The acute effect of maximal exercise on central and peripheral arterial stiffness indices and hemodynamics in children and adults

Xavier Melo is supported by a research grant from the Foundation for Science and Technology (FCT), Ministry of Education and Science of Portugal (grant: SFRH/ BD/ 70515/ 2010). Nuno M. Pimenta is cofinanced by national funds through the Programa Operacional do Alentejo 2007-2013 (ALENT-07-0262- FEDER-001883)This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η(2) = 0.394) increased more in adults after exercise (p < 0.05). Compliance (η(2) = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η(2) = 0.115) but apparently only in those with small MAP changes (η(2) = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults.info:eu-repo/semantics/publishedVersio

Vascular adaptation to exercise in humans: Role of hemodynamic stimuli

On the 400th anniversary of Harvey’s Lumleian lectures, this review focuses on “hemodynamic” forces associated with the movement of blood through arteries in humans and the functional and structural adaptations that result from repeated episodic exposure to such stimuli. The late 20th century discovery that endothelial cells modify arterial tone via paracrine transduction provoked studies exploring the direct mechanical effects of blood flow and pressure on vascular function and adaptation in vivo. In this review, we address the impact of distinct hemodynamic signals that occur in response to exercise, the interrelationships between these signals, the nature of the adaptive responses that manifest under different physiological conditions, and the implications for human health. Exercise modifies blood flow, luminal shear stress, arterial pressure, and tangential wall stress, all of which can transduce changes in arterial function, diameter, and wall thickness. There are important clinical implications of the adaptation that occurs as a consequence of repeated hemodynamic stimulation associated with exercise training in humans, including impacts on atherosclerotic risk in conduit arteries, the control of blood pressure in resistance vessels, oxygen delivery and diffusion, and microvascular health. Exercise training studies have demonstrated that direct hemodynamic impacts on the health of the artery wall contribute to the well-established decrease in cardiovascular risk attributed to physical activity. © 2017 the American Physiological Society

Acute Effects of Exercise Mode on Arterial Stiffness and Cardiac Autonomic Function in Healthy Young Adults

Purpose: To analyse the time-course of post-exercise cardiovagal modulation and local and regional changes on indices of arterial stiffness (AS) to three group fitness classes (GFC), in healthy young adults. Methods: 12 participants attended separated sessions of either BIKE, Pump Power (PUMP), Global Training (GT), or no exercise. In each session, participants initially undertook a supine rest followed by one of the sessions in a randomized order. Testing after each session took place at 10-, 20-, and 30-min, including assessments of regional and local indices of AS, cardiovagal modulation and baroreflex sensitivity (BRS). Results: No post-exercise changes were found in aortic and upper-limb pulse wave velocity (PWV). Local carotid indices remained unchanged following GT but increased immediately following (10-min) BIKE and PUMP. Lower-limb PWV, Ln-RMSSD, Ln-HF, BRS and BEI were immediately decreased following the three group fitness classes. Conclusions: These findings suggest that 1) exercise modality influences indices of local AS while having no effect on the remaining assessments, and 2) evidence derived from laboratorial experiments on the acute effects of exercise on indices of arterial stiffness seem to have ecological validity, but this may not be the case for cardiovagal modulation and BRS responses.Objetivo: Analisar a evolução temporal da modulação cardiovagal pós-exercício e as mudanças locais e regionais nos índices de rigidez arterial (RA), após 3 aulas de grupo, em jovens adultos saudáveis. Métodos: 12 participantes realizaram sessões de BIKE, Pump Power (PUMP), Global Training (GT) ou nenhum exercício. Em cada sessão, os participantes permaneceram em repouso seguido por uma das sessões. As avaliações após cada sessão ocorreram aos 10, 20 e 30 minutos, incluindo avaliações regionais e locais de RA, modulação cardiovagal e sensibilidade barorreflexa (SBR). Resultados: Não foram encontradas quaisquer alterações pós-exercicio na velocidade de onda de pulso (VOP) da aorta e dos membros superiores. Índices de RA local permaneceram inalterados após GT, porém aumentaram imediatamente após (10-min) BIKE e PUMP. A VOP dos membros-inferiores, Ln-RMSSD, Ln-HF, SBR e BEI diminuíram imediatamente após as três aulas de grupo. Conclusões: Estes resultados sugerem que 1) a modalidade de exercício influencia os índices de RA local, não tendo qualquer efeito nas restantes avaliações, e 2) estudos realizados em contexto laboratorial sobre efeitos agudos do exercício nos índices de rigidez arterial parecem ter validade ecológica, mas este não parece ser o caso para a modulação cardiovagal e SBR

The use of subclinical vascular markers of atherosclerosis in youth

The foundations for cardiovascular disease (CVD) in adults are laid in childhood and accelerated by the presence of comorbid conditions. Early detection of manifestations of cardiovascular pathology is an important clinical objective to identify those at risk for subsequent cardiovascular morbidity and events, and to initiate behavioral and medical interventions to reduce risk. Children were once considered to be at low risk, but with the growing health concerns related to lifestyle, cardiovascular screening may be needed earlier. Several noninvasive procedures are available to assess the cumulative effect of these exposures. These include carotid ultrasound, flow-mediated dilation, pulse wave velocity and measures left ventricular mass. This dissertation analyzes the comorbid conditions that increase cardiovascular risk in youth, namely obesity and low physical fitness, using carotid intima-media thickness to objectively detect early manifestations of cardiovascular pathology. Until recently researchers have not used surrogate markers of subclinical atherosclerosis to examine the role of a single bout of exercise. Utilizing the acute exercise model can be advantageous as it allows for an efficient manipulation of exercise variables and permits greater experimental control of confounding variables. It is possible that the effects of a bout of exercise can predict the effects of chronic exercise. We analyze the physiological factors pertinent to arterial stiffness using arterial distensibility and pulse wave velocity in the context of acute exercise in children and adults. In some instances, those who amend their trajectory by not maintaining risk factors into adulthood experience reductions in subclinical markers to levels associated with never having had the risk factor. Though avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. In this dissertation we present preliminary findings linking modifiable youth risk factors to subclinical markers of CVD in adulthood.As bases da doença cardiovascular (DCV) em adultos são estabelecidas na infância e aceleradas pela presença de comorbidades. A deteção precoce de manifestações da patologia cardiovascular é um objetivo clínico importante na identificação daqueles com risco de subsequente morbidade e eventos cardiovasculares, e no estabelecimento de intervenções comportamentais e médicas para reduzir o risco. As crianças já foram considerados de baixo risco, mas com as crescentes preocupações de saúde associadas ao estilo de vida, o rastreio cardiovascular é cada vez mais precoce. Vários procedimentos não invasivos estão disponíveis para avaliar o efeito cumulativo dessas exposições. Estes incluem ultrassom da artéria carótida, a dilatação fluxo-mediada, velocidade de onda de pulso e medidas da massa ventricular esquerda. Esta dissertação analisa comorbidades conhecidas que aumentam o risco cardiovascular em crianças e adolescentes, como a obesidade, pressão arterial elevada e baixa aptidão física, usando a espessura da parede intima-media da carótida para detetar objetivamente as manifestações precoces de patologia cardiovascular. Até recentemente, estes marcadores subclínicos de aterosclerose foram pouco utilizados para examinar os efeitos de uma única sessão de exercício físico. No entanto, a utilização do modelo de exercício agudo pode ser vantajoso, pois permite uma manipulação eficiente das variáveis do exercício e permite maior controle experimental de variáveis de enviezamento. É possível que os efeitos de uma sessão de exercício possam prever os efeitos do exercício crónico. Nesta dissertação analisamos os fatores fisiológicos associados à rigidez arterial usando a distensibilidade arterial e velocidade da onda de pulso no contexto de exercício agudo em crianças e adultos. Em alguns casos, aqueles que melhoram o seu perfil de risco de risco para as DCV até à idade adulta experienciam reduções em marcadores subclínicos de aterosclerose para níveis saudáveis. Embora a prevenção de fatores de risco na juventude seja o ideal, existe ainda uma janela para a intervenção em que os efeitos cardiovasculares de longa duração pode ser evitada. Nesta dissertação apresentamos resultados preliminares que ligam fatores de risco modificáveis na juventude com marcadores subclínicos de DCV na idade adulta

The effect of an acute bout of resistance exercise on carotid artery strain and strain rate

Arterial wall mechanics likely play an integral role in arterial responses to acute physiological stress. Therefore, this study aimed to determine the impact of low and moderate intensity double-leg press exercise on common carotid artery (CCA) wall mechanics using 2D vascular strain imaging. Short-axis CCA ultrasound images were collected in 15 healthy men (age: 21 ± 3 years; stature: 176.5 ± 6.2 cm; body mass; 80.6 ± 15.3 kg) before, during, and immediately after short-duration isometric double-leg press exercise at 30% and 60% of participants’ one-repetition maximum (1RM: 317 ± 72 kg). Images were analyzed for peak circumferential strain (PCS), peak systolic and diastolic strain rate (S-SR and D-SR) and arterial diameter. Heart rate (HR), systolic and diastolic blood pressure (SBP and DBP) were simultaneously assessed and arterial stiffness indices were calculated post hoc. A two-way repeated measures ANOVA revealed that during isometric contraction, PCS and S-SR decreased significantly (P < 0.01) before increasing significantly above resting levels post-exercise (P < 0.05 and P < 0.01 respectively). Conversely, D-SR was unaltered throughout the protocol (P = 0.25). No significant differences were observed between the 30% and 60% 1RM trials. Multiple regression analysis highlighted that HR, BP and arterial diameter did not fully explain the total variance in PCS, S-SR and D-SR. Acute double-leg press exercise is therefore associated with similar transient changes in CCA wall mechanics at low and moderate intensities. CCA wall mechanics likely provide additional insight into localized intrinsic vascular wall properties beyond current measures of arterial stiffness

Impact of 12-weeks of Nordic Pole walking on arterial stiffness in sedentary overweight and obese adults

Arterial stiffness (AS) is an independent predictor for cardiovascular disease morbidity and mortality. Regular aerobic exercise is considered to improve AS. Nordic walking provides important health benefits, however, the effect of this walking method as treatment for AS remains unclear. We conducted a randomized controlled study to examine the effect of a 12-week supervised group walking intervention (controlled pace, ~3000 steps/day, 30 minutes/day, 5 times/week), with (NW) and without (SW) Nordic poles, on AS in sedentary overweight and obese adults. Fourteen individuals were randomly assigned to NW (n=7; median age 54.0 years; body mass index (BMI)=31.3 kg/m2) or SW (n=7; median age 39.0 years, BMI 30.5 kg/m2). AS was measured via carotid-femoral pulse wave velocity (cf-PWV) and carotid-radial PWV (cr-PWV) using applanation tonometry at baseline and post-intervention. The following were also recorded at baseline and post: body weight, BMI, waist circumference, body composition, seated and supine blood pressure, glucose, HbA1C, lipid panel, maximal oxygen capacity, 7-day physical activity (PA), 3-day food records, and PACES (PA Enjoyement Scale). On average, median walking compliance, including supervised and self-reported walking, was 88.30% for both groups (SW=88.30% and NW=86.70%). Median supervised walking compliance was ~75% and ~70% for SW and NW, respectively. Central (cf-PWV) and peripheral (cr-PWV) AS was similar at baseline and did not change significantly in either group with the intervention. PACES scores increased significantly (pp

Effects of passive and active leg movements to interrupt sitting in mild hypercapnia on cardiovascular function in healthy adults

Prolonged sitting in a mild hypercapnic environment impairs peripheral vascular function. The effects of sitting interruptions using passive or active skeletal muscle contractions are still unclear. Therefore, we sought to examine the vascular effects of brief periods (2 min every half hour) of passive and active lower limb movement to interrupt prolonged sitting with mild hypercapnia in adults. Fourteen healthy adults (24 ± 2 yr) participated in three experimental visits sitting for 2.5 h in a mild hypercapnic environment (CO2 = 1,500 ppm): control (CON, no limb movement), passive lower limb movement (PASS), and active lower limb movement (ACT) during sitting. At all visits, brachial and popliteal artery flow-mediated dilation (FMD), microvascular function, plasmatic levels of nitrate/nitrite and endothelin-1, and heart rate variability were assessed before and after sitting. Brachial and popliteal artery FMDs were reduced in CON and PASS (P \u3c 0.05) but were preserved (P \u3e 0.05) in ACT. Microvascular function was blunted in CON (P \u3c 0.05) but was preserved in PASS and ACT (P \u3e 0.05). In addition, total plasma nitrate/nitrite was preserved in ACT (P \u3e 0.05) but was reduced in CON and PASS (P \u3c 0.05), and endothelin-1 levels were decreased in ACT (P \u3c 0.05). Both passive and active movement induced a greater ratio between the low-frequency and high-frequency bands for heart rate variability (P \u3c 0.05). For the first time, to our knowledge, we found that brief periods of passive leg movement can preserve microvascular function, but that an intervention that elicits larger increases in shear rate, such as low-intensity exercise, is required to fully protect both macrovascular and microvascular function and circulating vasoactive substance balance

Comparison of home vs gym-based delivery exercise modes of two 8-week supervised aerobic training regimes on cardiorespiratory fitness and arterial stiffness in adults with Intellectual and Developmental Disability

As doenças cardiovasculares (DCV) são uma das principais causas de morte em pessoas com dificuldade intelectual e de desenvolvimento (DID). Fatores de risco tradicionais e emergentes estão associados ao desenvolvimento de DCV. A atividade física é considerada uma estratégia universal para a redução do risco de DCV. No entanto, o confinamento domiciliário apenas permite aplicar intervenções domiciliárias e até ao momento, a eficácia deste tipo de intervenção na redução de fatores de risco em pessoas com DID permanece esclarecer. O objetivo do estudo foi comparar contextos de exercício, domiciliário vs presencial, durante 8 semanas de dois regimes de treino aeróbio supervisionados na rigidez arterial e na aptidão cardiorrespiratória em adultos com DID. A intervenção incluí-o 17 adultos com DID que foram divididos em dois regimes: treino intervalado em sprints (SIT) e treino contínuo (CAET). Os treinos foram realizados 3 vezes por semana durante 60 minutos. A intervenção presencial melhorou a aptidão cardiorrespiratória e ambos os contextos resultaram em melhorias semelhantes na rigidez arterial. Concluindo, uma intervenção domiciliária consegue minimizar alguns efeitos fisiológicos deletérios de um confinamento obrigatório em vários fatores de risco, no entanto não corresponde aos benefícios de uma intervenção presencial, independentemente do regime de treino aeróbio.Cardiovascular diseases (CVD) are a leading cause of death in people with intellectual and developmental disability (IDD). Traditional and emergent risk factors such as cardiorespiratory fitness and arterial stiffness are associated with the development of CVD. Physical activity has been appointed as an essential universal strategy for reducing the risk of CVD. However, during the mandatory lockdown home-based interventions are the only alternative to reduce risk factors, and the efficacy of these interventions needs to be confirmed in people with IDD. The present study aims to compare home vs gym-based delivery exercise modes of two 8- week supervised aerobic training regimes on cardiorespiratory fitness and arterial stiffness in adults with IDD. The intervention included 17 adults with IDD and participants were divided into two regimes: sprint interval training (SIT) and continuous aerobic exercise training (CAET). Training for both regimes was performed 3 times a week for 60 minutes. Only the gym-based intervention improved cardiorespiratory fitness and both contexts had similar results on arterial stiffness. In conclusion, a home-based intervention may minimize the deleterious physiological effects of a mandatory lockdown on several risk factors but does not match the benefits of a gym-based intervention, regardless of exercise regim