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Bohm C, Bennett P, Lambert K, Wilund K, Verdin N, Fowler K, Sumida K, Wang AYM, Tangri N, MacRae JM, Thompson S. Advancing Exercise Science for Better Health Outcomes Across the Spectrum of Chronic Kidney Disease. J Ren Nutr 2023; 33:S103-S109. [PMID: 37632512 DOI: 10.1053/j.jrn.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/27/2022] [Accepted: 12/10/2022] [Indexed: 08/28/2023] Open
Abstract
Despite over 30 years of evidence for improvements in physical function, physical fitness, and health-related quality of life with exercise training in individuals with chronic kidney disease, access to dedicated exercise training programs remains outside the realm of standard of care for most kidney care programs. In this review, we explore possible reasons for this by comparing approaches in other chronic diseases where exercise rehabilitation has become the standard of care, identifying enablers and factors that need to be addressed for continued growth in this area, and discussing knowledge gaps for future research. For exercise rehabilitation to be relevant to all stakeholders and become a sustainable component of kidney care, a focus on the effect of exercise on clinically relevant outcomes that are prioritized by individuals living with kidney disease, use of evidence-based implementation strategies for diverse settings and populations, and approaching exercise as a medical therapy are required.
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Affiliation(s)
- Clara Bohm
- Department of Medicine, University of Manitoba, Winnipeg, Canada; Chronic Disease Innovation Centre, Winnipeg, Canada.
| | - Paul Bennett
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Ken Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | | | - Kevin Fowler
- The Voice of the Patient, Inc, Saint Louis, Missouri
| | - Keiichi Sumida
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Angela Yee-Moon Wang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR
| | - Navdeep Tangri
- Department of Medicine, University of Manitoba, Winnipeg, Canada; Chronic Disease Innovation Centre, Winnipeg, Canada
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Molsted S, Bennett PN, Wilund K, Bruun K, Pakpour AH, Liljehult JM, Brandi L. Nurses' and medical doctors' attitudes towards exercise for people with chronic kidney disease in Denmark. J Ren Care 2023; 49:206-216. [PMID: 36274056 DOI: 10.1111/jorc.12445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Implementation of exercise training in people with kidney failure may be affected by clinicians' attitudes. OBJECTIVES To investigate Danish nephrology nurses' and medical doctors' attitudes towards: exercise for people undergoing dialysis; use of physical activity interventions in chronic kidney disease; and to compare Danish and previously reported Australian nurse attitudes. DESIGN Cross-sectional survey. PARTICIPANTS Nurses and medical doctors from the nephrology field in Denmark. MEASUREMENTS The questionnaire attitudes towards exercise in dialysis, and questions about exercise advice, counselling and interventions. RESULTS Nephrology nurses (n = 167) and 17 medical doctors (women 92%, age 47 ± 11 years) from 19 dialysis units participated. There were no differences between nurses' and medical doctors attitudes about training. Ninety-five % and 88% of nurses and medical doctors, respectively, agreed that most people undergoing dialysis could benefit from exercise. Exercise training was offered to people undergoing haemodialyses in 88% of 17 departments. Danish nurses reported more positive attitudes than Australian towards exercise (p < 0.05). Ninety-five % and 86% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people undergoing dialysis could benefit from exercise. Six % and 35% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people with dialysis were too sick to exercise. CONCLUSION Danish nephrology nurses and medical doctors had mostly positive attitudes to exercise training to people undergoing dialysis, and exercise to people with dialysis was offered frequently. Danish and Australian nurses had positive attitudes to exercise to people undergoing dialysis, it was however more positive in Danish nurses.
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Affiliation(s)
- Stig Molsted
- Department of Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Paul N Bennett
- Medical & Clinical Affairs, Satellite Healthcare, San Jose, California, USA
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Ken Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Karina Bruun
- The Department of Nephrology, Rigshospitalet, Copenhagen, Denmark
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Lisbet Brandi
- Department of Endocrinology and Nephrology, Nordsjaellands Hospital, Hillerød, Denmark
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Hernandez R, Wilund K, Solai K, Tamayo D, Fast D, Venkatesan P, Lash JP, Lora CM, Martinez L, Martin Alemañy G, Martinez A, Kwon S, Romero D, Browning MHEM, Moskowitz JT. Positive Psychological Intervention Delivered Using Virtual Reality in Patients on Hemodialysis With Comorbid Depression: Protocol and Design for the Joviality Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45100. [PMID: 37327026 DOI: 10.2196/45100] [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] [Received: 02/10/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Depression is highly prevalent in individuals on hemodialysis, but it is infrequently identified and remains undertreated. In this paper, we present details of the methodology of a randomized controlled trial (RCT) aimed at testing the feasibility and preliminary efficacy of a 5-week positive psychological intervention in individuals on hemodialysis with comorbid depression delivered using immersive virtual reality (VR) technology. OBJECTIVE We aim to describe the protocol and design of the Joviality trial whose main objectives are 2-fold: determine the feasibility of the Joviality VR software through metrics capturing rates of recruitment, refusal, retention, noncompliance, and adherence, as well as end-user feedback; and assess preliminary efficacy for outcomes measures of depressive symptoms, psychological well-being and distress, quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalizations. METHODS This 2-arm RCT is scheduled to enroll 84 individuals on hemodialysis with comorbid depression from multiple outpatient centers in Chicago, Illinois, United States. Enrollees will be randomized to the following groups: VR-based Joviality positive psychological intervention or sham VR (2D wildlife footage and nature-based settings with inert music presented using a head-mounted display). To be eligible, individuals must be on hemodialysis for at least 3 months, have Beck Depression Inventory-II scores of ≥11 (ie, indicative of mild-to-severe depressive symptoms), be aged ≥21 years, and be fluent in English or Spanish. The Joviality VR software was built using agile design principles and incorporates fully immersive content, digital avatars, and multiplex features of interactability. Targeted skills of the intervention include noticing positive events, positive reappraisal, gratitude, acts of kindness, and mindful or nonjudgmental awareness. The primary outcomes include metrics of feasibility and acceptability, along with preliminary efficacy focused on decreasing symptoms of depression. The secondary and tertiary outcomes include quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalization rates. There are 4 assessment time points: baseline, immediately after the intervention, 3 months after the intervention, and 6 months after the intervention. We hypothesize that depressive symptoms and hemodialysis-related markers of disease will substantially improve in participants randomized to the VR-based Joviality positive psychology treatment arm compared with those in the attention control condition. RESULTS This RCT is funded by the National Institute of Diabetes and Digestive and Kidney Diseases and is scheduled to commence participant recruitment in June 2023. CONCLUSIONS This trial will be the first to test custom-built VR software to deliver a positive psychological intervention, chairside, in individuals on hemodialysis to reduce symptoms of depression. Within the context of an RCT using an active control arm, if proven effective, VR technology may become a potent tool to deliver mental health programming in clinical populations during their outpatient treatment sessions. TRIAL REGISTRATION ClinicalTrials.gov NCT05642364; https://clinicaltrials.gov/ct2/show/NCT05642364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45100.
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Affiliation(s)
- Rosalba Hernandez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Ken Wilund
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Killivalavan Solai
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - David Tamayo
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Drew Fast
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Prasakthi Venkatesan
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - James P Lash
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Claudia M Lora
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Lizet Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Geovana Martin Alemañy
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Angela Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Soonhyung Kwon
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Dana Romero
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Derk G, Barton A, An R, Fang HY, Ashrafi SA, Wilund K. The Safety and Efficacy of Clonidine in Hemodialysis Patients: A Systematic Review and Meta-Analysis. Pharmacology 2022; 107:545-555. [PMID: 36075189 DOI: 10.1159/000525424] [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] [Received: 11/15/2021] [Accepted: 05/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clonidine is a frequently prescribed long-term antihypertensive medication in hemodialysis (HD) patients in the USA, but its safety and efficacy has not been clearly established in the HD population. OBJECTIVE To evaluate, we conducted a systematic review and meta-analysis on the safety and efficacy of clonidine in HD patients. METHODS Keyword search of "clonidine" and "dialysis" was conducted through April 2021 in PubMed, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov databases. Inclusion criteria were as follows - study design: randomized controlled trials, cohort studies, prospective studies, retrospective studies, or case series; subjects: adult HD patients; main outcome: blood pressure (BP) and safety; language: English; and article type: peer-reviewed publications. Studies that examined the effects of clonidine in populations other than adult HD patients were excluded. Meta-analysis was performed on BP reduction outcomes. RESULTS Eight studies met the inclusion criteria for the systematic review, including prospective pre-post studies (2), double-blind controlled trial (1), single-blinded placebo-controlled trial (1), crossover open-label clinical trial (1), retrospective analysis (1), and case report series (2). Three studies included in the meta-analysis ranged from 2 to 12 weeks duration, with a collective sample size of 24 (ages 12-77 years). Risk of bias, assessed using the ROBINS-1 tool, was high for all included studies. Significant adverse effects reported included hypotension, light-headedness, drowsiness, dry mouth, rebound hypertension, and contact dermatitis from patch application. Short-term clonidine use was associated with significant improvement in systolic BP (pooled effect: -12.985 mm Hg, 95% CI [-7.878, -18.092], p < 0.001), while changes in diastolic BP were not statistically significant (-11.119 mm Hg, 95% CI [-22.725, 0.487], p = 0.060). No data currently support the long-term efficacy of clonidine in HD patients. This study was unfunded and was developed using PRISMA guidelines and registered on PROSPERO (CRD42018112042). CONCLUSIONS There is no evidence supporting the long-term use of clonidine in the HD population and a significant side-effect profile. There is low-quality evidence demonstrating the efficacy of clonidine in lowering BP in HD patients in short-term use, but significant safety concerns remain. Fluid removal strategies and other antihypertensives should be used over clonidine for long-term BP control in the HD population.
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Affiliation(s)
- Gwendolyn Derk
- University of Illinois, College of Medicine, Urbana-Champaign, Urbana, Illinois, USA.,Department of Kinesiology & Community Health, University of Illinois, Urbana-Champaign, Urbana, Illinois, USA
| | - Amy Barton
- Department of Clinical Pharmacology, University of Michigan, Detroit, Michigan, USA
| | - Ruopeng An
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Hsin-Yu Fang
- Department of Kinesiology & Community Health, University of Illinois, Urbana-Champaign, Urbana, Illinois, USA
| | - Sadia Anjum Ashrafi
- Department of Kinesiology & Community Health, University of Illinois, Urbana-Champaign, Urbana, Illinois, USA
| | - Ken Wilund
- Department of Kinesiology & Community Health, University of Illinois, Urbana-Champaign, Urbana, Illinois, USA
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Wilund K, Thompson S, Bennett PN. A Global Approach to Increasing Physical Activity and Exercise in Kidney Care: The International Society of Renal Nutrition and Metabolism Global Renal Exercise Group. J Ren Nutr 2019; 29:467-470. [DOI: 10.1053/j.jrn.2019.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/19/2019] [Accepted: 08/25/2019] [Indexed: 12/22/2022] Open
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Biruete A, Kistler B, Allen J, Bauer L, Fahey G, Swanson K, Wilund K. MP434EFFECT OF INULIN SUPPLEMENTATION ON MINERAL METABOLISM AND SHORT-CHAIN FATTY ACID EXCRETION IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wilund K, Jeong J, Fernhall B, Biruete A, Perez L, Mitchell K. MP467ACUTE HEMODYNAMIC RESPONSES TO INTRADIALYTIC EXERCISE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx173.mp467] [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: 11/14/2022] Open
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Benner D, Burgess M, Stasios M, Brosch B, Wilund K, Shen S, Kistler B. In-Center Nutrition Practices of Clinics within a Large Hemodialysis Provider in the United States. Clin J Am Soc Nephrol 2016; 11:770-775. [PMID: 27084879 PMCID: PMC4858484 DOI: 10.2215/cjn.09270915] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/05/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Eating during hemodialysis treatment remains a controversial topic. It is perceived that more restrictive practices in the United States contribute to poorer nutritional status and elevated mortality compared with some other parts of the world. However, in-center food practices in the United States have not been previously described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In 2011, we conducted a survey of clinic practices and clinician (dietitian, facility administrator, and medical director) opinions related to in-center food consumption within a large dialysis organization. After the initial survey, we provided clinicians with educational materials about eating during treatment. In 2014, we performed a follow-up survey. Differences in practices and opinions were analyzed using chi-squared tests and logistic regression. RESULTS In 2011, 343 of 1199 clinics (28.6%) did not allow eating during treatment, 222 clinics (18.2%) did not allow drinking during treatment, and 19 clinics (1.6%) did not allow eating at the facility before or after treatment. In 2014, the proportion of clinics that did not allow eating during treatment had declined to 22.6% (321 of 1422 clinics), a significant shift in practice (P<0.001). Among the 178 (6.8%) clinics that self-reported that eating was "more allowed" in 2014, the main reason for this shift was an increased focus on nutritional status. Among clinicians, a higher percentage encouraged eating during treatment (53.1% versus 37.4%; P<0.05), and facility administrators and medical directors were less concerned about the seven reasons commonly cited for restricting eating during treatment in 2014 compared with 2011 (P<0.05 for all). CONCLUSIONS We found that 28.6% and 22.6% of hemodialysis clinics within the United States restricted eating during treatment in 2011 and 2014, respectively, a rate more than double that found in an international cohort on which we previously published. However, practices and clinician opinions are shifting toward allowing patients to eat. Additional research is warranted to understand the effect that these practices have on patient outcomes and outline best practices.
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Affiliation(s)
- Debbie Benner
- Nutrition Services Department, DaVita HealthCare Partners, Inc., Denver, Colorado
| | - Mary Burgess
- Nutrition Services Department, DaVita HealthCare Partners, Inc., Denver, Colorado
| | - Maria Stasios
- Nutrition Services Department, DaVita HealthCare Partners, Inc., Denver, Colorado
| | - Becky Brosch
- Nutrition Services Department, DaVita HealthCare Partners, Inc., Denver, Colorado
| | - Ken Wilund
- Department of Kinesiology and Community Health University of Illinois at Urbana-Champaign, Urbana, Illinois; and
| | - Sa Shen
- Department of Kinesiology and Community Health University of Illinois at Urbana-Champaign, Urbana, Illinois; and
| | - Brandon Kistler
- Department of Family and Consumer Sciences, Ball State University, Muncie, Indiana
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Biruete A, Allen J, Kistler B, Jeong JH, Fitschen P, Swanson K, Wilund K. SP345GUT MICROBIOME AND CLINICAL RISK FACTORS IN MAINTENANCE HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw167.18] [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: 11/12/2022] Open
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Wilund K, Biruete A, Barnes J, Kistler B, Wiens K, Fitschen P, Jeong JH, Merz C. FP787CHARACTERIZATION OF EATING PATTERNS IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv184.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lane AD, Yan H, Ranadive SM, Kappus RM, Sun P, Cook MD, Harvey I, Woods J, Wilund K, Fernhall B. Sex differences in ventricular-vascular coupling following endurance training. Eur J Appl Physiol 2014; 114:2597-606. [PMID: 25142819 PMCID: PMC4228114 DOI: 10.1007/s00421-014-2981-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 04/18/2014] [Accepted: 08/11/2014] [Indexed: 01/20/2023]
Abstract
Introduction
Ventricular and vascular coupling is defined as the ratio of arterial elastance (Ea) to ventricular elastance (Elv) and describes the interaction between the heart and arterial system. There are sex differences in both arterial and ventricular function in response to both acute exercise and aerobic exercise training. Purpose To examine the effects of aerobic exercise training on elastances and the coupling ratio in young adult men and women. We hypothesized a reduction in the coupling ratio in both sexes due to a decrease in Ea that would be more pronounced in men and an increase in Elv that would be larger in women. Methods Fifty-three healthy, young adults completed the study. Central pulse wave velocity and heart volumes were measured before and after an 8-week aerobic training intervention. Elastances were calculated as Ea = end-systolic pressure/stroke volume and Elv = end-systolic pressure/end-systolic volume and indexed to body surface area. Results After the intervention, women augmented indexed and un-indexed Elv from 2.09 ± 0.61 to 2.52 ± 0.80 mmHg/ml, p < 0.05, and reduced the coupling ratio from 0.72 ± 18 to 0.62 ± 15, p < 0.05, while men maintained their pre-training ratio (from 0.66 ± 0.20 to 0.74 ± 0.21, p > 0.05). Women also reduced end-systolic pressure (from 91 ± 10 to 87 ± 10 mmHg), and both groups reduced central pulse wave velocity (from 6.0 ± 1.0 to 5.6 ± 0.6 m/s, p < 0.05). Conclusion We conclude that after 8 weeks of aerobic training, only women reduced their coupling ratio due to an increase in Elv. This suggests that aerobic exercise training elicits sex-dependent changes in the coupling ratio in young, healthy individuals.
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Affiliation(s)
- A D Lane
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA,
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Lane AD, Ranadive SM, Yan H, Kappus RM, Cook MD, Sun P, Woods JA, Wilund K, Fernhall B. Effect of sex on wasted left ventricular effort following maximal exercise. Int J Sports Med 2013; 34:770-6. [PMID: 23526590 DOI: 10.1055/s-0032-1329990] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Wasted left ventricular effort (∆Ew) refers to work required of the left ventricle to eject blood that does not result in increased stroke volume and is related to left ventricular hypertrophy. Literature shows that men and women have differing ventricular and vascular responses to and following exercise. Our purpose was to determine how ∆Ew changes post-exercise in men and women and examine potential mechanisms. We hypothesized a reduction in ∆Ew that would be greater in men and that central pulse wave velocity and wave intensity (WIA) would be related to ∆Ew. Blood pressures, central pulse wave velocity (cPWV), and WIA were obtained at rest, 15 and 30 min after maximal exercise. Both sexes reduced ∆Ew post-maximal exercise (p>0.05 for interaction), but women had higher ∆Ew at each time point (p<0.05). The first peak of WIA increased 15 min post-exercise only in women (p<0.05). cPWV was attenuated (p<0.05) in women at 15 min and men at 30 min (p<0.05) post-exercise with a significant time by sex interaction (p<0.05). WIA (1st peak) was correlated (p<0.05) to ∆Ew in both sexes before and 15 min post-exercise, but cPWV was only associated with ∆Ew in men at 30 min post-exercise. We conclude that both sexes decrease ∆Ew after maximal exercise, but vascular and ventricular changes associated with the attenuation of ∆Ew are not uniform between sexes.
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Affiliation(s)
- A D Lane
- Kinesiology, Nutrition and Rehabilitation, University of Illinois Chicago, Chicago, IL 60608, United States.
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Kappus R, Ranadive S, Lane A, Yan H, Cook M, Woods J, Wilund K, Fernhall B. P5.15 SEX DIFFERENCES IN CENTRAL ARTERIAL STIFFNESS AND PRESSURES BEFORE AND FOLLOWING MAXIMAL EXERCISE. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.164] [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: 11/29/2022] Open
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Wilund K, Shin S, Ryong Chung H, Kistler B, Fitschen P, Sosnoff J. CONTRIBUTION OF COGNITIVE INTERFERENCE TO DECREMENTS IN WALKING PERFORMANCE IN HEMODIALYSIS PATIENTS. Kidney Res Clin Pract 2012. [DOI: 10.1016/j.krcp.2012.04.593] [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: 11/16/2022] Open
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Lane AD, Heffernan KS, Rossow LM, Fahs CA, Ranadive SM, Yan H, Baynard T, Wilund K, Fernhall B. Aortic reservoir function, estimated myocardial demand and coronary perfusion pressure following steady-state and interval exercise. Clin Physiol Funct Imaging 2012; 32:353-60. [DOI: 10.1111/j.1475-097x.2012.01136.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 03/13/2012] [Indexed: 01/09/2023]
Affiliation(s)
- A. D. Lane
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
| | - K. S. Heffernan
- Department of Exercise Science; Syracuse University; Syracuse; NY
| | - L. M. Rossow
- Department of Health and Exercise Science, Neuromuscular Research Laboratory; University of Oklahoma; Norman; OK; USA
| | - C. A. Fahs
- Department of Health and Exercise Science, Neuromuscular Research Laboratory; University of Oklahoma; Norman; OK; USA
| | - S. M. Ranadive
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
| | - H. Yan
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
| | - T. Baynard
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
| | - K. Wilund
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
| | - B. Fernhall
- Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health; University of Illinois at Urbana-Champaign; Champaign; IL
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Kappus RM, Ranadive S, Yan H, Lane AD, Cook MD, Hall G, Harvey IS, Scott Q, Wilund K, Woods JA, Fernhall B. End Systolic Pressure Changes Following an Acute Bout of Exercise in African Americans and Caucasians. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401255.52713.fb] [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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Lane AD, Rossow L, Fahs C, Baynard T, Wilund K, Yan H, Ranadive S, Agiovlastis S, Fernhall B. Aortic Reservoir Function is Attenuated Following Acute Endurance and Interval Exercise. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000384449.88688.a2] [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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Wilund K, Tomayko E, Wu E, Chung HR, Vallurupalli S, Cachia A, Cortez F, Masinelli A, Fernhall B. Inflammatory Response to Exercise Training in Chronic Kidney Disease. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000353004.98285.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Chung HR, Feeney LA, Tomayko EJ, Cachia A, Wilund K. Endurance Exercise Training and Gallstone Development in Mice. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000323179.58386.72] [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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Tomayko EJ, Evans E, Fernhall B, Wilund K. Physical Activity, Coronary Artery Calcium, and Bone Mineral Density in Elderly Men and Women. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000323224.88811.03] [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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Wilund K, Feeney LA, Tomayko EJ, Hagberg JM. Effect of Endurance Exercise Training on Markers of Cholesterol Absorption and Synthesis. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000323175.66009.55] [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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Wilund K. Exercise and Anti-inflammation in Atherosclerosis. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-00223] [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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Wilund K. Exercise and Anti-inflammation in Atherosclerosis. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-00082] [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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Garcia CK, Wilund K, Arca M, Zuliani G, Fellin R, Maioli M, Calandra S, Bertolini S, Cossu F, Grishin N, Barnes R, Cohen JC, Hobbs HH. Autosomal recessive hypercholesterolemia caused by mutations in a putative LDL receptor adaptor protein. Science 2001; 292:1394-8. [PMID: 11326085 DOI: 10.1126/science.1060458] [Citation(s) in RCA: 401] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Atherogenic low density lipoproteins are cleared from the circulation by hepatic low density lipoprotein receptors (LDLR). Two inherited forms of hypercholesterolemia result from loss of LDLR activity: autosomal dominant familial hypercholesterolemia (FH), caused by mutations in the LDLR gene, and autosomal recessive hypercholesterolemia (ARH), of unknown etiology. Here we map the ARH locus to an approximately 1-centimorgan interval on chromosome 1p35 and identify six mutations in a gene encoding a putative adaptor protein (ARH). ARH contains a phosphotyrosine binding (PTB) domain, which in other proteins binds NPXY motifs in the cytoplasmic tails of cell-surface receptors, including the LDLR. ARH appears to have a tissue-specific role in LDLR function, as it is required in liver but not in fibroblasts.
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Affiliation(s)
- C K Garcia
- McDermott Center for Human Growth and Development and Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
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