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Romero-Carrete CJ, Alquézar-Arbé A, Herrera Mateo S, Llorens P, Gil V, Curtelin D, Jacob J, Herrero P, Lopez Díez MP, Llauger L, López-Grima ML, Gil C, Tost J, Agüera Urbano C, Espinosa B, Campos-Meneses M, Fernandez G, Torres A, Escoda R, Martín E, Garrido JM, Lucas-Imbernón FJ, Rodríguez-Adrada E, Torres Garate R, Andueza JA, Peacock F, Miró Ò. Timing of previous heart failure hospitalization as a prognostic factor for emergency department heart failure patients. Intern Emerg Med 2024:10.1007/s11739-023-03505-3. [PMID: 38466555 DOI: 10.1007/s11739-023-03505-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/06/2023] [Indexed: 03/13/2024]
Abstract
To investigate whether the timing of a previous hospital admission for acute heart failure (AHF) is a prognostic factor for AHF patients revisiting the emergency department (ED) in the subsequent 12-month follow-up. All ED AHF patients enrolled in the previously described EAHFE registry were stratified by the presence or absence of an AHF hospitalization admission in the prior 12 months. The primary outcome was 12-month all-cause mortality post ED visit. Secondary end points were hospital admission, prolonged hospitalization (> 7 days), mortality during hospitalization and a 90-day post-discharge adverse composite event (ACE) rate, defined as ED revisits due to AHF, hospitalizations due to AHF, or all-cause mortality. Outcomes were adjusted for baseline and AHF episode characteristics.Of 5,757 patients included, the median age was 84 years (IQR 77-88); 57% were women, and 3,759 (65.3%) had an AHF hospitalization in the previous 12 months. The 12-month mortality was 37% (41.7% vs. 28.3% p < 0.001), hospital admission was 76.1% (78.8% vs. 71.1% p < 0.001) ACE was 60.2% (65.1% vs. 50.5% p < 0.001). In the adjusted analysis, patients with AHF hospitalization in the prior 12 months had a higher mortality (HR = 1.41; 95% CI 1.27-1.56), 90-day ACE rate (HR = 1.45: 95% CI 1.32-1.59), and more hospital admissions (OR = 1.32; 95% CI 1.16-1.51), with shorter times since the previous hospitalization being related to the outcomes analyzed. One-year mortality, adverse events at 90 days, and readmission rates are increased in ED AHF patients previously admitted within the last 12 months.
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Affiliation(s)
- C J Romero-Carrete
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain.
| | - A Alquézar-Arbé
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain
| | - S Herrera Mateo
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain
| | - Pere Llorens
- Emergency Department, Short-Stay Unit and Home Hospitalization, Hospital Doctor Balmis, Alicante, Spain
| | - Víctor Gil
- Emergency Department Hospital Clinic, Institut d'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
| | - David Curtelin
- Emergency Department Hospital Clinic, Institut d'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | - Pablo Herrero
- Emergency Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Lluís Llauger
- Emergency Department, Hospital Universitari de Vic, Barcelona, Catalonia, Spain
| | | | - Cristina Gil
- Emergency Department, Hospital de Salamanca, Salamanca, Spain
| | - Josep Tost
- Emergency Department, Hospital de Terrassa, Barcelona, Catalonia, Spain
| | | | - Begoña Espinosa
- Emergency Department, Short-Stay Unit and Home Hospitalization, Hospital Doctor Balmis, Alicante, Spain
| | - M Campos-Meneses
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain
| | - G Fernandez
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain
| | - A Torres
- Emergency Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Catalonia, Spain
| | - Rosa Escoda
- Emergency Department Hospital Clinic, Institut d'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
| | - Enrique Martín
- Emergency Department, Hospital Sant Pau I Santa Tecla, Tarragona, Catalonia, Spain
| | | | | | | | | | - Juan Antonio Andueza
- Emergency Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Frank Peacock
- Emergency Department, Baylor College of Medicine, Houston, TX, USA
| | - Òscar Miró
- Emergency Department Hospital Clinic, Institut d'Investigació Biomèdica August Pi I Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
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2
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Pedrianes-Martin PB, Martin-Rincon M, Morales-Alamo D, Perez-Suarez I, Perez-Valera M, Galvan-Alvarez V, Curtelin D, de Pablos-Velasco P, Calbet JAL. Treatment of hypertension with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and resting metabolic rate: A cross-sectional study. J Clin Hypertens (Greenwich) 2021; 23:2106-2114. [PMID: 34846787 PMCID: PMC8696230 DOI: 10.1111/jch.14392] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 12/26/2022]
Abstract
Hypertension in obese and overweight patients is associated with an elevated resting metabolic rate (RMR). The aim of this study was to determine whether RMR is reduced in hypertensive patients treated with angiotensin‐converting enzyme inhibitors (ACEI) and blockers (ARB). The RMR was determined by indirect calorimetry in 174 volunteers; 93 (46.5 %) were hypertensive, of which 16 men and 13 women were treated with ACEI/ARB, while 30 men and 19 women with untreated hypertension served as a control group. Treated and untreated hypertensives had similar age, BMI, physical activity, and cardiorespiratory fitness. The RMR normalized to the lean body mass (LBM) was 15% higher in the untreated than ACEI/ARB‐treated hypertensive women (p = .003). After accounting for LBM, whole‐body fat mass, age, the double product (heart rate x systolic blood pressure), and the distance walked per day, the RMR was 2.9% lower in the patients taking ACEI/ARB (p = .26, treatment x sex interaction p = .005). LBM, age, and the double product explained 78% of the variability in RMR (R2 = 0.78, p < .001). In contrast, fat mass, the distance walked per day, and total T4 or TSH did not add predictive power to the model. Compared to men, a greater RMR per kg of LBM was observed in untreated hypertensive overweight and obese women, while this sex difference was not observed in patients treated with ACEI or ARBs. In conclusion, our results indicate that elevated RMR per kg of LBM may be normalized by antagonizing the renin‐angiotensin system.
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Affiliation(s)
- Pablo B Pedrianes-Martin
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Morales-Alamo
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ismael Perez-Suarez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Mario Perez-Valera
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Victor Galvan-Alvarez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Pedro de Pablos-Velasco
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Jose A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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3
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Perez-Valera M, Martinez-Canton M, Gallego-Selles A, Galván-Alvarez V, Gelabert-Rebato M, Morales-Alamo D, Santana A, Martin-Rodriguez S, Ponce-Gonzalez JG, Larsen S, Losa-Reyna J, Perez-Suarez I, Dorado C, Curtelin D, Gonzalez-Henriquez JJ, Boushel R, Hallen J, de Pablos Velasco P, Freixinet-Gilart J, Holmberg HC, Helge JW, Martin-Rincon M, Calbet JAL. Angiotensin-Converting Enzyme 2 (SARS-CoV-2 receptor) expression in human skeletal muscle. Scand J Med Sci Sports 2021; 31:2249-2258. [PMID: 34551157 PMCID: PMC8662278 DOI: 10.1111/sms.14061] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022]
Abstract
The study aimed to determine the levels of skeletal muscle angiotensin-converting enzyme 2 (ACE2, the SARS-CoV-2 receptor) protein expression in men and women and assess whether ACE2 expression in skeletal muscle is associated with cardiorespiratory fitness and adiposity. The level of ACE2 in vastus lateralis muscle biopsies collected in previous studies from 170 men (age: 19-65 years, weight: 56-137 kg, BMI: 23-44) and 69 women (age: 18-55 years, weight: 41-126 kg, BMI: 22-39) was analyzed in duplicate by western blot. VO2 max was determined by ergospirometry and body composition by DXA. ACE2 protein expression was 1.8-fold higher in women than men (p = 0.001, n = 239). This sex difference disappeared after accounting for the percentage of body fat (fat %), VO2 max per kg of legs lean mass (VO2 max-LLM) and age (p = 0.47). Multiple regression analysis showed that the fat % (β = 0.47) is the main predictor of the variability in ACE2 protein expression in skeletal muscle, explaining 5.2% of the variance. VO2 max-LLM had also predictive value (β = 0.09). There was a significant fat % by VO2 max-LLM interaction, such that for subjects with low fat %, VO2 max-LLM was positively associated with ACE2 expression while as fat % increased the slope of the positive association between VO2 max-LLM and ACE2 was reduced. In conclusion, women express higher amounts of ACE2 in their skeletal muscles than men. This sexual dimorphism is mainly explained by sex differences in fat % and cardiorespiratory fitness. The percentage of body fat is the main predictor of the variability in ACE2 protein expression in human skeletal muscle.
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Affiliation(s)
- Mario Perez-Valera
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Miriam Martinez-Canton
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Angel Gallego-Selles
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Victor Galván-Alvarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Miriam Gelabert-Rebato
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Alfredo Santana
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria, Clinical Genetics Unit, Las Palmas de Gran Canaria, Spain
| | - Saul Martin-Rodriguez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | - Steen Larsen
- Center of Healthy Ageing, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Jose Losa-Reyna
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ismael Perez-Suarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Cecilia Dorado
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Juan Jose Gonzalez-Henriquez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Robert Boushel
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jostein Hallen
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Pedro de Pablos Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Jorge Freixinet-Gilart
- Department of Thoracic Surgery, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Hans-Christer Holmberg
- Department of Physiology and Pharmacology, Biomedicum C5, Karolinska Institute, Stockholm, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Jorn W Helge
- Center of Healthy Ageing, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marcos Martin-Rincon
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A L Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada.,Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
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4
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García-Martínez A, López-Barbeito B, Coll-Vinent B, Placer A, Font C, Rosa Vargas C, Sánchez C, Piñango D, Gómez-Angelats E, Curtelin D, Salgado E, Aya F, Martínez-Nadal G, Alonso JR, García-Gozalbes J, Fresco L, Galicia M, Perea M, Carbó M, Iniesta N, Escoda O, Perelló R, Cuerpo S, Flores V, Alemany X, Miró Ò, Ortega Romero MDM. Mortality in patients treated for COVID-19 in the emergency department of a tertiary care hospital during the first phase of the pandemic: Derivation of a risk model for emergency departments. Emergencias 2021; 33:273-281. [PMID: 34251140] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To develop a risk model to predict 30-day mortality after emergency department treatment for COVID-19. MATERIAL AND METHODS Observational retrospective cohort study including 2511 patients with COVID-19 who came to our emergency department between March 1 and April 30, 2020. We analyzed variables with Kaplan Meier survival and Cox regression analyses. RESULTS All-cause mortality was 8% at 30 days. Independent variables associated with higher risk of mortality were age over 50 years, a Barthel index score less than 90, altered mental status, the ratio of arterial oxygen saturation to the fraction of inspired oxygen (SaO2/FIO2), abnormal lung sounds, platelet concentration less than 100 000/mm3, a C-reactive protein concentration of 5 mg/dL or higher, and a glomerular filtration rate less than 45 mL/min. Each independent predictor was assigned 1 point in the score except age, which was assigned 2 points. Risk was distributed in 3 levels: low risk (score of 4 points or less), intermediate risk (5 to 6 points), and high risk (7 points or above). Thirty-day risk of mortality was 1.7% for patients who scored in the low-risk category, 28.2% for patients with an intermediate risk score, and 67.3% for those with a high risk score. CONCLUSION This mortality risk stratification tool for patients with COVID-19 could be useful for managing the course of disease and assigning health care resources in the emergency department.
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Affiliation(s)
- Ana García-Martínez
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | | | - Blanca Coll-Vinent
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Arrate Placer
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Carme Font
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Carmen Rosa Vargas
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Carolina Sánchez
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Daniela Piñango
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | | | - David Curtelin
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Emilio Salgado
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Francisco Aya
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Gemma Martínez-Nadal
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - José Ramón Alonso
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Julia García-Gozalbes
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Leticia Fresco
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Miguel Galicia
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Milagrosa Perea
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Miriam Carbó
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Nerea Iniesta
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Ona Escoda
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Rafael Perelló
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Sandra Cuerpo
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Vanesa Flores
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Xavier Alemany
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
| | - Òscar Miró
- Área de Urgencias, Hospital Clinic, Barcelona, España. Universitat de Barcelona, España
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5
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Pedrianes-Martin PB, Perez-Valera M, Morales-Alamo D, Martin-Rincon M, Perez-Suarez I, Serrano-Sanchez JA, Gonzalez-Henriquez JJ, Galvan-Alvarez V, Acosta C, Curtelin D, de Pablos-Velasco P, Calbet JAL. Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms. Scand J Med Sci Sports 2021; 31:1461-1470. [PMID: 33749940 DOI: 10.1111/sms.13955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 12/17/2022]
Abstract
The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2 max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20-68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p = .29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d-1 , p = .044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p < .001). The observed differences in absolute RMR were non-significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d-1 , CI: 1656-1750; and 1660 kcal d-1 , CI: 1611-1710 kcal d-1 , for the hypertensive and normotensive groups, respectively, p = .19, HTA × sex interaction p = .37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max . In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.
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Affiliation(s)
- Pablo B Pedrianes-Martin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Perez-Valera
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ismael Perez-Suarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A Serrano-Sanchez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Juan Jose Gonzalez-Henriquez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Victor Galvan-Alvarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Carmen Acosta
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Pedro de Pablos-Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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6
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López-Barbeito B, García-Martínez A, Coll-Vinent B, Placer A, Font C, Vargas CR, Sánchez C, Piñango D, Gómez-Angelats E, Curtelin D, Salgado E, Aya F, Martínez-Nada G, Alonso JR, García-Gozalbes J, Fresco L, Galicia M, Perea M, Carbó M, Iniesta N, Escoda O, Perelló R, Cuerpo S, Flores V, Alemany X, Miró Ó, Ortega MDM. Factors associated with revisits by patients with SARS-CoV-2 infection discharged from a hospital emergency department. Emergencias 2020; 32:386-394. [PMID: 33275358] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To analyze emergency department (ED) revisits from patients discharged with possible coronavirus disease 2019 (COVID-19). MATERIAL AND METHODS Retrospective observational study of consecutive patients who came to the ED over a period of 2 months and were diagnosed with possible COVID-19. We analyzed clinical and epidemiologic variables, treatments given in the ED, discharge destination, need to revisit, and reasons for revisits. Patients who did or did not revisit were compared, and factors associated with revisits were explored. RESULTS The 2378 patients included had a mean age of 57 years; 49% were women. Of the 925 patients (39%) discharged, 170 (20.5%) revisited the ED, mainly for persistence or progression of symptoms. Sixty-six (38.8%) were hospitalized. Odds ratios (ORs) for the following factors showed an association with revisits: history of rheumatologic disease (OR, 2.97; 95% CI, 1.10-7.99; P = .03), digestive symptoms (OR, 1.73; 95% CI, 1.14-2.63; P = .01), respiratory rate over 20 breaths per minute (OR, 1.03; 95% CI, 1.0-1.06; P = .05), and corticosteroid therapy given in the ED (OR, 7.78; 95% CI, 1.77-14.21, P = .01). Factors associated with hospitalization after revisits were age over 48 years (OR, 2.57; 95% CI, 1 42-4.67; P = .002) and fever (OR, 4.73; 95% CI, 1.99-11.27; P = .001). CONCLUSION Patients under the age of 48 years without comorbidity and with normal vitals can be discharged from the ED without fear of complications. A history of rheumatologic disease, fever, digestive symptoms, and a respiratory rate over 20 breaths per minute, or a need for corticosteroid therapy were independently associated with revisits. Fever and age over 48 years were associated with a need for hospitalization.
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Affiliation(s)
| | | | | | - Arrate Placer
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Carme Font
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | | | - Carolina Sánchez
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Daniela Piñango
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | | | - David Curtelin
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Emilio Salgado
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Francisco Aya
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | | | - José Ramón Alonso
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | | | - Leticia Fresco
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Miguel Galicia
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Milagrosa Perea
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Miriam Carbó
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Nerea Iniesta
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Ona Escoda
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Rafael Perelló
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Sandra Cuerpo
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Vanesa Flores
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Xavier Alemany
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Óscar Miró
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
| | - Mª Del Mar Ortega
- Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España
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7
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Martin-Rincon M, Perez-Valera M, Morales-Alamo D, Perez-Suarez I, Dorado C, Gonzalez-Henriquez JJ, Juan-Habib JW, Quintana-Garcia C, Galvan-Alvarez V, Pedrianes-Martin PB, Acosta C, Curtelin D, Calbet JA, de Pablos-Velasco P. Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate. J Clin Med 2020; 9:jcm9010203. [PMID: 31940840 PMCID: PMC7020055 DOI: 10.3390/jcm9010203] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/27/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20-68 years old) with overweight or obesity (BMI 27-45 kg m-2). All volunteers were residents in Gran Canaria (monthly temperatures: 18-24 °C). REE was lower than predicted by most equations in our population. Age and BMI were similar in both sexes. In the whole population, the equations of Mifflin, Henry and Rees, Livingston and Owen, had similar levels of accuracy (non-significant bias of 0.7%, 1.1%, 0.6%, and -2.2%, respectively). The best equation to predict resting energy expenditure in overweight and moderately obese men and women living in a temperate climate all year round is the Mifflin equation. In men, the equations by Henry and Rees, Livingston, and by Owen had predictive accuracies comparable to that of Mifflin. The body composition-based equation of Johnston was slightly more accurate than Mifflin's in men. In women, none of the body composition-based equations outperformed Mifflin's.
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Affiliation(s)
- Marcos Martin-Rincon
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Mario Perez-Valera
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - David Morales-Alamo
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Ismael Perez-Suarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Cecilia Dorado
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Juan J. Gonzalez-Henriquez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Mathematics, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Julian W. Juan-Habib
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
| | - Cristian Quintana-Garcia
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
| | - Victor Galvan-Alvarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Pablo B. Pedrianes-Martin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Carmen Acosta
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Jose A.L. Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Physical Performance, The Norwegian School of Sport Sciences, Postboks, 4014 Ulleval Stadion, 0806 Oslo, Norway
- Correspondence: (J.A.L.C.); (P.d.P.-V.)
| | - Pedro de Pablos-Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
- Correspondence: (J.A.L.C.); (P.d.P.-V.)
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8
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Martin-Rincon M, González-Henríquez JJ, Losa-Reyna J, Perez-Suarez I, Ponce-González JG, de La Calle-Herrero J, Perez-Valera M, Pérez-López A, Curtelin D, Cherouveim ED, Morales-Alamo D, Calbet JAL. Impact of data averaging strategies on V̇O 2max assessment: Mathematical modeling and reliability. Scand J Med Sci Sports 2019; 29:1473-1488. [PMID: 31173407 DOI: 10.1111/sms.13495] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 10/17/2018] [Revised: 05/27/2019] [Accepted: 06/04/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND No consensus exists on how to average data to optimize V ˙ O2max assessment. Although the V ˙ O2max value is reduced with larger averaging blocks, no mathematical procedure is available to account for the effect of the length of the averaging block on V ˙ O2max. AIMS: To determine the effect that the number of breaths or seconds included in the averaging block has on the V ˙ O2max value and its reproducibility and to develop correction equations to standardize V ˙ O2max values obtained with different averaging strategies. METHODS Eighty-four subjects performed duplicate incremental tests to exhaustion (IE) in the cycle ergometer and/or treadmill using two metabolic carts (Vyntus and Vmax N29). Rolling breath averages and fixed time averages were calculated from breath-by-breath data from 6 to 60 breaths or seconds. RESULTS V ˙ O2max decayed from 6 to 60 breath averages by 10% in low fit ( V ˙ O2max < 40 mL kg-1 min-1 ) and 6.7% in trained subjects. The V ˙ O2max averaged from a similar number of breaths or seconds was highly concordant (CCC > 0.97). There was a linear-log relationship between the number of breaths or seconds in the averaging block and V ˙ O2max (R2 > 0.99, P < 0.001), and specific equations were developed to standardize V ˙ O2max values to a fixed number of breaths or seconds. Reproducibility was higher in trained than low-fit subjects and not influenced by the averaging strategy, exercise mode, maximal respiratory rate, or IE protocol. CONCLUSIONS The V ˙ O2max decreases following a linear-log function with the number of breaths or seconds included in the averaging block and can be corrected with specific equations as those developed here.
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Affiliation(s)
- Marcos Martin-Rincon
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Juan José González-Henríquez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Losa-Reyna
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Ismael Perez-Suarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | | | - Jaime de La Calle-Herrero
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mario Perez-Valera
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Alberto Pérez-López
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Evgenia D Cherouveim
- Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - David Morales-Alamo
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Jose A L Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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9
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Gelabert-Rebato M, Wiebe JC, Martin-Rincon M, Gericke N, Perez-Valera M, Curtelin D, Galvan-Alvarez V, Lopez-Rios L, Morales-Alamo D, Calbet JAL. Mangifera indica L. Leaf Extract in Combination With Luteolin or Quercetin Enhances VO 2peak and Peak Power Output, and Preserves Skeletal Muscle Function During Ischemia-Reperfusion in Humans. Front Physiol 2018; 9:740. [PMID: 29937737 PMCID: PMC6002676 DOI: 10.3389/fphys.2018.00740] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 02/15/2018] [Accepted: 05/28/2018] [Indexed: 12/15/2022] Open
Abstract
It remains unknown whether polyphenols such as luteolin (Lut), mangiferin and quercetin (Q) have ergogenic effects during repeated all-out prolonged sprints. Here we tested the effect of Mangifera indica L. leaf extract (MLE) rich in mangiferin (Zynamite®) administered with either quercetin (Q) and tiger nut extract (TNE), or with luteolin (Lut) on sprint performance and recovery from ischemia-reperfusion. Thirty young volunteers were randomly assigned to three treatments 48 h before exercise. Treatment A: placebo (500 mg of maltodextrin/day); B: 140 mg of MLE (60% mangiferin) and 50 mg of Lut/day; and C: 140 mg of MLE, 600 mg of Q and 350 mg of TNE/day. After warm-up, subjects performed two 30 s Wingate tests and a 60 s all-out sprint interspaced by 4 min recovery periods. At the end of the 60 s sprint the circulation of both legs was instantaneously occluded for 20 s. Then, the circulation was re-opened and a 15 s sprint performed, followed by 10 s recovery with open circulation, and another 15 s final sprint. MLE supplements enhanced peak (Wpeak) and mean (Wmean) power output by 5.0-7.0% (P < 0.01). After ischemia, MLE+Q+TNE increased Wpeak by 19.4 and 10.2% compared with the placebo (P < 0.001) and MLE+Lut (P < 0.05), respectively. MLE+Q+TNE increased Wmean post-ischemia by 11.2 and 6.7% compared with the placebo (P < 0.001) and MLE+Lut (P = 0.012). Mean VO2 during the sprints was unchanged, suggesting increased efficiency or recruitment of the anaerobic capacity after MLE ingestion. In women, peak VO2 during the repeated sprints was 5.8% greater after the administration of MLE, coinciding with better brain oxygenation. MLE attenuated the metaboreflex hyperpneic response post-ischemia, may have improved O2 extraction by the Vastus Lateralis (MLE+Q+TNE vs. placebo, P = 0.056), and reduced pain during ischemia (P = 0.068). Blood lactate, acid-base balance, and plasma electrolytes responses were not altered by the supplements. In conclusion, a MLE extract rich in mangiferin combined with either quercetin and tiger nut extract or luteolin exerts a remarkable ergogenic effect, increasing muscle power in fatigued subjects and enhancing peak VO2 and brain oxygenation in women during prolonged sprinting. Importantly, the combination of MLE+Q+TNE improves skeletal muscle contractile function during ischemia/reperfusion.
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Affiliation(s)
- Miriam Gelabert-Rebato
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Nektium Pharma, Las Palmas de Gran Canaria, Spain
| | | | - Marcos Martin-Rincon
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | - Mario Perez-Valera
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Victor Galvan-Alvarez
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Laura Lopez-Rios
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A. L. Calbet
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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10
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Curtelin D, Morales-Alamo D, Torres-Peralta R, Rasmussen P, Martin-Rincon M, Perez-Valera M, Siebenmann C, Pérez-Suárez I, Cherouveim E, Sheel AW, Lundby C, Calbet JA. Cerebral blood flow, frontal lobe oxygenation and intra-arterial blood pressure during sprint exercise in normoxia and severe acute hypoxia in humans. J Cereb Blood Flow Metab 2018; 38:136-150. [PMID: 28186430 PMCID: PMC5757439 DOI: 10.1177/0271678x17691986] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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: 12/30/2022]
Abstract
Cerebral blood flow (CBF) is regulated to secure brain O2 delivery while simultaneously avoiding hyperperfusion; however, both requisites may conflict during sprint exercise. To determine whether brain O2 delivery or CBF is prioritized, young men performed sprint exercise in normoxia and hypoxia (PIO2 = 73 mmHg). During the sprints, cardiac output increased to ∼22 L min-1, mean arterial pressure to ∼131 mmHg and peak systolic blood pressure ranged between 200 and 304 mmHg. Middle-cerebral artery velocity (MCAv) increased to peak values (∼16%) after 7.5 s and decreased to pre-exercise values towards the end of the sprint. When the sprints in normoxia were preceded by a reduced PETCO2, CBF and frontal lobe oxygenation decreased in parallel ( r = 0.93, P < 0.01). In hypoxia, MCAv was increased by 25%, due to a 26% greater vascular conductance, despite 4-6 mmHg lower PaCO2 in hypoxia than normoxia. This vasodilation fully accounted for the 22 % lower CaO2 in hypoxia, leading to a similar brain O2 delivery during the sprints regardless of PIO2. In conclusion, when a conflict exists between preserving brain O2 delivery or restraining CBF to avoid potential damage by an elevated perfusion pressure, the priority is given to brain O2 delivery.
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Affiliation(s)
- David Curtelin
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,2 Emergency Medicine Department, Insular Universitary Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Rafael Torres-Peralta
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Peter Rasmussen
- 4 Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zürich, Switzerland
| | - Marcos Martin-Rincon
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mario Perez-Valera
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Christoph Siebenmann
- 4 Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zürich, Switzerland
| | - Ismael Pérez-Suárez
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Evgenia Cherouveim
- 5 Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - A William Sheel
- 6 School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Carsten Lundby
- 4 Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zürich, Switzerland
| | - José Al Calbet
- 1 Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.,3 Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Morales-Alamo D, Losa-Reyna J, Torres-Peralta R, Martin-Rincon M, Perez-Valera M, Curtelin D, Ponce-González JG, Santana A, Calbet JAL. What limits performance during whole-body incremental exercise to exhaustion in humans? J Physiol 2015; 593:4631-48. [PMID: 26250346 DOI: 10.1113/jp270487] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/29/2015] [Indexed: 12/13/2022] Open
Abstract
To determine the mechanisms causing task failure during incremental exercise to exhaustion (IE), sprint performance (10 s all-out isokinetic) and muscle metabolites were measured before (control) and immediately after IE in normoxia (P(IO2) 143 mmHg) and hypoxia (P(IO2): 73 mmHg) in 22 men (22 ± 3 years). After IE, subjects recovered for either 10 or 60 s, with open circulation or bilateral leg occlusion (300 mmHg) in random order. This was followed by a 10 s sprint with open circulation. Post-IE peak power output (W(peak)) was higher than the power output reached at exhaustion during IE (P < 0.05). After 10 and 60 s recovery in normoxia, W(peak) was reduced by 38 ± 9 and 22 ± 10% without occlusion, and 61 ± 8 and 47 ± 10% with occlusion (P < 0.05). Following 10 s occlusion, W(peak) was 20% higher in hypoxia than normoxia (P < 0.05), despite similar muscle lactate accumulation ([La]) and phosphocreatine and ATP reduction. Sprint performance and anaerobic ATP resynthesis were greater after 60 s compared with 10 s occlusions, despite the higher [La] and [H(+)] after 60 s compared with 10 s occlusion recovery (P < 0.05). The mean rate of ATP turnover during the 60 s occlusion was 0.180 ± 0.133 mmol (kg wet wt)(-1) s(-1), i.e. equivalent to 32% of leg peak O2 uptake (the energy expended by the ion pumps). A greater degree of recovery is achieved, however, without occlusion. In conclusion, during incremental exercise task failure is not due to metabolite accumulation or lack of energy resources. Anaerobic metabolism, despite the accumulation of lactate and H(+), facilitates early recovery even in anoxia. This points to central mechanisms as the principal determinants of task failure both in normoxia and hypoxia, with lower peripheral contribution in hypoxia.
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Affiliation(s)
- David Morales-Alamo
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - José Losa-Reyna
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Rafael Torres-Peralta
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Sports and Informatics, Pablo de Olavide University, Seville, Spain
| | - Mario Perez-Valera
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Emergency Medicine Department, Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria, Avenida Marítima del Sur, s/n, 35016, Las Palmas de Gran Canaria, Spain
| | - Jesús Gustavo Ponce-González
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain
| | - Alfredo Santana
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Clinical Genetics Unit, Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria, Avenida Marítima, del Sur, s/n, 35016, Las Palmas de Gran Canaria, Spain
| | - José A L Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira s/n, 35017, Las Palmas de Gran Canaria, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
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Calbet JAL, Mortensen SP, Munch GDW, Curtelin D, Boushel R. Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans. Scand J Med Sci Sports 2015; 26:518-27. [PMID: 25919489 DOI: 10.1111/sms.12473] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 12/29/2022]
Abstract
To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans.
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Affiliation(s)
- J A L Calbet
- Department of Physical Education, Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - S P Mortensen
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - G D W Munch
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - D Curtelin
- Department of Physical Education, Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Emergency Medicine Department, Insular Universitary Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Boushel
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Åstrand Laboratory, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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