Episodic bouts of hyperaemia and shear stress improve arterial blood flow and endothelial function.

INTRODUCTION: Exercise and heat stress lead to systemic improvements in arterial endothelial function, vascular stiffness, and cardiopulmonary capacity. The improvements in endothelial function may be primarily mediated via increases in shear stress. This study examined whether improvements in arterial function may be achieved in the absence of systemic vascular adaptations. Specifically, we hypothesized that repeated bouts of brief occlusion would improve arterial endothelial function via shear stress-dependent mechanisms. METHODS: Eleven healthy males underwent a shear stress intervention (5 s brachial occlusion, 10 s rest) for 30 min, five times weekly for 6 weeks on one arm while the other acted as an untreated control. Ultrasound was used to assess brachial arterial forearm blood flow (FBF) and vascular conductance (FVC), diameter, and shear rate (SR), while endothelial function was assessed by flow-mediated dilatation (FMD). Post-occlusive reactive hyperaemia and pulse wave velocity (PWV) were also measured. RESULTS: There were no changes in any of the measures in the control arm (all d < 0.2, p > 0.05). After 3 weeks of the intervention, FMD was increased from baseline (7.6 ± 0.6 vs. 5.9 ± 0.9%; d = 1.3, p = 0.038) and further increased after 6 weeks to 9.5 ± 2.6% (d = 1.7, p < 0.001). SR was also increased following the 6-week intervention (all d ≥ 0.6, p < 0.001). Resting and peak FBF and FVC were also increased in response to the intervention (all d ≥ 0.6, p < 0.001) and PWV was reduced. CONCLUSIONS: These data demonstrate that episodic increases in shear stress elicit marked increases in arterial endothelial function and vascular reactivity.

The Effects of Hyperoxia on Sea-Level Exercise Performance, Training, and Recovery: A Meta-Analysis.

BACKGROUND: Acute exercise performance can be limited by arterial hypoxemia, such that hyperoxia may be an ergogenic aid by increasing tissue oxygen availability. Hyperoxia during a single bout of exercise performance has been examined using many test modalities, including time trials (TTs), time to exhaustion (TTE), graded exercise tests (GXTs), and dynamic muscle function tests. Hyperoxia has also been used as a long-term training stimulus or a recovery intervention between bouts of exercise. However, due to the methodological differences in fraction of inspired oxygen (FiO2), exercise type, training regime, or recovery protocols, a firm consensus on the effectiveness of hyperoxia as an ergogenic aid for exercise training or recovery remains unclear. OBJECTIVES: The aims of this study were to (1) determine the efficacy of hyperoxia as an ergogenic aid for exercise performance, training stimulus, and recovery before subsequent exercise; and (2) determine if a dose-response exists between FiO2 and exercise performance improvements. DATA SOURCE: The PubMed, Web of Science, and SPORTDiscus databases were searched for original published articles up to and including 8 September 2017, using appropriate first- and second-order search terms. STUDY SELECTION: English-language, peer-reviewed, full-text manuscripts using human participants were reviewed using the process identified in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. DATA EXTRACTION: Data for the following variables were obtained by at least two of the authors: FiO2, wash-in time for gas, exercise performance modality, heart rate, cardiac output, stroke volume, oxygen saturation, arterial and/or capillary lactate, hemoglobin concentration, hematocrit, arterial pH, arterial oxygen content, arterial partial pressure of oxygen and carbon dioxide, consumption of oxygen and carbon dioxide, minute ventilation, tidal volume, respiratory frequency, ratings of perceived exertion of breathing and exercise, and end-tidal oxygen and carbon dioxide partial pressures. DATA GROUPING: Data were grouped into type of intervention (acute exercise, recovery, and training), and performance data were grouped into type of exercise (TTs, TTE, GXTs, dynamic muscle function), recovery, and training in hyperoxia. DATA ANALYSIS: Hedges' g effect sizes and 95% confidence intervals were calculated. Separate Pearson's correlations were performed comparing the effect size of performance versus FiO2, along with the effect size of arterial content of oxygen, arterial partial pressure of oxygen, and oxygen saturation. RESULTS: Fifty-one manuscripts were reviewed. The most common FiO2 for acute exercise was 1.00, with GXTs the most investigated exercise modality. Hyperoxia had a large effect improving TTE (g = 0.89), and small-to-moderate effects increasing TTs (g = 0.56), GXTs (g = 0.40), and dynamic muscle function performance (g = 0.28). An FiO2 ≥ 0.30 was sufficient to increase general exercise performance to a small effect or higher; a moderate positive correlation (r = 0.47-0.63) existed between performance improvement of TTs, TTE, and dynamic muscle function tests and FiO2, but not GXTs (r = 0.06). Exercise training and recovery supplemented with hyperoxia trended towards a large and small ergogenic effect, respectively, but the large variability and limited amount of research on these topics prevented a definitive conclusion. CONCLUSION: Acute exercise performance is increased with hyperoxia. An FiO2 ≥ 0.30 appears to be beneficial for performance, with a higher FiO2 being correlated to greater performance improvement in TTs, TTE, and dynamic muscle function tests. Exercise training and recovery supplemented with hyperoxic gas appears to have a beneficial effect on subsequent exercise performance, but small sample size and wide disparity in experimental protocols preclude definitive conclusions.

The role of shear stress on cutaneous microvascular endothelial function in humans.

PURPOSE: Previous studies suggest that exercise and heat stress improve cutaneous endothelial function, caused by increases in shear stress. However, as vasodilatation in the skin is primarily a thermogenic phenomenon, we investigated if shear stress alone without increases in skin temperature that occur with exercise and heat stress increases endothelial function. We examined the hypothesis that repeated bouts of brief occlusion would improve cutaneous endothelial function via shear stress-dependent mechanisms. METHODS: Eleven males underwent a shear stress intervention (forearm occlusion 5 s rest 10 s) for 30 min, five times·week-1 for 6 weeks on one arm, the other was an untreated control. Skin blood flow was measured using laser-Doppler flowmetry, and endothelial function was assessed with and without NOS-inhibition with L-NAME in response to three levels of local heating (39, 42, and 44 °C), ACh administration, and reactive hyperaemia. Data are cutaneous vascular conductance (CVC, laser-Doppler/blood pressure). RESULTS: There were no changes in the control arm (all d ≤ 0.2, p > 0.05). In the experimental arm, CVC to 39 °C was increased after 3 and 6 weeks (d = 0.6; p ≤ 0.01). Nitric oxide contribution was increased after 6 weeks compared to baseline (d = 0.85, p < 0.001). Following skin heating to 42 °C and 44 °C, CVC was not different at weeks 3 or 6 (d ≤ 0.8, p > 0.05). For both 42 and 44 °C, nitric oxide contribution was increased after weeks 3 and 6 (d ≥ 0.4, p < 0.03). Peak and area-under-the-curve responses to ACh increased following 6 weeks (p < 0.001). CONCLUSIONS: Episodic increases in shear stress, without changes in skin or core temperature, elicit an increase in cutaneous microvascular reactivity and endothelial function.