Effect of aerobic and resistance exercise training on endothelial function in individuals with overweight and obesity: a systematic review with meta-analysis of randomized clinical trials.

The objective of this systematic review was to examine the effects of exercise training on endothelial function in individuals with overweight and obesity. Our review study included only randomized controlled trials (RCTs) involving adults (≥ 18 years of age) with body mass index (BMI) ≥ 25.0 kg/m2. Our search was conducted in the electronic bases MEDLINE (PubMed), Cochrane, LILACS and EMBASE and in the gray literature. We performed random-effects analyses for effect estimates and used 95% prediction intervals (95% PI) for estimating the uncertainty of the study results. There were selected 10 RCTs involving 14 groups (n = 400). The quality assessment of studies using Cochrane risk-of-bias 2 (RoB 2) tool identified some concerns. Exercise training resulted in improved flow-mediated dilation (FMD) in individuals with overweight and obesity (p < 0.001) compared to the no-exercise control group. This effect of training modalities on FMD was seen for aerobic training (p < 0.001) but not for resistance training (p = 0.051). There was no difference in FMD in response to exercise training by BMI classification (overweight, obesity, overweight + obesity), p = 0.793. The present results are consistent with the notion that aerobic exercise training elicits favorable adaptations in endothelial function in individuals with overweight and obesity. Our findings should be interpreted with caution because of the small number of studies included in this review.

Effects of aerobic, resistance, and combined training on endothelial function and arterial stiffness in older adults: study protocol for a systematic review and meta-analysis.

INTRODUCTION: Aging is an independent risk factor for cardiovascular events. It promotes vascular dysfunction which is associated with risk factors for cardiovascular diseases (CVDs). Exercise can modulate vascular function parameters, but little is known about the effects of different modalities of training (aerobic, resistance, and combined) on endothelial function and arterial stiffness in older adults. METHODS: This systematic review study will include randomized controlled trials (RCTs) selected from the electronic databases MEDLINE (PubMed), Cochrane, LILACS, EMBASE, and Web of Science. We will follow the PRISMA guidelines and PICOS framework. Studies involving both male and female older adults (≥60 years old) with or without comorbidities undergoing aerobic, resistance, and/or combined training compared to a control group (no exercise) will be eligible. We will use the Cochrane Risk of Bias 2 (RoB 2) tool to evaluate the quality of individual studies and GRADE to assess the strength of evidence. Statistical analyses will be conducted with RStudio for Windows (v1.3.959) using R package meta. DISCUSSION: A systematic review and meta-analysis involving data from studies of older adults would deepen our understanding of vascular adaptations to exercise training in this population. It could provide new insights into how health providers can improve patient management and prevention of cardiovascular events in older adults. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 42021275451.

Preventive aerobic training preserves sympathovagal function and improves DNA repair capacity of peripheral blood mononuclear cells in rats with cardiomyopathy.

To evaluate the effect of preventive aerobic exercise training on sympathovagal function, cardiac function, and DNA repair capacity in a preclinical model of doxorubicin (DOX)-induced cardiomyopathy. Forty male Wistar-Kyoto rats were allocated into four groups (n = 10/group): D (DOX-treated) and C (controls) remained sedentary, and DT (DOX-trained) and CT (control-trained) performed aerobic training 4 days/week, during 4 weeks before exposure to DOX (4 mg/kg/week during 4 weeks) or saline solution. We evaluated cardiac function (echocardiography), hemodynamic and sympathovagal modulation (artery-femoral cannulation), cardiac troponin T levels, and DNA repair capacity (comet assay). Exercise training preserved ejection fraction (D: - 14.44% vs. DT: - 1.05%, p < 0.001), fractional shortening (D: - 8.96% vs. DT: - 0.27%, p = 0.025) and troponin T levels (D: 6.4 ± 3.6 vs. DT: 2.8 ± 1.7 ng/mL, p = 0.010). DOX increased heart rate variability (C: 27.7 ± 7.9 vs. D: 7.5 ± 2.2 ms2, p < 0.001) and induced sympathovagal dysfunction (LF/HF, C: 0.37 ± 0.15 vs. D: 0.15 ± 0.15, p = 0.036) through exacerbation of sympathetic function (LF, C: 0.22 ± 0.01 vs. D: 0.48 ± 0.24 Hz, p = 0.019). Peripheral mononuclear blood cells of DT animals presented lower residual DNA damage (D: 43.4 ± 8.4% vs. DT: 26 ± 3.4%, p = 0.003 after 1 h). Cardioprotective effects of preventive aerobic exercise training are mediated by preservation of sympathovagal function and improvement of DNA repair capacity of peripheral blood mononuclear cells.

Efeitos de Diferentes Tipos de Treinamento Físico na Função Endotelial em Pré-Hipertensos e Hipertensos: Uma Revisão Sistemática / Effects of Different Types of Exercise Training on Endothelial Function in Prehypertensive and Hypertensive Individuals: A Systematic Review

Resumo Fundamento: A hipertensão sustentada pode levar ao remodelamento vascular e lesão das células endoteliais, o que pode explicar a disfunção endotelial encontrada em hipertensos. O treinamento físico pode melhorar a saúde vascular em indivíduos com risco cardiovascular, mas pouco se sabe sobre seus efeitos em pré-hipertensos e hipertensos. Objetivo: Revisar a literatura mostrando evidências de alterações da função endotelial em resposta a diferentes modalidades de treinamento físico em pré-hipertensos e hipertensos. Métodos: Realizamos uma revisão sistemática de estudos nas bases de dados MEDLINE, Cochrane, LILACS, EMBASE e SciELO seguindo tanto as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) quanto a estratégia PICO (paciente/população, intervenção, comparação e resultados). Os ensaios clínicos randomizados (ECRs) publicados até abril de 2019 foram selecionados e avaliados por quatro revisores independentes. A qualidade metodológica foi avaliada por meio da escala PEDro (Physiotherapy Evidence Database). Resultados: Nossa busca rendeu 598 resumos, e 10 estudos foram elegíveis para revisão. Todos eles apresentaram qualidade metodológica aceitável pela escala PEDro. Dos 10 estudos, 7 envolveram treinamento aeróbico, 1 treinamento resistido isométrico e 2 treinamento aeróbico e treinamento resistido dinâmico separadamente. Sete estudos usaram dilatação fluxo-mediada (DFM) para avaliar a saúde vascular, e três usaram pletismografia. A maioria dos protocolos de treinamento envolveu indivíduos hipertensos e consistiu em exercícios de baixa e moderada intensidade. Conclusão: Nossa revisão sistemática mostrou que o treinamento aeróbico contínuo moderado é eficaz para melhorar a saúde vascular em indivíduos hipertensos. Em pré-hipertensos, o treinamento aeróbico intervalado vigoroso parece ser uma alternativa para benefícios à saúde vascular. O treinamento físico resistido isométrico ou dinâmico pode ser usado como alternativa secundária, mas ainda requer mais investigação.

Abstract Background: Sustained high blood pressure can lead to vascular remodeling and endothelial cell injury, which may explain the endothelial dysfunction found in hypertensive individuals. Exercise training can improve vascular health in individuals with cardiovascular risk, but little is known about its effects in prehypertensive and hypertensive individuals. Objective: To review the literature showing evidence of changes in endothelial function in response to different modalities of exercise training in prehypertensive and hypertensive individuals. Methods: We conducted a systematic review of studies in the MEDLINE, Cochrane, LILACS, EMBASE, and SciELO databases following both the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the PICO framework (patient/population, intervention, comparison and outcomes). Randomized clinical trials (RCTs) published up to April 2019 were selected and assessed by four independent reviewers. The methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. Results: Our search yielded 598 abstracts, and 10 studies were eligible for review. All of them had acceptable methodological quality by PEDro scale. Of the 10 studies, 7 involved aerobic training, 1 isometric resistance training, and 2 aerobic training and dynamic resistance training separately. Seven studies used flow-mediated dilation (FMD) to assess the vascular health, and three used plethysmography. Most training protocols involved hypertensive individuals and consisted of low and moderate-intensity exercise. Conclusion: Our systematic review showed that moderate continuous aerobic training is effective to improve vascular health in hypertensive individuals. In prehypertensive individuals, vigorous interval aerobic training seems to be an alternative to determine vascular health benefits. Resistance exercise training, either isometric or dynamic, can be used as a secondary alternative, but still requires further investigation.

Effects of Different Types of Exercise Training on Endothelial Function in Prehypertensive and Hypertensive Individuals: A Systematic Review. / Efeitos de Diferentes Tipos de Treinamento Físico na Função Endotelial em Pré-Hipertensos e Hipertensos: Uma Revisão Sistemática.

BACKGROUND: Sustained high blood pressure can lead to vascular remodeling and endothelial cell injury, which may explain the endothelial dysfunction found in hypertensive individuals. Exercise training can improve vascular health in individuals with cardiovascular risk, but little is known about its effects in prehypertensive and hypertensive individuals. OBJECTIVE: To review the literature showing evidence of changes in endothelial function in response to different modalities of exercise training in prehypertensive and hypertensive individuals. METHODS: We conducted a systematic review of studies in the MEDLINE, Cochrane, LILACS, EMBASE, and SciELO databases following both the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the PICO framework (patient/population, intervention, comparison and outcomes). Randomized clinical trials (RCTs) published up to April 2019 were selected and assessed by four independent reviewers. The methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. RESULTS: Our search yielded 598 abstracts, and 10 studies were eligible for review. All of them had acceptable methodological quality by PEDro scale. Of the 10 studies, 7 involved aerobic training, 1 isometric resistance training, and 2 aerobic training and dynamic resistance training separately. Seven studies used flow-mediated dilation (FMD) to assess the vascular health, and three used plethysmography. Most training protocols involved hypertensive individuals and consisted of low and moderate-intensity exercise. CONCLUSION: Our systematic review showed that moderate continuous aerobic training is effective to improve vascular health in hypertensive individuals. In prehypertensive individuals, vigorous interval aerobic training seems to be an alternative to determine vascular health benefits. Resistance exercise training, either isometric or dynamic, can be used as a secondary alternative, but still requires further investigation.

FUNDAMENTO: A hipertensão sustentada pode levar ao remodelamento vascular e lesão das células endoteliais, o que pode explicar a disfunção endotelial encontrada em hipertensos. O treinamento físico pode melhorar a saúde vascular em indivíduos com risco cardiovascular, mas pouco se sabe sobre seus efeitos em pré-hipertensos e hipertensos. OBJETIVO: Revisar a literatura mostrando evidências de alterações da função endotelial em resposta a diferentes modalidades de treinamento físico em pré-hipertensos e hipertensos. MÉTODOS: Realizamos uma revisão sistemática de estudos nas bases de dados MEDLINE, Cochrane, LILACS, EMBASE e SciELO seguindo tanto as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) quanto a estratégia PICO (paciente/população, intervenção, comparação e resultados). Os ensaios clínicos randomizados (ECRs) publicados até abril de 2019 foram selecionados e avaliados por quatro revisores independentes. A qualidade metodológica foi avaliada por meio da escala PEDro (Physiotherapy Evidence Database). RESULTADOS: Nossa busca rendeu 598 resumos, e 10 estudos foram elegíveis para revisão. Todos eles apresentaram qualidade metodológica aceitável pela escala PEDro. Dos 10 estudos, 7 envolveram treinamento aeróbico, 1 treinamento resistido isométrico e 2 treinamento aeróbico e treinamento resistido dinâmico separadamente. Sete estudos usaram dilatação fluxo-mediada (DFM) para avaliar a saúde vascular, e três usaram pletismografia. A maioria dos protocolos de treinamento envolveu indivíduos hipertensos e consistiu em exercícios de baixa e moderada intensidade. CONCLUSÃO: Nossa revisão sistemática mostrou que o treinamento aeróbico contínuo moderado é eficaz para melhorar a saúde vascular em indivíduos hipertensos. Em pré-hipertensos, o treinamento aeróbico intervalado vigoroso parece ser uma alternativa para benefícios à saúde vascular. O treinamento físico resistido isométrico ou dinâmico pode ser usado como alternativa secundária, mas ainda requer mais investigação.

Individuals with controlled hypertension show endothelial integrity following a bout of moderate-intensity exercise: randomized clinical trial.

To examine the acute effects of aerobic exercise (AE), resistance exercise (RE) or combined exercise (CE) on flow-mediated dilation (FMD), progenitor cells (PCs), endothelial progenitor cells (EPCs), oxidative stress markers and endothelial-cell derived microvesicles (EMVs) in patients with hypertension. This is a randomized, parallel-group clinical trial involving an intervention of one session of three different modalities of exercise. Thirty-three males (43 ± 2y) were randomly divided into three groups: a session of AE (n = 11, 40 min, cycle ergometer, 60% HRR); a session of RE (n = 11, 40 min, 4 × 12 lower limb repetitions, 60% 1-RM); or a session of CE (n = 11, 20-min RE + 20-min AE). FMD was assessed 10 min before and 10, 40 and 70 min post-intervention. Blood samples were collected at the same time points (except 40 min). FMD were similar in all groups and from baseline (within each group) after a single exercise bout (AE, RE or CE). At 70 min, RE group showed higher levels of PCs compared to the AE (81%) and CE group (60%). PC levels were reduced from baseline in all groups (AE: 32%, p = 0.037; RE: 15%, p = 0.003; CE: 17%, p = 0.048). The levels of EPCs, EMVs and oxidative stress were unchanged. There were no acute effects of moderate-intensity exercise on FMD, EPCs, EMVs and oxidative stress, but PCs decreased regardless of the exercise modality. Individuals with controlled hypertension do not seem to have impaired vascular function in response to a single exercise bout.

Physical training prior to myocardial infarction potentializes stem cell therapy, SDF-1/CXCR4 axis activation and inhibits the vasoconstrictor response in hypertensive rats.

Stem cell therapy is a promising strategy for recovering of injured cardiac tissue after acute myocardial infarction. The effects promoted by preventive physical training, beneficial for regeneration, are not yet understood on stem cell homing. In the present study, we evaluated the effect of preventive physical training on cell homing activation and associated mechanisms after acute myocardial infarction and therapy with adipose-derived stem cells in spontaneously hypertensive rats (SHR). Forty female SHR were allocated in sedentary (S), sedentary SHAM (S-SHAM), sedentary AMI (S-AMI), sedentary with cell therapy (S-ICT), aerobically trained (T), trained SHAM (T-SHAM), trained AMI (T-AMI) and trained with cell therapy (S-ICT) groups. Cell therapy was performed through the infusion of 2 × 105 ADSC/0.05 mL at the moment of AMI. Molecular markers of cell homing (SDF-1/CXCR4), inflammatory response (myeloperoxidase and cardiac expression of iNOS, gp91phox and NFkB), vasoconstrictor agents (Ang II and ET-1) and an angiogenesis inducer (VEGF) were measured. Functional capacity and echocardiographic parameters were also evaluated. Preventive physical training associated with cell therapy was able to reduce left ventricle ejection fraction losses in infarcted animals. Results demonstrated activation of the SDF-1/CXCR4 axis by physical training, besides a reduction in vasoconstrictor and systemic inflammatory responses. Physical training prior to AMI was able to induce a cardioprotective effect and optimize the reparative mechanism of cell therapy in an animal model of hypertension.

Effects of myocardial infarction and an intensive exercise bout on kinetic of lactate, and LDH-B levels in spontaneously hypertensive rats

Aims: This study aimed to evaluate the kinetics of lactate and lactate dehydrogenase B (LDH-B) protein levels as well as the maximum effort capacity of spontaneously hypertensive rats (SHRs) with experimental acute myocardial infarction (AMI). Methods: thirty-two SHRs were divided into (n=8/group): S (sham), SE (sham+exercise), I (AMI), and IE (AMI+exercise). A maximum exercise test (treadmill) was evaluated before AMI or sham surgery. Echocardiography was performed 48h after the surgery. Lactacidemia was assessed at rest and during an intense exercise bout (48h after echocardiography). A two-way ANOVA followed by the post-hoc (Bonferroni) test was used, p<0.05. Results: In the end, the heart was removed for analysis of LDH-B. AMI resulted in lower cardiac output (S vs I: ∆51.3%, p<0.001), ejection fraction (S vs I: ∆60.5%, p<0.001) and shortening fraction (S vs I: ∆72.4%, p<0.001). The IE showed a reduction in exercise capacity when compared with pre-AMI values (1.50±0.1 vs 1.38±0.2 km/h; p=0.030) but not when compared with SE (1.41±0.3 vs 1.38±0.2 km/h; p=0.208). During the exhaustion exercise session, IE group showed lower lactacidemia at 12 min (∆9.7%, p=0.042) and 18 min (∆8.3%, p=0.038). No differences were observed in the protein level of LDH-B among the groups (p=0.573). However, when the AMI factor was considered alone, LDH-B expression was lower (sham vs AMI rats, p=0.040). Conclusion: LDH-B protein levels in cardiac tissue appear to be associated with AMI only. Furthermore, AMI induced a reduction in exercise capacity but did not affect lactacidemia during the intense exercise bout.(AU)

Short-term exercise training improves cardiac function associated to a better antioxidant response and lower type 3 iodothyronine deiodinase activity after myocardial infarction.

AIMS: We assessed the effects of a short-term exercise training on cardiac function, oxidative stress markers, and type 3 iodothyronine deiodinase (D3) activity in cardiac tissue of spontaneously hypertensive rats (SHR) following experimental myocardial infarction (MI). METHODS: Twenty-four SHR (aged 3 months) were allocated to 4 groups: sham+sedentary, sham+trained, MI+sedentary and MI+trained. MI was performed by permanent ligation of the coronary artery. Exercise training (treadmill) started 96 hours after MI and lasted for 4 weeks (~60% maximum effort, 4x/week and 40 min/day). Cardiac function (echocardiography), thioredoxin reductase (TRx), total carbonyl levels, among other oxidative stress markers and D3 activity were measured. A Generalized Estimating Equation was used, followed by Bonferroni's test (p<0.05). RESULTS: MI resulted in an increase in left ventricular mass (p = 0.002) with decreased cardiac output (~22.0%, p = 0.047) and decreased ejection fraction (~41%, p = 0.008) as well as an increase in the carbonyl levels (p = 0.001) and D3 activity (~33%, p<0.001). Exercise training resulted in a decrease in left ventricular mass, restored cardiac output (~34%, p = 0.048) and ejection fraction (~20%, p = 0.040), increased TRx (~85%, p = 0.007) and reduced carbonyl levels (p<0.001) and D3 activity (p<0.001). CONCLUSIONS: Our short-term exercise training helped reverse the effects of MI on cardiac function. These benefits seem to derive from a more efficient antioxidant response and lower D3 activity in cardiac tissue.

Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: Comparative Cross-Sectional Study / Comparação de Parâmetros Cardíacos e Vasculares em Powerlifters e Corredores de Longa Distância: Um Estudo Transversal Comparativo

Abstract Background: Cardiac remodeling is a specific response to exercise training and time exposure. We hypothesized that athletes engaging for long periods in high-intensity strength training show heart and/or vascular damage. Objective: To compare cardiac characteristics (structure and function) and vascular function (flow-mediated dilation [FMD] and peripheral vascular resistance [PVR]) in powerlifters and long-distance runners. Methods: We evaluated 40 high-performance athletes (powerlifters [PG], n = 16; runners [RG], n = 24) and assessed heart structure and function (echocardiography), systolic and diastolic blood pressure (SBP/DBP), FMD, PVR, maximum force (squat, bench press, and deadlift), and maximal oxygen uptake (spirometry). A Student's t Test for independent samples and Pearson's linear correlation were used (p < 0.05). Results: PG showed higher SBP/DBP (p < 0.001); greater interventricular septum thickness (p < 0.001), posterior wall thickness (p < 0.001) and LV mass (p < 0.001). After adjusting LV mass by body surface area (BSA), no difference was observed. As for diastolic function, LV diastolic volume, wave E, wave e', and E/e' ratio were similar for both groups. However, LA volume (p = 0.016) and BSA-adjusted LA volume were lower in PG (p < 0.001). Systolic function (end-systolic volume and ejection fraction), and FMD were similar in both groups. However, higher PVR in PG was observed (p = 0.014). We found a correlation between the main cardiovascular changes and total weight lifted in PG. Conclusions: Cardiovascular adaptations are dependent on training modality and the borderline structural cardiac changes are not accompanied by impaired function in powerlifters. However, a mild increase in blood pressure seems to be related to PVR rather than endothelial function.

Resumo Fundamento: Remodelamento cardíaco é uma resposta específica ao tempo e modalidade de treinamento. Nós hipotetizamos que atletas de treinamento de força de alta intensidade, por longo tempo, mostram dano à estrutura cardíaca e/ou vascular. Objetivo: Comparar as características cardíacas (estrutura e funcionalidade) e função vascular (dilatação fluxo-mediada, FMD e resistência vascular periférica, PVR) em powerlifters e corredores. Métodos: Nós avaliamos 40 atletas de alto-desempenho (powerlifters [PG], n = 16; corredores [RG], n = 24). Mensuramos estrutura e funcionalidade cardíaca (ecocardiografia), pressão arterial (SBP/DBP), FMD, PVR, força máxima (agachamento, supino e levantamento terra) e consumo máximo de oxigênio (ergoespirometria). Foi utilizado teste T de Student e correlação linear de Pearson (p < 0,05). Resultados: PG mostrou maior SBP/DBP (p < 0,001), espessura de septo interventricular (p < 0,001), parede posterior (p < 0,001) e massa do VE (p < 0,001); após ajuste pela superfície corporal (BSA), não houve diferença na massa do VE. O volume do VE, onda E, onda e', e a razão E/e' foram similares entre os grupos. O volume do AE (p = 0,016), mesmo ajustado pela BSA (p < 0,001) foi menor no PG. A função sistólica (volume sistólico final e fração de ejeção) e FMD foram similares nos grupos. Contudo, foi observada maior PVR no PG (p = 0,014). Houve uma correlação direta entre as alterações cardíacas e a carga total levantada no PG. Conclusões: As adaptações cardiovasculares são dependentes da modalidade e os valores encontrados na estrutura do coração não são acompanhados por prejuízo na funcionalidade. Entretanto, um leve aumento na pressão arterial pode estar associado com maior PVR e não com a função endotelial.

Effects of exercise training on endothelial function in individuals with hypertension: a systematic review with meta-analysis.

A slight increase (1%) in endothelial function is associated with reduction of cardiovascular risks by 13% in individuals with cardiovascular disease risk, including those with hypertension. Thus, we conducted a systematic review and meta-analysis to assess the efficacy of exercise training on endothelial function in individuals with hypertension.We included randomized clinical trials (RCTs) with adult participants diagnosed with hypertension undergoing exercise training (≥4 weeks), and the primary outcome was endothelial function, measured by flow-mediated dilatation (FMD). Five studies comprising a total of 362 participants (252 exercise and 110 controls; 59.3 years old, ranged from 52.0 to 67.2 years) were included in the meta-analysis. The pooled mean estimate indicated increased FMD after exercise training of 1.45 (P = .001), and 95% confidence interval -0.11 to 3.00 compared with control comparators. The studies were characterized by significant heterogeneity (χ2 = 23.34, P < .001, I2 = 70%). The present results are consistent with the notion that aerobic exercise training elicits favorable adaptations in endothelial function in individuals with hypertension. However, more studies are needed to make more definitive conclusions.

Comparison of Cardiac and Vascular Parameters in Powerlifters and Long-Distance Runners: Comparative Cross-Sectional Study.

BACKGROUND: Cardiac remodeling is a specific response to exercise training and time exposure. We hypothesized that athletes engaging for long periods in high-intensity strength training show heart and/or vascular damage. OBJECTIVE: To compare cardiac characteristics (structure and function) and vascular function (flow-mediated dilation [FMD] and peripheral vascular resistance [PVR]) in powerlifters and long-distance runners. METHODS: We evaluated 40 high-performance athletes (powerlifters [PG], n = 16; runners [RG], n = 24) and assessed heart structure and function (echocardiography), systolic and diastolic blood pressure (SBP/DBP), FMD, PVR, maximum force (squat, bench press, and deadlift), and maximal oxygen uptake (spirometry). A Student's t Test for independent samples and Pearson's linear correlation were used (p < 0.05). RESULTS: PG showed higher SBP/DBP (p < 0.001); greater interventricular septum thickness (p < 0.001), posterior wall thickness (p < 0.001) and LV mass (p < 0.001). After adjusting LV mass by body surface area (BSA), no difference was observed. As for diastolic function, LV diastolic volume, wave E, wave e', and E/e' ratio were similar for both groups. However, LA volume (p = 0.016) and BSA-adjusted LA volume were lower in PG (p < 0.001). Systolic function (end-systolic volume and ejection fraction), and FMD were similar in both groups. However, higher PVR in PG was observed (p = 0.014). We found a correlation between the main cardiovascular changes and total weight lifted in PG. CONCLUSIONS: Cardiovascular adaptations are dependent on training modality and the borderline structural cardiac changes are not accompanied by impaired function in powerlifters. However, a mild increase in blood pressure seems to be related to PVR rather than endothelial function.

Cardiac parameters and endothelial function in a strength athlete: a case report

We aimed to discuss a case of strength training athlete who competes in international competitions regarding cardiac (dimension and function), vascular (endothelium and vascular resistance), hemodynamic (blood pressure), given limited evidence supporting these cardiovascular adaptations as well as concerning endothelial function in long-term high-intensity strength training. Methods: We assessed heart structure and function (echocardiography); systolic (SBP) and diastolic blood pressure (DBP); endothelium-dependent vasodilation (flow-mediated dilation, FMD); maximum force tested in the squat, bench press, and deadlift; and maximum oxygen consumption (spirometry). Results: powerlifter's cardiac dimensions (interventricular septum 13 mm; posterior wall thickness 12 mm; LV diastolic diameter 57 mm; left ventricle mass 383 g; LV mass adjusted by body surface area 151.4 g/m2) are above the proposed cutoff values beyond which pathology may be considered. Moreover, cardiovascular function systolic (ejection fraction by Simpson's rule, 71%) is preserved and FMD measure is fairly close and above normal; however, a mild increase in systolic and diastolic blood pressure was observed (130/89 mmHg, respectively). Conclusion: Cardiac remodeling cannot be viewed as either pathological or harmful to the cardiovascular system. Furthermore, we showed an improvement in endothelial function.(AU)

Preventive Physical Training Partially Preserves Heart Function and Improves Cardiac Antioxidant Responses in Rats After Myocardial Infarction Preventive Physical Training and Myocardial Infarction in Rats.

In acute myocardial infarction (AMI), reactive oxygen species may cause irreversible damage to the heart tissue. Physical training is capable of enhancing antioxidant capacity, acting as a cardioprotective factor. We assessed the preventive effects of physical training on the antioxidant and functional responses of the heart of Wistar Kyoto rats after AMI. Wistar Kyoto rats (n = 12) were allocated to sedentary (SED) or trained (EXE-aerobic training on a treadmill) groups. Echocardiographic exams were performed 48 hr before and 48 hr after the induction of AMI. Superoxide dismutase (SOD) and catalase (CAT) activities, and total glutathione (GSH) were measured in vitro in the heart tissue. After AMI, the EXE group showed higher left ventricular shortening fraction (29%; p = .004), higher cardiac output (37%; p = .032) and reduced myocardial infarction size (16%; p = .007) than SED. The EXE group showed a higher nonenzymatic antioxidant capacity (GSH, 23%; p = .004), but the SOD and CAT activities were higher in SED (23% SOD; p = .021 and 20% CAT; p = .016). In addition, the SOD activity was positively correlated with myocardial infarction size and inversely correlated with cardiac output. Physical training partially preserved cardiac function and increased intracellular antioxidant response in cardiac tissue of animals after AMI.

Aerobic training prior to myocardial infarction increases cardiac GLUT4 and partially preserves heart function in spontaneously hypertensive rats.

We assessed cardiac function (echocardiographic) and glucose transporter 4 (GLUT4) expression (Western blot) in response to 10 weeks of aerobic training (treadmill) prior to acute myocardial infarction (AMI) by ligation of the left coronary artery in spontaneously hypertensive rats. Animals were allocated to sedentary+sham, sedentary+AMI, training+sham, and training+AMI. Aerobic training prior to AMI partially preserves heart function. AMI and/or aerobic training increased GLUT4 expression. However, those animals trained prior to AMI showed a greater increase in GLUT4 in cardiomyocytes.

Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration.

The incidence of severe ischemic heart disease caused by coronary obstruction has progressively increased. Alternative forms of treatment have been studied in an attempt to regenerate myocardial tissue, induce angiogenesis, and improve clinical conditions. In this context, cell therapy has emerged as a promising alternative using cells with regenerative potential, focusing on the release of paracrine and autocrine factors that contribute to cell survival, angiogenesis, and tissue remodeling. Evidence of the safety, feasibility, and potential effectiveness of cell therapy has emerged from several clinical trials using different lineages of adult stem cells. The clinical benefit, however, is not yet well established. In this review, we discuss the therapeutic potential of cell therapy in terms of regenerative and angiogenic capacity after myocardial ischemia. In addition, we addressed nonpharmacological interventions that may influence this therapeutic practice, such as diet and physical training. This review brings together current data on pharmacological and nonpharmacological approaches to improve cell homing and cardiac repair.

Ballet dancers cardiorespiratory, oxidative and muscle damage responses to classes and rehearsals.

This study aimed to describe and compare ballet dancers' cardiorespiratory responses, muscle damage and oxidative stress levels during a ballet class (practice of isolated ballet exercises performed with barre/hand-rail support and across-the-floor movements to improve technical skills) and rehearsal (practice of ballet choreography involving technical-artistic skills to improve dancers' performance for shows). The 12 advanced female ballet dancers undertook three exercise sessions: maximum effort test, class and rehearsal. Heart rate (HR) and oxygen consumption (VO2) were continuously measured. Lactate was determined before 15 min and after class and rehearsal. Blood was sampled pre, post and 48 h after class and rehearsal for creatine kinase (CK), lipid peroxides (LPO) and glutathione analysis (GSSG/GSH). Class was of lower intensity than rehearsal as shown by VO2, HR and lactate values: VO2 (mL.kg(-1).min(-1)): 14.5±2.1 vs. 19.1±1.7 (p < 0.001); HR (bpm.min(-1)): 145.7±17.9 vs. 174.5±13.8 (p < 0.001); lactate (mmol.L(-1)): 4.2±1.1 vs. 5.5±2.7 (p = 0.049). CK (IU) increased following class and rehearsal, remaining high 48 h after: class (pre = 109.3±48.5; post = 144±60; 48 h = 117.2±64.6); rehearsal (pre = 78.6±52.1; post = 122±70.7; 48 h = 104.9±89.5). LPO (µM) increased from pre-class (1.27±0.19) to post-class (1.41±0.19) and went down after 48 h (1.20±0.22). No LPO time-course changes followed the rehearsal. GSSG/GSH decreased 48 h after class and rehearsal. Greater increases in LPO post-class suggest it promotes CK release by an oxidative membrane-damage mechanism. Physiological increases of LPO and CK in class indicate it prepares the dancers for exercise-induced oxidative stress and muscle damage during rehearsals. Ballet dancers' muscle damage and oxidative stress responses seem not to be dependent on exercise intensity based on VO2 responses.

Effect of antioxidant treatment on fibrogenesis in rats with carbon tetrachloride-induced cirrhosis.

Aim. This study aimed to assess the antioxidant activity of quercetin (Q) in an experimental model of cirrhosis induced by CCl(4) inhalation. Materials and Methods. We used 25 male Wistar rats (250 g) that were divided into 3 groups: control (CO), CCl(4), and CCl(4) + Q. The rats were subjected to CCl(4) inhalation (2x/week) for 16 weeks, and they received phenobarbital in their drinking water at a dose of 0.3 g/dL as a P450 enzyme inducer. Q (50 mg/Kg) was initiated intraperitoneally at 10 weeks of inhalation and lasted until the end of the experiment. Statistical analysis was by ANOVA Student Newman-Keuls (mean ± SEM), and differences were considered statistically significant when P < 0.05. Results. After treatment with quercetin, we observed an improvement in liver complications, decreased fibrosis, as analyzed by picrosirius for the quantification of collagen, and decreased levels of matrix metalloproteinase 2 (MMP-2) compared with the CCl(4) group. It also reduced oxidative stress, as confirmed by the decrease of substances reacting to thiobarbituric acid (TBARS), the increased activity of antioxidant enzymes, and the reduced glutathione ratio and glutathione disulfide (GSH/GSSG). Conclusion. We suggest that the use of quercetin might be promising as an antioxidant therapy in liver fibrosis.

The effects of periodized concurrent and aerobic training on oxidative stress parameters, endothelial function and immune response in sedentary male individuals of middle age.

The vascular endothelium plays a key role in arterial wall homeostasis by preventing atherosclerotic plaque formation. A primary causal factor of endothelial dysfunction is the reactive oxygen species. Aerobic exercise is ascribed as an important adjuvant therapy in endothelium-dependent cardiovascular disease. However, little is known about the effects of concurrent (aerobic + strength) training on that. For a comparison of the effects of aerobic and concurrent physical training on endothelial function, oxidative stress parameters and the immunoinflammatory activity of monocytes/macrophages, 20 adult male volunteers of middle age were divided into a concurrent training (CT) programme group and an aerobic training group. The glutathione disulphide to glutathione ratio (GSSG/GSH) and plasma lipoperoxide (LPO) levels, as well as flow-mediated dilation (FMD), monocyte/macrophage functional activity (zymosan phagocytosis), body lipid profiles, aerobic capacity (maximal oxygen uptake) and strength parameters (one-repetition maximum test), were measured before and after the exercise training programmes. The CT exhibited reduced acute effects of exercise on the GSSG/GSH ratio, plasma LPO levels and zymosan phagocytosis. The CT also displayed improved lipid profiles, glycaemic control, maximal oxygen uptake and one-repetition maximum test values. In both the aerobic training and the CT, training improved the acute responses to exercise, as inferred from a decrease in the GSSG/GSH ratios. The aerobic sessions did not alter basal levels of plasma LPO or macrophage phagocytic activity but improved FMD values as well as lipid profiles and glycaemic control. In summary, both training programmes improve systemic redox status and antioxidant defences. However, the aerobic training was more efficient in improving FMD in the individuals studied.