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Wachsmuth NB, Haupt S, Bauer P, Schierbauer JR, Treff G, Steinacker JM, Rilstone S, Schmidt WFJ. Impact of a single blood donation on hemoglobin mass, iron stores, and maximum oxygen uptake in pre-menopausal women-A pilot study. Transfusion 2024; 64:1481-1491. [PMID: 38884363 DOI: 10.1111/trf.17917] [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: 02/14/2024] [Revised: 05/24/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND During whole blood donation (BD), 500 mL of blood is drawn. The time interval between two BDs is at least 8-12 weeks. This period might be insufficient for restoring hemoglobin mass (Hbmass) and iron especially in women, who generally have lower Hbmass and iron availability. Since both variables influence physical performance, this pilot study aimed to monitor Hbmass, iron status, and maximum oxygen uptake (V̇O2max) recovery in women after a single BD. STUDY DESIGN AND METHODS In 10 women (24.7 ± 1.7 years), Hbmass, hemoglobin concentration [Hb], iron status, and V̇O2max were assessed before and up to 12 weeks after a single BD. RESULTS BD reduced Hbmass from 562 ± 70 g to 499 ± 64 g (p < .001). Although after 8 weeks no significant mean difference was detected, 7 women had not returned to baseline after 12 weeks. [Hb] did not return to initial values (13.4 ± 0.7 g/dL) after 12 weeks (12.9 ± 0.7 g/dL, p < .01). Ferritin decreased from baseline until week 6 (40.9 ± 34.2 ng/mL vs. 12.1 ± 6.9 ng/mL, p < .05) and was not restored after 12 weeks (18.4 ± 12.7 ng/mL, p < .05), with 6 out of 10 women exhibiting iron deficiency (ferritin <15 ng/mL). V̇O2max was reduced by 213 ± 47 mL/min (7.2 ± 1.2%; p < .001) and remained below baseline after 12 weeks (3.2 ± 1.4%, p < .01). DISCUSSION For most pre-menopausal women, 12 weeks were not sufficient to recover from BD and achieve baseline Hbmass and iron stores resulting in prolonged reduction of aerobic capacity. A subsequent BD might lead to a severe anemia.
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Affiliation(s)
- Nadine B Wachsmuth
- Division of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
- Division of Exercise Physiology and Metabolism, Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Sandra Haupt
- Division of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
- Division of Exercise Physiology and Metabolism, Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
- Division of Molecular Exercise Physiology, University of Bayreuth, Bayreuth, Germany
| | - Philipp Bauer
- Division of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Janis R Schierbauer
- Division of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
- Division of Exercise Physiology and Metabolism, Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Gunnar Treff
- Department of Internal Medicine, Division of Sports and Rehabilitation Medicine, Ulm University, Ulm, Germany
- Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Jürgen M Steinacker
- Department of Internal Medicine, Division of Sports and Rehabilitation Medicine, Ulm University, Ulm, Germany
| | - Sian Rilstone
- Department of Nutrition & Dietetics, Imperial College Healthcare NHS Trust, London, UK
| | - Walter F J Schmidt
- Division of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
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Fischer M, Jeppesen JS, Vigh-Larsen JF, Stöhr EJ, Mohr M, Wickham KA, Gliemann L, Bangsbo J, Hellsten Y, Hostrup M. Intensified training augments cardiac function, but not blood volume, in male youth elite ice hockey team players. Exp Physiol 2024. [PMID: 39014554 DOI: 10.1113/ep091674] [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: 11/23/2023] [Accepted: 04/29/2024] [Indexed: 07/18/2024]
Abstract
While it is well-established that a period of interval training performed at near maximal effort, such as speed endurance training (SET), enhances intense exercise performance in well-trained individuals, less is known about its effect on cardiac morphology and function as well as blood volume. To investigate this, we subjected 12 Under-20 Danish national team ice hockey players (age 18 ± 1 years, mean ± SD) to 4 weeks of SET, consisting of 6-10 × 20 s skating bouts at maximal effort interspersed by 2 min of recovery conducted three times weekly. This was followed by 4 weeks of regular training (follow-up). We assessed resting cardiac function and dimensions using transthoracic echocardiography and quantified total blood volume with the carbon monoxide rebreathing technique at three time points: before SET, after SET and after the follow-up period. After SET, stroke volume had increased by 10 (2-18) mL (mean (95% CI)), left atrial end-diastolic volume by 10 (3-17) mL, and circumferential strain improved by 0.9%-points (1.7-0.1) (all P < 0.05). At follow-up, circumferential strain and left atrial end-diastolic volume were reverted to baseline levels, while stroke volume remained elevated. Blood volume and morphological parameters for the left ventricle, including mass and end-diastolic volume, did not change during the study. In conclusion, our findings demonstrate that a brief period of SET elicits beneficial central cardiac adaptations in elite ice hockey players independent of changes in blood volume.
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Affiliation(s)
- Mads Fischer
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jan S Jeppesen
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jeppe F Vigh-Larsen
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Eric J Stöhr
- COR-HELIX (Cardiovascular Regulation and Exercise Laboratory - Integration and Xploration), Institute of Sports Science, Leibniz University, Hannover, Germany
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Centre of Health Sciences, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Kate A Wickham
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Morten Hostrup
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
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Wang J, Xiao X, Zhang H, Wu D, Luo F, Yu J. Effects of additional physical exercise on the nutritional status and disease progression during the low-protein diet in Chronic Kidney Disease Patients: a systematic review and meta-analysis. Eur J Clin Nutr 2024:10.1038/s41430-024-01466-0. [PMID: 38961262 DOI: 10.1038/s41430-024-01466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/05/2024]
Abstract
Low-protein diet (LPD) is the core of dietary and nutritional therapy for non-dialysis chronic kidney disease (CKD) patients. In addition, physical exercise could prevent and treat various illnesses and chronic diseases. The objective of the study was to search for and appraise evidence on the effect of additional physical exercise on patients' nutritional status and indicators of disease progression when compared with the LPD alone. PubMed Central, Embase, Cochrane, and Web of Knowledge for randomized controlled trials (published between January 1, 1956 and May 17, 2023) were searched. A total of 8698 identified studies, 9 were eligible and were included in our analysis (N = 250 participants). Compared with the LPD alone, additional physical exercise reduced serum creatinine by a mean of -0.21 mg/dL (95% CI -0.39 to -0.03) in CKD patients. Similarly, blood pressure decreased after physical exercise, with systolic blood pressure decreasing by -7.05 mm Hg (95% CI -13.13 to -0.96) and diastolic blood pressure decreasing by -5.31 mm Hg (95% CI -7.99 to -2.62). Subgroup analyses revealed that resistance exercise (RE) was effective in decreasing estimated glomerular filtration rate (eGFR) of -1.71 mL/min per 1.73 m² (95% CI -3.29 to -0.14). In addition, the VO2peak increasing by 2.41 mL/kg/min (95% CI 0.13 to 4.70) when physical exercise was continued for 24 weeks. The above results suggest that the LPD with additional physical exercise care is more beneficial for patients with CKD.
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Affiliation(s)
- Jing Wang
- Department of Nutrition, Fifth Hospital in Wuhan, Wuhan, China
| | - Xiaofen Xiao
- Department of Nutrition, Fifth Hospital in Wuhan, Wuhan, China
| | - Hui Zhang
- Department of Orthopaedics, Fifth Hospital in Wuhan, Wuhan, China
| | - Dan Wu
- Department of Orthopaedics, Fifth Hospital in Wuhan, Wuhan, China
| | - Feifei Luo
- Department of Cardiac Function, Fourth Hospital in Wuhan, Wuhan, China
| | - Juling Yu
- Department of Infection Management, Fifth Hospital in Wuhan, Wuhan, China.
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Guo MH, Diaz-Canestro C, Montero D. The Frank-Starling mechanism is not enough: blood volume expansion prominently decreases pulmonary O 2 uptake. Mil Med Res 2024; 11:43. [PMID: 38956634 PMCID: PMC11218401 DOI: 10.1186/s40779-024-00546-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Affiliation(s)
- Mei-Han Guo
- Faculty of Medicine, Hong Kong University, Hong Kong, China
| | - Candela Diaz-Canestro
- Department of Medicine, School of Clinical Medicine, Hong Kong University, Hong Kong, China
| | - David Montero
- Faculty of Medicine, Hong Kong University, Hong Kong, China.
- Department of Medicine, School of Clinical Medicine, Hong Kong University, Hong Kong, China.
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, T2N 4N1, Canada.
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Schierbauer J, Sanfilippo S, Grothoff A, Fehr U, Wachsmuth N, Voit T, Zimmermann P, Moser O. Effect of Fluid Intake on Acute Changes in Plasma Volume: A Randomized Controlled Crossover Pilot Trial. Metabolites 2024; 14:263. [PMID: 38786740 PMCID: PMC11123201 DOI: 10.3390/metabo14050263] [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: 03/07/2024] [Revised: 04/09/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
Plasma volume (PV) undergoes constant and dynamic changes, leading to a large intra-day variability in healthy individuals. Hydration is known to induce PV changes; however, the response to the intake of osmotically different fluids is still not fully understood. In a randomized controlled crossover trial, 18 healthy individuals (10 females) orally received an individual amount of an isotonic sodium-chloride (ISO), Ringer (RIN), or glucose (GLU) solution. Hemoglobin mass (Hbmass) was determined with the optimized carbon monoxide re-breathing method. Fluid-induced changes in PV were subsequently calculated based on capillary hemoglobin concentration ([Hb]) and hematocrit (Hct) before and then every 10 minutes until 120 min (t0-120) after the fluid intake and compared to a control trial arm (CON), where no fluid was administered. Within GLU and CON trial arms, no statistically significant differences from baseline until t120 were found (p > 0.05). In the ISO trial arm, PV was significantly increased at t70 (+138 mL, p = 0.01), t80 (+191 mL, p < 0.01), and t110 (+182 mL, p = 0.01) when compared to t0. Moreover, PV in the ISO trial arm was significantly higher at t70 (p = 0.02), t110 (p = 0.04), and t120 (p = 0.01) when compared to the same time points in the CON trial arm. Within the RIN trial arm, PV was significantly higher between t70 and t90 (+183 mL, p = 0.01) and between t110 (+194 mL, p = 0.03) and t120 (+186 mL, p < 0.01) when compared to t0. These results demonstrated that fluids with a higher content of osmotically active particles lead to acute hemodilution, which is associated with a decrease in [Hb] and Hct. These findings underpin the importance of the hydration state on PV and especially on PV constituent levels in healthy individuals.
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Affiliation(s)
- Janis Schierbauer
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Sabrina Sanfilippo
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Auguste Grothoff
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Ulrich Fehr
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Nadine Wachsmuth
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Thomas Voit
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, Bayreuth Centre of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (S.S.); (A.G.); (U.F.); (N.W.); (T.V.); (P.Z.); (O.M.)
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria
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6
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Thompson KMA, Gamble ASD, Kontro H, Lee JB, Burr JF. Low- and high-volume blood-flow restriction treadmill walking both improve maximal aerobic capacity independently of blood volume. Scand J Med Sci Sports 2024; 34:e14534. [PMID: 37961932 DOI: 10.1111/sms.14534] [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: 09/14/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
AIM Assess the effect of low- and high-volume blood flow restriction training (BFR) on maximal aerobic capacity (VO2 max) and determine if alteration in VO2 max is mediated through changes in hemoglobin mass (Hbmass) and blood volume. METHODS Participants' Hbmass (CO-rebreathe), single, and double-leg VO2 max and blood volume regulating hormonal responses (renin and copeptin) were measured before and after BFR training. Training consisted of treadmill walking either (1) twice-daily for 4week (CON and BFRHV ) or (2) twice-weekly for 6week (BFRLV ). Each session consisted of five intervals (3 min, 5% incline, 5 km/h, 100% of lowest occlusion pressure), with 1 min of standing rest between sets. RESULTS VO2 max increased using both training exposures, in as quickly as 2-weeks (BFRLV baseline to 4week: +315 ± 241 mL (8.7%), p = 0.02; BFRHV baseline to 2week: +360 ± 261 mL (7.9%), p < 0.01), for the BFRLV and BFRHV groups, with no change in CON. Single- and double-leg VO2 max improved proportionately (single/double-leg VO2 max ratio: BFRLV 78 ± 4.9-78 ± 5.8%, BFRHV 79 ± 6.5-77 ± 6.5%), suggesting that the mechanism for increased VO2 max is not solely limited to central or peripheral adaptations. Hbmass remained unchanged across groups (CON: +10.2 ± 34 g, BFRLV : +6.6 ± 42 g, BFRHV : +3.2 ± 44 g; p = 0.9), despite a significant release of blood volume regulating hormones after initial BFR exposure (renin +20.8 ± 21.9 ng/L, p < 0.01; copeptin +22.0 ± 23.8 pmol/L, p < 0.01), which was blunted following BFRHV training (renin: +13.4 ± 12.4 ng/L, p = 0.09; copeptin: +1.9 ± 1.7 pmol/L, p = 0.98). CONCLUSION BFR treadmill walking increases VO2 max irrespective of changes in Hbmass or blood volume despite a large release of blood volume regulating hormones in response to BFR treadmill walking.
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Affiliation(s)
- K M A Thompson
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - A S D Gamble
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - H Kontro
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - J B Lee
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - J F Burr
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Webb KL, Gorman EK, Morkeberg OH, Klassen SA, Regimbal RJ, Wiggins CC, Joyner MJ, Hammer SM, Senefeld JW. The relationship between hemoglobin and [Formula: see text]: A systematic review and meta-analysis. PLoS One 2023; 18:e0292835. [PMID: 37824583 PMCID: PMC10569622 DOI: 10.1371/journal.pone.0292835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between hemoglobin levels and maximal oxygen uptake ([Formula: see text]) in humans. However, there exists considerable variability in the scientific literature regarding the potential relationship between hemoglobin and [Formula: see text]. Thus, we aimed to provide a comprehensive analysis of the diverse literature and examine the relationship between hemoglobin levels (hemoglobin concentration and mass) and [Formula: see text] (absolute and relative [Formula: see text]) among both observational and interventional studies. METHODS A systematic search was performed on December 6th, 2021. The study procedures and reporting of findings followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article selection and data abstraction were performed in duplicate by two independent reviewers. Primary outcomes were hemoglobin levels and [Formula: see text] values (absolute and relative). For observational studies, meta-regression models were performed to examine the relationship between hemoglobin levels and [Formula: see text] values. For interventional studies, meta-analysis models were performed to determine the change in [Formula: see text] values (standard paired difference) associated with interventions designed to modify hemoglobin levels or [Formula: see text]. Meta-regression models were then performed to determine the relationship between a change in hemoglobin levels and the change in [Formula: see text] values. RESULTS Data from 384 studies (226 observational studies and 158 interventional studies) were examined. For observational data, there was a positive association between absolute [Formula: see text] and hemoglobin levels (hemoglobin concentration, hemoglobin mass, and hematocrit (P<0.001 for all)). Prespecified subgroup analyses demonstrated no apparent sex-related differences among these relationships. For interventional data, there was a positive association between the change of absolute [Formula: see text] (standard paired difference) and the change in hemoglobin levels (hemoglobin concentration (P<0.0001) and hemoglobin mass (P = 0.006)). CONCLUSION These findings suggest that [Formula: see text] values are closely associated with hemoglobin levels among both observational and interventional studies. Although our findings suggest a lack of sex differences in these relationships, there were limited studies incorporating females or stratifying results by biological sex.
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Affiliation(s)
- Kevin L. Webb
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ellen K. Gorman
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Olaf H. Morkeberg
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Stephen A. Klassen
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Riley J. Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Shane M. Hammer
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
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Pigakis KM, Stavrou VT, Pantazopoulos I, Daniil Z, Kontopodi-Pigaki AK, Gourgoulianis K. Effect of Hydration on Pulmonary Function and Development of Exercise-Induced Bronchoconstriction among Professional Male Cyclists. Adv Respir Med 2023; 91:239-253. [PMID: 37366805 DOI: 10.3390/arm91030019] [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: 05/06/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Exercise-induced bronchoconstriction (EIB) is a common problem in elite athletes. Classical pathways in the development of EIB include the osmotic and thermal theory as well as the presence of epithelial injury in the airway, with local water loss being the main trigger of EIB. This study aimed to investigate the effects of systemic hydration on pulmonary function and to establish whether it can reverse dehydration-induced alterations in pulmonary function. MATERIALS AND METHODS This follow-up study was performed among professional cyclists, without a history of asthma and/or atopy. Anthropometric characteristics were recorded for all participants, and the training age was determined. In addition, pulmonary function tests and specific markers such as fractional exhaled nitric oxide (FeNO) and immunoglobulin E (IgE) were measured. All the athletes underwent body composition analysis and cardiopulmonary exercise testing (CPET). After CPET, spirometry was followed at the 3rd, 5th, 10th, 15th, and 30th min. This study was divided into two phases: before and after hydration. Cyclists, who experienced a decrease in Forced Expiratory Volume in one second (FEV1) ≥ 10% and/or Maximal Mild-Expiratory Flow Rate (MEF25-75) ≥ 20% after CPET in relation to the results of the spirometry before CPET, repeated the test in 15-20 days, following instructions for hydration. RESULTS One hundred male cyclists (n = 100) participated in Phase A. After exercise, there was a decrease in all spirometric parameters (p < 0.001). In Phase B, after hydration, in all comparisons, the changes in spirometric values were significantly lower than those in Phase A (p < 0.001). CONCLUSIONS The findings of this study suggest that professional cyclists have non-beneficial effects on respiratory function. Additionally, we found that systemic hydration has a positive effect on spirometry in cyclists. Of particular interest are small airways, which appear to be affected independently or in combination with the decrease in FEV1. Our data suggest that pulmonary function improves systemic after hydration.
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Affiliation(s)
- Konstantinos M Pigakis
- Department of Respiratory & Critical Care Medicine, Creta Interclinic, 71304 Heraklion, Greece
| | - Vasileios T Stavrou
- Laboratory of Cardiopulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Ioannis Pantazopoulos
- Emergency Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Zoe Daniil
- Laboratory of Cardiopulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | | | - Konstantinos Gourgoulianis
- Laboratory of Cardiopulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
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9
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Schierbauer J, Wolf A, Wachsmuth NB, Maassen N, Schmidt WFJ. Relationship between Blood Volume, Blood Lactate Quantity, and Lactate Concentrations during Exercise. Metabolites 2023; 13:metabo13050632. [PMID: 37233674 DOI: 10.3390/metabo13050632] [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: 03/07/2023] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 05/27/2023] Open
Abstract
We wanted to determine the influence of total blood volume (BV) and blood lactate quantity on lactate concentrations during incremental exercise. Twenty-six healthy, nonsmoking, heterogeneously trained females (27.5 ± 5.9 ys) performed an incremental cardiopulmonary exercise test on a cycle ergometer during which maximum oxygen uptake (V·O2max), lactate concentrations ([La-]) and hemoglobin concentrations ([Hb]) were determined. Hemoglobin mass and blood volume (BV) were determined using an optimised carbon monoxide-rebreathing method. V·O2max and maximum power (Pmax) ranged between 32 and 62 mL·min-1·kg-1 and 2.3 and 5.5 W·kg-1, respectively. BV ranged between 81 and 121 mL·kg-1 of lean body mass and decreased by 280 ± 115 mL (5.7%, p = 0.001) until Pmax. At Pmax, the [La-] was significantly correlated to the systemic lactate quantity (La-, r = 0.84, p < 0.0001) but also significantly negatively correlated to the BV (r = -0.44, p < 0.05). We calculated that the exercise-induced BV shifts significantly reduced the lactate transport capacity by 10.8% (p < 0.0001). Our results demonstrate that both the total BV and La- have a major influence on the resulting [La-] during dynamic exercise. Moreover, the blood La- transport capacity might be significantly reduced by the shift in plasma volume. We conclude, that the total BV might be another relevant factor in the interpretation of [La-] during a cardio-pulmonary exercise test.
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Affiliation(s)
- Janis Schierbauer
- Division of Exercise Physiology & Metabolism, University of Bayreuth, 95447 Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, 95447 Bayreuth, Germany
| | - Alina Wolf
- Division of Exercise Physiology & Metabolism, University of Bayreuth, 95447 Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, 95447 Bayreuth, Germany
| | - Nadine B Wachsmuth
- Division of Exercise Physiology & Metabolism, University of Bayreuth, 95447 Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, 95447 Bayreuth, Germany
| | - Norbert Maassen
- Institute of Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Walter F J Schmidt
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, 95447 Bayreuth, Germany
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Diaz-Canestro C, Montero D. Sex-specific improvement in cardiac phenotype in older females combining blood withdrawal and exercise training. J Appl Physiol (1985) 2023; 134:296-304. [PMID: 36519567 DOI: 10.1152/japplphysiol.00328.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This study determined whether an intervention combining hematological and exercise stimuli may overcome the prevailing limitations to improve the cardiac phenotype and orthostatic tolerance (OT) of females with advanced age. Healthy females (n = 15) and males (n = 14) matched by age (63.7 ± 7.0 vs. 63.6 ± 8.7 yr) and moderate physical activity were recruited. OT, transthoracic echocardiography, and central hemodynamics were assessed during incremental lower body negative pressure (LBNP) levels (up to -50 mmHg) for 1 h or until presyncope, prior to and after an intervention comprising standard (10%) blood withdrawal and an 8-wk exercise training program designed to maximize central hemodynamic adaptations. OT time was lower in females compared with males (48.1 ± 10.6 vs. 57.0 ± 4.8 min, P = 0.008) before the intervention. Improved OT time (+11%) in females (48.1 ± 10.6 vs. 53.5 ± 6.1 min, P = 0.021) but not in males (57.0 ± 4.8 vs. 56.7 ± 5.6 min, P = 0.868) was found following the intervention, resulting in similar OT time between females and males (P = 0.156). The intervention induced improvements in left ventricular (LV) diastolic function (+13% for myocardial e') along with increased LV mass (+13%) in females (P ≤ 0.039) but not in males (P ≥ 0.257). During the initial LBNP stages (0 to -20 mmHg), LV stroke volume and cardiac output were exclusively increased in females after the intervention (P ≤ 0.034). In conclusion, the cardiac phenotype of females with advanced age can be structurally and functionally modified in parallel to improved OT via short-term hematological and central hemodynamic stimuli.NEW & NOTEWORTHY Based on previous studies, main features of the cardiac phenotype in females with advanced age are generally unresponsive to lifestyle interventions. The present findings reveals that the cardiac phenotype of middle-age and older females is amenable to large modification in a short-term period when hematological stimuli are combined with those induced by exercise training. The same intervention only induced minor adaptations in males matched by age and potential confounding factors.
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Affiliation(s)
- Candela Diaz-Canestro
- Department of Medicine, University of Hong Kong, Hong Kong, People's Republic of China
| | - David Montero
- Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China.,Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
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11
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Schierbauer J, Ficher S, Zimmermann P, Wachsmuth NB, Schmidt WFJ. Cardiac stroke volume in females and its correlation to blood volume and cardiac dimensions. Front Physiol 2022; 13:895805. [PMID: 36237526 PMCID: PMC9551173 DOI: 10.3389/fphys.2022.895805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
We aimed to continuously determine the stroke volume (SV) and blood volume (BV) during incremental exercise to evaluate the individual SV course and to correlate both variables across different exercise intensities. Twenty-six females with heterogeneous endurance capacities performed an incremental cycle ergometer test to continuously determine the oxygen uptake (V̇O2), cardiac output (Q̇) and changes in BV. Q̇ was determined by impedance cardiography and resting cardiac dimensions by 2D echocardiography. Hemoglobin mass and BV were determined using a carbon monoxide-rebreathing method. V̇O2max ranged from 32 to 62 mL·kg−1·min−1. Q̇max and SVmax ranged from 16.4 to 31.6 L·min−1 and 90–170 mL, respectively. The SV significantly increased from rest to 40% and from 40% to 80% V̇O2max. Changes in SV from rest to 40% V̇O2max were negatively (r = −0.40, p = 0.05), between 40% and 80% positively correlated with BV (r = 0.45, p < 0.05). At each exercise intensity, the SV was significantly correlated with the BV and the cardiac dimensions, i.e., left ventricular muscle mass (LVMM) and end-diastolic diameter (LVEDD). The BV decreased by 280 ± 115 mL (5.7%, p = 0.001) until maximum exercise. We found no correlation between the changes in BV and the changes in SV between each exercise intensity. The hemoglobin concentration [Hb] increased by 0.8 ± 0.3 g·dL−1, the capillary oxygen saturation (ScO2) decreased by 4.0% (p < 0.001). As a result, the calculated arterial oxygen content significantly increased (18.5 ± 1.0 vs. 18.9 ± 1.0 mL·dL−1, p = 0.001). A 1 L higher BV at V̇O2max was associated with a higher SVmax of 16.2 mL (r = 0.63, p < 0.001) and Q̇max of 2.5 L·min−1 (r = 0.56, p < 0.01). In conclusion, the SV strongly correlates with the cardiac dimensions, which might be the result of adaptations to an increased volume load. The positive effect of a high BV on SV is particularly noticeable at high and severe intensity exercise. The theoretically expected reduction in V̇O2max due to lower SV as a consequence of reduced BV is apparently compensated by the increased arterial oxygen content due to a higher [Hb].
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Affiliation(s)
- Janis Schierbauer
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
- *Correspondence: Janis Schierbauer,
| | - Sandra Ficher
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Cardiology, Klinikum Bamberg, Bamberg, Germany
| | - Nadine B. Wachsmuth
- Division of Exercise Physiology and Metabolism, University of Bayreuth, Bayreuth, Germany
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Walter F. J. Schmidt
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
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12
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Kontro H, Bertagnolli C, Murias JM, MacInnis MJ. Impairment in maximal lactate steady state after carbon monoxide inhalation is related to training status. Exp Physiol 2022; 107:1265-1282. [PMID: 36029041 DOI: 10.1113/ep090642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/17/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the effect of an elevated COHb concentration following carbon monoxide inhalation on the maximal lactate steady state (MLSS) in humans and is this effect dependent on aerobic fitness? What is the main finding and its importance? An elevated COHb concentration intensified physiological responses to exercise at the MLSS- including heart rate, ventilation, and peripheral fatigue-in all participants and reduced the MLSS (i.e., destabilized the blood lactate concentration) in trained but not untrained males and females. ABSTRACT This study investigated whether a lower effective [Hb], induced by carbon monoxide (CO) inhalation, reduces the peak oxygen uptake (V̇O2 peak) and the maximal lactate steady state (MLSS) and whether training status explains individual variation in these impairments. Healthy young participants completed two ramp incremental tests (n = 20 [10 female]) and two trials at MLSS (n = 16 [8 female]) following CO rebreathe tests and sham procedures (SHAM) in random orders. All fitness variables were normalized to fat-free mass (FFM) to account for sex-related differences in body composition, and males and females were matched for aerobic fitness. The V̇O2 peak (mean [SD]: -4.2 [3.7]%), peak power output (-3.3 [2.2]%), and respiratory compensation point (-6.3 [4.5]%) were reduced in CO compared with SHAM (P < 0.001 for all), but the gas exchange threshold (-3.3 [7.1]%) was not (P = 0.077). Decreases in V̇O2 peak (r = -0.45; P = 0.047) and peak power output (r = -0.49; P = 0.029) in CO were correlated with baseline aerobic fitness. Compared to SHAM, physiological and perceptual indicators of exercise-related stress were exacerbated by CO while cycling at MLSS. Notably, the mean blood lactate concentration ([La]) increased (i.e., Δ[La] > 1.0 mM) between 10 min (5.5 [1.4] mM) and 30 min (6.8 [1.3] mM; P = 0.026) in CO, with 9/16 participants classified as unstable. These unstable participants had a higher V̇O2 peak (66.2 [8.5] vs. 56.4 [8.8] mL·kg FFM-1 ·min-1 , P = 0.042) and V̇O2 at MLSS (55.8 vs. 44.3 mL·kg FFM-1 ·min-1 , P = 0.006) compared to the stable group. In conclusion, a reduced O2 -carrying capacity decreased maximal and submaximal exercise performance, with higher aerobic fitness associated with greater impairments in both. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hilkka Kontro
- Faculty of Kinesiology, Human Performance Lab, University of Calgary, Canada
| | - Craig Bertagnolli
- Faculty of Kinesiology, Human Performance Lab, University of Calgary, Canada
| | - Juan M Murias
- Faculty of Kinesiology, Human Performance Lab, University of Calgary, Canada
| | - Martin J MacInnis
- Faculty of Kinesiology, Human Performance Lab, University of Calgary, Canada
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13
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Mancera-Soto EM, Ramos-Caballero DM, Rojas J. JA, Duque L, Chaves-Gomez S, Cristancho-Mejía E, Schmidt WFJ. Hemoglobin Mass, Blood Volume and VO2max of Trained and Untrained Children and Adolescents Living at Different Altitudes. Front Physiol 2022; 13:892247. [PMID: 35721534 PMCID: PMC9204197 DOI: 10.3389/fphys.2022.892247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: To a considerable extent, the magnitude of blood volume (BV) and hemoglobin mass (Hbmass) contribute to the maximum O2-uptake (VO2max), especially in endurance-trained athletes. However, the development of Hbmass and BV and their relationships with VO2max during childhood are unknown. The aim of the present cross-sectional study was to investigate Hbmass and BV and their relationships with VO2max in children and adolescents. In addition, the possible influence of endurance training and chronic hypoxia was evaluated.Methods: A total of 475 differently trained children and adolescents (girls n = 217, boys n = 258; untrained n = 171, endurance trained n = 304) living at two different altitudes (∼1,000 m, n = 204, ∼2,600 m, n = 271) and 9–18 years old participated in the study. The stage of puberty was determined according to Tanner; Hbmass and BV were determined by CO rebreathing; and VO2max was determined by cycle ergometry and for runners on the treadmill.Results: Before puberty, there was no association between training status and Hbmass or BV. During and after puberty, we found 7–10% higher values in the trained groups. Living at a moderate altitude had a uniformly positive effect of ∼7% on Hbmass in all groups and no effect on BV. The VO2max before, during and after puberty was strongly associated with training (pre/early puberty: boys +27%, girls +26%; mid puberty: +42% and +45%; late puberty: +43% and +47%) but not with altitude. The associated effects of training in the pre/early pubertal groups were independent of Hbmass and BV, while in the mid- and late pubertal groups, 25% of the training effect could be attributed to the elevated Hbmass.Conclusions: The associated effects of training on Hbmass and BV, resulting in increased VO2max, can only be observed after the onset of puberty.
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Affiliation(s)
- Erica Mabel Mancera-Soto
- Departamento del Movimiento Corporal Humano, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
- Department of Sports Medicine and Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Diana Marcela Ramos-Caballero
- Departamento de Biología, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Joel A. Rojas J.
- Programa de Licenciatura en Educación Física Recreación y Deporte, Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca, Tuluá, Colombia
| | - Lohover Duque
- Programa de Licenciatura en Educación Física Recreación y Deporte, Facultad de Ciencias de la Educación, Unidad Central del Valle del Cauca, Tuluá, Colombia
| | - Sandra Chaves-Gomez
- Laboratorio de Control al Dopaje, Ministerio del Deporte de Colombia, Bogotá, Colombia
| | - Edgar Cristancho-Mejía
- Departamento de Biología, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Walter Franz-Joachim Schmidt
- Department of Sports Medicine and Sports Physiology, University of Bayreuth, Bayreuth, Germany
- *Correspondence: Walter Franz-Joachim Schmidt,
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14
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Nielsen HB, Volianitis S, Secher NH. Dose of Bicarbonate to Maintain Plasma pH During Maximal Ergometer Rowing and Consequence for Plasma Volume. Front Physiol 2022; 13:828708. [PMID: 35492607 PMCID: PMC9045408 DOI: 10.3389/fphys.2022.828708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Rowing performance may be enhanced by attenuated metabolic acidosis following bicarbonate (BIC) supplementation. This study evaluated the dose of BIC needed to eliminate the decrease in plasma pH during maximal ergometer rowing and assessed the consequence for change in plasma volume. Six oarsmen performed “2,000-m” maximal ergometer rowing trials with BIC (1 M; 100–325 ml) and control (CON; the same volume of isotonic saline). During CON, pH decreased from 7.42 ± 0.01 to 7.17 ± 0.04 (mean and SD; p < 0.05), while during BIC, pH was maintained until the sixth minute where it dropped to 7.32 ± 0.08 and was thus higher than during CON (p < 0.05). The buffering effect of BIC on metabolic acidosis was dose dependent and 300–325 mmol required to maintain plasma pH. Compared to CON, BIC increased plasma sodium by 4 mmol/L, bicarbonate was maintained, and lactate increased to 25 ± 7 vs. 18 ± 3 mmol/L (p < 0.05). Plasma volume was estimated to decrease by 24 ± 4% in CON, while with BIC the estimate was by only 7 ± 6% (p < 0.05) and yet BIC had no significant effect on performance [median 6 min 27 s (range 6 min 09 s to 6 min 57 s) vs. 6 min 33 s (6 min 14 s to 6 min 55 s)]. Bicarbonate administration attenuates acidosis during maximal rowing in a dose-dependent manner and the reduction in plasma volume is attenuated with little consequence for performance.
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Affiliation(s)
- Henning Bay Nielsen
- Department of Anaesthesia and Intensive Care, Zealand University Hospital Roskilde, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Henning Bay Nielsen,
| | - Stefanos Volianitis
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Niels H. Secher
- Department of Anaesthesia, Rigshospitalet, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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15
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Coyle MA, Goss CS, Manz WJ, Greenshields JT, Chapman RF, Stager JM. Nedocromil sodium and diphenhydramine HCl ameliorate exercise-induced arterial hypoxemia in highly trained athletes. Physiol Rep 2022; 10:e15149. [PMID: 35001564 PMCID: PMC8743671 DOI: 10.14814/phy2.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Exercise-induced arterial hypoxemia (EIAH) has been observed in highly trained endurance athletes during near maximal exercise, which may be influenced by a histamine-mediated inflammatory response at the pulmonary capillary-alveolar membrane. In order to test this hypothesis, we examined whether the mast cell stabilizer nedocromil sodium (NS) and H1 -receptor antagonist diphenhydramine HCL (DH) would ameliorate EIAH and mitigate the drop in arterial oxyhemoglobin saturation (Sa O2 ) during intensive exercise. METHODS Seven highly trained male cross country runners (age, 21 ± 2 years; V̇O2max , 74.7 ± 3.5 ml·kg-1 ·min-1 ) participated in the study. All subjects completed a maximal exercise treadmill test to exhaustion, followed by three 5-min constant-load exercise bouts at 70%, 80%, and 90% V̇O2max . Prior to testing, subjects received either placebo (PL), NS, or DH. RESULTS Compared to PL, there was a significant treatment effect on Sa O2 (p < 0.001) for both NS and DH during both constant-load exercise and at V̇O2max . Post hoc tests revealed Sa O2 values, compared to PL, were significantly higher at V̇O2max and during DH trials and higher with NS at constant-load intensities except at 70% (p = 0.13). CONCLUSION The findings provide further evidence that histamine contributes directly or indirectly to the development of EIAH during intense exercise in highly trained athletes.
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Affiliation(s)
- Michael A. Coyle
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Curtis S. Goss
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Wesley J. Manz
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Department of Orthopaedic SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | - Joel T. Greenshields
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- Dr. Lawrence D. Rink Center for Sports Medicine and TechnologyDepartment of Intercollegiate AthletesIndiana UniversityBloomingtonIndianaUSA
| | - Robert F. Chapman
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Joel M. Stager
- HH Morris Human Performance Laboratory, Department of Kinesiology, School of Public HealthIndiana UniversityBloomingtonIndianaUSA
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16
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The Effects of Sodium Phosphate Supplementation on the Cardiorespiratory System and Gross Efficiency during Exercise under Hypoxia in Male Cyclists: A Randomized, Placebo-Controlled, Cross-Over Study. Nutrients 2021; 13:nu13103556. [PMID: 34684557 PMCID: PMC8538808 DOI: 10.3390/nu13103556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022] Open
Abstract
The main aim of this study was to evaluate the effects of six days of tri-sodium phosphate (SP) supplementation on the cardiorespiratory system and gross efficiency (GE) during exercise under hypoxia in cyclists. Twenty trained male cyclists received SP (50 mg·kg−1 of fat-free mass/day) or placebo for six days in a randomized, cross-over study, with a three-week washout period between supplementation phases. Before and after each supplementation phase, the subjects performed an incremental exercise test to exhaustion under normobaric hypoxia (FiO2 = 16%, ~2500 m). It was observed that short-term SP supplementation led to a decrease in heart rate, an increase in stroke volume, and an improvement in oxygen pulse (VO2/HR) during low and moderate-intensity exercise under hypoxia. These changes were accompanied by an increase in the serum inorganic phosphate level by 8.7% (p < 0.05). No significant changes were observed in serum calcium levels. GE at a given workload did not change significantly after SP supplementation. These results indicated that SP promotes improvements in the efficiency of the cardiorespiratory system during exercise in a hypoxic environment. Thus, SP supplementation may be beneficial for endurance exercise in hypoxia.
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Zhou D, Deng LJ, Ling YF, Tang ML. Preoperative Hemoglobin Level, Oxygen Saturation and Postoperative Outcomes in Children With Cyanotic Congenital Heart Disease: A Propensity-Score Matching Analysis. Front Pediatr 2021; 9:762241. [PMID: 35127586 PMCID: PMC8814516 DOI: 10.3389/fped.2021.762241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The optimal preoperative hemoglobin (Hb) level is difficult to define in children with cyanotic congenital heart disease (CHD) due to hypoxemia-induced secondary erythrocytosis. This retrospective study integrated preoperative Hb and pulse oxygen saturation (SpO2) using the product of Hb × SpO2 to predict postoperative outcomes in children with cyanotic CHD. PATIENTS AND METHODS Children aged <18 years undergoing cardiac surgery with cyanotic CHD were included. The cutoff value of Hb × SpO2 was the age-adjusted lower limit of normal Hb (aaHb) in healthy children. The main outcomes were in-hospital death and the composite outcome of severe postoperative events. Multivariate logistic regression analysis and propensity score matching analysis were used to adjust for important confounders. RESULTS The presence of preoperative Hb × SpO2 < aaHb was observed in 21.6% of cyanotic children (n = 777). Children with Hb × SpO2 < aaHb had higher in-hospital mortality (12.5% vs. 4.6%, P < 0.001) and composite outcome incidence (69.6% vs. 32.3%, P < 0.001) than those with Hb × SpO2 ≥ aaHb. After propensity score matching, 141 pairs of children were successfully matched. Multivariate analysis showed that preoperative Hb × SpO2 < aaHb was significantly associated with the composite outcome in the entire population (odds ratio = 4.092, 95% confidence interval = 2.748-6.095, P < 0.001) and the matched cohorts (odds ratio = 2.277, 95% confidence interval = 1.366-3.795, P = 0.002). CONCLUSION Our results suggest that a preoperative Hb × SpO2 value below the lower limit of normal hemoglobin is a prognostic factor in cyanotic children undergoing cardiac surgery and is a potential criterion to evaluate preoperative anemia in this population.
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Affiliation(s)
- Dan Zhou
- Pediatric Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Li-Jing Deng
- Pediatric Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Fei Ling
- Department of Cardiac Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Meng-Lin Tang
- Pediatric Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
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