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Pettit-Mee RJ, Power G, Cabral-Amador FJ, Ramirez-Perez FI, Nogueira Soares R, Sharma N, Liu Y, Christou DD, Kanaley JA, Martinez-Lemus LA, Manrique-Acevedo CM, Padilla J. Endothelial HSP72 is not reduced in type 2 diabetes nor is it a key determinant of endothelial insulin sensitivity. Am J Physiol Regul Integr Comp Physiol 2022; 323:R43-R58. [PMID: 35470695 DOI: 10.1152/ajpregu.00006.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/22/2022]
Abstract
Impaired endothelial insulin signaling and consequent blunting of insulin-induced vasodilation is a feature of type 2 diabetes (T2D) that contributes to vascular disease and glycemic dysregulation. However, the molecular mechanisms underlying endothelial insulin resistance remain poorly known. Herein, we tested the hypothesis that endothelial insulin resistance in T2D is attributed to reduced expression of heat shock protein 72(HSP72). HSP72 is a cytoprotective chaperone protein that can be upregulated with heating and is reported to promote insulin sensitivity in metabolically active tissues, in part via inhibition of JNK activity. Accordingly, we further hypothesized that, in T2D individuals, seven days of passive heat treatment via hot water immersion to waist-level would improve leg blood flow responses to an oral glucose load (i.e., endogenous insulin stimulation) via induction of endothelial HSP72. In contrast, we found that: 1) endothelial insulin resistance in T2D mice and humans was not associated with reduced HSP72 in aortas and venous endothelial cells, respectively; 2) after passive heat treatment, improved leg blood flow responses to an oral glucose load did not parallel with increased endothelial HSP72; 3) downregulation of HSP72 (via small-interfering RNA) or upregulation of HSP72 (via heating) in cultured endothelial cells did not impair or enhance insulin signaling, respectively, nor was JNK activity altered. Collectively, these findings do not support the hypothesis that reduced HSP72 is a key driver of endothelial insulin resistance in T2D but provide novel evidence that lower-body heating may be an effective strategy for improving leg blood flow responses to glucose ingestion-induced hyperinsulinemia.
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Affiliation(s)
- Ryan J Pettit-Mee
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Gavin Power
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | | | | | | | - Neekun Sharma
- Department of Medicine, University of Missouri, Columbia, MO, United States
| | - Ying Liu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Luis A Martinez-Lemus
- Department of Medicine, University of Missouri, Columbia, MO, United States.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
| | - Camila M Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Missouri, Columbia, MO, United States.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
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Smith JR, Berg JD, Curry TB, Joyner MJ, Olson TP. Respiratory muscle work influences locomotor convective and diffusive oxygen transport in human heart failure during exercise. Physiol Rep 2021; 8:e14484. [PMID: 32562374 PMCID: PMC7305241 DOI: 10.14814/phy2.14484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction It remains unclear if naturally occurring respiratory muscle (RM) work influences leg diffusive O2 transport during exercise in heart failure patients with reduced ejection fraction (HFrEF). In this retrospective study, we hypothesized that RM unloading during submaximal exercise will lead to increases in locomotor muscle O2 diffusion capacity (DMO2) contributing to the greater leg VO2. Methods Ten HFrEF patients and 10 healthy control matched participants performed two submaximal exercise bouts (i.e., with and without RM unloading). During exercise, leg blood flow was measured via constant infusion thermodilution. Intrathoracic pressure was measured via esophageal balloon. Radial arterial and femoral venous blood gases were measured and used to calculate leg arterial and venous content (CaO2 and CvO2, respectively), VO2, O2 delivery, and DMO2. Results From CTL to RM unloading, leg VO2, O2 delivery, and DMO2 were not different in healthy participants during submaximal exercise (all, p > .15). In HFrEF, leg VO2 (CTL: 0.7 ± 0.3 vs. RM unloading: 1.0 ± 0.4 L/min, p < .01), leg O2 delivery (CTL: 0.9 ± 0.4 vs. RM unloading: 1.4 ± 0.5 L/min, p < .01), and leg DMO2 (CTL: 31.5 ± 11.4 vs. RM unloading: 49.7 ± 18.6 ml min−1 mmHg−1) increased from CTL to RM unloading during submaximal exercise (all, p < .01), whereas CaO2‐CvO2 was not different (p = .51). The degree of RM unloading (i.e., % decrease in esophageal pressure‐time integral during inspiration) was related to the % increase in leg DMO2 with RM unloading (r = −.76, p = .01). Conclusion Our data suggest RM unloading leads to increased leg VO2 due to greater convective and diffusive O2 transport during submaximal exercise in HFrEF patients.
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Affiliation(s)
- Joshua R Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jessica D Berg
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy B Curry
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas P Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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3
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Hardy TA, Paula-Ribeiro M, Silva BM, Lyall GK, Birch KM, Ferguson C, Taylor BJ. The cardiovascular consequences of fatiguing expiratory muscle work in otherwise resting healthy humans. J Appl Physiol (1985) 2021; 130:421-434. [PMID: 33356985 DOI: 10.1152/japplphysiol.00116.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In 11 healthy adults (25 ± 4 yr; 2 female, 9 male subjects), we investigated the effect of expiratory resistive loaded breathing [65% maximal expiratory mouth pressure (MEP), 15 breaths·min-1, duty cycle 0.5; ERLPm] on mean arterial pressure (MAP), leg vascular resistance (LVR), and leg blood flow ([Formula: see text]). On a separate day, a subset of five male subjects performed ERL targeting 65% of maximal expiratory gastric pressure (ERLPga). ERL-induced expiratory muscle fatigue was confirmed by a 17 ± 5% reduction in MEP (P < 0.05) and a 16 ± 12% reduction in the gastric twitch pressure response to magnetic nerve stimulation (P = 0.09) from before to after ERLPm and ERLPga, respectively. From rest to task failure in ERLPm and ERLPga, MAP increased (ERLPm = 31 ± 10 mmHg, ERLPga = 18 ± 9 mmHg, both P < 0.05), but group mean LVR and [Formula: see text] were unchanged (ERLPm: LVR = 0.78 ± 0.21 vs. 0.97 ± 0.36 mmHg·mL-1·min, [Formula: see text] = 133 ± 34 vs. 152 ± 74 mL·min-1; ERLPga: LVR = 0.70 ± 0.21 vs. 0.84 ± 0.33 mmHg·mL-1·min, [Formula: see text] = 160 ± 48 vs. 179 ± 110 mL·min-1) (all P ≥ 0.05). Interestingly, [Formula: see text] during ERLPga oscillated within each breath, increasing (∼66%) and decreasing (∼50%) relative to resting values during resisted expirations and unresisted inspirations, respectively. In conclusion, fatiguing expiratory muscle work did not affect group mean LVR or [Formula: see text] in otherwise resting humans. We speculate that any sympathetically mediated peripheral vasoconstriction was counteracted by transient mechanical effects of high intra-abdominal pressures during ERL.NEW & NOTEWORTHY Fatiguing expiratory muscle work in otherwise resting humans elicits an increase in sympathetic motor outflow; whether limb blood flow ([Formula: see text]) and leg vascular resistance (LVR) are affected remains unknown. We found that fatiguing expiratory resistive loaded breathing (ERL) did not affect group mean [Formula: see text] or LVR. However, within-breath oscillations in [Formula: see text] may reflect a sympathetically mediated vasoconstriction that was counteracted by transient increases in [Formula: see text] due to the mechanical effects of high intra-abdominal pressure during ERL.
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Affiliation(s)
- Tim A Hardy
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Marcelle Paula-Ribeiro
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Bruno M Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Gemma K Lyall
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Karen M Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Carrie Ferguson
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Bryan J Taylor
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
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4
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Amin SB, Hansen AB, Mugele H, Willmer F, Gross F, Reimeir B, Cornwell WK, Simpson LL, Moore JP, Romero SA, Lawley JS. Whole body passive heating versus dynamic lower body exercise: a comparison of peripheral hemodynamic profiles. J Appl Physiol (1985) 2020; 130:160-171. [PMID: 33090910 DOI: 10.1152/japplphysiol.00291.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Passive heating has emerged as a therapeutic intervention for the treatment and prevention of cardiovascular disease. Like exercise, heating increases peripheral artery blood flow and shear rate, which is thought to be a primary mechanism underpinning endothelium-mediated vascular adaptation. However, few studies have compared the increase in arterial blood flow and shear rate between dynamic exercise and passive heating. In a fixed crossover design study, 15 moderately trained healthy participants (25.6 ± 3.4 yr) (5 female) underwent 30 min of whole body passive heating (42°C bath), followed on a separate day by 30 min of semi-recumbent stepping exercise performed at two workloads corresponding to the increase in cardiac output (Qc) (Δ3.72 L·min-1) and heart rate (HR) (Δ40 beats/min) recorded at the end of passive heating. At the same Qc (Δ3.72 L·min-1 vs. 3.78 L·min-1), femoral artery blood flow (1,599 mL/min vs. 1,947 mL/min) (P = 0.596) and shear rate (162 s-1 vs. 192 s-1) (P = 0.471) measured by ultrasonography were similar between passive heating and stepping exercise. However, for the same HRMATCHED intensity, femoral blood flow (1,599 mL·min-1 vs. 2,588 mL·min-1) and shear rate (161 s-1 vs. 271 s-1) were significantly greater during exercise, compared with heating (both P = <0.001). The results indicate that, for moderately trained individuals, passive heating increases common femoral artery blood flow and shear rate similar to low-intensity continuous dynamic exercise (29% V̇o2max); however, exercise performed at a higher intensity (53% V̇o2max) results in significantly larger shear rates toward the active skeletal muscle.NEW & NOTEWORTHY Passive heating and exercise increase blood flow through arteries, generating a frictional force, termed shear rate, which is associated with positive vascular health. Few studies have compared the increase in arterial blood flow and shear rate elicited by passive heating with that elicited by dynamic continuous exercise. We found that 30 min of whole body passive hot-water immersion (42°C bath) increased femoral artery blood flow and shear rate equivalent to exercising at a moderate intensity (∼57% HRmax).
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Affiliation(s)
- Sachin B Amin
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Alexander B Hansen
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hendrik Mugele
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Felix Willmer
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Florian Gross
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Benjamin Reimeir
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - William K Cornwell
- Department of Medicine - Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Clinical and Translational Research Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lydia L Simpson
- School of Sport, Health & Exercise Science, Bangor University, Bangor, United Kingdom
| | - Jonathan P Moore
- School of Sport, Health & Exercise Science, Bangor University, Bangor, United Kingdom
| | - Steven A Romero
- University of North Texas Health Science Center, Fort Worth, Texas
| | - Justin S Lawley
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Skattebo Ø, Calbet JAL, Rud B, Capelli C, Hallén J. Contribution of oxygen extraction fraction to maximal oxygen uptake in healthy young men. Acta Physiol (Oxf) 2020; 230:e13486. [PMID: 32365270 PMCID: PMC7540168 DOI: 10.1111/apha.13486] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/16/2022]
Abstract
We analysed the importance of systemic and peripheral arteriovenous O2 difference (
a-v¯O2 difference and a‐vfO2 difference, respectively) and O2 extraction fraction for maximal oxygen uptake (
V˙O2max). Fick law of diffusion and the Piiper and Scheid model were applied to investigate whether diffusion versus perfusion limitations vary with
V˙O2max. Articles (n = 17) publishing individual data (n = 154) on
V˙O2max, maximal cardiac output (
Q˙max; indicator‐dilution or the Fick method),
a-v¯O2 difference (catheters or the Fick equation) and systemic O2 extraction fraction were identified. For the peripheral responses, group‐mean data (articles: n = 27; subjects: n = 234) on leg blood flow (LBF; thermodilution), a‐vfO2 difference and O2 extraction fraction (arterial and femoral venous catheters) were obtained.
Q˙max and two‐LBF increased linearly by 4.9‐6.0 L · min–1 per 1 L · min–1 increase in
V˙O2max (R2 = .73 and R2 = .67, respectively; both P < .001). The
a-v¯O2 difference increased from 118‐168 mL · L–1 from a
V˙O2max of 2‐4.5 L · min–1 followed by a reduction (second‐order polynomial: R2 = .27). After accounting for a hypoxemia‐induced decrease in arterial O2 content with increasing
V˙O2max (R2 = .17; P < .001), systemic O2 extraction fraction increased up to ~90% (
V˙O2max: 4.5 L · min–1) with no further change (exponential decay model: R2 = .42). Likewise, leg O2 extraction fraction increased with
V˙O2max to approach a maximal value of ~90‐95% (R2 = .83). Muscle O2 diffusing capacity and the equilibration index Y increased linearly with
V˙O2max (R2 = .77 and R2 = .31, respectively; both P < .01), reflecting decreasing O2 diffusional limitations and accentuating O2 delivery limitations. In conclusion, although O2 delivery is the main limiting factor to
V˙O2max, enhanced O2 extraction fraction (≥90%) contributes to the remarkably high
V˙O2max in endurance‐trained individuals.
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Affiliation(s)
- Øyvind Skattebo
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
| | - Jose A. L. Calbet
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
- Department of Physical Education and Research Institute of Biomedical and Health Sciences (IUIBS) University of Las Palmas de Gran Canaria Gran Canaria Spain
| | - Bjarne Rud
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
| | - Carlo Capelli
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
- Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona Italy
| | - Jostein Hallén
- Department of Physical Performance Norwegian School of Sport Sciences Oslo Norway
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Abstract
Background Vascular dysfunction dominates the clinical picture of peripheral autonomic neuropathy in lower extremity. Patients and Methods We have studied functional changes of leg vasculature in 30 patients with chronic ulceration due to peripheral autonomic neuropathy between clinical stages 1 and 3. They suffered from lower extremity wounds. After sympathetic skin response test, pedal arterial blood flow analysis including peak systolic velocity (PSV) and pulsatility index (PI) was made by duplex ultrasonography (DUS) in involved legs. Vascular anatomy of leg was also examined by magnetic resonance angiography. Results The mean PSV value was found 58.32 cm/s in stage 1, 35.31 cm/s in stage 2, and 15.71 cm/s in stage 3. The mean PI value was observed 1.17 in stage 1, 1.43 in stage 2, and 1.87 in stage 3. In chronic stage 3, three patients had inadequate arterial blood supply and recurrent ulcer. Conclusions We suggest that reduced sympathetic activity due to small fiber neuropathy causes temporal variations in leg blood flow. There was a nonlinear relationship between vascular functional changes and stages of disease with increased, intermediate, and decreased blood flow, respectively. DUS assessment of pedal arteries contributed to differentiation of clinical stages and permitted vascular evaluation in the course of peripheral autonomic neuropathy.
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Affiliation(s)
- Behçet K Ener
- Department of Thoracic and Vascular Surgery, Ümraniye Training and Research Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Handan Uçankale
- Department of Radiology, Ümraniye Training and Research Hospital, Istanbul Health Sciences University, Istanbul, Turkey
| | - Reyhan Sürmeli
- Department of Neurology, Ümraniye Training and Research Hospital, Istanbul Health Sciences University, Istanbul, Turkey
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7
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Hydren JR, Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Kithas AC, Richardson RS. Delineating the age-related attenuation of vascular function: Evidence supporting the efficacy of the single passive leg movement as a screening tool. J Appl Physiol (1985) 2019; 126:1525-1532. [PMID: 30946637 DOI: 10.1152/japplphysiol.01084.2018] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Continuous passive leg movement (PLM) is a promising clinical assessment of the age-related decline in peripheral vascular function. To further refine PLM, this study evaluated the efficacy of a single PLM (sPLM), a simplified variant of the more established continuous movement approach, to delineate between healthy young and old men based on vascular function. Twelve young (26 ± 5 yr) and 12 old (70 ± 7 yr) subjects underwent sPLM (a single passive flexion and extension of the knee joint through 90°), with leg blood flow (LBF, common femoral artery with Doppler ultrasound), blood pressure (finger photoplethysmography), and leg vascular conductance (LVC) assessed. A receiver operator characteristic curve analysis was used to determine an age-specific cut score, and a factor analysis was performed to assess covariance. Baseline LBF and LVC were not different between groups (P = 0.6). The high level of covariance and similar predictive value for all PLM-induced LBF and LVC responses indicates LBF, alone, can act as a surrogate variable in this paradigm. The peak sPLM-induced increase in LBF from baseline was attenuated in the old (Young: 717 ± 227, Old: 260 ± 97 ml/min, P < 0.001; cut score: 372 ml/min), as was the total LBF response (Young: 155 ± 67, Old: 26 ± 17 ml, P < 0.001; cut score: 58 ml). sPLM, a simplified version of PLM, exhibits the prerequisite qualities of a valid screening test for peripheral vascular dysfunction, as evidenced by an age-related attenuation in the peripheral hyperemic response and a clearly delineated age-specific cut score. NEW & NOTEWORTHY Single passive leg movement (sPLM) exhibits the prerequisite qualities of a valid screening test for peripheral vascular dysfunction. sPLM displayed an age-related reduction in the peripheral hemodynamic response for amplitude, duration, initial rate of change, and total change with clearly delineated age-specific cut scores. sPLM has a strong candidate variable that is a simple single numeric value, for which to appraise peripheral vascular function, the 45-s hyperemic response (leg blood flow area under the curve: 45 s).
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Affiliation(s)
- Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Salt Lake City Veteran Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Joel D Trinity
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veteran Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Jayson R Gifford
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Exercise Sciences, Brigham Young University, Utah
| | - Oh Sung Kwon
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Kinesiology, University of Connecticut , Storrs, Connecticut
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Salt Lake City Veteran Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
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8
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Iepsen UW, Munch GW, Ryrsø CK, Secher NH, Lange P, Thaning P, Pedersen BK, Mortensen SP. Muscle α-adrenergic responsiveness during exercise and ATP-induced vasodilation in chronic obstructive pulmonary disease patients. Am J Physiol Heart Circ Physiol 2017; 314:H180-H187. [PMID: 29030339 DOI: 10.1152/ajpheart.00398.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sympathetic vasoconstriction is blunted in exercising muscle (functional sympatholysis) but becomes attenuated with age. We tested the hypothesis that functional sympatholysis is further impaired in chronic obstructive pulmonary disease (COPD) patients. We determined leg blood flow and calculated leg vascular conductance (LVC) during 1) femoral-arterial Tyramine infusion (evokes endogenous norepinephrine release, 1 µmol·min-1·kg leg mass-1), 2) one-legged knee extensor exercise with and without Tyramine infusion [10 W and 20% of maximal workload (WLmax)], 3) ATP (0.05 µmol·min-1·kg leg mass-1) and Tyramine infusion, and 4) incremental ATP infusions (0.05, 0.3, and 3.0 µmol·min-1·kg leg mass-1). We included 10 patients with moderate to severe COPD and 8 age-matched healthy control subjects. Overall, leg blood flow and LVC were lower in COPD patients during exercise ( P < 0.05). Tyramine reduced LVC in both groups at 10-W exercise (COPD: -3 ± 1 ml·min-1·mmHg-1 and controls: -3 ± 1 ml·min-1·mmHg-1, P < 0.05) and 20% WLmax (COPD: -4 ± 1 ml·min-1·mmHg-1 and controls: -3 ± 1 ml·min-1·mmHg-1, P < 0.05) with no difference between groups. Incremental ATP infusions induced dose-dependent vasodilation with no difference between groups, and, in addition, the vasoconstrictor response to Tyramine infused together with ATP was not different between groups (COPD: -0.03 ± 0.01 l·min-1·kg leg mass-1 vs. CONTROLS -0.04 ± 0.01 l·min-1·kg leg mass-1, P > 0.05). Compared with age-matched healthy control subjects, the vasodilatory response to ATP is intact in COPD patients and their ability to blunt sympathetic vasoconstriction (functional sympatholysis) as evaluated by intra-arterial Tyramine during exercise or ATP infusion is maintained. NEW & NOTEWORTHY The ability to blunt sympathetic vasoconstriction in exercising muscle and ATP-induced dilation in chronic obstructive pulmonary disease patients remains unexplored. Chronic obstructive pulmonary disease patients demonstrated similar sympathetic vasoconstriction in response to intra-arterial Tyramine during exercise and ATP-induced vasodilation compared with age-matched healthy control subjects.
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Affiliation(s)
- U W Iepsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark
| | - G W Munch
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark
| | - C K Ryrsø
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark
| | - N H Secher
- Department of Anesthesiology, The Copenhagen Muscle Research Centre, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark
| | - P Lange
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark.,Medical Department O, Respiratory Section, Herlev and Gentofte Hospital, Copenhagen , Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen , Copenhagen , Denmark
| | - P Thaning
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark.,Medical Department O, Respiratory Section, Herlev and Gentofte Hospital, Copenhagen , Denmark
| | - B K Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark
| | - S P Mortensen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, University of Copenhagen, Rigshospitalet, Copenhagen , Denmark.,Department of Cardiovascular and Renal Research, University of Southern Denmark, Denmark
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9
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Chiesa ST, Trangmar SJ, González-Alonso J. Temperature and blood flow distribution in the human leg during passive heat stress. J Appl Physiol (1985) 2016; 120:1047-58. [PMID: 26823344 PMCID: PMC4894946 DOI: 10.1152/japplphysiol.00965.2015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 01/22/2016] [Indexed: 01/19/2023] Open
Abstract
The ability of direct heat stress to increase limb blood flow is well known, but the magnitude and profile of hemodynamic responses within the major vessels of the leg have not been explored. Here, we systematically characterize these responses through a wide range of heat stress levels and show that isolated leg heating confers potentially beneficial hemodynamic changes equivalent to those of moderate whole body hyperthermia, with these hemodynamic adjustments being predominantly driven by local temperature-sensitive mechanisms. The influence of temperature on the hemodynamic adjustments to direct passive heat stress within the leg's major arterial and venous vessels and compartments remains unclear. Fifteen healthy young males were tested during exposure to either passive whole body heat stress to levels approaching thermal tolerance [core temperature (Tc) + 2°C; study 1; n = 8] or single leg heat stress (Tc + 0°C; study 2; n = 7). Whole body heat stress increased perfusion and decreased oscillatory shear index in relation to the rise in leg temperature (Tleg) in all three major arteries supplying the leg, plateauing in the common and superficial femoral arteries before reaching severe heat stress levels. Isolated leg heat stress increased arterial blood flows and shear patterns to a level similar to that obtained during moderate core hyperthermia (Tc + 1°C). Despite modest increases in great saphenous venous (GSV) blood flow (0.2 l/min), the deep venous system accounted for the majority of returning flow (common femoral vein 0.7 l/min) during intense to severe levels of heat stress. Rapid cooling of a single leg during severe whole body heat stress resulted in an equivalent blood flow reduction in the major artery supplying the thigh deep tissues only, suggesting central temperature-sensitive mechanisms contribute to skin blood flow alone. These findings further our knowledge of leg hemodynamic responses during direct heat stress and provide evidence of potentially beneficial vascular alterations during isolated limb heat stress that are equivalent to those experienced during exposure to moderate levels of whole body hyperthermia.
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Affiliation(s)
- Scott T Chiesa
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Steven J Trangmar
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
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Chiesa ST, Trangmar SJ, Kalsi KK, Rakobowchuk M, Banker DS, Lotlikar MD, Ali L, González-Alonso J. Local temperature-sensitive mechanisms are important mediators of limb tissue hyperemia in the heat-stressed human at rest and during small muscle mass exercise. Am J Physiol Heart Circ Physiol 2015; 309:H369-80. [PMID: 25934093 PMCID: PMC4504966 DOI: 10.1152/ajpheart.00078.2015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/27/2015] [Indexed: 11/30/2022]
Abstract
Limb tissue and systemic blood flow increases with heat stress, but the underlying mechanisms remain poorly understood. Here, we tested the hypothesis that heat stress-induced increases in limb tissue perfusion are primarily mediated by local temperature-sensitive mechanisms. Leg and systemic temperatures and hemodynamics were measured at rest and during incremental single-legged knee extensor exercise in 15 males exposed to 1 h of either systemic passive heat-stress with simultaneous cooling of a single leg (n = 8) or isolated leg heating or cooling (n = 7). Systemic heat stress increased core, skin and heated leg blood temperatures (Tb), cardiac output, and heated leg blood flow (LBF; 0.6 ± 0.1 l/min; P < 0.05). In the cooled leg, however, LBF remained unchanged throughout (P > 0.05). Increased heated leg deep tissue blood flow was closely related to Tb (R2 = 0.50; P < 0.01), which is partly attributed to increases in tissue V̇O2 (R2 = 0.55; P < 0.01) accompanying elevations in total leg glucose uptake (P < 0.05). During isolated limb heating and cooling, LBFs were equivalent to those found during systemic heat stress (P > 0.05), despite unchanged systemic temperatures and hemodynamics. During incremental exercise, heated LBF was consistently maintained ∼0.6 l/min higher than that in the cooled leg (P < 0.01), with LBF and vascular conductance in both legs showing a strong correlation with their respective local Tb (R2 = 0.85 and 0.95, P < 0.05). We conclude that local temperature-sensitive mechanisms are important mediators in limb tissue perfusion regulation both at rest and during small-muscle mass exercise in hyperthermic humans.
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Affiliation(s)
- Scott T Chiesa
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and
| | - Steven J Trangmar
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and
| | - Kameljit K Kalsi
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and
| | - Mark Rakobowchuk
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and
| | - Devendar S Banker
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and Department of Anaesthetics, Ealing Hospital NHS Trust, Southall, UK
| | - Makrand D Lotlikar
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and Department of Anaesthetics, Ealing Hospital NHS Trust, Southall, UK
| | - Leena Ali
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and Department of Anaesthetics, Ealing Hospital NHS Trust, Southall, UK
| | - José González-Alonso
- Centre for Sports Medicine and Human Performance, Brunel University London, Uxbridge, UK; and
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11
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Trinity JD, Groot HJ, Layec G, Rossman MJ, Ives SJ, Morgan DE, Gmelch BS, Bledsoe A, Richardson RS. Passive leg movement and nitric oxide-mediated vascular function: the impact of age. Am J Physiol Heart Circ Physiol 2015; 308:H672-9. [PMID: 25576629 PMCID: PMC4360052 DOI: 10.1152/ajpheart.00806.2014] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/05/2015] [Indexed: 01/14/2023]
Abstract
In young healthy men, passive leg movement (PLM) elicits a robust nitric oxide (NO)-dependent increase in leg blood flow (LBF), thus providing a novel approach to assess NO-mediated vascular function. While the magnitude of the LBF response to PLM is markedly reduced with age, the role of NO in this attenuated response in the elderly is unknown. Therefore, this study sought to determine the contribution of NO in the PLM-induced LBF with age. Fourteen male subjects (7 young, 24 ± 1 yr; and 7 old, 75 ± 3 yr) underwent PLM with and without NO synthase (NOS) inhibition achieved by intra-arterial infusion of N(G)-monomethyl-L-arginine (L-NMMA). LBF was determined second-by-second by Doppler ultrasound, and central hemodynamics were measured by finger photoplethysmography. NOS inhibition blunted the PLM-induced peak increase in LBF in the young (control: 668 ± 106; L-NMMA 431 ± 95 Δml/min; P = 0.03) but had no effect in the old (control: 266 ± 98; L-NMMA 251 ± 92 Δml/min; P = 0.59). Likewise, the magnitude of the reduction in the overall (i.e., area under the curve) PLM-induced LBF response to NOS inhibition was less in the old (LBF: -31 ± 18 ml) than the young (LBF: -129 ± 21 ml; P < 0.01). These findings suggest that the age-associated reduction in PLM-induced LBF in the elderly is primarily due to a reduced contribution to vasodilation from NO and therefore support the use of PLM as a novel approach to assess NO-mediated vascular function across the lifespan.
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Affiliation(s)
- Joel D Trinity
- Geriatric Research Education and Clinical Center, George E. Wahlen, Veteran Affairs Medical Center, Salt Lake City, Utah; Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah;
| | - H Jonathan Groot
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
| | - Gwenael Layec
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Matthew J Rossman
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
| | - Stephen J Ives
- Geriatric Research Education and Clinical Center, George E. Wahlen, Veteran Affairs Medical Center, Salt Lake City, Utah; Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah; Department of Health and Exercise Sciences, Skidmore College, Saratoga Springs, New York
| | - David E Morgan
- Department of Anesthesia, University of Utah, Salt Lake City, Utah; and
| | - Ben S Gmelch
- Department of Anesthesia, University of Utah, Salt Lake City, Utah; and
| | - Amber Bledsoe
- Department of Anesthesia, University of Utah, Salt Lake City, Utah; and
| | - Russell S Richardson
- Geriatric Research Education and Clinical Center, George E. Wahlen, Veteran Affairs Medical Center, Salt Lake City, Utah; Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah; Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah
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