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Lasocka-Koriat Z, Lewicka-Potocka Z, Kaleta-Duss A, Siekierzycka A, Kalinowski L, Lewicka E, Dąbrowska-Kugacka A. Differences in cardiac adaptation to exercise in male and female athletes assessed by noninvasive techniques: a state-of-the-art review. Am J Physiol Heart Circ Physiol 2024; 326:H1065-H1079. [PMID: 38391314 DOI: 10.1152/ajpheart.00756.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 02/24/2024]
Abstract
Athlete's heart is generally regarded as a physiological adaptation to regular training, with specific morphological and functional alterations in the cardiovascular system. Development of the noninvasive imaging techniques over the past several years enabled better assessment of cardiac remodeling in athletes, which may eventually mimic certain pathological conditions with the potential for sudden cardiac death, or disease progression. The current literature provides a compelling overview of the available methods that target the interrelation of prolonged exercise with cardiac structure and function. However, this data stems from scientific studies that included mostly male athletes. Despite the growing participation of females in competitive sport meetings, little is known about the long-term cardiac effects of repetitive training in this population. There are several factors-biochemical, physiological and psychological, that determine sex-dependent cardiac response. Herein, the aim of this review was to compare cardiac adaptation to endurance exercise in male and female athletes with the use of electrocardiographic, echocardiographic, and biochemical examination, to determine the sex-specific phenotypes, and to improve the healthcare providers' awareness of cardiac remodeling in athletes. Finally, we discuss the possible exercise-induced alternations that should arouse suspicion of pathology and be further evaluated.
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Affiliation(s)
- Zofia Lasocka-Koriat
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
- First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Zuzanna Lewicka-Potocka
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
- First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Kaleta-Duss
- Institute for Radiology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Anna Siekierzycka
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.pl, Medical University of Gdańsk, Gdańsk, Poland
| | - Leszek Kalinowski
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.pl, Medical University of Gdańsk, Gdańsk, Poland
- BioTechMed Centre/Department of Mechanics of Materials and Structures, Gdańsk University of Technology, Gdańsk, Poland
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
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Phansangiemjit A, Kasemjiwat K, Patchanee K, Panninvong Y, Sunisarud A, Choisunirachon N, Thanaboonnipat C. The Differences in Radiographic Vertebral Size in Dogs with Different Chest and Skull Types. Animals (Basel) 2024; 14:470. [PMID: 38338115 PMCID: PMC10854823 DOI: 10.3390/ani14030470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
The objective of this study was to elucidate the differences in vertebral length, vertebral height, and vertebral length/height ratio of the fourth thoracic vertebra (T4), the second lumbar vertebra (L2), the fifth lumbar vertebra (L5) and the seventh lumbar vertebra (L7) based on radiographs in dogs with various body sizes, skull types, and thoracic conformations and to determine the relationships of these parameters with age and sex. A total of 258 dogs were included in this study and classified by three criteria-BW (Criterion 1), skull type (Criterion 2), and thoracic conformation (Criterion 3). Age had weak negative correlations with vertebral length and height. Sex did not affect the vertebral size parameters. BW had strong positive correlations with vertebral length and height, but there was no influence of BW on vertebral length/height ratio. Regarding the different body sizes and conformations, large breeds had vertebrae with significantly greater length and height than small and medium breeds (p < 0.001). In Criterion 2, the vertebrae of the mesocephalic dogs had significantly greater length and height than those of the brachycephalic and dolichocephalic dogs (p < 0.05). In Criterion 3, both deep-chest and round-chest dogs had vertebrae with significantly greater length and height than the barrel-chest dogs (p < 0.0001). Only vertebral length/height ratios of T4 were not influenced by age, sex, BW, skull type, and thoracic conformation. Age, differences in body size, skull type, and thoracic conformation could affect the vertebral size in dogs. Therefore, using breed-specific vertebral lengths and/or heights is a better approach for comparative radiographic analysis with vertebral measurements.
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Affiliation(s)
- Amonsiri Phansangiemjit
- Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand; (A.P.); (K.K.); (K.P.); (Y.P.); (A.S.)
| | - Kamolphatra Kasemjiwat
- Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand; (A.P.); (K.K.); (K.P.); (Y.P.); (A.S.)
| | - Krit Patchanee
- Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand; (A.P.); (K.K.); (K.P.); (Y.P.); (A.S.)
| | - Yossapat Panninvong
- Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand; (A.P.); (K.K.); (K.P.); (Y.P.); (A.S.)
| | - Ana Sunisarud
- Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand; (A.P.); (K.K.); (K.P.); (Y.P.); (A.S.)
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand;
| | - Chutimon Thanaboonnipat
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand;
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Zholshybek N, Khamitova Z, Toktarbay B, Jumadilova D, Khissamutdinov N, Dautov T, Rakhmanov Y, Bekbossynova M, Gaipov A, Salustri A. Cardiac imaging in athlete's heart: current status and future prospects. Cardiovasc Ultrasound 2023; 21:21. [PMID: 38098064 PMCID: PMC10720202 DOI: 10.1186/s12947-023-00319-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Physical activity contributes to changes in cardiac morphology, which are known as "athlete's heart". Therefore, these modifications can be characterized using different imaging modalities such as echocardiography, including Doppler (flow Doppler and Doppler myocardial imaging) and speckle-tracking, along with cardiac magnetic resonance, and cardiac computed tomography. MAIN TEXT Echocardiography is the most common method for assessing cardiac structure and function in athletes due to its availability, repeatability, versatility, and low cost. It allows the measurement of parameters like left ventricular wall thickness, cavity dimensions, and mass. Left ventricular myocardial strain can be measured by tissue Doppler (using the pulse wave Doppler principle) or speckle tracking echocardiography (using the two-dimensional grayscale B-mode images), which provide information on the deformation of the myocardium. Cardiac magnetic resonance provides a comprehensive evaluation of cardiac morphology and function with superior accuracy compared to echocardiography. With the addition of contrast agents, myocardial state can be characterized. Thus, it is particularly effective in differentiating an athlete's heart from pathological conditions, however, is less accessible and more expensive compared to other techniques. Coronary computed tomography is used to assess coronary artery anatomy and identify anomalies or diseases, but its use is limited due to radiation exposure and cost, making it less suitable for young athletes. A novel approach, hemodynamic forces analysis, uses feature tracking to quantify intraventricular pressure gradients responsible for blood flow. Hemodynamic forces analysis has the potential for studying blood flow within the heart and assessing cardiac function. CONCLUSIONS In conclusion, each diagnostic technique has its own advantages and limitations for assessing cardiac adaptations in athletes. Examining and comparing the cardiac adaptations resulting from physical activity with the structural cardiac changes identified through different diagnostic modalities is a pivotal focus in the field of sports medicine.
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Affiliation(s)
- Nurmakhan Zholshybek
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Zaukiya Khamitova
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Bauyrzhan Toktarbay
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Dinara Jumadilova
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
- National Research Cardiac Surgery Center, Radiology Unit, Astana, 01000, Kazakhstan
| | - Nail Khissamutdinov
- National Research Cardiac Surgery Center, Cardiology Unit #2, Astana, 01000, Kazakhstan
| | - Tairkhan Dautov
- Clinical and Academic Department of Radiology and Nuclear Medicine, CF "University Medical Center", Astana, 01000, Kazakhstan
| | - Yeltay Rakhmanov
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | | | - Abduzhappar Gaipov
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan
| | - Alessandro Salustri
- School of Medicine, Department of Medicine, Nazarbayev University, Astana, 01000, Kazakhstan.
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4
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Carrick-Ranson G, Howden EJ, Brazile TL, Levine BD, Reading SA. Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women. J Appl Physiol (1985) 2023; 135:1215-1235. [PMID: 37855034 DOI: 10.1152/japplphysiol.00798.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in women in developed societies. Unfavorable structural and functional adaptations within the heart and central blood vessels with sedentary aging in women can act as the substrate for the development of debilitating CVD conditions such as heart failure with preserved ejection fraction (HFpEF). The large decline in cardiorespiratory fitness, as indicated by maximal or peak oxygen uptake (V̇o2max and V̇o2peak, respectively), that occurs in women as they age significantly affects their health and chronic disease status, as well as the risk of cardiovascular and all-cause mortality. Midlife and older women who have performed structured endurance exercise training for several years or decades of their adult lives exhibit a V̇o2max and cardiac and vascular structure and function that are on par or even superior to much younger sedentary women. Therefore, regular endurance exercise training appears to be an effective preventative strategy for mitigating the adverse physiological cardiovascular adaptations associated with sedentary aging in women. Herein, we narratively describe the aging and short- and long-term endurance exercise training adaptations in V̇o2max, cardiac structure, and left ventricular systolic and diastolic function at rest and exercise in midlife and older women. The role of circulating estrogens on cardiac structure and function is described for consideration in the timing of exercise interventions to maximize beneficial adaptations. Current research gaps and potential areas for future investigation to advance our understanding in this critical knowledge area are highlighted.
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Affiliation(s)
- Graeme Carrick-Ranson
- Department of Surgery, the University of Auckland, Auckland, New Zealand
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| | - Erin J Howden
- Human Integrative Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Tiffany L Brazile
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stacey A Reading
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
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5
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Liu MY, Liu PY, Tsai KZ, Lima JAC, Lavie CJ, Lin GM. Asian Female Athlete's Heart: The CHIEF Heart Study. ACTA CARDIOLOGICA SINICA 2023; 39:888-900. [PMID: 38022423 PMCID: PMC10646586 DOI: 10.6515/acs.202311_39(6).20230306f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/06/2023] [Indexed: 12/01/2023]
Abstract
Background The cardiac characteristics of Asian female endurance athletes and strength athletes have rarely been investigated. Methods This study included 177 Taiwanese young women undergoing military training. Cardiac features were assessed by electrocardiography (ECG) and echocardiography. Then, all participants completed a 3000-meter run to assess endurance capacity, and 89 participants completed a 2-minute push-up test to assess muscular strength. Athletes were those whose exercise performance fell one standard deviation above the mean, and the remaining participants were defined as controls. Multiple logistic regression analysis was used to determine the predictors of the cardiac characteristics of female athletes. Results Compared to the female controls, female endurance athletes had a greater QRS duration (ms) (92.12 ± 10.35 vs. 87.26 ± 9.89, p = 0.01) and a higher prevalence of right axis deviation (RAD) (34.9% vs. 11.1%, p < 0.001). There were no differences in any echocardiographic parameters. Greater QRS duration and RAD and lower systolic blood pressure were independent predictors of female endurance athletes [odds ratios (OR) and 95% confidence intervals: 1.05 (1.01-1.09), 2.91 (1.12-7.59) and 0.93 (0.88-0.98), respectively]. Female strength athletes had a greater right ventricular outflow tract (RVOT) (mm) (28.06 ± 3.57 vs. 25.38 ± 3.61, p = 0.007) but revealed no differences in ECG variables. Greater RVOT was the only predictor of female strength athletes [OR: 1.26 (1.05-1.50)]. Conclusions In Asian military women, a wider QRS duration and the presence of RAD in ECG rather than heart structure and function were found to characterize endurance athletes, whereas a wider RVOT but no ECG features were found to characterize strength athletes.
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Affiliation(s)
- Ming-Yueh Liu
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien
- Department of Radiation Oncology, Taichung Armed Forces General Hospital, Taichung
| | - Pang-Yen Liu
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien
- Division of Cardiology, Department of Medicine, Tri-Service General Hospital and National Defense Medical Center
| | - Kun-Zhe Tsai
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien
- Department of Stomatology of Periodontology, MacKay Memorial Hospital
- Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Joao A. C. Lima
- Departments of Cardiology and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien
- Division of Cardiology, Department of Medicine, Tri-Service General Hospital and National Defense Medical Center
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Chori BS, An DW, Martens DS, Yu YL, Gilis-Malinowska N, Abubakar SM, Ibrahim EA, Ajanya O, Abiodun OO, Anya T, Tobechukwu I, Isiguzo G, Cheng HM, Chen CH, Liao CT, Mokwatsi G, Stolarz-Skrzypek K, Wojciechowska W, Narkiewicz K, Rajzer M, Brguljan-Hitij J, Nawrot TS, Asayama K, Reyskens P, Mischak H, Odili AN, Staessen JA. Urinary proteomics combined with home blood pressure telemonitoring for health care reform trial-First progress report. J Clin Hypertens (Greenwich) 2023. [PMID: 37147930 DOI: 10.1111/jch.14664] [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: 02/13/2023] [Revised: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 05/07/2023]
Abstract
High blood pressure (BP) and type-2 diabetes (T2DM) are forerunners of chronic kidney disease and left ventricular dysfunction. Home BP telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling risk stratification and personalized prevention. UPRIGHT-HTM (NCT04299529) is an investigator-initiated, multicenter, open-label, randomized trial with blinded endpoint evaluation designed to assess the efficacy of HTM plus UPP (experimental group) over HTM alone (control group) in guiding treatment in asymptomatic patients, aged 55-75 years, with ≥5 cardiovascular risk factors. From screening onwards, HTM data can be freely accessed by all patients and their caregivers; UPP results are communicated early during follow-up to patients and caregivers in the intervention group, but at trial closure in the control group. From May 2021 until January 2023, 235 patients were screened, of whom 53 were still progressing through the run-in period and 144 were randomized. Both groups had similar characteristics, including average age (62.0 years) and the proportions of African Blacks (81.9%), White Europeans (16.7%), women 56.2%, home (31.2%), and office (50.0%) hypertension, T2DM (36.4%), micro-albuminuria (29.4%), and ECG (9.7%) and echocardiographic (11.5%) left ventricular hypertrophy. Home and office BP were 128.8/79.2 mm Hg and 137.1/82.7 mm Hg, respectively, resulting in a prevalence of white-coat, masked and sustained hypertension of 40.3%, 11.1%, and 25.7%. HTM persisted after randomization (48 681 readings up to 15 January 2023). In conclusion, results predominantly from low-resource sub-Saharan centers proved the feasibility of this multi-ethnic trial. The COVID-19 pandemic caused delays and differential recruitment rates across centers.
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Affiliation(s)
- Babangida S Chori
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
| | - De-Wei An
- Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Dries S Martens
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Yu-Ling Yu
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | | | - Sani M Abubakar
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Gwagwalada, Nigeria
| | - Etubi A Ibrahim
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Gwagwalada, Nigeria
| | - Ojonojima Ajanya
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Gwagwalada, Nigeria
| | - Olugbenga O Abiodun
- Department of Internal Medicine, Federal Medical Center Jabi, Jabi, Abuja, Nigeria
| | - Tina Anya
- Department of Internal Medicine, Federal Medical Center Jabi, Jabi, Abuja, Nigeria
| | - Iyidobi Tobechukwu
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi, Nigeria
| | - Godsent Isiguzo
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi, Nigeria
| | - Hao-Min Cheng
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, People's Republic of China
| | - Chen-Huan Chen
- Medical Building, National Yang-Min University School of Medicine, Taipei, People's Republic of China
| | - Chia-Te Liao
- Chi Mei Medical Center, Yong Kang, Tainan, People's Republic of China
| | - Gontse Mokwatsi
- Hypertension in Africa Research Team, North-Western University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Katarzyna Stolarz-Skrzypek
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagellonian University, Kraków, Poland
| | - Jana Brguljan-Hitij
- Department of Internal Medicine, Division of Hypertension, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Tim S Nawrot
- Center for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kei Asayama
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | | | | | - Augustine N Odili
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Gwagwalada, Nigeria
| | - Jan A Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Biomedical Science Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
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Lindner R, Raj IS, Yang AWH, Zaman S, Larsen B, Denham J. Moderate to Vigorous-intensity Continuous Training versus High-intensity Interval Training for improving VO2max in women: A systematic review and meta-analysis. Int J Sports Med 2023. [PMID: 37084758 DOI: 10.1055/a-2044-8952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Traditional continuous training and high-intensity interval training (HIIT) can increase maximal oxygen uptake (V̇O2max). However, there is conflicting evidence regarding which form of training demonstrates the greatest improvements to V̇O2max, and data in women is sparse. We conducted a systematic review and meta-analyses to assess whether moderate to vigorous-intensity continuous training (MVICT) or HIIT was superior at improving V̇O2max in women. Randomised controlled and parallel studies examined the influence of MVICT and/or HIIT on V̇O2max in women. There was no statistical difference in V̇O2max improvements after training between women in the MVICT and HIIT cohorts (mean difference [MD]: -0.42, 95%CI: -1.43 to 0.60, p>0.05). Both MVICT and HIIT increased V̇O2max from baseline (MD: 3.20, 95% CI: 2.73 to 3.67 and MD: 3.16, 95% CI 2.09 to 4.24, respectively, p<0.001). Greater improvements in V̇O2max were observed in women who participated in more training sessions in both training formats. Long-HIIT was superior to short-HIIT protocols at increasing V̇O2max. Although MVICT and long-HIIT sessions elicited greater increases in V̇O2max in younger women compared to short-HIIT protocols, these differences were negligible in older women. Our findings suggest MVICT and HIIT are equally effective strategies for improving V̇O2max and indicate an effect of age on its response to training in women.
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Affiliation(s)
- Robert Lindner
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Isaac Selva Raj
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | | | - Shadman Zaman
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Brianna Larsen
- School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, Australia
- Institute for Resilient Regions Centre, Centre for Health Research, Toowoomba, Queensland, Australia
| | - Joshua Denham
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
- School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, Australia
- Institute for Resilient Regions Centre, Centre for Health Research, Toowoomba, Queensland, Australia
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Chou CH, Yin JH, Lin YK, Yang FC, Chu TW, Chuang YC, Lin CW, Peng GS, Sung YF. The optimal pulse pressures for healthy adults with different ages and sexes correlate with cardiovascular health metrics. Front Cardiovasc Med 2022; 9:930443. [PMID: 36545016 PMCID: PMC9760735 DOI: 10.3389/fcvm.2022.930443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/10/2022] [Indexed: 12/07/2022] Open
Abstract
Background Pulse pressure (PP) may play a role in the development of cardiovascular disease, and the optimal PP for different ages and sexes is unknown. In a prospective cohort, we studied subjects with favorable cardiovascular health (CVH), proposed the mean PP as the optimal PP values, and demonstrated its relationship with healthy lifestyles. Methods and results Between 1996 and 2016, a total of 162,636 participants (aged 20 years or above; mean age 34.9 years; 26.4% male subjects; meeting criteria for favorable health) were recruited for a medical examination program. PP in male subjects was 45.6 ± 9.4 mmHg and increased after the age of 50 years. PP in female subjects was 41.8 ± 9.5 mmHg and increased after the age of 40 years, exceeding that of male subjects after the age of 50 years. Except for female subjects with a PP of 40-70 mmHg, PP increase correlates with both systolic blood pressure (BP) increase and diastolic BP decrease. Individuals with mean PP values are more likely to meet health metrics, including body mass index (BMI) <25 kg/m2 (chi-squared = 9.35, p<0.01 in male subjects; chi-squared = 208.79, p < 0.001 in female subjects) and BP <120/80 mmHg (chi-squared =1,300, p < 0.001 in male subjects; chi-squared =11,000, p < 0.001 in female subjects). We propose a health score (Hscore) based on the sum of five metrics (BP, BMI, being physically active, non-smoking, and healthy diet), which significantly correlates with the optimal PP. Conclusion The mean PP (within ±1 standard deviation) could be proposed as the optimal PP in the adult population with favorable CVH. The relationship between health metrics and the optimal PP based on age and sex was further demonstrated to validate the Hscore.
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Affiliation(s)
- Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,MJ Health Screening Center, Taipei, Taiwan
| | | | - Chia Wen Lin
- MJ Health Research Foundation, MJ Group, Taipei, Taiwan
| | - Giia-Sheun Peng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,*Correspondence: Yueh-Feng Sung
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Bartra C, Jager LA, Alcarraz A, Meza-Ramos A, Sangüesa G, Corpas R, Guasch E, Batlle M, Sanfeliu C. Antioxidant Molecular Brain Changes Parallel Adaptive Cardiovascular Response to Forced Running in Mice. Antioxidants (Basel) 2022; 11:1891. [PMID: 36290614 PMCID: PMC9598430 DOI: 10.3390/antiox11101891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 10/03/2023] Open
Abstract
Physically active lifestyle has huge implications for the health and well-being of people of all ages. However, excessive training can lead to severe cardiovascular events such as heart fibrosis and arrhythmia. In addition, strenuous exercise may impair brain plasticity. Here we investigate the presence of any deleterious effects induced by chronic high-intensity exercise, although not reaching exhaustion. We analyzed cardiovascular, cognitive, and cerebral molecular changes in young adult male mice submitted to treadmill running for eight weeks at moderate or high-intensity regimens compared to sedentary mice. Exercised mice showed decreased weight gain, which was significant for the high-intensity group. Exercised mice showed cardiac hypertrophy but with no signs of hemodynamic overload. No morphological changes in the descending aorta were observed, either. High-intensity training induced a decrease in heart rate and an increase in motor skills. However, it did not impair recognition or spatial memory, and, accordingly, the expression of hippocampal and cerebral cortical neuroplasticity markers was maintained. Interestingly, proteasome enzymatic activity increased in the cerebral cortex of all trained mice, and catalase expression was significantly increased in the high-intensity group; both first-line mechanisms contribute to maintaining redox homeostasis. Therefore, physical exercise at an intensity that induces adaptive cardiovascular changes parallels increases in antioxidant defenses to prevent brain damage.
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Affiliation(s)
- Clara Bartra
- Institut d’Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), 08036 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Lars Andre Jager
- Institut d’Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), 08036 Barcelona, Spain
| | - Anna Alcarraz
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Arrhythmia Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Aline Meza-Ramos
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Arrhythmia Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Gemma Sangüesa
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Arrhythmia Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Rubén Corpas
- Institut d’Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), 08036 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Eduard Guasch
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Arrhythmia Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red-Cardiovascular (CIBERCV), 28029 Madrid, Spain
| | - Montserrat Batlle
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Arrhythmia Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red-Cardiovascular (CIBERCV), 28029 Madrid, Spain
| | - Coral Sanfeliu
- Institut d’Investigacions Biomèdiques de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), 08036 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
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10
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St. Pierre SR, Peirlinck M, Kuhl E. Sex Matters: A Comprehensive Comparison of Female and Male Hearts. Front Physiol 2022; 13:831179. [PMID: 35392369 PMCID: PMC8980481 DOI: 10.3389/fphys.2022.831179] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/02/2022] [Indexed: 12/27/2022] Open
Abstract
Cardiovascular disease in women remains under-diagnosed and under-treated. Recent studies suggest that this is caused, at least in part, by the lack of sex-specific diagnostic criteria. While it is widely recognized that the female heart is smaller than the male heart, it has long been ignored that it also has a different microstructural architecture. This has severe implications on a multitude of cardiac parameters. Here, we systematically review and compare geometric, functional, and structural parameters of female and male hearts, both in the healthy population and in athletes. Our study finds that, compared to the male heart, the female heart has a larger ejection fraction and beats at a faster rate but generates a smaller cardiac output. It has a lower blood pressure but produces universally larger contractile strains. Critically, allometric scaling, e.g., by lean body mass, reduces but does not completely eliminate the sex differences between female and male hearts. Our results suggest that the sex differences in cardiac form and function are too complex to be ignored: the female heart is not just a small version of the male heart. When using similar diagnostic criteria for female and male hearts, cardiac disease in women is frequently overlooked by routine exams, and it is diagnosed later and with more severe symptoms than in men. Clearly, there is an urgent need to better understand the female heart and design sex-specific diagnostic criteria that will allow us to diagnose cardiac disease in women equally as early, robustly, and reliably as in men. Systematic Review Registration https://livingmatter.stanford.edu/.
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Affiliation(s)
- Sarah R. St. Pierre
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
| | - Mathias Peirlinck
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
- Department of Biomedical Engineering, Erasmus MC, Rotterdam, Netherlands
| | - Ellen Kuhl
- Department of Mechanical Engineering, Stanford University, Stanford, CA, United States
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11
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Abstract
The Exercise Boom of the 1970's resulted in the adoption of habitual exercise in a significant portion of the population. Many of these individuals are defying the cultural norms by remaining physically active and competing at a high level in their later years. The juxtaposition between masters athletes and non-exercisers demonstrate the importance of remaining physically active throughout the lifespan on physiological systems related to healthspan (years of healthy living). This includes ~50% improved maximal aerobic capacity (VO2max) and enhanced skeletal muscle health (size, function, as well as metabolic and communicative properties) compared to non-exercisers at a similar age. By taking a reductionist approach to VO2max and skeletal muscle health, we can gain insight into how aging and habitual exercise affects the aging process. Collectively, this review provides a physiological basis for the elite performances seen in masters athletes, as well as the health implications of lifelong exercise with a focus on VO2max, skeletal muscle metabolic fitness, whole muscle size and function, single muscle fiber physiology, and communicative properties of skeletal muscle. This review has significant public health implications due to the potent health benefits of habitual exercise across the lifespan.
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Affiliation(s)
- Kevin J Gries
- Exercise and Sports Science, Marian University, Indianapolis, United States
| | - S W Trappe
- Human Performance Laboratory, Ball State University, Muncie, United States
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12
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Rabineau J, Nonclercq A, Leiner T, van de Borne P, Migeotte PF, Haut B. Closed-Loop Multiscale Computational Model of Human Blood Circulation. Applications to Ballistocardiography. Front Physiol 2021; 12:734311. [PMID: 34955874 PMCID: PMC8697684 DOI: 10.3389/fphys.2021.734311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiac mechanical activity leads to periodic changes in the distribution of blood throughout the body, which causes micro-oscillations of the body's center of mass and can be measured by ballistocardiography (BCG). However, many of the BCG findings are based on parameters whose origins are poorly understood. Here, we generate simulated multidimensional BCG signals based on a more exhaustive and accurate computational model of blood circulation than previous attempts. This model consists in a closed loop 0D-1D multiscale representation of the human blood circulation. The 0D elements include the cardiac chambers, cardiac valves, arterioles, capillaries, venules, and veins, while the 1D elements include 55 systemic and 57 pulmonary arteries. The simulated multidimensional BCG signal is computed based on the distribution of blood in the different compartments and their anatomical position given by whole-body magnetic resonance angiography on a healthy young subject. We use this model to analyze the elements affecting the BCG signal on its different axes, allowing a better interpretation of clinical records. We also evaluate the impact of filtering and healthy aging on the BCG signal. The results offer a better view of the physiological meaning of BCG, as compared to previous models considering mainly the contribution of the aorta and focusing on longitudinal acceleration BCG. The shape of experimental BCG signals can be reproduced, and their amplitudes are in the range of experimental records. The contributions of the cardiac chambers and the pulmonary circulation are non-negligible, especially on the lateral and transversal components of the velocity BCG signal. The shapes and amplitudes of the BCG waveforms are changing with age, and we propose a scaling law to estimate the pulse wave velocity based on the time intervals between the peaks of the acceleration BCG signal. We also suggest new formulas to estimate the stroke volume and its changes based on the BCG signal expressed in terms of acceleration and kinetic energy.
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Affiliation(s)
- Jeremy Rabineau
- TIPs, Université Libre de Bruxelles, Brussels, Belgium
- LPHYS, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Philippe van de Borne
- Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Benoit Haut
- TIPs, Université Libre de Bruxelles, Brussels, Belgium
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Młyńczak M, Krysztofiak H. Respiratory Activity during Exercise: A Feasibility Study on Transition Point Estimation Using Impedance Pneumography. SENSORS 2021; 21:s21186233. [PMID: 34577438 PMCID: PMC8473346 DOI: 10.3390/s21186233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/24/2022]
Abstract
The current diagnostic procedures for assessing physiological response to exercise comprise blood lactates measurements, ergospirometry, and electrocardiography. The first is not continuous, the second requires specialized equipment distorting natural breathing, and the last is indirect. Therefore, we decided to perform the feasibility study with impedance pneumography as an alternative technique. We attempted to determine points in respiratory-related signals, acquired during stress test conditions, that suggest a transition similar to the gas exchange threshold. In addition, we analyzed whether or not respiratory activity reaches steady states during graded exercise. Forty-four students (35 females), practicing sports on different levels, performed a graded exercise test until exhaustion on cycloergometer. Eventually, the results from 34 of them were used. The data were acquired with Pneumonitor 2. The signals demonstrated that the steady state phenomenon is not as evident as for heart rate. The results indicated respiratory rate approaches show the transition point at the earliest (more than 6 min before the end of the exercise test on average), and the tidal volume ones at the latest (less than 5 min). A combination gave intermediate findings. The results showed the impedance pneumography appears reasonable for the transition point estimation, but this should be further studied with the reference.
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Affiliation(s)
- Marcel Młyńczak
- Institute of Metrology and Biomedical Engineering, Faculty of Mechatronics, Warsaw University of Technology, 02-525 Warsaw, Poland
- Correspondence:
| | - Hubert Krysztofiak
- Department of Applied Physiology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland;
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