The Effects of a Multiflavonoid Supplement on Vascular and Hemodynamic Parameters following Acute Exercise

Antioxidants can decrease oxidative stress and combined with acute exercise they may lead to further decreases in blood pressure. The purpose of this study was to investigate the effects of 2 weeks of antioxidant supplementation on vascular distensibility and cardiovascular hemodynamics during postexercise hypotension. Methods. Twenty young subjects were randomized to placebo (n = 10) or antioxidant supplementation (n = 10) for two weeks. Antioxidant status, vascular distensibility, and hemodynamics were obtained before, immediately, and 30 minutes after an acute bout of aerobic exercise both before and after supplementation. Results. Two weeks of antioxidant supplementation resulted in a greater systolic blood pressure (SBP) decrease during postexercise hypotension (PEH) and significant decreases in augmentation index versus placebo (12.5% versus 3.5%, resp.). Also ferric-reducing ability of plasma (FRAP) increased significantly (interaction P = 0.024) after supplementation. Conclusion. Supplementation showed an additive effect on PEH associated with increased FRAP values and decreases in systolic blood pressure and augmentation index

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Effect of Moderate Dehydration on Torque, Electromyography, and Mechanomyography

The purpose of the present investigation was to test the hypotheses that the mechanomyographic (MMG) signal would be affected by hydration status due to changes in the intra- and extracellular fluid content (which could affect the degree of fluid turbulence), changes in the filtering properties of the tissues between the MMG sensor and muscle, and changes in torque production that may accompany dehydration. Ten subjects (age 22.5 +/- 1.6 years) were tested for maximal isometric (MVC), submaximal isometric (25, 50, and 75%MVC), and maximal concentric isokinetic muscle strength of the biceps brachii in either a euhydrated or dehydrated state while the electromyographic (EMG) and MMG signals were recorded. Separate three-way and two-way ANOVAs indicated no change in torque, EMG amplitude, EMG mean power frequency (MPF), MMG amplitude, and MMG MPF with dehydration. The lack of dehydration effect suggests that MMG may be more reflective of the intrinsic contractile processes of a muscle fiber (torque production) or the motor control mechanisms (reflected by the EMG) than the tissues and fluids surrounding the muscle fiber. (C) 2002 Wiley Periodicals, Inc

The Effect of Glycerol on Torque Electromyography, and Mechanomyography

The effect of glycerol on torque, electromyography, and mechanomyography. J. Strength Cond. Res. 18(4):000-000. 2004 - The purpose of this investigation was to determine the effect of hyperhydration on the electromyographic (EMG) and mechanomyographic (MMG) responses during isometric and isokinetic muscle actions of the biceps brachii. Eight (22.1 +/- 1.8 years, 79.5 +/- 22.8 kg) subjects were tested for maximal isometric, submaximal isometric, and maximal concentric isokinetic muscle strength in either a control (C) or hyperhydrated (H) state induced by glycerol ingestion while the EMG and MMG signals were recorded. Although fluid retention was significantly greater during the H protocol, the analyses indicated no change in torque, EMG amplitude, EMG mean power frequency (MPF), MMG amplitude, or MMG MPF with hyperhydration. These results indicated that glycerol-induced fluid retention does not affect the torque-producing capabilities of a muscle, the impulses (EMG) going to a muscle, or muscular vibrations (MMG). It has been suggested that EMG and MMG can be used as direct electrical/mechanical monitoring, which could be presented to trainers and athletes; however, before determining the utility of these signals, the MMG and EMG responses should be examined under a variety of conditions such as in the present study