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Matheson C, Simovic T, Heefner A, Colon M, Tunon E, Cobb K, Thode C, Breland A, Cobb CO, Nana-Sinkam P, Garten R, Rodriguez-Miguelez P. Evidence of premature vascular dysfunction in young adults who regularly use e-cigarettes and the impact of usage length. Angiogenesis 2024; 27:229-243. [PMID: 38345700 PMCID: PMC11021332 DOI: 10.1007/s10456-023-09903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 04/17/2024]
Abstract
BACKGROUND Electronic (e-) cigarettes are increasingly popular tobacco products on the US market. Traditional tobacco products are known to cause vascular dysfunction, one of the earliest indicators of cardiovascular disease (CVD) development. However, little is known about the effect of regular e-cigarette use on vascular function. The purpose of this study was to investigate the impact of regular e-cigarette use on vascular function and cardiovascular health in young, healthy adults. METHODS Twenty-one regular users of e-cigarettes (ECU) and twenty-one demographically matched non-users (NU) completed this study. Vascular health was assessed in the cutaneous microcirculation through different reactivity tests to evaluate overall functionality, endothelium-dependent vasodilation (EDD), and endothelium-independent vasodilation (EID). Macrovascular function was assessed using flow-mediated dilation (FMD). RESULTS Our results suggest that regular users of e-cigarettes present with premature microvascular impairment when compared to non-users. Specifically, they exhibit lower hyperemic (p = 0.003), thermal (p = 0.010), and EDD (p = 0.004) responses. No differences in EID between the groups were identified. We also identified that individuals who use e-cigarettes for longer than 3 years also present with systemic manifestations, as observed by significantly reduced macrovascular (p = 0.002) and microvascular (p ≤ 0.044) function. CONCLUSIONS Our novel data suggests that young, apparently healthy, regular users of e-cigarettes present with premature vascular dysfunction in the microcirculation when compared to non-users. We have also identified systemic vascular dysfunction affecting both the micro and macrovasculature in those young individuals who used e-cigarettes for longer than 3 years. Taken together, these findings associate regular e-cigarette use with premature vascular dysfunctions and adverse cardiovascular outcomes.
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Affiliation(s)
- Chloe Matheson
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Tijana Simovic
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Allison Heefner
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Marisa Colon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Enrique Tunon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Kolton Cobb
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Christopher Thode
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Alison Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Patrick Nana-Sinkam
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, USA
| | - Ryan Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA.
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, USA.
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2
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Tegg NL, Myburgh C, O'Donnell E, Kennedy M, Norris CM. Impact of Secondary Amenorrhea on Cardiovascular Disease Risk in Physically Active Women: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2024; 13:e033154. [PMID: 38497482 PMCID: PMC11010010 DOI: 10.1161/jaha.123.033154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Exercise-associated secondary amenorrhea results in estrogen deficiency, which may lead to dysfunction in estrogen's normal cardioprotective pathways. Estrogen may be essential in a woman's endothelial adaptations to exercise. The objective of this review was to assess the association between secondary amenorrhea in physically active women and cardiovascular disease (CVD) risk. METHODS AND RESULTS A literature search was performed in January 2023 and updated in August 2023 of the Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations. Citation chaining was done to screen for additional studies. Eight sources were searched for gray literature. Studies that compared physically active women with amenorrhea to physically active women with eumenorrhea aged 18 to 35 years with evidence of CVD, alterations to cardiovascular physiology, or CVD risks were included. Eighteen observational studies from 3 countries were included. Overall, the quality of evidence was good. A meta-analysis was performed. Physically active women with secondary amenorrhea had significantly lower estradiol, flow-mediated dilation, resting heart rate, systolic blood pressure, and diastolic blood pressure and higher total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein cholesterol. CONCLUSIONS Estrogen deficiency resulting from exercise-associated secondary amenorrhea in physically active women may impact cardiovascular physiology and certain CVD risk factors. The research in this area is observational; therefore, findings should be interpreted cautiously. However, as exercise-associated secondary amenorrhea is reversible and the primary prevention of CVD is important for public health, it may be important to treat secondary amenorrhea and restore estrogen levels.
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Affiliation(s)
- Nicole L. Tegg
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Caitlynd Myburgh
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
- Faculty of Natural SciencesThe Kings UniversityEdmontonAlbertaCanada
| | | | | | - Colleen M. Norris
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
- Cavarzan Chair in Mature Women’s Research, WCHRIEdmontonAlbertaCanada
- Faculty of Medicine, School of Public Health SciencesUniversity of AlbertaEdmontonAlbertaCanada
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3
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Steward CJ, Hill M, Menzies C, Bailey SJ, Rahman M, Thake CD, Pugh CJA, Cullen T. Post exercise hot water immersion and hot water immersion in isolation enhance vascular, blood marker, and perceptual responses when compared to exercise alone. Scand J Med Sci Sports 2024; 34:e14600. [PMID: 38470997 DOI: 10.1111/sms.14600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
Exercise and passive heating induce some similar vascular hemodynamic, circulating blood marker, and perceptual responses. However, it remains unknown whether post exercise hot water immersion can synergise exercise derived responses and if they differ from hot water immersion alone. This study investigated the acute responses to post moderate-intensity exercise hot water immersion (EX+HWI) when compared to exercise (EX+REST) and hot water immersion (HWI+HWI) alone. Sixteen physically inactive middle-aged adults (nine males and seven females) completed a randomized cross-over counterbalanced design. Each condition consisted of two 30-min bouts separated by 10 min of rest. Cycling was set at a power output equivalent to 50% V̇o2 peak . Water temperature was controlled at 40°C up to the mid sternum with arms not submerged. Venous blood samples and artery ultrasound scans were assessed at 0 (baseline), 30 (immediately post stressor one), 70 (immediately post stressor two), and 100 min (recovery). Additional physiological and perceptual measures were assessed at 10-min intervals. Brachial and superficial femoral artery shear rates were higher after EX+HWI and HWI+HWI when compared with EX+REST (p < 0.001). Plasma nitrite was higher immediately following EX+HWI and HWI+HWI than EX+REST (p < 0.01). Serum interleukin-6 was higher immediately after EX+HWI compared to EX+REST (p = 0.046). Serum cortisol was lower at 30 min in the HWI+HWI condition in contrast to EX+REST (p = 0.026). EX+HWI and HWI+HWI were more enjoyable than EX+REST (p < 0.05). Irrespective of whether hot water immersion proceeded exercise or heating, hot water immersion enhanced vascular and blood marker responses, while also being more enjoyable than exercise alone.
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Affiliation(s)
- Charles J Steward
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Mathew Hill
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Campbell Menzies
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mushidur Rahman
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - C Douglas Thake
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
| | - Christopher J A Pugh
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, UK
| | - Tom Cullen
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
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4
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Riley S, Paterson C, Bates-Fraser LC, Ondrak KS, Stoner L, Hanson ED. Uninterrupted prolonged sitting and arterial stiffness: moderating effect of prior aerobic exercise in physically active adults. Eur J Appl Physiol 2024:10.1007/s00421-024-05419-0. [PMID: 38280015 DOI: 10.1007/s00421-024-05419-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/02/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE Prolonged sitting acutely increases arterial stiffness, with interruption strategies only providing limited success in offsetting these rises. Acute aerobic exercise is a potent stimulus to decrease arterial stiffness. However, limited information exists on the effectiveness of acute exercise to maintain arterial stiffness when performed prior to prolonged sitting, particularly within physically active individuals. METHODS Using a randomized crossover design, 22 young, active individuals (50% female) performed two conditions 30 min of walking at 55-65% of heart rate reserve (EX) and 30 min of standing (STAND) followed by 2.5-h of sitting. Brachial-femoral (bfPWV) and femoral-ankle pulse wave velocity (faPWV) were assessed at Baseline, post-exercise and pre-sitting (Pre), and post-sitting (Post) as estimates of central and peripheral arterial stiffness, respectively. RESULTS For bfPWV, no interaction, condition, or time effects were observed. For faPWV, an interaction was present (p < 0.001); compared to Baseline, there was a 6.1% decrease for EX (- 0.4 m/s, p < 0.001) and a 4.6% increase for STAND (0.3 m/s, p = 0.016) for STAND such that there was an 11.3% difference between conditions at Pre (0.7 m/s, p < 0.001). From Pre to Post, EX then increased by 11.7% (0.9 m/s p < 0.001) while STAND remained unchanged, resulting in no difference between conditions (0.1 m/s, p = 0.569). CONCLUSIONS While aerobic exercise resulted in a significant decrease in faPWV prior to sitting, the prior exercise bout did not confer a protective effect against the deleterious effects of uninterrupted sitting. Future work should investigate the combined effect of prior exercise and sitting interruption strategies on markers of arterial stiffness.
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Affiliation(s)
- Sasha Riley
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Craig Paterson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lauren C Bates-Fraser
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristin S Ondrak
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Han Y, Zhang J, Yang Z, Jian W, Zhu Y, Gao S, Liu Y, Li Y, He S, Zhang C, Li Y, You B, Liu J, Du J. Palmdelphin Deficiency Evokes NF-κB Signaling in Valvular Endothelial Cells and Aggravates Aortic Valvular Remodeling. JACC Basic Transl Sci 2023; 8:1457-1472. [PMID: 38093741 PMCID: PMC10714178 DOI: 10.1016/j.jacbts.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 01/24/2024]
Abstract
Palmd-deficient mice of advanced age manifest increased aortic valve peak velocity, thickened aortic valve leaflets, and excessive extracellular matrix deposition, which are key features of calcific aortic valve disease. PALMD is predominantly expressed in endothelial cells of aortic valves, and PALMD-silenced valvular endothelial cells are prone to oscillatory shear stress-induced endothelial-to-mesenchymal transition. Mechanistically, PALMD is associated with TNFAIP3 interaction protein 1, a binding protein of TNFAIP3 and IKBKG in NF-κB signaling. Loss of PALMD impairs TNFAIP3-dependent deubiquitinating activity and promotes the ubiquitination of IKBKG and subsequent NF-κB activation. Adeno-associated virus-mediated PALMD overexpression ameliorates aortic valvular remodeling in mice with calcific aortic valve disease, indicating protection.
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Affiliation(s)
- Yingchun Han
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Jichao Zhang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Zhao Yang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wen Jian
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yuexin Zhu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Shijuan Gao
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Yan Liu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Yingkai Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Songyuan He
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Congcong Zhang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Yang Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
| | - Bin You
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jinghua Liu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jie Du
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Vascular Diseases, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China
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6
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Plouffe AA, Fischer KP, Vranish JR. Acute upper and lower limb hemodynamic responses during single sessions of low- versus high-intensity inspiratory muscle strength training. J Appl Physiol (1985) 2023; 135:995-1000. [PMID: 37732375 DOI: 10.1152/japplphysiol.00558.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/22/2023] Open
Abstract
Inspiratory muscle strength training (IMST) has shown potential to improve both respiratory and cardiovascular function in health and disease. Less is known about acute hemodynamic responses to a single IMST session, therefore we assessed upper and lower limb blood flow via Doppler ultrasound in the brachial and popliteal arteries, respectively. Mean, anterograde, and retrograde blood flow (BF) and shear rate (SR) were assessed relative to baseline during low-intensity (15% maximal inspiratory pressure - PImax) and high-intensity (75% PImax) IMST. During low-intensity IMST, popliteal BF and SR were reduced by ∼10%, and brachial BF and SR were reduced by ∼40%. During high-intensity IMST, popliteal BF and SR were reduced by ∼20%, and brachial BF and SR were reduced by ∼35%. BF and SR responses were not statistically different between low-intensity and high-intensity training for either blood vessel (P > 0.05). In addition, anterograde BF and SR were significantly decreased in the brachial artery for both low-intensity and high-intensity training (P < 0.05), but not the popliteal artery (P > 0.05). Finally, during IMST retrograde BF and SR were significantly increased in both the upper and lower limbs during low-intensity and high-intensity training (P < 0.05). These data provide novel insight into the acute BF and SR responses to a single bout of IMST and may enhance our understanding of the mechanism(s) by which IMST imparts its beneficial chronic effects on cardiovascular function.NEW & NOTEWORTHY Herein, we demonstrate for the first time that upper and lower limb blood flow and shear rate patterns are altered during a single bout of IMST, at low- and high-intensity training. Specifically, anterograde blood flow and shear rate are significantly reduced in the brachial artery, whereas retrograde blood flow is significantly elevated in both the brachial and popliteal arteries. These findings provide insight into the vascular impact of IMST, which may inform future mechanistic studies.
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Affiliation(s)
- Audrey A Plouffe
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan, United States
| | - Kylah P Fischer
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan, United States
| | - Jennifer R Vranish
- Department of Integrative Physiology and Health Science, Alma College, Alma, Michigan, United States
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7
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Hanson BE, Casey DP. Intermittent versus continuous handgrip exercise and peripheral endothelial function: impact of shear rate fluctuations. J Appl Physiol (1985) 2023; 135:892-901. [PMID: 37650140 DOI: 10.1152/japplphysiol.00362.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/08/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
Sustained exercise-induced elevations in shear rate (SR) have been well established as beneficial for improving endothelial function. However, the impact of intermittent fluctuations in SR is not understood. We investigated the effect of intermittent SR elevations compared with sustained elevations on peripheral endothelial function. Brachial artery flow-mediated dilation (FMD) was assessed in 13 adults (9 M/4 F; 22 ± 4 yr) before and after 30 min of handgrip exercise. Three different rhythmic forearm exercise interventions were performed at a rate of 20 contractions/min. Intermittent exercises (6 × 3 min exercise interspersed by 2 min of rest) were performed at 25% (INT-25%) and 15% (INT-15%) maximum voluntary contraction (MVC), and continuous exercise was completed at 15% MVC. Brachial artery diameter and velocity were measured using Doppler ultrasound. The total increase in SR above baseline throughout exercise was greater during INT-25% (4,441 ± 516 s-1) and continuous (4,070 ± 407 s-1) compared with INT-15% (2,811 ± 342 s-1, P < 0.05). The %FMD increased following all exercises (INT-25%: 5.7 ± 1.2% to 8.1 ± 1.2%; INT-15%: 5.2 ± 1.2% to 7.0 ± 1.1%; continuous: 5.5 ± 1.3% to 6.8 ± 1.3%, P < 0.05 for all). The increase following INT-25% was significantly greater than INT-15% and continuous (P < 0.05 for both). Normalized FMD to shear rate area under the curve increased with intermittent exercise (INT-25%: 2.2 ± 0.2% to 3.4 ± 0.3%; INT-15%: 2.1 ± 0.2% to 3.2 ± 0.2%, P < 0.05 for both) but did not following continuous (2.1 ± 0.2% to 2.5 ± 0.1%, P = 0.06). The increase in normalized FMD with intermittent exercises were greater than continuous (P < 0.05 for both). These findings suggest intermittent fluctuations in SR during handgrip exercise may be more beneficial than sustained elevations on improving peripheral endothelial function.NEW & NOTEWORTHY Exercise-induced increases in shear rate is a well-established stimulus for improving peripheral endothelial function. This study presents novel findings that intermittent elevations in shear rate may be more effective at acutely improving endothelial function compared with continuous elevations. Despite similar increases in total shear rate during handgrip exercise intermittent elevations produced a significantly greater increase in endothelial function when compared with continuous elevations potentially indicating intermittent elevations as a more effective stimulus for acute improvements.
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Affiliation(s)
- Brady E Hanson
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa, United States
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, United States
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Cavalcante S, Teixeira M, Gouveia M, Duarte A, Ferreira M, Simões MI, Conceição M, Costa M, Ribeiro IP, Gonçalves AC, Oliveira J, Ribeiro F. Reaktion der endothelialen Progenitorzellen auf ein Multikomponenten-Trainingsprogramm bei Erwachsenen mit kardiovaskulären Risikofaktoren. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2023. [DOI: 10.1007/s12662-023-00882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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9
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Pekas EJ, Allen MF, Park SY. Prolonged sitting and peripheral vascular function: potential mechanisms and methodological considerations. J Appl Physiol (1985) 2023; 134:810-822. [PMID: 36794688 PMCID: PMC10042610 DOI: 10.1152/japplphysiol.00730.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/23/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Sitting time is associated with increased risks for subclinical atherosclerosis and cardiovascular disease development, and this is thought to be partially due to sitting-induced disturbances in macro- and microvascular function as well as molecular imbalances. Despite surmounting evidence supporting these claims, contributing mechanisms to these phenomena remain largely unknown. In this review, we discuss evidence for potential mechanisms of sitting-induced perturbations in peripheral hemodynamics and vascular function and how these potential mechanisms may be targeted using active and passive muscular contraction methods. Furthermore, we also highlight concerns regarding the experimental environment and population considerations for future studies. Optimizing prolonged sitting investigations may allow us to not only better understand the hypothesized sitting-induced transient proatherogenic environment but to also enhance methods and devise mechanistic targets to salvage sitting-induced attenuations in vascular function, which may ultimately play a role in averting atherosclerosis and cardiovascular disease development.
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Affiliation(s)
- Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, United States
| | - Michael F Allen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, United States
| | - Song-Young Park
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska, United States
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10
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Willems L, Vermeulen J, Wiegerinck A, Fekkes S, Reijnen M, Warlé M, De Korte C, Thijssen D. Construct Validity and Reproducibility of Handheld Ultrasound Devices in Carotid Artery Diameter Measurement. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:866-874. [PMID: 36567191 DOI: 10.1016/j.ultrasmedbio.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
The construct validity and reproducibility of three commonly used handheld ultrasound (US) devices in measuring carotid arterial diameter was evaluated: Telemed MicrUs EXT-1H (Telemed, Vilnius, Lithuania), Butterfly iQ (Butterfly Network, Inc., Guilford, CT, USA) and Philips Lumify (Philips Healthcare, Best, The Netherlands). An in vitro setup was built to evaluate construct validity, compared with high-end US, and intra-observer variability of handheld US devices. Handheld devices showed a mean difference of 0.023 ± 0.030 cm, 0.012 ± 0.037 cm and 0.009 ± 0.046 cm for, respectively, Telemed, Butterfly and Lumify in comparison with high-end US devices. Intraclass agreement with the high-end system as well as intra-observer variability for handheld US devices was classified as excellent, with all values greater than 0.95. Subsequently, inter-observer variability of handheld US devices was investigated in an in vivo setup with 20 healthy volunteers. Inter-observer variability was classified as excellent for Telemed (0.901), good for Lumify (0.827) and moderate for Butterfly (0.684) with a difference of, respectively, 0.005 ± 0.031 cm, 0.020 ± 0.050 cm and -0.003 ± 0.033 cm. In conclusion, handheld US devices demonstrated an excellent construct validity and intra-observer variability. Additionally, excellent-to-good inter-observer variability for Telemed and Lumify was observed, and Butterfly demonstrated a moderate inter-observer agreement. These results indicate that handheld US devices are effective for measuring carotid arterial diameter.
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Affiliation(s)
- Loes Willems
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Jenske Vermeulen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Anouk Wiegerinck
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Stein Fekkes
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Michel Reijnen
- Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands; Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Michiel Warlé
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Chris De Korte
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Dick Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Badour MI, Stone RM, Parikh KS, Lester NJ, Meloche OL, Wulterkens RN, Bain AR. Circulating Notch1 in response to altered vascular wall shear stress in adults. Exp Physiol 2022; 107:1426-1431. [PMID: 36116111 DOI: 10.1113/ep090749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/15/2022] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the central question of this study? Is the plasma concentration of Notch1 extracellular domain altered in response to decreased and increased vascular wall shear stress in the forearm in humans? What is the main finding and its importance? Notch1 extracellular domain is increased with acute increases in antegrade shear rate but does not change with 20 min of decreased shear rate caused by distal forearm occlusion. A novel and integral endothelial mechanosensor in humans that can help explain vascular endothelial adjustments in response to increases in antegrade shear stress was characterized. ABSTRACT Notch1 has been proposed as a novel endothelial mechanosensor that is central for signalling adjustments in response to changes in vascular wall shear stress. However, there remains no controlled in vivo study in humans. Accordingly, we sought to address the question of whether plasma concentrations of Notch1 extracellular domain (ECD) is altered in response to transient changes in vascular wall shear stress. In 10 young healthy adults (6M/4F), alterations in shear stress were induced by supra-systolic cuff inflation around the wrist. The opposite arm was treated as a time control with no wrist cuff inflation. Plasma was collected from an antecubital vein of both arms at baseline, 20 min of wrist cuff inflation (low shear), as well as 1-2 min (high shear) and 15 min following (recovery) wrist cuff release. The Notch1 ECD was quantified using a commercially available ELISA. Duplex ultrasound was used to confirm alterations in shear stress. In the experimental arm, concentrations of Notch1 ECD remained statistically similar to baseline at all time points except for immediately following cuff release where it was elevated by ∼50% (P = 0.033), coinciding with the condition of high antegrade shear rate. Concentrations of Notch1 ECD remained unchanged in the control arm through all time points. These data indicate that Notch1 is a viable biomarker for quantifying mechanotransduction in response to increased shear stress in humans, and it may underlie the vascular adaptations or mal-adaptations associated with conditions that impact antegrade shear.
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Affiliation(s)
- Matthew I Badour
- Faculty of Human Kinetics, University of Windsor, Ontario, Canada
| | - Rachel M Stone
- Faculty of Human Kinetics, University of Windsor, Ontario, Canada
| | | | | | - Olivia L Meloche
- Faculty of Human Kinetics, University of Windsor, Ontario, Canada
| | | | - Anthony R Bain
- Faculty of Human Kinetics, University of Windsor, Ontario, Canada
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12
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The effects of high-intensity interval training and moderate-intensity continuous training on visceral fat and carotid hemodynamics parameters in obese adults. J Exerc Sci Fit 2022; 20:355-365. [PMID: 36186829 PMCID: PMC9486563 DOI: 10.1016/j.jesf.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/14/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives The present study aimed to examine the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on visceral fat and hemodynamic parameters in obese adults. Methods Fifty-two males were included in this study and divided into three groups: HIIT group (n = 21, age = 20.86 ± 1.62 years, BF (%) = 30.10 ± 5.02), MICT group (n = 22, age = 20.76 ± 1.14 years, BF (%) = 30.19 ± 5.76), and control group (CON) (n = 9, age = 21.38 ± 1.77 years, BF (%) = 30.40 ± 5.10). The HIIT and MICT groups received the exercise intervention three to four times per week for eight weeks (HIIT: exercise intensity 80–95% HRmax, circuit; MICT: exercise intensity 60–70% HRmax, running), and the control (CON) group received health education and guidance without exercise intervention. The body compositions and serum lipid indexes were tested to calculated LAP and VAI. The color doppler ultrasound diagnostic technology was used to test the artery diameter and blood velocity before and after the intervention. Based on the test data, MATLAB software and Womersley theory were used to calculate the hemodynamic parameters of the common carotid artery, including wall shear stress, flow rate, blood pressure, oscillatory shear index, elasticity modulus, dynamic resistance, artery diameter, arterial stiffness, circumferential strain and pulsatility index. Results We found that lipid accumulation product (LAP) was significantly decreased in both the HIIT group (p < 0.01) and MICT (p < 0.05) group but not in the CON group (p > 0.05). In contrast, visceral adiposity index (VAI) decreased in both the HIIT and MICT groups and increased in the CON group, although the difference among groups was not significant (p > 0.05). After 8 weeks of intervention, the blood velocity and wall shear stress were greater after HIIT and MICT intervention (p < 0.01). Artery diameter, oscillatory shear index, arterial stiffness, and pulsatility index decreased significantly, and circumferential strain increased significantly in the HIIT group (all, p < 0.01, p < 0.05) but not in the MICT group (p > 0.05). Dynamic resistance was significantly decreased in the MICT group. There was no difference in the CON group after the period of intervention (all, p > 0.05). LAP was positively related to artery diameter (r = 0.48, p = 0.011), blood pressure (r = 0.46, p = 0.002), flow rate (r = 0.31, p = 0.04), oscillatory shear index (r = 0.44, p = 0.03), and elasticity modulus (r = 0.33, p = 0.029) but inversely related to circumferential strain (r = −0.36, p = 0.028). The VAI was also positively associated with artery diameter (r = 0.33, p = 0.03), elasticity modulus (r = 0.38, p = 0.009), and arterial stiffness (r = 0.39, p = 0.012). In addition, the VAI was negatively correlated with the circumferential strain (r = −0.33, p = 0.04). Conclusion The present study demonstrated that both HIIT and MICT exercises for 8 weeks could effectively enhance visceral fat indices and partial hemodynamic parameters. Therefore, HIIT and MICT exert important effects on reducing fat content and improving hemodynamic environment. But HIIT on oscillatory shear index, arterial stiffness, circumferential strain, and pulsatility index was superior to MICT. In addition, there are close correlations between visceral fat and partial hemodynamic parameters of the common carotid artery.
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Daniele A, Lucas SJE, Rendeiro C. Detrimental effects of physical inactivity on peripheral and brain vasculature in humans: Insights into mechanisms, long-term health consequences and protective strategies. Front Physiol 2022; 13:998380. [PMID: 36237532 PMCID: PMC9553009 DOI: 10.3389/fphys.2022.998380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
The growing prevalence of physical inactivity in the population highlights the urgent need for a more comprehensive understanding of how sedentary behaviour affects health, the mechanisms involved and what strategies are effective in counteracting its negative effects. Physical inactivity is an independent risk factor for different pathologies including atherosclerosis, hypertension and cardiovascular disease. It is known to progressively lead to reduced life expectancy and quality of life, and it is the fourth leading risk factor for mortality worldwide. Recent evidence indicates that uninterrupted prolonged sitting and short-term inactivity periods impair endothelial function (measured by flow-mediated dilation) and induce arterial structural alterations, predominantly in the lower body vasculature. Similar effects may occur in the cerebral vasculature, with recent evidence showing impairments in cerebral blood flow following prolonged sitting. The precise molecular and physiological mechanisms underlying inactivity-induced vascular dysfunction in humans are yet to be fully established, although evidence to date indicates that it may involve modulation of shear stress, inflammatory and vascular biomarkers. Despite the steady increase in sedentarism in our societies, only a few intervention strategies have been investigated for their efficacy in counteracting the associated vascular impairments. The current review provides a comprehensive overview of the evidence linking acute and short-term physical inactivity to detrimental effects on peripheral, central and cerebral vascular health in humans. We further examine the underlying molecular and physiological mechanisms and attempt to link these to long-term consequences for cardiovascular health. Finally, we summarize and discuss the efficacy of lifestyle interventions in offsetting the negative consequences of physical inactivity.
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Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Catarina Rendeiro,
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14
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Michel JB, Lagrange J, Regnault V, Lacolley P. Conductance Artery Wall Layers and Their Respective Roles in the Clearance Functions. Arterioscler Thromb Vasc Biol 2022; 42:e253-e272. [PMID: 35924557 DOI: 10.1161/atvbaha.122.317759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Evolutionary organization of the arterial wall into layers occurred concomitantly with the emergence of a highly muscularized, pressurized arterial system that facilitates outward hydraulic conductance and mass transport of soluble substances across the arterial wall. Although colliding circulating cells disperse potential energy within the arterial wall, the different layers counteract this effect: (1) the endothelium ensures a partial barrier function; (2) the media comprises smooth muscle cells capable of endocytosis/phagocytosis; (3) the outer adventitia and perivascular adipocytic tissue are the final receptacles of convected substances. While the endothelium forms a physical and a biochemical barrier, the medial layer is avascular, relying on the specific permeability properties of the endothelium for metabolic support. Different components of the media interact with convected molecules: medial smooth muscle cells take up numerous molecules via scavenger receptors and are capable of phagocytosis of macro/micro particles. The outer layers-the highly microvascularized innervated adventitia and perivascular adipose tissue-are also involved in the clearance functions of the media: the adventitia is the seat of immune response development, inward angiogenesis, macromolecular lymphatic drainage, and neuronal stimulation. Consequently, the clearance functions of the arterial wall are physiologically essential, but also may favor the development of arterial wall pathologies. This review describes how the walls of large conductance arteries have acquired physiological clearance functions, how this is determined by the attributes of the endothelial barrier, governed by endocytic and phagocytic capacities of smooth muscle cells, impacting adventitial functions, and the role of these clearance functions in arterial wall diseases.
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15
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Ogoh S, Washio T, Stacey BS, Tsukamoto H, Iannetelli A, Owens TS, Calverley TA, Fall L, Marley CJ, Bailey DM. Effects of continuous hypoxia on flow-mediated dilation in the cerebral and systemic circulation: on the regulatory significance of shear rate phenotype. J Physiol Sci 2022; 72:16. [PMID: 35858836 DOI: 10.1186/s12576-022-00841-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/07/2022] [Indexed: 11/10/2022]
Abstract
Emergent evidence suggests that cyclic intermittent hypoxia increases cerebral arterial shear rate and endothelial function, whereas continuous exposure decreases anterior cerebral oxygen (O2) delivery. To examine to what extent continuous hypoxia impacts cerebral shear rate, cerebral endothelial function, and consequent cerebral O2 delivery (CDO2), eight healthy males were randomly assigned single-blind to 7 h passive exposure to both normoxia (21% O2) and hypoxia (12% O2). Blood flow in the brachial and internal carotid arteries were determined using Duplex ultrasound and included the combined assessment of systemic and cerebral endothelium-dependent flow-mediated dilatation. Systemic (brachial artery) flow-mediated dilatation was consistently lower during hypoxia (P = 0.013 vs. normoxia), whereas cerebral flow-mediated dilation remained preserved (P = 0.927 vs. normoxia) despite a reduction in internal carotid artery antegrade shear rate (P = 0.002 vs. normoxia) and CDO2 (P < 0.001 vs. normoxia). Collectively, these findings indicate that the reduction in CDO2 appears to be independent of cerebral endothelial function and contrasts with that observed during cyclic intermittent hypoxia, highlighting the regulatory importance of (hypoxia) dose duration and flow/shear rate phenotype.
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Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Kawagoe, Saitama, Japan.,Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Takuro Washio
- Department of Biomedical Engineering, Toyo University, Kawagoe, Saitama, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Benjamin S Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Hayato Tsukamoto
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK.,Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Angelo Iannetelli
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Thomas S Owens
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Thomas A Calverley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Lewis Fall
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Christopher J Marley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 4AT, UK. .,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
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16
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Barr LC, Liblik K, Johri AM, Smith GN. Maternal Cardiovascular Function Following a Pregnancy Complicated by Preeclampsia. Am J Perinatol 2022; 39:1055-1064. [PMID: 33321533 DOI: 10.1055/s-0040-1721694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Preeclampsia is a hypertensive pregnancy complication with an unknown etiology and high maternal burden worldwide. Burgeoning research has linked preeclampsia to adverse maternal health outcomes remote from pregnancy; however, the intermediary mechanisms responsible for this association have not been sufficiently established. In the present narrative review, we summarize leading evidence of structural and functional cardiovascular changes associated with prior preeclampsia, and how these changes may be linked to future maternal disease. KEY POINTS: · Prior preeclampsia is associated with subclinical structural and functional vascular changes remote from pregnancy.. · Maternal cardiac adaptations to preeclampsia may have long-term implications on cardiovascular health.. · Clinicians have an opportunity to minimize maternal disease risk following preeclampsia..
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Affiliation(s)
- Logan C Barr
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kiera Liblik
- Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Amer M Johri
- Cardiovascular Imaging Network at Queen's, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Graeme N Smith
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
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17
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Morishima T, Iemitsu M, Fujie S, Ochi E. Prior beetroot juice ingestion offsets endothelial dysfunction following prolonged sitting. J Appl Physiol (1985) 2022; 133:69-74. [PMID: 35652829 DOI: 10.1152/japplphysiol.00200.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nutritional strategies to prevent endothelial dysfunction following prolonged sitting remain largely unknown. Given that beetroot juice (BRJ) ingestion enhances nitric oxide (NO) bioavailability, we aimed to evaluate whether prior BRJ ingestion would prevent sitting-induced endothelial dysfunction in the leg. Eleven healthy young males (n = 7) and females (n = 4) underwent two experimental trials of prolonged sitting with prior: 1) placebo ingestion (PL trial) and 2) BRJ ingestion (BRJ trial). All subjects ingested 140 ml of PL or BRJ (~0.0055 or ~12.8 mmol of nitrate, respectively) immediately before 3 h of sitting. Pre and post-sitting measurement of popliteal artery flow-mediated dilation (FMD) and blood pressure, and blood collection were undertaken. During the sitting period, an hourly assessment of popliteal artery diameter and blood velocity, blood pressure, and blood collection was performed. Popliteal artery blood flow and shear rate were significantly and similarly reduced during the sitting period in both trials (p < 0.001). Plasma nitrate and NOx (total nitrite and nitrate) concentrations were significantly increased relative to baseline in the only BRJ trial, and the overall concentrations were significantly higher in the BRJ trial (p < 0.001). Popliteal artery FMD was significantly reduced after the sitting period in the PL trial (p < 0.05), whereas no reduction was observed in the BRJ trial. Therefore, prior BRJ ingestion would prevent sitting-induced leg endothelial dysfunction via enhancing NO bioavailability.
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Affiliation(s)
- Takuma Morishima
- Faculty of Liberal Arts and Sciences, Chukyo University, Aichi, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Shumpei Fujie
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Eisuke Ochi
- Faculty of Bioscience and Applied Chemistry, Hosei University, Tokyo, Japan.,Graduate School of Sports and Health Studies, Hosei University, Tokyo, Japan
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18
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Lopes KG, Farinatti P, Bottino D, Souza MDGD, Maranhão P, Bouskela E, Lourenço R, Oliveira RD. Exercise with blood flow restriction improves muscle strength and mass while preserving the vascular and microvascular function and structure of older adults. Clin Hemorheol Microcirc 2022; 82:13-26. [DOI: 10.3233/ch-221395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Changes in muscle mass, strength, vascular function, oxidative stress, and inflammatory biomarkers were compared in older adults after resistance training (RT) performed with low-intensity without blood flow restriction (RT-CON); low-intensity with BFR (RT-BFR); and high-intensity without BFR (RT-HI). METHODS: Thirty-two untrained individuals (72±7 y) performed a 12-week RT after being randomized into three groups: RT-CON –30% of 1 repetition maximum (RM); RT-BFR –30% of 1RM and mild BFR (50% of arterial occlusion pressure); RT-HI –70% of 1 RM. RESULTS: Improvements in handgrip strength were similar in RT-BFR (17%) and RT-HI (16%) vs. RT-CON (–0.1% ), but increases in muscle mass (6% vs. 2% and –1%) and IGF-1 (2% vs. –0.1% and –1.5%) were greater (p < 0.05) in RT-BFR vs. RT-HI and RT-CON. Changes in vascular function, morphology, inflammation, and oxidative stress were similar between groups, except for time to reach maximum red blood cell velocity which showed a greater reduction (p < 0.05) in RT-BFR (–55%) vs. RT-HI (–11%) and RT-CON (–4% ). CONCLUSION: RT with low intensity and mild BFR improved muscle strength and mass in older individuals while preserving vascular function. This modality should be considered an adjuvant strategy to improve muscle function in older individuals with poor tolerance to high loads.
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Affiliation(s)
- Karynne Grutter Lopes
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Paulo Farinatti
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Daniel Bottino
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Maria das Graças de Souza
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Priscila Maranhão
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Eliete Bouskela
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Roberto Lourenço
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
| | - Ricardo de Oliveira
- Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, RJ, Brazil
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19
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Stanford DM, Mouser JG, Chatlaong MA, Jessee MB. A narrative review of the effects of blood flow restriction on vascular structure and function. Physiol Int 2022; 109:186-203. [PMID: 35587387 DOI: 10.1556/2060.2022.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/19/2022]
Abstract
Blood flow restriction is growing in popularity as a tool for increasing muscular size and strength. Currently, guidelines exist for using blood flow restriction alone and in combination with endurance and resistance exercise. However, only about 1.3% of practitioners familiar with blood flow restriction applications have utilized it for vascular changes, suggesting many of the guidelines are based on skeletal muscle outcomes. Thus, this narrative review is intended to explore the literature available in which blood flow restriction, or a similar application, assess the changes in vascular structure or function. Based on the literature, there is a knowledge gap in how applying blood flow restriction with relative pressures may alter the vasculature when applied alone, with endurance exercise, and with resistance exercise. In many instances, the application of blood flow restriction was not in accordance with the current guidelines, making it difficult to draw definitive conclusions as to how the vascular system would be affected. Additionally, several studies report no change in vascular structure or function, but few studies look at variables for both outcomes. By examining outcomes for both structure and function, investigators would be able to generate recommendations for the use of blood flow restriction to improve vascular structure and/or function in the future.
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Affiliation(s)
- Daphney M Stanford
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - J Grant Mouser
- 2 Department of Kinesiology and Health Promotion, Applied Physiology Laboratory, Troy University, Troy, AL, USA
| | - Matthew A Chatlaong
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
| | - Matthew B Jessee
- 1 The Department of Health, Exercise Science, and Recreation Management, Applied Human Health and Physical Function Laboratory, The University of Mississippi, Mississippi, MS, USA
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20
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Alali MH, Lucas RAI, Junejo RT, Fisher JP. Impact of acute dynamic exercise and arterial shear rate modification on radial artery low-flow mediated constriction in young men. Eur J Appl Physiol 2022; 122:1885-1895. [PMID: 35551453 PMCID: PMC9287252 DOI: 10.1007/s00421-022-04963-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
Abstract
Purpose Leg cycling exercise acutely augments radial artery low-flow mediated constriction (L-FMC). Herein, we sought to determine whether this is associated with exercise-induced changes in arterial shear rate (SR). Methods Ten healthy and recreationally active young men (23 ± 2 years) participated in 30 min of incremental leg cycling exercise (50, 100, 150 Watts). Trials were repeated with (Exercise + WC) and without (Exercise) the use of a wrist cuff (75 mmHg) placed distal to the radial artery to increase local retrograde SR while reducing mean and anterograde SR. Radial artery characteristics were measured throughout the trial, and L-FMC and flow mediated dilatation (FMD) were assessed before and acutely (~ 10 min) after leg cycling. Results Exercise increased radial artery mean and anterograde SR, along with radial artery diameter, velocity, blood flow and conductance (P < 0.05). Exercise + WC attenuated the exercise-induced increase in mean and anterograde SR (P > 0.05) but also increased retrograde SR (P < 0.05). In addition, increases in radial artery blood flow and diameter were reduced during Exercise + WC (Exercise + WC vs. Exercise, P < 0.05). After Exercise, L-FMC was augmented (− 4.4 ± 1.4 vs. − 13.1 ± 1.6%, P < 0.05), compared to no change in L-FMC after Exercise + WC (− 5.2 ± 2.0 vs. − 3.0 ± 1.6%, P > 0.05). In contrast, no change in FMD was observed in either Exercise or Exercise + WC trials (P > 0.05). Conclusions These findings indicate that increases in L-FMC following exercise are abolished by the prevention of increases radial artery diameter, mean and anterograde SR, and by elevation of retrograde SR, during exercise in young men.
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Affiliation(s)
- Mohammad H Alali
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rehan T Junejo
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - James P Fisher
- Department of Physiology, Faculty of Medical and Health Sciences, Manaaki Manawa-The Centre for Heart Research, University of Auckland, 85 Park Road, Grafton, Auckland, 1142, New Zealand.
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21
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Targeting vascular inflammation through emerging methods and drug carriers. Adv Drug Deliv Rev 2022; 184:114180. [PMID: 35271986 PMCID: PMC9035126 DOI: 10.1016/j.addr.2022.114180] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/18/2022] [Accepted: 03/04/2022] [Indexed: 12/16/2022]
Abstract
Acute inflammation is a common dangerous component of pathogenesis of many prevalent conditions with high morbidity and mortality including sepsis, thrombosis, acute respiratory distress syndrome (ARDS), COVID-19, myocardial and cerebral ischemia-reperfusion, infection, and trauma. Inflammatory changes of the vasculature and blood mediate the course and outcome of the pathology in the tissue site of insult, remote organs and systemically. Endothelial cells lining the luminal surface of the vasculature play the key regulatory functions in the body, distinct under normal vs. pathological conditions. In theory, pharmacological interventions in the endothelial cells might enable therapeutic correction of the overzealous damaging pro-inflammatory and pro-thrombotic changes in the vasculature. However, current agents and drug delivery systems (DDS) have inadequate pharmacokinetics and lack the spatiotemporal precision of vascular delivery in the context of acute inflammation. To attain this level of precision, many groups design DDS targeted to specific endothelial surface determinants. These DDS are able to provide specificity for desired tissues, organs, cells, and sub-cellular compartments needed for a particular intervention. We provide a brief overview of endothelial determinants, design of DDS targeted to these molecules, their performance in experimental models with focus on animal studies and appraisal of emerging new approaches. Particular attention is paid to challenges and perspectives of targeted therapeutics and nanomedicine for advanced management of acute inflammation.
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22
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Cavalcante S, Teixeira M, Duarte A, Ferreira M, Simões MI, Conceição M, Costa M, Ribeiro IP, Gonçalves AC, Oliveira J, Ribeiro F. Endothelial Progenitor Cell Response to Acute Multicomponent Exercise Sessions with Different Durations. BIOLOGY 2022; 11:biology11040572. [PMID: 35453771 PMCID: PMC9025950 DOI: 10.3390/biology11040572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/30/2022] [Accepted: 04/06/2022] [Indexed: 12/04/2022]
Abstract
It is widely accepted that exercise training has beneficial effects on vascular health. Although a dose-dependent relation has been suggested, little is known about the effects of different exercise durations on endothelial markers. This study aimed to assess the effect of single exercise sessions with different durations in the circulating levels of endothelial progenitor cells (EPCs) and endothelial cells (CECs) among adults with cardiovascular risk factors. Ten participants performed two multicomponent exercise sessions, one week apart, lasting 30 and 45 min (main exercise phase). Before and after each exercise session, blood samples were collected to quantify EPCs and CECs by flow cytometry. The change in EPCs was significantly different between sessions by 3.0% (95% CI: 1.3 to 4.7), being increased by 1.8 ± 1.7% (p = 0.009) in the 30 min session vs. −1.2 ± 2.0% (p > 0.05) in the 45 min session. No significant change was observed in CECs [−2.0%, 95%CI: (−4.1 to 0.2)] between the sessions. In conclusion, a multicomponent exercise session of 30 min promotes an acute increase in the circulating levels of EPCs without increasing endothelial damage (measured by the levels of CECs) among adults with cardiovascular risk factors.
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Affiliation(s)
- Suiane Cavalcante
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4099-002 Porto, Portugal; (S.C.); (J.O.)
| | - Manuel Teixeira
- Institute of Biomedicine—iBiMED, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Ana Duarte
- Unidade Cuidados na Comunidade Cubo Mágico da Saúde, ACES Baixo Vouga, 3800-120 Aveiro, Portugal; (A.D.); (M.F.); (M.I.S.); (M.C.)
| | - Miriam Ferreira
- Unidade Cuidados na Comunidade Cubo Mágico da Saúde, ACES Baixo Vouga, 3800-120 Aveiro, Portugal; (A.D.); (M.F.); (M.I.S.); (M.C.)
| | - Maria I. Simões
- Unidade Cuidados na Comunidade Cubo Mágico da Saúde, ACES Baixo Vouga, 3800-120 Aveiro, Portugal; (A.D.); (M.F.); (M.I.S.); (M.C.)
| | - Maria Conceição
- Unidade Cuidados na Comunidade Cubo Mágico da Saúde, ACES Baixo Vouga, 3800-120 Aveiro, Portugal; (A.D.); (M.F.); (M.I.S.); (M.C.)
| | - Mariana Costa
- Câmara Municipal de Oliveira do Bairro—Projeto Não Fique Parado, 3800-120 Aveiro, Portugal;
| | - Ilda P. Ribeiro
- Cytogenetics and Genomics Laboratory, Institute of Cellular and Molecular Biology, Faculty of Medicine (FMUC), University of Coimbra, 3004-531 Coimbra, Portugal;
- Institute for Clinical and Biomedical Research (iCBR), Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine (FMUC), University of Coimbra, 3004-531 Coimbra, Portugal
| | - Ana Cristina Gonçalves
- Institute for Clinical and Biomedical Research (iCBR)—Group of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine (FMUC), Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal;
- Laboratory of Oncobiology and Hematology, University Clinic of Hematology, Faculty of Medicine (FMUC), University of Coimbra, 3004-531 Coimbra, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4099-002 Porto, Portugal; (S.C.); (J.O.)
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, 4099-002 Porto, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine—iBiMED, School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
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23
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Nascimento DDC, Rolnick N, Neto IVDS, Severin R, Beal FLR. A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation. Front Physiol 2022; 13:808622. [PMID: 35360229 PMCID: PMC8963452 DOI: 10.3389/fphys.2022.808622] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Blood flow restriction training (BFRT) is a modality with growing interest in the last decade and has been recognized as a critical tool in rehabilitation medicine, athletic and clinical populations. Besides its potential for positive benefits, BFRT has the capability to induce adverse responses. BFRT may evoke increased blood pressure, abnormal cardiovascular responses and impact vascular health. Furthermore, some important concerns with the use of BFRT exists for individuals with established cardiovascular disease (e.g., hypertension, diabetes mellitus, and chronic kidney disease patients). In addition, considering the potential risks of thrombosis promoted by BFRT in medically compromised populations, BFRT use warrants caution for patients that already display impaired blood coagulability, loss of antithrombotic mechanisms in the vessel wall, and stasis caused by immobility (e.g., COVID-19 patients, diabetes mellitus, hypertension, chronic kidney disease, cardiovascular disease, orthopedic post-surgery, anabolic steroid and ergogenic substance users, rheumatoid arthritis, and pregnant/postpartum women). To avoid untoward outcomes and ensure that BFRT is properly used, efficacy endpoints such as a questionnaire for risk stratification involving a review of the patient’s medical history, signs, and symptoms indicative of underlying pathology is strongly advised. Here we present a model for BFRT pre-participation screening to theoretically reduce risk by excluding people with comorbidities or medically complex histories that could unnecessarily heighten intra- and/or post-exercise occurrence of adverse events. We propose this risk stratification tool as a framework to allow clinicians to use their knowledge, skills and expertise to assess and manage any risks related to the delivery of an appropriate BFRT exercise program. The questionnaires for risk stratification are adapted to guide clinicians for the referral, assessment, and suggestion of other modalities/approaches if/when necessary. Finally, the risk stratification might serve as a guideline for clinical protocols and future randomized controlled trial studies.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Department of Physical Education, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
- *Correspondence: Dahan da Cunha Nascimento,
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY, United States
| | - Ivo Vieira de Sousa Neto
- Laboratory of Molecular Analysis, Graduate Program of Sciences and Technology of Health, University of Brasília, Brasília, Brazil
| | - Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL, United States
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States
| | - Fabiani Lage Rodrigues Beal
- Department of Gerontology, Catholic University of Brasília (UCB), Brasília, Brazil
- Department of Nutrition, Health and Medicine School, Catholic University of Brasília (UCB), Brasília, Brazil
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24
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Araujo GSM, Silva TOC, Guerra GM, Izaias JE, Rocha HMN, Faria D, Rocha NG, Dalmazo AL, Araujo A, Marciano Consolim-Colombo F, de Angelis K, Irigoyen MCC, Sales ARK. Effects of Postprandial Lipemia Combined With Disturbed Blood Flow on the Flow-Mediated Dilation, Oxidative Stress, and Endothelial Microvesicles in Healthy Subjects. Front Physiol 2022; 13:812942. [PMID: 35283771 PMCID: PMC8907728 DOI: 10.3389/fphys.2022.812942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Aims Both postprandial lipemia (PPL) and disturbed blood flow (DBF) induce endothelial dysfunction. However, the interactive effect of these stimuli on endothelial function is currently unknown. In the present study, we tested whether PPL plus DBF causes a greater reduction in flow-mediated dilation (FMD) than PPL and if this response is associated with elevations in oxidative stress and endothelial microvesicles (EMVs). Methods Eighteen individuals (aged 28 ± 1yrs, 3 females, and BMI 24.43 ± 0.8kg/m2) randomly underwent two experimental sessions: PPL and PPL plus DBF. FMD and venous blood samples were obtained at baseline and 30, 70, and 110 min after stimulation. PPL was induced by fat overload via mozzarella pizza ingestion and DBF by forearm cuff inflation to 75 mm Hg per 30 min. Lipidic profile, oxidative stress (thiobarbituric acid reactive substances, TBARS; ferric reducing/antioxidant power, FRAP; hydrogen peroxide, H2O2) and EMVs were measured in blood samples. Results Hypertriglyceridemia was observed in both sessions. Retrograde shear rate and oscillatory index responses were significantly higher in the PPL plus DBF compared with PPL. PPL plus DBF evoked a greater reduction in FMD than did PPL and EMVs, NADPH oxidase, and H2O2 similarly increased in both sessions, but TBARS and FRAP did not change. Conclusion These data indicate that the association of PPL plus DBF additively impairs endothelium-dependent function in 110 min after stimulus in healthy individuals, despite a similar increase in oxidative stress and EMVs. Further studies are needed to understand the mechanisms associated with the induced-endothelial dysfunction by association of PPL and DBF.
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Affiliation(s)
- Gustavo S. M. Araujo
- Heart Institute, University of São Paulo Medical School, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Thiago O. C. Silva
- Heart Institute, University of São Paulo Medical School, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Grazia M. Guerra
- Heart Institute, University of São Paulo Medical School, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - João E. Izaias
- D’OR Institute for Research and Education, São Paulo, Brazil
| | - Helena M. N. Rocha
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Diego Faria
- D’OR Institute for Research and Education, São Paulo, Brazil
| | - Natalia G. Rocha
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
| | - Aline Lopes Dalmazo
- Cardiology Institute of Rio Grande do Sul/Cardiology University Foundation (IC-FUC), Porto Alegre, Brazil
| | - Amanda Araujo
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Katia de Angelis
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Maria C. C. Irigoyen
- Heart Institute, University of São Paulo Medical School, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Allan R. K. Sales
- D’OR Institute for Research and Education, São Paulo, Brazil
- *Correspondence: Allan R. K. Sales,
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25
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Badhwar S, Chandran DS, Jaryal AK, Narang R, Patel C, Deepak KK. Brachial Artery "Low-Flow Mediated Constriction" Is Associated with Myocardial Perfusion Defect Severity and Mediated by an Altered Flow Pattern during Occlusion. Pulse (Basel) 2022; 9:99-108. [PMID: 35083176 DOI: 10.1159/000519558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/08/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction The relationship between low flow-mediated constriction (LFMC), a new proposed measure of endothelial function, with cardiovascular disease severity and its hypothesized stimulus, that is, low flow, has not been comprehensively evaluated. The study evaluated association between change in brachial artery diameter during constriction with severity of myocardial perfusion defect (PD) and alterations in different components of flow profile. Methods Brachial artery responses to occlusion were assessed in 91 patients and 30 healthy subjects. Change in anterograde and retrograde blood flow velocities (delta anterograde blood flow velocity and retrograde blood flow velocity), anterograde shear rate and retrograde shear rate (delta ASR and RSR, respectively), and oscillatory shear index (delta) during forearm occlusion at 50 mm Hg above systolic pressure, from baseline was calculated. Myocardial perfusion was evaluated in patients using exercise single positron emission computed tomography and % myocardial PD was calculated from summed stress score. Results LFMC emerged as independent predictor of defect severity after correcting for age and gender (p = 0.014). Sixty-seven patients (73.6%) and 15 healthy subjects (50%) showed constriction during occlusion. In stepwise backward regression analysis, RSR contributed 35.5% and ASR contributed 20.1% of the total 63.9% variability in artery diameter during occlusion. Conclusion The results suggest that LFMC is independently associated with myocardial perfusion severity and is "mediated" by an altered flow profile during occlusion.
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Affiliation(s)
- Smriti Badhwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Dinu S Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok K Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chetan Patel
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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26
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Hemingway HW, Richey RE, Moore AM, Shokraeifard AM, Thomas GC, Olivencia-Yurvati AH, Romero SA. Shear stress induced by acute heat exposure is not obligatory to protect against endothelial ischemia-reperfusion injury in humans. J Appl Physiol (1985) 2022; 132:199-208. [PMID: 34941435 PMCID: PMC8759960 DOI: 10.1152/japplphysiol.00748.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Acute heat exposure protects against endothelial ischemia-reperfusion (I/R) injury in humans. However, the mechanism/s mediating this protective effect remain unclear. We tested the hypothesis that inhibiting the increase in shear stress induced by acute heat exposure would attenuate the protection of endothelial function following I/R injury. Nine (3 women) young healthy participants were studied under three experimental conditions: 1) thermoneutral control; 2) whole body heat exposure to increase body core temperature by 1.2°C; and 3) heat exposure + brachial artery compression to inhibit the temperature-dependent increase in shear stress. Endothelial function was assessed via brachial artery flow-mediated dilatation before (pre-I/R) and after (post-I/R) 20 min of arm ischemia followed by 20 min of reperfusion. Brachial artery shear rate was increased during heat exposure (681 ± 359 s-1), but not for thermoneutral control (140 ± 63 s-1; P < 0.01 vs. heat exposure) nor for heat + brachial artery compression (139 ± 60 s-1; P < 0.01 vs. heat exposure). Ischemia-reperfusion injury reduced flow-mediated dilatation following thermoneutral control (pre-I/R, 5.5 ± 2.9% vs. post-I/R, 3.8 ± 2.9%; P = 0.06), but was protected following heat exposure (pre-I/R, 5.8 ± 2.9% vs. post-I/R, 6.1 ± 2.9%; P = 0.5) and heat + arterial compression (pre-I/R, 4.4 ± 2.8% vs. post-I/R, 5.8 ± 2.8%; P = 0.1). Contrary to our hypothesis, our findings demonstrate that shear stress induced by acute heat exposure is not obligatory to protect against endothelial I/R injury in humans.NEW & NOTEWORTHY Acute heat exposure protects against endothelial ischemia-reperfusion injury in humans. However, the mechanism/s mediating this protective effect remain unclear. We utilized arterial compression to inhibit the temperature-dependent increase in brachial artery blood velocity that occurs during acute heat exposure to isolate the contribution of shear stress to the protection of endothelial function following ischemia-reperfusion injury. Our findings demonstrate that shear stress induced by acute heat exposure is not obligatory to protect against endothelial I/R injury.
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Affiliation(s)
- Holden W. Hemingway
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Rauchelle E. Richey
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Amy M. Moore
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Austin M. Shokraeifard
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Gabriel C. Thomas
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Albert H. Olivencia-Yurvati
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas,2Department of Surgery, University of North Texas Health Science Center, Fort Worth, Texas
| | - Steven A. Romero
- 1Human Vascular Physiology Laboratory, Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas
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27
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Taylor FC, Pinto AJ, Maniar N, Dunstan DW, Green DJ. The Acute Effects of Prolonged Uninterrupted Sitting on Vascular Function: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2022; 54:67-76. [PMID: 34334722 DOI: 10.1249/mss.0000000000002763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to determine the dose-response relationship between prolonged sitting and vascular function in healthy individuals and those with metabolic disturbances and to investigate the acute effects, on vascular function, of interventions that target interrupting prolonged sitting. DESIGN This is a systematic review with meta-analysis. DATA SOURCES Ovid Embase, Ovid Medline, PubMed, and CINAHL were searched from inception to 4 December 2020. ELIGIBILITY CRITERIA Randomized crossover trials, quasi-randomized trials, and parallel group trials where vascular function (flow-mediated dilation [FMD]) was assessed before and after an acute period of sedentary behavior was used in this study. RESULTS Prolonged sitting resulted in a significant decrease in the standardized mean change (SMC) for lower-limb FMD at the 120-min (SMC = -0.85, 95% confidence interval [CI] = -1.32 to -0.38) and 180-min (SMC = -1.18, 95% CI = -1.69 to -0.66) time points. A similar pattern was observed for lower-limb shear rate. No significant changes were observed for any outcomes in the upper limb. Subgroup analysis indicated that prolonged sitting decreased lower-limb FMD in healthy adults (SMC = -1.33, 95% CI = -1.89 to -0.78) who had higher a priori vascular endothelial function, but not in those with metabolic and vascular dysfunction (SMC = -0.51, 95% CI = -1.18 to 0.15). Interrupting sitting with active interruptions increased the standardized mean difference for FMD, relative to prolonged sitting, but it was not statistically significant (0.13, 95% CI = -0.20 to 0.45). CONCLUSIONS Lower-limb vascular function is progressively impaired as a consequence of prolonged sitting, up to 180 min. A similar trend was not observed in upper-limb vascular function. Subgroup analysis indicated that prolonged sitting negatively affects healthy populations, a finding not observed in those with metabolic disturbances. Regularly interrupting sitting with activity may be beneficial for those with metabolic disturbances.
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Affiliation(s)
| | - Ana J Pinto
- Applied Physiology and Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BRAZIL
| | | | | | - Daniel J Green
- Department of Exercise and Sport Science, School of Human Sciences, The University of Western Australia, Perth, AUSTRALIA
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28
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Larson EA, Ely BR, Brunt VE, Francisco MA, Harris SM, Halliwill JR, Minson CT. Brachial and carotid hemodynamic response to hot water immersion in men and women. Am J Physiol Regul Integr Comp Physiol 2021; 321:R823-R832. [PMID: 34643115 DOI: 10.1152/ajpregu.00110.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study sought to compare the brachial and carotid hemodynamic response to hot water immersion (HWI) between healthy young men and women. Ten women (W) and 11 men (M) (24 ± 4 yr) completed a 60-min HWI session immersed to the level of the sternum in 40°C water. Brachial and carotid artery hemodynamics (Doppler ultrasound) were measured at baseline (seated rest) and every 15 min throughout HWI. Within the brachial artery, total shear rate was elevated to a greater extent in women [+479 (+364, +594) s-1] than in men [+292 (+222, +361) s-1] during HWI (P = 0.005). As shear rate is inversely proportional to blood vessel diameter and directly proportional to blood flow velocity, the sex difference in brachial shear response to HWI was the result of a smaller brachial diameter among women at baseline (P < 0.0001) and throughout HWI (main effect of sex, P < 0.0001) and a greater increase in brachial velocity seen in women [+48 (+36, +61) cm/s] compared with men [+35 (+27, +43) cm/s] with HWI (P = 0.047) which allowed for a similar increase in brachial blood flow between sexes [M: +369 (+287, +451) mL/min, W: +364 (+243, +486) mL/min, P = 0.943]. In contrast, no differences were seen between sexes in carotid total shear rate, flow, velocity, or diameter at baseline or throughout HWI. These data indicate the presence of an artery-specific sex difference in the hemodynamic response to a single bout of HWI.
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Affiliation(s)
- Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - Sarianne M Harris
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
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29
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Taylor JL, Keating SE, Holland DJ, Green DJ, Coombes JS, Bailey TG. Comparison of high intensity interval training with standard cardiac rehabilitation on vascular function. Scand J Med Sci Sports 2021; 32:512-520. [PMID: 34825728 DOI: 10.1111/sms.14106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To compare the short- and long-term effects of high-intensity interval training (HIIT) with usual care moderate intensity continuous training (MICT) on systemic vascular function and stiffness in patients with coronary artery disease undergoing a cardiac rehabilitation program. DESIGN Randomized controlled trial. METHODS Fifty-four patients (age = 63 ± 8 years, 93% male) were randomized to complete 3 sessions/week (2 supervised, 1 home-based) of either (1) 4 × 4-min HIIT or (2) 40-min MICT, for 4 weeks. Patients then continued 3 unsupervised home-based sessions/week of their allocated training for 11 months. Brachial artery flow-mediated dilation, pulse wave velocity, and blood pressure were measured at baseline, 4 weeks, 3 months, 6 months, and 12 months. Data were analyzed using linear mixed modeling and are presented as mean change from baseline (95% CI). RESULTS HIIT showed a greater improvement in flow-mediated dilation compared to MICT after 4 weeks [1.5% (0.9, 2.1) vs 0.1% (-0.5, 0.8); p = 0.004) but not 12 months [1.2% (-0.2, 2.5) vs 0.4% (-0.8, 1.7); p = 0.153). There were no short- or long-term group differences for changes in pulse wave velocity, peripheral or central blood pressure between HIIT and MICT after 4 weeks, or over 12 months. CONCLUSIONS A 4-week HIIT program was superior to MICT for improving vascular function, but not arterial stiffness or blood pressure. Over 12 months, changes in vascular function, blood pressure, and arterial stiffness were similar for HIIT and MICT.
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Affiliation(s)
- Jenna L Taylor
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Cardiac Rehabilitation Department, The Wesley Hospital, Brisbane, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - David J Holland
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Department of Cardiology, Sunshine Coast University Hospital, Birtinya, Australia.,School of Medicine, Griffith University, Sunshine Coast, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), University of Western Australia, Perth, WA, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Tom G Bailey
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Qld, Australia
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30
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Kraler S, Blaser MC, Aikawa E, Camici GG, Lüscher TF. Calcific aortic valve disease: from molecular and cellular mechanisms to medical therapy. Eur Heart J 2021; 43:683-697. [PMID: 34849696 DOI: 10.1093/eurheartj/ehab757] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 09/12/2021] [Accepted: 10/20/2021] [Indexed: 12/12/2022] Open
Abstract
Calcific aortic valve disease (CAVD) is a highly prevalent condition that comprises a disease continuum, ranging from microscopic changes to profound fibro-calcific leaflet remodelling, culminating in aortic stenosis, heart failure, and ultimately premature death. Traditional risk factors, such as hypercholesterolaemia and (systolic) hypertension, are shared among atherosclerotic cardiovascular disease and CAVD, yet the molecular and cellular mechanisms differ markedly. Statin-induced low-density lipoprotein cholesterol lowering, a remedy highly effective for secondary prevention of atherosclerotic cardiovascular disease, consistently failed to impact CAVD progression or to improve patient outcomes. However, recently completed phase II trials provide hope that pharmaceutical tactics directed at other targets implicated in CAVD pathogenesis offer an avenue to alter the course of the disease non-invasively. Herein, we delineate key players of CAVD pathobiology, outline mechanisms that entail compromised endothelial barrier function, and promote lipid homing, immune-cell infiltration, and deranged phospho-calcium metabolism that collectively perpetuate a pro-inflammatory/pro-osteogenic milieu in which valvular interstitial cells increasingly adopt myofibro-/osteoblast-like properties, thereby fostering fibro-calcific leaflet remodelling and eventually resulting in left ventricular outflow obstruction. We provide a glimpse into the most promising targets on the horizon, including lipoprotein(a), mineral-binding matrix Gla protein, soluble guanylate cyclase, dipeptidyl peptidase-4 as well as candidates involved in regulating phospho-calcium metabolism and valvular angiotensin II synthesis and ultimately discuss their potential for a future therapy of this insidious disease.
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Affiliation(s)
- Simon Kraler
- Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Department of Cardiology, University Hospital, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Mark C Blaser
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 3 Blackfan Street, Boston, MA 02115, USA
| | - Elena Aikawa
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 3 Blackfan Street, Boston, MA 02115, USA.,Center for Excellence in Vascular Biology, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 77 Ave Louis Pasteur, NRB7, Boston, MA 02115, USA
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Department of Cardiology, University Hospital, Rämistrasse 100, 8091 Zurich, Switzerland.,Department of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland.,Heart Division, Royal Brompton & Harefield Hospitals, Sydney Street, London SW3 6NP, UK.,National Heart and Lung Institute, Imperial College, Guy Scadding Building, Dovehouse Street, London SW3 6LY, UK
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31
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Kurosawa Y, Nirengi S, Tabata I, Isaka T, Clark JF, Hamaoka T. Effects of Prolonged Sitting with or without Elastic Garments on Limb Volume, Arterial Blood Flow, and Muscle Oxygenation. Med Sci Sports Exerc 2021; 54:399-407. [PMID: 34711709 PMCID: PMC8830891 DOI: 10.1249/mss.0000000000002822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Supplemental digital content is available in the text. Purpose The physiological response induced by acute prolonged sitting is not fully understood. Therefore, we examined the effects of 8-h constant sitting on microcirculation and associated factors in the lower extremity among healthy males. We also evaluated the protective effects of lower-pressure thigh-length elastic compression garments on these parameters. Methods Nine healthy males (age, 22.6 ± 1.4 yr; body mass index, 22.4 ± 1.8 kg·m−2) completed the 8-h constant sitting experiment. Following baseline measurements, each subject was randomized to wear a lower-pressure elastic garment on the right or left leg from the inguinal region to the ankle joint, with the noncompressed contralateral leg as a control. Circumferences of the calf and malleolus, extracellular water contents, blood flow and shear rate of the dorsal metatarsal artery, and oxygen dynamics in the gastrocnemius muscles were measured in both extremities before and during 8-h constant sitting. Results Compared with baseline values, 8-h constant sitting caused enlargement of circumferences (calf, 2.4% ± 0.7%; malleolus, 2.7% ± 1.4%), retention of extracellular water in lower extremity muscles (10.1% ± 1.78%), deterioration of the blood flow (61.4% ± 16.2% of baseline) and shear rate of the dorsal metatarsal artery, and decrease in oxygenated hemoglobin and total hemoglobin levels in the gastrocnemius muscle (P < 0.05, respectively). When subjects wore the lower-pressure thigh-length compression garment, a significant reduction of these effects was observed (P < 0.05, for all). Conclusions Prolonged sitting for 8 h induced edema, as well as deterioration of the arterial blood flow, shear rate, and microcirculation in lower limb muscles. Conversely, application of the lower-pressure elastic garment successfully prevented the pathophysiological deterioration associated with prolonged sitting.
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Affiliation(s)
- Yuko Kurosawa
- Department of Sports Medicine for Health Promotion, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan Department of Physiology and Cell Biology, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan Department of Neurology, University of Cincinnati, Cincinnati, OH
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Claassen JAHR, Thijssen DHJ, Panerai RB, Faraci FM. Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation. Physiol Rev 2021; 101:1487-1559. [PMID: 33769101 PMCID: PMC8576366 DOI: 10.1152/physrev.00022.2020] [Citation(s) in RCA: 273] [Impact Index Per Article: 91.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Brain function critically depends on a close matching between metabolic demands, appropriate delivery of oxygen and nutrients, and removal of cellular waste. This matching requires continuous regulation of cerebral blood flow (CBF), which can be categorized into four broad topics: 1) autoregulation, which describes the response of the cerebrovasculature to changes in perfusion pressure; 2) vascular reactivity to vasoactive stimuli [including carbon dioxide (CO2)]; 3) neurovascular coupling (NVC), i.e., the CBF response to local changes in neural activity (often standardized cognitive stimuli in humans); and 4) endothelium-dependent responses. This review focuses primarily on autoregulation and its clinical implications. To place autoregulation in a more precise context, and to better understand integrated approaches in the cerebral circulation, we also briefly address reactivity to CO2 and NVC. In addition to our focus on effects of perfusion pressure (or blood pressure), we describe the impact of select stimuli on regulation of CBF (i.e., arterial blood gases, cerebral metabolism, neural mechanisms, and specific vascular cells), the interrelationships between these stimuli, and implications for regulation of CBF at the level of large arteries and the microcirculation. We review clinical implications of autoregulation in aging, hypertension, stroke, mild cognitive impairment, anesthesia, and dementias. Finally, we discuss autoregulation in the context of common daily physiological challenges, including changes in posture (e.g., orthostatic hypotension, syncope) and physical activity.
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Affiliation(s)
- Jurgen A H R Claassen
- Department of Geriatrics, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- >National Institute for Health Research Leicester Biomedical Research Centre, University of Leicester, Leicester, United Kingdom
| | - Frank M Faraci
- Departments of Internal Medicine, Neuroscience, and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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Arterial blood flow waveform shapes – their original quantification and importance in chosen aspects of physiology and psychology: A review. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sakellariou XM, Papafaklis MI, Domouzoglou EM, Katsouras CS, Michalis LK, Naka KK. Exercise-mediated adaptations in vascular function and structure: Beneficial effects in coronary artery disease. World J Cardiol 2021; 13:399-415. [PMID: 34621486 PMCID: PMC8462042 DOI: 10.4330/wjc.v13.i9.399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/30/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium, thereby leading to functional and structural adaptations that lower cardiovascular risk. The patterns of blood flow and endothelial shear stress during exercise lead to atheroprotective hemodynamic stimuli on the endothelium and contribute to adaptations in vascular function and structure. The structural adaptations observed in arterial lumen dimensions after prolonged exercise supplant the need for acute functional vasodilatation in case of an increase in endothelial shear stress due to repeated exercise bouts. In contrast, wall thickness is affected by rather systemic factors, such as transmural pressure modulated during exercise by generalized changes in blood pressure. Several mechanisms have been proposed to explain the exercise-induced benefits in patients with coronary artery disease (CAD). They include decreased progression of coronary plaques in CAD, recruitment of collaterals, enhanced blood rheological properties, improvement of vascular smooth muscle cell and endothelial function, and coronary blood flow. This review describes how exercise via alterations in hemodynamic factors influences vascular function and structure which contributes to cardiovascular risk reduction, and highlights which mechanisms are involved in the positive effects of exercise on CAD.
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Affiliation(s)
- Xenofon M Sakellariou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
| | - Michail I Papafaklis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Eleni M Domouzoglou
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- Department of Pediatrics, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Christos S Katsouras
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Lampros K Michalis
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
| | - Katerina K Naka
- Michailideion Cardiac Centre, University of Ioannina, Ioannina 45100, Epirus, Greece
- 2nd Department of Cardiology, University Hospital of Ioannina, Ioannina 45100, Epirus, Greece
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Sit less and move more for cardiovascular health: emerging insights and opportunities. Nat Rev Cardiol 2021; 18:637-648. [PMID: 34017139 DOI: 10.1038/s41569-021-00547-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 02/01/2023]
Abstract
Sedentary behaviour - put simply, too much sitting, as a distinct concept from too little exercise - is a novel determinant of cardiovascular risk. This definition provides a perspective that is complementary to the well-understood detrimental effects of physical inactivity. Sitting occupies the majority of the daily waking hours in most adults and has become even more pervasive owing to the COVID-19 pandemic. The potential for a broad cardiovascular health benefit exists through an integrated approach that involves 'sitting less and moving more'. In this Review, we first consider observational and experimental evidence on the adverse effects of prolonged, uninterrupted sitting and the evidence identifying the possible mechanisms underlying the associated risk. We summarize the results of randomized controlled trials demonstrating the feasibility of changing sedentary behaviour. We also highlight evidence on the deleterious synergies between sedentary behaviour and physical inactivity as the underpinnings of our case for addressing them jointly in mitigating cardiovascular risk. This integrated approach should not only reduce the specific risks of too much sitting but also have a positive effect on the total amount of physical activity, with the potential to more broadly benefit the health of individuals living with or at risk of developing cardiovascular disease.
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A 50 Hz magnetic field affects hemodynamics, ECG and vascular endothelial function in healthy adults: A pilot randomized controlled trial. PLoS One 2021; 16:e0255242. [PMID: 34351946 PMCID: PMC8341886 DOI: 10.1371/journal.pone.0255242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/20/2021] [Indexed: 11/19/2022] Open
Abstract
Application of exposure to 50/60 Hz magnetic fields (MFs) has been conducted in the treatment of muscle pain and fatigue mainly in Japan. However, whether MFs could increase blood flow leading to muscle fatigue recovery has not been sufficiently tested. We investigated the acute effects of a 50 Hz sinusoidal MF at Bmax 180 mT on hemodynamics, electrocardiogram, and vascular endothelial function in healthy young men. Three types of regional exposures to a 50 Hz MF, i.e., forearm, upper arm, or neck exposure to MF were performed. Participants who received three types of real MF exposures had significantly increased ulnar arterial blood flow velocity compared to the sham exposures. Furthermore, after muscle loading exercise, MF exposure recovered hemoglobin oxygenation index values faster and higher than sham exposure from the loading condition. Moreover, participants who received real MF exposure in the neck region had significantly increased parasympathetic high-frequency activity relative to the sham exposure. The MF exposure in the upper arm region significantly increased the brachial artery flow-mediated dilation compared to the sham exposure. Computer simulations of induced in situ electric fields indicated that the order-of-magnitude estimates of the peak values were 100-500 mV/m, depending on the exposure conditions. This study provides the first evidence that a 50 Hz MF can activate parasympathetic activity and thereby lead to increase vasodilation and blood flow via a nitric oxide-dependent mechanism. Trial registration: UMIN Clinical Trial Registry (CTR) UMIN000038834. The authors confirm that all ongoing and related trials for this drug/intervention are registered.
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Boparai RS, Skow RJ, Farooq S, Steinback CD, Davenport MH. Prenatal exercise and cardiovascular health (PEACH) study: The remote effect of aerobic exercise training on conduit artery and resistance vessel function. Appl Physiol Nutr Metab 2021; 46:1459-1468. [PMID: 34161737 DOI: 10.1139/apnm-2020-0902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We assessed the impact of a structured lower-limb aerobic exercise training intervention during pregnancy on brachial artery endothelial function, shear rate and patterns, and forearm blood flow and reactive hyperemia. Twenty-seven pregnant women were recruited and randomized into either a control group (n=11; 31.0 ± 0.7 years), or an exercise intervention group (n=16; 32.6 ± 0.9 years; NCT02948439). The exercise group completed 40 minutes of aerobic exercise (50-70% heart rate reserve) 3-4 times per week, between the second and third trimester of pregnancy. Endothelial function was assessed using flow-mediated dilation (FMD, normalized for shear stress) pre- (16-20 weeks) and post-intervention (34-36 weeks). The exercise training group experienced an attenuated increase in mean arterial pressure (MAP) relative to the control group (∆MAP exercise: +2± 2 mmHg vs. control: +7±3 mmHg; p=0.044) from pre- to post-intervention. % FMD change corrected for shear stress was not different between groups (p=0.460); however, the post occlusion mean flow rate (exercise: 437±32 mL/min vs. control: 364±35 mL/min; p=0.001) and post occlusion anterograde flow rate (exercise: 438±32 mL/min vs. control: 364±46 mL/min;p=0.001) were larger for the exercise training group compared to controls, post-intervention. Although endothelial function was not different between groups, we observed an increase in microcirculatory dilatory capacity, as suggested by the augmented reactive hyperemia in the exercise training group. Novelty: • Endothelial function was not altered with exercise training during pregnancy. • Exercise training did contribute to improved cardiovascular outcomes, which may have been associated with augmented reactive hyperaemia, indicative of increased microcirculatory dilatory capacity.
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Affiliation(s)
- Rakhbeer Singh Boparai
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
| | - Rachel J Skow
- University of Alberta, Faculty of Physical Education and Recreation, 8602 112St NW, 1-052 Li Ka Shing Center, Edmonton, Alberta, Canada, T6G 2E3;
| | - Sauleha Farooq
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Edmonton, Alberta, Canada;
| | - Craig D Steinback
- University of Alberta, Faculty of Physical Education and Recreation, -1059A Li Ka Shing Centre for Health Research Innovation, 8602-112 St., Edmonton, Alberta, Canada, T6G2E1;
| | - Margie H Davenport
- University of Alberta, Faculty of Kinesiology, Sport, and Recreation, Program for Pregnancy and Postpartum Health, 1-059A Li Ka Shing Center for Health Research Innovation, Edmonton, Alberta, Canada, T6G 2E1;
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Zhang Y, Zhang YJ, Zhang HW, Ye WB, Korivi M. Low-to-Moderate-Intensity Resistance Exercise Is More Effective than High-Intensity at Improving Endothelial Function in Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136723. [PMID: 34206463 PMCID: PMC8297299 DOI: 10.3390/ijerph18136723] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/29/2022]
Abstract
Aerobic exercise has been confirmed to improve endothelial function (EF). However, the effect of resistance exercise (RE) on EF remains controversial. We conducted this systematic review and meta-analysis on randomized controlled trials (RCTs) to determine the effect of RE and its intensities on EF. We searched Web of Science, PubMed/MEDLINE, Scopus, and Wiley Online Library, and included 15 articles (17 trials) for the synthesis. Overall, RE intervention significantly improved flow-mediated dilatation (FMD) in brachial artery (SMD = 0.76; 95% CI: 0.47, 1.05; p < 0.00001), which represents improved EF. Meta-regression showed that the RE intensity was correlated with changes in FMD (Coef. = −0.274, T = −2.18, p = 0.045). We found both intensities of RE improved FMD, but the effect size for the low- to moderate-intensity (30–70%1RM) was bigger (SMD = 1.02; 95% CI: 0.60, 1.43; p < 0.0001) than for the high-intensity (≥70%1RM; SMD = 0.48; 95% CI: 0.21, 0.74; p = 0.005). We further noticed that RE had a beneficial effect (SMD = 0.61; 95% CI: 0.13, 1.09; p = 0.01) on the brachial artery baseline diameter at rest (BADrest), and the age variable was correlated with the changes in BADrest after RE (Coef. = −0.032, T = −2.33, p = 0.038). Young individuals (<40 years) presented with a bigger effect size for BADrest (SMD = 1.23; 95% CI: 0.30, 2.15; p = 0.009), while middle-aged to elderly (≥40 years) were not responsive to RE (SMD = 0.07; 95% CI: −0.28, 0.42; p = 0.70). Based on our findings, we conclude that RE intervention can improve the EF, and low- to moderate-intensity is more effective than high-intensity.
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Affiliation(s)
- Yong Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
| | - Ya-Jun Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
- Correspondence: (Y.-J.Z.); (H.-W.Z.)
| | - Hong-Wei Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
- Correspondence: (Y.-J.Z.); (H.-W.Z.)
| | - Wei-Bing Ye
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China; (W.-B.Y.); (M.K.)
| | - Mallikarjuna Korivi
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China; (W.-B.Y.); (M.K.)
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Paterson C, Fryer S, Zieff G, Stone K, Credeur DP, Barone Gibbs B, Padilla J, Parker JK, Stoner L. The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-analysis. Sports Med 2021; 50:1929-1942. [PMID: 32757163 DOI: 10.1007/s40279-020-01325-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Exposure to acute prolonged sitting can result in vascular dysfunction, particularly within the legs. This vascular dysfunction, assessed using flow-mediated dilation (FMD), is likely the consequence of decreased blood flow-induced shear stress. With mixed success, several sitting interruption strategies have been trialled to preserve vascular function. OBJECTIVES The objectives of this meta-analysis were to (1) assess the effects of acute prolonged sitting exposure on vascular function in the upper- and lower-limb arteries, and (2) evaluate the effectiveness of sitting interruption strategies in preserving vascular function. Sub-group analyses were conducted to determine whether artery location or interruption modality explain heterogeneity. DATA SOURCES Electronic databases (PubMed, Web of Science, SPORTDiscus, and Google Scholar) were searched from inception to January 2020. Reference lists of eligible studies and relevant reviews were also checked. STUDY SELECTION Inclusion criteria for objective (1) were: (i) FMD% was assessed pre- and post-sitting; (ii) studies were either randomised-controlled, randomised-crossover, or quasi-experimental trials; (iii) the sitting period was ≥ 1 h; and (iv) participants were healthy non-smoking adults (≥ 18 years), and free of vascular-acting medication and disease at the time of testing. Additional inclusion criteria for objective (2) were: (i) the interruption strategy must have been during the sitting period; (ii) there was a control (uninterrupted sitting) group/arm; and (iii) the interruption strategy must have involved the participants actively moving their lower- or upper-limbs. APPRAISAL AND SYNTHESIS METHODS One thousand eight hundred and two articles were identified, of which 17 (22 trials, n = 269) met inclusion criteria for objective (1). Of those 17 articles, 6 studies (9 trials, n = 127) met the inclusion criteria for objective (2). Weighted mean differences (WMD), 95% confidence intervals (95% CI), and standardised mean difference (SMD) were calculated for all trials using random-effects meta-analysis modelling. SMD was used to determine the magnitude of effect, where < 0.2, 0.2, 0.5, and 0.8 was defined as trivial, small, moderate, and large respectively. RESULTS (1) Random-effects modelling showed uninterrupted bouts of prolonged sitting resulted in a significant decrease in FMD% (WMD = - 2.12%, 95% CI - 2.66 to - 1.59, SMD = 0.84). Subgroup analysis revealed reductions in lower- but not upper-limb FMD%. (2) Random-effects modelling showed that interrupting bouts of sitting resulted in a significantly higher FMD% compared to uninterrupted sitting (WMD = 1.91%, 95% CI 0.40 to 3.42, SMD = 0.57). Subgroup analyses failed to identify an optimum interruption strategy but revealed moderate non-significant effects for aerobic interventions (WMD = 2.17%, 95% CI - 0.34 to 4.67, SMD = 0.69) and simple resistance activities (WMD = 2.40%, 95% CI - 0.08 to 4.88, SMD = 0.55) and a trivial effect for standing interruptions (WMD = 0.24%, 95% CI - 0.90 to 1.38, SMD = 0.16). CONCLUSIONS Exposure to acute prolonged sitting leads to significant vascular dysfunction in arteries of the lower, but not upper, limbs. The limited available data indicate that vascular dysfunction can be prevented by regularly interrupting sitting, particularly with aerobic or simple resistance activities.
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Affiliation(s)
- Craig Paterson
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK.
| | - Simon Fryer
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Gabriel Zieff
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keeron Stone
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | | | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
| | - John K Parker
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Lee Stoner
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Brunt VE, Minson CT. Heat therapy: mechanistic underpinnings and applications to cardiovascular health. J Appl Physiol (1985) 2021; 130:1684-1704. [PMID: 33792402 DOI: 10.1152/japplphysiol.00141.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide, and novel therapies are drastically needed to prevent or delay the onset of CVD to reduce the societal and healthcare burdens associated with these chronic diseases. One such therapy is "heat therapy," or chronic, repeated use of hot baths or saunas. Although using heat exposure to improve health is not a new concept, it has received renewed attention in recent years as a growing number of studies have demonstrated robust and widespread beneficial effects of heat therapy on cardiovascular health. Here, we review the existing literature, with particular focus on the molecular mechanisms that underscore the cardiovascular benefits of this practice.
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Affiliation(s)
- Vienna E Brunt
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado.,Department of Human Physiology, University of Oregon, Eugene, Oregon
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41
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Ogoh S, Bailey DM. Differential impact of shear rate in the cerebral and systemic circulation: implications for endothelial function. J Appl Physiol (1985) 2021; 130:1152-1154. [DOI: 10.1152/japplphysiol.00735.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Saitama, Japan
- Neurovascular Research Laboratory, University of South Wales, Pontypridd, United Kingdom
| | - Damian M. Bailey
- Neurovascular Research Laboratory, University of South Wales, Pontypridd, United Kingdom
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Cardozo GG, Lopes KG, Bottino DA, Souza MDGCD, Bouskela E, Farinatti P, Brandão de Oliveira R. Acute effects of physical exercise with different levels of blood flow restriction on vascular reactivity and biomarkers of muscle hypertrophy, endothelial function and oxidative stress in young and elderly subjects - A randomized controlled protocol. Contemp Clin Trials Commun 2021; 22:100740. [PMID: 33937579 PMCID: PMC8076709 DOI: 10.1016/j.conctc.2021.100740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/15/2020] [Accepted: 02/04/2021] [Indexed: 11/26/2022] Open
Abstract
Background Gains in muscle mass and strength have been documented in exercise training with blood flow restriction (BFR). However, the impact of retrograde blood flow during BFR training on vascular health remains unclear. The present study designed a protocol to evaluate the acute effects of exercise performed with different levels of BFR on vascular reactivity and biomarkers of endothelial function, oxidative stress, and muscle hypertrophy in young and older individuals. Methods and study design Sixty-eight physically inactive eutrophic men [34 young (18–25-yrs old) and 34 elderly (≥65-yrs old)] will be included in the study. Subjects will undergo three experimental protocols: a) control (ExCON) – handgrip exercise with intensity of 30% of the maximum voluntary contraction (MVC); b) blood flow restriction (ExBFR) – handgrip exercise with a resistance of 30% of the MVC with low level of BFR [80% of arterial occlusion pressure at rest (rAOP)]; and c) arterial occlusion pressure (ExAOP) – handgrip exercise with a resistance of 30% of the MVC with high level of BFR (120% of rAOP). Primary outcomes will be: a) vascular reactivity assessed by venous occlusion plethysmography; b) endothelial function (nitric oxide and apoptotic endothelial micro particles; c) oxidative stress (thiobarbituric acid reactive substances). Growth hormone and lactate concentration will be measured as secondary outcomes reflecting the hypertrophic drive and metabolic stress, respectively. Discussion The findings of the present study may help to elucidate the age-related impacts of BFR training on the vascular health.
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Affiliation(s)
- Gustavo Gonçalves Cardozo
- Graduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Karynne Grutter Lopes
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Graduate Program in Clinical and Experimental Physiopathology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Daniel Alexandre Bottino
- Graduate Program in Clinical and Experimental Physiopathology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Maria das Graças Coelho de Souza
- Graduate Program in Clinical and Experimental Physiopathology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Eliete Bouskela
- Graduate Program in Clinical and Experimental Physiopathology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory for Clinical and Experimental Research on Vascular Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Paulo Farinatti
- Graduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, Brazil
| | - Ricardo Brandão de Oliveira
- Graduate Program in Exercise and Sport Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Laboratory of Active Living - Rio de Janeiro State University, Rio de Janeiro, Brazil
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Francisco MA, Colbert C, Larson EA, Sieck DC, Halliwill JR, Minson CT. Hemodynamics of post-exercise vs. post hot water immersion recovery. J Appl Physiol (1985) 2021; 130:1362-1372. [PMID: 33630675 PMCID: PMC8354820 DOI: 10.1152/japplphysiol.00260.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 01/16/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023] Open
Abstract
This study sought to compare the hemodynamics of the recovery periods following exercise versus hot water immersion. Twelve subjects (6 F, 22.7 ± 0.8 y; BMI: 21.8 ± 2.1 kg·m-2) exercised for 60 minutes at 60% VO2peak or were immersed in 40.5oC water for 60 minutes on separate days, in random order. Measurements were made before, during, and for 60-minutes post-intervention (i.e., recovery) and included heart rate, arterial pressure, core temperature, and subjective measures. Brachial and superficial femoral artery blood flows were assessed using Doppler ultrasonography and cardiac output was measured using the acetylene wash-in method. Internal temperature increased to a similar extent during exercise and hot water immersion. Cardiac outputand mean arterial pressure were greater during exercise than during hot water immersion (both p<0.01). Sustained reductions in mean arterial pressure compared to baseline were observed in both conditions during recovery (p<0.001 vs before each intervention). Cardiac output was similar during recovery between the interventions. Stroke volume was reduced throughout recovery following exercise, but not following hot water immersion (p<0.01). Brachial artery retrograde shear was reduced following hot water immersion, but not following exercise (Interaction; p=0.035). Antegrade shear in the superficial femoral artery was elevated compared to baseline (p=0.027) for 60 minutes following exercise, whereas it returned near baseline values (p=0.564) by 40 minutes following hot water immersion. Many of the changes observed during the post-exercise recovery period that are thought to contribute to long-term beneficial cardiovascular adaptations were also observed during the post-hot water immersion recovery period.
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Affiliation(s)
| | - Cameron Colbert
- Department of Human Physiology, University of Oregon, United States
| | - Emily A Larson
- Department of Human Physiology, University of Oregon, United States
| | - Dylan C Sieck
- Department of Human Physiology, University of Oregon, United States
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, United States
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Kollet DP, Marenco AB, Bellé NL, Barbosa E, Boll L, Eibel B, Waclawovsky G, Lehnen AM. Aerobic exercise, but not isometric handgrip exercise, improves endothelial function and arterial stiffness in patients with myocardial infarction undergoing coronary intervention: a randomized pilot study. BMC Cardiovasc Disord 2021; 21:101. [PMID: 33596832 PMCID: PMC7887833 DOI: 10.1186/s12872-021-01849-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 01/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background Aerobic exercise improves endothelial function and arterial stiffness after myocardial infarction (MI), but the effects of isometric exercise on cardiovascular parameters are still uncertain. We aimed to assess the effects of one session of aerobic or isometric exercise on flow-mediated dilation (FMD) and pulse wave velocity (PWV) in post-MI volunteers undergoing percutaneous coronary intervention (PCI). Methods Twenty post-MI patients undergoing PCI were randomized to aerobic (AE, n = 10) or isometric (IE, n = 10) exercise groups. We evaluated cardiac structure and function (echocardiographic); carotid plaque presence (ultrasound). FMD and PWV were measured 10 min before and 10 min after the intervention: a single session of moderate-intensity AE (30 min; ratings 12–14 on Borg’s scale or 50–60% HRreserve) or handgrip IE (four two-minute bilateral contractions; 30% maximal voluntary contraction; 1-min rest). Generalized estimating equations (Bonferroni post-hoc) was used to assess differences (p ≤ 0.050). Results FMD improved only in the AE group (Δ = 4.9%; p = 0.034), with no difference between groups after exercise. Even after adjustment (for baseline brachial artery diameter) the effectiveness of AE remained (p = 0.025) with no change in the IE group. PWV was slightly reduced from baseline in the AE group (Δ = 0.61 m/s; p = 0.044), and no difference when compared to the IE group. Peripheral vascular resistance decreased in AE versus IE (p = 0.050) and from baseline (p = 0.014). Conclusions Vascular measurements (FMD and PWV) improved after a single session of AE. There are apparently no benefits following a session of IE. Trial registration http://www.clinicaltrials.gov and ID number NCT04000893.
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Affiliation(s)
- Daniel P Kollet
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Ana Beatriz Marenco
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Nathan L Bellé
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Eduardo Barbosa
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Liliana Boll
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Bruna Eibel
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Gustavo Waclawovsky
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil
| | - Alexandre Machado Lehnen
- Institute of Cardiology of Rio Grande Do Sul/University Foundation of Cardiology, Unidade de Pesquisa, 3ºAndar, Av. Princesa Isabel, 395 Santana, Porto Alegre, RS, 90620-001, Brazil.
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Bäck M, Michel JB. From organic and inorganic phosphates to valvular and vascular calcifications. Cardiovasc Res 2021; 117:2016-2029. [PMID: 33576771 PMCID: PMC8318101 DOI: 10.1093/cvr/cvab038] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/26/2020] [Accepted: 02/03/2021] [Indexed: 02/06/2023] Open
Abstract
Calcification of the arterial wall and valves is an important part of the pathophysiological process of peripheral and coronary atherosclerosis, aortic stenosis, ageing, diabetes, and chronic kidney disease. This review aims to better understand how extracellular phosphates and their ability to be retained as calcium phosphates on the extracellular matrix initiate the mineralization process of arteries and valves. In this context, the physiological process of bone mineralization remains a human model for pathological soft tissue mineralization. Soluble (ionized) calcium precipitation occurs on extracellular phosphates; either with inorganic or on exposed organic phosphates. Organic phosphates are classified as either structural (phospholipids, nucleic acids) or energetic (corresponding to phosphoryl transfer activities). Extracellular phosphates promote a phenotypic shift in vascular smooth muscle and valvular interstitial cells towards an osteoblast gene expression pattern, which provokes the active phase of mineralization. A line of defense systems protects arterial and valvular tissue calcifications. Given the major roles of phosphate in soft tissue calcification, phosphate mimetics, and/or prevention of phosphate dissipation represent novel potential therapeutic approaches for arterial and valvular calcification.
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Affiliation(s)
- Magnus Bäck
- Division of Valvular and Coronary Disease, Department of Cardiology, Karolinska University Hospital, 141 86 Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,University of Lorraine, Nancy University Hospital, INSERM U1116, Nancy, France
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46
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Dawson EA, Boidin M, Thompson R, Cable NT, Thijssen DHJ, Green DJ. Impact of proximal and distal cuff inflation on brachial artery endothelial function in healthy individuals. Eur J Appl Physiol 2021; 121:1135-1144. [PMID: 33484336 DOI: 10.1007/s00421-021-04605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/10/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE In this study, we examined whether the decrease in endothelial function associated with short-term exposure to elevated retrograde shear rate (SR), could be prevented when combined with a concurrent drop in transmural pressure in humans. METHODS Twenty-five healthy individuals reported to our laboratory on three occasions to complete 30-min experimental conditions, preceded and followed by assessment of endothelial function using flow-mediated dilation (FMD). We used cuff inflation for 30-min to manipulate retrograde SR and transmural pressure in the brachial artery. Subjects underwent, in randomised order: (1) forearm cuff inflation to 60 mmHg (distal cuff; causing increase in retrograde SR), (2) upper arm cuff inflation to 60 mmHg (proximal cuff; causing increase in retrograde SR + decrease in transmural pressure), and (3) no cuff inflation (Control). RESULTS The distal and proximal cuff conditions both increased brachial artery retrograde SR (p < 0.001) and oscillatory shear index (p < 0.001). The Control intervention did not alter SR patterns or FMD (p > 0.05). A significant interaction-effect was found for FMD (p < 0.05), with the decrease during distal cuff (from 6.9 ± 2.3% to 6.1 ± 2.5%), being reversed to an increase with proximal cuff (from 6.3 ± 2.0 to 6.9 ± 2.0%). The proximal cuff-related increase in FMD could not be explained by the decrease in antegrade or increase in retrograde shear. CONCLUSION This study suggests that a decrease in transmural pressure may ameliorate the decline in endothelial function that occurs following exposure to elevated retrograde shear in healthy individuals.
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Affiliation(s)
- Ellen A Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Maxime Boidin
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute, Montreal, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Ruth Thompson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Nigel T Cable
- School of Sport, Exercise and Rehabilitations Sciences, University of Birmingham, Birmingham, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Department of Physiology, Research Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
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47
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Miura K, Kashima H, Namura S, Morimoto M, Endo MY, Oue A, Fukuba Y. Effects of cooling or warming of the distal upper limb on skin vascular conductance and brachial artery shear profiles during cycling exercise. Res Sports Med 2021; 30:308-324. [PMID: 33472421 DOI: 10.1080/15438627.2021.1872573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relative influence of skin vascular conductance in glabrous (G; palm) and non-glabrous (NG; dorsal and forearm) regions to upstream brachial artery-shear stress (BA-SS) profile are unknown. This study aimed to elucidate the effects of G and/or NG skin vascular conductance (VC), which were modulated by warming or cooling manipulation, on BA-shear rate (SR, an estimate of SS) during cycling exercise. Seven healthy subjects performed 60-min exercise. Between 20 and 50 min of the exercise, the NG+G or G skin region were warmed to 42°C or cooled to 15°C using a water bath. Throughout the protocol, diameter and blood velocity in BA and skin VCs in forearm and palm were measured. All measurements showed that a steady-state response was reached after 20 min of exercise. Subsequently, during cooling manipulation, forearm VC was significantly decreased, and the concomitant BA-SR profile was revealed (primarily characterized by decreased antegrade SR and increased retrograde SR) in the NG+G. Such changes were not observed in G alone. During warming manipulation, forearm VC and mean BA-SR significantly increased only in the NG+G. In conclusion, vascular response in NG skin possibly plays a major role in the modulation of BA-SS profile during cycling exercise.
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Affiliation(s)
- Kohei Miura
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan.,Department of Health and Nutrition, Faculty of Health Sciences, University of Hiroshima Shudo, Hiroshima, Japan
| | - Hideaki Kashima
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Saki Namura
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Marina Morimoto
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Masako Y Endo
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Anna Oue
- Faculty of Food and Nutritional Sciences, Toyo University, Gunma, Japan
| | - Yoshiyuki Fukuba
- Department of Exercise Science and Physiology, School of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
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Casey DP, Bock JM. Inorganic nitrate supplementation attenuates conduit artery retrograde and oscillatory shear in older adults. Am J Physiol Heart Circ Physiol 2021; 320:H991-H998. [PMID: 33449848 DOI: 10.1152/ajpheart.00843.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Aging causes deleterious changes in resting conduit artery shear patterns and reduced blood flow during exercise partially attributable to reduced nitric oxide (NO). Inorganic nitrate increases circulating NO bioavailability and may, therefore, improve age-associated changes in shear rate as well as exercise hyperemia. Ten older adults (age: 67 ± 3 yr) consumed 4.03 mmol nitrate and 0.29 mmol nitrite (active) or devoid of both (placebo) daily for 4 wk in a randomized, double-blinded, crossover fashion. Brachial artery diameter (D) and blood velocity (Vmean) were measured via Doppler ultrasound at rest for the characterization of shear profile as well as during two handgrip exercise trials (4 and 8 kg) for calculation of forearm blood flow (Vmean × cross-sectional area, FBF) and conductance [FBF/mean arterial pressure, forearm vascular conductance (FVC)]. Plasma [nitrate] and [nitrite] increased following active (P < 0.05 for both) but not placebo (P = 0.68 and 0.40, respectively) supplementation. Neither mean nor antegrade shear rate changed following either supplement (beverage-by-time P = 0.14 and 0.21, respectively). Retrograde (-13.4 ± 7.0 to -9.7 ± 6.8·s-1) and oscillatory (0.20 ± 0.08 to 0.15 ± 0.09 A.U., P < 0.05 for both) shear decreased following active, but not placebo (P = 0.81 and 0.70, respectively), supplementation. The FBF response (Δ from rest) to neither 4-kg nor 8-kg trials changed following either supplement (beverage-by-time P = 0.53 and 0.11, respectively). Similarly, no changes were observed in FVC responses to 4-kg or 8-kg trials (beverage-by-time P = 0.23 and 0.07, respectively). These data indicate that inorganic nitrate supplementation improves conduit artery shear profiles, but not exercise hyperemia, in older adults.NEW & NOTEWORTHY We report for the first time, to our knowledge, that 4 wk of inorganic nitrate supplementation attenuates retrograde and oscillatory shear in the brachial artery of older adults. However, this was not associated with greater hyperemic or vasodilatory responses to exercise. In sum, these data highlight favorable changes in shear patterns with aging, which may reduce the risk of atherosclerotic cardiovascular disease.
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Affiliation(s)
- Darren P Casey
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Joshua M Bock
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa
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49
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Hydren JR, Gifford JR, Jarrett CL, Park SH, Shields KL, Broxterman RM, Kithas AC, Bisconti AV, Thurston TS, Ratchford SM, Wray DW, Stehlik J, Selzman CH, Drakos SG, Richardson RS. Vascular function in continuous-flow left ventricular assist device recipients: effect of a single pulsatility treatment session. Am J Physiol Regul Integr Comp Physiol 2021; 320:R425-R437. [PMID: 33438517 DOI: 10.1152/ajpregu.00274.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vascular function is further attenuated in patients with chronic heart failure implanted with a continuous-flow left ventricular assist device (LVAD), likely due to decreased arterial pulsatility, and this may contribute to LVAD-associated cardiovascular complications. However, the impact of increasing pulsatility on vascular function in this population is unknown. Therefore, 15 LVAD recipients and 15 well-matched controls underwent a 45-min, unilateral, arm pulsatility treatment, evoked by intermittent cuff inflation/deflation (2-s duty cycle), distal to the elbow. Vascular function was assessed by percent brachial artery flow-mediated dilation (%FMD) and reactive hyperemia (RH) (Doppler ultrasound). Pretreatment, %FMD (LVAD: 4.0 ± 1.7; controls: 4.2 ± 1.4%) and RH (LVAD: 340 ± 101; controls: 308 ± 94 mL) were not different between LVAD recipients and controls; however, %FMD/shear rate was attenuated (LVAD: 0.10 ± 0.04; controls: 0.17 ± 0.06%/s-1, P < 0.05). The LVAD recipients exhibited a significantly attenuated pulsatility index (PI) compared with controls prior to treatment (LVAD: 2 ± 2; controls: 15 ± 7 AU, P < 0.05); however, during the treatment, PI was no longer different (LVAD: 37 ± 38; controls: 36 ± 14 AU). Although time to peak dilation and RH were not altered by the pulsatility treatment, %FMD (LVAD: 7.0 ± 1.8; controls: 7.4 ± 2.6%) and %FMD/shear rate (LVAD: 0.19 ± 0.07; controls: 0.33 ± 0.15%/s-1) increased significantly in both groups, with, importantly, %FMD/shear rate in the LVAD recipients being restored to that of the controls pretreatment. This study documents that a localized pulsatility treatment in LVAD recipients and controls can recover local vascular function, an important precursor to the development of approaches to increase systemic pulsatility and reduce systemic vascular complications in LVAD recipients.
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Affiliation(s)
- Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Angela Valentina Bisconti
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Taylor S Thurston
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Stephen M Ratchford
- Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina
| | - D Walter Wray
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Josef Stehlik
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Craig H Selzman
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Stavros G Drakos
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, 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, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
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50
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Coombs GB, Tremblay JC, Shkredova DA, Carr JMJR, Wakeham DJ, Patrician A, Ainslie PN. Distinct contributions of skin and core temperatures to flow-mediated dilation of the brachial artery following passive heating. J Appl Physiol (1985) 2021; 130:149-159. [DOI: 10.1152/japplphysiol.00502.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The primary determinant of vascular adaptations to lifestyle interventions, such as exercise and heat therapy, is repeated elevations in vascular shear stress. Whether skin or core temperatures also modulate the vascular adaptation to acute heat exposure is unknown, likely due to difficulty in dissociating the thermal and hemodynamic responses to heat. We found that skin and core temperatures modify the acute vascular responses to passive heating irrespective of the magnitude of increase in shear stress.
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Affiliation(s)
- Geoff B. Coombs
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Joshua C. Tremblay
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Daria A. Shkredova
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jay M. J. R Carr
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Denis J. Wakeham
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Alexander Patrician
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Philip N. Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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