Cycling Exercise Training Alleviates Hypoxia-Impaired Erythrocyte Rheology

The effects of high-intensity interval training versus moderate-intensity continuous training on athletes' aerobic endurance performance parameters

OBJECTIVE

To systematically evaluate and meta-analyze the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on athletes of aerobic endurance performance parameters.

METHODS

PubMed, Web of Science, EBSCO, Embase, and Cochrane databases were searched. The assessment of quality was conducted employing The Cochrane Risk of Bias Assessment Tool, while heterogeneity examination and subgroup analysis were performed. Moreover, regression and sensitivity analyses were executed.

RESULTS

There was no significant difference between the effects of HIIT and MICT on the enhancement of athletes' running economy (RE) (P > 0.05); 1-3 weeks and 4-9 weeks of HIIT were more effective in improving athletes' maximum oxygen uptake (VO2max) (P < 0.05), and 10 weeks and above were not significant (P > 0.05); 1-3 weeks of HIIT was more effective in improving athletes' anaerobic threshold (AT) (P < 0.05), and 4-10 weeks was not significant (P > 0.05); 3 weeks of high-intensity interval training (HIIT) did not significantly enhance athletes' minute ventilation (VE) (P > 0.05), whereas a duration of 6-10 weeks yielded superior results (P < 0.05); 8 weeks of moderate-intensity continuous training (MICT) did not significantly enhance athletes' hemoglobin (Hb) level (P > 0.05), whereas a duration of 2-3 weeks yielded superior results (P < 0.05).

CONCLUSIONS

(1) HIIT and MICT have similar effects on enhancing athletes' RE. (2) 6-9 weeks' HIIT was more effective in improving athletes' VO2max and VE, and 3 weeks' HIIT was more effective in improving athletes' AT. (3) Within 3 weeks, MICT was more effective in improving the Hb level of athletes.

REGISTRATION NUMBER ON PROSPERO

CRD42024499039.

Effects of a Maximal Exercise Followed by a Submaximal Exercise Performed in Normobaric Hypoxia (2500 m), on Blood Rheology, Red Blood Cell Senescence, and Coagulation in Well-Trained Cyclists

Acute normoxic exercise impacts the rheological properties of red blood cells (RBC) and their senescence state; however, there is a lack of data on the effects of exercise performed in hypoxia on RBC properties. This crossover study compared the effects of acute hypoxia vs. normoxia on blood rheology, RBC senescence, and coagulation during exercise. Nine trained male cyclists completed both a session in normoxia (FiO₂ = 21%) and hypoxia (FiO₂ = 15.3% ≈ 2500 m). The two sessions were randomly performed, separated by one week, and consisted of an incremental and maximal exercise followed by a 20 min exercise at the first ventilatory threshold (VT1) on a home-trainer. Blood samples were taken before and after exercise to analyze hematological parameters, blood rheology (hematocrit, blood viscosity, RBC deformability and aggregation), RBC senescence markers (phosphatidylserine (PS) and CD47 exposure, intraerythrocyte reactive oxygen species (ROS), and calcium content), and blood clot viscoelastic properties. Hemoglobin oxygen saturation (SpO₂) and blood lactate were also measured. In both conditions, exercise induced an increase in blood viscosity, hematocrit, intraerythrocyte calcium and ROS content, and blood lactate concentration. We also observed an increase in blood clot amplitude, and a significant drop in SpO₂ during exercise in the two conditions. RBC aggregation and CD47 exposure were not modified. Exercise in hypoxia induced a slight decrease in RBC deformability which could be related to the slight increase in mean corpuscular hemoglobin concentration (MCHC). However, the values of RBC deformability and MCHC after the exercise performed in hypoxia remained in the normal range of values. In conclusion, acute hypoxia does not amplify the RBC and coagulation changes induced by an exercise bout.

Supervised Cycling Training Improves Erythrocyte Rheology in Individuals With Peripheral Arterial Disease

Peripheral arterial disease (PAD) results in insufficient flow to lower extremities. Aerobic exercise provides health benefits for individuals with PAD, but basic science behind it is still debated. Twenty-one PAD patients aged about 70 years with female/male as 7/14 were recruited. Among them, 11 were randomized to have supervised cycling training (SCT) and 10 to receive general healthcare (GHC) as controls. SCT participants completed 36 sessions of SCT at the first ventilation threshold within 12 weeks and the controls received GHC for 12 weeks. Ankle-brachial index (ABI), 6-min walk test (6MWT), peak oxygen consumption (V˙O_2peak), minute ventilation (V˙_E), minute carbon dioxide production (V˙CO₂), erythrocyte rheology, including the maximal elongation index (EI_max) and shear stress at 50% of maximal elongation (SS_1/2), and the Short Form-36 (SF-36) questionnaire for quality of life (QoL) were assessed before and 12 weeks after initial visit. SCT significantly decreased the SS_1/2 as well as SS_1/2 to EI_max ratio (SS_1/2/EI_max) and increased the erythrocyte osmolality in the hypertonic region as well as the area under EI-osmolality curve. The supervised exercise-induced improvement of erythrocyte deformability could contribute to the increased peripheral tissue O₂ delivery and was possibly related with increased V˙O_2peak. The physiological benefit was associated with significantly increased ABI, 6-min walking distance, cardiorespiratory fitness, and SF-36 score. However, no significant changes in aerobic capacity and erythrocyte rheological properties were observed after 12-week of GHC. In conclusion, SCT improves aerobic capacity by enhancing erythrocyte membrane deformability and consequently promotes QoL in PAD patients.

Eccentric Cycling Training Improves Erythrocyte Antioxidant and Oxygen Releasing Capacity Associated with Enhanced Anaerobic Glycolysis and Intracellular Acidosis

The antioxidant capacity of erythrocytes protects individuals against the harmful effects of oxidative stress. Despite improved hemodynamic efficiency, the effect of eccentric cycling training (ECT) on erythrocyte antioxidative capacity remains unclear. This study investigates how ECT affects erythrocyte antioxidative capacity and metabolism in sedentary males. Thirty-six sedentary healthy males were randomly assigned to either concentric cycling training (CCT, n = 12) or ECT (n = 12) at 60% of the maximal workload for 30 min/day, 5 days/week for 6 weeks or to a control group (n = 12) that did not receive an exercise intervention. A graded exercise test (GXT) was performed before and after the intervention. Erythrocyte metabolic characteristics and O₂ release capacity were determined by UPLC-MS and high-resolution respirometry, respectively. An acute GXT depleted Glutathione (GSH), accumulated Glutathione disulfide (GSSG), and elevated the GSSG/GSH ratio, whereas both CCT and ECT attenuated the extent of the elevated GSSG/GSH ratio caused by a GXT. Moreover, the two exercise regimens upregulated glycolysis and increased glucose consumption and lactate production, leading to intracellular acidosis and facilitation of O₂ release from erythrocytes. Both CCT and ECT enhance antioxidative capacity against severe exercise-evoked circulatory oxidative stress. Moreover, the two exercise regimens activate erythrocyte glycolysis, resulting in lowered intracellular pH and enhanced O₂ released from erythrocytes.

Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise

Background

The Fontan circulation is a unique palliation procedure for several congenital heart defects. Impaired exercise capacity has previously been demonstrated in these patients and also a higher risk for cardiopulmonary mortality. Hemorheology was shown to affect cardiopulmonary capacity and in turn to be affected by regular exercise and hypoxia but none of these have been investigated in Fontan patients so far. The aim of this study was to detect general differences in hemorheology in normoxia as well as possible altered hemorheological responses to hypoxia exposure and hypoxic exercise between Fontan patients and healthy controls.

Methods and Findings

26 Fontan patients and 20 healthy controls performed an acute exercise test (AET) on a bicycle ergometer under hypoxia with ambient 15.2% oxygen saturation (sO₂). Blood samples were taken at rest in normoxia (T0), at rest in hypoxia (T1), after maximum exhaustion in hypoxia (T2), and after 50 min recovery in normoxia (T3). Hemorheological and blood parameters were investigated. Additionally, arterial stiffness was tested at T0. Red blood cell (RBC) deformability, NOx, erythropoietin (EPO) concentration, RBC count, hemoglobin (Hb) concentration and hematocrit (hct) were significantly increased in Fontan patients compared to controls. Same was observed for arterial stiffness. No changes were observed for RBC aggregation, fibrinogen concentration, free radical levels and vascular endothelial growth factor (VEGF). Hypoxia exposure did not change parameters, whereas exercise in hypoxia increased aggregation and hct significantly in both groups. Fontan patients showed significantly increased aggregation-disaggregation balance compared to controls.

Conclusion

Acute hypoxia exposure and exercise under hypoxia might have similar impact on hemorheology in Fontan patients and controls and was clinically well tolerated. Nevertheless, exercise alters aggregation and possibly hemodynamics which requires special attention in Fontan patients.

Impact of a 10 km running trial on eryptosis, red blood cell rheology, and electrophysiology in endurance trained athletes: a pilot study

PURPOSE

Blood rheology is a key determinant of blood flow and tissue perfusion. There are still large discrepancies regarding the effects of an acute running exercise on blood rheological properties and red blood cell (RBC) physiology. We investigated the effect of a 10 km running trial on markers of blood rheology and RBC physiology in endurance trained athletes.

METHODS

Blood was sampled before and after the exercise to measure lactate and glucose, hematological and hemorheological parameters (blood viscosity, RBC deformability, and aggregation), eryptosis markers (phosphatidylserine and CD47 exposure, RBC reactive oxygen species), RBC-derived microparticles (RBC-MPs), and RBC electrophysiological activity. Weight was measured before and after exercise. Peripheral oxygen saturation and heart rate were monitored before and during the trial.

RESULTS

Blood lactate and glucose levels increased after exercise and subjects significantly lost weight. All athletes experienced a significant fall in oxygen saturation. Mean corpuscular volume (MCV) was increased from 95.1 ± 3.2 to 96.0 ± 3.3 and mean corpuscular hemoglobin concentration (MCHC) decreased after exercise suggesting a slight RBC rehydration. Exercise increased RBC deformability from 0.344 ± 0.04 to 0.378 ± 0.07, decreased RBC aggregates strength and blood viscosity, while hematocrit (Hct) remained unaffected. While RBC electrophysiological recording suggested a modulation in RBC calcium content and/or chloride conductance, eryptosis markers and RBC-MPs were not modified by the exercise.

CONCLUSION

A 10 km acute running exercise had no effect on RBC senescence and membrane blebbing. In contrast, this exercise increased RBC deformability, probably through rehydration process which resulted in a decrease in blood viscosity.

High-Intensity Interval Training Improves Erythrocyte Osmotic Deformability

INTRODUCTION

Physical exercise or hypoxic exposure influences erythrocyte susceptibility to osmotic stress, and the aquaporin 1 (AQP1) facilitates the transport of water in erythrocytes. This study investigated whether high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) affect erythrocyte osmotic deformability by modulating AQP1 function under hypoxic stress.

METHODS

Forty-five healthy sedentary males were randomized to engage in either HIIT (3-min intervals at 40% and 80% V˙O2 reserve, n = 15) or MICT (sustained 60% V˙O2 reserve, n = 15) on a bicycle ergometer for 30 min·d, 5 d·wk for 6 wk, or to a control group that did not perform any exercise (n = 15). All subjects were analyzed with osmotic gradient ektacytometry for assessing erythrocyte membrane stability and osmotic deformability after hypoxic exercise (HE) (100 W under 12%O2 for 30 min).

RESULTS

Before the intervention, HE increased the shear stress at 50% of maximal elongation (SS1/2) and the ratio of SS1/2 to maximal elongation index (SS1/2/EImax) on erythrocytes pretreated with 50 Pa of shear stress for 30 min and diminished HgCl2-depressed osmolality at 50%EImax (Ohyper). However, both HIIT and MICT for 6 wk diminished the elevations of erythrocyte SS1/2 and SS1/2/EImax caused by HE. Moreover, HIIT also increased contents of erythrocyte AQP1 proteins while enhancing HgCl2-depressed Ohyper and area under elongation index-osmolarity curve after HE. Additionally, changes in erythrocyte AQP1 contents were associated with changes in HgCl2-depressed erythrocyte Ohyper and area under elongation index-osmolarity curve.

CONCLUSIONS

Acute HE reduces erythrocyte membrane stability, whereas either HIIT or MICT attenuates the depression of erythrocyte membrane stability by HE. Moreover, HIIT increases the AQP1 content and facilitates the HgCl2-mediated osmotic deformability of erythrocytes after HE.