The "Abdominal Circulatory Pump": An Auxiliary Heart during Exercise?

Apart from its role as a flow generator for ventilation the diaphragm has a circulatory role. The cyclical abdominal pressure variations from its contractions cause swings in venous return from the splanchnic venous circulation. During exercise the action of the abdominal muscles may enhance this circulatory function of the diaphragm. Eleven healthy subjects (25 ± 7 year, 70 ± 11 kg, 1.78 ± 0.1 m, 3 F) performed plantar flexion exercise at ~4 METs. Changes in body volume (ΔVb) and trunk volume (ΔVtr) were measured simultaneously by double body plethysmography. Volume of blood shifts between trunk and extremities (Vbs) was determined non-invasively as ΔVtr-ΔVb. Three types of breathing were studied: spontaneous (SE), rib cage (RCE, voluntary emphasized inspiratory rib cage breathing), and abdominal (ABE, voluntary active abdominal expiration breathing). During SE and RCE blood was displaced from the extremities into the trunk (on average 0.16 ± 0.33 L and 0.48 ± 0.55 L, p < 0.05 SE vs. RCE), while during ABE it was displaced from the trunk to the extremities (0.22 ± 0.20 L p < 0.001, p < 0.05 RCE and SE vs. ABE respectively). At baseline, Vbs swings (maximum to minimum amplitude) were bimodal and averaged 0.13 ± 0.08 L. During exercise, Vbs swings consistently increased (0.42 ± 0.34 L, 0.40 ± 0.26 L, 0.46 ± 0.21 L, for SE, RCE and ABE respectively, all p < 0.01 vs. baseline). It follows that during leg exercise significant bi-directional blood shifting occurs between the trunk and the extremities. The dynamics and partitioning of these blood shifts strongly depend on the relative predominance of the action of the diaphragm, the rib cage and the abdominal muscles. Depending on the partitioning between respiratory muscles for the act of breathing, the distribution of blood between trunk and extremities can vary by up to 1 L. We conclude that during exercise the abdominal muscles and the diaphragm might play a role of an "auxiliary heart.

The Effect of Lower-Body Positive Pressure on the Cardiorespiratory Response at Rest and during Submaximal Running Exercise.

Anti-gravity treadmills facilitate locomotion by lower-body positive pressure (LBPP). Effects on cardiorespiratory regulation are unknown. Healthy men (30 ± 8 y, 178.3 ± 5.7 cm, 70.3 ± 8.0 kg; mean ± SD) stood upright ( javax.xml.bind.JAXBElement@57c008e9 = 10) or ran ( javax.xml.bind.JAXBElement@7a503138 = 9) at 9, 11, 13, and 15 km.h javax.xml.bind.JAXBElement@189f9fd6 (5 min stages) with LBPP (0, 15, 40 mmHg). Cardiac output (CO), stroke volume (SV), heart rate (HR), blood pressure (BP), peripheral resistance (PR), and oxygen uptake (VO javax.xml.bind.JAXBElement@270f0b82 ) were monitored continuously. During standing, LBPP increased SV [by +29 ± 13 (+41%) and +42 ± 15 (+60%) ml, at 15 and 40 mmHg, respectively ( javax.xml.bind.JAXBElement@705fd8ca < 0.05)] and decreased HR [by -15 ± 6 (-20%) and -22 ± 9 (-29%) bpm ( javax.xml.bind.JAXBElement@bfdfe08 < 0.05)] resulting in a transitory increase in CO [by +1.6 ± 1.0 (+32%) and +2.0 ± 1.0 (+39%) l.min javax.xml.bind.JAXBElement@6ff8b18e ( javax.xml.bind.JAXBElement@3074f4e8 < 0.05)] within the first seconds of LBPP. This was accompanied by a transitory decrease in end-tidal PO javax.xml.bind.JAXBElement@3e63f3a4 [by -5 ± 3 (-5%) and -10 ± 4 (-10%) mmHg ( javax.xml.bind.JAXBElement@5a8a47de < 0.05)] and increase in VO javax.xml.bind.JAXBElement@7054e9c0 [by +66 ± 53 (+26%) and +116 ± 64 (+46%) ml.min javax.xml.bind.JAXBElement@67908096 ( javax.xml.bind.JAXBElement@464fa113 < 0.05)], suggesting increased venous return and pulmonary blood flow. The application of LBPP increased baroreflex sensitivity (BRS) [by +1.8 ± 1.6 (+18%) and +4.6 ± 3.7 (+47%) at 15 and 40 mmHg LBPP, respectively javax.xml.bind.JAXBElement@4e73aab3 < 0.05]. After reaching steady-state exercise CO vs. VO javax.xml.bind.JAXBElement@19be4054 relationships remained linear with similar slope and intercept for each participant (mean javax.xml.bind.JAXBElement@7ac9e7c5 javax.xml.bind.JAXBElement@41b586b6 = 0.84 ± 0.13) while MAP remained unchanged. It follows that (1) LBPP affects cardiorespiratory integration at the onset of exercise; (2) at a given LBPP, once reaching steady-state exercise, the cardiorespiratory load is reduced proportionally to the lower metabolic demand resulting from the body weight support; (3) the balance between cardiovascular response, oxygen delivery to the exercising muscles and blood pressure regulation is maintained at exercise steady-state; and (4) changes in baroreflex sensitivity may be involved in the regulation of cardiovascular parameters during LBPP

Glucose, Insulin and Renin activity after sodium loading and depletion in Vipera aspis.

Sodium, potassium, chloride, glucose, insulin and renin activity were investigated in fasted Vipera aspis subjected for 3 days to administration of 3% NaCl 5 ml, or injection of a diuretic and water loading to produce sodium depletion. After sodium loading, plasma sodium and glucose were significantly elevated if compared with those of controls, while plasma renin-like activity and plasma insulin were depressed. The insulin and somatostatin producing cells (B- and D-cells) showed only a weak immunoreactivity, while in the glucagon producing cells (A-cells) the immunoreactivity was stronger if compared with the handled controls. After sodium depletion, plasma sodium and glucose were significantly depressed and plasma renin-like activity and plasma insulin were significantly elevated. A strong immunoreactivity was present in B- and D-cells and only a weak immunoreactivity was detectable in the A-cells. These data suggest that the secretory activity of the endocrine pancreas and kidney may be affected, in vipers, by sodium and/or volume status

Blood shifts between body compartments during submaximal exercise with induced expiratory flow limitation in healthy humans

Abstract: External expiratory flow limitation (EFLe) can be applied in healthy subjects to mimic the effects of chronic obstructive pulmonary disease during exercise. At maximal exercise intensity, EFLe leads to exercise intolerance owing to respiratory pump dysfunction limiting venous return. We quantified blood shifts between body compartments to determine whether such effects can be observed during submaximal exercise, when the load on the respiratory system is milder. Ten healthy men (25.2 ± 3.2 years of age, 177.3 ± 5.4 cm in height and weighing 67.4 ± 5.8 kg) exercised at 100 W (∼40% of maximal oxygen uptake) while breathing spontaneously (CTRL) or with EFLe. We measured respiratory dynamics with optoelectronic plethysmography, oesophageal (Pes) and gastric (Pga) pressures with balloon catheters, and blood shifting between body compartments with double body plethysmography. During exercise, EFLe resulted in the following changes: (i) greater intrabreath blood shifts between the trunk and the extremities [518 ± 221 (EFLe) vs. 224 ± 60 ml (CTRL); P < 0.001] associated with lower Pes during inspiration (r = 0.53, P < 0.001) and higher Pga during expiration (r = 0.29, P < 0.024); and (ii) a progressive pooling of blood in the trunk over time (∼700 ml after 3 min of exercise; P < 0.05), explained by a predominant effect of lower inspiratory Pes (r = 0.54, P < 0.001) over that of increased Pga. It follows that during submaximal exercise, EFLe amplifies the respiratory pump mechanism, with a prevailing contribution from lower inspiratory Pes over increased expiratory Pga, drawing blood into the trunk. Whether these results can be replicated in chronic obstructive pulmonary disease patients remains to be determined. (Figure presented.). Key points: External expiratory flow limitation (EFLe) can be applied in healthy subjects to mimic the effects of chronic obstructive pulmonary disease and safely study the mechanisms of exercise intolerance associated with the disease. At maximal exercise intensity with EFLe, exercise intolerance results from high expiratory pressures altering the respiratory pump mechanism and limiting venous return. We used double body plethysmography to quantify blood shifting between the trunk and the extremities and to examine whether the same effects occur with EFLe at submaximal exercise intensity, where the increase in expiratory pressures is milder. Our data show that during submaximal exercise, EFLe amplifies the respiratory pump mechanism, each breath producing greater blood displacements between the trunk and the extremities, with a prevailing effect from lower inspiratory intrathoracic pressure progressively drawing blood into the trunk. These results help us to understand the haemodynamic effects of respiratory pressures during submaximal exercise with expiratory flow restriction

Effect of oral nitrate supplementation on pulmonary hemodynamics during exercise and time trial performance in normoxia and hypoxia: a randomized controlled trial.

BACKGROUND: Hypoxia-induced pulmonary vasoconstriction increases pulmonary arterial pressure (PAP) and may impede right heart function and exercise performance. This study examined the effects of oral nitrate supplementation on right heart function and performance during exercise in normoxia and hypoxia. We tested the hypothesis that nitrate supplementation would attenuate the increase in PAP at rest and during exercise in hypoxia, thereby improving exercise performance. METHODS: Twelve trained male cyclists [age: 31 ± 7 year (mean ± SD)] performed 15 km time-trial cycling (TT) and steady-state submaximal cycling (50, 100, and 150 W) in normoxia and hypoxia (11% inspired O2) following 3-day oral supplementation with either placebo or sodium nitrate (0.1 mmol/kg/day). We measured TT time-to-completion, muscle tissue oxygenation during TT and systolic right ventricle to right atrium pressure gradient (RV-RA gradient: index of PAP) during steady state cycling. RESULTS: During steady state exercise, hypoxia elevated RV-RA gradient (p > 0.05), while oral nitrate supplementation did not alter RV-RA gradient (p > 0.05). During 15 km TT, hypoxia lowered muscle tissue oxygenation (p < 0.05). Nitrate supplementation further decreased muscle tissue oxygenation during 15 km TT in hypoxia (p < 0.05). Hypoxia impaired time-to-completion during TT (p < 0.05), while no improvements were observed with nitrate supplementation in normoxia or hypoxia (p > 0.05). CONCLUSION: Our findings indicate that oral nitrate supplementation does not attenuate acute hypoxic pulmonary vasoconstriction nor improve performance during time trial cycling in normoxia and hypoxia

Regulatory peptides in the urinary bladder of two genera of Antarctic Teleosts

Somatostatin 14, prolactin, atrial natriuretic peptide, galanin and urotensin II were found using immunohistochemistry in the urinary bladders of the Antarctic \uaeshes Trematomus bernacchii (Nototheniidae) and Chionodraco hamatus (Channichthyidae) caught in the Ross Sea. The urinary bladders of the two species showed a dierent histology in the epithelial layer. In T. bernacchii the epithelium comprises a single type of columnar cells, while in C. hamatus the columnar cells are restricted to the ventral portion of the bladder, and the dorso-lateral region is lined by cuboidal cells. No dierence in the intensity of the immunostaining was observed in the two cell types; the only variation was a dierent distribution of the immunoreactions, which were present in the whole cytoplasm in the cuboidal cells and restricted to the apical and/or basal portion of the columnar cells

Self-reported variables as determinants of upper limb musculoskeletal symptoms in assembly line workers

Background: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms—discomfort/pain–during a 6-month follow-up. Methods: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. Results: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, “having upper limb symptoms during the previous 6 months” and “education” were possible predictors. Conclusion: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.publishersversionpublishe

Ions and water transmembrane transport in nervous and testicular cultured cells in low gravity conditions

Aim of the present study was to investigate on the possible alter- ations induced by on ground modeled microgravity on ion-water transport proteins at cellular level. For the purpose we used astrocytes, C6 line, neurons (NT2 line from human teratocarci- noma) and testicular cells (germ cells, Sertoli cells, and Leydig cells; primary cultures from trypsinised prepuberal pig testes). Modeled microgravity was achieved by a desktop 3D Random Positioning Machine, cultures were kept rotating for 30’, 1h and 24h. After 30’, immunopositivity for the antibodies to Na+/K+ATPase and Na+/K+/Cl- co-transporters was greatly diminished, the plasma membrane appeared to be altered, and the mitochondria inner cristae were disrupted. Immunostaining to the antibody to the water channel aquaporin 4 was very bright. After 1h at random rotation immunostaining for the heat shock protein Hsp27 was visible, After 24h, immunostaining for the ion transport proteins was again like that of the controls,plasma membrane and the mitochondria were again normal. Immunostaining for aquaporin 4 become again similar to that of the controls. We conclude that low gravity induces only tran- sient alterations in the cell’s transmembrane ion-water trans- port: the cells are able to adapt to the gravity vector changes in few hours

Graft dysfunction in simultaneous pancreas kidney transplantation (SPK): Results of concurrent kidney and pancreas allograft biopsies

Simultaneous pancreas and kidney transplants offer significant therapeutic advantages but present a diagnostic approach dilemma in the diagnosis of rejection. Because both organs are from the same donor, the kidney has been treated traditionally as the “sentinel” organ to biopsy, presumably representing the status of both allografts. Truly concurrent biopsy studies, however, are needed to confirm this hypothesis. We examined 101 concurrent biopsies from 70 patients with dysfunction in either or both organs. Results showed concurrent rejection in 23 of 57 (40%) of cases with rejection; 19 of 57 (33.5%) and 15 of 57 (26.5%) showed kidney or pancreas only rejection, respectively. The degree and type of rejection differed in the majority (13 of 23, 56.5%) of cases with concurrent rejection, with the pancreas more often showing higher rejection grade. Taking into account pancreas dysfunction, a positive kidney biopsy should correctly predict pancreas rejection in 86% of the instances. However, the lack of complete concordance between the 2 organs, the discrepancies in grade and type of rejection, and the tendency for higher rejection grades in concurrent or pancreas only rejections, all support the rationale for pancreas biopsies. The latter provide additional data on the overall status of the organ, as well as information on nonrejection-related pathologies.Fil: Uva, Pablo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Papadimitriou, J. C.. University of Maryland; Estados UnidosFil: Drachenberg, Cinthia B.. University of Maryland; Estados UnidosFil: Toniolo, María F.. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Quevedo, Alejandra. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Dotta, A. C.. Instituto de Nefrología de Buenos Aires; ArgentinaFil: Chuluyan, Hector Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Casadei, D. H.. Instituto de Nefrología de Buenos Aires; Argentin

An Explicit Expression for the Fisher Information Matrix of a Multiple Time

Abstract The principal result in this paper is concerned with the derivative of a vector with respect to a block vector or matrix. This is applied to the asymptotic Fisher information matrix (FIM) of a stationary vector autoregressive and moving average time series process (VARMA). Representations which can be used for computing the components of the FIM are then obtained. In a related paper [1], the derivative is taken with respect to a vector. This is obtained by vectorizing the appropriate matrix products whereas in this paper the corresponding matrix products are left unchanged