Search

Background: Black compared with White adults have a higher risk for left-ventricular hypertrophy and heart failure possibly due to the early onset of alterations in ventricular-vascular coupling (ie, arterial [ E a ] to ventricular elastance [ E es ] ratio) and wasted pressure effort ( E w ). Aerobic training preserves the coupling ratio ( E a / E es ) and attenuates E w , but whether this applies to Black adults is unknown. We hypothesized that Black rather than White adults would have greater training-induced improvements in the E a / E es and E w ., Methods and Results: Fifty-four young adults with normal blood pressure (Black=24 [58% female]; White=30 [47% female], mean=24 years; SD=5 years) completed an 8-week aerobic training (3 times/week, 65%-85% peak oxygen uptake). E a / E es was estimated via echocardiography and scaled to body surface area, and the E w was estimated from pulse contour analysis. Black adults had lower E a / E es (difference ( d )=0.49 [95% CI, 0.14-0.84 mm Hg/mL], P =0.007) and higher E w ( d =1127 [95% CI, 104-2007 dyne cm -2  s], P =0.005). Both groups exhibited similar (race-by-training interaction, P =0.986) training-induced reductions in scaled E a ( d =-0.11 [95% CI, -0.18 to -0.04 mm Hg/mL], P <0.001). Only in White adults, scaled E es increased ( d white =0.39 [95% CI, 0.11-0.32 mm Hg/mL], P =0.003) and E a / E es was reduced ( d white =-0.16 [95% CI, -0.33 to -0.18 mm Hg/mL/m 2 ], P <0.001). Conversely, only Black adults exhibited reductions in E w after training ( d black =-699 [95% CI, -1209 to -189 dyne cm -2  s], P =0.008)., Conclusions: Aerobic training-induced differential effects on E a / E es and E w of White and Black young adults hold the potential to reduce racial disparities. This warrants confirmation in a larger sample., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01024634.

Purpose: We examined heart rate variability (HRV) and baroreflex sensitivity (BRS) disease- and age-related response at 10-and 60-min after an acute high-intensity interval (HIIE) and moderate continuous exercise (MICE) in older adults with and without type 2 diabetes mellitus (T2DM) and healthy young adults., Methods: Twelve older male adults with (57-84 years) and without T2DM (57-76 years) and 12 healthy young male adults (20-40 years) completed an isocaloric acute bout of HIIE, MICE, and a non-exercise condition in a randomized order. Time and Wavelets-derived frequency domain indices of HRV and BRS were obtained in a supine position and offline over 2-min time-bins using Matlab., Results: HIIE but not MICE reduced natural logarithm root mean square of successive differences (Ln-RMSSD) (d = - 0.85; 95% CI - 1.15 to - 0.55 ms, p < 0.001), Ln-high-frequency power (d = - 1.60; 95% CI - 2.24 to - 0.97 ms 2 ; p < 0.001), and BRS (d = - 6.32; 95% CI - 9.35 to - 3.29 ms/mmHg, p < 0.001) in adults without T2DM (averaged over young and older adults without T2DM), returning to baseline 60 min into recovery. These indices remained unchanged in older adults with T2DM after HIIE and MICE. Older adults with T2DM had lower resting Ln-RMSSD and BRS than aged-matched controls (Ln-RMSSD, d = - 0.71, 95% CI - 1.16 to - 0.262 ms, p = 0.001; BRS d = - 3.83 ms/mmHg), 95% CI - 6.90 to - 0.76, p = 0.01)., Conclusions: Cardiovagal modulation following acute aerobic exercise is intensity-dependent only in adults without T2DM, and appears age-independent. These findings provide evidence of cardiac autonomic impairments in older adults with T2DM at rest and following aerobic exercise., (© 2023. The Author(s).)

Exercise testing unmasks more exaggerated systolic blood pressure responses (SBP) in Black compared with White male adults. Such responses, if translatable to females, may detect racial disparities particularly relevant during menopause. Given the endothelial involvement in BP regulation and as a source of fibrinolytic markers, it follows that fibrinolytic and BP response to exercise could be linked. Thus, we examined BP and fibrinolytic responses to exercise testing in Black and White postmenopausal females. Postmenopausal females (Black = 40; White = 41; 51-70 yr) performed maximal treadmill exercise. BP and blood draws were conducted before and immediately after exercise. Plasma samples, using minimal stasis, were analyzed for tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) activity and antigen, respectively. Resting SBP and fibrinolytic potential were similar between races. Black females exhibited greater increases in SBP during exercise [change (d)=75, 95% CI: 64-86 mmHg, P < 0.001] than White females (d = 60, 95% CI: 48-71 mmHg, P < 0.001). Black compared with White females had smaller changes in tPA (d = 3.27, 95% CI: 2.28-4.27 IU/mL, P < 0.001 vs. d = 5.55, 95% CI: 4.58-6.53, P < 0.001) and PAI-1 (d = -2.89, 95% CI: -4.39 to -1.40 IU/mL, P < 0.001 vs. d = -5.08, 95% CI: -6.59 to -3.61, P < 0.001) activities after exercise. SBP exercise-induced changes were not associated with tPA ( r = -0.10, P = 0.42) or PAI-1 ( r = 0.13, P = 0.30), without any influence of race ( P > 0.05). Our findings show that maximal exercise unmasks risk factors for cardiovascular disease in Black postmenopausal females. NEW & NOTEWORTHY Exaggerated SBP responses to exercise testing are more frequent in Black than in White male adults. Such responses, if translatable to females, may detect early racial disparities arriving during menopause. Because the endothelium regulates BP and fibrinolytic responses, these could be linked during exercise. At peak exercise, Black but not White postmenopausal females had more exaggerated SPB responses regardless of reduced fibrinolytic potential. Maximal exercise unmasked risk factors for cardiovascular disease in Black postmenopausal females.

Background: We compared the effects of home- vs gym-based delivery modes of two 8-week supervised multicomponent intensity training regimes on cardiorespiratory fitness and arterial stiffness in 17 adults with intellectual and developmental disability during the COVID-19 pandemic. Methods : Participants were assigned to sprint interval training or continuous aerobic training, both incorporating resistance training. The intervention started with 8-weeks of online training (M1-M2), 1-month of detraining, plus 8-weeks of gym-based training (M3-M4). Results : Peak oxygen uptake decreased from M1-M2 and increased from M2-M4. Central arterial stiffness decreased between M1-M2, and M1-M4, along with peripheral arterial stiffness. Central systolic blood pressure decreased from M1-M2 only with sprint interval training. Conclusion : Home-based training minimized the negative impact of the lockdown on central arterial stiffness and central blood pressure, but it did not match the benefits on cardiorespiratory fitness and peripheral arterial stiffness of a gym-based intervention, irrespective of the multicomponent intensity training regime. Registered in ClinicalTrials.gov NCT05701943., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

To clarify the role of socioeconomic status (SES) in cardiovascular and cancer mortality disparities observed between Black, Hispanic, and Asian compared to White adults, we conducted a meta-analysis of the longitudinal research in the USA. A PubMed, Ovid Medline, Web of Science, and EBSCO search was performed from January 1995 to May 2023. Two authors independently screened the studies and conducted risk assessments, with conflicts resolved via consensus. Studies were required to analyze mortality data using Cox proportional hazard regression. Random-effects models were used to pool hazard ratios (HR) and reporting followed PRISMA guidelines. Twenty-two studies with cardiovascular mortality (White and Black (n = 22), Hispanic (n = 7), and Asian (n = 3) adults) and twenty-three with cancer mortality endpoints (White and Black (n = 23), Hispanic (n = 11), and Asian (n = 10) adults) were included. The meta-analytic sample for cardiovascular mortality endpoints was 6,199,049 adults (White = 4,891,735; Black = 935,002; Hispanic = 295,623; Asian = 76,689), while for cancer-specific mortality endpoints was 7,745,180 adults (White = 5,988,392; Black= 1,070,447; Hispanic= 484,848; Asian = 201,493). Median follow-up was 10 and 11 years in cohorts with cardiovascular and cancer mortality endpoints, respectively. Adjustments for SES attenuated the higher risk for cardiovascular (HR, 1.46; 95% CI, 1.30-1.64) and cancer mortality (HR, 1.35; 95% CI, 1.32-1.38) of Black compared to White adults by 25% (HR, 1.21; 95% CI, 1.15-1.28) and 19% (HR, 1.16; 95% CI, 1.13-1.18), respectively. However, the Hispanic cardiovascular (HR, 0.79; 95% CI, 0.73-0.85) and Asian cancer mortality (HR, 0.81; 95% CI, 0.76-0.86) advantage were independent of SES. These findings emphasize the need to develop strategies focused on SES to reduce cardiovascular and cancer mortality in Black adults., (© 2023. W. Montague Cobb-NMA Health Institute.)

Sex differences in resting cerebral hemodynamics decline with aging. Given that acute resistance exercise (RE) is a hypertensive challenge, it may reveal sex-dependent abnormalities in cerebral hemodynamics. Thus, we hypothesized that cerebral blood velocity and pulsatility responses to RE would be sex-dependent in older adults. Fourteen older females and 11 males (50-68 yr) completed a high-intensity unilateral isokinetic knee flexion/extension exercise. Measurements were collected at baseline, immediately, 5- and 30-min post-RE. Blood pressure was measured via finger photoplethysmography. Mean middle cerebral artery blood velocity (MCAv) and pulsatility were assessed via transcranial Doppler ultrasound. Carotid pulsatility was obtained via duplex ultrasound. MCAv increased immediately after RE in older females [mean difference ( d ) = 6.02, 95% CI: 1.66 to 10.39 cm/s, P < 0.001] but not in males ( d = -0.72, 95% CI: -3.83 to 5.27 cm/s, P = 0.99), followed by similar reductions 5-min post-RE in older females ( d = -4.40, 95% CI: -8.81 to -0.10 cm/s, P = 0.045) and males ( d = -6.41, 95% CI: -11.19 to -1.62 cm/s, P = 0.003). MCAv pulsatility increased similarly in older females ( d = 0.24, 95% CI: 0.11 to 0.40, P < 0.001) and males ( d = 0.38, 95% CI: 0.20 to 0.53, P < 0.001), persisting 5-min post-RE. Older females showed smaller increases in carotid pulsatility immediately after RE ( d = 0.18, 95% CI: 0.03 to 0.38, P = 0.01) than males ( d = 0.48, 95% CI: 0.26 to 0.68, P < 0.001). An exercise-mediated hypertensive stimulus revealed differential sex responses in MCAv and carotid pulsatility but not in cerebral pulsatility. Cerebral pulsatility findings suggest a similar sex susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus in older adults. NEW & NOTEWORTHY Sex differences in resting cerebral hemodynamics decline with advancing age as females experience larger reductions in cerebral blood velocity and steeper pulsatility increases than males. However, an exercise-mediated hypertensive stimulus might reveal sex differences in cerebral hemodynamics not apparent at rest. Following high-intensity resistance exercise, older females but not males exhibit increases in cerebral blood velocity, despite similar increases in cerebral pulsatility. The susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus appears similar between sexes.

Flow-mediated slowing (FMS) is a non-invasive measure of endothelial function measured through reactive hyperemia-induced changes in pulse wave velocity (PWV). FMS is suggested to mitigate known pitfalls of flow-mediated dilation (FMD) including suboptimal repeatability and high-operator dependency. However, the few single-rater studies that examined FMS repeatability have shown controversial results and used only regional measurements of PWV, which might not reflect local brachial artery stiffness responses to reactive hyperemia. We assessed the inter- and intra-rater repeatability of ultrasound-based changes in local PWV (FMS) and diameter (FMD). Twenty-four healthy male participants aged 23-75 yr, were examined on two separate days. Reactive hyperemia-induced changes in PWV were calculated using a tailored R-script. The inter- and intra-rater repeatability were tested with the intraclass correlation coefficient (ICC), coefficient of variation (CV), and the Bland-Altman plot estimates. The inter-rater repeatability of FMS (bias: -0.08%; ICC: 0.85; 95% CI: 0.65 to 0.93; CV: 11%) and FMD (bias: -0.02%; ICC: 0.98; 95% CI: 0.97 to 0.99; CV: 7%) showed overall good repeatability over different days. The intra-rater repeatability of FMD (1st rater: bias: 0.27%; ICC: 0.90; 95% CI: 0.78 to 0.96; CV: 14%; 2nd rater: bias: 0.60%; ICC: 0.85; 95% CI: 0.64 to 0.94; CV: 18%) was better than FMS (1st rater: bias: -1.03%; ICC: 0.76; 95% CI: 0.44 to 0.91; CV: 21%; 2nd rater: bias:-0.49%; ICC: 0.70; 95% CI: 0.34 to 0.80; CV: 23%) but not different between raters. Ultrasound-based local measurements of PWV deceleration reactive hyperemia were repeatable among the raters., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Marôco et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

We examined the effects of adding a Kettlebell Swing training program (KB) to the regular skill-training protocol (REGULAR) on cardiorespiratory fitness, cardiorespiratory/metabolic demand, and recovery to a simulated competition of female artistic gymnastics. Nine gymnasts (13±2 years) had their REGULAR complemented with a 4-week kettlebell training (REGULAR+KB), consisting of 3 sessions/week of 12x30" swings x 30" rest with ¼ of their body weight, while 9 aged-matched gymnasts acted as a comparison group. Peak oxygen uptake ([Formula: see text]) during routines was estimated from the O2 recovery curve using backward extrapolation and off-kinetics parameters were modeled through a mono-exponential function. Heart rate (HR) was monitored continuously and capillary blood lactate (BLa-) was measured before and after each routine (1st and 3rd min). Cardiorespiratory fitness ([Formula: see text]) was evaluated using a ramp cycle ergometer test. A training-by-time interaction effect was observed for [Formula: see text] (p = 0.009) as increments were only observed after REGULAR+KB (M = 8.85, SD = 9.67 ml.kg.min-1). No training-by-time interactions were observed for HRpeak (p = 0.39), [Formula: see text] (p = 0.07), or La-post3 (p = 0.25), both training protocols reduced HRpeak (M = -12; SD = 11 b.min-1) and BLa-post1 (M = -0.70; SD = 1.29 mmol.L-1) during the simulated competition, but not relative [Formula: see text]. No training-by-time interaction was observed for the off-transient [Formula: see text] time constant (p = 0.38). [Formula: see text] recovery was slower (M = 5; SD = 10 s) after both protocols. Both training protocols improved cardiorespiratory and metabolic demands and recovery kinetics to a simulated competition of female artistic gymnastics, although increases in cardiorespiratory fitness were only observed in REGULAR+KB., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Melo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Electroencephalography (EEG) is attracting increasing attention in the sports and exercise fields, as it provides insights into brain behavior during specific tasks. However, it remains unclear if the promising wireless EEG caps provide reliable results despite the artifacts associated with head movement. The present study aims to evaluate the repeatability of brain activity as measured by a wireless 32-channel EEG system (EMOTIV flex cap) during resistance exercises in 18 apparently healthy but physically inactive young adults (10 men and 8 women). Moderate-intensity leg press exercises are performed with two evaluations with 48 h. between. This intensity allows enough time for data analysis while reducing unnecessary but involuntary head movements. Repeated measurements of EEG during the resistance exercise show high repeatability in all frequency bands, with excellent ICCs (>0.90) and bias close to zero, regardless of sex. These results suggest that a 32-channel wireless EEG system can be used to collect data on controlled resistance exercise tasks performed at moderate intensities. Future studies should replicate these results with a bigger sample size and different resistance exercises and intensities.

We compared central and peripheral arterial stiffness response patterns between persons with and without intellectual and developmental disabilities (IDD) of different age groups at rest and following a cardiopulmonary exercise test (CPET). Fifteen young adults with and without IDD, and 15 middle-aged adults without IDD performed a CPET. Central and peripheral arterial stiffness were measured at rest and following CPET using estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-ankle (cdPWV) pulse wave velocity derived from piezoelectric mechano-transducers. cfPWV remained unchanged following CPET in adults with and without IDD but increased in middle-aged adults ( d  = 0.85; 95% CI: 0.27-1.42 m·s -1 , p  = 0.005), whereas cdPWV was similarly reduced ( d  = -0.77; 95% CI: -1.06 to -0.48 m·s -1 , p  < 0.001) in all groups. crPWV remained unchanged in all groups. These results were independent of exercise-related changes in mean arterial pressure. Overall group differences suggested that persons with IDD ( d = -1.78; 95% CI: -3.20 to -0.37 m·s -1 , p  = 0.009) and without IDD ( d = -1.84; 95% CI: -3.26 to -0.43 m·s -1 , p  = 0.007) had lower cfPWV than middle-aged adults. We found no evidence of early vascular aging and diminished vascular reserve following CPET in adults with IDD.

We compared response patterns of cardiovagal modulation through heart-rate variability (HRV) and baroreflex sensitivity (BRS) indices at 10 and 60 min after an acute bout of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in active young and older adults. Twelve young (aged 20-40 years) and older (aged 57-76 years) healthy and active male adults performed an isocaloric acute bout of HIIE, MICE, or a non-exercise condition in a randomized order. HRV and BRS indices were analyzed offline with R-R intervals obtained from a supine position. HIIE decreased natural logarithm (Ln) standard deviation of NN intervals (d=-0.53; 95% CI: -0.77 to -0.30 ms, p <0.001), Ln-root mean square of successive differences (d=-0.85; 95% CI: -1.09 to -0.61 ms, p <0.001), Ln-high-frequency power (d=-1.60; 95% CI: -2.11 to -1.10 ms 2 ; p <0.001), and BRS (d=-6.28; 95% CI: -8.91 to -3.64 ms/mmHg, p <0.001) after exercise in young and older adults, whereas MICE did not. Indices returned to baseline after 60 min. We found no evidence of age-associated response patterns in HRV or BRS to a single bout HIIE or MICE in active participants. HIIE reduced cardiovagal modulation in active young and older adults, returning to baseline values 60 min into recovery., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Pulse wave velocity (PWV) deceleration to reactive hyperemia-flow-mediated slowing (FMS)-has been suggested as an alternative method to flow-mediated dilation (FMD) to evaluate brachial artery endothelial function. FMS is suggested to address major caveats of the FMD procedure including its suboptimal repeatability and high-operator dependency. However, the repeatability of FMS has not been thoroughly examined, especially given the plethora of methods claiming to measure PWV. We assessed and compared the intra- and inter-day repeatability of FMS as measured by piezoelectric pressure mechanotransducers placed in the carotid and radial arteries, and brachial artery FMD as measured by echo-tracking. Twenty-four healthy male participants aged 23-75 yr, were examined on three separate days to assess intra and inter-day repeatability. All FMD and FMS examinations were conducted simultaneously by the same researcher complying with standardized guidelines. Repeatability was examined with intraclass correlation coefficient (ICC; >0.80), coefficient of variation (CV; <15%), and limits of agreement (95% LOA). Relative (%) FMD and FMS were scaled for baseline brachial artery diameter and PWV, respectively. Intra- (ICC: 0.72; CV: 136%; 95% LOA: -19.38 to 29.19%) and Inter-day (ICC: 0.69; CV: 145%, 95% LOA: -49.50 to 46.08%) repeatability of %FMS was poor, whereas %FMD demonstrated moderate-to-good intra- (ICC: 0.93; CV: 18%, 95% LOA: -3.02 to 3.75%) and inter-day repeatability (ICC: 0.74; CV: 25%, 95% LOA: -9.16 to 7.04%). Scaling FMD reduced the intra-day CV (-5%), and the uncertainty of the 95% LOA (- 37.64 to 35.69%) estimates of FMS. Carotid-radial artery FMS showed poorer repeatability compared to FMD., Competing Interests: The authors have declared that no competing interests exist.

Objectives. To examine the acute effect of a maximal aerobic exercise effort on aortic, peripheral arterial stiffness and cardiovagal modulation of trained and untrained patients with coronary artery disease (CAD). Design . Cross-sectional study. Methods . Eighteen untrained patients with CAD, 18 trained patients with CAD, and 18 apparently healthy trained subjects were sampled and matched for age and body mass index. Aortic and peripheral stiffness were measured by applanation tonometry estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-dorsalis pedis pulse wave velocity (cdPWV), respectively. Cardiovagal modulation was assessed by heart-rate variability (HRV) indices including the standard deviation of normal-to-normal RR intervals (SDNN), root-mean-square of successive differences (RMSSD), and the high-frequency power band (HF). cfPWV, crPWV, cdPWV, and HRV indices were measured at rest, 10 and 30 min following a maximal cardiopulmonary exercise test on a cycle ergometer. Results . No differences were observed between groups at rest nor over time in indices of HRV, cfPWV and cdPWV. Still, main effects of time were observed in cfPWV ( p  < .001; ɳ 2 = 0.313) and cdPWV ( p  = .003, ɳ 2 = 0.111), RMSSD ( p  < .001, ɳ 2 = 0.352), HF ( p  < .001, ɳ 2 = 0.265) and LF/HF ( p  = .001, ɳ 2 = 0.239), as cdPWV, RMSSD, and HF were reduced 10 min following exercise, whereas cfPWV and LF/HF were increased. Changes in cPP were associated with changes in HRV from rest to min 10 (HF, r  = 0.302), and to min 30 (HF, r  = 0.377; SDNN, r  = 0.357; RMSSD, r  = 0.429). Conclusion . Training level and CAD do not seem to influence arterial stiffness and cardiac autonomic responses to maximal exercise.