The angiotensin-converting enzyme I/D polymorphism does not impact training-induced adaptations in exercise capacity in patients with stable coronary artery disease

Abstract Systematic exercise training effectively improves exercise capacity in patients with coronary artery disease (CAD), but the magnitude of improvements is highly heterogeneous. We investigated whether this heterogeneity in exercise capacity gains is influenced by the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene. Patients with CAD (n = 169) were randomly assigned to 12 weeks of exercise training or standard care, and 142 patients completed the study. The ACE polymorphism was determined for 128 patients (82% males, 67 ± 9 years). Peak oxygen uptake was measured before and after the 12-week intervention. The ACE I/D polymorphism frequency was n = 48 for D/D homozygotes, n = 61 for I/D heterozygotes and n = 19 for I/I homozygotes. Baseline peak oxygen uptake was 23.3 ± 5.0 ml/kg/min in D/D homozygotes, 22.1 ± 5.3 ml/kg/min in I/D heterozygotes and 23.1 ± 6.0 ml/kg/min in I/I homozygotes, with no statistical differences between genotype groups (P = 0.50). The ACE I/D polymorphism frequency in the exercise group was n = 26 for D/D, n = 21 for I/D and n = 12 for I/I. After exercise training, peak oxygen uptake was increased (P < 0.001) in D/D homozygotes by 2.6 ± 1.7 ml/kg/min, in I/D heterozygotes by 2.7 ± 1.9 ml/kg/min, and in I/I homozygotes by 2.1 ± 1.3 ml/kg/min. However, the improvements were similar between genotype groups (time × genotype, P = 0.55). In conclusion, the ACE I/D polymorphism does not affect baseline exercise capacity or exercise capacity gains in response to 12 weeks of high-intensity exercise training in patients with stable CAD. Clinical trial registration: www.clinicaltrials.gov (NCT04268992)

Effect of angiotensin-converting enzyme inhibition on cardiovascular adaptation to exercise training

Angiotensin‐converting enzyme (ACE) activity may be one determinant of adaptability to exercise training, but well‐controlled studies in humans without confounding conditions are lacking. Thus, the purpose of the present study was to investigate whether ACE inhibition affects cardiovascular adaptations to exercise training in healthy humans. Healthy participants of both genders (40 ± 7 years) completed a randomized, double‐blind, placebo‐controlled trial. Eight weeks of exercise training combined with placebo (PLA, n = 25) or ACE inhibitor (ACEi, n = 23) treatment was carried out. Before and after the intervention, cardiovascular characteristics were investigated. Mean arterial blood pressure was reduced (p < 0.001) by −5.5 [−8.4; −2.6] mmHg in ACE(i), whereas the 0.7 [−2.0; 3.5] mmHg fluctuation in PLA was non‐significant. Maximal oxygen uptake increased (p < 0.001) irrespective of ACE inhibitor treatment by 13 [8; 17] % in ACE(i) and 13 [9; 17] % in PLA. In addition, skeletal muscle endurance increased (p < 0.001) to a similar extent in both groups, with magnitudes of 82 [55; 113] % in ACE(i) and 74 [48; 105] % in PLA. In contrast, left atrial volume decreased (p < 0.05) by −9 [−16; −2] % in ACE(i), but increased (p < 0.01) by 14 [5; 23] % in PLA. Total hemoglobin mass was reduced (p < 0.01) by −3 [−6; −1] % in ACE(i), while a non‐significant numeric increase of 2 [−0.4; 4] % existed in PLA. The lean mass remained constant in ACE(i) but increased (p < 0.001) by 3 [2; 4] % in PLA. In healthy middle‐aged adults, 8 weeks of high‐intensity exercise training increases maximal oxygen uptake and skeletal muscle endurance irrespective of ACE inhibitor treatment. However, ACE inhibitor treatment counteracts exercise training‐induced increases in lean mass and left atrial volume. ACE inhibitor treatment compromises total hemoglobin mass

The Faroe Islands COVID-19 Recreational Football Study: Player-to-Player Distance, Body-to-Body Contact, Body-to-Ball Contact and Exercise Intensity during Various Types of Football Training for Both Genders and Various Age Groups

We determined player-to-player distance, body-to-ball contact, and exercise intensity during three training modalities in various football populations. 213 participants were recruited, ranging from 9-year-old boys to young men and 11-year-old girls to middleaged women. All groups were analysed with video-filming and GPS-based Polar Pro monitors during three types of football training for 20 min, i.e., COVID-19-modified training (CMT) with >2-metre player-to-player distance, small-sided games (SSG), and simulated match-play with normal rules (SMP), in randomised order. Time spent in a danger zone (1.5 m) perpercent-infected-player (DZ PPIP) ranged from 0.015 to 0.279% of playing time. DZ PPIP for SSG was higher (P < 0:05) than CMT and SMP. The average number of contacts (within 1.5 m) with a potentially infected player ranged from 12 to 73 contacts/hour. SSG had more (P < 0:05) contacts than CMT and SMP, with SMP having a higher (P < 0:05) number of contacts than CMT. Time/contact ranged from 0.87 to 3.00 seconds for the groups. No player-to-player and body-to-ball touches were registered for CMT. Total player-to-player contacts were 264% higher (P < 0:05) in SSG than SMP, ranging from 80 to 170 and 25 to 56 touches, respectively. In all groups, a greater total distance was covered during SMP compared to CMT (38–114%; P < 0:05). All groups performed more high-intensity running (33–54%; P < 0:05) and had higher heart rates during SMP compared to CMT. Different types of football training all appear to exert a minor COVID-19 infection risk; however, COVID-19-modified training may be safer than small-sided game training, but also match-play. In contrast, exercise intensity is lower during COVID-19-modified training than match-play