycling is a very demanding physical activity that may create various health disorders during an athlete’s career. Recently, smart mobile and wearable technologies have been used to monitor physiological responses and possible disturbances during physical activity. Thus, the application of mHealth methods in sports poses a challenge today. This study used a novel mobile-Health method to monitor athletes’ physiological responses and to detect health disorders early during cycling in elite athletes. Methods: Sixteen high-level cyclists participated in this study, which included a series of measurements in the laboratory; health and performance assessments; and then application in the field of mHealth monitoring in two training seasons, at the beginning of their training period and in the race season. A field monitoring test took place during 30 min of uphill cycling with the participant’s heart rate at the ventilatory threshold. During monitoring periods, heart rate, oxygen saturation, respiratory rate, and electrocardiogram were monitored via the mHealth system. Moreover, the SpO2 was estimated continuously, and the symptoms during effort were reported. Results: A significant correlation was found between the symptoms reported by the athletes in the two field tests and the findings recorded with the application of the mHealth monitoring method. However, from the pre-participation screening in the laboratory and from the spiroergometric tests, no abnormal findings were detected that were to blame for the appearance of the symptoms. Conclusions: The application of mHealth monitoring during competitive cycling is a very useful method for the early recording of cardiac and other health disorders of athletes, whose untimely evaluation could lead to unforeseen events.
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Kanda M, Kajimoto C, Kashima H, Ogino A, Miura A, Fukuba Y, Endo MY. Carotid baroreflex control of central and peripheral hemodynamics during recovery after moderate leg cycling exercise. J Appl Physiol (1985) 2020; 128:1477-1486. [PMID: 32352342 DOI: 10.1152/japplphysiol.00023.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This study aimed to examine the carotid baroreflex (CBR) control of the central and peripheral hemodynamics after exercise using the neck pressure (NP) and neck suction (NS) technique. Sixteen healthy young male participants (age: 27 ± 1.5 yr) were in a supine position for 30 min preexercise, followed by 60 min of cycling exercise, and then returned to a supine position for an additional 60 min postexercise. Both pre- and postexercise, the CBR-mediated responses of the central and peripheral hemodynamics were evaluated using 5-s periods of NP and NS (-60, -40, or +40 mmHg). As the central hemodynamics measurements, heart rate (HR), mean arterial pressure (MAP), cardiac output, and total vascular conductance were assessed. To determine peripheral circulation, vascular conductance in active and inactive limbs was measured. Eight participants [responder (RE) group] showed substantial postexercise hypotension (PEH) during recovery from exercise (Δ MAP: approximately -5 ± 0.9 mmHg, P < 0.05). The other eight participants did not display a reduction in MAP after exercise (non-RE group). In the non-RE group, the responsiveness of CBR-mediated changes in HR, MAP, and vascular conductance increased, particularly in response to -40 mmHg NS during postexercise compared with preexercise. However, in the RE group, any alterations in responsiveness to NP and NS were unchanged during PEH compared with preexercise. In conclusion, some normotensive individuals do not show PEH because the responsiveness of the CBR in central and peripheral hemodynamics following exercise is augmented, particularly to high blood pressure.NEW & NOTEWORTHY The carotid baroreflex (CBR) control of central and peripheral hemodynamics was investigated after exercise in both the presence and absence of postexercise hypotension (PEH). In individuals with no PEH, the responsiveness of CBR-mediated changes in all hemodynamics was augmented after exercise, particularly to high blood pressure; conversely, the CBR responsiveness remained unchanged in individuals with PEH. These findings provide insight into the mechanism of CBR control after exercise.
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Affiliation(s)
- Masako Kanda
- Department of Nutritional Sciences, Faculty of Human Ecology, Yasuda Women's University, Hiroshima, Japan
| | - Chie Kajimoto
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Hideaki Kashima
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Ai Ogino
- Department of Nutritional Sciences, Faculty of Human Ecology, Yasuda Women's University, Hiroshima, Japan
| | - Akira Miura
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Yoshiyuki Fukuba
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Masako Yamaoka Endo
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
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Su YT, Cheng YP, Zhang X, Xie XP, Chang YM, Bao JX. Acid sphingomyelinase/ceramide mediates structural remodeling of cerebral artery and small mesenteric artery in simulated weightless rats. Life Sci 2020; 243:117253. [PMID: 31927048 DOI: 10.1016/j.lfs.2019.117253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/18/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022]
Abstract
AIMS Weightlessness exposure conduces to substantial vascular remodeling, mechanisms behind which remain unclear. Acid sphingomyelinase (ASM) catalyzed ceramide (Cer) generation accounts for multiple vascular disorders, so the role of it in adjustment of cerebral artery (CA) and small mesenteric artery (MA) was investigated in simulated weightless rats. MAIN METHODS Rats were hindlimb unloaded tail suspended (HU) to simulate the effect of weightlessness. Arterial morphology was examined by hematoxylin-eosin staining. Cer abundance was measured by immunohistochemistry. Western blotting was used to detect protein content. Apoptosis was detected by transferase-mediated dUTP nick end labeling. KEY FINDINGS During 4 weeks of tail suspension, intima-media thickness (IMT) and media cross section area (CSA) were increased gradually in CA but decreased gradually in MA (P < 0.05). Correspondingly, the apoptosis and proliferation of vascular smooth muscle cells were reduced and enhanced respectively in CA (P < 0.05), while promoted and restrained in MA (P < 0.05). As compared to control, both ASM protein expression and Cer content were lowered in CA and elevated in MA of HU rats (P < 0.05). Permeable Cer incubation reversed the change of apoptosis and proliferation in CA of HU rats, while ASM inhibition recapitulated it in control rats. On the contrary, ASM inhibitors restored the alteration of apoptosis and proliferation in MA of HU. SIGNIFICANCE The results suggest that by controlling the balance between apoptosis and proliferation, ASM/Cer exerts an important role in structural adaptation of CA and MA to simulated weightlessness.
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Affiliation(s)
- Yu-Ting Su
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China
| | - Yao-Ping Cheng
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China
| | - Xi Zhang
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China
| | - Xiao-Ping Xie
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China
| | - Yao-Ming Chang
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China.
| | - Jun-Xiang Bao
- Department of Aerospace Hygiene, Fourth Military Medical University, Xi'an 710032, PR China.
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Stavres J, Fischer SM, McDaniel J. Exaggerated post exercise hypotension following concentric but not eccentric resistance exercise: Implications for metabolism. Eur J Sport Sci 2019; 19:983-993. [PMID: 30606088 DOI: 10.1080/17461391.2018.1564368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Post exercise hypotension (PEH) is primarily attributed to post-exercise vasodilation via central and peripheral mechanisms. However, the specific contribution of metabolic cost during exercise, independent of force production, is less clear. This study aimed to use isolated concentric and eccentric exercise to examine the role of metabolic activity in eliciting PEH, independent of total work. Twelve participants (6 male) completed upper and lower body concentric (CONC), eccentric (ECC), and traditional (TRAD) exercise sessions matched for work (3 × 10 in TRAD and 3 × 20 in CONC and ECC; all at 65% 1RM). Blood pressure was collected at baseline and every 15 min after exercise for 120 min. Brachial blood flow and vascular conductance were also assessed at baseline, immediately after exercise, and every 30 min after exercise. ⩒O2 was lower during ECC compared to CONC and TRAD (-2.7 mL/Kg/min ± 0.4 and -2.2 mL/Kg/min ± 0.4, respectively p < 0.001). CONC augmented the PEH response (Peak ΔMAP -3.3 mmHg ± 0.9 [mean ± SE], p = 0.006) through 75 min of recovery and ECC elicited a post-exercise hypertensive response through 120 min of recovery (Peak ΔMAP +4.5 mmHg ± 0.8, p < 0.001). CONC and TRAD elicited greater increases in brachial blood flow post exercise than ECC (Peak Δ brachial flow +190.4 mL/min ± 32.3, +202.3 mL/min ± 39.2, and 69.6 mL/min ± 19.8, respectively, p ≤ 0.005), while conductance increased immediately post exercise in all conditions and then decreased throughout recovery following ECC (-32.9 mL/min/mmHg ± 9.3, p = 0.005). These data suggest that more metabolically demanding concentric exercise augments PEH compared to work-matched eccentric exercise.
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Affiliation(s)
- Jon Stavres
- a School of Health Sciences, Kent State University , Kent , OH , USA.,b Penn State Milton S. Hershey Medical Center , Hershey , PA , USA
| | - Stephen M Fischer
- a School of Health Sciences, Kent State University , Kent , OH , USA
| | - John McDaniel
- a School of Health Sciences, Kent State University , Kent , OH , USA.,c Louis Stokes Cleveland VA Medical Center , Cleveland , OH , USA
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de Freitas Brito A, Brasileiro-Santos MDS, Coutinho de Oliveira CV, da Cruz Santos A. Postexercise Hypotension Is Volume-Dependent in Hypertensives: Autonomic and Forearm Blood Responses. J Strength Cond Res 2019; 33:234-241. [DOI: 10.1519/jsc.0000000000001735] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Intermittent versus constant aerobic exercise in middle-aged males: acute effects on arterial stiffness and factors influencing the changes. Eur J Appl Physiol 2018; 118:1625-1633. [PMID: 29796858 DOI: 10.1007/s00421-018-3893-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 05/13/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE Both constant and intermittent acute aerobic exercises have been found to decrease arterial stiffness. However, direct comparisons of these two types of exercise are sparse. It is not known which type of exercise has the greatest effect. METHODS We evaluated the haemodynamic responses in 15 males (age 48.5 ± 1.3 years; BMI 27.5 ± 0.8 kg m-2) following acute constant (CE) and intermittent cycling exercise (IE). Duration and heart rate were matched during both exercises (131.8 ± 3.2 bpm for CE and 132.0 ± 3.1 bpm for IE). Central and peripheral arterial stiffness was assessed through pulse wave velocity (PWV). Plasma concentrations of nitric oxide (NO), atrial natriuretic peptide (ANP), blood lactate, noradrenaline, and adrenaline were measured before and after each exercise. RESULTS Central (+ 1.8 ± 7.4 and - 6.5 ± 6.8% for CE and IE) and upper limb PWV (+ 2.7 ± 6.2 and - 8 ± 4.6% for CE and IE) were not significantly altered although a small decrease (small effect size) was observed after IE. However, lower limb PWV significantly decreased after exercises (- 7.3 ± 5.7 and - 15.9 ± 4% after CE and IE), with a larger effect after IE. CONCLUSIONS Greater decrease in lower limb PWV occurred after IE despite greater heart rate. This may be due to the higher blood levels of lactate during IE, while NO, ANP, noradrenaline, and adrenaline levels remained not statistically different from CE. These results underlined the importance of lactate in triggering the post-exercise vascular response to exercise, as well as its regional characteristic.
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Christou GA, Christou KA, Kiortsis DN. Pathophysiology of Noncardiac Syncope in Athletes. Sports Med 2018; 48:1561-1573. [PMID: 29605837 DOI: 10.1007/s40279-018-0911-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The most frequent cause of syncope in young athletes is noncardiac etiology. The mechanism of noncardiac syncope (NCS) in young athletes is neurally-mediated (reflex). NCS in athletes usually occurs either as orthostasis-induced, due to a gravity-mediated reduced venous return to the heart, or in the context of exercise. Exercise-related NCS typically occurs after the cessation of an exercise bout, while syncope occurring during exercise is highly indicative of the existence of a cardiac disorder. Postexercise NCS appears to result from hypotension due to impaired postexercise vasoconstriction, as well as from hypocapnia. The mechanisms of postexercise hypotension can be divided into obligatory (which are always present and include sympathoinhibition, histaminergic vasodilation, and downregulation of cardiovagal baroreflex) and situational (which include dehydration, hyperthermia and gravitational stress). Regarding postexercise hypocapnia, both hyperventilation during recovery from exercise and orthostasis-induced hypocapnia when recovery occurs in an upright posture can produce postexercise cerebral vasoconstriction. Athletes have been shown to exhibit differential orthostatic responses compared with nonathletes, involving augmented stroke volume and increased peripheral vasodilation in the former, with possibly lower propensity to orthostatic intolerance.
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Affiliation(s)
- Georgios A Christou
- Laboratory of Physiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.
| | | | - Dimitrios N Kiortsis
- Laboratory of Physiology, Medical School, University of Ioannina, 45110, Ioannina, Greece
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Kashima H, Harada N, Miyamoto K, Fujimoto M, Fujita C, Endo MY, Kobayashi T, Miura A, Fukuba Y. Timing of postexercise carbohydrate-protein supplementation: roles of gastrointestinal blood flow and mucosal cell damage on gastric emptying in humans. J Appl Physiol (1985) 2017; 123:606-613. [PMID: 28596270 DOI: 10.1152/japplphysiol.00247.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/01/2017] [Accepted: 06/07/2017] [Indexed: 01/25/2023] Open
Abstract
It is well known that protein ingestion immediately after exercise greatly stimulates muscle protein synthesis during the postexercise recovery phase. However, immediately after strenuous exercise, the gastrointestinal (GI) mucosa is frequently injured by hypoperfusion in the organ/tissue, possibly resulting in impaired GI function (e.g., gastric emptying; GE). The aim of this study was to examine the effect of GI blood flow on the GE rate. Eight healthy young subjects performed an intermittent supramaximal cycling exercise for 30 min, which consisted of a 120% V̇o2peak for 20 s, followed by 20 W for 40 s. The subjects ingested 300 ml of a nutrient drink containing carbohydrate-protein at either 5 min postexercise in one trial (PE-5) or 30 min postexercise in another trial (PE-30). In the control trial (Con), the subjects ingested the same drink without exercise. The celiac artery blood flow (CABF) and superior mesenteric artery blood flow (SMABF) and GE rate were assessed by ultrasonography. Before drink ingestion in PE-5, CABF significantly decreased from baseline, whereas in PE-30, it returned to baseline. Following drink ingestion in PE-5, CABF did not change from baseline, but it significantly increased in PE-30 and Con. SMABF increased significantly later in PE-5 than in PE-30 and Con. The GE rate was consistently slower in PE-5 than in PE-30 and Con. In conclusion, the CABF response after exercise seems to modulate the subsequent GE rate and SMABF response.NEW & NOTEWORTHY A carbohydrate-protein drink was ingested at either 5 min (i.e., profoundly decreased celiac artery blood flow; CABF) or 30 min (i.e., already recovered CABF) postexercise. In the 5-min postexercise trial, the gastric emptying (GE) rate and superior mesenteric artery blood flow (SMABF) response were slower than those in the 30-min postexercise trial. The GE rate and SMABF response may be altered depending on the postexercise CABF response.
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Affiliation(s)
- Hideaki Kashima
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Nao Harada
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Kanae Miyamoto
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Masaki Fujimoto
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Chiaki Fujita
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Masako Yamaoka Endo
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Toshio Kobayashi
- Department of Health Promotion and Development, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Miura
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
| | - Yoshiyuki Fukuba
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan; and
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Systematic review: the impact of exercise on mesenteric blood flow and its implication for preoperative rehabilitation. Tech Coloproctol 2017; 21:185-201. [PMID: 28243813 PMCID: PMC5360832 DOI: 10.1007/s10151-017-1589-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 01/11/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Exercise in the preoperative period, or prehabilitation, continues to evolve as an important tool in optimising patients awaiting major intra-abdominal surgery. It has been shown to reduce rates of post-operative morbidity and length of hospital stay. The mechanism by which this is achieved remains poorly understood. Adaptations in mesenteric flow in response to exercise may play a role in improving post-operative recovery by reducing rates of ileus and anastomotic leak. AIMS To systematically review the existing literature to clarify the impact of exercise on mesenteric arterial blood flow using Doppler ultrasound. METHODS PubMed, EMBASE and the Cochrane library were systematically searched to identify clinical trials using Doppler ultrasound to investigate the effect of exercise on flow through the superior mesenteric artery (SMA). Data were extracted including participant characteristics, frequency, intensity, timing and type of exercise and the effect on SMA flow. The quality of each study was assessed using the Downs and Black checklist. RESULTS Sixteen studies, comprising 305 participants in total, were included. Methodological quality was generally poor. Healthy volunteers were used in twelve studies. SMA flow was found to be reduced in response to exercise in twelve studies, increased in one and unchanged in two studies. Clinical heterogeneity precluded a meta-analysis. CONCLUSION The weight of evidence suggests that superior mesenteric arterial flow is reduced immediately following exercise. Differences in frequency, intensity, timing and type of exercise make a consensus difficult. Further studies are warranted to provide a definitive understanding of the impact of exercise on mesenteric flow.
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Endo MY, Fujihara C, Miura A, Kashima H, Fukuba Y. Effects of meal ingestion on blood pressure and regional hemodynamic responses after exercise. J Appl Physiol (1985) 2016; 120:1343-8. [DOI: 10.1152/japplphysiol.00842.2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/22/2016] [Indexed: 11/22/2022] Open
Abstract
This study investigated the combined effects of consuming a meal during postexercise hypotension (PEH) on hemodynamics. Nine healthy young male subjects performed each of three trials in random order: 1) cycling at 50% of heart rate reserve for 60 min, 2) oral ingestion of a carbohydrate liquid meal (75 g glucose), or 3) carbohydrate ingestion at 40 min after cycling exercise. Blood pressure, heart rate, cardiac output, and blood flow in the superior mesenteric (SMA), brachial, and popliteal arteries were measured continuously before and after each trial. Regional vascular conductance (VC) was calculated as blood flow/mean arterial pressure. Blood pressure decreased relative to baseline values ( P < 0.05) after exercise cessation. Blood flow and VC in the calf and arm increased after exercise, whereas blood flow and VC in the SMA did not. Blood pressure did not change after meal ingestion; however, blood flow and VC significantly decreased in the brachial and popliteal arteries and increased in the SMA for 120 min after the meal ( P < 0.05). When the meal was ingested during PEH, blood pressure decreased below PEH levels and remained decreased for 40 min before returning to postexercise levels. The sustained increase in blood flow and VC in the limbs after exercise was reduced to baseline resting levels immediately after the meal, postprandial cardiac output was unchanged by the increased blood flow in the SMA, and total VC and SMA VC increased. Healthy young subjects can suppress severe hypotension by vasoconstriction of the limbs even when carbohydrate is ingested during PEH.
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Affiliation(s)
- Masako Yamaoka Endo
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Chizuko Fujihara
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Akira Miura
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Hideaki Kashima
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Yoshiyuki Fukuba
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
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13
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Brito ADF, de Oliveira CVC, Brasileiro-Santos MDS, Santos ADC. Resistance exercise with different volumes: blood pressure response and forearm blood flow in the hypertensive elderly. Clin Interv Aging 2014; 9:2151-8. [PMID: 25540580 PMCID: PMC4270306 DOI: 10.2147/cia.s53441] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this study was to evaluate the effect of two sessions of resistance exercise with different volumes on post-exercise hypotension, forearm blood flow, and forearm vascular resistance in hypertensive elderly subjects. Methods The study was conducted with ten hypertensive elderly (65±3 years, 28.7±3 kg/m2) subjected to three experimental sessions, ie, a control session, exercise with a set (S1), and exercise with three sets (S3). For each session, the subjects were evaluated before and after intervention. In the pre-intervention period, blood pressure, forearm blood flow, and forearm vascular resistance were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same time period. Both S1 and S3 comprised a set of ten repetitions of ten exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (post-intervention) in the supine position. Results Post-exercise hypotension was greater in S3 than in S1 (systolic blood pressure, −26.5±4.2 mmHg versus −17.9±4.7 mmHg; diastolic blood pressure, −13.8±4.9 mmHg versus −7.7±5 mmHg, P<0.05). Similarly, forearm blood flow and forearm vascular resistance changed significantly in both sessions with an increase and decrease, respectively, that was more evident in S3 than in S1 (P<0.05). Conclusion Resistance exercises with higher volume were more effective in causing post-exercise hypotension, being accompanied by an increase in forearm blood flow and a reduction of forearm vascular resistance.
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Influence of single bout of aerobic exercise on aortic pulse pressure. Eur J Appl Physiol 2014; 115:739-46. [PMID: 25428726 DOI: 10.1007/s00421-014-3061-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Regular aerobic exercise has come to the forefront of non-pharmacological treatment for hypertension. In this line, post-exercise hypotension may have a potential tool for efficient blood pressure management. However, less is known about the influence of acute aerobic exercise on aortic pulse pressure (PP), an important property underlying the pathophysiology of cardiovascular disease. We tested the hypotheses that aortic PP would be attenuated with a single aerobic exercise and that its extent would be associated with the delayed return of reflected wave and the leg vasodilatory capacity. METHODS In 23 apparent healthy men (22 ± 4 years), hemodynamic variables and aortic pulse wave velocity (PWV) were measured before and 20 and 50 min after a 60-min bout of cycling exercise at moderate intensity (corresponding to 65-75 % heart rate reserve). Aortic pressure was estimated from applanation tonometrically measured radial arterial pressure waveform via general transfer function. Peak calf vascular dilatory capacity was measured with the ischemic exercise-induced hyperemia (via venous occlusion plethysmography). RESULTS Finger, brachial, and aortic PP were significantly attenuated following the exercise. At 20 min after the exercise cessation, individual changes in aortic PWV significantly correlated with corresponding changes in aortic PP (r = 0.541, P < 0.05), but this correlation was no longer significant at 50 min after the exercise cessation. Peak calf vascular dilatory capacity was not associated with change in aortic PP. CONCLUSIONS We conclude that in young men the aortic PP would be attenuated with the moderate-intensity dynamic exercise partly due to the delayed return of reflection wave from periphery.
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Endo MY, Fujihara C, Yamazaki C, Kashima H, Eguchi K, Miura A, Fukuoka Y, Fukuba Y. Acute responses of regional vascular conductance to oral ingestion of fructose in healthy young humans. J Physiol Anthropol 2014; 33:11. [PMID: 24887175 PMCID: PMC4068077 DOI: 10.1186/1880-6805-33-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 05/01/2014] [Indexed: 11/25/2022] Open
Abstract
Background Recently, it was reported in healthy young subjects that fructose containing drinks increased blood pressure acutely, without any apparent change in total vascular conductance (TVC). However, because it is well known that the splanchnic vasculature is dilated by oral fructose ingestion, it is assumed to be the concomitant vasoconstriction in other peripheral region(s) that is responsible for this finding. Thus, the purpose of this study was to determine the acute response of regional VC to oral fructose ingestion in young healthy humans. Results In 12 healthy young subjects, mean arterial blood pressure (MAP), heart rate, cardiac output, and blood flow (BF) in the superior mesenteric (SMA), brachial (BA), and popliteal (PA) arteries, in addition to forearm skin BF, were measured continuously for 2 h after ingestion of 400 ml fructose solution (containing 50 g fructose). Regional VC was calculated as BF/MAP. MAP increased for 120 min after fructose ingestion without any change in TVC. While VC in the SMA was elevated after ingestion, VC in BA and PA and forearm skin decreased. Conclusions While TVC was apparently unchanged during the 2 h after fructose ingestion, there were coincident changes in regional VCs in the peripheral circulation, but no net change in TVC.
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Affiliation(s)
| | | | | | | | | | | | | | - Yoshiyuki Fukuba
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, 1-1-71 Ujina-higashi, Minami-ku, Hiroshima, 734-8558, Japan.
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