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Belbis MD, Yap Z, Hobart SE, Ferguson SK, Hirai DM. Effects of acute phosphodiesterase type 5 inhibition on skeletal muscle interstitial PO 2 during contractions and recovery. Nitric Oxide 2024; 142:16-25. [PMID: 37979932 DOI: 10.1016/j.niox.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/26/2023] [Accepted: 11/14/2023] [Indexed: 11/20/2023]
Abstract
The oxygen partial pressure within the interstitial space (PO2is; mmHg) provides the driving force for oxygen diffusion into the myocyte thereby supporting oxidative phosphorylation. We tested the hypothesis that potentiation of the nitric oxide pathway with sildenafil (phosphodiesterase type 5 inhibitor) would enhance PO2is during muscle metabolic transitions, thereby slowing PO2is on- and accelerating PO2is off-kinetics. The rat spinotrapezius muscle (n = 17) was exposed for PO2is measurements via phosphorescence quenching under control (CON), low-dose sildenafil (1 mg/kg i.a., SIL1) and high-dose sildenafil (7 mg/kg i.a., SIL7). Data were collected at rest and during submaximal twitch contractions (1 Hz, 4-6 V, 3 min) and recovery (3 min). Mean arterial blood pressure (MAP; mmHg) was reduced with both SIL1 (pre:132 ± 5; post:99 ± 5) and SIL7 (pre:111 ± 6; post:99 ± 4) (p < 0.05). SIL7 elevated resting PO2is (18.4 ± 1.1) relative to both CON (15.7 ± 0.7) and SIL1 (15.2 ± 0.7) (p < 0.05). In addition, SIL7 increased end-recovery PO2is (17.7 ± 1.6) compared to CON (12.8 ± 0.9) and SIL1 (13.4 ± 0.8) (p < 0.05). The overall PO2is response during recovery (i.e., area under the PO2is curve) was greater in SIL7 (4107 ± 444) compared to CON (3493 ± 222) and SIL1 (3114 ± 205 mmHg s) (p < 0.05). Contrary to our hypothesis, there was no impact of acute SIL (1 or 7 mg/kg) on the speed of the PO2is response during contractions or recovery (p > 0.05). However, sildenafil lowered MAP and improved skeletal muscle interstitial oxygenation in healthy rats. Specifically, SIL7 enhanced PO2is at rest and during recovery from submaximal muscle contractions. Potentiation of the nitric oxide pathway with sildenafil enhances microvascular blood-myocyte O2 transport and is expected to improve repeated bouts of contractile activity.
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Affiliation(s)
- Michael D Belbis
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA; Department of Exercise Science, Aurora University, Aurora, IL, USA
| | - Zhen Yap
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Sara E Hobart
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Scott K Ferguson
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA.
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Neder JA, Rocha A, Arbex FF, Alencar MCN, Sperandio PA, Hirai DM, Berton DC. Exertional oscillatory ventilation in subjects without heart failure reporting chronic dyspnoea. ERJ Open Res 2023; 9:00324-2022. [PMID: 36726368 PMCID: PMC9885272 DOI: 10.1183/23120541.00324-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022] Open
Abstract
Oscillatory ventilation detected on incremental cardiopulmonary exercise testing might be found in subjects without heart failure reporting exertional dyspnoea despite the best available therapy for their underlying cardiopulmonary disease https://bit.ly/3Tyl7bE.
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Affiliation(s)
- J. Alberto Neder
- Laboratory of Clinical Exercise Physiology (LACEP) and Respiratory Investigation Unit (RIU), Queen's University and Kingston General Hospital, Kingston, ON, Canada,J. Alberto Neder ()
| | - Alcides Rocha
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Flavio F. Arbex
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Clara N. Alencar
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Priscila A. Sperandio
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Daniel M. Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Danilo C. Berton
- Division of Respirology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Belbis MD, Holmes MJ, Yao J, Kinnick CW, Kargl CK, Day C, Noel NL, Gavin TP, Roseguini BT, Hirai DM. Effects Of Acute Selective COX-2 Inhibition On Skeletal Muscle Microvascular Oxygenation And Exercise Tolerance. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000877580.21105.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Smith JR, Hirai DM, Copp SW, Ferguson SK, Holdsworth CT, Hageman KS, Poole DC, Musch TI. Exercise training decreases intercostal and transversus abdominis muscle blood flows in heart failure rats during submaximal exercise. Respir Physiol Neurobiol 2021; 292:103710. [PMID: 34091075 DOI: 10.1016/j.resp.2021.103710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/18/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
Diaphragm muscle blood flow (BF) and vascular conductance (VC) are elevated with chronic heart failure (HF) during exercise. Exercise training (ExT) elicits beneficial respiratory muscle and pulmonary system adaptations in HF. We hypothesized that diaphragm BF and VC would be lower in HF rats following ExT than their sedentary counterparts (Sed). Respiratory muscle BFs and mean arterial pressure were measured via radiolabeled microspheres and carotid artery catheter, respectively, during submaximal treadmill exercise (20 m/min, 5 % grade). During exercise, no differences were present between HF + ExT and HF + Sed in diaphragm BFs (201 ± 36 vs. 227 ± 44 mL/min/100 g) or VCs (both, p > 0.05). HF + ExT compared to HF + Sed had lower intercostal BF (27 ± 3 vs. 41 ± 5 mL/min/100 g) and VC (0.21 ± 0.02 vs. 0.31 ± 0.04 mL/min/mmHg/100 g) during exercise (both, p < 0.05). Further, HF + ExT compared to HF + Sed had lower transversus abdominis BF (20 ± 1 vs. 35 ± 6 mL/min/100 g) and VC (0.14 ± 0.02 vs. 0.27 ± 0.05 mL/min/mmHg/100 g) during exercise (both, p < 0.05). These data suggest that exercise training lowers the intercostal and transversus abdominis BF responses in HF rats during submaximal treadmill exercise.
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Affiliation(s)
- Joshua R Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Steven W Copp
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States
| | - Scott K Ferguson
- Department of Kinesiology and Exercise Sciences, University of Hawaii, Hilo, HI, United States
| | - Clark T Holdsworth
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - K Sue Hageman
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
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Hirai DM, Tabuchi A, Craig JC, Colburn TD, Musch TI, Poole DC. Regulation of capillary hemodynamics by K ATP channels in resting skeletal muscle. Physiol Rep 2021; 9:e14803. [PMID: 33932103 PMCID: PMC8087980 DOI: 10.14814/phy2.14803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
ATP-sensitive K+ channels (KATP ) have been implicated in the regulation of resting vascular smooth muscle membrane potential and tone. However, whether KATP channels modulate skeletal muscle microvascular hemodynamics at the capillary level (the primary site for blood-myocyte O2 exchange) remains unknown. We tested the hypothesis that KATP channel inhibition would reduce the proportion of capillaries supporting continuous red blood cell (RBC) flow and impair RBC hemodynamics and distribution in perfused capillaries within resting skeletal muscle. RBC flux (fRBC ), velocity (VRBC ), and capillary tube hematocrit (Hctcap ) were assessed via intravital microscopy of the rat spinotrapezius muscle (n = 6) under control (CON) and glibenclamide (GLI; KATP channel antagonist; 10 µM) superfusion conditions. There were no differences in mean arterial pressure (CON:120 ± 5, GLI:124 ± 5 mmHg; p > 0.05) or heart rate (CON:322 ± 32, GLI:337 ± 33 beats/min; p > 0.05) between conditions. The %RBC-flowing capillaries were not altered between conditions (CON:87 ± 2, GLI:85 ± 1%; p > 0.05). In RBC-perfused capillaries, GLI reduced fRBC (CON:20.1 ± 1.8, GLI:14.6 ± 1.3 cells/s; p < 0.05) and VRBC (CON:240 ± 17, GLI:182 ± 17 µm/s; p < 0.05) but not Hctcap (CON:0.26 ± 0.01, GLI:0.26 ± 0.01; p > 0.05). The absence of GLI effects on the %RBC-flowing capillaries and Hctcap indicates preserved muscle O2 diffusing capacity (DO2 m). In contrast, GLI lowered both fRBC and VRBC thus impairing perfusive microvascular O2 transport (Q̇m) and lengthening RBC capillary transit times, respectively. Given the interdependence between diffusive and perfusive O2 conductances (i.e., %O2 extraction∝DO2 m/Q̇m), such GLI alterations are expected to elevate muscle %O2 extraction to sustain a given metabolic rate. These results support that KATP channels regulate capillary hemodynamics and, therefore, microvascular gas exchange in resting skeletal muscle.
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Affiliation(s)
- Daniel M. Hirai
- Department of Health and KinesiologyPurdue UniversityWest LafayetteIndianaUSA,Department of KinesiologyKansas State UniversityManhattanKansasUSA
| | - Ayaka Tabuchi
- Department of KinesiologyKansas State UniversityManhattanKansasUSA,Department of Engineering ScienceUniversity of Electro‐CommunicationsTokyoJapan
| | - Jesse C. Craig
- Department of KinesiologyKansas State UniversityManhattanKansasUSA,Department of Internal MedicineUniversity of UtahSalt Lake CityUtahUSA,Geriatric ResearchEducation and Clinical CenterVeterans Affairs Medical CenterSalt Lake CityUtahUSA
| | | | - Timothy I. Musch
- Department of KinesiologyKansas State UniversityManhattanKansasUSA,Department of Anatomy and PhysiologyKansas State UniversityManhattanKansasUSA
| | - David C. Poole
- Department of KinesiologyKansas State UniversityManhattanKansasUSA,Department of Anatomy and PhysiologyKansas State UniversityManhattanKansasUSA
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Ferguson SK, Woessner MN, Holmes MJ, Belbis MD, Carlström M, Weitzberg E, Allen JD, Hirai DM. Effects of inorganic nitrate supplementation on cardiovascular function and exercise tolerance in heart failure. J Appl Physiol (1985) 2021; 130:914-922. [PMID: 33475460 PMCID: PMC8424551 DOI: 10.1152/japplphysiol.00780.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 01/11/2023] Open
Abstract
Heart failure (HF) results in a myriad of central and peripheral abnormalities that impair the ability to sustain skeletal muscle contractions and, therefore, limit tolerance to exercise. Chief among these abnormalities is the lowered maximal oxygen uptake, which is brought about by reduced cardiac output and exacerbated by O2 delivery-utilization mismatch within the active skeletal muscle. Impaired nitric oxide (NO) bioavailability is considered to play a vital role in the vascular dysfunction of both reduced and preserved ejection fraction HF (HFrEF and HFpEF, respectively), leading to the pursuit of therapies aimed at restoring NO levels in these patient populations. Considering the complementary role of the nitrate-nitrite-NO pathway in the regulation of enzymatic NO signaling, this review explores the potential utility of inorganic nitrate interventions to increase NO bioavailability in the HFrEF and HFpEF patient population. Although many preclinical investigations have suggested that enhanced reduction of nitrite to NO in low Po2 and pH environments may make a nitrate-based therapy especially efficacious in patients with HF, inconsistent results have been found thus far in clinical settings. This brief review provides a summary of the effectiveness (or lack thereof) of inorganic nitrate interventions on exercise tolerance in patients with HFrEF and HFpEF. Focus is also given to practical considerations and current gaps in the literature to facilitate the development of effective nitrate-based interventions to improve exercise tolerance in patients with HF.
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Affiliation(s)
- Scott K Ferguson
- Department of Kinesiology and Exercise Science, College of Natural and Health Sciences, University of Hawaii at Hilo, Hilo, Hawaii
| | - Mary N Woessner
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Michael J Holmes
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Michael D Belbis
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Jason D Allen
- Department of Kinesiology & Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
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Monroe JC, Song Q, Emery MS, Hirai DM, Motaganahalli RL, Roseguini BT. Acute effects of leg heat therapy on walking performance and cardiovascular and inflammatory responses to exercise in patients with peripheral artery disease. Physiol Rep 2021; 8:e14650. [PMID: 33369253 PMCID: PMC7758979 DOI: 10.14814/phy2.14650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/25/2020] [Indexed: 11/24/2022] Open
Abstract
Lower-extremity peripheral artery disease (PAD) is associated with increased risk of cardiovascular events and impaired exercise tolerance. We have previously reported that leg heat therapy (HT) applied using liquid-circulating trousers perfused with warm water increases leg blood flow and reduces blood pressure (BP) and the circulating levels of endothelin-1 (ET-1) in patients with symptomatic PAD. In this sham-controlled, randomized, crossover study, sixteen patients with symptomatic PAD (age 65 ± 5.7 years and ankle-brachial index: 0.69 ± 0.1) underwent a single 90-min session of HT or a sham treatment prior to a symptom-limited, graded cardiopulmonary exercise test on the treadmill. The primary outcome was the peak walking time (PWT) during the exercise test. Secondary outcomes included the claudication onset time (COT), resting and exercise BP, calf muscle oxygenation, pulmonary oxygen uptake (V̇O2 ), and plasma levels of ET-1, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Systolic, but not diastolic BP, was significantly lower (~7 mmHg, p < .05) during HT when compared to the sham treatment. There was also a trend for lower SBP throughout the exercise and the recovery period following HT (p = .057). While COT did not differ between treatments (p = .77), PWT tended to increase following HT (CON: 911 ± 69 s, HT: 954 ± 77 s, p = .059). Post-exercise plasma levels of ET-1 were also lower in the HT session (CON: 2.0 ± 0.1, HT: 1.7 ± 0.1, p = .02). Calf muscle oxygenation, V̇O2 , COT, IL-6, and TNF-α did not differ between treatments. A single session of leg HT lowers BP and post-exercise circulating levels of ET-1 and may enhance treadmill walking performance in symptomatic PAD patients.
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Affiliation(s)
- Jacob C. Monroe
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
| | - Qifan Song
- Department of StatisticsPurdue UniversityWest LafayetteINUSA
| | - Michael S. Emery
- Department of Cardiovascular MedicineCleveland ClinicClevelandOHUSA
| | - Daniel M. Hirai
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
| | - Raghu L. Motaganahalli
- Division of Vascular SurgeryDepartment of SurgeryIndiana University School of MedicineIndianapolisINUSA
| | - Bruno T. Roseguini
- Department of Health and KinesiologyPurdue UniversityWest LafayetteINUSA
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Tan AL, Farrow M, Biglands J, Fernandes RJ, Abraldes JA, de Souza Castro FA, de Souza HL, Arriel RA, Meireles A, Marocolo M, González-Rayas JM, Rayas-Gómez AL, Mobayed-Vega FN, González-Yáñez JM, Hirai DM, Belbis MD, Holmes MJ, Calvo N, Ferguson SK, Fernandes T, Oliveira EM, Pun M, Bhandari SS. Commentaries on Viewpoint: The interaction between SARS-CoV-2 and ACE2 may have consequences for skeletal muscle viral susceptibility and myopathies. J Appl Physiol (1985) 2020; 129:868-871. [PMID: 33027604 PMCID: PMC7839240 DOI: 10.1152/japplphysiol.00775.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Ai Lyn Tan
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Matthew Farrow
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom,School of Pharmacy and Medical Sciences, University of Bradford, United Kingdom
| | - John Biglands
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Ricardo J. Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal,Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - J. Arturo Abraldes
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, Murcia, Spain
| | - Flávio Antônio de Souza Castro
- School of Physical Education, Physiotherapy and Dance, Aquatic Sports Research Group, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Hiago L.R. de Souza
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Rhai A. Arriel
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Anderson Meireles
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Moacir Marocolo
- Physiology and Human Performance Research Group, Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - José Manuel González-Rayas
- School of Medicine and Health Sciences, Monterrey Institute of Technology and Higher Education, Monterrey, México
| | | | | | | | - Daniel M. Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Michael D. Belbis
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Michael J. Holmes
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Nainoa Calvo
- Department of Kinesiology and Exercise Science, College of Natural and Health Sciences, University of Hawaii at Hilo, Hilo, Hawaii
| | - Scott K. Ferguson
- Department of Kinesiology and Exercise Science, College of Natural and Health Sciences, University of Hawaii at Hilo, Hilo, Hawaii
| | - Tiago Fernandes
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Edilamar Menezes Oliveira
- Laboratory of Biochemistry and Molecular Biology of Exercise, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil
| | - Matiram Pun
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Tabuchi A, Craig JC, Hirai DM, Colburn TD, Kano Y, Poole DC, Musch TI. Systemic NOS inhibition reduces contracting muscle oxygenation more in intact female than male rats. Nitric Oxide 2020; 100-101:38-44. [PMID: 32371102 DOI: 10.1016/j.niox.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/14/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
Females respond to baroreceptor stimulation with enhanced modulation of heart rate (HR) to regulate blood pressure and also express greater reliance on nitric oxide (NO) for vascular control compared to males. Sex differences in muscle oxygenation consequent to central hemodynamic challenge induced by systemic NO synthase (NOS) inhibition are unknown. We tested the hypotheses that systemic NOS inhibition would induce lower contracting skeletal muscle oxygenation in females compared to males. The spinotrapezius of Sprague-Dawley rats (females (♀) = 9, males (♂) = 9) was surgically exposed and contracted by electrical stimulation (180s, 1 Hz, ~6 V) under pentobarbital sodium anesthesia. Oxyphor G4 was injected into the muscle and phosphorescence quenching was used to measure the interstitial PO2 (PO2is, determined by O2 delivery-to-utilization matching) under control (Krebs-Henseleit solution) and after intra-arterial infusion of nitro-l-arginine methyl ester (l-NAME; NOS blockade; 10 mg kg-1). At rest, females showed a greater PO2is increase (ΔPO2is/ΔMAP) and HR (ΔHR/ΔMAP) reduction than males in response to the elevated MAP induced by systemic NOS inhibition (both p < 0.05). Following l-NAME, during the contracting steady-state, females exhibited lower PO2is than males (♂: 17.1 ± 1.4 vs ♀: 10.8 ± 1.4 mmHg, p < 0.05). The rate pressure product was lower in females than males (♂: 482 ± 14 vs ♀: 392 ± 29, p < 0.05) and correlated with the steady-state PO2is (r = 0.66, p < 0.05). These results support that females express greater reductions in HR than males in response to l-NAME-induced elevation of MAP via the baroreceptor reflex and provide new insights on how central hemodynamics affect skeletal muscle oxygenation in a sex-specific manner.
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Affiliation(s)
- Ayaka Tabuchi
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA; Department of Engineering Science, Bioscience and Technology Program, University of Electro-Communications, Tokyo, Japan
| | - Jesse C Craig
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA
| | - Daniel M Hirai
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA
| | - Trenton D Colburn
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA
| | - Yutaka Kano
- Department of Engineering Science, Bioscience and Technology Program, University of Electro-Communications, Tokyo, Japan
| | - David C Poole
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA
| | - Timothy I Musch
- Departments of Kinesiology and Anatomy & Physiology, Kansas State University, Manhattan, KS, USA.
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10
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Ferguson SK, Redinius KM, Harral JW, Pak DI, Swindle DC, Hirai DM, Blackwell JR, Jones AM, Stenmark KR, Buehler PW, Irwin DC. The effect of dietary nitrate supplementation on the speed-duration relationship in mice with sickle cell disease. J Appl Physiol (1985) 2020; 129:474-482. [PMID: 32702277 DOI: 10.1152/japplphysiol.00122.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Sickle cell disease (SCD) causes exercise intolerance likely due to impaired skeletal muscle function and low nitric oxide (NO) bioavailability. Dietary nitrate improves hemodynamic and metabolic control during exercise in humans and animals. The purpose of this investigation was to assess the impact of nitrate supplementation on exercise capacity as measured by the running speed to exercise duration relationship [critical speed (CS)]in mice with SCD. We tested the hypothesis that nitrate supplementation via beetroot juice (BR) would attenuate the exercise intolerance observed in mice with SCD. Ten wild-type (WT) and 18 Berkley sickle-cell mice (BERK) received water (WT: n = 10, BERK: n = 10) or nitrate-rich BR (BERK+BR: n = 8, nitrate dose 1 mmol/kg/day) for 5 days. Following the supplementation period, all mice performed 3-5 constant-speed treadmill tests that resulted in exhaustion within 1.5 to 20 min. Time to exhaustion vs. treadmill speed was fit to a hyperbolic model to determine CS. CS was significantly lower in BERK vs. WT and BERK+BR with no significant difference between WT and BERK+BR (WT: 36.6 ± 1.6, BERK: 23.8 ± 1.5, BERK+BR: 31.1 ± 2.1 m/min, P < 0.05). Exercise tolerance, measured via CS, was significantly lower in BERK mice relative to WT. However, BERK mice receiving 5 days of nitrate supplementation exhibited no difference in exercise tolerance when compared with WT. These results support the potential utility of a dietary nitrate intervention to improve functionality in SCD patients.NEW & NOTEWORTHY Sickle cell disease compromises muscle O2 delivery resulting in exercise intolerance. Dietary nitrate supplementation increases skeletal muscle blood flow during exercise and may improve exercise capacity in a mouse model of sickle cell disease. We investigated the effects of dietary nitrate supplementation on exercise tolerance in a mouse model of sickle cell disease using the treadmill speed-duration relationship (critical speed). Mice with sickle cell disease provided with a dietary nitrate supplement had a critical speed not significantly different from healthy wild-type mice.
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Affiliation(s)
- Scott K Ferguson
- Department of Kinesiology and Exercise Science, College of Natural and Health Sciences, University of Hawaii at Hilo, Hilo, Hawaii.,Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Katherine M Redinius
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Julie W Harral
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - David I Pak
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Delaney C Swindle
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Daniel M Hirai
- Department of Health and Kinesiology, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
| | - Jamie R Blackwell
- Department of Sport and Health Sciences, University of Exeter St. Luke's Campus, Exeter, United Kingdom
| | - Andrew M Jones
- Department of Sport and Health Sciences, University of Exeter St. Luke's Campus, Exeter, United Kingdom
| | - Kurt R Stenmark
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Paul W Buehler
- Department of Pathology and The Center for Blood Oxygen Transport and Hemostasis, Department of Pediatrics, The University of Maryland School of Medicine, Baltimore, Maryland
| | - David C Irwin
- Cardiovascular and Pulmonary Research Laboratory, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
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11
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Ferguson SK, Colburn TD, Craig JC, Hageman KS, Stenmark KR, Buehler PW, Hirai DM, Irwin DC, Poole DC, Musch TI. Impact Of Cell-free Hemoglobin On Exercising Muscle Vascular Control In Rats. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000675968.08514.7c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Colburn TD, Hirai DM, Craig JC, Ferguson SK, Weber RE, Schulze KM, Behnke BJ, Musch TI, Poole DC. Transcapillary PO 2 gradients in contracting muscles across the fibre type and oxidative continuum. J Physiol 2020; 598:3187-3202. [PMID: 32445225 DOI: 10.1113/jp279608] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Within skeletal muscle the greatest resistance to oxygen transport is thought to reside across the short distance at the red blood cell-myocyte interface. These structures generate a significant transmural oxygen pressure (PO2 ) gradient in mixed fibre-type muscle. Increasing O2 flux across the capillary wall during exercise depends on: (i) the transmural O2 pressure gradient, which is maintained in mixed-fibre muscle, and/or (ii) elevating diffusing properties between microvascular and interstitial compartments resulting, in part, from microvascular haemodynamics and red blood cell distribution. We evaluated the PO2 within the microvascular and interstitial spaces of muscles spanning the slow- to fast-twitch fibre and high- to low-oxidative capacity spectrums, at rest and during contractions, to assess the magnitude of transcapillary PO2 gradients in rats. Our findings demonstrate that, across the metabolic rest-contraction transition, the transcapillary pressure gradient for O2 flux is: (i) maintained in all muscle types, and (ii) the lowest in contracting highly oxidative fast-twitch muscle. ABSTRACT In mixed fibre-type skeletal muscle transcapillary PO2 gradients (PO2 mv-PO2 is; microvascular and interstitial, respectively) drive O2 flux across the blood-myocyte interface where the greatest resistance to that O2 flux resides. We assessed a broad spectrum of fibre-type and oxidative-capacity rat muscles across the rest-to-contraction (1 Hz, 120 s) transient to test the novel hypotheses that: (i) slow-twitch PO2 is would be greater than fast-twitch, (ii) muscles with greater oxidative capacity have greater PO2 is than glycolytic counterparts, and (iii) whether PO2 mv-PO2 is at rest is maintained during contractions across all muscle types. PO2 mv and PO2 is were determined via phosphorescence quenching in soleus (SOL; 91% type I+IIa fibres and CSa: ∼21 μmol min-1 g-1 ), peroneal (PER; 33% and ∼20 μmol min-1 g-1 ), mixed (MG; 9% and ∼26 μmol min-1 g-1 ) and white gastrocnemius (WG; 0% and ∼8 μmol min-1 g-1 ) across the rest-contraction transient. PO2 mv was higher than PO2 is in each muscle (∼6-13 mmHg; P < 0.05). SOL PO2 isarea was greater than in the fast-twitch muscles during contractions (P < 0.05). Oxidative muscles had greater PO2 isnadir (9.4 ± 0.8, 7.4 ± 0.9 and 6.4 ± 0.4; SOL, PER and MG, respectively) than WG (3.0 ± 0.3 mmHg, P < 0.05). The magnitude of PO2 mv-PO2 is at rest decreased during contractions in MG only (∼11 to 7 mmHg; time × (PO2 mv-PO2 is) interaction, P < 0.05). These data support the hypothesis that, since transcapillary PO2 gradients during contractions are maintained in all muscle types, increased O2 flux must occur via enhanced intracapillary diffusing conductance, which is most extreme in highly oxidative fast-twitch muscle.
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Affiliation(s)
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
| | - Jesse C Craig
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Scott K Ferguson
- Department of Kinesiology and Exercise Sciences, University of Hawaii, Hilo, HI
| | - Ramona E Weber
- Department of Kinesiology, Kansas State University Manhattan, KS
| | - Kiana M Schulze
- Department of Kinesiology, Kansas State University Manhattan, KS
| | - Brad J Behnke
- Department of Kinesiology, Kansas State University Manhattan, KS
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University Manhattan, KS.,Department of Anatomy and Physiology, Kansas State University Manhattan, KS
| | - David C Poole
- Department of Kinesiology, Kansas State University Manhattan, KS.,Department of Anatomy and Physiology, Kansas State University Manhattan, KS
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13
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Colburn TD, Holdsworth CT, Craig JC, Hirai DM, Montgomery S, Poole DC, Musch TI, Kenney MJ. ATP-sensitive K + channel inhibition in rats decreases kidney and skeletal muscle blood flow without increasing sympathetic nerve discharge. Respir Physiol Neurobiol 2020; 278:103444. [PMID: 32330600 DOI: 10.1016/j.resp.2020.103444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 01/06/2023]
Abstract
ATP-sensitive K+ (KATP) channels contribute to exercise-induced hyperemia in skeletal muscle either locally by vascular hyperpolarization or by sympathoinhibition and decreased sympathetic vasoconstriction. However, mean arterial pressure (MAP) regulation via baroreceptors and subsequent efferent activity may confound assessment of vascular versus neural KATP channel function. We hypothesized that systemic KATP channel inhibition via glibenclamide (GLI) would increase MAP without increasing sympathetic nerve discharge (SND). Lumbar and renal nerve SND were measured in anesthetized male rats with intact baroreceptors (n = 12) and sinoaortic denervated (SAD; n = 4) counterparts and blood flow (BF) and vascular conductance (VC) assessed in conscious rats (n = 6). GLI increased MAP (p < 0.05) and transiently decreased HR in intact (p < 0.05), but not SAD rats. Renal (-30 %) and lumbar (-40 %) ΔSND decreased in intact but increased in SAD rats (∼40 % and 20 %; p < 0.05). BF and VC decreased in kidneys and total hindlimb skeletal muscle (p < 0.05). Thus, because KATP inhibition decreases SND, GLI-induced reductions in blood flow cannot result from enhanced sympathetic activity.
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Affiliation(s)
- Trenton D Colburn
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA.
| | - Clark T Holdsworth
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Jesse C Craig
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - Daniel M Hirai
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - Shawnee Montgomery
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Michael J Kenney
- College of Science, University of Texas at El Paso, El Paso, TX 79902, USA
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14
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Hirai DM, Tabuchi A, Craig JC, Colburn TD, Caldwell JT, Ade CJ, Baumfalk DR, Opoku-Acheampong AB, Behnke BJ, Hageman KS, Musch TI, Poole DC. Skeletal Muscle Capillary Hemodynamics in Rats with Heart Failure with Preserved Ejection Fraction. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Hirai DM, Craig JC, Colburn TD, Eshima H, Kano Y, Musch TI, Poole DC. Skeletal muscle interstitial Po 2 kinetics during recovery from contractions. J Appl Physiol (1985) 2019; 127:930-939. [PMID: 31369325 DOI: 10.1152/japplphysiol.00297.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The oxygen partial pressure in the interstitial space (Po2 is) drives O2 into the myocyte via diffusion, thus supporting oxidative phosphorylation. Although crucial for metabolic recovery and the capacity to perform repetitive tasks, the time course of skeletal muscle Po2 is during recovery from contractions remains unknown. We tested the hypothesis that Po2 is would recover to resting values and display considerable on-off asymmetry (fast on-, slow off-kinetics), reflective of asymmetric capillary hemodynamics. Microvascular Po2 (Po2 mv) was also evaluated to test the hypothesis that a significant transcapillary gradient (ΔPo2 = Po2 mv - Po2 is) would be sustained during recovery. Po2 mv and Po2 is (expressed in mmHg) were determined via phosphorescence quenching in the exposed rat spinotrapezius muscle during and after submaximal twitch contractions (n = 12). Po2 is rose exponentially (P < 0.05) from end-contraction (11.1 ± 5.1), such that the end-recovery value (17.9 ± 7.9) was not different from resting Po2 is (18.5 ± 8.1; P > 0.05). Po2 is off-kinetics were slower than on-kinetics (mean response time: 53.1 ± 38.3 versus 18.5 ± 7.3 s; P < 0.05). A significant transcapillary ΔPo2 observed at end-contraction (16.6 ± 7.4) was maintained throughout recovery (end-recovery: 18.8 ± 9.6; P > 0.05). Consistent with our hypotheses, muscle Po2 is recovered to resting values with slower off-kinetics compared with the on-transient in line with the on-off asymmetry for capillary hemodynamics. Maintenance of a substantial transcapillary ΔPo2 during recovery supports that the microvascular-interstitium interface provides considerable resistance to O2 transport. As dictated by Fick's law (V̇o2 = Do2 × ΔPo2), modulation of O2 flux (V̇o2) during recovery must be achieved via corresponding changes in effective diffusing capacity (Do2; mainly capillary red blood cell hemodynamics and distribution) in the face of unaltered ΔPo2.NEW & NOTEWORTHY Capillary blood-myocyte O2 flux (V̇o2) is determined by effective diffusing capacity (Do2; mainly erythrocyte hemodynamics and distribution) and microvascular-interstitial Po2 gradients (ΔPo2 = Po2 mv - Po2 is). We show that Po2 is demonstrates on-off asymmetry consistent with Po2 mv and erythrocyte kinetics during metabolic transitions. A substantial transcapillary ΔPo2 was preserved during recovery from contractions, indicative of considerable resistance to O2 diffusion at the microvascular-interstitium interface. This reveals that effective Do2 declines in step with V̇o2 during recovery, as per Fick's law.
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Affiliation(s)
- Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana.,Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Jesse C Craig
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Trenton D Colburn
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Hiroaki Eshima
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Yutaka Kano
- Department of Engineering Science, University of Electro-Communications, Tokyo, Japan
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
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16
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Craig JC, Colburn TD, Caldwell JT, Hirai DM, Tabuchi A, Baumfalk DR, Behnke BJ, Ade CJ, Musch TI, Poole DC. Central and peripheral factors mechanistically linked to exercise intolerance in heart failure with reduced ejection fraction. Am J Physiol Heart Circ Physiol 2019; 317:H434-H444. [PMID: 31225988 DOI: 10.1152/ajpheart.00164.2019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise intolerance is a primary symptom of heart failure (HF); however, the specific contribution of central and peripheral factors to this intolerance is not well described. The hyperbolic relationship between exercise intensity and time to exhaustion (speed-duration relationship) defines exercise tolerance but is underused in HF. We tested the hypotheses that critical speed (CS) would be reduced in HF, resting central functional measurements would correlate with CS, and the greatest HF-induced peripheral dysfunction would occur in more oxidative muscle. Multiple treadmill-constant speed runs to exhaustion were used to quantify CS and D' (distance coverable above CS) in healthy control (Con) and HF rats. Central function was determined via left ventricular (LV) Doppler echocardiography [fractional shortening (FS)] and a micromanometer-tipped catheter [LV end-diastolic pressure (LVEDP)]. Peripheral O2 delivery-to-utilization matching was determined via phosphorescence quenching (interstitial Po2, Po2 is) in the soleus and white gastrocnemius during electrically induced twitch contractions (1 Hz, 8V). CS was lower in HF compared with Con (37 ± 1 vs. 44 ± 1 m/min, P < 0.001), but D' was not different (77 ± 8 vs. 69 ± 13 m, P = 0.6). HF reduced FS (23 ± 2 vs. 47 ± 2%, P < 0.001) and increased LVEDP (15 ± 1 vs. 7 ± 1 mmHg, P < 0.001). CS was related to FS (r = 0.72, P = 0.045) and LVEDP (r = -0.75, P = 0.02) only in HF. HF reduced soleus Po2 is at rest and during contractions (both P < 0.01) but had no effect on white gastrocnemius Po2 is (P > 0.05). We show in HF rats that decrements in central cardiac function relate directly with impaired exercise tolerance (i.e., CS) and that this compromised exercise tolerance is likely due to reduced perfusive and diffusive O2 delivery to oxidative muscles.NEW & NOTEWORTHY We show that critical speed (CS), which defines the upper boundary of sustainable activity, can be resolved in heart failure (HF) animals and is diminished compared with controls. Central cardiac function is strongly related with CS in the HF animals, but not controls. Skeletal muscle O2 delivery-to-utilization dysfunction is evident in the more oxidative, but not glycolytic, muscles of HF rats and is explained, in part, by reduced nitric oxide bioavailability.
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Affiliation(s)
- Jesse C Craig
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Trenton D Colburn
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Jacob T Caldwell
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Daniel M Hirai
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Ayaka Tabuchi
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Dryden R Baumfalk
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Bradley J Behnke
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Carl J Ade
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
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17
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Craig JC, Colburn TD, Hirai DM, Musch TI, Poole DC. Sexual dimorphism in the control of skeletal muscle interstitial Po 2 of heart failure rats: effects of dietary nitrate supplementation. J Appl Physiol (1985) 2019; 126:1184-1192. [PMID: 30844332 DOI: 10.1152/japplphysiol.01004.2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Sex differences in the mechanisms underlying cardiovascular pathophysiology of O2 transport in heart failure (HF) remain to be explored. In HF, nitric oxide (NO) bioavailability is reduced and contributes to deficits in O2 delivery-to-utilization matching. Females may rely more on NO for cardiovascular control and as such experience greater decrements in HF. We tested the hypotheses that moderate HF induced by myocardial infarction would attenuate the skeletal muscle interstitial Po2 response to contractions (Po2is; determined by O2 delivery-to-utilization matching) compared with healthy controls and females would express greater dysfunction than male counterparts. Furthermore, we hypothesized that 5 days of dietary nitrate supplementation (Nitrate; 1 mmol·kg-1·day-1) would raise Po2is in HF rats. Forty-two Sprague-Dawley rats were randomly assigned to healthy, HF, or HF + Nitrate groups (each n = 14; 7 female/7 male). Spinotrapezius Po2is was measured via phosphorescence quenching during electrically induced twitch contractions (180 s; 1 Hz). HF reduced resting Po2is for both sexes compared with healthy controls (P < 0.01), and females were lower than males (14 ± 1 vs. 17 ± 2 mmHg) (P < 0.05). In HF both sexes expressed reduced Po2is amplitudes following the onset of muscle contractions compared with healthy controls (female: -41 ± 7%, male: -26 ± 12%) (P < 0.01). In HF rats, Nitrate elevated resting Po2is to values not different from healthy rats and removed the sex difference. Female HF + Nitrate rats expressed greater resting Po2is and amplitudes compared with female HF (P < 0.05). In this model of moderate HF, O2 delivery-to-utilization matching in the interstitial space is diminished in a sex-specific manner and dietary nitrate supplementation may serve to offset this reduction in HF rats with greater effects in females. NEW & NOTEWORTHY Interstitial Po2 (Po2is; indicative of O2 delivery-to-utilization matching) determines, in part, O2 flux into skeletal muscle. We show that heart failure (HF) reduces Po2is at rest and during skeletal muscle contractions in rats and this negative effect is amplified for females. However, elevating NO bioavailability with dietary nitrate supplementation increases resting Po2is and alters the dynamic response with greater efficacy in female HF rats, particularly at rest and following the onset of muscle contractions.
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Affiliation(s)
- Jesse C Craig
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Trenton D Colburn
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Daniel M Hirai
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University , Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University , Manhattan, Kansas
| | - David C Poole
- Department of Kinesiology, Kansas State University , Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University , Manhattan, Kansas
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18
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Bock JM, Kruse NT, Donnelly C, Hirai DM, Craig JC, Colburn TD, Musch TI, Poole DC, Rosenberry R, Tian F, Liu H, Nelson MD, Piknova B, Willis WT, Zuo L, Zhou T, Riveros-Rivera A, Cristancho E, Gunga HC. Commentaries on Viewpoint: Managing the power grid: How myoglobin can regulate Po 2 and energy distribution in skeletal muscle. J Appl Physiol (1985) 2019; 126:791-794. [PMID: 30907709 DOI: 10.1152/japplphysiol.01107.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Joshua M Bock
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa
| | - Nicholas T Kruse
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Chris Donnelly
- Institute of Sport Sciences and Department of Physiology, University of Lausanne, Switzerland
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Jesse C Craig
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah,Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, Salt Lake City, Utah
| | - Trenton D Colburn
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, Kansas,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, Kansas,Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas
| | - Ryan Rosenberry
- Department of Kinesiology, University of Texas at Arlington, Texas
| | - Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Texas
| | - Hanli Liu
- Department of Bioengineering, University of Texas at Arlington, Texas
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington, Texas,Department of Bioengineering, University of Texas at Arlington, Texas
| | - Barbora Piknova
- Molecular Medicine Branch, NIDDK National Institutes of Health, Bethesda, Maryland
| | | | - Li Zuo
- Radiologic Sciences and Respiratory Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio,Interdisciplinary Biophysics Graduate Program, The Ohio State University, Columbus, Ohio,Department of Biology, University of Maine, Presque Isle, Maine
| | - Tingyang Zhou
- Radiologic Sciences and Respiratory Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio,Interdisciplinary Biophysics Graduate Program, The Ohio State University, Columbus, Ohio
| | - Alain Riveros-Rivera
- Institute of Physiology, Center for Space Medicine and Extreme Environments, Charité - Universitätsmedizin Berlin, Germany
| | - Edgar Cristancho
- Department of Biology. Universidad Nacional de Colombia. Bogotá, Colombia
| | - Hanns-Christian Gunga
- Institute of Physiology, Center for Space Medicine and Extreme Environments, Charité - Universitätsmedizin Berlin, Germany
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19
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Bentley RF, Jones JH, Hirai DM, Zelt JT, Giles MD, Raleigh JP, Quadrilatero J, Gurd BJ, Neder JA, Tschakovsky ME. Submaximal exercise cardiac output is increased by 4 weeks of sprint interval training in young healthy males with low initial Q̇-V̇O2: Importance of cardiac response phenotype. PLoS One 2019; 14:e0195458. [PMID: 30673702 PMCID: PMC6343875 DOI: 10.1371/journal.pone.0195458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/22/2018] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular adaptations to exercise, particularly at the individual level, remain poorly understood. Previous group level research suggests the relationship between cardiac output and oxygen consumption ( Q˙- V˙O2) is unaffected by training as submaximal Q˙ is unchanged. We recently identified substantial inter-individual variation in the exercise Q˙- V˙O2 relationship that was correlated to stroke volume (SV) as opposed to arterial oxygen content. Therefore we explored the effects of sprint interval training (SIT) on modulating Q˙- V˙O2 given an individual’s specific Q˙- V˙O2 relationship. 22 (21±2 yrs) healthy, recreationally active males participated in a 4-week SIT (8, 20 second sprints; 4x/week, 170% of the work rate at V˙O2 peak) study with progressive exercise tests (PET) until exhaustion. Cardiac output ( Q˙ L/min; inert gas rebreathe, Finometer Modelflow™), oxygen consumption ( V˙O2 L/min; breath-by-breath pulmonary gas exchange), quadriceps oxygenation (near infrared spectroscopy) and exercise tolerance (6–20; Borg Scale RPE) were measured throughout PET both before and after training. Data are mean Δ from bsl±SD. Higher Q˙ ( HQ˙) and lower Q˙ ( LQ˙) responders were identified post hoc (n = 8/group). SIT increased the Q˙- V˙O2 post-training in LQ˙ (3.8±0.2 vs. 4.7±0.2; P = 0.02) while HQ˙ was unaffected (5.8±0.1 vs. 5.3±0.6; P = 0.5). ΔQ˙ was elevated beyond 80 watts in LQ˙ due to a greater increase in SV (all P<0.04). Peak V˙O2 (ml/kg/min) was increased in LQ˙ (39.7±6.7 vs. 44.5±7.3; P = 0.015) and HQ˙ (47.2±4.4 vs. 52.4±6.0; P = 0.009) following SIT, with HQ˙ having a greater peak V˙O2 both pre (P = 0.02) and post (P = 0.03) training. Quadriceps muscle oxygenation and RPE were not different between groups (all P>0.1). In contrast to HQ˙, LQ˙ responders are capable of improving submaximal Q˙- V˙O2 in response to SIT via increased SV. However, the increased submaximal exercise Q˙ does not benefit exercising muscle oxygenation.
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Affiliation(s)
- Robert F. Bentley
- School of Kinesiology and Health Studies, Human Vascular Control Laboratory, Queen’s University, Kingston, ON, Canada
| | - Joshua H. Jones
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, ON, Canada
| | - Daniel M. Hirai
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, ON, Canada
| | - Joel T. Zelt
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, ON, Canada
| | - Matthew D. Giles
- School of Kinesiology and Health Studies, Queen’s Muscle Physiology Laboratory, Queen’s University, Kingston, ON, Canada
| | - James P. Raleigh
- School of Kinesiology and Health Studies, Queen’s Muscle Physiology Laboratory, Queen’s University, Kingston, ON, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, Muscle Biology and Cell Death Laboratory, University of Waterloo, Waterloo, ON, Canada
| | - Brendon J. Gurd
- School of Kinesiology and Health Studies, Queen’s Muscle Physiology Laboratory, Queen’s University, Kingston, ON, Canada
| | - J. Alberto Neder
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, ON, Canada
| | - Michael E. Tschakovsky
- School of Kinesiology and Health Studies, Human Vascular Control Laboratory, Queen’s University, Kingston, ON, Canada
- * E-mail:
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20
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Bentley RF, Jones JH, Hirai DM, Zelt JT, Giles MD, Raleigh JP, Quadrilatero J, Gurd BJ, Neder JA, Tschakovsky ME. Do interindividual differences in cardiac output during submaximal exercise explain differences in exercising muscle oxygenation and ratings of perceived exertion? Physiol Rep 2019; 6. [PMID: 29368399 PMCID: PMC5789726 DOI: 10.14814/phy2.13570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/14/2017] [Accepted: 12/15/2017] [Indexed: 11/24/2022] Open
Abstract
Considerable interindividual differences in the Q˙-V˙O2 relationship during exercise have been documented but implications for submaximal exercise tolerance have not been considered. We tested the hypothesis that these interindividual differences were associated with differences in exercising muscle deoxygenation and ratings of perceived exertion (RPE) across a range of submaximal exercise intensities. A total of 31 (21 ± 3 years) healthy recreationally active males performed an incremental exercise test to exhaustion 24 h following a resting muscle biopsy. Cardiac output (Q˙ L/min; inert gas rebreathe), oxygen uptake (V˙O2 L/min; breath-by-breath pulmonary gas exchange), quadriceps saturation (near infrared spectroscopy) and exercise tolerance (6-20; Borg Scale RPE) were measured. The Q˙-V˙O2 relationship from 40 to 160 W was used to partition individuals post hoc into higher (n = 10; 6.3 ± 0.4) versus lower (n = 10; 3.7 ± 0.4, P < 0.001) responders. The Q˙-V˙O2 difference between responder types was not explained by arterial oxygen content differences (P = 0.5) or peripheral skeletal muscle characteristics (P from 0.1 to 0.8) but was strongly associated with stroke volume (P < 0.05). Despite considerable Q˙-V˙O2 difference between groups, no difference in quadriceps deoxygenation was observed during exercise (all P > 0.4). Lower cardiac responders had greater leg (P = 0.027) and whole body (P = 0.03) RPE only at 185 W, but this represented a higher %peak V˙O2 in lower cardiac responders (87 ± 15% vs. 66 ± 12%, P = 0.005). Substantially lower Q˙-V˙O2 in the lower responder group did not result in altered RPE or exercising muscle deoxygenation. This suggests substantial recruitment of blood flow redistribution in the lower responder group as part of protecting matching of exercising muscle oxygen delivery to demand.
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Affiliation(s)
- Robert F Bentley
- Human Vascular Control Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Daniel M Hirai
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Joel T Zelt
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Matthew D Giles
- Queen's Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - James P Raleigh
- Queen's Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Joe Quadrilatero
- Muscle Biology and Cell Death Laboratory, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Brendon J Gurd
- Queen's Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Michael E Tschakovsky
- Human Vascular Control Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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Hirai DM, Colburn TD, Craig JC, Hotta K, Kano Y, Musch TI, Poole DC. Skeletal muscle interstitial O 2 pressures: bridging the gap between the capillary and myocyte. Microcirculation 2018; 26:e12497. [PMID: 30120845 DOI: 10.1111/micc.12497] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/26/2018] [Accepted: 08/13/2018] [Indexed: 01/18/2023]
Abstract
The oxygen transport pathway from air to mitochondria involves a series of transfer steps within closely integrated systems (pulmonary, cardiovascular, and tissue metabolic). Small and finite O2 stores in most mammalian species require exquisitely controlled changes in O2 flux rates to support elevated ATP turnover. This is especially true for the contracting skeletal muscle where O2 requirements may increase two orders of magnitude above rest. This brief review focuses on the mechanistic bases for increased microvascular blood-myocyte O2 flux (V̇O2 ) from rest to contractions. Fick's law dictates that V̇O2 elevations driven by muscle contractions are produced by commensurate changes in driving force (ie, O2 pressure gradients; ΔPO2 ) and/or effective diffusing capacity (DO2 ). While previous evidence indicates that increased DO2 helps modulate contracting muscle O2 flux, up until recently the role of the dynamic ΔPO2 across the capillary wall was unknown. Recent phosphorescence quenching investigations of both microvascular and novel interstitial PO2 kinetics in health have resolved an important step in the O2 cascade between the capillary and myocyte. Specifically, the significant transmural ΔPO2 at rest was sustained (but not increased) during submaximal contractions. This supports the contention that the blood-myocyte interface provides a substantial effective resistance to O2 diffusion and underscores that modulations in erythrocyte hemodynamics and distribution (DO2 ) are crucial to preserve the driving force for O2 flux across the capillary wall (ΔPO2 ) during contractions. Investigation of the O2 transport pathway close to muscle mitochondria is key to identifying disease mechanisms and develop therapeutic approaches to ameliorate dysfunction and exercise intolerance.
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Affiliation(s)
- Daniel M Hirai
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, Kansas
| | - Trenton D Colburn
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, Kansas
| | - Jesse C Craig
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, Kansas
| | - Kazuki Hotta
- Department of Engineering Science, University of Electro-Communications, Tokyo, Japan
| | - Yutaka Kano
- Department of Engineering Science, University of Electro-Communications, Tokyo, Japan
| | - Timothy I Musch
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, Kansas
| | - David C Poole
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, Kansas
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Craig JC, Merino JH, Hirai DM, Colburn TD, Tabuchi A, Caldwell JT, Ade CJ, Musch TI, Poole DC. Critical Speed in Heart Failure Rats. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000537186.12862.b9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Hirai DM, Colburn TD, Craig JC, Tabuchi A, Musch TI, Poole DC. Dynamics of Skeletal Muscle Interstitial PO2 During Recovery from Contractions. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536748.66222.2d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Colburn TD, Craig JC, Hirai DM, Musch TI, Poole DC. Recovery Interstitial PO2 Dynamics Following Contractions in Healthy Skeletal Muscle of Different Oxidative Capacity. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536751.11964.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Affiliation(s)
- Daniel M. Hirai
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | - Jesse C. Craig
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | | | - Ayaka Tabuchi
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | - K. Sue Hageman
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | - Timothy I. Musch
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | - David C. Poole
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
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26
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Craig JC, Colburn TD, Caldwell JT, Hirai DM, Tabuchi A, Merino JH, Ade CJ, Poole DC, Musch TI. Central Cardiac Determinants of the Speed‐duration Relationship in Heart Failure Rats. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.853.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Ayaka Tabuchi
- Dept of KinesiologyKansas State UniversityManhattanKS
| | | | - Carl J. Ade
- Dept of KinesiologyKansas State UniversityManhattanKS
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Colburn TD, Craig JC, Hirai DM, Tabuchi A, Hageman KS, Musch TI, Poole DC. Interstitial PO
2
Dynamics During Contractions in Healthy Skeletal Muscle: Relationship to Oxidative Capacity and Nitric Oxide Bioavailability. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.704.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Ayaka Tabuchi
- Engineering ScienceUniversity of Electro‐CommunicationsTokyoJapan
| | | | - Timothy I. Musch
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
| | - David C. Poole
- Kinesiology, Anatomy & PhysiologyKansas State UniversityManhattanKS
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Hirai DM, Craig JC, Colburn TD, Eshima H, Kano Y, Sexton WL, Musch TI, Poole DC. Skeletal muscle microvascular and interstitial PO2 from rest to contractions. J Physiol 2018; 596:869-883. [PMID: 29288568 DOI: 10.1113/jp275170] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/01/2017] [Indexed: 01/21/2023] Open
Abstract
KEY POINTS Oxygen pressure gradients across the microvascular walls are essential for oxygen diffusion from blood to tissue cells. At any given flux, the magnitude of these transmural gradients is proportional to the local resistance. The greatest resistance to oxygen transport into skeletal muscle is considered to reside in the short distance between red blood cells and myocytes. Although crucial to oxygen transport, little is known about transmural pressure gradients within skeletal muscle during contractions. We evaluated oxygen pressures within both the skeletal muscle microvascular and interstitial spaces to determine transmural gradients during the rest-contraction transient in anaesthetized rats. The significant transmural gradient observed at rest was sustained during submaximal muscle contractions. Our findings support that the blood-myocyte interface provides substantial resistance to oxygen diffusion at rest and during contractions and suggest that modulations in microvascular haemodynamics and red blood cell distribution constitute primary mechanisms driving increased transmural oxygen flux with contractions. ABSTRACT Oxygen pressure (PO2) gradients across the blood-myocyte interface are required for diffusive O2 transport, thereby supporting oxidative metabolism. The greatest resistance to O2 flux into skeletal muscle is considered to reside between the erythrocyte surface and adjacent sarcolemma, although this has not been measured during contractions. We tested the hypothesis that O2 gradients between skeletal muscle microvascular (PO2 mv ) and interstitial (PO2 is ) spaces would be present at rest and maintained or increased during contractions. PO2 mv and PO2 is were determined via phosphorescence quenching (Oxyphor probes G2 and G4, respectively) in the exposed rat spinotrapezius during the rest-contraction transient (1 Hz, 6 V; n = 8). PO2 mv was higher than PO2 is in all instances from rest (34.9 ± 6.0 versus 15.7 ± 6.4) to contractions (28.4 ± 5.3 versus 10.6 ± 5.2 mmHg, respectively) such that the mean PO2 gradient throughout the transient was 16.9 ± 6.6 mmHg (P < 0.05 for all). No differences in the amplitude of PO2 fall with contractions were observed between the microvasculature and interstitium (10.9 ± 2.3 versus 9.0 ± 3.5 mmHg, respectively; P > 0.05). However, the speed of the PO2 is fall during contractions was slower than that of PO2 mv (time constant: 12.8 ± 4.7 versus 9.0 ± 5.1 s, respectively; P < 0.05). Consistent with our hypothesis, a significant transmural gradient was sustained (but not increased) from rest to contractions. This supports that the blood-myocyte interface is the site of a substantial PO2 gradient driving O2 diffusion during metabolic transients. Based on Fick's law, elevated O2 flux with contractions must thus rely primarily on modulations in effective diffusing capacity (mainly erythrocyte haemodynamics and distribution) as the PO2 gradient is not increased.
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Affiliation(s)
- Daniel M Hirai
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Jesse C Craig
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Trenton D Colburn
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Hiroaki Eshima
- Department of Engineering Science, University of Electro-Communications, Tokyo, Japan
| | - Yutaka Kano
- Department of Engineering Science, University of Electro-Communications, Tokyo, Japan
| | - William L Sexton
- Department of Physiology, A.T. Still University of Health Sciences, Kirksville, MO, USA
| | - Timothy I Musch
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, KS, USA
| | - David C Poole
- Departments of Anatomy & Physiology, Kinesiology, Kansas State University, Manhattan, KS, USA
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29
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Craig JC, Colburn TD, Hirai DM, Schettler MJ, Musch TI, Poole DC. Sex and nitric oxide bioavailability interact to modulate interstitial Po 2 in healthy rat skeletal muscle. J Appl Physiol (1985) 2018; 124:1558-1566. [PMID: 29369738 DOI: 10.1152/japplphysiol.01022.2017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Premenopausal women express reduced blood pressure and risk of cardiovascular disease relative to age-matched men. This purportedly relates to elevated estrogen levels increasing nitric oxide synthase (NOS) activity and NO-mediated vasorelaxation. We tested the hypotheses that female rat skeletal muscle would: 1) evince a higher O2 delivery-to-utilization ratio (Q̇o2/V̇o2) during contractions; and 2) express greater modulation of Q̇o2/V̇o2 with changes to NO bioavailability compared with male rats. The spinotrapezius muscle of Sprague-Dawley rats (females = 8, males = 8) was surgically exposed and electrically-stimulated (180 s, 1 Hz, 6 V). OxyphorG4 was injected into the muscle and phosphorescence quenching employed to determine the temporal profile of interstitial Po2 (Po2is, determined by Q̇o2/V̇o2). This was performed under three conditions: control (CON), 300 µM sodium nitroprusside (SNP; NO donor), and 1.5 mM Nω-nitro-l-arginine methyl ester (l-NAME; NOS blockade) superfusion. No sex differences were found for the Po2is kinetics parameters in CON or l-NAME ( P > 0.05), but females elicited a lower baseline following SNP (males 42 ± 3 vs. females 36 ± 2 mmHg, P < 0.05). Females had a lower ΔPo2is during contractions following SNP (males 22 ± 3 vs. females 17 ± 2 mmHg, P < 0.05), but there were no sex differences for the temporal response to contractions ( P > 0.05). The total NO effect (SNP minus l-NAME) on Po2is was not different between sexes. However, the spread across both conditions was shifted to a lower absolute range for females (reduced SNP baseline and greater reduction following l-NAME). These data support that females have a greater reliance on basal NO bioavailability and males have a greater responsiveness to exogenous NO and less responsiveness to reduced endogenous NO. NEW & NOTEWORTHY Interstitial Po2 (Po2is; determined by O2 delivery-to-utilization matching) plays an important role for O2 flux into skeletal muscle. We show that both sexes regulate Po2is at similar levels at rest and during skeletal muscle contractions. However, modulating NO bioavailability exposes sex differences in this regulation with females potentially having a greater reliance on basal NO bioavailability and males having a greater responsiveness to exogenous NO and less responsiveness to reduced endogenous NO.
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Affiliation(s)
- Jesse C Craig
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Trenton D Colburn
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Daniel M Hirai
- Department of Kinesiology, Kansas State University , Manhattan, Kansas
| | - Michael J Schettler
- Department of Anatomy and Physiology, Kansas State University , Manhattan, Kansas
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University , Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University , Manhattan, Kansas
| | - David C Poole
- Department of Kinesiology, Kansas State University , Manhattan, Kansas.,Department of Anatomy and Physiology, Kansas State University , Manhattan, Kansas
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Zelt JT, Jones JH, Hirai DM, King TJ, Berton DC, Pyke KE, O'Donnell DE, Neder JA. Systemic vascular dysfunction is associated with emphysema burden in mild COPD. Respir Med 2018; 136:29-36. [PMID: 29501244 DOI: 10.1016/j.rmed.2018.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cardiovascular diseases play a major role in morbidity and mortality in the earlier stages of COPD. We hypothesized that systemic vascular dysfunction would be present even in patients who are currently considered at "low-risk" for negative cardiovascular outcomes, i.e., those with largely preserved FEV1, few exacerbations and only mild burden of respiratory symptoms (GOLD spirometric grade 1, clinical group A). METHODS 16 patients (FEV1 = 86 ± 13%) and 16 age- and gender-matched controls underwent measurements of: a) central arterial stiffness by pulse wave velocity, b) brachial flow-mediated dilation and c) forearm muscle oxygenation by near-infrared spectroscopy. Computed tomography quantified emphysema (% of low attenuation areas (LAA)) and airway disease. RESULTS Patients and controls were well matched for key clinical variables including co-morbidities burden. Thirteen patients presented with more than 5% LAA: emphysema extension was negatively related to transfer factor for carbon monoxide (TLCO) (r = -0.63; p = .01). Compared to controls, patients had higher central arterial stiffness, lower normalized (to shear stress) flow-mediated dilation, delayed time to peak flow-mediated dilation and poorer muscle oxygenation (p < .05). TLCO and emphysema, but not airway disease, were significantly related to each of these functional abnormalities (r values ranging from 0.51 to 0.66; p < .05). CONCLUSION Systemic vascular dysfunction is present in the earlier stages of COPD, particularly in patients with greater emphysema burden and low TLCO. Regardless FEV1, patients showing those structural and functional abnormalities might be at higher risk of negative events thereby deserving closer follow-up for early detection of cardiovascular disease.
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Affiliation(s)
- Joel T Zelt
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Daniel M Hirai
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Trevor J King
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Danilo C Berton
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada; Division of Respirology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Kyra E Pyke
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Denis E O'Donnell
- Respiratory Investigation Unit (RIU), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada.
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31
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Poole DC, Richardson RS, Haykowsky MJ, Hirai DM, Musch TI. Exercise limitations in heart failure with reduced and preserved ejection fraction. J Appl Physiol (1985) 2017; 124:208-224. [PMID: 29051336 DOI: 10.1152/japplphysiol.00747.2017] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The hallmark symptom of chronic heart failure (HF) is severe exercise intolerance. Impaired perfusive and diffusive O2 transport are two of the major determinants of reduced physical capacity and lowered maximal O2 uptake in patients with HF. It has now become evident that this syndrome manifests at least two different phenotypic variations: heart failure with preserved or reduced ejection fraction (HFpEF and HFrEF, respectively). Unlike HFrEF, however, there is currently limited understanding of HFpEF pathophysiology, leading to a lack of effective pharmacological treatments for this subpopulation. This brief review focuses on the disturbances within the O2 transport pathway resulting in limited exercise capacity in both HFpEF and HFrEF. Evidence from human and animal research reveals HF-induced impairments in both perfusive and diffusive O2 conductances identifying potential targets for clinical intervention. Specifically, utilization of different experimental approaches in humans (e.g., small vs. large muscle mass exercise) and animals (e.g., intravital microscopy and phosphorescence quenching) has provided important clues to elucidating these pathophysiological mechanisms. Adaptations within the skeletal muscle O2 delivery-utilization system following established and emerging therapies (e.g., exercise training and inorganic nitrate supplementation, respectively) are discussed. Resolution of the underlying mechanisms of skeletal muscle dysfunction and exercise intolerance is essential for the development and refinement of the most effective treatments for patients with HF.
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Neder JA, Hirai DM, Jones JH, Zelt JT, Berton DC, O'Donnell DE. A 56-Year-Old, Otherwise Healthy Woman Presenting With Light-headedness and Progressive Shortness of Breath. Chest 2017; 150:e23-7. [PMID: 27396797 DOI: 10.1016/j.chest.2016.02.672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 11/16/2022] Open
Abstract
A 56-year-old white woman was referred to the pulmonary clinic for evaluation of unexplained shortness of breath. She enjoyed good health until 3 months prior to this visit when she reported experiencing recurrent episodes of shortness of breath and oppressive retrosternal chest discomfort with radiation to the neck. Episodes lasting 5 to 10 min often occurred at rest and were inconsistently related to physical activity. These symptoms became progressively worse and were often associated with light-headedness and presyncope. Her past medical history was uneventful apart from a prior diagnosis of breast cysts and suspected prolactinoma. Her symptoms escalated to such a level that she was forced to seek urgent medical attention at our institutional ED on two separate occasions in the preceding weeks. These visits precipitated a number of investigations and, eventually, a referral to the pulmonary clinic.
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Affiliation(s)
- J Alberto Neder
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
| | - Daniel M Hirai
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Joel T Zelt
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Danilo C Berton
- Respiratory Division, Department of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Denis E O'Donnell
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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33
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Craig JC, Schettler MJ, Colburn TD, Hirai DM, Poole DC, Musch TI. No Sex Differences in Muscle O2 Delivery-to-Utilization Matching Before or During Contractions in Rats. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517806.85429.a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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34
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Colburn TD, Craig JC, Hirai DM, Sue Hageman K, Musch TI, Poole DC. NOS Blockade Reveals No Sex Difference in Contracting Muscle O2 Delivery-to-Utilization Matching in Rats. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517812.93053.d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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35
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Hirai DM, Jones JH, Zelt JT, da Silva ML, Bentley RF, Edgett BA, Gurd BJ, Tschakovsky ME, O'Donnell DE, Neder JA. Oral N-acetylcysteine and exercise tolerance in mild chronic obstructive pulmonary disease. J Appl Physiol (1985) 2017; 122:1351-1361. [PMID: 28255088 DOI: 10.1152/japplphysiol.00990.2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 01/25/2023] Open
Abstract
Heightened oxidative stress is implicated in the progressive impairment of skeletal muscle vascular and mitochondrial function in chronic obstructive pulmonary disease (COPD). Whether accumulation of reactive oxygen species contributes to exercise intolerance in the early stages of COPD is unknown. The purpose of the present study was to determine the effects of oral antioxidant treatment with N-acetylcysteine (NAC) on respiratory, cardiovascular, and locomotor muscle function and exercise tolerance in patients with mild COPD. Thirteen patients [forced expiratory volume in 1 s (FEV1)-to-forced vital capacity ratio < lower limit of normal (LLN) and FEV1 ≥ LLN) were enrolled in a double-blind, randomized crossover study to receive NAC (1,800 mg/day) or placebo for 4 days. Severe-intensity constant-load exercise tests were performed with noninvasive measurements of central hemodynamics (stroke volume, heart rate, and cardiac output via impedance cardiography), arterial blood pressure, pulmonary ventilation and gas exchange, quadriceps muscle oxygenation (near-infrared spectroscopy), and estimated capillary blood flow. Nine patients completed the study with no major adverse clinical effects. Although NAC elevated plasma glutathione by ~27% compared with placebo (P < 0.05), there were no differences in exercise tolerance (placebo: 325 ± 47 s, NAC: 336 ± 51 s), central hemodynamics, arterial blood pressure, pulmonary ventilation or gas exchange, locomotor muscle oxygenation, or capillary blood flow from rest to exercise between conditions (P > 0.05 for all). In conclusion, modulation of plasma redox status with oral NAC treatment was not translated into beneficial effects on central or peripheral components of the oxygen transport pathway, thereby failing to improve exercise tolerance in nonhypoxemic patients with mild COPD.NEW & NOTEWORTHY Acute antioxidant treatment with N-acetylcysteine (NAC) elevated plasma glutathione but did not modulate central or peripheral components of the O2 transport pathway, thereby failing to improve exercise tolerance in patients with mild chronic obstructive pulmonary disease (COPD).
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Affiliation(s)
- Daniel M Hirai
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada; .,Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Joel T Zelt
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Marianne L da Silva
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.,Division of Physical Therapy, University of Brasilia, Brasilia, Brazil
| | - Robert F Bentley
- Human Vascular Control Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Brittany A Edgett
- Queen's Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada; and
| | - Brendon J Gurd
- Queen's Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada; and
| | - Michael E Tschakovsky
- Human Vascular Control Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Denis E O'Donnell
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Hirai DM, Zelt JT, Jones JH, Castanhas LG, Bentley RF, Earle W, Staples P, Tschakovsky ME, McCans J, O’Donnell DE, Neder JA. Dietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fraction. Am J Physiol Regul Integr Comp Physiol 2017; 312:R13-R22. [DOI: 10.1152/ajpregu.00263.2016] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/03/2016] [Accepted: 10/26/2016] [Indexed: 11/22/2022]
Abstract
Endothelial dysfunction and reduced nitric oxide (NO) signaling are key abnormalities leading to skeletal muscle oxygen delivery-utilization mismatch and poor physical capacity in patients with heart failure with reduced ejection fraction (HFrEF). Oral inorganic nitrate supplementation provides an exogenous source of NO that may enhance locomotor muscle function and oxygenation with consequent improvement in exercise tolerance in HFrEF. Thirteen patients (left ventricular ejection fraction ≤40%) were enrolled in a double-blind, randomized crossover study to receive concentrated nitrate-rich (nitrate) or nitrate-depleted (placebo) beetroot juice for 9 days. Low- and high-intensity constant-load cardiopulmonary exercise tests were performed with noninvasive measurements of central hemodynamics (stroke volume, heart rate, and cardiac output via impedance cardiography), arterial blood pressure, pulmonary oxygen uptake, quadriceps muscle oxygenation (near-infrared spectroscopy), and blood lactate concentration. Ten patients completed the study with no adverse clinical effects. Nitrate-rich supplementation resulted in significantly higher plasma nitrite concentration compared with placebo (240 ± 48 vs. 56 ± 8 nM, respectively; P < 0.05). There was no significant difference in the primary outcome of time to exercise intolerance between nitrate and placebo (495 ± 53 vs. 489 ± 58 s, respectively; P > 0.05). Similarly, there were no significant differences in central hemodynamics, arterial blood pressure, pulmonary oxygen uptake kinetics, skeletal muscle oxygenation, or blood lactate concentration from rest to low- or high-intensity exercise between conditions. Oral inorganic nitrate supplementation with concentrated beetroot juice did not present with beneficial effects on central or peripheral components of the oxygen transport pathway thereby failing to improve exercise tolerance in patients with moderate HFrEF.
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Affiliation(s)
- Daniel M. Hirai
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, Ontario, Canada
- Department of Medicine, Respiratory Division, Pulmonary Function and Clinical Exercise Physiology Unit, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Joel T. Zelt
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, Ontario, Canada
| | - Joshua H. Jones
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, Ontario, Canada
| | - Luiza G. Castanhas
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, Ontario, Canada
| | - Robert F. Bentley
- School of Kinesiology and Health Studies, Human Vascular Control Laboratory, Queen’s University, Kingston, Ontario, Canada
| | - Wendy Earle
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, Ontario, Canada; and
| | - Patti Staples
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, Ontario, Canada; and
| | - Michael E. Tschakovsky
- School of Kinesiology and Health Studies, Human Vascular Control Laboratory, Queen’s University, Kingston, Ontario, Canada
| | - John McCans
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, Ontario, Canada; and
| | - Denis E. O’Donnell
- Department of Medicine, Division of Respirology, Respiratory Investigation Unit, Queen’s University, Kingston, Ontario, Canada
| | - J. Alberto Neder
- Department of Medicine, Division of Respirology, Laboratory of Clinical Exercise Physiology, Queen’s University, Kingston, Ontario, Canada
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Jones JH, Zelt JT, Hirai DM, Diniz CV, Zaza A, O'Donnell DE, Neder JA. Emphysema on Thoracic CT and Exercise Ventilatory Inefficiency in Mild-to-Moderate COPD. COPD 2016; 14:210-218. [PMID: 27997255 DOI: 10.1080/15412555.2016.1253670] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
There is growing evidence that emphysema on thoracic computed tomography (CT) is associated with poor exercise tolerance in COPD patients with only mild-to-moderate airflow obstruction. We hypothesized that an excessive ventilatory response to exercise (ventilatory inefficiency) would underlie these abnormalities. In a prospective study, 19 patients (FEV1 = 82 ± 13%, 12 Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 1) and 26 controls underwent an incremental exercise test. Ventilatory inefficiency was assessed by the ventilation ([Formula: see text]E)/CO2 output ([Formula: see text]CO2) nadir. Pulmonary blood flow (PBF) in a submaximal test was calculated by inert gas rebreathing. Emphysema was quantified as % of attenuation areas below 950 HU. Patients typically presented with centrilobular emphysema (76.8 ± 10.1% of total emphysema) in the upper lobes (upper/total lung ratio = 0.82 ± 0.04). They had lower peak oxygen uptake ([Formula: see text]O2), higher [Formula: see text]E/[Formula: see text]CO2 nadir, and greater dyspnea scores than controls (p < 0.05). Lower peak [Formula: see text]O2 and worse dyspnea were found in patients with higher [Formula: see text]E/[Formula: see text]CO2 nadirs (≥30). Patients had blunted increases in PBF from rest to iso-[Formula: see text]O2 exercise (p < 0.05). Higher [Formula: see text]E/[Formula: see text]CO2 nadir in COPD was associated with emphysema severity (r = 0.63) which, in turn, was related to reduced lung diffusing capacity (r = -0.72) and blunted changes in PBF from rest to exercise (r = -0.69) (p < 0.01). Ventilation "wasted" in emphysematous areas is associated with impaired exercise ventilatory efficiency in mild-to-moderate COPD. Exercise ventilatory inefficiency links structure (emphysema) and function (DLCO) to a key clinical outcome (poor exercise tolerance) in COPD patients with only modest spirometric abnormalities.
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Affiliation(s)
- Joshua H Jones
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - Joel T Zelt
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - Daniel M Hirai
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - Camilla V Diniz
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - Aida Zaza
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - Denis E O'Donnell
- b Respiratory Investigation Unit (RIU), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
| | - J Alberto Neder
- a Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University , Kingston , ON , Canada
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Rocha A, Arbex FF, Alencar MCN, Sperandio PA, Hirai DM, Berton DC, O'Donnell DE, Neder JA. Physiological and sensory consequences of exercise oscillatory ventilation in heart failure-COPD. Int J Cardiol 2016; 224:447-453. [DOI: 10.1016/j.ijcard.2016.09.077] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 12/31/2022]
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Arbex FF, Alencar MC, Souza A, Mazzuco A, Sperandio PA, Rocha A, Hirai DM, Mancuso F, Berton DC, Borghi-Silva A, Almeida DR, O'Donnell DE, Neder JA. Exercise Ventilation in COPD: Influence of Systolic Heart Failure. COPD 2016; 13:693-699. [DOI: 10.1080/15412555.2016.1174985] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Flavio F. Arbex
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Clara Alencar
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Aline Souza
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Adriana Mazzuco
- Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Priscila A. Sperandio
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Alcides Rocha
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Daniel M. Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, Canada
| | - Frederico Mancuso
- Division of Cardiology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Danilo C. Berton
- Division of Respirology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Audrey Borghi-Silva
- Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Dirceu R. Almeida
- Division of Cardiology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Denis E. O'Donnell
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, Canada
| | - J. Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Federal University of Sao Paulo, Sao Paulo, Brazil
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, Canada
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Neder JA, Alharbi A, Berton DC, Alencar MCN, Arbex FF, Hirai DM, Webb KA, O'Donnell DE. Exercise Ventilatory Inefficiency Adds to Lung Function in Predicting Mortality in COPD. COPD 2016; 13:416-24. [DOI: 10.3109/15412555.2016.1158801] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Neder JA, Ramos RP, Ota-Arakaki JS, Ferreira EMV, Hirai DM, Sperandio PA, Alencar MCN, Arbex FF, Berton DC, D'Arsigny C, O'Donnell DE. Insights into ventilation-gas exchange coupling in chronic thromboembolic pulmonary hypertension. Eur Respir J 2016; 48:252-4. [PMID: 27076589 DOI: 10.1183/13993003.01948-2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 02/28/2016] [Indexed: 11/05/2022]
Affiliation(s)
- J Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University, Kingston, ON, Canada
| | - Roberta P Ramos
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil Pulmonary Vascular Group, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Jaquelina S Ota-Arakaki
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil Pulmonary Vascular Group, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Eloara M V Ferreira
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil Pulmonary Vascular Group, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Daniel M Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University, Kingston, ON, Canada
| | - Priscila A Sperandio
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Clara N Alencar
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Flavio F Arbex
- Pulmonary Function and Clinical Exercise Physiology Unit, Respiratory Division, Dept of Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Danilo C Berton
- Respiratory Division, Dept of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christine D'Arsigny
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University, Kingston, ON, Canada
| | - Denis E O'Donnell
- Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Dept of Medicine, Queen's University, Kingston, ON, Canada
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Oliveira MF, Arbex FF, Alencar MC, Souza A, Sperandio PA, Medeiros WM, Mazzuco A, Borghi-Silva A, Medina LA, Santos R, Hirai DM, Mancuso F, Almeida D, O'Donnell DE, Neder JA. Heart Failure Impairs Muscle Blood Flow and Endurance Exercise Tolerance in COPD. COPD 2016; 13:407-15. [PMID: 26790095 DOI: 10.3109/15412555.2015.1117435] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Heart failure, a prevalent and disabling co-morbidity of COPD, may impair cardiac output and muscle blood flow thereby contributing to exercise intolerance. To investigate the role of impaired central and peripheral hemodynamics in limiting exercise tolerance in COPD-heart failure overlap, cycle ergometer exercise tests at 20% and 80% peak work rate were performed by overlap (FEV1 = 56.9 ± 15.9% predicted, ejection fraction = 32.5 ± 6.9%; N = 16), FEV1-matched COPD (N = 16), ejection fraction-matched heart failure patients (N = 15) and controls (N = 12). Differences (Δ) in cardiac output (impedance cardiography) and vastus lateralis blood flow (indocyanine green) and deoxygenation (near-infrared spectroscopy) between work rates were expressed relative to concurrent changes in muscle metabolic demands (ΔO2 uptake). Overlap patients had approximately 30% lower endurance exercise tolerance than COPD and heart failure (p < 0.05). ΔBlood flow was closely proportional to Δcardiac output in all groups (r = 0.89-0.98; p < 0.01). Overlap showed the largest impairments in Δcardiac output/ΔO2 uptake and Δblood flow/ΔO2 uptake (p < 0.05). Systemic arterial oxygenation, however, was preserved in overlap compared to COPD. Blunted limb perfusion was related to greater muscle deoxygenation and lactate concentration in overlap (r = 0.78 and r = 0.73, respectively; p < 0.05). ΔBlood flow/ΔO2 uptake was related to time to exercise intolerance only in overlap and heart failure (p < 0.01). In conclusion, COPD and heart failure add to decrease exercising cardiac output and skeletal muscle perfusion to a greater extent than that expected by heart failure alone. Treatment strategies that increase muscle O2 delivery and/or decrease O2 demand may be particularly helpful to improve exercise tolerance in COPD patients presenting heart failure as co-morbidity.
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Affiliation(s)
- Mayron F Oliveira
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Flavio F Arbex
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Maria Clara Alencar
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Aline Souza
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Priscila A Sperandio
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Wladimir M Medeiros
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Adriana Mazzuco
- b Department of Physiotherapy , Federal University of São Carlos (UFSCAR) , São Carlos , Brazil
| | - Audrey Borghi-Silva
- b Department of Physiotherapy , Federal University of São Carlos (UFSCAR) , São Carlos , Brazil
| | - Luiz A Medina
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Rita Santos
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Daniel M Hirai
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , Canada
| | - Frederico Mancuso
- d Cardiology Division, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Dirceu Almeida
- d Cardiology Division, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Denis E O'Donnell
- e Respiratory Investigation Unit (RIU), Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , Canada
| | - J Alberto Neder
- a Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen's University , Kingston , Canada
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Oliveira MF, Alencar MC, Arbex F, Souza A, Sperandio P, Medina L, Medeiros WM, Hirai DM, O'Donnell DE, Neder JA. Effects of heart failure on cerebral blood flow in COPD: Rest and exercise. Respir Physiol Neurobiol 2016; 221:41-8. [DOI: 10.1016/j.resp.2015.10.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/07/2015] [Accepted: 10/10/2015] [Indexed: 12/13/2022]
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Neder JA, Jones JH, Zelt JTJ, Ramos RP, Ota-Arakaki JS, Hirai DM, Sperandio PA, Alencar MCN, Arbex FF, O'Donnell DE. Pulmonary artery wedge pressure and exercise oscillatory ventilation in pre-capillary pulmonary hypertension. Int J Cardiol 2015; 206:164-6. [PMID: 26577023 DOI: 10.1016/j.ijcard.2015.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
Affiliation(s)
- J Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada.
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Joel T J Zelt
- Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Roberta P Ramos
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Pulmonary Vascular Group, Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Jaquelina S Ota-Arakaki
- Pulmonary Vascular Group, Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel M Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - Priscila A Sperandio
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria Clara N Alencar
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Flavio F Arbex
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Denis E O'Donnell
- Respiratory Investigation Unit (RIU), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
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Hirai DM, Musch TI, Poole DC. Exercise training in chronic heart failure: improving skeletal muscle O2 transport and utilization. Am J Physiol Heart Circ Physiol 2015; 309:H1419-39. [PMID: 26320036 DOI: 10.1152/ajpheart.00469.2015] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/23/2015] [Indexed: 01/13/2023]
Abstract
Chronic heart failure (CHF) impairs critical structural and functional components of the O2 transport pathway resulting in exercise intolerance and, consequently, reduced quality of life. In contrast, exercise training is capable of combating many of the CHF-induced impairments and enhancing the matching between skeletal muscle O2 delivery and utilization (Q̇mO2 and V̇mO2 , respectively). The Q̇mO2 /V̇mO2 ratio determines the microvascular O2 partial pressure (PmvO2 ), which represents the ultimate force driving blood-myocyte O2 flux (see Fig. 1). Improvements in perfusive and diffusive O2 conductances are essential to support faster rates of oxidative phosphorylation (reflected as faster V̇mO2 kinetics during transitions in metabolic demand) and reduce the reliance on anaerobic glycolysis and utilization of finite energy sources (thus lowering the magnitude of the O2 deficit) in trained CHF muscle. These adaptations contribute to attenuated muscle metabolic perturbations (e.g., changes in [PCr], [Cr], [ADP], and pH) and improved physical capacity (i.e., elevated critical power and maximal V̇mO2 ). Preservation of such plasticity in response to exercise training is crucial considering the dominant role of skeletal muscle dysfunction in the pathophysiology and increased morbidity/mortality of the CHF patient. This brief review focuses on the mechanistic bases for improved Q̇mO2 /V̇mO2 matching (and enhanced PmvO2 ) with exercise training in CHF with both preserved and reduced ejection fraction (HFpEF and HFrEF, respectively). Specifically, O2 convection within the skeletal muscle microcirculation, O2 diffusion from the red blood cell to the mitochondria, and muscle metabolic control are particularly susceptive to exercise training adaptations in CHF. Alternatives to traditional whole body endurance exercise training programs such as small muscle mass and inspiratory muscle training, pharmacological treatment (e.g., sildenafil and pentoxifylline), and dietary nitrate supplementation are also presented in light of their therapeutic potential. Adaptations within the skeletal muscle O2 transport and utilization system underlie improvements in physical capacity and quality of life in CHF and thus take center stage in the therapeutic management of these patients.
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Affiliation(s)
- Daniel M Hirai
- Department of Medicine, Queen's University, Kingston, Ontario, Canada; Department of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil; and
| | - Timothy I Musch
- Departments of Anatomy and Physiology and Kinesiology, Kansas State University, Manhattan, Kansas
| | - David C Poole
- Departments of Anatomy and Physiology and Kinesiology, Kansas State University, Manhattan, Kansas
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Oliveira MF, Zelt JTJ, Jones JH, Hirai DM, O'Donnell DE, Verges S, Neder JA. Does impaired O2 delivery during exercise accentuate central and peripheral fatigue in patients with coexistent COPD-CHF? Front Physiol 2015; 5:514. [PMID: 25610401 PMCID: PMC4285731 DOI: 10.3389/fphys.2014.00514] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/15/2014] [Indexed: 02/04/2023] Open
Abstract
Impairment in oxygen (O2) delivery to the central nervous system ("brain") and skeletal locomotor muscle during exercise has been associated with central and peripheral neuromuscular fatigue in healthy humans. From a clinical perspective, impaired tissue O2 transport is a key pathophysiological mechanism shared by cardiopulmonary diseases, such as chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). In addition to arterial hypoxemic conditions in COPD, there is growing evidence that cerebral and muscle blood flow and oxygenation can be reduced during exercise in both isolated COPD and CHF. Compromised cardiac output due to impaired cardiopulmonary function/interactions and blood flow redistribution to the overloaded respiratory muscles (i.e., ↑work of breathing) may underpin these abnormalities. Unfortunately, COPD and CHF coexist in almost a third of elderly patients making these mechanisms potentially more relevant to exercise intolerance. In this context, it remains unknown whether decreased O2 delivery accentuates neuromuscular manifestations of central and peripheral fatigue in coexistent COPD-CHF. If this holds true, it is conceivable that delivering a low-density gas mixture (heliox) through non-invasive positive pressure ventilation could ameliorate cardiopulmonary function/interactions and reduce the work of breathing during exercise in these patients. The major consequence would be increased O2 delivery to the brain and active muscles with potential benefits to exercise capacity (i.e., ↓central and peripheral neuromuscular fatigue, respectively). We therefore hypothesize that patients with coexistent COPD-CHF stop exercising prematurely due to impaired central motor drive and muscle contractility as the cardiorespiratory system fails to deliver sufficient O2 to simultaneously attend the metabolic demands of the brain and the active limb muscles.
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Affiliation(s)
- Mayron F Oliveira
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP) São Paulo, Brazil
| | - Joel T J Zelt
- Laboratory of Clinical Exercise Physiology, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University Kingston, ON, Canada
| | - Joshua H Jones
- Laboratory of Clinical Exercise Physiology, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University Kingston, ON, Canada
| | - Daniel M Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP) São Paulo, Brazil ; Laboratory of Clinical Exercise Physiology, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University Kingston, ON, Canada
| | - Denis E O'Donnell
- Respiratory Investigation Unit, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University Kingston, ON, Canada
| | - Samuel Verges
- HP2 Laboratory, Grenoble Alpes University Grenoble, France
| | - J Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP) São Paulo, Brazil ; Laboratory of Clinical Exercise Physiology, Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University Kingston, ON, Canada
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Medeiros WM, Fernandes MCT, Azevedo DP, de Freitas FFM, Amorim BC, Chiavegato LD, Hirai DM, O'Donnell DE, Neder JA. Oxygen delivery-utilization mismatch in contracting locomotor muscle in COPD: peripheral factors. Am J Physiol Regul Integr Comp Physiol 2014; 308:R105-11. [PMID: 25477423 DOI: 10.1152/ajpregu.00404.2014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Central cardiorespiratory and gas exchange limitations imposed by chronic obstructive pulmonary disease (COPD) impair ambulatory skeletal muscle oxygenation during whole body exercise. This investigation tested the hypothesis that peripheral factors per se contribute to impaired contracting lower limb muscle oxygenation in COPD patients. Submaximal neuromuscular electrical stimulation (NMES; 30, 40, and 50 mA at 50 Hz) of the quadriceps femoris was employed to evaluate contracting skeletal muscle oxygenation while minimizing the influence of COPD-related central cardiorespiratory constraints. Fractional O₂ extraction was estimated by near-infrared spectroscopy (deoxyhemoglobin/myoglobin concentration; deoxy-[Hb/Mb]), and torque output was measured by isokinetic dynamometry in 15 nonhypoxemic patients with moderate-to-severe COPD (SpO2 = 94 ± 2%; FEV₁ = 46.4 ± 10.1%; GOLD II and III) and in 10 age- and gender-matched sedentary controls. COPD patients had lower leg muscle mass than controls (LMM = 8.0 ± 0.7 kg vs. 8.9 ± 1.0 kg, respectively; P < 0.05) and produced relatively lower absolute and LMM-normalized torque across the range of NMES intensities (P < 0.05 for all). Despite producing less torque, COPD patients had similar deoxy-[Hb/Mb] amplitudes at 30 and 40 mA (P > 0.05 for both) and higher deoxy-[Hb/Mb] amplitude at 50 mA (P < 0.05). Further analysis indicated that COPD patients required greater fractional O₂ extraction to produce torque (i.e., ↑Δdeoxy-[Hb/Mb]/torque) relative to controls (P < 0.05 for 40 and 50 mA) and as a function of NMES intensity (P < 0.05 for all). The present data obtained during submaximal NMES of small muscle mass indicate that peripheral abnormalities contribute mechanistically to impaired contracting skeletal muscle oxygenation in nonhypoxemic, moderate-to-severe COPD patients.
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Affiliation(s)
- Wladimir M Medeiros
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mari C T Fernandes
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Diogo P Azevedo
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Flavia F M de Freitas
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Beatriz C Amorim
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luciana D Chiavegato
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel M Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada; and
| | - Denis E O'Donnell
- Respiratory Investigation Unit (RIU), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada
| | - J Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Department of Medicine, School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada; and
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Roseguini BT, Hirai DM, Alencar MC, Ramos RP, Silva BM, Wolosker N, Neder JA, Nery LE. Sildenafil improves skeletal muscle oxygenation during exercise in men with intermittent claudication. Am J Physiol Regul Integr Comp Physiol 2014; 307:R396-404. [DOI: 10.1152/ajpregu.00183.2014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Endothelial dysfunction caused by defective nitric oxide (NO) signaling plays a pivotal role in the pathogenesis of intermittent claudication (IC). In the present study, we evaluated the acute effects of sildenafil, a phosphodiesterase type 5 inhibitor that acts by prolonging NO-mediated cGMP signaling in vascular smooth muscle, on blood pressure (BP), skeletal muscle oxygenation, and walking tolerance in patients with IC. A randomized, double-blind, crossover study was conducted in which 12 men with stable IC received two consecutive doses of 50 mg of sildenafil or matching placebo and underwent a symptom-limited exercise test on the treadmill. Changes in gastrocnemius deoxy-hemoglobin by near-infrared spectroscopy estimated peripheral muscle O2delivery-to-utilization matching. Systolic BP was significantly lower during the sildenafil trial relative to placebo during supine rest (∼15 mmHg), submaximal exercise (∼14 mmHg), and throughout recovery (∼18 mmHg) ( P < 0.05). Diastolic BP was also lower after sildenafil during upright rest (∼6 mmHg) and during recovery from exercise (∼7 mmHg) ( P < 0.05). Gastrocnemius deoxygenation was consistently reduced during submaximal exercise (∼41%) and at peak exercise (∼34%) following sildenafil compared with placebo ( P < 0.05). However, pain-free walking time (placebo: 335 ± 42 s vs. sildenafil: 294 ± 35 s) and maximal walking time (placebo: 701 ± 58 s vs. sildenafil: 716 ± 62 s) did not differ between trials. Acute administration of sildenafil lowers BP and improves skeletal muscle oxygenation during exercise but does not enhance walking tolerance in patients with IC. Whether the beneficial effects of sildenafil on muscle oxygenation can be sustained over time and translated into positive clinical outcomes deserve further consideration in this patient population.
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Affiliation(s)
- Bruno T. Roseguini
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Daniel M. Hirai
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Maria C. Alencar
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Roberta P. Ramos
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Bruno M. Silva
- Department of Physiology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Nelson Wolosker
- Department of Surgery, Division of Vascular Surgery, University of Sao Paulo, Sao Paulo, Brazil; and
| | - J. Alberto Neder
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
- Queen's University and Kingston General Hospital, Laboratory of Clinical Exercise Physiology, Department of Medicine, Kingston, Ontario, Canada
| | - Luiz E. Nery
- Pulmonary Function and Clinical Exercise Physiology Unit, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
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Holdsworth CT, Copp SW, Hirai DM, Ferguson SK, Sims GE, Hageman KS, Poole DC, Musch TI. Blockade Of ATP-sensitive Potassium Channels Impairs Vascular Control In Exercising Rats. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000493197.21101.b5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ferguson SK, Hirai DM, Copp SW, Holdsworth CT, Allen JD, Jones AM, Musch TI, Poole DC. Dose dependent effects of nitrate supplementation on cardiovascular control and microvascular oxygenation dynamics in healthy rats. Nitric Oxide 2014; 39:51-8. [PMID: 24769046 DOI: 10.1016/j.niox.2014.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/11/2014] [Accepted: 04/13/2014] [Indexed: 01/21/2023]
Abstract
High dose nitrate (NO3(-)) supplementation via beetroot juice (BR, 1 mmol/kg/day) lowers mean arterial blood pressure (MAP) and improves skeletal muscle blood flow and O2 delivery/utilization matching thereby raising microvascular O2 pressure (PO2mv). We tested the hypothesis that a low dose of NO3(-) supplementation, consistent with a diet containing NO3(-) rich vegetables (BRLD, 0.3 mmol/kg/day), would be sufficient to cause these effects. Male Sprague-Dawley rats were administered a low dose of NO3(-) (0.3 mmol/kg/day; n=12), a high dose (1 mmol/kg/day; BRHD, n=6) or tap water (control, n=10) for 5 days. MAP, heart rate (HR), blood flow (radiolabeled microspheres) and vascular conductance (VC) were measured during submaximal treadmill exercise (20 m/min, 5% grade, equivalent to ~60% of maximal O2 uptake). Subsequently, PO2mv (phosphorescence quenching) was measured at rest and during 180 s of electrically-induced twitch contractions (1 Hz, ~6 V) of the surgically-exposed spinotrapezius muscle. BRLD and BRHD lowered resting (control: 139 ± 4, BRLD: 124 ± 5, BRHD: 128 ± 9 mmHg, P<0.05, BRLD vs. control) and exercising (control: 138 ± 3, BRLD: 126 ± 4, BRHD: 125 ± 5 mmHg, P<0.05) MAP to a similar extent. For BRLD this effect occurred in the absence of altered exercising hindlimb muscle(s) blood flow or spinotrapezius PO2mv (rest and across the transient response at the onset of contractions, all P>0.05), each of which increased significantly for the BRHD condition (all P<0.05). Whereas BRHD slowed the PO2mv kinetics significantly (i.e., >mean response time, MRT; control: 16.6 ± 2.1, BRHD: 23.3 ± 4.7s) following the onset of contractions compared to control, in the BRLD group this effect did not reach statistical significance (BRLD: 20.9 ± 1.9s, P=0.14). These data demonstrate that while low dose NO3(-) supplementation lowers MAP during exercise it does so in the absence of augmented muscle blood flow, VC and PO2mv; all of which are elevated at a higher dose. Thus, in healthy animals, a high dose of NO3(-) supplementation seems necessary to elicit significant changes in exercising skeletal muscle O2 delivery/utilization.
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Affiliation(s)
- Scott K Ferguson
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA.
| | - Daniel M Hirai
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Steven W Copp
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Clark T Holdsworth
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA
| | - Jason D Allen
- Department of Community and Family Medicine, Department of Medicine, Duke University, Durham, NC 27710, USA
| | - Andrew M Jones
- Sport and Health Sciences, University of Exeter, St. Luke's Campus, Exeter EX12LU, UK
| | - Timothy I Musch
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA; Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
| | - David C Poole
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS 66506, USA; Department of Kinesiology, Kansas State University, Manhattan, KS 66506, USA
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