High-intensity endurance training results in faster vessel-specific rate of vasorelaxation in type 1 diabetic rats

High-intensity exercise in hypoxia improves endothelial function via increased nitric oxide bioavailability in C57BL/6 mice

Aim

The optimal exercise intensity to improve endothelial function remains unclear, as well as whether the addition of hypoxia could potentiate this function. Therefore, the aim of this study was to compare the effects of different exercise intensities in normoxia and hypoxia on vascular reactivity and nitric oxide (NO) bioavailability in mice.

Methods

C57BL/6 mice underwent treadmill running three times per week, for 4 weeks at either low, maximal or supramaximal intensity in normoxia or hypoxia (inspire oxygen fraction = 0.13). Vascular reactivity and expression of genes and proteins involved in NO production/bioavailability were assessed in aorta using isolated vessel tension experiments, RT‐qPCR and western blot, respectively. Circulating NO metabolites and pro‐/antioxidant markers were measured.

Results

Hypoxic exercise improved both acetylcholine‐induced vasorelaxation and phenylephrine‐induced vasoconstriction compared to normoxic exercise, independently of intensity. In hypoxia, a higher acetylcholine‐induced vasorelaxation was observed with high intensities (supramaximal and maximal) compared to low intensity. Exercise protocols modulated endothelial nitric oxide synthase (eNOS) and α1‐adrenergic receptor (α₁‐AR) mRNA level, but not superoxide dismutase 3 (SOD3) and p47phox. No significant differences were observed for protein expression of α₁‐AR, total eNOS, phosphorylated eNOS, SOD isoforms and p47phox. However, plasma SOD and catalase activities were significantly increased in hypoxic supramaximal compared to hypoxic low intensity, while concentration of nitrotyrosine significantly decreased. The latter was also observed in hypoxic maximal and supramaximal compared to the same intensities in normoxia.

Conclusion

Hypoxic high‐intensity exercise increases NO bioavailability and improves vascular function, opening promising clinical perspectives for cardiovascular disease prevention.

Effects of interval training on cardio metabolic risk factors and nitric oxide in type 2 diabetes patients: a randomized controlled trial

Purpose

The purpose of this study was to investigate the effects of interval training on cardio metabolic risk factors and nitric oxide in type 2 diabetes patients.

Method

This single blinded randomized controlled trial was conducted at cardiology clinic of Rajaee hospital in Karaj. Thirty female patients with type 2 diabetes randomly assigned to interval training exercise (n = 15) and control (n = 15). In interval training exercise patients received interval training exercise with 18 sessions (three sessions per week). Each training session took 25 min and consists a single set of exercise with 10 time repetitions. Training was performed on a cycle ergometer set in constant watt mode at a pedal cadence of 80-100 revolutions/min. Each repetition of the training takes 60 s and there will be a 60 s recovery pried between each repetition. Each training session include a 3-min warm-up and 2-min cool-down at 50 W for a total of 25 min. Blood samples and of all the subjects were taken at baseline, 3 weeks after intervention and at the end of the study (6 weeks).

Results

In intervention group, comparing with controls participants, a significant decrease were observed in levels of total cholesterol, triglyceride and HA1c after training program (p < 0.05). Moreover,exercise significantly increased the level of NOx (p < 0.05). Other cardiometabolic risk factors including SBP, DBP, FPG, LDL, HDL, insulin level, insulin resistance, HR, VO2 max, did not show significant differences between the two groups (p > 0.05).

Conclusion

Results of current study showed that interval training as a type of planned physical activity can be effective in lowering cardiovascular risk factors, especially lowering cholesterol and triglycerides, and can also have a beneficial effect on improving NO.

The role of vascular function on exercise capacity in health and disease

Three sentinel parameters of aerobic performance are the maximal oxygen uptake ( V ̇ O 2 max ), critical power (CP) and speed of the V ̇ O 2 kinetics following exercise onset. Of these, the latter is, perhaps, the cardinal test of integrated function along the O2 transport pathway from lungs to skeletal muscle mitochondria. Fast V ̇ O 2 kinetics demands that the cardiovascular system distributes exercise-induced blood flow elevations among and within those vascular beds subserving the contracting muscle(s). Ideally, this process must occur at least as rapidly as mitochondrial metabolism elevates V ̇ O 2 . Chronic disease and ageing create an O2 delivery (i.e. blood flow × arterial [O2 ], Q ̇ O 2 ) dependency that slows V ̇ O 2 kinetics, decreasing CP and V ̇ O 2 max , increasing the O2 deficit and sowing the seeds of exercise intolerance. Exercise training, in contrast, does the opposite. Within the context of these three parameters (see Graphical Abstract), this brief review examines the training-induced plasticity of key elements in the O2 transport pathway. It asks how structural and functional vascular adaptations accelerate and redistribute muscle Q ̇ O 2 and thus defend microvascular O2 partial pressures and capillary blood-myocyte O2 diffusion across a ∼100-fold range of muscle V ̇ O 2 values. Recent discoveries, especially in the muscle microcirculation and Q ̇ O 2 -to- V ̇ O 2 heterogeneity, are integrated with the O2 transport pathway to appreciate how local and systemic vascular control helps defend V ̇ O 2 kinetics and determine CP and V ̇ O 2 max in health and how vascular dysfunction in disease predicates exercise intolerance. Finally, the latest evidence that nitrate supplementation improves vascular and therefore aerobic function in health and disease is presented.

Interaction of genetic background and exercise training intensity on endothelial function in mouse aorta

The purpose of this study was to characterize the genetic contribution to endothelial adaptation to exercise training. Vasoreactivity was assessed in aortas from four inbred mouse strains (129S1, B6, NON, and SJL) after 4 weeks of moderate intensity continuous exercise training (MOD), high intensity interval training (HIT) or in sedentary controls (SED). Intrinsic variations in endothelium-dependent vasorelaxation (EDR) to acetylcholine (ACh) as well as vasocontractile responses were observed across SED groups. For responses to exercise training, there was a significant interaction between mouse strain and training intensity on EDR. Exercise training had no effect on EDR in aortas from 129S1 and B6 mice. In NON, EDR was improved in aortas from MOD and HIT compared with respective SED, accompanied by diminished responses to PE in those groups. Interestingly, EDR was impaired in aorta from SJL HIT compared with SED. The transcriptional activation of endothelial genes was also influenced by the interaction between mouse strain and training intensity. The number of genes altered by HIT was greater than MOD, and there was little overlap between genes altered by HIT and MOD. HIT was associated with gene pathways for inflammatory responses. NON MOD genes showed enrichment for vessel growth pathways. These findings indicate that exercise training has non-uniform effects on endothelial function and transcriptional activation of endothelial genes depending on the interaction between genetic background and training intensity.

Aerobic exercise training improves insulin-induced vasorelaxation in a vessel-specific manner in rats with insulin-treated experimental diabetes

Vascular insulin resistance often precedes endothelial dysfunction in type 1 diabetes mellitus. Strategies to limit vascular dysfunction include intensive insulin therapy (4-9 mM) and aerobic training. To avoid the risk of hypoglycaemia, individuals often prescribed conventional insulin therapy (9-15 mM) and participate in resistance training. In a model of type 1 diabetes mellitus, this study examined insulin-induced vasomotor function in the aorta and femoral artery to determine (1) whether resistance training with conventional insulin therapy provides the same benefits as aerobic training with conventional insulin therapy, (2) whether aerobic training or resistance training, when paired with conventional insulin therapy, results in superior vasomotor function compared to intensive insulin therapy alone and (3) whether vessel-specific adaptations exist. Groups consisted of conventional insulin therapy, intensive insulin therapy, aerobic training with conventional insulin therapy and resistance training with conventional insulin therapy. Following multiple low doses of streptozotocin, male Sprague-Dawley rats were supplemented with insulin to maintain blood glucose concentrations (9-15 mM: conventional insulin therapy, aerobic training and resistance training; 4-9 mM: intensive insulin therapy) for 12 weeks. Aerobic training performed treadmill exercise and resistance training consisted of weighted climbing. Coinciding with increased Akt signalling, aerobic training resulted in enhanced insulin-induced vasorelaxation in the femoral artery. Intensive insulin therapy displayed increased mitogen-activated protein kinase signalling and no improvement in insulin-stimulated vasorelaxation compared to all other groups. These data suggest that aerobic training may be more beneficial for limiting the pathogenesis of vascular disease in type 1 diabetes mellitus than merely intensive insulin therapy.

Exercise Training Induced Cardioprotection with Moderate Hyperglycemia versus Sedentary Intensive Glycemic Control in Type 1 Diabetic Rats

Intensive insulin therapy (IIT; 4-7 mmol/L) is the preferred treatment for type 1 diabetes mellitus (T1DM) patients to reduce the risk of cardiovascular disease (CVD). However, this treatment strategy has been questioned as it is accompanied with a sedentary lifestyle leading to weight gain and insulin resistance. T1DM patients who partake in high-intensity aerobic training (AThigh) to reduce CVD often utilize conventional insulin therapy (CIT; 9-15 mmol/L) to offset the risk of hypoglycemia. Moreover, exercise modalities incorporating resistance training (RT) have been shown to further reduce this risk. The purpose of this investigation was twofold: (1) to determine if CIT paired with AThigh results in larger cardioprotection from an ischemia-reperfusion (I-R) injury than IIT and (2) to establish if the integration of RT with AThigh (ART) results in similar cardioprotection as AThigh. Diabetic (D) male Sprague-Dawley rats were divided into D-IIT (n = 12), D-CIT (n = 12), D-AThigh (n = 8), D-RT (n = 8), and D-ART (n = 8). T1DM was induced with streptozotocin, and blood glucose was adjusted with insulin. D-AThigh occurred on a treadmill (27 m/min; 1 hr), D-RT performed weighted ladder climbs, and D-ART alternated daily between AThigh and RT. Exercise occurred 5 days/wk for 12 wks. This investigation demonstrates that cardioprotection following an I-R injury was similar between D-AThigh and D-IIT. This cardioprotection is not exercise-specific, and each provides unique advantages. D-AThigh leads to improved glycemia while insulin sensitivity was enhanced following resistance exercises. Thus, exercise is an effective means to elicit cardioprotection in T1DM. However, in addition to glycemia, other factors should be considered when tailoring an exercise program for T1DM patients.

Effects of Ginseng Supplementation and Endurance-Exercise in the Artery-Specific Vascular Responsiveness of Diabetic and Sedentary Rats

This study examined the effects of 12 weeks North-American ginseng supplementation, exercise training, and sedentary behavior on vascular responses in type I diabetic rats. The following hypotheses were tested: (1) ginseng supplementation would result in improved vascular responsiveness and sensitivity; (2) exercise training would result in further improvement in these vascular responses; (3) control rats with no access to exercise would show a depressed vascular response compared to control rats that were not exposed to a sedentary lifestyle. Groups: non-diabetic sedentary control (C_S), sedentary diabetic (D_S), sedentary diabetic with ginseng supplementation (D_S+GS), diabetic with ginseng supplementation and high-intensity endurance exercise (D+GS+EX), and control not exposed to sedentary behavior (C). Diabetes was induced by streptozotocin. Arteries were excised, cleaned, and mounted onto a myography system. Percent vasorelaxation to acetylcholine (ACh) (10^-8 M ACh to 10^-4 M ACh) of the carotid artery was similar in C_S (57 ± 31%), C (66 ± 35%), D_S (58 ± 36%), D+GS+Ex (71 ± 37%), and D_S+GS (64 ± 37%) (p > 0.05). Percent vasorelaxation of the aorta was smaller in C_S (23 ± 17%) compared to C (46 ± 35%), D_S (60 ± 40%), D+GS+Ex (64 ± 40%), and D_S+GS (56 ± 39%) (p < 0.05), and smaller in C compared to D+GS+Ex (p < 0.05). In the femoral, the percent vasorelaxation was reduced in D_S (18 ± 16%) compared to all the other conditions (C_S, 43 ± 22%; C, 79 ± 28%; D+GS+Ex, 55 ± 27%; D_S+GS, 45 ± 26%; p < 0.05), but larger in C compared to the other conditions (C_S, D_S, D+GS+Ex, D_S+GS; p < 0.05). Diabetes and sedentary lifestyle have detrimental effects on vascular responses that are evident in the femoral arteries of the diabetic rats. Ginseng supplementation restored the loss of sensitivity, with no added vascular protection of exercise training.

Relationship between osteogenesis and angiogenesis in ovariectomized osteoporotic rats after exercise training

To reveal the role of exercise training in regulating osteogenesis and angiogenesis in rats after ovariectomy (OVX), then further examine the relationship between osteoporosis (OP) and local blood supply. Ninety-six rats were randomly assigned to OVX, OVX + exercise (OVX + Exe), sham operation (CON), and sham + exercise (CON + Exe) groups. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometer (DXA). Microarchitecture and angiogenesis of the femoral condyles were measured by micro-cumputed tomography (micro-CT). The femoral artery was separated for evaluating the vasodilation and endothelial nitric oxide synthase (eNOS) gene expression.BMD was markedly lower in the OVX than CON and CON + Exe groups. The trabecular bone integrity was better in the OVX + Exe than OVX group, but BMD showed no significant difference. The bone parameters indicated OP characteristics in rats after OVX, parts of them were relatively improved after exercise training. Acetylcholine-induced vessel vasodilation was enhanced by exercise training, but blocked by a NOS inhibitor. eNOS gene expression in femoral vessels showed a downward trend after OVX, and a upward trend in CON group, but seemed not to be affected by exercise training. Angiogenesis in the femur was lower in the OVX group than the CON group, but substantially better in the OVX + Exe than OVX group. Exercise training enhancing acetylcholine-induced femoral artery vasodilation and bone angiogenesis improve the blood supply of bone to facilitate osteogenesis in the OP site and therefore delay the progression of OP after menopause.

Arginine and aerobic training prevent endothelial and metabolic alterations in rats at high risk for the development of the metabolic syndrome

Endothelial function is a key mechanism in the development of CVD. Arginine and exercise are important non-pharmacological strategies for mitigating the impact of metabolic changes in the metabolic syndrome, but the effect of their combined administration is unknown. Thus, the aim of this study was to investigate the isolated and combined effects of aerobic training and arginine supplementation on metabolic variables and vascular reactivity in rats at high risk for developing the metabolic syndrome. Wistar rats were divided into two groups: control and fructose (F – water with 10 % fructose). After 2 weeks, the F group was divided into four groups: F, fructose+arginine (FA, 880 mg/kg per d of l-arginine), fructose+training (FT) and fructose+arginine+training (FTA); treatments lasted for 8 weeks, and no difference was observed in body mass gain. Arginine did not improve the body protein content, and both the FA and FT groups show a reversal of the increase in adipose tissue. Insulin increase was prevented by training and arginine, without additive effect, and the increase in serum TAG was prevented only by training. The F group showed impaired endothelium-dependent vasodilation and hyperreactivity to phenylephrine, but arginine and training were capable of preventing these effects, even separately. Higher nitric oxide level was observed in the FA and FT groups, and no potentiating effect was detected. Thus, only training was able to prevent the increase in TAG and improve the protein mass, and training and arginine exert similar effects on fat content, insulin and endothelial function, but these effects are not additive.

Similar pattern of change in V̇o2 kinetics, vascular function, and tissue oxygen provision following an endurance training stimulus in older and young adults

The purpose of this study was to examine the time course of changes in the oxygen uptake (V̇o₂) kinetics response subsequent to short-term exercise training (i.e., 24, 48, 72, and 120 h posttraining) and examine the relationship with the time course of changes in microvascular [deoxygenated hemoglobin concentration ([HHb])-to-V̇o₂ ratio ([HHb])/V̇o₂)] and macrovascular [flow-mediated dilation (FMD)] O₂ delivery to the active tissues/limbs. Seven healthy older [OA; 74 ± 6 (SD) yr] and young men (YA; 25 ± 3 yr) completed three endurance cycling exercise training sessions at 70% V̇o_2peak Moderate-intensity exercise on-transient V̇o₂ (measured breath by breath) and [HHb] (measured by near-infrared spectroscopy) were modeled with a monoexponential and normalized (0-100% of response), and the [HHb])/V̇o₂ was calculated. Ultrasound-derived FMD of the popliteal artery was assessed after 5 min of cuff occlusion. %FMD was calculated as the greatest percent change in diameter from baseline. Time constant of V̇o₂ (τV̇o₂) was significantly reduced in both OA (~18%) and YA (~23%) at 24 h (P < 0.001) posttraining and remained decreased at 48 h before returning toward pretraining (PRE) values. Both groups showed a significant decrease in the [HHb])/V̇o₂ at 24, 48, and 72 h (P = 0.001, 0.01, and 0.03, respectively) posttraining before returning toward PRE values at 120 h. %FMD followed a similar time course to that of changes in the [HHb])/V̇o₂, being significantly greater in both OA (by ~64%) and YA (by ~26%) at 24 h (P < 0.001), remaining increased at 48 and 72 h (P = 0.02 and 0.03, respectively), and returning toward PRE values at 120 h. These data suggest the rate of adjustment of V̇o₂ may be constrained by O₂ availability in the active tissues.

Faster heart rate and muscular oxygen uptake kinetics in type 2 diabetes patients following endurance training

Cardiorespiratory kinetics were analyzed in type 2 diabetes patients before and after a 12-week endurance exercise-training intervention. It was hypothesized that muscular oxygen uptake and heart rate (HR) kinetics would be faster after the training intervention and that this would be detectable using a standardized work rate protocol with pseudo-random binary sequences. The cardiorespiratory kinetics of 13 male sedentary, middle-aged, overweight type 2 diabetes patients (age, 60 ± 8 years; body mass index, 33 ± 4 kg·m^-2) were tested before and after the 12-week exercise intervention. Subjects performed endurance training 3 times a week on nonconsecutive days. Pseudo-random binary sequences exercise protocols in combination with time series analysis were used to estimate kinetics. Greater maxima in cross-correlation functions (CCF_max) represent faster kinetics of the respective parameter. CCF_max of muscular oxygen uptake (pre-training: 0.31 ± 0.03; post-training: 0.37 ± 0.1, P = 0.024) and CCF_max of HR (pre-training: 0.25 ± 0.04; post-training: 0.29 ± 0.06, P = 0.007) as well as peak oxygen uptake (pre-training: 24.4 ± 4.7 mL·kg^-1·min^-1; post-training: 29.3 ± 6.5 mL·kg^-1·min^-1, P = 0.004) increased significantly over the course of the exercise intervention. In conclusion, kinetic responses to changing work rates in the moderate-intensity range are similar to metabolic demands occurring in everyday habitual activities. Moderate endurance training accelerated the kinetic responses of HR and muscular oxygen uptake. Furthermore, the applicability of the used method to detect these accelerations was demonstrated.

Effects of age and long-term endurance training on VO2 kinetics

PURPOSE

This study examined the effects of age and training status on the pulmonary oxygen uptake (VO2p) kinetics of untrained and chronically trained young, middle-age, and older groups of men.

METHODS

Breath-by-breath VO2p and near-infrared spectroscopy-derived muscle deoxygenation ([HHb]) were monitored continuously in young (20-39 yr) trained (YT, n = 8) and untrained (YuT, n = 8), middle-age (40-59 yr) trained (MT, n = 9) and untrained (MuT, n = 9), and older (60-85 yr) trained (OT, n = 9) and untrained (OuT, n = 8) men. On-transient VO2p and [HHb] responses to cycling exercise at 80% of the estimated lactate threshold (three repeats) were modeled as monoexponential. Data were scaled to a relative percentage of the response (0%-100%), the signals time aligned, and the individual [HHb]-to-VO2p ratio was calculated as the average [HHb]/VO2 during the 20- to 120-s period after exercise onset.

RESULTS

The time constant for the adjustment of phase II pulmonary VO2 (τVO2p) was larger in OuT (42.0 ± 11.3 s) compared with that in YT (17.0 ± 7.5 s), MT (18.1 ± 5.3 s), OT (19.8 ± 5.4 s), YuT (25.7 ± 6.6 s), and MuT (24.4 ± 7.4 s) (P < 0.05). Similarly, the [HHb]/VO2 ratio was larger than 1.0 in OuT (1.30 ± 0.13, P < 0.05) and this value was larger than that observed in YT (1.01 ± 0.07), MT (1.04 ± 0.05), OT (1.04 ± 0.04), YuT (1.05 ± 0.03), and MuT (1.02 ± 0.09) (P < 0.05).

CONCLUSIONS

This study showed that the slower VO2kinetics typically observed in older individuals can be prevented by long-term endurance training interventions. Although the role of O2 delivery relative to peripheral use cannot be elucidated from the current measures, the absence of age-related slowing of VO2 kinetics seems to be partly related to a preservation of the matching of O2 delivery to O2 utilization in chronically trained older individuals, as suggested by the reduction in the [HHb]/VO2 ratio.

High Intensity Aerobic Exercise Training Improves Deficits of Cardiovascular Autonomic Function in a Rat Model of Type 1 Diabetes Mellitus with Moderate Hyperglycemia

Indices of cardiovascular autonomic neuropathy (CAN) in experimental models of Type 1 diabetes mellitus (T1DM) are often contrary to clinical data. Here, we investigated whether a relatable insulin-treated model of T1DM would induce deficits in cardiovascular (CV) autonomic function more reflective of clinical results and if exercise training could prevent those deficits. Sixty-four rats were divided into four groups: sedentary control (C), sedentary T1DM (D), control exercise (CX), or T1DM exercise (DX). Diabetes was induced via multiple low-dose injections of streptozotocin and blood glucose was maintained at moderate hyperglycemia (9-17 mM) through insulin supplementation. Exercise training consisted of daily treadmill running for 10 weeks. Compared to C, D had blunted baroreflex sensitivity, increased vascular sympathetic tone, increased serum neuropeptide Y (NPY), and decreased intrinsic heart rate. In contrast, DX differed from D in all measures of CAN (except NPY), including heart rate variability. These findings demonstrate that this T1DM model elicits deficits and exercise-mediated improvements to CV autonomic function which are reflective of clinical T1DM.

Vascular responsiveness determined by near-infrared spectroscopy measures of oxygen saturation

Vascular impairments at the macro- and microcirculatory levels are associated with increased risk for cardiovascular disease. Flow-mediated dilation (FMD) is currently the most widely used method for non-invasive assessment of vascular endothelial function. Recently, near-infrared spectroscopy (NIRS)-derived measures of tissue oxygen saturation (StO2) have been used to characterize the dynamic response of local tissue perfusion to a brief period of ischaemia. The purpose of the present study was to establish correlations between the reperfusion rate of StO2 and FMD. Ultrasound-derived FMD was quantified after 5 min of distal cuff occlusion of the popliteal artery in 20 healthy young men (26 ± 3 years old). Triplicate measurements of end-diastolic arterial diameter were made every 15 s after cuff release, and FMD response was calculated as the greatest percentage change in diameter from baseline (%FMD). The StO2 was measured using NIRS throughout the duration of each test. Two consecutive FMD tests were performed, separated by 30 min of rest, and were averaged for %FMD and StO2. The %FMD was significantly correlated with the reperfusion slope of StO2 after cuff release (slope 2 StO2; r = 0.63, P = 0.003). In conclusion, the present study established a correlation between slope 2 StO2 and %FMD in healthy young men. These data suggest that NIRS-derived slope 2 StO2 can be used as a measure of vascular endothelial function.

Physical exercise associated with NO production: signaling pathways and significance in health and disease

Here we review available data on nitric oxide (NO)-mediated signaling in skeletal muscle during physical exercise. Nitric oxide modulates skeletal myocyte function, hormone regulation, and local microcirculation. Nitric oxide underlies the therapeutic effects of physical activity whereas the pharmacological modulators of NO-mediated signaling are the promising therapeutic agents in different diseases. Nitric oxide production increases in skeletal muscle in response to physical activity. This molecule can alter energy supply in skeletal muscle through hormonal modulation. Mitochondria in skeletal muscle tissue are highly abundant and play a pivotal role in metabolism. Considering NO a plausible regulator of mitochondrial biogenesis that directly affects cellular respiration, we discuss the mechanisms of NO-induced mitochondrial biogenesis in the skeletal muscle cells. We also review available data on myokines, the molecules that are expressed and released by the muscle fibers and exert autocrine, paracrine and/or endocrine effects. The article suggests the presence of putative interplay between NO-mediated signaling and myokines in skeletal muscle. Data demonstrate an important role of NO in various diseases and suggest that physical training may improve health of patients with diabetes, chronic heart failure, and even degenerative muscle diseases. We conclude that NO-associated signaling represents a promising target for the treatment of various diseases and for the achievement of better athletic performance.

Exercise interventions and peripheral arterial function: implications for cardio-metabolic disease

Physical inactivity is a major risk factor for the development of obesity and other cardiovascular (CV) disease (CVD). Vascular endothelial dysfunction is a key event in the development of CVD and is associated with a sedentary lifestyle in otherwise healthy adults. In addition, vascular endothelial dysfunction may be exacerbated in sedentary individuals who are obese and insulin resistant, since excess body fat is associated with elevated levels of pro-atherogenic inflammatory adipokines and cytokines that reduce the nitric oxide (NO) and other upstream paracrine signaling substances which reduces vascular health. Since blood flow-related shear stress is a major stimulus to NO release from the endothelium, disturbed flow or low shear stress is the likely mechanism by which vascular endothelial function is altered with inactivity. Evidence shows that regular physical exercise has beneficial effects on CVD and the risk factors that promote peripheral arterial function and health. Both aerobic and resistance exercise training are generally believed to improve endothelial function and are commonly recommended for CV health, including the management of obesity, hypertension, and insulin resistance. However, many factors including age, disease status, and race appear to influence these outcomes. Although evidence supporting the health benefits of exercise is compelling, the optimum prescription (volume and intensity) and the exact mechanism underlying the effects of exercise training on arterial function and cardiometabolic risk has yet to be identified. The focus of this review will be on the evidence supporting exercise interventions for peripheral arterial function.

Ischemia-reperfusion injury and hypoglycemia risk in insulin-treated T1DM rats following different modalities of regular exercise

While regular exercise is known to improve cardiovascular function, individuals with type 1 diabetes mellitus (T1DM) have an increased risk for exercise-induced hypoglycemia. Clinical data suggest that higher intensities of acute exercise may alleviate the onset of hypoglycemia; however, the cardiovascular benefit from these forms of exercise in patients with T1DM has yet to be established. The purpose of this study was to investigate the cardiovascular benefit of different regular exercise regimes, while monitoring blood glucose concentrations during the post-exercise period. Fifty rats (8-week-old Sprague-Dawley male) were equally divided into the following groups: nondiabetic sedentary (C), diabetic sedentary (DS), diabetic low-intensity aerobic exercise (DL), diabetic high-intensity aerobic exercise (DH) or diabetic resistance exercise (DR). Diabetes was induced using multiple streptozotocin injections (5×; 20 mg/kg) while subcutaneous insulin pellets maintained glycemia in a range typical for individuals that exercise with T1DM. Exercise consisted of six weeks of treadmill running (DL and DH) or weighted ladder climbs (DR). The cardiovascular benefit of each exercise program was determined by the myocardial recovery from ischemia-reperfusion injury. Exercise-related cardiovascular protection was dependent on the exercise modality, whereby DH demonstrated the greatest protection following an ischemic-reperfusion injury. Each exercise modality caused a significant decline in blood glucose in the post-exercise period; however, blood glucose levels did not reach hypoglycemic concentrations (<3.0 mmol/L) throughout the exercise intervention. These results suggest that elevating blood glucose concentrations prior to exercise allows patients with T1DM to perform exercise that is beneficial to the myocardium without the accompanying risk of hypoglycemia.

The critical role of O2 provision in the dynamic adjustment of oxidative phosphorylation

It has been proposed that the adjustment of oxygen uptake (V˙O2) during the exercise on-transient is controlled intracellularly in young healthy individuals and that insufficient local O2 delivery plays a rate-limiting role in aging and disease only. This review shows that adequate O2 provision to the active tissues is critical in the dynamic adjustment of oxidative phosphorylation even in young healthy individuals.

Breath-by-breath pulmonary O2 uptake kinetics: effect of data processing on confidence in estimating model parameters

To improve the signal-to-noise ratio of breath-by-breath pulmonary O2 uptake (V̇O2p) data, it is common practice to perform multiple step transitions, which are subsequently processed to yield an ensemble-averaged profile. The effect of different data-processing techniques on phase II V̇O2p kinetic parameter estimates (V̇O2p amplitude, time delay and phase II time constant (τV̇O2p)] and model confidence [95% confidence interval (CI95)] was examined. Young (n = 9) and older men (n = 9) performed four step transitions from a 20 W baseline to a work rate corresponding to 90% of their estimated lactate threshold on a cycle ergometer. Breath-by-breath V̇O2p was measured using mass spectrometry and volume turbine. Mono-exponential kinetic modelling of phase II V̇O2p data was performed on data processed using the following techniques: (A) raw data (trials time aligned, breaths of all trials combined and sorted in time); (B) raw data plus interpolation (trials time aligned, combined, sorted and linearly interpolated to second by second); (C) raw data plus interpolation plus 5 s bin averaged; (D) individual trial interpolation plus ensemble averaged [trials time aligned, linearly interpolated to second by second (technique 1; points joined by straight-line segments), ensemble averaged]; (E) 'D' plus 5 s bin averaged; (F) individual trial interpolation plus ensemble averaged [trials time aligned, linearly interpolated to second by second (technique 2; points copied until subsequent point appears), ensemble averaged]; and (G) 'F' plus 5 s bin averaged. All of the model parameters were unaffected by data-processing technique; however, the CI95 for τV̇O2p in condition 'D' (4 s) was lower (P < 0.05) than the CI95 reported for all other conditions (5-10 s). Data-processing technique had no effect on parameter estimates of the phase II V̇O2p response. However, the narrowest interval for CI95 occurred when individual trials were linearly interpolated and ensemble averaged.

Increase in insulin-induced relaxation of consecutive arterial segments toward the periphery: Role of vascular oxidative state

RATIONALE

The oxidative state has been implicated in the signaling of various vasomotor functions, yet its role regarding the vasomotor action of insulin is less known.

OBJECTIVE

To investigate the insulin-evoked relaxations of consecutive arterial segments of different oxidative state and the role of extracellular signal-regulated kinase (ERK) pathway.

METHODS AND RESULTS

The oxidative state, as assessed by the level of ortho-tyrosine, was higher in the thoracic aorta of rats than in the abdominal aorta, and was the lowest in the femoral artery. The vasomotor function of vessels of same origin was studied using a small-vessel myograph. Insulin-induced relaxations increased toward the periphery (i.e., thoracic < abdominal < femoral). Aortic banding and hydrogen peroxide/aminotriazole increased the oxidative state of the thoracic aorta that was accompanied by ERK activation and decreased relaxation to insulin, and vice versa, acutely lowered oxidative state by superoxide dismutase/catalase improved relaxation. In contrast, insulin-induced relaxation of the femoral artery could be enhanced with a higher oxidative state, and reduced with a lower state.

CONCLUSIONS

Oxidative state of vessels modulates the magnitude of vasomotor responses to insulin, which appears to be mediated via the ERK signaling pathway.