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Benitez-Albiter A, Anderson CP, Jones M, Park SS, Layec G, Park SY. Contributing Factors to Endothelial Dysfunction in Individuals with Spinal Cord Injuries. Pulse (Basel) 2024; 12:49-57. [PMID: 39022560 PMCID: PMC11250044 DOI: 10.1159/000539199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/27/2024] [Indexed: 07/20/2024] Open
Abstract
Background Patients with spinal cord injuries (SCIs) are at a greater risk for the development of cardiovascular diseases (CVDs) than able-bodied individuals due to the high risk of endothelial dysfunction. Summary For instance, patients with SCIs lose autonomic control of the heart and vasculature, which results in severe fluctuations in blood pressure. These oscillations between hypotension and hypertension have been shown to damage blood vessel endothelial cells and may contribute to the development of atherosclerosis. Furthermore, the loss of skeletal muscle control results in skeletal muscle atrophy and inward remodeling of the conduit arteries. It has been shown that blood vessels in the legs are chronically exposed to high shear, while the aorta experiences chronically low shear. These alterations to shear forces may adversely impact endothelial vasodilatory capacity and promote inflammatory signaling and leukocyte adherence. Additionally, microvascular endothelial vasodilatory capacity is impaired in patients with an SCI, and this may precede changes in conduit artery endothelial function. Finally, due to immobility and a loss of skeletal muscle mass, patients with SCIs have a higher risk of metabolic disorders, inflammation, and oxidative stress. Key Messages Collectively, these factors may impair endothelium-dependent vasodilatory capacity, promote leukocyte adhesion and infiltration, promote the peroxidation of lipids, and ultimately support the development of atherosclerosis. Therefore, future interventions to prevent CVDs in patients with SCIs should focus on the management of endothelial health to prevent endothelial dysfunction and atherosclerosis.
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Affiliation(s)
| | - Cody P. Anderson
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Matthew Jones
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Sang-Seo Park
- Department of Physiology, Kyung Hee University, Seoul, Republic of Korea
| | - Gwenael Layec
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
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Königstein K, Dipla K, Zafeiridis A. Training the Vessels: Molecular and Clinical Effects of Exercise on Vascular Health-A Narrative Review. Cells 2023; 12:2544. [PMID: 37947622 PMCID: PMC10649652 DOI: 10.3390/cells12212544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
Accelerated biological vascular ageing is still a major driver of the increasing burden of cardiovascular disease and mortality. Exercise training delays this process, known as early vascular ageing, but often lacks effectiveness due to a lack of understanding of molecular and clinical adaptations to specific stimuli. This narrative review summarizes the current knowledge about the molecular and clinical vascular adaptations to acute and chronic exercise. It further addresses how training characteristics (frequency, intensity, volume, and type) may influence these processes. Finally, practical recommendations are given for exercise training to maintain and improve vascular health. Exercise increases shear stress on the vascular wall and stimulates the endothelial release of circulating growth factors and of exerkines from the skeletal muscle and other organs. As a result, remodeling within the vascular walls leads to a better vasodilator and -constrictor responsiveness, reduced arterial stiffness, arterio- and angiogenesis, higher antioxidative capacities, and reduced oxidative stress. Although current evidence about specific aspects of exercise training, such as F-I-T-T, is limited, and exact training recommendations cannot be given, some practical implications can be extracted. As such, repeated stimuli 5-7 days per week might be necessary to use the full potential of these favorable physiological alterations, and the cumulative volume of mechanical shear stress seems more important than peak shear stress. Because of distinct short- and long-term effects of resistance and aerobic exercise, including higher and moderate intensities, both types of exercise should be implemented in a comprehensive training regimen. As vascular adaptability towards exercise remains high at any age in both healthy individuals and patients with cardiovascular diseases, individualized exercise-based vascular health prevention should be implemented in any age group from children to centenarians.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, 4052 Basel, Switzerland
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece;
| | - Andreas Zafeiridis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece;
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Luck JC, Blaha C, Cauffman A, Gao Z, Arnold AC, Cui J, Sinoway LI. Autonomic and vascular function testing in collegiate athletes following SARS-CoV-2 infection: an exploratory study. Front Physiol 2023; 14:1225814. [PMID: 37528892 PMCID: PMC10389084 DOI: 10.3389/fphys.2023.1225814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction: Recent studies suggest that SARS-CoV-2 infection alters autonomic and vascular function in young, otherwise healthy, adults. However, whether these alterations exist in young competitive athletes remains unknown. This study aimed to assess the effects of COVID-19 on cardiac autonomic control and vascular function in collegiate athletes who tested positive for COVID-19, acknowledging the limitations imposed by the early stages of the pandemic. Methods: Sixteen collegiate athletes from various sports underwent a battery of commonly used autonomic and vascular function tests (23 ± 9, range: 12-44 days post-infection). Additionally, data from 26 healthy control participants were included. Results: In response to the Valsalva maneuver, nine athletes had a reduced early phase II blood pressure response and/or reduced Valsalva ratio. A depressed respiratory sinus arrhythmia amplitude was observed in three athletes. Three athletes became presyncopal during standing and did not complete the 10-min orthostatic challenge. Brachial artery flow-mediated dilation, when allometrically scaled to account for differences in baseline diameter, was not different between athletes and controls (10.0% ± 3.5% vs. 7.1% ± 2.4%, p = 0.058). Additionally, no differences were observed between groups when FMD responses were normalized by shear rate (athletes: 0.055% ± 0.026%/s-1, controls: 0.068% ± 0.049%/s-1, p = 0.40). Discussion: Few atypical and borderline responses to autonomic function tests were observed in athletes following an acute SARS-CoV-2 infection. The most meaningful autonomic abnormality being the failure of three athletes to complete a 10-min orthostatic challenge. These findings suggest that some athletes may develop mild alterations in autonomic function in the weeks after developing COVID-19, while vascular function is not significantly impaired.
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Affiliation(s)
- J. Carter Luck
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Cheryl Blaha
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Aimee Cauffman
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Zhaohui Gao
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Amy C. Arnold
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Jian Cui
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Lawrence I. Sinoway
- Milton S. Hershey Medical Center, Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, United States
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Hansen RK, Samani A, Laessoe U, Handberg A, Mellergaard M, Figlewski K, Thijssen DHJ, Gliemann L, Larsen RG. Rowing exercise increases cardiorespiratory fitness and brachial artery diameter but not traditional cardiometabolic risk factors in spinal cord-injured humans. Eur J Appl Physiol 2023; 123:1241-1255. [PMID: 36781425 PMCID: PMC9924870 DOI: 10.1007/s00421-023-05146-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 01/26/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE This study assessed the effects of upper-body rowing exercise on cardiorespiratory fitness, traditional cardiometabolic risk factors, and vascular health in individuals with spinal cord injury (SCI). METHODS Seventeen male and female adults with chronic (> 1 yr) motor-complete and incomplete SCI (level of injury: C4-L3) were randomized to control (CON, n = 9) or exercise (UBROW, n = 8). Participants in UBROW performed 12-week, 3 weekly sessions of 30-min upper-body ergometer rowing exercise, complying with current exercise guidelines for SCI. Cardiorespiratory fitness ([Formula: see text]O2peak), traditional risk factors (lipid profile, glycemic control) as well as inflammatory and vascular endothelium-derived biomarkers (derived from fasting blood samples) were measured before and after 6 (6W) and 12 weeks (12W). Brachial artery resting diameter and flow-mediated dilation (FMD) were determined by ultrasound as exploratory outcomes. RESULTS UBROW increased [Formula: see text]O2peak from baseline (15.1 ± 5.1 mL/kg/min; mean ± SD) to 6W (16.5 ± 5.3; P < 0.01) and 12W (17.5 ± 6.1; P < 0.01). UBROW increased resting brachial artery diameter from baseline (4.80 ± 0.72 mm) to 12W (5.08 ± 0.91; P < 0.01), with no changes at 6W (4.96 ± 0.91), and no changes in CON. There were no significant time-by-group interactions in traditional cardiometabolic blood biomarkers, or in unadjusted or baseline diameter corrected FMD. Explorative analyses revealed inverse correlations between changes (∆12W-baseline) in endothelin-1 and changes in resting diameter (r = - 0.56) and FMD% (r = - 0.60), both P < 0.05. CONCLUSION These results demonstrate that 12 weeks of upper-body rowing complying with current exercise guidelines for SCI improves cardiorespiratory fitness and increases resting brachial artery diameter. In contrast, the exercise intervention had no or only modest effects on traditional cardiometabolic risk factors. The study was registered at Clinicaltrials.gov (N-20190053, May 15, 2020).
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Affiliation(s)
- Rasmus Kopp Hansen
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark.
- Department of Research and Development, University College of Northern Jutland, Aalborg, Denmark.
| | - Afshin Samani
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark
| | - Uffe Laessoe
- Department of Research and Development, University College of Northern Jutland, Aalborg, Denmark
| | - Aase Handberg
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Maiken Mellergaard
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Dick H J Thijssen
- Department of Medical BioSciences, Radboud University Medical Centre, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University Of Copenhagen, Copenhagen, Denmark
| | - Ryan Godsk Larsen
- Department of Health Science and Technology, Sport Sciences - Performance and Technology, Aalborg University, Aalborg, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark
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Sakellariou XM, Papafaklis MI, Domouzoglou EM, Katsouras CS, Michalis LK, Naka KK. Exercise-mediated adaptations in vascular function and structure: Beneficial effects in coronary artery disease. World J Cardiol 2021; 13:399-415. [PMID: 34621486 PMCID: PMC8462042 DOI: 10.4330/wjc.v13.i9.399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/30/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium, thereby leading to functional and structural adaptations that lower cardiovascular risk. The patterns of blood flow and endothelial shear stress during exercise lead to atheroprotective hemodynamic stimuli on the endothelium and contribute to adaptations in vascular function and structure. The structural adaptations observed in arterial lumen dimensions after prolonged exercise supplant the need for acute functional vasodilatation in case of an increase in endothelial shear stress due to repeated exercise bouts. In contrast, wall thickness is affected by rather systemic factors, such as transmural pressure modulated during exercise by generalized changes in blood pressure. Several mechanisms have been proposed to explain the exercise-induced benefits in patients with coronary artery disease (CAD). They include decreased progression of coronary plaques in CAD, recruitment of collaterals, enhanced blood rheological properties, improvement of vascular smooth muscle cell and endothelial function, and coronary blood flow. This review describes how exercise via alterations in hemodynamic factors influences vascular function and structure which contributes to cardiovascular risk reduction, and highlights which mechanisms are involved in the positive effects of exercise on CAD.
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Affiliation(s)
- Xenofon M Sakellariou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
| | - Michail I Papafaklis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Eleni M Domouzoglou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- Department of Pediatrics, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Christos S Katsouras
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Lampros K Michalis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Katerina K Naka
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
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Argarini R, Carter HH, Smith KJ, Naylor LH, McLaughlin RA, Green DJ. Adaptation to Exercise Training in Conduit Arteries and Cutaneous Microvessels in Humans: An Optical Coherence Tomography Study. Med Sci Sports Exerc 2021; 53:1945-1957. [PMID: 33731650 DOI: 10.1249/mss.0000000000002654] [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: 11/21/2022]
Abstract
INTRODUCTION Exercise training has antiatherogenic effects on conduit and resistance artery function and structure in humans and induces angiogenic changes in skeletal muscle. However, training-induced adaptation in cutaneous microvessels is poorly understood, partly because of technological limitations. Optical coherence tomography (OCT) is a novel high-resolution imaging technique capable of visualizing cutaneous microvasculature at a resolution of ~30 μm. We utilized OCT to visualize the effects of training on cutaneous microvessels, alongside assessment of conduit artery flow-mediated dilation (FMD). METHODS We assessed brachial FMD and cutaneous microcirculatory responses at rest and in response to local heating and reactive hyperemia: pretraining and posttraining in eight healthy men compared with age-matched untrained controls (n = 8). Participants in the training group underwent supervised cycling at 80% maximal heart rate three times a week for 8 wk. RESULTS We found a significant interaction (P = 0.04) whereby an increase in FMD was observed after training (post 9.83% ± 3.27% vs pre 6.97% ± 1.77%, P = 0.01), with this posttraining value higher compared with the control group (6.9% ± 2.87%, P = 0.027). FMD was not altered in the controls (P = 0.894). There was a significant interaction for OCT-derived speed (P = 0.038) whereby a significant decrease in the local disk heating response was observed after training (post 98.6 ± 3.9 μm·s-1 vs pre 102 ± 5 μm·s-1, P = 0.012), whereas no changes were observed for OCT-derived speed in the control group (P = 0.877). Other OCT responses (diameter, flow rate, and density) to local heating and reactive hyperemia were unaffected by training. CONCLUSIONS Our findings suggest that vascular adaptation to exercise training is not uniform across all levels of the arterial tree; although exercise training improves larger artery function, this was not accompanied by unequivocal evidence for cutaneous microvascular adaptation in young healthy subjects.
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Affiliation(s)
| | - Howard H Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
| | | | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
| | | | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, AUSTRALIA
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Baumgartner L, Weberruß H, Engl T, Schulz T, Oberhoffer-Fritz R. Exercise Training Duration and Intensity Are Associated With Thicker Carotid Intima-Media Thickness but Improved Arterial Elasticity in Active Children and Adolescents. Front Cardiovasc Med 2021; 8:618294. [PMID: 34307488 PMCID: PMC8295565 DOI: 10.3389/fcvm.2021.618294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Even though exercise generally has a positive effect on health, intensive exercise can have adverse effects on the vascular system of adults. This study aimed to investigate the association between training duration and intensity and vascular structure and function in 427 physically active children and adolescents (14.0 ± 1.94 years). In this study, we examined carotid intima-media thickness (cIMT), carotid diameter, and cIMT:diameter-ratio as parameters of carotid arterial structure and arterial compliance (AC), stiffness index β (β), elastic modulus (Ep), and carotid pulse wave velocity (PWVβ) as parameters of carotid arterial function with high-resolution ultrasound. We collected central systolic blood pressure (cSBP) and aortic pulse wave velocity (aPWV) as parameters of central arterial stiffness with an oscillometric device. We used the MoMo Physical Activity Questionnaire to record training duration and intensity. Training duration (p = 0.022) and intensity (p = 0.024) were associated with higher cIMT. Further, training duration was associated with lower central arterial stiffness (cSBP: p = 0.001; aPWV: p = 0.033) and improved AC (p < 0.001). Higher training intensity was related to improved AC (p < 0.001) and larger carotid diameter (p = 0.040). Boys presented thicker cIMT (p = 0.010), improved AC (p = 0.006), and lower central arterial stiffness (cSBP: p < 0.001; aPWV: p = 0.016) associated with higher training duration. Girls presented improved AC (p = 0.023) and lower Ep (p = 0.038) but higher β (p = 0.036) associated with higher training duration. Only boys demonstrated thicker cIMT (p = 0.016) and improved AC (p = 0.002) associated with higher training intensity. A quintile analyses of the training duration revealed thicker cIMT of children and adolescents in Q1 and Q5 than that in Q4 and Q5. Besides, Q1 showed lower cSBP compared to Q4 and Q5. Regarding training intensity, Q5 had thicker cIMT than Q2 and Q3. Although a higher training load is associated with thicker cIMT, the common carotid artery is also more elastic. This suggests that a higher training load leads to a functional adaptation of the carotid artery in youth.
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Affiliation(s)
- Lisa Baumgartner
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Heidi Weberruß
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Tobias Engl
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Thorsten Schulz
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
| | - Renate Oberhoffer-Fritz
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Science, Technical University of Munich, Munich, Germany
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Jansen E, de Groot S, Smit CA, Thijssen DHJ, Te Hopman M, Janssen TWJ. Vascular adaptations in nonstimulated areas during hybrid cycling or handcycling in people with a spinal cord injury: a pilot study of 10 cases. Spinal Cord Ser Cases 2021; 7:54. [PMID: 34193818 PMCID: PMC8245507 DOI: 10.1038/s41394-021-00417-2] [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: 02/02/2020] [Revised: 05/04/2021] [Accepted: 06/04/2021] [Indexed: 11/08/2022] Open
Abstract
STUDY DESIGN Sub-study of a randomized controlled trial. OBJECTIVES To examine if hybrid cycling (cycling with the legs via electrical stimulation combined with voluntary handcycling) compared to handcycling leads to different systemic vascular adaptations in individuals with a long-term spinal cord injury (SCI). SETTING Two rehabilitation centers in the Netherlands. METHODS Ten individuals with a SCI trained on a hybrid bicycle (N = 5) or a handcycle (N = 5) for 16 weeks twice a week. Prior to and following the training the intima media thickness (IMT) of the common coronary artery (CCA) and superficial femoral artery (SFA) were measured and the flow-mediated dilation (FMD) of the brachial artery (BA) was analyzed. RESULTS Before training, there were no significant differences in any of the outcome measures between the groups. We found no change in CCA IMT (pre: 0.616 mm, post: 0.586 mm), or in SFA (pre: 0.512 mm, post: 0.520 mm) after hybrid cycling. We also found no change in FMD % of BA after hybrid cycling (pre: 9.040%, post: 9.220%). There were no changes in CCA IMT, SFA IMT, and FMD% after handcycling either. CONCLUSIONS It appears that 16 weeks of twice-weekly training of up to 30 min on a hybrid bicycle or handcycle does not lead to systemic vascular adaptations. A larger sample size and training protocol with more frequent and higher intensity training (which might involve a home-based setting and an adapted period prior to the training) might show different results.
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Affiliation(s)
- Evelien Jansen
- Amsterdam Rehabilitation Research Centre Reade, Amsterdam, The Netherlands.
- Centre Basalt Wassenaarseweg 501, Leiden, The Netherlands.
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, The Netherlands
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Dick H J Thijssen
- Department of Physiology, Radboud University, Nijmegen, The Netherlands
- Cardiovascular Physiology and Exercise at Liverpool John Moores University, Liverpool, UK
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Is there an athlete's artery? A comparison of brachial and femoral artery structure and function in male strength, power and endurance athletes. J Sci Med Sport 2021; 24:635-640. [PMID: 33840624 DOI: 10.1016/j.jsams.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Exercise places physiological demands upon the cardiovascular system, subsequently leading to adaptations in structure and function. Different exercise modalities (endurance, strength and power) lead to distinct hemodynamic demands and, possibly, different patterns of adaptation. Our aim was to assess and compare brachial and femoral artery function and structure in elite level athletes engaged in endurance, strength and power sports. DESIGN cross sectional comparison. METHODS 30 male elite athletes (runners n=10, powerlifters n=11, weightlifters n=9) and 23 healthy controls were recruited. Brachial and femoral arterial diameters were assessed using ultrasound. Arterial function (brachial and femoral arteries) was determined using the flow mediated dilation (FMD) technique and body composition using body mass index (BMI) and body surface area (BSA). RESULTS Weightlifters had significantly larger brachial arterial diameters compared to controls (4.39±0.34 vs 3.86±0.42mm, p<0.01). As weightlifter and power athletes had significantly higher body mass, BMI and BSA, we adjusted diameter for BSA. BSA-correction ameliorated differences in brachial artery resting diameters between athletes and controls. However, BSA-corrected femoral artery diameter was significantly larger in runners compared to controls (3.51±0.28 vs 3.25±0.34mm, p<0.05). There were no differences in brachial FMD between groups. Femoral artery FMD was significantly higher in runners and weightlifters compared to controls (p<0.05 for both groups). CONCLUSIONS Heterogeneous, limb-specific structural and functional vascular adaptation is evident in athletes, which may be influenced by exercise modality. Further, vascular remodelling relates to differences in body shape, specifically body composition, which should be accounted for when comparing athletes.
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The Impact of Exercise and Athletic Training on Vascular Structure and Function. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2020. [DOI: 10.1007/s11936-020-00861-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hansen RK, Samani A, Laessoe U, Handberg A, Larsen RG. Effect of wheelchair-modified rowing exercise on cardiometabolic risk factors in spinal cord injured wheelchair users: protocol for a randomised controlled trial. BMJ Open 2020; 10:e040727. [PMID: 33067301 PMCID: PMC7569950 DOI: 10.1136/bmjopen-2020-040727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Cardiovascular and metabolic diseases are a growing concern for individuals with spinal cord injury (SCI). Physical inactivity contributes to cardiometabolic morbidity and mortality in the SCI population. However, previous studies have shown mixed results regarding the effects of exercise on cardiometabolic risk factors in individuals with SCI. This discrepancy could be influenced by insufficient exercise stimuli. Recent guidelines recommend 30 min of moderate-to-vigorous intensity aerobic exercise, three times per week, for improvement in cardiometabolic health in individuals with SCI. However, to date, no studies have implemented an exercise intervention matching the new recommendations to examine the effects on cardiometabolic risk factors. Therefore, the primary objective of this study is to determine the effects of 12 weeks of wheelchair user-modified upper-body rowing exercise on both traditional (constituents of the metabolic syndrome) and novel (eg, vascular structure and function) cardiometabolic risk factors in manual wheelchair users with SCI. METHODS AND ANALYSIS A randomised controlled trial will compare 12 weeks of upper-body rowing exercise, 30 min three times per week, with a control group continuing their normal lifestyle. Outcome measurements will be performed immediately before (baseline), after 6 weeks (halfway), 12 weeks of training (post) and 6 months after the termination of the intervention period (follow-up). Outcomes will include inflammatory (eg, C reactive protein) and metabolic biomarkers determined from venous blood (with serum fasting insulin as primary outcome), body composition, arterial blood pressure, cardiorespiratory fitness level, brachial artery vascular structure and function and autonomic nervous system function. ETHICS AND DISSEMINATION This trial is reported to the Danish Data Protection Agency (J.nr. 2019-899/10-0406) and approved by the Committees on Health Research Ethics in The North Denmark Region on 12 December 2019 (J.nr. N-20190053). The principal investigator will collect written informed consent from all participants prior to inclusion. Irrespective of study outcomes, the results will be submitted to peer-reviewed scientific journals for publication. TRIAL REGISTRATION NUMBER NCT04390087.
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Affiliation(s)
- Rasmus Kopp Hansen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Uffe Laessoe
- Department of Research and Development, University College of Northern Jutland (UCN), Aalborg, Denmark
- Physical Therapy Department, University College of Northern Jutland (UCN), Aalborg, Denmark
| | - Aase Handberg
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ryan Godsk Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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12
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Gifford JR, Hanson BE, Proffit M, Wallace T, Kofoed J, Griffin G, Hanson M. Indices of leg resistance artery function are independently related to cycling V̇O 2 max. Physiol Rep 2020; 8:e14551. [PMID: 32812353 PMCID: PMC7435036 DOI: 10.14814/phy2.14551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE While maximum blood flow influences one's maximum rate of oxygen consumption (V̇O2 max), with so many indices of vascular function, it is still unclear if vascular function is related to V̇O2 max in healthy, young adults. The purpose of this study was to determine if several common vascular tests of conduit artery and resistance artery function provide similar information about vascular function and the relationship between vascular function and V̇O2 max. METHODS Twenty-two healthy adults completed multiple assessments of leg vascular function, including flow-mediated dilation (FMD), reactive hyperemia (RH), passive leg movement (PLM), and rapid onset vasodilation (ROV). V̇O2 max was assessed with a graded exercise test on a cycle ergometer. RESULTS Indices associated with resistance artery function (e.g., peak flow during RH, PLM, and ROV) were generally related to each other (r = 0.47-77, p < .05), while indices derived from FMD were unrelated to other tests (p < .05). Absolute V̇O2 max (r = 0.57-0.73, p < .05) and mass-specific V̇O2 max (r = 0.41-0.46, p < .05) were related to indices of resistance artery function, even when controlling for factors like body mass and sex. FMD was only related to mass-specific V̇O2 max after statistically controlling for baseline artery diameter (r = 0.44, p < .05). CONCLUSION Indices of leg resistance artery function (e.g., peak flow during RH, PLM, and ROV) relate well to each other and account for ~30% of the variance in V̇O2 max not accounted for by other factors, like body mass and sex. Vascular interventions should focus on improving indices of resistance artery function, not conduit artery function, when seeking to improve exercise capacity.
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Affiliation(s)
- Jayson R. Gifford
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
- Program of GerontologyBrigham Young UniversityProvoUTUSA
| | - Brady E. Hanson
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
| | - Meagan Proffit
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
- Program of GerontologyBrigham Young UniversityProvoUTUSA
| | - Taysom Wallace
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
| | - Jason Kofoed
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
| | - Garrett Griffin
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
| | - Melina Hanson
- Department of Exercise SciencesBrigham Young UniversityProvoUTUSA
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13
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Lujan HL, DiCarlo SE. Direct comparison of cervical and high thoracic spinal cord injury reveals distinct autonomic and cardiovascular consequences. J Appl Physiol (1985) 2020; 128:554-564. [PMID: 31999525 DOI: 10.1152/japplphysiol.00721.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A wide range of spinal cord levels (cervical 8-thoracic 6) project to the stellate ganglia (which provides >90% of sympathetic supply to the heart), with a peak at the thoracic 2 (T2) level. We hypothesize that despite the proximity of the lesions, high thoracic spinal cord injuries (i.e., T2-3 SCI) do not closely mimic the hemodynamic responses recorded with cervical SCI (i.e., C6-7 SCI). To test this hypothesis, rats were instrumented with an intra-arterial telemetry device (Data Sciences International PA-C40) for recording arterial pressure, heart rate, and locomotor activity as well as a catheter within the intraperitoneal space. After recovery, rats were subjected to complete C6-7 spinal cord transection (n = 8), sham transection (n = 4), or T2-3 spinal cord transection (n = 7). After the spinal cord transection or sham transection, arterial pressure, heart rate, and activity counts were recorded in conscious animals, in a thermoneutral environment, for 20 s every minute, 24 h/day for 12 consecutive weeks. After 12 wk, chronic reflex- and stress-induced cardiovascular and hormonal responses were compared in all groups. C6-7 rats had hypotension, bradycardia, and reduced physical activity. In contrast, T2-3 rats were tachycardic. C6-7 rats compared with T2-3 and spinal intact rats also had reduced cardiac sympathetic tonus, reduced reflex- and stress induced cardiovascular responses, and reduced sympathetic support of blood pressure as well as enhanced reliance on angiotensin to maintain arterial blood pressure. Thus injuries above and below the peak level (T2) of spinal cord projections to the stellate ganglia have remarkably different outcomes.NEW & NOTEWORTHY Twelve consecutive weeks of resting hemodynamic data as well as chronic reflex- and stress-induced cardiovascular, autonomic, and hormonal responses were compared in spinal intact and C6-7 and T2-3 spinal cord-transected rats. C6-7 rats compared with T2-3 and spinal intact rats had reduced cardiac sympathetic tonus, reduced reflex- and stress-induced cardiovascular responses, and reduced sympathetic support of blood pressure as well as enhanced reliance on angiotensin to maintain arterial blood pressure. Thus injuries above and below the peak level (T2) of spinal cord projections to the stellate ganglia have remarkably different outcomes.
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Affiliation(s)
- Heidi L Lujan
- Department of Physiology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
| | - Stephen E DiCarlo
- Department of Physiology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan
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14
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Duarte-Mendes P, Paulo R, Coelho P, Rodrigues F, Marques V, Mateus S. Variability of Lower Limb Artery Systolic-Diastolic Velocities in Futsal Athletes and Non-Athletes: Evaluation by Arterial Doppler Ultrasound. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E570. [PMID: 31963123 PMCID: PMC7013457 DOI: 10.3390/ijerph17020570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 12/15/2022]
Abstract
Background: Sports athletes, namely high-intensity practitioners, suffer from vascular remodeling overtime. The purpose of this study was to analyze the systolic and diastolic velocities' variation between non-athletes and futsal athletes by means of arterial lower limb doppler ultrasound. Additionally, we intended to verify if the velocity variations occur primarily at the systolic or the diastolic level and in which arteries. Methods: Seventy-six young males (mean ± SD: 24.9 ± 2.8 years old) volunteered to participate in this cross-sectional study and were divided into two groups: a futsal athletes group (n = 38; 24 ± 2.78 years) in the central region of Portugal playing on the 2nd national league with the same level of practice (16 ± 2.4 years of practice) and a non-athletes group (n = 38: 26 ± 1.8 years) who did not practice sports regularly and were not federated in any sport. All the subjects agreed to participate in the study with the aim of assessing the arterial lower limb through doppler ultrasound (Philips HD7 echograph with linear transducer 7-12 MHz). Results: Differences between groups (p ≤ 0.05) in the systolic velocity of the left deep femoral artery (p = 0.022; d = 0.546, small) and in the right superficial femoral artery (p = 0.028; d = -0.515, small) were found. We also found differences in the diastolic velocity: in the left common femoral artery (p = 0.002; d = -0.748, moderate), in the right deep femoral artery (p = 0.028; d = -0.521, small), in the right superficial femoral artery (p = 0.026; d = -0.522, small), in the right popliteal artery (p = 0.002; d = -0.763, moderate), and in the left popliteal artery (p = 0.007; d = -0.655, moderate). Moreover, the athletes' group presented the highest mean values, with the exception of the systolic velocity of the left deep femoral artery. In intragroup analysis of variance referring to systolic and diastolic velocities in arterial levels in the right and left arteries, differences were found in all analyses (p ≤ 0.05). Conclusions: We conclude that futsal athletes of our sample go through a process of changes such as increased blood flow velocity in systolic and diastolic cardiac phase in all studied lower limb arteries, showing that the remodeling occurs regardless of vessel radius. Our results reinforce the existence of vascular remodeling that may vary with the sport and its intensity.
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Affiliation(s)
- Pedro Duarte-Mendes
- Department of Sports and Well-being, Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal;
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (P.C.); (F.R.)
- Research Unit in Education and Community Intervention (RECI), 3515-776 Viseu, Portugal
| | - Rui Paulo
- Department of Sports and Well-being, Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal;
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (P.C.); (F.R.)
- Research Unit in Education and Community Intervention (RECI), 3515-776 Viseu, Portugal
| | - Patrícia Coelho
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (P.C.); (F.R.)
- Department of Clinical Physiology, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- Quality of Life in the Rural World (Q-Rural), Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
| | - Francisco Rodrigues
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (P.C.); (F.R.)
- Quality of Life in the Rural World (Q-Rural), Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- Department Biomedical Sciences Laboratory, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
| | - Vasco Marques
- Vascular Ultrasound Laboratory, Angiology and Vascular Surgery Service, University Hospital Centre of Lisbon University Hospital Centre of Lisbon, 1169-024 Lisboa, Portugal;
| | - Sónia Mateus
- Sport, Health & Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (P.C.); (F.R.)
- Department of Clinical Physiology, Polytechnic Institute of Castelo Branco, 6000-767 Castelo Branco, Portugal
- EPE–Neurovascular and Cardíac Ultrasound Lab, Espiríto Santo of Évora Hospital, 7000-811 Évora, Portugal
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15
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Limberg JK, Casey DP, Trinity JD, Nicholson WT, Wray DW, Tschakovsky ME, Green DJ, Hellsten Y, Fadel PJ, Joyner MJ, Padilla J. Assessment of resistance vessel function in human skeletal muscle: guidelines for experimental design, Doppler ultrasound, and pharmacology. Am J Physiol Heart Circ Physiol 2019; 318:H301-H325. [PMID: 31886718 DOI: 10.1152/ajpheart.00649.2019] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The introduction of duplex Doppler ultrasound almost half a century ago signified a revolutionary advance in the ability to assess limb blood flow in humans. It is now widely used to assess blood flow under a variety of experimental conditions to study skeletal muscle resistance vessel function. Despite its pervasive adoption, there is substantial variability between studies in relation to experimental protocols, procedures for data analysis, and interpretation of findings. This guideline results from a collegial discussion among physiologists and pharmacologists, with the goal of providing general as well as specific recommendations regarding the conduct of human studies involving Doppler ultrasound-based measures of resistance vessel function in skeletal muscle. Indeed, the focus is on methods used to assess resistance vessel function and not upstream conduit artery function (i.e., macrovasculature), which has been expertly reviewed elsewhere. In particular, we address topics related to experimental design, data collection, and signal processing as well as review common procedures used to assess resistance vessel function, including postocclusive reactive hyperemia, passive limb movement, acute single limb exercise, and pharmacological interventions.
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Affiliation(s)
- Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,François M. 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
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | | | - D Walter Wray
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Michael E Tschakovsky
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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16
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Schroeder EC, Hilgenkamp TIM, Lefferts WK, Robinson N, Baynard T, Fernhall B. No effect of fitness on brachial or forearm vascular function during acute inflammation in young adults. Am J Physiol Regul Integr Comp Physiol 2019; 317:R746-R753. [PMID: 31553624 DOI: 10.1152/ajpregu.00120.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Acute inflammation is associated with increased risk of cardiovascular events and impaired vasodilatory capacity. Vasodilatory capacity can be measured in different segments of the arterial tree; however, it is unknown if the effects of acute inflammation are vascular segment-specific or if inflammation-induced dysfunction can be attenuated by factors that modulate cardiovascular risk, such as high cardiorespiratory fitness. The purpose of this study was to determine the effect of acute inflammation and fitness on conduit artery, resistance artery, and microvascular function in healthy, young adults. Vascular function was assessed at baseline and 24 h after a typhoid vaccination in 11 low-fit (5 male, 24 yr of age, 34.5 ± 2.9 ml·kg-1·min-1 peak O2 uptake (V̇o2peak)] and 12 high-fit (7 male, 27 yr of age, 56.4 ± 9.7 ml·kg-1·min-1 V̇o2peak) young adults. Vascular assessments included flow-mediated dilation (FMD) of the brachial artery, forearm reactive hyperemia (RH) via venous occlusion plethysmography, and near-infrared spectroscopy (NIRS) during a 5-min arterial occlusion. Acute inflammation was evident with increases in IL-6 and C-reactive protein (P < 0.01), and mean arterial pressure did not change (P = 0.33). FMD was lower in the high-fit group, yet it was reduced in both groups at 24 h, even after controlling for shear (P < 0.05). No effect of acute inflammation was observed for RH or NIRS (P > 0.05). Acute inflammation had nonuniform effects on vascular function throughout the arterial tree in young adults, and fitness did not alter the vascular response. This suggests that cardiorespiratory fitness may not protect the vasculature during acute inflammation in young adults in the absence of age- or disease-related decline in vascular function.
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Affiliation(s)
- Elizabeth C Schroeder
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Thessa I M Hilgenkamp
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Wesley K Lefferts
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Nadia Robinson
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, Illinois
| | - Tracy Baynard
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
| | - Bo Fernhall
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois
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17
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Akerman AP, Thomas KN, van Rij AM, Body ED, Alfadhel M, Cotter JD. Heat therapy vs. supervised exercise therapy for peripheral arterial disease: a 12-wk randomized, controlled trial. Am J Physiol Heart Circ Physiol 2019; 316:H1495-H1506. [DOI: 10.1152/ajpheart.00151.2019] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Peripheral arterial disease (PAD) is characterized by lower limb atherosclerosis impairing blood supply and causing walking-induced leg pain or claudication. Adherence to traditional exercise training programs is poor due to these symptoms despite exercise being a mainstay of conservative treatment. Heat therapy improves many cardiovascular health outcomes, so this study tested if this was a viable alternative cardiovascular therapy for PAD patients. Volunteers with PAD were randomized to 12 wk of heat ( n = 11; mean age 76 ± 8 yr, BMI 28.7 ± 3.5 kg/m2, 4 females) or exercise ( n = 11; 74 ± 10 yr, 28.5 ± 6.8 kg/m2, 3 females). Heat involved spa bathing at ∼39°C, 3–5 days/wk for ≤30 min, followed by ≤30 min of callisthenics. Exercise involved ≤90 min of supervised walking and gym-based exercise, 1–2 days/wk. Following the interventions, total walking distance during a 6-min walk test increased (from ∼350 m) by 41 m (95% CI: [13, 69], P = 0.006) regardless of group, and pain-free walking distance increased (from ∼170 m) by 43 m ([22, 63], P < 0.001). Systolic blood pressure was reduced more following heat (−7 mmHg, [−4, −10], P < 0.001) than following exercise (−3 mmHg, [0, −6], P = 0.078), and diastolic and mean arterial pressure decreased by 4 mmHg in both groups ( P = 0.002). There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were no differences in the improvement in functional or blood pressure outcomes between heat and exercise in individuals with PAD. NEW & NOTEWORTHY Heat therapy via hot-water immersion and supervised exercise both improved walking distance and resting blood pressure in peripheral arterial disease (PAD) patients over 12 wk. Adherence to heat therapy was excellent, and the heat intervention was well tolerated. The results of the current study indicate that heat therapy can improve functional ability and has potential as an effective cardiovascular conditioning tool for individuals with PAD. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/heat-therapy-vs-exercise-in-peripheral-arterial-disease/ .
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Affiliation(s)
- Ashley P. Akerman
- School of Physical Education, Sport, and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Kate N. Thomas
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Andre M. van Rij
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - E. Dianne Body
- Physiotherapy Department, Dunedin Public Hospital, Dunedin, New Zealand
| | - Mesfer Alfadhel
- Cardiology Department, Dunedin Public Hospital, Dunedin, New Zealand
| | - James D. Cotter
- School of Physical Education, Sport, and Exercise Sciences, University of Otago, Dunedin, New Zealand
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18
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Bianchini E, Bruno RM, Di Lascio N, Vezzoli A, Mrakic-Sposta S, Corciu AI, Comassi M, Pratali L. Acute Cardiovascular Adaptation to Strenuous Exercise: An Integrative Ultrasound Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:463-470. [PMID: 30058080 DOI: 10.1002/jum.14719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the acute effects of participation in an Ironman distance triathlon competition on arterial function by ultrasound, in relation to cardiac function and body water content. METHODS Twenty-eight male triathletes participating in an Ironman distance competition underwent carotid, femoral, and cardiac ultrasound examinations. Moreover, the presence of extravascular lung water was identified by lung echo B-lines (echogenic coherent wedge-shaped signal with a narrow origin from the hyperechoic pleural line) at rest and within 20 minutes of arrival. RESULTS At the end of the competition, athletes showed an increased heart rate (mean ± SD, from 60.2 ± 13.1 to 82.8 ± 15.6 beats/min; P < .0001) and unchanged mean blood pressure (from 93 ± 14 to 91 ± 10 mm Hg; P > .05) in the presence of negligible dehydration (total body water from 48.0 ± 4.0 to 46.5 ± 3.9 kg; P > .05). Cardiac output increased (from 5.5 ± 1.2 to 6.7 ± 2.4 L/min; P < .05) in the presence of an unchanged stroke volume (from 64 ± 14 to 59 ± 16 mL; P > .05) and unchanged left ventricular elastance (from 1.52 ± 0.48 to 1.39 ± 0.48 mm Hg/mL/m2 ; P > .05). The mean carotid diameter increased (from 7.19 ± 0.65 to 7.61 ± 0.76 mm; P < .05), whereas the mean femoral diameter was unchanged at the end of the competition (from 10.41 ± 0.83 to 10.49 ± 0.82 mm; P > .05). Carotid intima-media thickness was significantly reduced (from 537 ± 70 to 495 ± 70 μm; P < .05), whereas B-lines increased significantly after the competition (from 1 [0-4] to 12 [5-23]; P < .0001). CONCLUSIONS These data suggest different acute functional adaptation in central arteries with respect to peripheral leg vessels.
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Affiliation(s)
- Elisabetta Bianchini
- Institute of Clinical Physiology, Consiglio Nazionale Delle Ricerche, Pisa, Italy
| | | | - Nicole Di Lascio
- Institute of Life Science, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandra Vezzoli
- Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale Delle Ricerche, Milan, Italy
| | - Simona Mrakic-Sposta
- Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale Delle Ricerche, Milan, Italy
| | - Anca Irina Corciu
- Institute of Clinical Physiology, Consiglio Nazionale Delle Ricerche, Pisa, Italy
- Department of Cardiology, Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico S. Donato, Milan, Italy
| | - Mario Comassi
- Azienda Ospedaliera Universitaria Pisana, Unità Operativa Medicina di Urgenza e Pronto Soccorso Servizio Sanitario Nazionale, Pisa, Italy
| | - Lorenza Pratali
- Institute of Clinical Physiology, Consiglio Nazionale Delle Ricerche, Pisa, Italy
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19
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Brunt VE, Howard MJ, Francisco MA, Ely BR, Minson CT. Reply from Vienna E. Brunt, Matthew J. Howard, Michael A. Francisco, Brett R. Ely and Christopher T. Minson. J Physiol 2018; 595:3669-3670. [PMID: 28568770 DOI: 10.1113/jp274129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Matthew J Howard
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Michael A Francisco
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
| | - Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, OR, 97403, USA
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20
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Marchio P, Guerra-Ojeda S, Vila JM, Aldasoro M, Valles SL, Soler C, Mauricio MD. Chronic exercise impairs nitric oxide pathway in rabbit carotid and femoral arteries. J Physiol 2018; 596:4361-4374. [PMID: 29968308 DOI: 10.1113/jp275611] [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] [Received: 05/20/2018] [Accepted: 06/27/2018] [Indexed: 01/03/2023] Open
Abstract
KEY POINTS Some of the beneficial effects of exercise in preventing vascular related diseases are mediated by the enhancement of endothelial function where the role of nitric oxide (NO) is well documented, although the relevance of calcium activated potassium channels is not fully understood. The impact of oxidative stress induced by training on endothelial function remains to be clarified. By evaluating different endothelial vasodilator pathways on two vascular beds in a rabbit model of chronic exercise, we found a decreased NO bioavailability and endothelial nitric oxide synthase expression in both carotid and femoral arteries. Physical training induced carotid endothelial dysfunction as a result of an increase in oxidative stress and a reduction in superoxide dismutase expression. In the femoral artery, the lower production of NO was counteracted by an increased participation of large conductance calcium activated potassium channels, preventing endothelial dysfunction. ABSTRACT The present study aimed to evaluate the effects of chronic exercise on vasodilator response in two different arteries. Rings of carotid and femoral arteries from control and trained rabbits were suspended in organ baths for isometric recording of tension. Endothelial nitric oxide synthase (eNOS), Cu/Zn and Mn-superoxide dismutase (SOD), and large conductance calcium activated potassium (BKCa) channel protein expression were measured by western blotting. In the carotid artery, training reduced the relaxation to ACh (10-9 to 3 × 10-6 m) that was reversed by N-acetylcysteine (10-3 m). l-NAME (10-4 m) reduced the relaxation to ACh in both groups, although the effect was lower in the trained group (in mean ± SEM, 39 ± 2% vs. 28 ± 3%). Physical training did not modify the relaxation to ACh in femoral arteries, although the response to l-NAME was lower in the trained group (in mean ± SEM, 41 ± 5% vs. 17 ± 2%). Charybdotoxin (10-7 m) plus apamin (10-6 m) further reduced the maximal relaxation to ACh only in the trained group. The remaining relaxation in both carotid and femoral arteries was abolished by KCl (2 × 10-2 m) and BaCl2 (3 × 10-6 m) plus ouabain (10-4 m) in both groups. Physical training decreased eNOS expression in both carotid and femoral arteries and Cu/Zn and Mn-SOD expression only in the carotid artery. BKCa channels were overexpressed in the trained group in the femoral artery. In conclusion, chronic exercise induces endothelial dysfunction in the carotid artery as a result of oxidative stress. In the femoral artery, it modifies the vasodilator pathways, enhancing the participation of BKCa channels, thus compensating for the impairment of NO-mediated vasodilatation.
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Affiliation(s)
- Patricia Marchio
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Solanye Guerra-Ojeda
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - José M Vila
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Martín Aldasoro
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Soraya L Valles
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Carlos Soler
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
| | - Maria D Mauricio
- Department of Physiology, School of Medicine, Universitat de Valencia, Valencia, Spain
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21
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Hoskin JD, Miyatani M, Craven BC. Quality reporting of carotid intima-media thickness methodology; Current state of the science in the field of spinal cord injury. J Spinal Cord Med 2018; 41:479-489. [PMID: 28357930 PMCID: PMC6055970 DOI: 10.1080/10790268.2017.1301622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Carotid intima-media thickness (cIMT) may be used increasingly as a cardiovascular disease (CVD) screening tool in individuals with spinal cord injury (SCI) as other routine invasive diagnostic tests are often unfeasible. However, variation in cIMT acquisition and analysis methods is an issue in the current published literature. The growth of the field is dependent on cIMT quality acquisition and analysis to ensure accurate reporting of CVD risk. The purpose of this study is to evaluate the quality of the reported methodology used to collect cIMT values in SCI. METHODS Data from 12 studies, which measured cIMT in individuals with SCI, were identified from the Medline, Embase and CINAHL databases. The quality of the reported methodologies was scored based on adherence to cIMT methodological guidelines abstracted from two consensus papers. RESULTS Five studies were scored as 'moderate quality' in methodological reporting, having specified 9 to 11 of 15 quality reporting criterion. The remaining seven studies were scored as 'low quality', having reported less than 9 of 15 quality reporting criterion. No study had methodological reporting that was scored as 'high quality'. The overall reporting of quality methodology was poor in the published SCI literature. CONCLUSIONS A greater adherence to current methodological guidelines is needed to advance the field of cIMT in SCI. Further research is necessary to refine cIMT acquisition and analysis guidelines to aid authors designing research and journals in screening manuscripts for publication.
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Affiliation(s)
- Jordan D. Hoskin
- Toronto Rehabilitation Institute-UHN, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada,Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Masae Miyatani
- Toronto Rehabilitation Institute-UHN, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada
| | - B. Catharine Craven
- Toronto Rehabilitation Institute-UHN, Brain and Spinal Cord Rehabilitation Program, Toronto, Ontario, Canada,Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada,Department of Medicine, University of Toronto, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, BA, MD, MSc, FRCPC, Lyndhurst Centre, Toronto Rehabilitation Institute-UHN, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada.
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22
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Bjarnegård N, Länne T, Cinthio M, Ekstrand J, Hedman K, Nylander E, Henriksson J. Vascular characteristics in young women-Effect of extensive endurance training or a sedentary lifestyle. Acta Physiol (Oxf) 2018; 223:e13041. [PMID: 29359513 DOI: 10.1111/apha.13041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 12/13/2022]
Abstract
AIM To explore whether high-level endurance training in early age has an influence on the arterial wall properties in young women. METHODS Forty-seven athletes (ATH) and 52 controls (CTR), all 17-25 years of age, were further divided into runners (RUN), whole-body endurance athletes (WBA), sedentary controls (SC) and normally active controls (AC). Two-dimensional ultrasound scanning of the carotid arteries was conducted to determine local common carotid artery (CCA) geometry and wall distensibility. Pulse waves were recorded with a tonometer to determine regional pulse wave velocity (PWV) and pulse pressure waveform. RESULTS Carotid-radial PWV was lower in WBA than in RUN (P < .05), indicating higher arterial distensibility along the arm. Mean arterial pressure was lower in ATH than in CTR and in RUN than in WBA (P < .05). Synthesized aortic augmentation index (AI@75) was lower among ATH than among CTR (-12.8 ± 1.6 vs -2.6 ± 1.2%, P < .001) and in WBA than in RUN (-16.4 ± 2.5 vs -10.7 ± 2.0%, P < .05), suggesting a diminished return of reflection waves to the aorta during systole. Carotid-femoral PWV and intima-media thickness (IMT), lumen diameter and radial distensibility of the CCA were similar in ATH and CTR. CONCLUSION Elastic artery distensibility and carotid artery IMT are not different in young women with extensive endurance training over several years and in those with sedentary lifestyle. On the other hand, our data suggest that long-term endurance training is associated with potentially favourable peripheral artery adaptation, especially in sports where upper body work is added. This adaptation, if persisting later in life, could contribute to lower cardiovascular risk.
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Affiliation(s)
- N. Bjarnegård
- Division of Cardiovascular Medicine; Department of Medical and Health Sciences; Linköping University; Linköping Sweden
- Department of Clinical Physiology; Region Jönköping County; Jönköping Sweden
| | - T. Länne
- Division of Cardiovascular Medicine; Department of Medical and Health Sciences; Linköping University; Linköping Sweden
- Department of Thoracic and Vascular Surgery; Region Östergötland; Linköping Sweden
| | - M. Cinthio
- Department of Biomedical Engineering; Faculty of Engineering; Lund University; Lund Sweden
| | - J. Ekstrand
- Division of Community Medicine; Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - K. Hedman
- Department of Clinical Physiology and Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - E. Nylander
- Department of Clinical Physiology and Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - J. Henriksson
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
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23
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Green DJ, Smith KJ. Effects of Exercise on Vascular Function, Structure, and Health in Humans. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a029819. [PMID: 28432115 DOI: 10.1101/cshperspect.a029819] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Physical activity has profound impacts on the vasculature in humans. Acute exercise induces immediate changes in artery function, whereas repeated episodic bouts of exercise induce chronic functional adaptation and, ultimately, structural arterial remodeling. The nature of these changes in function and structure are dependent on the characteristics of the training load and may be modulated by other factors such as exercise-induced inflammation and oxidative stress. The clinical implications of these physiological adaptations are profound. Exercise impacts on the development of atherosclerosis and on the incidence of primary and secondary cardiovascular events, including myocardial infarction and stroke. Exercise also plays a role in the amelioration of other chronic diseases that possess a vascular etiology, including diabetes and dementia. The mechanisms responsible for these effects of exercise on the vasculature are both primary and secondary in nature, in that the benefits conferred by changes in cardiovascular risk factors such as lipid profiles and blood pressure occur in concert with direct effects of arterial shear stress and mechanotransduction. From an evolutionary perspective, exercise is an essential stimulus for the maintenance of vascular health: exercise is vascular medicine.
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Affiliation(s)
- Daniel J Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L33AF, United Kingdom.,School of Human Sciences, The University of Western Australia, Crawley 6009, Australia.,Principal Research Fellow, National Health and Medical Research Council of Australia, Canberra 2601, Australia
| | - Kurt J Smith
- School of Human Sciences, The University of Western Australia, Crawley 6009, Australia
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24
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Rzechorzek W, Zhang H, Buckley BK, Hua K, Pomp D, Faber JE. Aerobic exercise prevents rarefaction of pial collaterals and increased stroke severity that occur with aging. J Cereb Blood Flow Metab 2017; 37:3544-3555. [PMID: 28685617 PMCID: PMC5669350 DOI: 10.1177/0271678x17718966] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 11/16/2022]
Abstract
Variation in extent of the brain's collateral circulation is an important determinant of variation in the severity of stroke and efficacy of revascularization therapies. However, the number and diameter of pial collateral "arterioles" decrease with aging in associated with reduced eNOS and increased oxidative stress. We tested whether exercise reduces this aging-induced rarefaction. Twelve-month-old mice were randomized to sedentary or voluntary wheel-running. At 26 months' age, permanent MCA occlusion was followed 72 h later by determination of infarct volume and vascular casting after maximal dilation. The decline in collateral number and diameter and 2.4-fold increase in infarct volume evident in 26-versus 3-month-old sedentary mice were prevented by exercise-training. In contrast, number and diameter of the posterior communicating collateral "arteries" were unaffected by aging or exercise. Interestingly, diameter of the primary intracranial arteries increased with aging. Mechanistically, genetic overexpression of eNOS inhibited age-induced collateral rarefaction, and exercise increased eNOS and SOD2 and decreased the inflammatory marker NFkB assessed in hindlimb arteries. In conclusion, exercise prevented age-induced rarefaction of pial collaterals and reduced infarct volume. Aging also promoted outward remodeling of intracranial arteries. These effects were associated with increased eNOS and reduced markers of inflammation and aging in the vascular wall.
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Affiliation(s)
- Wojciech Rzechorzek
- Departments of Cell Biology and Physiology, University of North Carolina at Chapel Hill, NC, USA
| | - Hua Zhang
- Departments of Cell Biology and Physiology, University of North Carolina at Chapel Hill, NC, USA
| | - Brian K Buckley
- Departments of Cell Biology and Physiology, University of North Carolina at Chapel Hill, NC, USA
| | - Kunjie Hua
- Department of Genetics, University of North Carolina at Chapel Hill, NC, USA
| | - Daniel Pomp
- Department of Genetics, University of North Carolina at Chapel Hill, NC, USA
| | - James E Faber
- Departments of Cell Biology and Physiology, University of North Carolina at Chapel Hill, NC, USA
- McAllister Heart Institute, University of North Carolina at Chapel Hill, NC, USA
- Curriculum in Neurobiology, University of North Carolina at Chapel Hill, NC, USA
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25
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Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiol Rev 2017; 97:1351-1402. [PMID: 28814614 PMCID: PMC6347102 DOI: 10.1152/physrev.00019.2016] [Citation(s) in RCA: 340] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022] Open
Abstract
This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.
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Affiliation(s)
- Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Christian K Roberts
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - John P Thyfault
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Gregory N Ruegsegger
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Ryan G Toedebusch
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
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26
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Green DJ, Hopman MTE, Padilla J, Laughlin MH, Thijssen DHJ. Vascular Adaptation to Exercise in Humans: Role of Hemodynamic Stimuli. Physiol Rev 2017; 97:495-528. [PMID: 28151424 DOI: 10.1152/physrev.00014.2016] [Citation(s) in RCA: 429] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
On the 400th anniversary of Harvey's Lumleian lectures, this review focuses on "hemodynamic" forces associated with the movement of blood through arteries in humans and the functional and structural adaptations that result from repeated episodic exposure to such stimuli. The late 20th century discovery that endothelial cells modify arterial tone via paracrine transduction provoked studies exploring the direct mechanical effects of blood flow and pressure on vascular function and adaptation in vivo. In this review, we address the impact of distinct hemodynamic signals that occur in response to exercise, the interrelationships between these signals, the nature of the adaptive responses that manifest under different physiological conditions, and the implications for human health. Exercise modifies blood flow, luminal shear stress, arterial pressure, and tangential wall stress, all of which can transduce changes in arterial function, diameter, and wall thickness. There are important clinical implications of the adaptation that occurs as a consequence of repeated hemodynamic stimulation associated with exercise training in humans, including impacts on atherosclerotic risk in conduit arteries, the control of blood pressure in resistance vessels, oxygen delivery and diffusion, and microvascular health. Exercise training studies have demonstrated that direct hemodynamic impacts on the health of the artery wall contribute to the well-established decrease in cardiovascular risk attributed to physical activity.
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Affiliation(s)
- Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Maria T E Hopman
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - M Harold Laughlin
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Dick H J Thijssen
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
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27
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Nyberg SK, Berg OK, Helgerud J, Wang E. Blood flow regulation and oxygen uptake during high-intensity forearm exercise. J Appl Physiol (1985) 2017; 122:907-917. [PMID: 28057820 DOI: 10.1152/japplphysiol.00983.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/20/2016] [Accepted: 01/03/2017] [Indexed: 12/29/2022] Open
Abstract
The vascular strain is very high during heavy handgrip exercise, but the intensity and kinetics to reach peak blood flow, and peak oxygen uptake, are uncertain. We included 9 young (25 ± 2 yr) healthy males to evaluate blood flow and oxygen uptake responses during continuous dynamic handgrip exercise with increasing intensity. Blood flow was measured using Doppler-ultrasound, and venous blood was drawn from a deep forearm vein to determine arteriovenous oxygen difference (a-vO2diff) during 6-min bouts of 60, 80, and 100% of maximal work rate (WRmax), respectively. Blood flow and oxygen uptake increased (P < 0.05) from 60%WRmax [557 ± 177(SD) ml/min; 56.0 ± 21.6 ml/min] to 80%WRmax (679 ± 190 ml/min; 70.6 ± 24.8 ml/min), but no change was seen from 80%WRmax to 100%WRmax Blood velocity (49.5 ± 11.5 to 58.1 ± 11.6 cm/s) and brachial diameter (0.49 ± 0.05 to 0.50 ± 0.06 cm) showed concomitant increases (P < 0.05) with blood flow from 60% to 80%WRmax, whereas no differences were observed in a-vO2diff Shear rate also increased (P < 0.05) from 60% (822 ± 196 s-1) to 80% (951 ± 234 s-1) of WRmax The mean response time (MRT) was slower (P < 0.05) for blood flow (60%WRmax 50 ± 22 s; 80%WRmax 51 ± 20 s; 100%WRmax 51 ± 23 s) than a-vO2diff (60%WRmax 29 ± 9 s; 80%WRmax 29 ± 5 s; 100%WRmax 20 ± 5 s), but not different from oxygen uptake (60%WRmax 44 ± 25 s; 80%WRmax 43 ± 14 s; 100%WRmax 41 ± 32 s). No differences were observed in MRT for blood flow or oxygen uptake with increased exercise intensity. In conclusion, when approaching maximal intensity, oxygen uptake appeared to reach a critical level at ~80% of WRmax and be regulated by blood flow. This implies that high, but not maximal, exercise intensity may be an optimal stimulus for shear stress-induced small muscle mass training adaptations.NEW & NOTEWORTHY This study evaluated blood flow regulation and oxygen uptake during small muscle mass forearm exercise with high to maximal intensity. Despite utilizing only a fraction of cardiac output, blood flow reached a plateau at 80% of maximal work rate and regulated peak oxygen uptake. Furthermore, the results revealed that muscle contractions dictated bulk oxygen delivery and yielded three times higher peak blood flow in the relaxation phase compared with mean values.
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Affiliation(s)
- S K Nyberg
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway
| | - O K Berg
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
| | - J Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway.,Hokksund Medical Rehabilitation Centre, Hokksund, Norway.,Department of Sports and Outdoor Life Studies, Telemark University College, Bø, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Trondheim, Norway; .,Department of Medicine, University of Utah, Salt Lake City, Utah; and.,Department of Research and Development, St. Olav's University Hospital, Trondheim, Norway
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Exercise and Hypertension: Uncovering the Mechanisms of Vascular Control. Prog Cardiovasc Dis 2016; 59:226-234. [PMID: 27697533 DOI: 10.1016/j.pcad.2016.09.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 09/25/2016] [Indexed: 12/18/2022]
Abstract
Hypertension (HTN) has recently been determined to be the number one overall risk factor of disease. With direct and indirect costs amounting to $46.4 billion in 2011 and projections of six-fold increases by 2030, the importance of low-cost nonpharmacological interventions can be appreciated. Vascular structural changes, endothelial dysfunction, and sympathetic overstimulation are major contributing factors to the pathophysiology of HTN. Exercise training (ET) for blood pressure (BP) control has been shown to be an effective and integral component of nonpharmacological interventions for BP control. Different ET modalities (aerobic, resistance, and concurrent training) have contributed differently to BP reduction and control, driving scientific discourse regarding the optimum ET prescription (modality, volume, and intensity) for such effects; ET results in a multitude of physiological effects, with vascular and autonomic adaptations providing major contributions to BP control. Despite widespread acceptance of the role and importance of ET for BP reduction, only 15% of US adults have been found to meet ET/physical activity recommendations. The purpose of this review is to explore BP lowering effects of aerobic and resistance ET and the underlying physiological mechanisms that result in such effects. Further research is required to enhance our understanding of the proper ET prescription for BP control across different age groups and racial ethnicities. Furthermore, research into methods of improving awareness and adherence to ET recommendations proves to be equally important.
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Lundgren KM, Karlsen T, Sandbakk Ø, James PE, Tjønna AE. Sport-Specific Physiological Adaptations in Highly Trained Endurance Athletes. Med Sci Sports Exerc 2016; 47:2150-7. [PMID: 25668407 DOI: 10.1249/mss.0000000000000634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE This study aims to compare maximal oxygen uptake (V˙O2max), blood volume (BV), hemoglobin mass (Hbmass), and brachial endothelial function, measured as flow-mediated dilatation (FMD), in international-level endurance athletes primarily exercising with the whole body (cross-country skiing), lower body (orienteering), or upper body (flatwater kayak). METHODS Seventeen cross-country skiers, 15 orienteers, and 11 flatwater kayakers were tested for V˙O2max, BV, Hbmass, and FMD. Additionally, body composition and annual training (type, volume, and intensity of training) were analyzed. RESULTS Absolute and body-mass-normalized V˙O2max values were 11.3% and 9.9% higher, respectively, in skiers (5.83 ± 0.60 L·min and 77.9 ± 4.2 mL·min·kg) compared to orienteers (5.24 ± 0.45 L·min and 70.9 ± 3.5 mL·min·kg) (P < 0.01), whereas kayakers (5.78 ± 0.56 L·min and 73.7 ± 6.3 mL·min·kg) did not differ from skiers. BV was 9.9%-11.8% higher in skiers and orienteers compared to kayakers when normalized for total body mass and fat-free mass, and skiers had 9.2% and 9.9% higher Hbmass normalized for total body mass and fat-free mass compared to kayakers (all P < 0.05). Arterial diameter was 11.8%-15.0% larger in kayakers (4.38 ± 0.63 mm) and skiers (4.22 ± 0.36 mm) compared to orienteers (3.81 ± 0.32 mm) (P < 0.05), whereas FMD did not differ between groups. CONCLUSIONS This study indicates that higher V˙O2max in cross-country skiers and greater arterial diameters in the arms of skiers and kayakers are sport-specific physiological adaptations to chronic endurance training in whole-body and upper-body exercise modes. However, variations in these variables are not associated with BV or Hbmass.
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Affiliation(s)
- Kari Margrethe Lundgren
- 1K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, NORWAY; 2Department of Cardiology, St. Olavs University Hospital, Trondheim, NORWAY; 3Center for Elite Sports Research, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, NORWAY; and 4Wales Heart Research Institute, Department of Cardiology, Cardiff University, Cardiff, UNITED KINGDOM
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Abstract
BACKGROUND Exercise training favorably alters arterial anatomy in trained limbs, though the simultaneous effects on passively trained arteries are unclear. Thus, brachial (non-trained limb), popliteal (trained limb) and carotid total wall thickness (TWT), wall-to-lumen ratios (W:L), intima-media thickness (IMT) and lumen diameters (LD) were compared between experimental (n = 14) and control (n = 11) participants before and after the experimental participants participated in marathon training. METHODS Arterial dimensions were measured with B-mode ultrasonography. Initial and final testing of VO2max and running speed at 3.5 mmol lactate were measured in the experimental group. RESULTS VO2max was unchanged by training, but running speed at 3.5 mmol lactate increased by 5 % (p = .008). Time by group interactions were observed for the brachial and popliteal measures (p < 0.05), but not the carotid. No changes were observed in the control group. Prior to the intervention the experimental group had larger LD in the brachial (p = .002) and popliteal arteries (p = .007) than controls; no other pre-testing differences were found. Following training, TWT declined in the brachial (pre = .99 ± .16 mm; post = .84 ± .10 mm; p = .007) and popliteal (pre = .96 ± .09 mm; post = .86 ± .11 mm; p = .005) arteries, characterized by a 0.07 mm decrease in brachial IMT (p = .032) and a non-significant 0.03 mm reduction in popliteal IMT. LD increased in the brachial (pre = 3.38 ± .35 mm; post = 3.57 ± .41 mm; p = .015) and popliteal (pre = 4.73 ± .48 mm; post = 5.11 ± .72 mm; p = .002) arteries. CONCLUSIONS These data suggest that exercise-induced alterations in arterial dimensions occur in trained and non-trained limbs, and that adaptations may be dose dependent.
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31
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Influence of exercise training mode on arterial diameter: A systematic review and meta-analysis. J Sci Med Sport 2016; 19:74-80. [DOI: 10.1016/j.jsams.2014.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/03/2014] [Accepted: 12/17/2014] [Indexed: 02/04/2023]
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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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Menéndez H, Ferrero C, Martín-Hernández J, Figueroa A, Marín PJ, Herrero AJ. Acute effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury. Spinal Cord 2015; 54:383-9. [PMID: 26458973 DOI: 10.1038/sc.2015.181] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 08/31/2015] [Accepted: 09/12/2015] [Indexed: 12/20/2022]
Abstract
STUDY DESIGN Randomized crossover. OBJECTIVES To analyze the acute effects of isolated and simultaneous application of whole-body vibration (WBV) and electromyostimulation (ES) on popliteal artery blood velocity (BV) and skin temperature (ST) of the calf in subjects with spinal cord injury (SCI). SETTING Valladolid, Spain. METHODS Ten subjects with SCI were assessed in five different sessions. After a familiarization session, four interventions were applied in random order; WBV, ES, simultaneous WBV and ES (WBV+ES), and 30 s of WBV followed by 30 s of ES (WBV30/ES30). Each intervention consisted of 10 sets × 1 min ON+1 min OFF. Subjects were seated on their own wheelchairs with their feet on the vibration platform (10 Hz, 5 mm peak-to-peak), and ES was applied on the gastrocnemius muscle of both legs (8 Hz, 400 μs). RESULTS The simultaneous application (WBV+ES) produced the greatest increase in mean BV (MBV; 36% and 42%, respectively) and peak BV (PBV; 30% and 36%, respectively) during the intervention. This intervention produced the greatest mean increases in MBV (21%) and PBV (19%) during the recovery period. Last, this intervention produced the highest increase in ST during the intervention (2.1 °C). CONCLUSION The simultaneous application of WBV+ES seems to produce a greater increase in MBV and PBV of the popliteal artery and ST of the calf than the isolated (WBV or ES) or consecutive application of both stimuli (WBV30/ES30). This study provides an efficient therapeutic methodology to improve peripheral arterial properties, which is pivotal in SCI patient's rehabilitation.
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Affiliation(s)
- H Menéndez
- Research Centre on Physical Disability, ASPAYM Castilla y León Foundation, Valladolid, Spain.,Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - C Ferrero
- Research Centre on Physical Disability, ASPAYM Castilla y León Foundation, Valladolid, Spain.,Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - J Martín-Hernández
- Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - A Figueroa
- Department of Nutrition, Food, and Exercise Sciences, The Florida State University, Tallahassee, FL, USA
| | - P J Marín
- CyMO Research Institute, Valladolid, Spain
| | - A J Herrero
- Research Centre on Physical Disability, ASPAYM Castilla y León Foundation, Valladolid, Spain.,Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
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Liu HB, Yuan WX, Qin KR, Hou J. Acute effect of cycling intervention on carotid arterial hemodynamics: basketball athletes versus sedentary controls. Biomed Eng Online 2015; 14 Suppl 1:S17. [PMID: 25602805 PMCID: PMC4306107 DOI: 10.1186/1475-925x-14-s1-s17] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To compare the acute effects of a cycling intervention on carotid arterial hemodynamics between basketball athletes and sedentary controls. METHODS Ten young long-term trained male basketball athletes (BA) and nine age-matched male sedentary controls (SC) successively underwent four bouts of exercise on a bicycle ergometer at the same workload. Hemodynamic variables at right common carotid artery were determined at rest and immediately following each bout of exercise. An ANCOVA was used to compare differences between the BA and SC groups at rest and immediately following the cycling intervention. The repeated ANOVA was used to assess differences between baseline and each bout of exercise within the BA or SC group. RESULTS In both groups, carotid hemodynamic variables showed significant differences at rest and immediately after the cycling intervention. At rest, carotid arterial stiffness was significantly decreased and carotid arterial diameter was significantly increased in the BA group as compared to the SC group. Immediately following the cycling intervention, carotid arterial stiffness showed no obvious changes in the BA group but significantly increased in the SC group. It is worth noting that while arterial stiffness was lower in the BA group than in the SC group, the oscillatory shear index (OSI) was significantly higher in the BA group than in the SC group both at rest and immediately following the cycling intervention. CONCLUSION Long-term basketball exercise had a significant impact on common carotid arterial hemodynamic variables not only at rest but also after a cycling intervention. The role of OSI in the remodeling of arterial structure and function in the BA group at rest and after cycling requires clarification.
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Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes. Eur J Appl Physiol 2014; 115:317-26. [DOI: 10.1007/s00421-014-3016-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 10/01/2014] [Indexed: 02/01/2023]
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LAAKSONEN MARKOS, HEINONEN ILKKA, LUOTOLAHTI MATTI, KNUUTI JUHANI, KALLIOKOSKI KARIK. V˙O2peak, Myocardial Hypertrophy, and Myocardial Blood Flow in Endurance-Trained Men. Med Sci Sports Exerc 2014; 46:1498-505. [DOI: 10.1249/mss.0000000000000264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Rock climbers perform repeated isometric forearm muscle contractions subjecting the vasculature to repeated ischaemia and distorted haemodynamic signals. This study investigated forearm vascular characteristics in rock climbers compared to healthy untrained controls. Eight climbers (CLIMB) (BMI; 22.3, s = 2.0 kg/m(2), isometric handgrip strength; 46, s = 8 kg) were compared against eight untrained controls (CON) (BMI; 23.8, s = 2.6 kg/m(2), isometric handgrip strength; 37, s = 9 kg). Brachial artery diameter and blood flow were measured, using Doppler ultrasound, at rest and following 5-mins ischaemia (peak diameter) and ischaemic exercise (maximal dilation) to calculate flow mediated dilation (FMD) and dilatory capacity (DC). Capillary filtration capacity was assessed using venous occlusion plethysmography. Resting (4.30, s = 0.26 vs. 3.79, s = 0.39 mm), peak (4.67, s = 0.31 vs. 4.12, s = 0.45 mm) and maximal (5.14, s = 0.42 vs. 4.35, s = 0.47 mm) diameters were greater (P < 0.05) in CLIMB than CON, respectively, despite no difference in FMD (9.2, s = 2.6 vs. 8.7, s = 2.9%). Peak reactive hyperaemic blood flow (1136, s = 504 vs. 651, s = 221 ml/min) and capillary filtration capacity (3.8, s = 0.9 vs. 5.2, s = 0.7 ml.min(-1).mmHg(-1).100 ml tissue(-1) × 10(-3)) were greater (P < 0.05) in CLIMB compared to CON, respectively. Rock climbers exhibit structural vascular adaptation compared to untrained control participants but have similar vascular function. This may contribute to the enhanced ability of climbers to perform repeated isometric contractions.
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Vasiliadis AV, Zafeiridis A, Dipla K, Galanis N, Chatzidimitriou D, Kyparos A, Nikolaidis MG, Vrabas IS. Circulating angiogenic biomolecules at rest and in response to upper-limb exercise in individuals with spinal cord injury. J Spinal Cord Med 2014; 37:226-32. [PMID: 24090471 PMCID: PMC4066432 DOI: 10.1179/2045772313y.0000000141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Individuals with spinal cord injury (SCI) show structural and functional vascular maladaptations and muscle loss in their lower limbs. Angiogenic biomolecules play important roles in physiological and pathological angiogenesis, and are implicated in the maintenance of muscle mass. This study examined the responses of angiogenic molecules during upper-limb aerobic exercise in patients with SCI and in able-bodied (AB) individuals. METHODS Eight SCI patients with thoracic lesions (T6-T12, ASIA A) and eight AB individuals performed an arm-cranking exercise for 30 minutes at 60% of their VO2max. Plasma concentrations of vascular endothelial growth factor (VEGF-A165), VEGF receptor 1 (sVEGFr-1), VEGF receptor 2 (sVEGFr-2), metalloproteinase 2 (MMP-2), and endostatin were measured at rest, after exercise, and at 1.5 and 3.0 hours during recovery. RESULTS The two-way analysis of variance showed non-significant main effects of "group" and significant main effects of "time/exercise" for all angiogenic biomolecules examined (P < 0.01-0.001). The arm-cranking exercise significantly increased plasma concentrations of VEGF, sVEGFr-1, sVEGFr-2, MMP-2, and endostatin in both groups (P < 0.001-0.01). The magnitude of the increase was similar in both patients with SCI and AB individuals, as shown by the non-significant group × time interaction for all angiogenic parameters. CONCLUSIONS Upper-limb exercise (arm-cranking for 30 minutes at 60% of VO2max) is a sufficient stimulus to trigger a coordinated circulating angiogenic response in patients with SCI. The response of angiogenic molecules to upper-limb aerobic exercise in SCI appears relatively similar to that observed in AB individuals.
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Affiliation(s)
- Angelo V. Vasiliadis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece,Correspondence to: Andreas Zafeiridis, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Ag. Ioannis, 62110 Serres, Greece.
| | - Konstantina Dipla
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Nikiforos Galanis
- Department of Orthopedics, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Chatzidimitriou
- 2nd Department of Microbiology and National Influenza Center for Northern Greece, Medical School, Aristotle University of Thessaloniki, Greece
| | - Antonios Kyparos
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Michalis G. Nikolaidis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Ioannis S. Vrabas
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
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Lewis NCS, Bailey DM, Dumanoir GR, Messinger L, Lucas SJE, Cotter JD, Donnelly J, McEneny J, Young IS, Stembridge M, Burgess KR, Basnet AS, Ainslie PN. Conduit artery structure and function in lowlanders and native highlanders: relationships with oxidative stress and role of sympathoexcitation. J Physiol 2013; 592:1009-24. [PMID: 24324004 DOI: 10.1113/jphysiol.2013.268615] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Research detailing the normal vascular adaptions to high altitude is minimal and often confounded by pathology (e.g., chronic mountain sickness) and methodological issues. We examined vascular function and structure in: (1) healthy lowlanders during acute hypoxia and prolonged (∼2 weeks) exposure to high altitude, and (2) high-altitude natives at 5050 m (highlanders). In 12 healthy lowlanders (aged 32 ± 7 years) and 12 highlanders (Sherpa; 33 ± 14 years) we assessed brachial endothelium-dependent flow-mediated dilatation (FMD), endothelium-independent dilatation (via glyceryl trinitrate; GTN), common carotid intima-media thickness (CIMT) and diameter (ultrasound), and arterial stiffness via pulse wave velocity (PWV; applanation tonometry). Cephalic venous biomarkers of free radical-mediated lipid peroxidation (lipid hydroperoxides, LOOH), nitrite (NO2-) and lipid soluble antioxidants were also obtained at rest. In lowlanders, measurements were performed at sea level (334 m) and between days 3-4 (acute high altitude) and 12-14 (chronic high altitude) following arrival to 5050 m. Highlanders were assessed once at 5050 m. Compared with sea level, acute high altitude reduced lowlanders' FMD (7.9 ± 0.4 vs. 6.8 ± 0.4%; P = 0.004) and GTN-induced dilatation (16.6 ± 0.9 vs. 14.5 ± 0.8%; P = 0.006), and raised central PWV (6.0 ± 0.2 vs. 6.6 ± 0.3 m s(-1); P = 0.001). These changes persisted at days 12-14, and after allometrically scaling FMD to adjust for altered baseline diameter. Compared to lowlanders at sea level and high altitude, highlanders had a lower carotid wall:lumen ratio (∼19%, P ≤ 0.04), attributable to a narrower CIMT and wider lumen. Although both LOOH and NO2- increased with high altitude in lowlanders, only LOOH correlated with the reduction in GTN-induced dilatation evident during acute (n = 11, r = -0.53) and chronic (n = 7, r = -0.69; P ≤ 0.01) exposure to 5050 m. In a follow-up, placebo-controlled experiment (n = 11 healthy lowlanders) conducted in a normobaric hypoxic chamber (inspired O2 fraction (F IO 2) = 0.11; 6 h), a sustained reduction in FMD was evident within 1 h of hypoxic exposure when compared to normoxic baseline (5.7 ± 1.6 vs. 8.0 ±1.3%; P < 0.01); this decline in FMD was largely reversed following α1-adrenoreceptor blockade. In conclusion, high-altitude exposure in lowlanders caused persistent impairment in vascular function, which was mediated partially via oxidative stress and sympathoexcitation. Although a lifetime of high-altitude exposure neither intensifies nor attenuates the impairments seen with short-term exposure, chronic high-altitude exposure appears to be associated with arterial remodelling.
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Affiliation(s)
- Nia C S Lewis
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Okanagan Campus, School of Health and Exercise Sciences 111 Health Science Centre 1088 Discovery Avenue, Kelowna, British Columbia, Canada.
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Thijssen DHJ, Dawson EA, van den Munckhof ICL, Birk GK, Timothy Cable N, Green DJ. Local and systemic effects of leg cycling training on arterial wall thickness in healthy humans. Atherosclerosis 2013; 229:282-6. [PMID: 23880177 DOI: 10.1016/j.atherosclerosis.2013.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 04/17/2013] [Accepted: 05/01/2013] [Indexed: 12/21/2022]
Abstract
UNLABELLED Exercise training is associated with direct effects on conduit artery function and structure. Cross-sectional studies suggest the presence of systemic changes in wall thickness as a result of exercise in healthy subjects, but no previous study has examined this question in humans undertaking exercise training. OBJECTIVE To examine the change in superficial femoral (SFA, i.e. local effect) and carotid (CA, i.e. systemic effect) artery wall thickness across 8 weeks of lower limb cycle training in healthy young men. METHODS Fourteen healthy young male subjects were assigned to an 8-week training study of cycling exercise (n = 9) or a control period (n = 5). Before, during (2, 4 and 6 weeks) and after training, SFA and CA wall thickness was examined using automated edge-detection of high resolution ultrasound images. We also measured resting diameter and calculated the wall:lumen(W:L)-ratio. RESULTS Exercise training did not alter CA or SFA baseline diameter (P = 0.14), but was associated with gradual, consistent and significant decreases in wall thickness and W:L-ratio in both the CA and SFA (P < 0.001 and 0.002, respectively). Two-way ANOVA revealed a comparable magnitude of decrease in wall thickness and W:L-ratio in both arteries across the 8-week period (interaction-effect; P = 0.29 and 0.12, respectively). No changes in artery diameter, wall thickness or W:L-ratio were apparent in controls (0.82, 0.38 and 0.52, respectively). CONCLUSION We found that cycle exercise training in healthy young individuals is associated with modest, but significant, decreases in wall thickness in the superficial femoral and carotid arteries. These findings suggest that exercise training causes systemic adaptation of the arterial wall in healthy young subjects.
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Affiliation(s)
- Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, United Kingdom.
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Stoner L, Faulkner J, Sabatier MJ. Is allometric scaling really a panacea for flow-mediated dilation? Commentary on paper by Atkinson and Batterham. Atherosclerosis 2013; 228:280-1. [PMID: 23434048 DOI: 10.1016/j.atherosclerosis.2013.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
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Spence AL, Carter HH, Naylor LH, Green DJ. A prospective randomized longitudinal study involving 6 months of endurance or resistance exercise. Conduit artery adaptation in humans. J Physiol 2012; 591:1265-75. [PMID: 23247114 DOI: 10.1113/jphysiol.2012.247387] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Abstract This randomized trial evaluated the impact of different exercise training modalities on the function and size of conduit arteries in healthy volunteers. Young (27 ± 5 years) healthy male subjects were randomized to undertake 6 months of either endurance training (ET; n = 10) or resistance training (RT; n = 13). High-resolution ultrasound was used to determine brachial, femoral and carotid artery diameter and wall thickness (IMT) and femoral and brachial flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)-mediated dilatation. Improvements in peak oxygen uptake occurred with ET (from 3.6 ± 0.7 to 3.8 ± 0.6 l min(-1), P = 0.024) but not RT. Upper body muscular strength increased following RT (from 57.8 ± 17.7 to 69.0 ± 19.5 kg, P < 0.001), but not ET. Both groups exhibited increases in lean body mass (ET, 1.4 ± 1.8 kg and RT, 2.3 ± 1.3 kg, P < 0.05). Resistance training increased brachial artery resting diameter (from 3.8 ± 0.5 to 4.1 ± 0.4 mm, P < 0.05), peak FMD diameter (+0.2 ± 0.2 mm, P < 0.05) and GTN-mediated diameter (+0.3 ± 0.3 mm, P < 0.01), as well as brachial FMD (from 5.1 ± 2.2 to 7.0 ± 3.9%, P < 0.05). No improvements in any brachial parameters were observed following ET. Conversely, ET increased femoral artery resting diameter (from 6.2 ± 0.7 to 6.4 ± 0.6 mm, P < 0.05), peak FMD diameter (+0.4 ± 0.4 mm, P < 0.05) and GTN-induced diameter (+0.3 ± 0.3 mm, P < 0.05), as well as femoral FMD-to-GTN ratio (from 0.6 ± 0.3 to 1.1 ± 0.8, P < 0.05). Resistance training did not induce changes in femoral artery parameters. Carotid artery IMT decreased in response to both forms of training. These findings indicate that 6 months of supervised exercise training induced changes in brachial and femoral artery size and function and decreased carotid artery IMT. These impacts of both RT and ET would be expected to translate to decreased cardiovascular risk.
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Affiliation(s)
- Angela L Spence
- School of Sport Science, Exercise & Health (M408), The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia.
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Phillips AA, Krassioukov AV, Ainslie PN, Warburton DE. Baroreflex Function after Spinal Cord Injury. J Neurotrauma 2012; 29:2431-45. [DOI: 10.1089/neu.2012.2507] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Aaron A. Phillips
- Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, British Columbia, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
| | - Andrei V. Krassioukov
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, British Columbia, Canada
| | - Philip N. Ainslie
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Darren E.R. Warburton
- Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, British Columbia, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, British Columbia, Canada
- International Collaboration of Repair Discoveries, University of British Columbia, British Columbia, Canada
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Weber T, Beijer Å, Rosenberger A, Mulder E, Yang P, Schönau E, Bloch W, Rittweger J. Vascular adaptations induced by 6 weeks WBV resistance exercise training. Clin Physiol Funct Imaging 2012; 33:92-100. [PMID: 23383686 DOI: 10.1111/j.1475-097x.2012.01166.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 08/13/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The impact of whole-body vibration (WBV) upon the cardiovascular system is receiving increasing attention. Despite numerous studies addressing the acute cardiovascular effects of WBV training, very little is known regarding long-term adaptations in healthy humans. METHODS A 6-week training study, with a 70 days follow-up was designed to compare resistive exercise with or without super-imposed whole-body vibrations. Arterial diameter, intima media thickness and flow-mediated dilation (FMD) were assessed by ultrasonography in the superficial femoral artery (SFA), the brachial (BA) and the carotid arteries (CA). RESULTS SFA resting diameter was increased from 6·22 mm (SD = 0·69 mm) at baseline to 6·52 mm (SD = 0·74 mm) at the end of the training period (P = 0·03) with no difference between groups (P = 0·48). Arterial wall thickness was significantly reduced by 4·3% (SD = 11%) in the CA only (P = 0·04). FMD was not affected by any of the interventions and in any of the investigated arteries. CONCLUSION To the best of our knowledge, this has been the first study to show that the superposition of vibration upon conventional resistance exercise does not have a specific effect upon long-term vascular adaptation in asymptomatic humans. Our findings seem to be at variance with the findings observed in a bed-rest setting. One possible explanation could be that the independently saturable effects of flow-mediated versus acceleration-related endothelial shear stresses on arterial structure and function differ between ambulatory and bed-rest conditions.
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Affiliation(s)
- Tobias Weber
- Department of Space Physiology, German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany.
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