1
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Lundstrom CJ, Biltz GR, Uithoven KE, Snyder EM. Effects of marathon training on heart rate variability during submaximal running: a comparison of analysis techniques. Sport Sci Health 2023. [DOI: 10.1007/s11332-023-01062-y] [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: 04/05/2023]
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2
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Polverino F, Stern DA, Snyder EM, Wheatley-Guy C, Bhatt SP, Martinez FD, Guerra S, Morgan WJ. Lower respiratory illnesses in childhood are associated with the presence of air trapping in early adulthood. Respir Med 2023; 206:107062. [PMID: 36508986 PMCID: PMC10389168 DOI: 10.1016/j.rmed.2022.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022]
Abstract
Several factors occurring in early life, including lower respiratory tract illnesses (LRIs), are involved in determining lung structure and function in adulthood, but the effects of these factors on lung development remain largely unknown. Hereby, we evaluated the parameters from computed tomography (CT) scans performed at the age of 26 years in 39 subjects from the birth cohort of the Tucson Children's Respiratory Study (TCRS) in order to determine the relationship between early childhood factors and lung structural changes in young adult life. We found that participants with LRIs in childhood had increased air trapping at the age of 26 suggesting an association between childhood infections and lung development.
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Affiliation(s)
- Francesca Polverino
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA; Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - Debra A Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | | | | | - Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, 35924, USA
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
| | - Wayne J Morgan
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, 85719, USA
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3
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Snyder EM, Sprissler R, Olson TP. Data at 36 months for the Symplicity SPYRAL HTN-ON MED pilot. Lancet 2022; 400:491-492. [PMID: 35964607 DOI: 10.1016/s0140-6736(22)01471-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022]
Affiliation(s)
| | - Ryan Sprissler
- Geneticure, Rochester, MN, 55902, USA; Department of Medicine, University of Arizona Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Thomas P Olson
- Geneticure, Rochester, MN, 55902, USA; Disivion of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
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4
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Abstract
ConspectusContrast agents are used in approximately 40% of all magnetic resonance imaging (MRI) procedures to improve the quality of the images based on the distribution and dynamic clearance of the agent. To date, all clinically approved contrast agents are Gd(III) coordination complexes that serve to shorten the longitudinal (T1) and transverse (T2) proton relaxation times of water. Recent interest in replacing Gd with biologically relevant metal ions such as Mn or Fe has led to increased interest in the aqueous coordination chemistry of their complexes. In this Account, we focus on high-spin Fe(III) complexes that have been recently reported as MRI contrast agents or probes in our laboratory.The highly Lewis acidic Fe(III) center has distinct coordination chemistry in aqueous solutions, facilitating alternative strategies in the design of MRI probes. To illustrate this, we describe different classes of Fe(III) MRI probes with a focus on macrocyclic complexes and multinuclear complexes such as self-assembled metal organic polyhedra (MOP). Our initial efforts focused on macrocyclic complexes of Fe(III) in order to tune spin and oxidation states with the goal of stabilizing high-spin Fe(III) in reducing biological environments. Our probes feature six-coordinate Fe(III) complexes of 1,4,7-triazacyclononane with hydroxypropyl, phosphonate, or carboxylate pendant groups to produce Fe(III) complexes that shorten proton T1 times predominantly from second-sphere or outer-sphere interactions at neutral pH. Analogues with pentadentate macrocyclic ligands have an inner-sphere water that does not exchange rapidly on the NMR time scale, yet these complexes are effective relaxation agents. Fe(III) macrocyclic complexes in this class can be modified to modulate their biodistribution and pharmacokinetic clearance in mice. The goal of these studies is for the Fe(III) agents to clear as extracellular fluid agents and produce profiles similar to those of Gd agents. Finally, studies of multimeric Fe(III) complexes are of interest to produce probes that give large proton relaxivity. In this approach the two Fe(III) centers are connected through aryl linkers as demonstrated for several macrocyclic complexes. Even more tightly connected Fe(III) centers are produced in a Fe(III) self-assembled cage with relaxivity of 21 mM-1 s-1 at 4.7 T, 37 °C in the presence of serum albumin to which it is tightly bound. This cage enhances contrast of the vasculature as a blood pool agent and accumulates in tumors. Finally, we present our perspectives on the further development of Fe(III) complexes for various applications in MRI.
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Affiliation(s)
- Elizabeth A. Kras
- Department of Chemistry, University at Buffalo, the State University of New York, Amherst, New York 14260, United States
| | - Eric M. Snyder
- Department of Chemistry, University at Buffalo, the State University of New York, Amherst, New York 14260, United States
| | - Gregory E. Sokolow
- Department of Chemistry, University at Buffalo, the State University of New York, Amherst, New York 14260, United States
| | - Janet R. Morrow
- Department of Chemistry, University at Buffalo, the State University of New York, Amherst, New York 14260, United States
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5
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Guerra S, Lombardi E, Stern DA, Sherrill DL, Gilbertson-Dahdal D, Wheatley-Guy CM, Snyder EM, Wright AL, Martinez FD, Morgan WJ. Fetal Origins of Asthma: A Longitudinal Study from Birth to Age 36 Years. Am J Respir Crit Care Med 2021; 202:1646-1655. [PMID: 32649838 DOI: 10.1164/rccm.202001-0194oc] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Deficits in infant lung function-including the ratio of the time to reach peak tidal expiratory flow to the total expiratory time (tptef/te) and maximal expiratory flow at FRC (V̇maxFRC)-have been linked to increased risk for childhood asthma.Objectives: To examine the individual and combined effects of tptef/te and V̇maxFRC in infancy on risk for asthma and abnormalities of airway structure into mid-adult life.Methods: One hundred eighty participants in the Tucson Children's Respiratory Study birth cohort had lung function measured by the chest-compression technique in infancy (mean age ± SD: 2.0 ± 1.2 mo). Active asthma was assessed in up to 12 questionnaires between ages 6 and 36 years. Spirometry and chest high-resolution computed tomographic (HRCT) imaging were completed in a subset of participants at age 26. The relations of infant tptef/te and V̇maxFRC to active asthma and airway structural abnormalities into adult life were tested in multivariable mixed models.Measurements and Main Results: After adjustment for covariates, a 1-SD decrease in infant tptef/te and V̇maxFRC was associated with a 70% (P = 0.001) and 55% (P = 0.005) increased risk of active asthma, respectively. These effects were partly independent, and two out of three infants who were in the lowest tertile for both tptef/te and V̇maxFRC developed active asthma by mid-adult life. Infant V̇maxFRC predicted reduced airflow and infant tptef/te reduced HRCT airway caliber at age 26.Conclusions: These findings underscore the long-lasting effects of the fetal origins of asthma, support independent contributions by infant tptef/te and V̇maxFRC to development of asthma, and link deficits at birth in tptef/te with HRCT-assessed structural airway abnormalities in adult life.
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Affiliation(s)
- Stefano Guerra
- Asthma and Airway Disease Research Center.,Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine - Tucson.,Mel and Enid Zuckerman College of Public Health
| | - Enrico Lombardi
- Asthma and Airway Disease Research Center.,Department of Medical Imaging, College of Medicine - Tucson, and
| | | | - Duane L Sherrill
- Asthma and Airway Disease Research Center.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | | | | | - Eric M Snyder
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona; and
| | | | | | - Wayne J Morgan
- Asthma and Airway Disease Research Center.,Geneticure, Rochester, Minnesota
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6
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Schwartz JC, Snyder EM, Olson TP, Johnson BD, Wheatley-Guy CM. Alveolar to arterial gas exchange during constant-load exercise in healthy active men and women. J Sports Sci 2020; 39:961-968. [PMID: 33242298 DOI: 10.1080/02640414.2020.1851927] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Inadequate hyperventilation and inefficient alveolar to arterial gas exchange are gas exchange challenges that can limit capacity and cause exercise-induced arterial hypoxaemia (EIAH). This work evaluated if the prevalence of gas exchange inefficiencies, defined as AaDO2>25 mmHg, PaCO2>38 mmHg, and/or ΔPaO2>-10 mmHg at any point during constant-load exercise in healthy, active, but not highly trained, individuals suggested an innate sex difference that would make females more susceptible to EIAH. Sixty-four healthy, active males and females completed 18-min of cycling exercise (moderate and vigorous intensity, 9 min/stage). Arterial blood gases were measured at rest and every 3-min during exercise, while constantly assessing gas exchange. Both sexes demonstrated similar levels of AaDO2 widening until the final 3 min of vigorous exercise, where females demonstrated a trend for greater widening than males (16.3±6.2 mmHg vs. 19.1±6.0 mmHg, p=0.07). Males demonstrated a blunted ventilatory response to moderate exercise with higher PaCO2 (38.5±2.6 vs. 36.5±2.4, p=0.002) and a lower ventilation when corrected for workload (0.42±0.1 vs. 0.48±0.1, p=0.002). No significant arterial hypoxaemia occurred, but in 6 M and 5 F SaO2 dropped by ≥2%. There was no difference in prevalence of pulmonary gas exchange inefficiencies between sexes, but the type of inefficiency was influenced by sex.Abbreviations: AaDO2: alveolar-arterial oxygen difference; BP: blood pressure; EIAH: exercise-induced arterial hypoxaemia; F: females; HR: heart rate; M: males; Q: cardiac output; PaCO2: arterial partial pressure of carbon dioxide; PaO2: arterial partial pressure of oxygen; ΔPaO2: change in arterial partial pressure of oxygen; PAO2: alveolar partial pressure of oxygen; RPE: rating of perceived exertion; SaO2: arterial oxygen saturation; VE: ventilation; VE/VCO2: ventilatory equivalent for carbon dioxide; VO2PEAK: peak oxygen consumption; WMAX: workload maximum.
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Affiliation(s)
- Jesse C Schwartz
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | - Thomas P Olson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
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7
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Snyder EM, Chowdhury MSI, Morrow JR. Co(II) and Fe(II) triazole-appended 4,10-diaza-15-crown-5-ether Macrocyclic complexes for CEST MRI applications. Inorganica Chim Acta 2020. [DOI: 10.1016/j.ica.2020.119649] [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: 10/24/2022]
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8
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Patel A, Asik D, Snyder EM, Dilillo AE, Cullen PJ, Morrow JR. Front Cover: Binding and Release of FeIII Complexes from Glucan Particles for the Delivery of T
1
MRI Contrast Agents (ChemMedChem 12/2020). ChemMedChem 2020. [DOI: 10.1002/cmdc.202000366] [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: 11/10/2022]
Affiliation(s)
- Akanksha Patel
- Department of Chemistry, University at BuffaloState University of New York Amherst NY 14260 USA
| | - Didar Asik
- Department of Chemistry, University at BuffaloState University of New York Amherst NY 14260 USA
| | - Eric M. Snyder
- Department of Chemistry, University at BuffaloState University of New York Amherst NY 14260 USA
| | - Alexandra E. Dilillo
- Department of Chemistry, University at BuffaloState University of New York Amherst NY 14260 USA
| | - Paul J. Cullen
- Department of Biology, University at BuffaloState University of New York Amherst NY 14260 USA
| | - Janet R. Morrow
- Department of Chemistry, University at BuffaloState University of New York Amherst NY 14260 USA
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9
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Patel A, Asik D, Snyder EM, Dilillo AE, Cullen PJ, Morrow JR. Binding and Release of FeIII Complexes from Glucan Particles for the Delivery of T 1 MRI Contrast Agents. ChemMedChem 2020; 15:1050-1057. [PMID: 32168421 DOI: 10.1002/cmdc.202000003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 01/03/2020] [Revised: 03/10/2020] [Indexed: 12/15/2022]
Abstract
Yeast-derived β-glucan particles (GPs) are a class of microcarriers under development for the delivery of drugs and imaging agents to immune-system cells for theranostic approaches. However, the encapsulation of hydrophilic imaging agents in the porous GPs is challenging. Here, we show that the unique coordination chemistry of FeIII -based macrocyclic T1 MRI contrast agents permits facile encapsulation in GPs. Remarkably, GPs labeled with the simple FeIII complexes are stable under physiologically relevant conditions, despite the absence of amphiphilic groups. In contrast to the free FeIII coordination complex, the labeled FeIII -GPs have lowered T1 relaxivity and act as a silenced form of the contrast agent. Addition of a fluorescent tag to the FeIII complex produces a bimodal agent to further enable tracking of the nanoparticles and to monitor release. Treatment of the iron-labeled GPs with a maltol chelator or with mildly acidic conditions releases the intact iron complex and restores enhanced T1 relaxation of the water protons.
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Affiliation(s)
- Akanksha Patel
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, NY 14260, USA
| | - Didar Asik
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, NY 14260, USA
| | - Eric M Snyder
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, NY 14260, USA
| | - Alexandra E Dilillo
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, NY 14260, USA
| | - Paul J Cullen
- Department of Biology, University at Buffalo, State University of New York, Amherst, NY 14260, USA
| | - Janet R Morrow
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, NY 14260, USA
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10
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Abstract
COVID-19 utilizes the ACE2 pathway as a means of infection. Early data on COVID-19 suggest heterogeneity in the severity of symptoms during transmission and infection ranging from no symptoms to death. The source of this heterogeneity is likely multifaceted and may have a genetic component. Demographic and clinical comorbidities associated with the severity of infection suggest that possible variants known to influence the renin–angiotensin–aldosterone (RAAS) system pathway (particularly those that influence ACE2) may contribute to the heterogenous infection response. ACE2 and Ang(1–7) (the product of ACE2) seem to have a protective effect on the pulmonary and cardiac systems. Hypertension medication modulation, may alter ACE2 and Ang(1–7), particularly in variants that have been shown to influence RAAS system function, which could be clinically useful in patients with COVID-19.
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Affiliation(s)
- Eric M Snyder
- Geneticure, Inc., Four 3rd St. SW, Rochester, MN 55902, USA
| | - Bruce D Johnson
- Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55902, USA
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11
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Lee EJ, Snyder EM, Lundstrom CJ. Effects of marathon training on maximal aerobic capacity and running economy in experienced marathon runners. J Hum Sport Exerc 2020; 15:79-93. [PMID: 38146393 PMCID: PMC10749560 DOI: 10.14198/jhse.2020.151.08] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Maximal aerobic capacity (VO2max) and running economy (RE) are markers of running performance. A valid evaluation of RE may occur through allometric scaling of body mass (alloVO2; ml kg-0.66 min-1), energy cost (EC; kcal kg-1 km-1), or percent of VO2max (%VO2max). Little is known about physiological changes that occur in competitive runners over a marathon training cycle. The VDOT score, incorporating VO2max and RE, enables comparison of race performances under different temperature conditions. This study's purpose was to determine whether VO2max and measures of RE change with marathon training, and to evaluate the relationship between these variables and VDOT. Eight runners (age 34±2 years; marathon <3:00 males, <3:30 females; five females) completed treadmill marathon-intensity-effort (MIE) and VO2max tests at 10 and 1-2 weeks pre-marathon. Body composition (%BF) was determined using hydrostatic weighing. Paired t-tests were used to compare pre- and post-training values. The alpha level for significance was set at 0.05. Body fat decreased from 18.7±1.5% to 16.7±1.6%, VO2max increased from 51.6±2.4 to 63.9±1.1 ml kg-1 min-1, and %VO2max during the MIE decreased from 82.1±2.0 to 72.3±3.2% (p < 0.05 for all). VDOT was significantly associated with alloVO2 (r = -0.779, p = 0.039) but not with VO2max (r = 0.071, p = 0.867). Experienced competitive runners may increase VO2max and decrease %BF after a marathon-specific training cycle. The decrease in %VO2max in a MIE is likely due to a higher VO2max, as other measures of RE did not change significantly. In this cohort, alloVO2 was negatively correlated with race performance.
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Affiliation(s)
- Emma J Lee
- School of Kinesiology, University of Minnesota, Minneapolis, MN, United States of America
| | - Eric M Snyder
- School of Kinesiology, University of Minnesota, Minneapolis, MN, United States of America
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12
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Van Iterson EH, Snyder EM. Does partitioning the subcomponents of the ventilatory equivalent for carbon dioxide slope provide evidence that ventilatory efficiency is retained in cystic fibrosis? Pediatr Pulmonol 2020; 55:276-277. [PMID: 31544352 DOI: 10.1002/ppul.24529] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/12/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Erik H Van Iterson
- Section of Preventive Cardiology and Rehabilitation, Heart and Vascular Institute, Cleveland, Ohio
| | - Eric M Snyder
- Research and Development Division, Geneticure, Inc, Rochester, Minnesota
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13
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Snyder EM, Asik D, Abozeid SM, Burgio A, Bateman G, Turowski SG, Spernyak JA, Morrow JR. A Class of Fe
III
Macrocyclic Complexes with Alcohol Donor Groups as Effective
T
1
MRI Contrast Agents. Angew Chem Int Ed Engl 2019. [DOI: 10.1002/ange.201912273] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Eric M. Snyder
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
| | - Didar Asik
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
| | - Samira M. Abozeid
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
| | - Ariel Burgio
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
| | - Gage Bateman
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
| | - Steven G. Turowski
- Department of Cell Stress Biology Roswell Park Comprehensive Cancer Center Buffalo New York 14263 USA
| | - Joseph A. Spernyak
- Department of Cell Stress Biology Roswell Park Comprehensive Cancer Center Buffalo New York 14263 USA
| | - Janet R. Morrow
- Department of Chemistry University at Buffalo State University of New York Amherst New York 14260 USA
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14
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Snyder EM, Asik D, Abozeid SM, Burgio A, Bateman G, Turowski SG, Spernyak JA, Morrow JR. A Class of Fe III Macrocyclic Complexes with Alcohol Donor Groups as Effective T 1 MRI Contrast Agents. Angew Chem Int Ed Engl 2019; 59:2414-2419. [PMID: 31725934 DOI: 10.1002/anie.201912273] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 09/25/2019] [Revised: 11/07/2019] [Indexed: 12/12/2022]
Abstract
Early studies suggested that FeIII complexes cannot compete with GdIII complexes as T1 MRI contrast agents. Now it is shown that one member of a class of high-spin macrocyclic FeIII complexes produces more intense contrast in mice kidneys and liver at 30 minutes post-injection than does a commercially used GdIII agent and also produces similar T1 relaxivity in serum phantoms at 4.7 T and 37 °C. Comparison of four different FeIII macrocyclic complexes elucidates the factors that contribute to relaxivity in vivo including solution speciation. Variable-temperature 17 O NMR studies suggest that none of the complexes has a single, integral inner-sphere water that exchanges rapidly on the NMR timescale. MRI studies in mice show large in vivo differences of three of the FeIII complexes that correspond, in part, to their r1 relaxivity in phantoms. Changes in overall charge of the complex modulate contrast enhancement, especially of the kidneys.
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Affiliation(s)
- Eric M Snyder
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
| | - Didar Asik
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
| | - Samira M Abozeid
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
| | - Ariel Burgio
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
| | - Gage Bateman
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
| | - Steven G Turowski
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, 14263, USA
| | - Joseph A Spernyak
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, 14263, USA
| | - Janet R Morrow
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York, 14260, USA
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15
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Kelley EF, Cross TJ, Snyder EM, McDonald CM, Hoffman EP, Bello L. Influence of β 2 adrenergic receptor genotype on risk of nocturnal ventilation in patients with Duchenne muscular dystrophy. Respir Res 2019; 20:221. [PMID: 31619245 PMCID: PMC6796481 DOI: 10.1186/s12931-019-1200-1] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease resulting in severe respiratory derangements. As such, DMD patients are at a high risk of nocturnal hypoventilation, thereby requiring nocturnal ventilation (NV). To this end, NV is an important clinical milestone in the management of DMD. Emerging evidence suggests that ß2 adrenergic receptors (ADRB2) may play a role in determining respiratory function, whereby more functional ADRB2 genotype variants (e.g., Gly16) are associated with improved pulmonary function and respiratory muscle strength. These findings suggest that the more functional ADRB2 genotype may help to preserve respiratory function in patients with DMD. The purpose of this study was to identify the influence of ADRB2 genotype on the risk of NV use in DMD. Data from the CINRG Duchenne Natural History Study including 175 DMD patients (3–25 yrs) were analyzed focusing on ADRB2 genotype variants. Time-to-event analyses were used to examine differences in the age at prescription of full-time NV use between genotypes. There were no differences between genotype groups in age, height, weight, corticosteroid use, proportion of ambulatory patients, or age at loss of ambulation. DMD patients expressing the Gly16 polymorphism had a significantly (P < 0.05) lower mean age at NV prescription compared with those patients expressing the Arg16 polymorphism (21.80 ± 0.59 yrs. vs 25.91 ± 1.31 yrs., respectively). In addition, a covariate-adjusted Cox model revealed that the Gly16 variant group possessed a 6.52-fold higher risk of full-time NV use at any given age compared with the Arg16 polymorphism group. These data suggest that genetic variations in the ADRB2 gene may influence the age at which DMD patients are first prescribed NV, whereby patients with the Gly16 polymorphism are more likely to require NV assistance at an earlier age than their Arg16 counterparts.
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Affiliation(s)
- Eli F Kelley
- Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA. .,Department of Cardiovascular Diseases, Mayo Clinic, RO_GE_MN_10, 1216 2nd Street SW, Rochester, MN, 55902, USA.
| | - Troy J Cross
- Department of Cardiovascular Diseases, Mayo Clinic, RO_GE_MN_10, 1216 2nd Street SW, Rochester, MN, 55902, USA
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Craig M McDonald
- University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Eric P Hoffman
- Binghamton University - SUNY, Binghamton, NY, USA.,Center for Genetic Medicine, Children's Research Institute, Children's National Health System, Washington, DC, USA
| | - Luca Bello
- Department of Neurosciences, University of Padova, Padova, Italy
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16
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Snyder EM, Kelley EF, Sprissler R, Olson TP. The importance and challenges of developing a pharmacogenetics test for hypertension. Pharmacogenomics 2019; 20:563-566. [PMID: 31136254 DOI: 10.2217/pgs-2019-0056] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Eli F Kelley
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ryan Sprissler
- Geneticure, Inc., Rochester, MN 55902, USA.,University of Arizona Genomics Core, Tucson, Arizona, AZ 85721 USA
| | - Thomas P Olson
- Geneticure, Inc., Rochester, MN 55902, USA.,Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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17
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Lee EJ, Snyder EM, Lundstrom CJ. Effects of Marathon Training on Maximal Aerobic Capacity and Running Economy in Experienced Marathon Runners. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562868.60124.cc] [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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18
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Kelley EF, Olson TP, Curry TB, Sprissler R, Snyder EM. The Effect of Genetically Guided Mathematical Prediction and the Blood Pressure Response to Pharmacotherapy in Hypertension Patients. Clin Med Insights Cardiol 2019; 13:1179546819845883. [PMID: 31105432 PMCID: PMC6501483 DOI: 10.1177/1179546819845883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/14/2018] [Accepted: 04/03/2019] [Indexed: 01/13/2023] Open
Abstract
Purpose: The purpose of this study was to determine the effectiveness of a simple algorithm to mathematically predict a patients’ response to blood pressure (BP) therapy using functional genes in the 3 major organ systems involved in hypertension. Methods: Eighty-six patients with controlled hypertension completed 1 study visit consisting of a buccal swab collection, measurement of office BP, and a medical chart review for BP history. Genes in the analysis included 14 functional alleles in 11 genes. These genotypes were mathematically summed per organ system to determine whether a patient would likely respond to target therapy. Results: Patients recommended to and taking a diuretic had significantly higher rates of control (<120/<80) than patients recommended but not taking this drug class (0.2 ± 0.1 and 0.03 ± 0.03, respectively). Furthermore, there was a difference between patients genetically recommended and taking an angiotensin receptor blocker (ARB) vs patients recommended but not taking an ARB for the lowest diastolic blood pressure (DBP) and mean arterial pressure (MAP) recorded in the past 2 years (DBP = 66.2 ± 2.9 and 75.3 ± 1.7, MAP = 82.3 ± 2.8 and 89.3 ± 1.5, respectively). In addition, there was a nonsignificant trend for greater reductions in ΔSBP, ΔDBP, and ΔMAP in patients on recommended drug class for beta-blockers, diuretics, and angiotensin II receptor blockers vs patients not on these classes. Conclusion: The present study suggests that simple mathematical weighting of functional genotypes known to control BP may be ineffective in predicting control. This study demonstrates the need for a more complex, weighted, multigene algorithm to more accurately predict BP therapy response.
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Affiliation(s)
- Eli F Kelley
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Thomas P Olson
- Geneticure, Inc, Rochester, MN, USA.,College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Timothy B Curry
- Geneticure, Inc, Rochester, MN, USA.,College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
| | - Ryan Sprissler
- Geneticure, Inc, Rochester, MN, USA.,Department of Genetics, University of Arizona Genomics Core, Tucson, AZ, USA
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19
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Phelps PK, Snyder EM, Walla DM, Ross JK, Simmons JJ, Bulock EK, Ayres A, Akre MK, Sprissler R, Olson TP. Relationship Between a Weighted Multi‐Gene Algorithm and Blood Pressure Control in Hypertension. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.819.6] [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)
| | | | | | | | | | | | | | | | - Ryan Sprissler
- GeneticureRochesterMN
- Genomics Core FacilityUniversity of ArizonaTucsonAZ
| | - Thomas P Olson
- GeneticureRochesterMN
- Cardiovascular DiseasesMayo ClinicRochesterMN
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20
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Bisch AL, Wheatley CM, Baker SE, Peitzman ER, Van Iterson EH, Laguna TA, Morgan WJ, Snyder EM. Cystic Fibrosis Transmembrane Conductance Regulator Genotype, Not Circulating Catecholamines, Influences Cardiovascular Function in Patients with Cystic Fibrosis. Clin Med Insights Circ Respir Pulm Med 2019; 13:1179548419835788. [PMID: 30956528 PMCID: PMC6442074 DOI: 10.1177/1179548419835788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/30/2019] [Indexed: 01/07/2023]
Abstract
Background: Cystic fibrosis (CF) is a genetic disease affecting multiple organ systems of the body and is characterized by mutation in the gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR). Previous work has shown that a single dose of aβ-agonist increases cardiac output (Q) and stroke volume (SV) and decreases systemic vascular resistance (SVR) in healthy subjects. This effect is attenuated in patients with CF; however, the mechanism is unknown. Potential explanations for this decreased cardiovascular response to a β-agonist in CF include inherent cardiovascular deficits secondary to the CFTR mutation, receptor desensitization from prolonged β-agonist use as part of clinical care, or inhibited drug delivery to the bloodstream due to mucus buildup in the lungs. This study sought to determine the effects of endogenous epinephrine (EPI) and norepinephrine (NE) on cardiovascular function in CF and to evaluate the relationship between cardiovascular function and CFTR F508del mutation. Methods: A total of 19 patients with CF and 31 healthy control subjects completed an assessment of Q (C2H2 rebreathing), SV (calculated from Q and heart rate [HR]), Q and SV indexed to body surface area (BSA, QI, and SVI, respectively), SVR (through assessment of Q and mean arterial blood pressure [MAP]), and HR (from 12-lead electrocardiogram [ECG]) at rest along with plasma measures of EPI and NE. We compared subjects by variables of cardiovascular function relative to EPI and NE, and also based on genetic variants of the F508del mutation (homozygous deletion for F508del, heterozygous deletion for F508del, or no deletion of F508del). Results: Cystic fibrosis patients demonstrated significantly lower BSA (CF = 1.71 ± 0.05 m2 vs healthy = 1.84 ± 0.04 m2, P = .03) and SVI (CF = 30.6 ± 2.5 mL/beat/m2 vs healthy = 39.9 ± 2.5 mL/beat/m2, P = .02) when compared with healthy subjects. Cystic fibrosis patients also demonstrated lower Q (CF = 4.58 ± 0.36 L/min vs healthy = 5.71 ± 0.32 L/min, P = .03) and SV (CF = 54 ± 5.5 mL/beat vs healthy = 73.3 ± 4.5 mL/beat, P = .01), and a higher HR (CF = 93.2 ± 3.9 bpm vs healthy = 80.5 ± 2.7 bpm, P < .01) and SVR (CF = 2082 ± 156 dynes*s/cm−5 vs healthy = 1616 ± 74 dynes*s/cm−5, P = .01) compared with healthy subjects. Furthermore, CF patients demonstrated a lower SV (P < .01) corrected for NE when compared with healthy subjects. No significant differences were seen in HR or Q relative to NE, or SVR relative to EPI. Differences were seen in SV (F(2,14) = 7.982, P < .01) and SV index (F(2,14) = 2.913, P = .08) when patients with CF were stratified according to F508del mutation (number of deletions). Conclusions: Individuals with CF have lower cardiac and peripheral hemodynamic function parameters at rest. Furthermore, these results suggest that impairment in cardiovascular function is likely the result of F508del CFTR genotype, rather than receptor desensitization or inhibited drug delivery.
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Affiliation(s)
- Alexander L Bisch
- Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Courtney M Wheatley
- Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Sarah E Baker
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth R Peitzman
- Department of Biology, Health Science Center, University of Wisconsin La Crosse, La Crosse, WI, USA
| | | | - Theresa A Laguna
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Wayne J Morgan
- Arizona Respiratory Center, The University of Arizona, Tucson, AZ, USA
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA
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21
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Phelps PK, Kelley EF, Walla DM, Ross JK, Simmons JJ, Bulock EK, Ayres A, Akre MK, Sprissler R, Olson TP, Snyder EM. Relationship between a Weighted Multi-Gene Algorithm and Blood Pressure Control in Hypertension. J Clin Med 2019; 8:jcm8030289. [PMID: 30823438 PMCID: PMC6463118 DOI: 10.3390/jcm8030289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/16/2019] [Accepted: 02/25/2019] [Indexed: 01/01/2023] Open
Abstract
Hypertension (HTN) is a complex disease with interactions among multiple organ systems, including the heart, vasculature, and kidney with a strong heritable component. Despite the multifactorial nature of HTN, no clinical guidelines utilize a multi-gene approach to guide blood pressure (BP) therapy. Non-smokers with a family history of HTN were included in the analysis (n = 384; age = 61.0 ± 0.9, 11% non-white). A total of 17 functional genotypes were weighted according to the previous effect size in the literature and entered into an algorithm. Pharmacotherapy was ranked from 1–4 as most to least likely to respond based on the algorithmic assessment of individual patient’s genotypes. Three-years of data were assessed at six-month intervals for BP and medication history. There was no difference in BP at diagnosis between groups matching the top drug recommendation using the multi-gene weighted algorithm (n = 92) vs. those who did not match (n = 292). However, from diagnosis to nadir, patients who matched the primary recommendation had a significantly greater drop in BP when compared to patients who did not. Further, the difference between diagnosis to current 1-year average BP was lower in the group that matched the top recommendation. These data suggest an association between a weighted multi-gene algorithm on the BP response to pharmacotherapy.
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Affiliation(s)
- Pamela K Phelps
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | - Eli F Kelley
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Danielle M Walla
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | - Jennifer K Ross
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | - Jerad J Simmons
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | - Emma K Bulock
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | - Audrie Ayres
- Medical Center, University of Minnesota, Fairview, Minneapolis, MN 55455, USA.
| | | | - Ryan Sprissler
- Geneticure, Inc., Rochester, MN 55902, USA.
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ 85705, USA.
| | - Thomas P Olson
- Geneticure, Inc., Rochester, MN 55902, USA.
- College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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22
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Kelley EF, Snyder EM, Johnson BD. Influence of Beta-1 Adrenergic Receptor Genotype on Cardiovascular Response to Exercise in Healthy Subjects. Cardiol Res 2019; 9:343-349. [PMID: 30627284 PMCID: PMC6306116 DOI: 10.14740/cr785] [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: 10/01/2018] [Accepted: 10/23/2018] [Indexed: 11/11/2022] Open
Abstract
Background The beta-1 adrenergic receptor (ADRB1) has been shown to play a functional role in cardiomyocyte function and accounts for up to 80% of the cardiac tissue adrenergic receptors with ADRB1 stimulation increasing cardiac rate, contractility and work. Multiple polymorphisms of the ADRB1 have been identified such as the Gly49 polymorphism that includes at least one glycine (Gly) for serine (Ser) at amino acid 49 resulting in either homozygous for Gly (Gly49Gly) or heterozygous for Gly (Gly49Ser) polymorphisms. Heart failure patients with this polymorphism (Gly49) have been shown to have improved cardiac function and decreased mortality risk, but if there is an effect in healthy subjects is less clear. The purpose of this study was to determine the effects of the Gly/Ser polymorphism at position 49 of the ADRB1on the cardiovascular response to exercise in healthy subjects. Methods We performed genotyping of the ADRB1 (amino acid 49) and high-intensity, steady-state exercise on 71 healthy subjects (Ser49Ser = 52, Gly49Ser = 19). Results There were no differences between genotype groups in age, height, weight, body mass index (BMI), or watts achieved (age = 28.9 ± 5.6 years (yrs.), 30.6 ± 6.4yrs., height = 173.6 ± 9.9 cm, 174 ± 7.5 cm, weight = 74.4 ± 13.3 kg, 71.9 ± 13.5 kg, BMI = 24.6 ± 3.5, 23.6 ± 3.3, and watts = 223.8 ± 76.8, 205 ± 49.4, for Ser49Ser and Gly49Ser respectively). Additionally, there were no differences for genotype groups for cardiac output (CO), systolic blood pressure (BPsys), or diastolic blood pressure (BPdias) at rest, maximal exercise, or in change from rest to maximal exercise. The genotype groups differed significantly in heart rate (HRmax) at maximal exercise and cardiac index at rest (CI) (HRmax = 184.2 ± 9.5 bpm, 190.7 ± 10.6 bpm, CI = 0.063 ± 0.014, 0.071 ± 0.013, for Ser49Ser and Gly49Ser respectively). There was a trend towards significance (P = 0.058) for the change in stroke volume from rest to peak exercise (ΔSV) (0.016 ± 0.018 L, 0.0076 ± 0.012 L, for Ser49Ser and Gly49Ser respectively). Conclusions These data suggest genetic variations of the ADRB1 may influence cardiovascular responses to exercise in healthy subjects.
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Affiliation(s)
- Eli F Kelley
- Department of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
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23
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Wheatley CM, Baker SE, Daines CM, Phan H, Martinez MG, Morgan WJ, Snyder EM. Influence of the Vibralung Acoustical Percussor on pulmonary function and sputum expectoration in individuals with cystic fibrosis. Ther Adv Respir Dis 2019; 12:1753466618770997. [PMID: 29697011 PMCID: PMC5961921 DOI: 10.1177/1753466618770997] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The Vibralung Acoustical Percussor is a new airway clearance therapy (ACT) utilizing intrapulmonary sound waves in addition to positive expiratory pressure (PEP). We evaluated the safety of the Vibralung and collected preliminary data on its ability to mediate sputum expectoration in individuals with cystic fibrosis (CF). Methods: Over two separate studies, 10 and 11 mild to moderate CF patients were recruited for study I and II, respectively. Study I: Vibralung was used for 20 min with either no sound (NS: PEP only) or sound (S: PEP and sound) on randomized visits. Pulmonary function, diffusion capacity of the lungs for carbon monoxide and nitric oxide (DLCO/DLNO), symptoms, and peripheral oxygen saturation (SpO2) were measured at baseline and at 1 and 4 h post treatment. Expectorated sputum was collected over 4 h post treatment. Study II: over 5 days of in-hospital therapy, the Vibralung or vibratory vest therapy (Vest) were used for two therapy sessions per day, with sputum collected for 20 min following each therapy and pulmonary function accessed pre and post each 5-day period (days 1–5 or 7–11) in a randomized crossover design. Results: Vibralung usage resulted in no change from baseline to 4 h post in pulmonary function, SpO2 or symptoms (p > 0.05). At 4 h post therapy, the DLCO- and DLNO-derived measure of alveolar–capillary unit function (DM/VC) showed improvement (DM/VC = 12.5 ± 5.5 versus 7.3 ± 18.8% change, S versus NS) with no difference between S and NS (p = 0.74). Sputum expectoration was similar between S and NS conditions (wet sputum = 10.5 ± 4.6 versus 9.9 ± 3.2 g, S versus NS, p = 0.25). There were no differences in the improvement in pulmonary function between Vibralung and Vest during either 5-day period during the hospital stay. Conclusions: Vibralung was well tolerated and caused no detrimental changes in pulmonary function metrics. The Vibralung appears to be a safe ACT in individuals with CF.
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Affiliation(s)
- Courtney M Wheatley
- Department of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA
| | - Sarah E Baker
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA
| | - Cori M Daines
- Department of Pediatrics-Pediatric Pulmonology and Sleep, University of Arizona, Tucson, AZ, USA Banner-University Medical Center, Tucson, AZ, USA
| | - Hanna Phan
- Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA Department of Pediatrics-Pediatric Pulmonology and Sleep, University of Arizona, Tucson, AZ, USA
| | - Marina G Martinez
- Arizona Clinical Research Center, University of Arizona, Tucson, AZ, USA
| | - Wayne J Morgan
- Department of Pediatrics-Pediatric Pulmonology and Sleep, University of Arizona, Tucson, AZ, USA Banner-University Medical Center, Tucson, AZ, USA
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, MN, USA; and Department of Pharmacy Practice and Science, University of Arizona, Tucson, AZ, USA
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24
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Patanwala AE, Norwood C, Steiner H, Morrison D, Li M, Walsh K, Martinez M, Baker SE, Snyder EM, Karnes JH. Psychological and Genetic Predictors of Pain Tolerance. Clin Transl Sci 2018; 12:189-195. [PMID: 30468309 PMCID: PMC6440569 DOI: 10.1111/cts.12605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 11/09/2018] [Indexed: 12/18/2022] Open
Abstract
Previous studies have shown associations between genetic polymorphisms and pain tolerance, but psychological evaluations are seldom measured. The objective of this study was to determine the independent effects of demographic, psychological, and genetic predictors of cold noxious pain tolerance. Healthy subjects (n = 89) completed the Pain Catastrophizing Scale (PCS) and Fear of Pain Questionnaire (FPQ‐III), underwent genotyping for candidate single nucleotide polymorphisms (SNPs), and completed a cold‐pressor test in a 1–2°C water bath for a maximum of 3 minutes. The primary outcome measure was pain tolerance, defined as the maximum duration of time subjects left their nondominant hand in the cold‐water bath. Cox proportional hazards regression indicated that female sex, Asian race, and increasing PCS and FPQ‐III scores were associated with lower pain tolerance. No candidate SNP was significantly associated with pain tolerance. Future genetic studies should include demographic and psychological variables as confounders in experimental pain models.
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Affiliation(s)
- Asad E Patanwala
- Sydney School of Pharmacy, University of Sydney, Sydney, Australia
| | - Charles Norwood
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Heidi Steiner
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Daniel Morrison
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - May Li
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Keith Walsh
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
| | - Marina Martinez
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA.,Department of Neurology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jason H Karnes
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona, USA
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25
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Kelley EF, Snyder EM, Alkhatib NS, Snyder SC, Sprissler R, Olson TP, Akre MK, Abraham I. Economic evaluation of a pharmacogenomic multi-gene panel test to optimize anti-hypertension therapy: simulation study. J Med Econ 2018; 21:1246-1253. [PMID: 30280614 DOI: 10.1080/13696998.2018.1531011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS Hypertension is the strongest modifiable risk factor for cardiovascular disease, affecting 80 million individuals in the US and responsible for ∼360,000 deaths, at total annual costs of $93.5 billion. Antihypertension therapies guided by single genotypes are clinically more effective and may avert more adverse events than the standard of care of layering anti-hypertensive drug therapies, thus potentially decreasing costs. This study aimed to determine the economic benefits of the implementation of multi-gene panel guided therapies for hypertension from the payer perspective within a 3-year time horizon. MATERIALS AND METHODS A simulation analysis was conducted for a panel of 10 million insured patients categorized clinically as untreated, treated but uncontrolled, and treated and controlled over a 3-year treatment period. Inputs included research data; empirical data from a 11-gene panel with known functional, heart, blood vessel, and kidney genotypes; and therapy efficacy and safety estimates from literature. Cost estimates were categorized as related to genetic testing, evaluation and management, medication, or adverse events. RESULTS Multi-gene panel guided therapy yielding savings of $6,256,607,500 for evaluation and management, $908,160,000 for medications, and $37,467,508,716 for adverse events, after accounting for incremental genetic testing costs of $2,355,540,000. This represents total 3-year savings of $42,276,736,216, or a 47% reduction, and 3-year savings of $4,228 and annual savings of $1,409 per covered patient. CONCLUSIONS A precision medicine approach to genetically guided therapy for hypertension patients using a multi-gene panel reduced total 3-year costs by 47%, yielding savings exceeding $42.3 billion in an insured panel of 10 million patients. Importantly, 89% of these savings are generated by averting specific adverse events and, thus, optimizing choice of therapy in function of both safety and efficacy.
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Affiliation(s)
- Eli F Kelley
- a University of Minnesota , Minneapolis , MN , USA
| | | | - Nimer S Alkhatib
- c University of Arizona, Center for Health Outcomes and Pharmaco Economic Research , Tucson , AZ , USA
| | | | - Ryan Sprissler
- b Geneticure, Inc. , Rochester , MN , USA
- d University of Arizona Genomics Core , Tucson , AZ , USA
- e University of Arizona, Center for Applied Genetics and Genomic Medicine , Tucson , AZ , USA
| | - Thomas P Olson
- f Mayo Clinic, College of Medicine , Rochester , MN , USA
| | | | - Ivo Abraham
- c University of Arizona, Center for Health Outcomes and Pharmaco Economic Research , Tucson , AZ , USA
- e University of Arizona, Center for Applied Genetics and Genomic Medicine , Tucson , AZ , USA
- g University of Arizona , Department of Family and Community Medicine , Tucson , AZ , USA
- h Matrix45 , Tucson , AZ , USA
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26
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Van Iterson EH, Baker SE, Wheatley CM, Morgan WJ, Olson TP, Snyder EM. Exercise Stroke Volume in Adult Cystic Fibrosis: A Comparison of Acetylene Pulmonary Uptake and Oxygen Pulse. Clin Med Insights Circ Respir Pulm Med 2018; 12:1179548418790564. [PMID: 30083061 PMCID: PMC6073827 DOI: 10.1177/1179548418790564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 06/28/2018] [Indexed: 12/19/2022]
Abstract
Cardiac hemodynamic assessment during cardiopulmonary exercise testing (CPET) is proposed to play an important role in the clinical evaluation of individuals with cystic fibrosis (CF). Cardiac catheterization is not practical for routine clinical CPET. Use of oxygen pulse (O2pulse) as a noninvasive estimate of stroke volume (SV) has not been validated in CF. This study tested the hypothesis that peak exercise O2pulse is a valid estimate of SV in CF. Measurements of SV via the acetylene rebreathe technique were acquired at baseline and peak exercise in 17 mild-to-moderate severity adult CF and 25 age-matched healthy adults. We calculated O2pulse=V.O2HR. Baseline relationships between SV and O2pulse were significant in CF (r = .80) and controls (r = .40), persisting to peak exercise in CF (r = .63) and controls (r = .73). The standard error of estimate for O2pulse-predicted SV with respect to measured SV was similar at baseline (14.1 vs 20.1 mL) and peak exercise (18.2 vs 13.9 mL) for CF and controls, respectively. These data suggest that peak exercise O2pulse is a valid estimate of SV in CF. The ability to noninvasively estimate SV via O2pulse during routine clinical CPET can be used to improve test interpretation and advance our understanding of the impact cardiac dysfunction has on exercise intolerance in CF.
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Affiliation(s)
| | - Sarah E Baker
- College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - Courtney M Wheatley
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.,College of Pharmacy, The University of Arizona, Tucson, AZ, USA
| | - Wayne J Morgan
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA
| | - Thomas P Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Eric M Snyder
- College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
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27
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Van Iterson EH, Snyder EM, Johnson BD. Alveolar air and oxidative metabolic demand during exercise in healthy adults: the role of single-nucleotide polymorphisms of the β2AR gene. Physiol Rep 2018; 5:5/20/e13476. [PMID: 29061864 PMCID: PMC5661237 DOI: 10.14814/phy2.13476] [Citation(s) in RCA: 5] [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: 09/07/2017] [Accepted: 09/17/2017] [Indexed: 11/30/2022] Open
Abstract
The predominating β‐adrenergic receptor subtype expressed on human alveolar tissue is the β2AR. The homozygous arginine (Arg16Arg) single‐nucleotide polymorphism (SNP) at codon 16 of the β2AR gene has been associated with abnormal β2AR function accompanied by decreased resting alveolar‐capillary membrane gas‐transfer in certain healthy adults. Although not previously studied in the context of the β2AR gene, pulmonary gas‐transfer is also influenced by alveolar volume (VA) and with it the availability of alveolar surface area, particularly during exercise. Small VA implies less alveolar surface area available for O2 transport. We tested the following hypothesis in healthy adults during exercise: compared with Gly16Gly and Arg16Gly β2AR genotypes, Arg16Arg will demonstrate reduced VA and ventilation (V̇A) relative to V̇E and oxidative metabolic demand. Age‐ BMI‐ and gender‐matched groups of Arg16Arg (N = 16), Gly16Gly (N = 31), and Arg16Gly (N = 17) performed consecutive low (9‐min, 40%‐peak workload) and moderate (9‐min, 75%‐peak workload) intensity exercise. We derived VA and V̇A using “ideal” alveolar equations via arterialized gases combined with breath‐by‐breath ventilation and gas‐exchange measurements; whereas steady‐state V̇O2 was used in metabolic equations to derive exercise economy (EC = workload÷V̇O2). Variables at rest did not differ across β2AR genotype. Strongest β2AR genotype effects occurred during moderate exercise. Accordingly, while V̇E did not differ across genotype (P > 0.05), decreased in Arg16Arg versus Arg16Gly and Gly16Gly were V̇O2 (1110 ± 263, 1269 ± 221, 1300 ± 319 mL/(min·m2), respectively, both P < 0.05), V̇A (59 ± 21, 70 ± 16, 70 ± 21 L/min, respectively, both P < 0.05), and VA (1.43 ± 0.37, 1.95 ± 0.61, 1.93 ± 0.65 L, respectively, both P < 0.05). Also reduced was EC in Arg16Arg versus Arg16Gly (P < 0.05) and Gly16Gly (P > 0.05) (1.81 ± 0.23, 1.99 ± 0.30, and 1.94 ± 0.26 kcal/(L·m2), respectively). Compared with Gly16Gly and Arg16Gly genotypes, these data suggest the Arg16Arg β2AR genotype plays a role in the loss of oxidative metabolic efficiency coupled with an inadaptive VA and, hence, smaller alveolar surface area available for O2 transport during submaximal exercise in healthy adults.
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Affiliation(s)
- Erik H Van Iterson
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Eric M Snyder
- Department of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Bruce D Johnson
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
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Abozeid SM, Snyder EM, Lopez AP, Steuerwald CM, Sylvester E, Ibrahim KM, Zaky RR, Abou‐El‐Nadar HM, Morrow JR. Nickel(II) Complexes as Paramagnetic Shift and paraCEST Agents. Eur J Inorg Chem 2018. [DOI: 10.1002/ejic.201800021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Samira M. Abozeid
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
- Department of Chemistry Faculty of Science Mansoura University El‐Gomhoria Street 35516 Mansoura Egypt
| | - Eric M. Snyder
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
| | - Alejandra P. Lopez
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
| | - Charles M. Steuerwald
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
| | - Eric Sylvester
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
| | - Kamal M. Ibrahim
- Department of Chemistry Faculty of Science Mansoura University El‐Gomhoria Street 35516 Mansoura Egypt
| | - Rania R. Zaky
- Department of Chemistry Faculty of Science Mansoura University El‐Gomhoria Street 35516 Mansoura Egypt
| | - Hamed M. Abou‐El‐Nadar
- Department of Chemistry Faculty of Science Mansoura University El‐Gomhoria Street 35516 Mansoura Egypt
| | - Janet R. Morrow
- University at Buffalo, State University of New York Department of Chemistry 526 Natural Sciences Complex 14260 Amherst NY USA
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Kelley EF, Snyder EM, Johnson BD. Influence of Beta‐1 Adrenergic Receptor Genotype on Cardiovascular Response to Exercise in Healthy Subjects. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.lb299] [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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Abstract
Kelley, EF, Johnson, BD, and Snyder, EM. Beta-2 adrenergic receptor genotype influences power output in healthy subjects. J Strength Cond Res 31(8): 2053-2059, 2017-The purpose of this study was to determine the effects of ADRB2 genotypes on muscle function (absolute power and relative power) in healthy subjects. We performed genotyping of the ADRB2 (amino acid 16) and high-intensity, steady-state exercise on 77 healthy subjects (AA = 18, AG = 25, GG = 34). There were no differences between genotype groups in age, height, weight, or body mass index (BMI) (age = 28.9 ± 5.7 years, 27.9 ± 5.7 years, 29.2 ± 5.9 years, height = 170.7 ± 8.6 cm, 174.9 ± 8.7 cm, 173.4 ± 9.6 cm, weight = 68.5 ± 13.0 kg, 75.0 ± 12.9 kg, 74.4 ± 12.9 kg, and BMI = 23.4 ± 3.9, 24.4 ± 2.9, 24.7 ± 3.4, for AA, AG, and GG, respectively). The genotype groups differed significantly in watts, and watts/V[Combining Dot Above]O2 with heavy exercise (watts = 186.3 ± 54.6, 237.8 ± 54.4, 219.4 ± 79.5, watts/V[Combining Dot Above]O2 = 0.08 ± 0.006, 0.09 ± 0.005, 0.08 ± 0.006). There was a trend toward significance (p = 0.058) for W·kg (2.7 ± 0.4, 3.2 ± 0.5, 2.9 ± 0.8, for AA, AG, and GG, respectively). These data suggest that genetic variation of the ADRB2 may influence relative strength in healthy subjects and may become an important genetic determinant of muscular strength and functional capacity in patients with diseases that result in a loss of muscle strength.
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Affiliation(s)
- Eli F Kelley
- 1University of Minnesota, Minneapolis, Minnesota; and 2Mayo Clinic, Rochester, Minnesota
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Abozeid SM, Snyder EM, Tittiris TY, Steuerwald CM, Nazarenko AY, Morrow JR. Inner-Sphere and Outer-Sphere Water Interactions in Co(II) paraCEST Agents. Inorg Chem 2018; 57:2085-2095. [DOI: 10.1021/acs.inorgchem.7b02977] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Samira M. Abozeid
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York 14260, United States
| | - Eric M. Snyder
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York 14260, United States
| | - Timothy Y. Tittiris
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York 14260, United States
| | - Charles M. Steuerwald
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York 14260, United States
| | - Alexander Y. Nazarenko
- Chemistry Department, SUNY College at Buffalo, 1300 Elmwood Avenue, Buffalo, New York 14222, United States
| | - Janet R. Morrow
- Department of Chemistry, University at Buffalo, State University of New York, Amherst, New York 14260, United States
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Van Iterson EH, Olson TP, Borlaug BA, Johnson BD, Snyder EM. Comparisons of Noninvasive Methods Used to Assess Exercise Stroke Volume in Heart Failure with Preserved Ejection Fraction. Med Sci Sports Exerc 2018; 49:1758-1768. [PMID: 28471812 DOI: 10.1249/mss.0000000000001308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cardiopulmonary exercise testing (CPET) plays an important role in properly phenotyping signs and symptoms of heart failure with preserved ejection fraction (HFpEF). The prognostic value of CPET is strengthened when accompanied by cardiac hemodynamic measurements. Although recognized as the "gold" standard, cardiac catheterization is impractical for routine CPET. Thus, advancing the scientific/methodologic understanding of noninvasive techniques for exercise cardiac hemodynamic assessment is clinically impactful in HFpEF. This study tested the concurrent validity of noninvasive acetylene gas (C2H2) uptake, echocardiography (ECHO), and oxygen pulse (O2pulse) for measuring/predicting exercise stroke volume (SV) in HFpEF. METHODS Eighteen white HFpEF and 18 age-/sex-matched healthy controls participated in upright CPET (ages, 69 ± 9 yr vs 63 ± 9 yr). At rest, 20 W, and peak exercise, SV was measured at steady-state via C2H2 rebreathe (SVACET) and ECHO (SVECHO), whereas O2pulse was derived (=V˙O2/HR). RESULTS Resting relationships between SVACET and SVECHO, SVECHO and O2pulse, or SVACET and O2pulse were significant in HFpEF (R = 0.30, 0.36, 0.67), but not controls (R = 0.07, 0.01, 0.09), respectively. Resting relationships persisted to 20 W in HFpEF (R = 0.70, 0.53, 0.70) and controls (R = 0.05, 0.07, 0.21), respectively. Peak exercise relationships were significant in HFpEF (R = 0.62, 0.24, 0.64), but only for SVACET versus O2pulse in controls (R = 0.07, 0.04, 0.33), respectively. Standardized standard error of estimate between techniques was strongest in HFpEF at 20 W: SVACET versus SVECHO = 0.57 ± 0.22; SVECHO versus O2pulse = 0.71 ± 0.28; SVACET versus O2pulse = 0.56 ± 0.22. CONCLUSIONS Constituting a clinically impactful step towards construct validation testing, these data suggest SVACET, SVECHO, and O2pulse demonstrate moderate-to-strong concurrent validity for measuring/predicting exercise SV in HFpEF.
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Affiliation(s)
- Erik H Van Iterson
- 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN; and 2Department of Kinesiology, University of Minnesota, Minneapolis, MN
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Wheatley CM, Baker SE, Taylor BJ, Keller-Ross ML, Chase SC, Carlson AR, Wentz RJ, Snyder EM, Johnson BD. Influence of Inhaled Amiloride on Lung Fluid Clearance in Response to Normobaric Hypoxia in Healthy Individuals. High Alt Med Biol 2017; 18:343-354. [PMID: 28876128 DOI: 10.1089/ham.2017.0032] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Wheatley, Courtney M., Sarah E. Baker, Bryan J. Taylor, Manda L. Keller-Ross, Steven C. Chase, Alex R. Carlson, Robert J. Wentz, Eric M. Snyder, and Bruce D. Johnson. Influence of inhaled amiloride on lung fluid clearance in response to normobaric hypoxia in healthy individuals. High Alt Med Biol 18:343-354, 2017. AIM To investigate the role of epithelial sodium channels (ENaC) on lung fluid clearance in response to normobaric hypoxia, 20 healthy subjects were exposed to 15 hours of hypoxia (fraction of inspired oxygen [FiO2] = 12.5%) on two randomized occasions: (1) inhaled amiloride (A) (1.5 mg/5 mL saline); and (2) inhaled saline placebo (P). Changes in lung fluid were assessed through chest computed tomography (CT) for lung tissue volume (TV), and the diffusion capacity of the lungs for carbon monoxide (DLCO) and nitric oxide (DLNO) for pulmonary capillary blood volume (VC). Extravascular lung water (EVLW) was derived as TV-VC and changes in the CT attenuation distribution histograms were reviewed. RESULTS Normobaric hypoxia caused (1) a reduction in EVLW (change from baseline for A vs. P, -8.5% ± 3.8% vs. -7.9% ± 5.2%, p < 0.05), (2) an increase in VC (53.6% ± 28.9% vs. 53.9% ± 52.3%, p < 0.05), (3) a small increase in DLCO (9.6% ± 29.3% vs. 9.9% ± 23.9%, p > 0.05), and (4) CT attenuation distribution became more negative, leftward skewed, and kurtotic (p < 0.05). CONCLUSION Acute normobaric hypoxia caused a reduction in lung fluid that was unaffected by ENaC inhibition through inhaled amiloride. Although possible amiloride-sensitive ENaC may not be necessary to maintain lung fluid balance in response to hypoxia, it is more probable that normobaric hypoxia promotes lung fluid clearance rather than accumulation for the majority of healthy individuals. The observed reduction in interstitial lung fluid means alveolar fluid clearance may not have been challenged.
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Affiliation(s)
- Courtney M Wheatley
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Sarah E Baker
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Bryan J Taylor
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | | | - Steven C Chase
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Alex R Carlson
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Robert J Wentz
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
| | - Eric M Snyder
- 1 Department of Pharmaceutical Science, University of Arizona , Tucson, Arizona
| | - Bruce D Johnson
- 2 Division of Cardiovascular Diseases, Mayo Clinic , Rochester, Minnesota
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Van Iterson EH, Fitzgerald JS, Dietz CC, Snyder EM, Peterson BJ. Reliability of Triaxial Accelerometry for Measuring Load in Men's Collegiate Ice Hockey. J Strength Cond Res 2017; 31:1305-1312. [PMID: 27548782 DOI: 10.1519/jsc.0000000000001611] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Van Iterson, EH, Fitzgerald, JS, Dietz, CC, Snyder, EM, and Peterson, BJ. Reliability of triaxial accelerometry for measuring load in men's collegiate ice hockey. J Strength Cond Res 31(5): 1305-1312, 2017-Wearable microsensor technology incorporating triaxial accelerometry is used to quantify an index of mechanical stress associated with sport-specific movements termed PlayerLoad. The test-retest reliability of PlayerLoad in the environmental setting of ice hockey is unknown. The primary aim of this study was to quantify the test-retest reliability of PlayerLoad in ice hockey players during performance of tasks simulating game conditions. Division I collegiate male ice hockey players (N = 8) wore Catapult Optimeye S5 monitors during repeat performance of 9 ice hockey tasks simulating game conditions. Ordered ice hockey tasks during repeated bouts included acceleration (forward or backward), 60% top-speed, top-speed (forward or backward), repeated shift circuit, ice coasting, slap shot, and bench sitting. Coefficient of variation (CV), intraclass correlation coefficient (ICC), and minimum difference (MD) were used to assess PlayerLoad reliability. Test-retest CVs and ICCs of PlayerLoad were as follows: 8.6% and 0.54 for forward acceleration, 13.8% and 0.78 for backward acceleration, 2.2% and 0.96 for 60% top-speed, 7.5% and 0.79 for forward top-speed, 2.8% and 0.96 for backward top-speed, 26.6% and 0.95 for repeated shift test, 3.9% and 0.68 for slap shot, 3.7% and 0.98 for coasting, and 4.1% and 0.98 for bench sitting, respectively. Raw differences between bouts were not significant for ice hockey tasks (p > 0.05). For each task, between-bout raw differences were lower vs. MD: 0.06 vs. 0.35 (forward acceleration), 0.07 vs. 0.36 (backward acceleration), 0.00 vs. 0.06 (60% top-speed), 0.03 vs. 0.20 (forward top-speed), 0.02 vs. 0.09 (backward top-speed), 0.18 vs. 0.64 (repeated shift test), 0.02 vs. 0.10 (slap shot), 0.00 vs. 0.10 (coasting), and 0.01 vs. 0.11 (bench sitting), respectively. These data suggest that PlayerLoad demonstrates moderate-to-large test-retest reliability in the environmental setting of male Division I collegiate ice hockey. Without previously testing reliability, these data are important as PlayerLoad is routinely quantified in male collegiate ice hockey to assess on ice physical activity.
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Affiliation(s)
- Erik H Van Iterson
- 1Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; 2School of Kinesiology, University of Minnesota, Minneapolis, Minnesota; 3Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, North Dakota; 4Athletic Department, University of Minnesota, Minneapolis, Minnesota; and 5Catapult Group International Ltd., Melbourne, Australia
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Lee EJ, Lundstrom CJ, Snyder EM. Downhill Running Followed by Foam Rolling Has No Effect on the Cost of Running. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000519931.98305.51] [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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Lundstrom CJ, Miller AM, Betker MR, Uithoven KE, Snyder EM. Marathon Training Improves Aerobic Capacity, Running Performance, and Reduces Body Fat in Men and Women. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517225.43519.ed] [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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Van Iterson EH, Snyder EM, Johnson BD. The Influence of 17 Hours of Normobaric Hypoxia on Parallel Adjustments in Exhaled Nitric Oxide and Airway Function in Lowland Healthy Adults. High Alt Med Biol 2017; 18:1-10. [PMID: 28135110 DOI: 10.1089/ham.2016.0086] [Citation(s) in RCA: 2] [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] [Indexed: 11/12/2022] Open
Abstract
Van Iterson, Erik H., Eric M. Snyder, and Bruce D. Johnson. The influence of 17 hours of normobaric hypoxia on parallel adjustments in exhaled nitric oxide and airway function in lowland healthy adults. High Alt Med Biol. 18:1-10, 2017.-Currently, there is a disparate understanding of the role that normobaric hypoxia plays in affecting nitric oxide (NO) measured in exhaled air (eNO) and airway function in lowland healthy adults. Compared to normobaric normoxia, this study aimed to test the effect of 17 hours of normobaric hypoxia on relationships between eNO and airway function in healthy adults. In a crossover study including 2 separate visits, 26 lowland healthy Caucasian adults performed eNO and pulmonary function tests on visit 1 in normobaric normoxia, while repeating all tests on visit 2 following 17 hours of normobaric hypoxia (12.5% O2). Compared to normobaric normoxia, eNO (29 ± 24 vs. 36 ± 28 ppb), forced expiratory volume in one second (FEV1) (4.1 ± 0.7 vs. 4.3 ± 0.8 L), mean forced expiratory flow between 25% and 75% FVC (FEF25-75) (3.9 ± 1.0 vs. 4.2 ± 1.2 L/s), and forced expiratory flow at 75% FVC (FEF75) (2.0 ± 0.7 vs. 2.3 ± 0.8 L/s) increased in normobaric hypoxia, respectively (all p < 0.05). Correlations at normoxia between eNO and FEV1 (r = 0.39 vs. 0.44), FEF25-75 (r = 0.51 vs. 0.51), and FEF75 (r = 0.53 vs. 0.55) persisted as both parameters increased in hypoxia, respectively. For the first time, these data suggest that 17 hours of hypoxic breathing in the absence of low ambient pressure contribute to increased eNO and airway function in lowland healthy adults.
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Affiliation(s)
- Erik H Van Iterson
- 1 Department of Cardiovascular Diseases, Mayo Clinic College of Medicine , Rochester, Minnesota
| | - Eric M Snyder
- 2 Department of Kinesiology, University of Minnesota , Minneapolis, Minnesota
| | - Bruce D Johnson
- 1 Department of Cardiovascular Diseases, Mayo Clinic College of Medicine , Rochester, Minnesota
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Abstract
PURPOSE An impaired metaboreflex is associated with abnormal ventilatory and peripheral vascular function in heart failure (HF), whereas its influence on cardiac function or pulmonary vascular pressure remains unclear. We aimed to assess whether metabolite-sensitive neural feedback (metaboreflex) from locomotor muscles via postexercise regional circulatory occlusion (RCO) attenuates pulmonary vascular capacitance (GXCAP) and/or circulatory power (CircP) in patients with HF. METHODS Eleven patients with HF (NYHA class, I/II; ages, 51 ± 15 yr; ejection fraction, 32% ± 9%) and 11 age- and gender-matched controls (ages, 43 ± 9 yr) completed three cycling sessions (4 min, 60% peak oxygen uptake (V˙O2)). Session 1 was a control trial including normal recovery (NR). Session 2 or 3 included bilateral upper thigh pressure tourniquets inflated suprasystolic at end of exercise (RCO) for 2-min recovery with or without inspired CO2 (RCO + CO2) (randomized). Mean arterial pressure, HR, and V˙O2 were continuously measured. Estimates of central hemodynamics; CircP = (V˙O2 × mean arterial pressure)/weight; oxygen pulse index (O2pulseI = (V˙O2/HR)/body surface area); and GXCAP = O2pulseI × end-tidal partial pressure CO2 were calculated. RESULTS At rest and end of exercise, CircP and GXCAP were lower in HF versus those in controls (P < 0.05), with no differences between transients (P > 0.05). At 2-min recovery, GXCAP was lower during RCO versus that during NR in both groups (72 ± 23 vs 98 ± 20 and 73 ± 34 vs 114 ± 35 mL·beat·mm Hg·m, respectively; P < 0.05), whereas CircP did not differ between transients (P > 0.05). Differences (% and Δ) between baseline and 2-min recovery among transients suggest that metaboreflex attenuates GXCAP in HF. Differences (% and Δ) between baseline and 2-min recovery among transients suggest that metaboreflex may attenuate CircP in controls. CONCLUSIONS The present observations suggest that locomotor muscle metaboreflex activation may influence CircP in controls but not in HF. However, metaboreflex activation may evoke decreases in GXCAP (increased pulmonary vascular pressures) in HF and controls.
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Affiliation(s)
- Erik H Van Iterson
- 1Department of Kinesiology, University of Minnesota, Minneapolis, MN; 2Cardiovascular Medicine Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; and 3Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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Lundstrom CJ, Biltz GR, Snyder EM, Ingraham SJ. Allometric scaling of body mass in running economy data: An important consideration in modeling marathon performance. jhse 2017. [DOI: 10.14198/jhse.2017.122.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Van Iterson EH, Wheatley CM, Baker SE, Olson TP, Morgan WJ, Snyder EM. The Coupling of Peripheral Blood Pressure and Ventilatory Responses during Exercise in Young Adults with Cystic Fibrosis. PLoS One 2016; 11:e0168490. [PMID: 27997623 PMCID: PMC5172623 DOI: 10.1371/journal.pone.0168490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 06/26/2016] [Accepted: 11/30/2016] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Cystic fibrosis (CF) is commonly recognized as a pulmonary disease associated with reduced airway function. Another primary symptom of CF is low exercise capacity where ventilation and gas-exchange are exacerbated. However, an independent link between pathophysiology of the pulmonary system and abnormal ventilatory and gas-exchange responses during cardiopulmonary exercise testing (CPET) has not been established in CF. Complicating this understanding, accumulating evidence suggests CF demonstrate abnormal peripheral vascular function; although, the clinical implications are unclear. We hypothesized that compared to controls, relative to total work performed (WorkTOT), CF would demonstrate increased ventilation accompanied by augmented systolic blood pressure (SBP) during CPET. METHODS 16 CF and 23 controls (age: 23±4 vs. 27±4 years, P = 0.11; FEV1%predicted: 73±14 vs. 96±5, P<0.01) participated in CPET. Breath-by-breath oxygen uptake ([Formula: see text]), ventilation ([Formula: see text]), and carbon dioxide output ([Formula: see text]) were measured continuously during incremental 3-min stage step-wise cycle ergometry CPET. SBP was measured via manual sphygmomanometry. Linear regression was used to calculate [Formula: see text] slope from rest to peak-exercise. RESULTS Compared to controls, CF performed less WorkTOT during CPET (90±19 vs. 43±14 kJ, respectively, P<0.01). With WorkTOT as a covariate, peak [Formula: see text] (62±8 vs. 90±4 L/min, P = 0.76), [Formula: see text] (1.8±0.3 vs. 2.7±0.1 L/min, P = 0.40), and SBP (144±13 vs. 152±6 mmHg, P = 0.88) were similar between CF and controls, respectively; whereas CF demonstrated increased [Formula: see text] slope (38±4 vs. 28±2, P = 0.02) but lower peak [Formula: see text] versus controls (22±5 vs. 33±4 mL/kg/min, P<0.01). There were modest-to-moderate correlations between peak SBP with [Formula: see text] (r = 0.30), [Formula: see text] (r = 0.70), and [Formula: see text] (r = 0.62) in CF. CONCLUSIONS These data suggest that relative to WorkTOT, young adults with mild-to-moderate severity CF demonstrate augmented [Formula: see text] slope accompanied by increased SBP during CPET. Although the underlying mechanisms remain unclear, the coupling of ventilatory inefficiency with increased blood pressure suggest important contributions from peripheral pathophysiology to low exercise capacity in CF.
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Affiliation(s)
- Erik H. Van Iterson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
| | - Courtney M. Wheatley
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
| | - Sarah E. Baker
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States of America
| | - Thomas P. Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America
| | - Wayne J. Morgan
- Department of Pediatrics, University of Arizona, 1501 N. Campbell Avenue, Room 3301, Tucson, AZ, United States of America
| | - Eric M. Snyder
- College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, United States of America
- Department of Kinesiology, University of Minnesota, Cooke Hall, 1900 University Ave SE. Minneapolis, MN, United States of America
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Taylor NE, Baker SE, Olson TP, Lalande S, Johnson BD, Snyder EM. Albuterol Improves Alveolar-Capillary Membrane Conductance in Healthy Humans. Clin Med Insights Circ Respir Pulm Med 2016; 10:19-25. [PMID: 27773996 PMCID: PMC5063752 DOI: 10.4137/ccrpm.s30251] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 06/02/2016] [Accepted: 06/07/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Beta-2 adrenergic receptors (β2ARs) are located throughout the body including airway and alveolar cells. The β2ARs regulate lung fluid clearance through a variety of mechanisms including ion transport on alveolar cells and relaxation of the pulmonary lymphatics. We examined the effect of an inhaled β2-agonist (albuterol) on alveolar-capillary membrane conductance (DM) and pulmonary capillary blood volume (VC) in healthy humans. METHODS We assessed the diffusing capacity of the lungs for carbon monoxide (DLCO) and nitric oxide (DLNO) at baseline, 30 minutes, and 60 minutes following nebulized albuterol (2.5 mg, diluted in 3 mL normal saline) in 45 healthy subjects. Seventeen subjects repeated these measures following nebulized normal saline (age = 27 ± 9 years, height = 165 ± 21 cm, weight = 68 ± 12 kg, BMI = 26 ± 9 kg/m2). Cardiac output (Q), heart rate, systemic vascular resistance (SVR), blood pressure, oxygen saturation, forced expiratory volume at one-second (FEV1), and forced expiratory flow at 50% of forced vital capacity (FEF50) were assessed at baseline, 30 minutes, and 60 minutes following the administration of albuterol or saline. RESULTS Albuterol resulted in a decrease in SVR, and an increase in Q, FEV1, and FEF50 compared to saline controls. Albuterol also resulted in a decrease in VC at 60 minutes post albuterol. Both albuterol and normal saline resulted in no change in DLCO or DM when assessed alone, but a significant increase was observed in DM when accounting for changes in VC. CONCLUSION These data suggest that nebulized albuterol improves pulmonary function in healthy humans, while nebulization of both albuterol and saline results in an increase in DM/VC.
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Affiliation(s)
- Natalie E Taylor
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Sarah E Baker
- Research Fellow, Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - Thomas P Olson
- Assistant Professor of Medicine, Consultant, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Sophie Lalande
- Assistant Professor, Department of Kinesiology, University of Toledo, OH, USA
| | - Bruce D Johnson
- Professor of Medicine and Physiology, Consultant, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Eric M Snyder
- Assistant Professor, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
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Taylor BJ, Snyder EM, Richert ML, Wheatley CM, Chase SC, Olson LJ, Johnson BD. Effect of β 2-adrenergic receptor stimulation on lung fluid in stable heart failure patients. J Heart Lung Transplant 2016; 36:418-426. [PMID: 27863863 DOI: 10.1016/j.healun.2016.09.008] [Citation(s) in RCA: 14] [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: 05/26/2016] [Revised: 08/05/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine: (1) whether stable heart failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) when compared with healthy control subjects; and (2) the effect of acute β2-adrenergic receptor (β2AR) agonist inhalation on lung fluid balance. METHODS Twenty-two stable HFrEF patients and 18 age- and gender-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), pulmonary capillary blood volume (Vc) (via re-breathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 minutes after administration of nebulized albuterol. EVLW was derived as Vtis - Vc. RESULTS Before administration of albuterol, Vtis and EVLW were higher in HFrEF vs control (998 ± 200 vs 884 ± 123 ml, p = 0.041; and 943 ± 202 vs 802 ± 133 ml, p = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF patients (-4.6 ± 7.8%, p = 0.010; -4.6 ± 8.8%, p = 0.018) and control subjects (-2.8 ± 4.9%, p = 0.029; -3.0 ± 5.7%, p = 0.045). There was an inverse relationship between pre-albuterol values and pre- to post-albuterol change for EVLW (r2 = -0.264, p = 0.015) and DmCO (r2 = -0.343, p = 0.004) in HFrEF only. CONCLUSION Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of β2ARs may cause fluid removal in HFrEF, especially in patients with greater evidence of increased lung water at baseline.
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Affiliation(s)
- Bryan J Taylor
- Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds, Leeds, UK; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Eric M Snyder
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Maile L Richert
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Courtney M Wheatley
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Steven C Chase
- Division of Cardiovascular Diseases, Mayo Graduate School, Mayo Clinic, Rochester, Minnesota, USA
| | - Lyle J Olson
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Chase SC, Wheatley CM, Olson LJ, Beck KC, Wentz RJ, Snyder EM, Taylor BJ, Johnson BD. Impact of chronic systolic heart failure on lung structure-function relationships in large airways. Physiol Rep 2016; 4:4/13/e12867. [PMID: 27418546 PMCID: PMC4945845 DOI: 10.14814/phy2.12867] [Citation(s) in RCA: 10] [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: 06/07/2016] [Accepted: 06/22/2016] [Indexed: 11/24/2022] Open
Abstract
Heart failure (HF) is often associated with pulmonary congestion, reduced lung function, abnormal gas exchange, and dyspnea. We tested whether pulmonary congestion is associated with expanded vascular beds or an actual increase in extravascular lung water (EVLW) and how airway caliber is affected in stable HF. Subsequently we assessed the influence of an inhaled short acting beta agonist (SABA). Thirty‐one HF (7F; age, 62 ± 11 years; ht. 175 ± 9 cm; wt. 91 ± 17 kg; LVEF, 28 ± 15%) and 29 controls (11F; age; 56 ± 11 years; ht. 174 ± 8 cm; wt. 77 ± 14 kg) completed the study. Subjects performed PFTs and a chest computed tomography (CT) scan before and after SABA. CT measures of attenuation, skew, and kurtosis were obtained from areas of lung tissue to assess EVLW. Airway luminal areas and wall thicknesses were also measured. CT tissue density suggested increased EVLW in HF without differences in the ratio of airway wall thickness to luminal area or luminal area to TLC (skew: 2.85 ± 1.08 vs. 2.11 ± 0.79, P < 0.01; Kurtosis: 15.5 ± 9.5 vs. 9.3 ± 5.5 P < 0.01; control vs. HF). PFTs were decreased in HF at baseline (% predicted FVC:101 ± 15% vs. 83 ± 18%, P < 0.01;FEV1:103 ± 15% vs. 82 ± 19%, P < 0.01;FEF25–75: 118 ± 36% vs. 86 ± 36%, P < 0.01; control vs. HF). Airway luminal areas, but not CT measures, were correlated with PFTs at baseline. The SABA cleared EVLW and decreased airway wall thickness but did not change luminal area. Patients with HF had evidence of increased EVLW, but not an expanded bronchial circulation. Airway caliber was maintained relative to controls, despite reductions in lung volume and flow rates. SABA improved lung function, primarily by reducing EVLW.
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Affiliation(s)
- Steven C Chase
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Lyle J Olson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Kenneth C Beck
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Robert J Wentz
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Eric M Snyder
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Bryan J Taylor
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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Abstract
An effective approach for determining the clinical classification of heart failure (HF) patients is to estimate cardiac hemodynamics during exercise. This approach is strengthened further when measurements including cardiac power are used to describe cardiac hemodynamics. We hypothesize that cardiac power quantifies the hemodynamic and pressure-generating capability of the heart, relating with exercise tolerance better than traditional measurements in HF.
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Affiliation(s)
- Eric M Snyder
- 1School of Kinesiology, University of Minnesota, Minneapolis, MN; 2Cardiovascular Medicine Division, University of Pennsylvania, Philadelphia, PA; and 3Division of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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Lee EJ, Wheatley CM, Baker SE, Snyder EM. Differences in Oxygen Extraction Compared to Healthy Subjects Contribute to Muscular Efficiency in Cystic Fibrosis. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485852.57265.8d] [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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Lundstrom CJ, Betker MR, McGuirk EK, Uithoven KE, Rourk ZT, Lee EJ, Snyder EM. Marathon Training Increases Fat Metabolism in Women During Moderate-Intensity Steady State Running. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485511.27684.18] [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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Uithoven KE, Wheatley CM, Baker SE, Snyder EM. Relationship Between The Change In DLCO With Albuterol And The Change In DLCO With Exercise. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486371.29386.99] [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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McGuirk EK, Lundstrum CJ, Betker MR, Rourk ZT, Uithoven KE, Lee EJ, Snyder EM. Respiratory Exchange Ratio is Not Associated with Slowing in the Marathon. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486406.76020.8f] [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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Kelley EF, Snyder EM, Johnson BD. Genetic Variation Of The Beta-2 Adrenergic Receptor Influences Power Output In Healthy Subjects. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485055.75657.55] [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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Zavala H, Wheatley CM, Baker SE, Snyder EM. Estimated Pulmonary Capacitance in Patients with Cystic Fibrosis Compared to Healthy Subjects. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485845.26839.71] [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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