Dietary nitrate (BR) and caffeine (CAF) ingestion have been shown to increase sports performance. However, the isolated and combined effects of BR and CAF ingestion on time trial (TT) performance as well as the accompanying physiological and perceptual responses have never been investigated in highly trained kayak athletes. Therefore, the present study examined the impact of an isolated and combined supplementation with BR (140 ml beetroot concentrate, ~12.5 mmol nitrate) and CAF (3 mg/kg bodyweight) on 1000 m ergometer TT performance as well as the accompanying physiological (i.e. cardiorespiratory function, muscle oxygenation, muscle activity) and perceptual responses (i.e. fatigue, effort, and exercise-induced pain perception) in male highly trained kayakers. It was hypothesized that the isolated ingestion of BR and CAF would both improve ergometer-based 1000 m TT performance and induce supplement-specific physiological and perceptual responses. Considering the primary effects of BR on muscle function and of CAF on the central nervous system, it was further assumed that the combined ingestion will result in an additional performance increase and supplement-specific physiological and perceptual responses.

Using a prospective, randomized, controlled, double-blind crossover design, 12 male highly trained kayak athletes from local clubs were investigated. They completed four measurement sessions resulting in four randomized conditions: (i) BR+CAF; (ii) BR+CAF placebo (BR+PLA); (iii) CAF+BR placebo (CAF+PLA); and (iv) BR placebo + CAF placebo (PLA+PLA). An air-braked instrumented kayak-ergometer was used to record 1000 m TT performance, power output, and stroke frequency. Heart rate (HR), oxygen uptake (VO2), maximum VO2 (VO2max), respiratory equivalent of O2 (VE/VO2), and carbon dioxide (VE/VCO2) were measured continuously. Furthermore, oxygenation of the deltoid muscle was measured with near-infrared spectroscopy (mNIRS) and muscle activity of nine unilateral muscles with surface electromyography (i.e. deltoideus, serratus anterior, triceps brachii caput lateralis, trapezius, infraspinatus, latissimus dorsi, obliquus externus, flexor carpi radialis, and vastus lateralis muscle) during the 1000 m TT. After the TT, fatigue, effort, and exercise-induced pain perception were queried. One- and two-way analysis of variance with repeated measures were conducted to determine differences between conditions for the entire 1000 m TT and predefined sections (0-50 m, 50-100 m, 100-150 m, 150-250 m, 250-500 m, 500-750 m, 750-1000 m), respectively (p ≤ 0.05).

The supplements did not have an ergogenic effect on TT performance compared to the PLA+PLA condition, either in isolation or in combination. The same applied to the majority of physiological parameters and the perceptual responses. Nevertheless, VE/VO2 was lower during the sections 150-250 m (-5.00%; p = 0.02) and 250-500 m (-3.49%; p = 0.03) in the BR+PLA condition, whereby VE/VCO2 was higher during the section 150-250 m (4.19%; p = 0.04) in the CAF+PLA compared to the PLA+PLA condition, respectively.

Data indicate that the isolated and combined ingestion of BR and CAF had no effect on 1000 m TT performance, the majority of physiological responses, and perceptual responses in highly trained kayakers. These findings might be related to the dosage and/or a ceiling effect due to the already efficient vascular, metabolic, and muscle function, including high amounts of endogenous produced nitric oxide, in athletes.

Eccentric exercise has gained attention as a novel exercise modality that increases muscle performance at a lower metabolic demand. However, vascular responses to eccentric cycling (ECC) are unknown, thus gaining knowledge regarding endothelial shear stress (ESS) during ECC may be crucial for its application in patients. The purpose of this study was to explore ECC-induced blood flow patterns and ESS across three different intensities in ECC. Eighteen young, apparently healthy subjects were recruited for two laboratory visits. Maximum oxygen consumption, power output, and blood lactate (BLa) threshold were measured to determine workload intensities. Blood flow patterns in the brachial artery were measured via ultrasound imaging and Doppler on an eccentric ergometer during a 5 min workload steady exercise test at low (BLa of 0-2 mmol/L), moderate (BLa 2-4 mmol/L), and high intensity (BLa levels > 4 mmol/L). There was a significant increase in the antegrade ESS in an intensity-dependent manner (baseline: 44.2 ± 8.97; low: 55.6 ± 15.2; moderate: 56.0 ± 10.5; high: 70.7 ± 14.9, all dynes/cm2, all p values < 0.0002) with the exception between low and moderate and Re (AU) showed turbulent flow at all intensities. Regarding retrograde flow, ESS also increased in an intensity-dependent manner (baseline 9.72 ± 4.38; low: 12.5 ± 3.93; moderate: 15.8 ± 5.45; high: 15.7 ± 6.55, all dynes/cm2, all p values < 0.015) with the exception between high and moderate and Re (AU) showed laminar flow in all intensities. ECC produced exercise-induced blood flow patterns that are intensity-dependent. This suggests that ECC could be beneficial as a modulator of endothelial homeostasis.

Heightened central and peripheral chemoreflex sensitivity are associated with poor outcomes, but therapeutic approaches to target them are lacking. Endurance and resistance exercise training improve a multitude of physiological outcomes, but their effects on ventilatory chemoreflex sensitivity are unclear. Accordingly, the cardiorespiratory responses to steady-state isocapnic hypoxia (10 % O2, 5-minutes) and hyperoxic hypercapnic rebreathing (5 % CO2-95 % O2) were compared in endurance, resistance, and untrained groups. Central chemoreflex sensitivity was taken as the slope of the relationship between minute ventilation (V̇E) and end-tidal partial pressure of CO2. Peripheral chemoreflex sensitivity was determined from the absolute increase in V̇E from baseline to peak V̇E expressed relative to the fall in oxygen saturation. Neither central (P = 0.093) nor peripheral (P = 0.847) ventilatory chemoreflex sensitivities were different between groups. Future investigations should seek to understand whether exercise training modality influences central and peripheral chemoreflex sensitivity in older and clinical populations.

Short stature is a prevalent pediatric endocrine disorder for which early detection and prediction are pivotal for improving treatment outcomes. However, existing diagnostic criteria often lack the necessary sensitivity and specificity because of the complex etiology of the disorder. Hence, this study aims to employ machine learning techniques to develop an interpretable predictive model for normal-variant short stature and to explore how growth environments influence its development.

We conducted a case‒control study including 100 patients with normal-variant short stature who were age-matched with 200 normal controls from the Endocrinology Department of Nanjing Children's Hospital from April to September 2021. Parental surveys were conducted to gather information on the children involved. We assessed 33 readily accessible medical characteristics and utilized conditional logistic regression to explore how growth environments influence the onset of normal-variant short stature. Additionally, we evaluated the performance of the nine machine learning algorithms to determine the optimal model. The Shapley additive explanation (SHAP) method was subsequently employed to prioritize factor importance and refine the final model.

In the multivariate logistic regression analysis, children's weight (OR = 0.92, 95% CI: 0.86, 0.99), maternal height (OR = 0.79, 95% CI: 0.72, 0.87), paternal height (OR = 0.83, 95% CI: 0.75, 0.91), sufficient nighttime sleep duration (OR = 0.48, 95% CI: 0.26, 0.89), and outdoor activity time exceeding three hours (OR = 0.02, 95% CI: 0.00, 0.66) were identified as protective factors for normal-variant short stature. This study revealed that parental height, caregiver education, and children's weight significantly influenced the prediction of normal-variant short stature risk, and both the random forest model and gradient boosting machine model exhibited the best discriminatory ability among the 9 machine learning models.

This study revealed a close correlation between environmental growth factors and the occurrence of normal-variant short stature, particularly anthropometric characteristics. The random forest model and gradient boosting machine model performed exceptionally well, demonstrating their potential for clinical applications. These findings provide theoretical support for clinical identification and preventive measures for short stature.

Exercise intensity has been shown to elicit different cerebral blood flow velocity (CBFv) responses. This study aimed to compare the acute effects of resistance exercise at different intensities on hemodynamics and cerebrovascular reactivity in healthy young males. Eleven healthy young males were recruited, and three trials of dumbbell alternating curls were performed in order of increasing intensity: low (30%-35% 1RM), medium (55%-60% 1RM), and high (75%-80% 1RM). Blood pressure, heart rate, CBFv, and cerebrovascular reactivity were measured at baseline, 1, 5, and 10 min after exercise. (1) At 10 min, the mean blood pressure in the medium-intensity was significantly lower than that at baseline. (2) At 1 min, the systolic velocity of the middle cerebral artery in the medium-intensity increased significantly. (3) At 1 min, the pulsatility index (PI) and resistance index (RI) of the high-intensity increased significantly. At 10 min, the PI and RI of the medium-intensity were significantly lower than the baseline. (4) At 5 min, the breath-holding index significantly increased in the medium-intensity but decreased in the high-intensity. Compared with low and high intensities, medium-intensity resistance exercise may be more effective in lowering blood pressure and enhancing cerebral hemodynamics.

BACKGROUND The benefits of exercise for vascular and physical health in patients on chronic hemodialysis (CHD) are controversial. This study evaluated the outcomes of an intradialytic aerobic exercise program on carotid-femoral pulse wave velocity (cfPWV, an index of arterial stiffness), gait speed, and a sit-to-stand test in patients with CHD. MATERIAL AND METHODS A total of 114 CHD patients were randomly assigned to the exercise or the control (regular care) group. Patients performed intradialytic cycling exercises (3 sessions/week for 12 months) for 20 minutes in a supine position and the exercise protocol was set at a low-to-moderate intensity, defined as activities eliciting 3 to 5.9 metabolic equivalents. Data on cfPWV, gait speed, and the 5-times sit-to-stand test were collected. cfPWV was determined from the time taken for the arterial pulse to propagate from the carotid to the femoral artery and were compared between the 2 groups. RESULTS Arterial stiffness was improved, as evidenced by a significant decrease in cfPWV, in the exercise group compared to the control group (p<0.001). Generalized estimating equations analysis revealed a reduction in cfPWV at 6 and 12 months after the exercise intervention (p<0.001). Gait speed was significantly faster in the exercise group than in the control group (p=0.019). No exercise-related adverse events were reported. Results of 5-times sit-to-stand and body composition did not differ significantly between the 2 study groups. CONCLUSIONS Intradialytic cycling exercise significantly improved cfPWV and gait speed in CHD patients during the 12-month study period.

Comparing the effects of 8 weeks of aerobic (AE) and resistance exercise (RE) on cardiovascular function in obese young adults. Exploring the mechanisms of resistance exercise on cardiovascular function. 44 subjects (22.4 ± 2.7 years, female/male: 26/18) were randomly divided into the AE and RE group. AE group performed platform running with 70-75% heart rate max. RE group performed deep squat, bench press, and hard pull training in sequence with 70-75% 1 repetition maximum. Body composition, cardio-vascular function indicators were measured before and after the interventions. After eight weeks, body fat percentage was reduced in both groups (AE: P < 0.0001, RE:P = 0.03). Hemodynamic indices (P < 0.05), endothelium-dependent diastolic function (AE:P = 0.01, RE:P = 0.024) and endothelial nitric oxide synthase (P < 0.0001) were increased. Both AE and RE exercise increased cardiac function (P < 0.05). The RE group (P = 0.002) had a significantly higher muscle mass. Brachial-ankle pulse wave conduction velocity (left: P = 0.006; right: P < 0.0001) was significantly lower in the AE group. Both AE and RE significantly reduced the body fat percentage, improved cardiac function, hemodynamic, and vascular endothelial function in obese young adults. AE has a stronger effect on reducing arterial stiffness, whereas resistance exercise has a stronger effect on building muscle, but does not change arterial stiffness.

In this randomised two-period crossover trial, the objective was to compare acute changes in arterial distensibility between high-intensity interval physical exercise (HIIPE) and moderate-intensity continuous physical exercise (MICPE) sessions in subjects with elevated blood pressure (BP).

Participants underwent either MICPE-HIIPE or HIIPE-MICPE sequences with intensity based on cardiopulmonary exercise testing. The main outcome measures included arterial stiffness (by pulse wave velocity (PWV)) at baseline, until 30 min and 24 hours after each physical exercise session. Other measures include office BP, 24-hour ambulatory blood pressure monitoring (ABPM) and applanation tonometry.

The study involved 29 subjects with elevated BP (76% female, 48±7 years, body mass index=28.3±4.3 kg/m², systolic BP=126±9 mm Hg and diastolic BP=84±4 mm Hg). They presented lower PWV 24 hours after MICPE compared with baseline and to 24-hour HIIPE ((-0.83 (-1.29;-0.37) p=0.001) and (-0.98 (-1.84;-0.12), p=0.021), respectively). Despite no differences in office BP, aortic systolic BP was lower after HIIPE compared with baseline and to 24-hour MICPE (113±19; 118±10 and 117±10 mm Hg; p=0.013).

In subjects with elevated BP, arterial distensibility is greater 24 hours after MICPE, while aortic systolic BP is lower after HIIPE. The particularities of each method and each exercise intensity can provide specific mechanisms of vascular response to exercise and detect vascular damage early in these subjects.

NCT04200716.

Although exercise-induced vascular adaptations have been extensively reported in racket sports athletes, the applicability of these findings to athletes in other overhead sports is unclear. This study aimed to investigate exercise-induced vascular adaptations in college male baseball players. Furthermore, since the training frequency of the upper arm may differ by baseball playing position, this study also focused on playing position-specific differences in brachial arterial adaptations.

Cross-sectional study.

Seventy-five baseball players and 23 sedentary young men aged 18-23 years participated in this study. The participants' brachial artery diameter, blood flow velocity, and blood flow volume were measured using an ultrasonic diagnostic imaging system. Brachial hemodynamic measurements of both hands were obtained randomly in a seated resting position.

Baseball players demonstrated significantly greater brachial lean mass, circumference, arterial diameter, and blood flow volume than sedentary control participants. Statistically significant differences in brachial artery diameters between the non-dominant and dominant arms were observed only in the baseball pitcher group. Furthermore, body surface area- and brachial lean mass-corrected artery diameters in the dominant arm were also significantly larger than those in the non-dominant arm in the baseball pitcher group. A simple correlation analysis revealed a positive association between brachial lean mass/circumference and arterial diameter in all participants.

These findings suggest asymmetrical exercise-induced vascular adaptations in the brachial artery of baseball players, particularly pitchers, indicating the potential role of playing position-specific demands in vascular remodeling. Understanding these adaptations may inform training strategies and help prevent injuries in baseball players.

This study evaluated the effectiveness of inspiratory muscle strength training (IMST) as a time-efficient alternative to widely recommended aerobic exercise (AE) for reducing and maintaining blood pressure in hypertensive patients.

Twenty-eight hypertensive patients (aged 61 ± 7 years) were randomly assigned to IMST (n = 14) and AE (n = 14) groups. The IMST performed 30 breaths/session at 75% of maximal inspiratory pressure (PImax), totaling about 8 minutes, 5 days/week. The AE group exercised at 70% of heart rate reserve for 30 minutes/session, 5 days/week. Both supervised interventions lasted 8 weeks, followed by a 4-week detraining period. Brachial and central systolic blood pressure (SBP) were taken at baseline, 8-week post-intervention, and post-detraining.

The mean (standard deviation) change in brachial SBP from baseline to 8 week post-intervention significantly decreased in both the IMST group [-9.1 (12.1) mmHg, P = 0.01] and the AE group [-6.2 (7.2) mmHg, P = 0.01], with no significant difference between groups (P = 0.46). Central SBP also significantly reduced in the IMST group [-9.0 (11.9) mmHg, P = 0.01] and in the AE group [-5.7 (6.2) mmHg, P = 0.01], with no significant difference between groups (P = 0.37). However, the IMST group did not show significant persistence in SBP reduction, whereas the AE group did.

Both IMST and AE effectively reduced brachial and central BP after 8-week interventions in hypertensive patients. While IMST presents a time-efficient adjunctive option to AE, its long-term effectiveness remains uncertain.

In South Korea, around 105,000 individuals experience strokes annually, with over 26,000 deaths and the incidence rate is keep rising due to the aging population. Physical inactivity is a major global health issue, and regular exercise is known to prevent many diseases, including stroke. Yet, previous observational studies may be biased due to unobserved factors influencing exercise and stroke occurrence. Therefore, this study aims to examine an impact of regular physical activity on stroke prevention among South Korean adults using instrumental variable approach in order to avoid problems with reverse causality and other unobserved confounding factors.

Data were obtained from the 2014 and 2016 Korean Community Health Surveys of 416,032 Korean adults. Regular exercise was the main independent variable and proximity to exercise facilities is used as an instrument. The dependent variable, presence of stroke, was defined by a doctor's diagnosis. Probit regression analyses were performed to examine the associations between the independent variable and both dependent variable and an instrument. Causal effect of regular exercise on stroke prevention were estimated with the bivariate probit regressions using proximity to exercise facilities as an instrument for regular exercise.

Consistent with prior knowledge, proximity to exercise facilities positively influenced regular exercise. The results from both multivariable probit and bivariate probit models indicate that engaging in regular exercise has a strong negative effect on the incidence of stroke. The estimated effects of regular physical activity on stroke prevention range from -0.174 percentage points (ATE) to -0.154 percentage points (ATT) in the bivariate probit model.

This study makes an important contribution by providing IV estimates on the effects of conducting regular exercise on stroke prevention based on a representative sample of South Korean adults. My findings suggest that conducting regular exercise reduces the risk of stroke even after accounting for the potential reverse causality and unobserved related factors.

Cerebrovascular reactivity (CVR) and cerebral pulsatility (CP) are important indicators of cerebrovascular health, which are associated with physical activity (PA). While sex differences influence the impact of PA on cerebrovascular health, sex-specific effects of PA intensity and dose on CP and CVR remains unknown. This study aimed to evaluate the sex-specific effects of self-reported PA dose and intensity on CVR and CP. The Human Connectome Project - Aging dataset was used, including 626 participants (350 females, 276 males) aged 36-85. The effect of menopausal status was also assessed. Resting state fMRI data was used to estimate both CVR and CP. Weekly self-reported PA was quantified as metabolic equivalent of task. Females presented a unique non-linear relationship between relative CVR and total PA in the cerebral cortex. Females and menopausal subgroups revealed negative linear relationships with total and walking PA in occipital and cingulate regions. Males exhibited negative linear relationships between total and vigorous PA and CVR in parietal and cingulate regions. Postmenopausal females showed greater reductions across more regions in CP than other groups. Overall, males and females appear to benefit from different amounts and intensities of PA, with menopause status influencing the effect of PA on cerebrovascular health.

Background and Objectives: Cardiovascular diseases (CVD) are the primary causes of death throughout the world. Engaging in physical activity (PA) is crucial for the prevention of CVD, as a lack of exercise significantly impacts global health. For health promotion purposes, it is important to optimize PA and develop the main physical components. Multimodal exercise program (MEP) interventions cause unique cardiac changes that can be systematically analyzed using advanced ECG techniques. Using algebraic co-integration methods, this study examined the physiological cardiac adaptations of a 6-week MEP compared to sedentary control subjects. Materials and Methods: A total of 50 physically inactive males, aged 20-35 years, were recruited for a 6-week MEP. The intervention group (IG) consisted of 28 participants, while the control group (CG) included 22 participants. The MEP included balance, endurance, muscle strength, and flexibility exercises in one session. The cardiovascular system (CVS) was assessed using electrocardiography (ECG) and arterial blood pressure during an incremental cycle ergometer test, both before and after the 6-week period. Results: After the post-MEP, the IG's resting HR showed a slight but insignificant decrease, from 84.5 to 82 bpm, with improved recovery rates at minute 1 (113.1-104.7 bpm). The CG showed a similar trend. pBP in IG significantly increased post-MEP during recovery at minute 1 (73-81) and minute 2 (65-72), where the CG showed a slight but significant difference. DskJT-QRS in IG post-MEP increased significantly during recovery in minutes 1-4, with all values showing p < 0.05. CG showed significance only at minute 3. Conclusions: Both the 6-week MEP and control had a positive impact on the CVS. The statement refers to changes in dynamic interactions between ECG parameters registered during the incremental exercise test and especially during the recovery after workload. Algebraic data co-integration analysis of ECG parameters demonstrated a sensitive assessment of the influence of exercising on the cardiovascular system.

Exercise has direct and indirect anti-atherogenic impacts on arterial function and health in humans. Few studies have directly compared the impacts of different commonly adopted exercise approaches on femoral artery function. We hypothesized that, owing to its direct impact via sustained increases in shear stress, endurance (END) training would have larger impacts on arterial diameter and function than resistance (RES) training. Thirty-nine young, healthy participants (age 26.9 ± 6.2 years, 22♀) completed 12 weeks of both RES and END training in random order, separated by a 12 week washout. Resting femoral artery diameter and flow-mediated dilatation (FMD) were collected before and after each exercise intervention. END training was associated with an increase in both FMD (Δ1.61 ± 3.09%, P = 0.005) and resting diameter (Δ0.15 ± 0.29 mm, P = 0.004). Neither resting diameter nor FMD increased following RES. However, sex difference analysis revealed that males increased FMD following RES (Δ2.21 ± 3.76%, P = 0.015), whereas no RES change was evident for females. Following END, both males and females increased FMD (♂, Δ1.11 ± 1.65%; ♀, Δ1.88 ± 3.67%; both P = 0.025), with males also showing an increase in resting arterial diameter following END (Δ0.23 ± 0.2 mm, P < 0.001). Group data revealed that END has greater impacts than RES on femoral artery diameter and flow-mediated functional responses, which are endothelium mediated and nitric oxide dependent. Males exhibit beneficial impacts in response to both END and RES, whereas females respond predominantly to END. Our findings suggest that arterial adaptation to exercise might be influenced by exercise modality and sex. KEY POINTS: Exercise has anti-atherogenic effects and lowers the risk of cardiovascular diseases. This is mediated, in part, by the direct haemodynamic impacts of exercise on arterial function, structure and health. Different modalities of exercise have distinct effects on arterial haemodynamics, but few studies have directly compared, within subjects and using a cross-over design of trial, the relative impacts of distinct forms of exercise training on arterial adaptation. In this study, endurance training increased baseline femoral artery diameter and flow-mediated dilatation, which is endothelium dependent and mediated by nitric oxide. Resistance training had a beneficial but lesser impact. Females and males were responsive to endurance training, but only males responded positively to resistance training in this study. These results show that changing the training mode modifies training-induced arterial adaptation; this has implications for the optimization of exercise prescription for individual benefit.

The acquisition and evolution of cardiovascular (CV) adaptation to physical activity or exercise training are critical in enhancing cardiorespiratory fitness and reducing CV disease (CVD) risk. CV adaptations to exercise occur through structural, functional, and molecular changes that enhance cardiac efficiency. These adaptations, such as increased stroke volume, improved blood pressure regulation, and enhanced endothelial function, collectively reduce CVD morbidity and mortality. In this review we explore how CV adaptations vary across different demographic characteristics, and highlight the importance of exercise timing, intensity, and recovery periods. We delve into the immediate physiological responses to physical activity, such as increased heart rate and cardiac output, and the longer-term adaptations, including cardiac hypertrophy and improved vascular function. The influence of age, sex, and preexisting health conditions on CV responses to exercise is also discussed, emphasizing the need for tailored exercise interventions. Finally, the review highlights the significance of recovery periods in optimizing CV adaptations and how insufficient recovery might lead to adverse outcomes. Overall, understanding the timing and evolution of CV adaptations can inform exercise prescriptions to improve CV health across populations for the primary and secondary prevention of CVD.

The role of physical activity (i.e. any bodily movement that requires energy expenditure) and exercise (i.e. planned, structured, and repetitive physical activity to improve/maintain fitness) in the primary and secondary prevention of atrial fibrillation (AF) is increasingly recognized. Physical activity has been associated with lower risks to develop AF and associated complications (e.g. stroke, heart failure, and myocardial infarction). Exercise-based cardiac rehabilitation (ExCR) is increasingly examined in the treatment of AF and sometimes combined with rhythm control strategies (e.g. catheter ablation). Nonetheless, several important clinical, practical, and mechanistic questions remain not fully understood. This state-of-the-art review first provides a contemporary update on the evidence base for the clinical effects of ExCR in AF. Despite the ongoing need for high-quality studies, existing randomized controlled trials and cohort studies suggest ExCR reduces AF burden, lowers risks for major adverse cardiovascular events, and improves health-related quality of life. Second, to facilitate implementation of ExCR, we have observed comparable effects of distinct exercise protocols (e.g. type of training and centre-/home-based) and discussed similarity of effectiveness across patient characteristics (e.g. age, sex, and AF subtype). Critically, we have discussed potential barriers that may prohibit the uptake of ExCR for patients with AF, categorized at clinician- (e.g. referral and training), patient- (e.g. motivation, transportation, and psychosocial factors), and system-levels (e.g. insurance and resources). Third, we have summarized the potential mechanisms underlying these effects of ExCR, classified by their potential role in reducing AF burden (e.g. atrial/ventricular function, autonomic balance, and inflammation) and lowering risks for adverse events (e.g. modifiable risk factors, vascular function, and thrombogenesis). Based on the increasing evidence for clinical benefits, e.g. improved health-related quality of life and better clinical outcomes, we advocate stronger focus on regular physical activity and referral to multidisciplinary ExCR for sustainable lifestyle changes within the ESC AF-CARE pathway for the prevention and treatment of AF.

Arterial stiffness, a critical predictor of cardiovascular events, varies regionally across peripheral, central, and systemic arteries, necessitating targeted exercise interventions for young men. However, research on the effects of exercise on arterial stiffness in these regions among young men remains limited. This review aims to (i) examine the effects of exercise on arterial stiffness in young men across these regions, and (ii) investigate the underlying mechanisms involved.

Database searches on PubMed, ScienceDirect, Web of Science, and Scopus were conducted up to July 2024. The keywords were: exercise, men/male, and arterial stiffness. Inclusion criteria were studies involving young men, supervised exercise, and arterial stiffness measures. Thirty-five papers were categorized into groups based on peripheral, central and systemic arterial stiffness.

Peripheral arterial stiffness: continuous aerobic cycling (light to high intensity), interval aerobic cycling (moderate to high intensity), and 30-s stretching exercises demonstrated positive effects, likely due to short-term changes in sympathetic nervous system activity, nitric oxide availability, and vascular tone. Central arterial stiffness: chronic high-intensity continuous and interval aerobic cycling exercises promoted vascular remodeling, including elastin preservation and collagen regulation. For systemic arterial stiffness, continuous and interval aerobic cycling and light-intensity squats with whole-body vibration exercises improve endothelial function, smooth muscle relaxation, and vascular remodeling.

Tailored exercise intervention can effectively reduce arterial stiffness across peripheral, central and systemic regions in young men. Improvements in peripheral stiffness are linked to short-term metabolic shifts, central stiffness responds to long-term remodeling, while systemic arterial stiffness involves both short- and long-term metabolic adaptations.

Background: Intermittent negative pressure is an emerging treatment for lower limb vascular disease but the specific physiological effects, particularly upon large artery haemodynamics are unclear. This study examined the influence of intermittent negative pressure upon popliteal artery shear rate during both supine and sitting postures. Participants and methods: Eleven healthy participants (5 female; age: 28.3 ± 5.8 y; weight: 69.6 ± 9.8 kg, height: 1.75 ± 0.07 m) received intermittent negative pressure (-37 mmHg; 9.5-sec on, 7.5-sec off), upon the lower leg during both supine and sitting postures. Popliteal artery blood flow and shear rate were recorded (duplex ultrasound), accompanied by heart rate (3-lead ECG) and blood pressure (volume clamp method). Results: Compared to sitting, a supine posture led to greater mean shear rate during baseline (supine: 21[9]; sitting: 17[13] sec-1; all median [IQR]) and negative pressure phases (supine: 24[15]; sitting: 17[14] sec-1; both p<0.05). While supine, negative pressure raised mean shear rate above baseline levels (p<0.05) and reduced it upon return to atmospheric pressure (p < 0.05). In sitting, mean shear rate only differed from baseline at the points of peak and minimum shear (peak:18[17]; minimum: 10[9] sec-1; both p<0.05). Shear pattern (oscillatory shear index) showed changes from baseline during both postures (p<0.05), but was not different between postures. Conclusions: Intermittent negative pressure influenced lower limb popliteal artery shear rate during both the supine and sitting postures, the effect was greater while supine. Fluctuation in shear pattern seen during both positions may account for positive clinical effects observed following intermittent negative pressure treatment. These findings are framed against previous work investigating clinical populations. Future work should investigate any differences in lower limb haemodynamics and markers of endothelial function among patients with vascular disease.

Thrombosis, a major cause of morbidity and mortality worldwide, presents a complex challenge in cardiovascular medicine due to the intricacy of clotting mechanisms in living organisms. Traditional research approaches, including clinical studies and animal models, often yield conflicting results due to the inability to control variables in these complex systems, highlighting the need for more precise investigative tools. This review explores the evolution of in vitro thrombosis models, from conventional polydimethylsiloxane (PDMS)-based microfluidic devices to advanced hydrogel-based systems and cutting-edge 3D bioprinted vascular constructs. We discuss how these emerging technologies, particularly vessel-on-a-chip platforms, are enabling researchers to control previously unmanageable factors, thereby offering unprecedented opportunities to pinpoint specific clotting mechanisms. While PDMS-based devices offer optical transparency and fabrication ease, their inherent limitations, including non-physiological rigidity and surface properties, have driven the development of hydrogel-based systems that better mimic the extracellular matrix of blood vessels. The integration of microfluidics with biomimetic materials and tissue engineering approaches has led to the development of sophisticated models capable of simulating patient-specific vascular geometries, flow dynamics, and cellular interactions under highly controlled conditions. The advent of 3D bioprinting further enables the creation of complex, multi-layered vascular structures with precise spatial control over geometry and cellular composition. Despite significant progress, challenges remain in achieving long-term stability, incorporating immune components, and translating these models to clinical applications. By providing a comprehensive overview of current advancements and future prospects, this review aims to stimulate further innovation in thrombosis research and accelerate the development of more effective, personalized approaches to thrombosis prevention and treatment.

Background and Objectives: This study investigates the effects of hormonal fluctuations during the menstrual cycle and oral contraceptive (OCP) cycles on peripheral vascular circulation in the lower limbs of healthy childbearing-age women across different phases of the menstrual cycle. Materials and Methods: Fourteen eumenorrheic non-oral contraceptive (non-OCP) users (mean age 28.9 ± 3.5 years; height 165.0 ± 5.8 cm; weight 66.8 ± 11.2 kg) were evaluated during the follicular and ovulatory phases. Fifteen monophasic oral contraceptive (OCP) users (mean age 26.4 ± 2.67 years; height 162.3 ± 8.1 cm; weight 62.0 ± 9.8 kg) were assessed during their placebo and active pill phases. Doppler recordings of the femoral and popliteal arteries were obtained, and standard Doppler indices (systolic/diastolic ratio, pulsatility index, and resistance index) were analyzed across the menstrual and OCP cycles. Results: There were no significant interactions in the standard Doppler indices for the popliteal and femoral arteries between the menstrual phases and user groups (p > 0.05). Additionally, no significant group effects were observed between non-OCP users and OCP users, nor were there significant phase effects in any of the Doppler index variables (p > 0.05). Conclusions: Peripheral vascular function remained stable across menstrual and OCP phases, suggesting minimal impact of hormonal fluctuations on blood flow characteristics in young, healthy females.

Physical activity has proven effective in preventing atherosclerotic cardiovascular disease, but its role in preventing degenerative valvular heart disease (VHD) remains uncertain. This study aimed to explore the dose-response association between moderate to vigorous physical activity (MVPA) volume and the risk of degenerative VHD among middle-aged adults.

A full week of accelerometer-derived MVPA data from 87 248 UK Biobank participants (median age 63.3, female: 56.9%) between 2013 and 2015 were used for primary analysis. Questionnaire-derived MVPA data from 361 681 UK Biobank participants (median age 57.7, female: 52.7%) between 2006 and 2010 were used for secondary analysis. The primary outcome was the diagnosis of incident degenerative VHD, including aortic valve stenosis (AS), aortic valve regurgitation (AR), and mitral valve regurgitation (MR). The secondary outcome was VHD-related intervention or mortality.

In the accelerometer-derived MVPA cohort, 555 incident AS, 201 incident AR, and 655 incident MR occurred during a median follow-up of 8.11 years. Increased MVPA volume showed a steady decline in AS risk and subsequent AS-related intervention or mortality risk, levelling off beyond approximately 300 min/week. In contrast, its association with AR or MR incidence was less apparent. The adjusted rates of AS incidence (95% confidence interval) across MVPA quartiles (Q1-Q4) were 11.60 (10.20, 13.20), 7.82 (6.63, 9.23), 5.74 (4.67, 7.08), and 5.91 (4.73, 7.39) per 10 000 person-years. The corresponding adjusted rates of AS-related intervention or mortality were 4.37 (3.52, 5.43), 2.81 (2.13, 3.71), 1.93 (1.36, 2.75), and 2.14 (1.50, 3.06) per 10 000 person-years, respectively. Aortic valve stenosis risk reduction was also observed with questionnaire-based MVPA data [adjusted absolute difference Q4 vs. Q1: AS incidence, -1.41 (-.67, -2.14) per 10 000 person-years; AS-related intervention or mortality, -.38 (-.04, -.88) per 10 000 person-years]. The beneficial association remained consistent in high-risk populations for AS, including patients with hypertension, obesity, dyslipidaemia, and chronic kidney disease.

Higher MVPA volume was associated with a lower risk of developing AS and subsequent AS-related intervention or mortality. Future research needs to validate these findings in diverse populations with longer durations and repeated periods of activity monitoring.

To evaluate the accuracy of a wrist-based heart rate (HR) monitor at different exercise intensities across different skin tones.

Using a cross-sectional design, we compared HR measures from the wrist-based photoplethysmography Fitbit Charge 5 to the Polar H10 chest strap at rest and during the YMCA Protocol using a recumbent cycle ergometer. Participant were grouped into three skin tone categories: light (Fitzpatrick Scale Skin Types 1+2), medium (Types 3+4), and darker skin tone (Types 5+6). HR measures using the Polar chest strap during the exercise test were categorized as <40%, 40-60%, or >60% HR reserve (HRR). Absolute error in beats per minute (bpm) between the two devices was calculated for each measure. A linear mixed effects model was used to assess interaction effects between skin tone and exercise intensity, with participants as the random effect. Bland-Altman plots were used for visual analyses.

Twenty-five participants [mean (SD): 25.8 (1.9) years old; 64% female] were included with 495 observations of simultaneous Fitbit and Polar HR recordings collected during exercise. During exercise, we observed a statistically significant interaction effect between skin tone and exercise intensity. Compared with light skin tone at <40% HRR, mean error was greater for medium skin tone at >60% HRR [mean error (95%CI): 11.8 (5.6-17.9) bpm, p<0.001] and darker skin tone at 40-60% HRR [7.6 (1.7-13.5) bpm, p = 0.011] and >60% HRR [11.7 (5.3-18.0) bpm, p<0.001].

HR measurement error using a wrist-based device was greater with increasing exercise intensity for people with darker skin tones.

Physical activity (PA) protects against cardiovascular disease. However, previous research has shown that high PA is associated with an increased carotid intima-media-thickness (cIMT), an independent predictor for future cardiovascular disease. Our aim was to further investigate this unexpected association with two different measurement methods of PA and two established markers for Early Vascular Ageing: cIMT and carotid-femoral pulse-wave velocity (cfPWV).

The community-based Early Vascular Ageing-Tyrol cohort study included adolescents in western Austria and northern Italy. Medical examinations included anthropometric measurements, fasting blood analysis, a physician guided interview to assess lifestyle factors, measurement of cIMT and cfPWV. PA was rated by an in-person interview on the basis of average minutes of moderate- or vigorous sports per day and by the Baecke questionnaire expressed as Baecke score (BS).

Complete data set was available for 1,001 adolescents with a mean age of 17.8 years (standard deviation ±0.9 years). 558 (55.7%) of participants were female. cIMT was positively associated with both measures of PA in univariate (minutes sports per day: p < 0.001; BS: p < 0.001) as well as multivariable analysis adjusting for established cardiovascular risk factors (minutes sports per day: p = 0.001; BS: p = 0.002). Using cfPWV in a multivariate model an inverse correlation with the BS (p = 0.023) was observed, but not for minutes sports per day (p = 0.554).

In our large community-based cohort of adolescents, PA was associated with an increased cIMT but shows a trend towards lower aortic stiffness measured by cfPWV. We hypothesize that the association of PA with increased cIMT is not caused by early atherosclerotic vessel wall changes but is rather a physiologic adaptive process of the vessel wall.

The EVA-Tyrol Study has been registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.

To provide an overview of the predictive value of A Body Shape Index (ABSI) for the risk of cardiovascular events.

ABSI has been reported to have an association with development of cardiovascular diseases, and its usefulness for predicting major cardiovascular events including cardiovascular mortality, nonfatal coronary syndrome and nonfatal stroke has been investigated. The formula for ABSI includes waist circumference, which is not included in the conventional calculation of body mass index (BMI), along with BMI and height. High ABSI is independently associated with a high incidence of cardiovascular events. ABSI with specific cutoff values can be a useful tool for cardiovascular risk stratification by detecting the presence of abdominal obesity and it can be used for evaluation of the risk of cardiovascular events. Nonetheless, other factors such as race, gender, age, and physical, environmental and socioeconomic purviews also need be taken into consideration.

Hypertension increases the risk of cerebrovascular disease and death. In addition to aerobic exercise, which is currently recommended for its antihypertensive effects, recent studies have suggested that dynamic and isometric resistance exercises also have antihypertensive effects. However, the magnitude of the antihypertensive effect of such resistance exercises is not well known. To clarify the differences in these effects, we conducted an umbrella review of a meta-analysis of randomized controlled trials (RCTs). A systematic search was performed on the Ovid MEDLINE and Cochrane Library, covering the period from inception to August 1, 2023. Eligible studies were RCTs comparing the effects of exercise and non-exercise on office, home, or ambulatory blood pressure (BP) in hypertensive patients aged 18 years or older. A random effects model meta-analysis was performed to estimate the effect size across multiple studies. A sub-analysis determined outcomes by the type of exercise (aerobic exercise, dynamic resistance exercise, isometric resistance exercise, and combined exercise). Eighty-four RCTs with 5065 hypertensive patients were included in the study. All exercise significantly reduced systolic BP (SBP) and diastolic BP (DBP) compared to non-exercise (SBP:-7.52 mmHg, 95% confidence interval [CI] -8.77 to -6.27, p < 0.001; DBP: -4.36 mmHg, 95% CI - 5.15 to -3.57, p < 0.001). There were no significant differences in the magnitude of the reduction in BP between the types of exercise (p for interaction = 0.815 for SBP, p = 0.417 for DBP). These data from 84 RCTs showed that exercise intervention significantly reduced BP and that resistance exercise has a similar antihypertensive effect to aerobic exercise in hypertensive patients. This meta-analysis showed that exercise significantly reduced blood pressure in hypertensive patients. There were no significant differences in the magnitude of this reduction in BP between the types of exercise.

The present study aims to examine the effect of 4 h of continuous sitting on cerebral endothelial function, which is a crucial component of cerebral blood flow regulation. We hypothesized that 4 h of sitting may impair cerebral endothelial function similarly to how it affects lower limb vasculature. Thirteen young, healthy participants were instructed to remain seated for 4 h without moving their lower limbs. The blood flow and shear rate (SR) in the popliteal and internal carotid artery (ICA) were measured using duplex Doppler ultrasound. During the 4-h sitting, peripheral (popliteal artery) and cerebral (ICA) endothelial function were assessed every hour. We induced peripheral and cerebral flow-mediated dilation (pFMD and ICA FMD) using hyperemia (5 min of cuff inflation on lower limb, then deflation) or hypercapnia (30s of hypercapnia, end-tidal partial pressure of CO2 + 9 mmHg), respectively. We then calculated each relative peak dilation from the baseline diameter to identify both pFMD and ICA FMD. We observed a significant decrease in pFMD starting at 2 h from the onset of sitting, and this reduction persisted throughout the 4-h sitting [Base (6.8 ± 4.2%) vs. 2-h (3.9 ± 2.0%), p = 0.044; vs. 3-h (3.2 ± 1.8%), p = 0.016; vs. 4-h (3.2 ± 1.9%), p = 0.005]. In contrast, during the 4-h sitting, ICA blood flow, SR, and ICA FMD remained unchanged (p = 0.062, p = 0.068, and p = 0.203, respectively). Unlike peripheral endothelial function, cerebral endothelial function remained stable during 4-h sitting. This suggests that the acute effect of prolonged sitting on cerebral vasculature differs from that of lower limb vasculature.

Vasoactive molecules are central regulators of vascular tone, angiogenesis and inflammation. Key molecular agents include nitric oxide (NO), endothelin-1 (ET-1), prostacyclin, free triiodothyronine (fT3), leptin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), superoxide dismutase (SOD), and glutathione peroxidase (GPX). Dysregulation of these compounds can lead to endothelial dysfunction, an early predictor of atherosclerosis and cardiovascular diseases (CVD). Maintaining endothelial health is thus essential for vascular homeostasis and cardiovascular risk prevention. Regular exercise serves as a vital protective measure against CVD and the risk of cardiovascular conditions. However, young athletes often significantly exceed recommended levels of training load, engaging in highly intensive training that leads to substantial physiological adaptations. Despite this, research on the impact of exercise on vasoactive substances in children and adolescents, particularly young athletes, is limited and inconsistent. Most studies focus on those with pre-existing conditions, like obesity or diabetes mellitus. Existing findings suggest exercise may favorably affect vascular biomarkers in youth, but methodological variations hinder consistent conclusions. This literature review examines 68 studies on the effects of exercise on vascular molecules in children and adolescents, young athletes, and children and adolescents with pre-existing conditions, offering deeper insights into how exercise may influence vascular health at the molecular level.

This study examines how heart rate (HR) affects hemodynamics in a South African infant with Coarctation of the Aorta. Computed tomography angiography segments aortic coarctation anatomy; Doppler echocardiography derives inlet flow waveforms. Simulations occur at 100, 120, and 160 beats per minute, representing reduced, resting, and elevated HR levels. Turbulence was analyzed over time and space using turbulence-resolving and pulsatile large-eddy simulations. Specifically, a 60% reduction in HR led to a reduction in maximum velocity by 45%, and a 57% decrease in pressure drop. The reduction in turbulence-related metrics was less significant. The ratio of turbulent kinetic energy to total kinetic energy decreased by 2%, while turbulent wall shear stress decreased by 3%. These results demonstrate that HR significantly affects velocity and pressure drop, while turbulence arising from the coarctation region is relatively unaffected. The balance between turbulent kinetic energy and total kinetic energy shows minimal enhancement due to the complex interplay among HR, turbulence, and geometry. This complexity prompts discussion on how HR-slowing medications, such as beta-blockers or ivabradine, could positively influence hemodynamic stresses. In particular, the results indicate that while HR modulation can influence flow dynamics, it may not significantly reduce turbulence-induced shear stresses within the coarctation zone. Therefore, further investigation is necessary to understand the potential impact of HR modulation in the management of CoA, and whether interventions targeting the anatomical correction of the coarctation may be more effective in improving hemodynamic outcomes.

Physical activity (PA) may be considered an alternative method to ameliorate the elevated mortality risks associated with cadmium exposure. In this prospective cohort study, a total of 20,253 participants (weighted mean age, 47.79 years), including 10,247 men (weighted prevalence: 50.1 %), aged 18 years or older, were selected from the National Health and Nutrition Examination Survey from 2007 to 2018. Multivariable Cox proportional hazards regression models were utilized to evaluate the associations between blood cadmium levels, PA, and the risks of mortality. Restricted cubic spline analyses were employed to investigate the nonlinear relationships between blood cadmium and PA levels and mortality risks. During a median follow-up of 7.6 years, a total of 2002 (9.89 %) all-cause deaths occurred, of which 581 (2.87 %) participants were due to cardiovascular disease (CVD) and 498 (2.46 %) died of cancer. J-shaped associations were observed for blood cadmium with risks of mortality (all Poverall < 0.001; all Pnonlinearity < 0.001). Blood cadmium and PA had multiplicative interactions on mortality risk (all Pinteraction < 0.05). Compared with the subgroup with the lowest quartile of blood cadmium and recommended PA, the combination of the highest quartile of blood cadmium and without recommended PA was associated with the highest risks of all-cause and cancer mortality, followed by those meeting recommended PA but in the highest quartile of blood cadmium (hazard ratios, 2.43; 95 % confidence interval, 1.95-3.02). Achieving recommended PA significantly attenuated the detrimental effects of blood cadmium on all-cause, CVD, and cancer mortality risks.

Fatty acid metabolism, exercise, and insulin action play critical roles in maintaining vascular health, especially relevant in metabolic disorders such as obesity, type 2 diabetes, and cardiovascular disease. Insulin, a vasoactive hormone, induces arterial vasodilation throughout the arterial tree, increasing arterial compliance and enhancing tissue perfusion. These effects, however, are impaired in individuals with obesity and type 2 diabetes, and evidence suggests that vascular insulin resistance contributes to the pathogenesis of type 2 diabetes and its cardiovascular complications. Elevated plasma levels of free fatty acids in people with insulin resistance engender vascular inflammation, endothelial dysfunction, and vascular insulin resistance. Importantly, these effects are both functionally and structurally dependent, with saturated fatty acids as the primary culprits, while polyunsaturated fatty acids may support insulin sensitivity and endothelial function. Exercise enhances fatty acid oxidation, reduces circulating free fatty acids, and improves insulin sensitivity, thereby mitigating lipotoxicity and promoting endothelial function. Additionally, exercise induces beneficial vascular adaptations. This review examines the complex interplay among fatty acid metabolism, exercise training-induced vascular adaptations, and insulin-mediated vascular changes, highlighting their collective impact on vascular health and underlying mechanisms in both healthy and insulin-resistant states. It also explores the therapeutic potential of targeted exercise prescriptions and fatty acid-focused dietary strategies for enhancing vascular health, emphasizing tailored interventions to maximize metabolic benefits. Future research should investigate the pathways linking fatty acid metabolism to vascular insulin resistance, with a focus on how exercise and dietary modifications can be personalized to enhance vascular insulin sensitivity, optimize vascular health, and reduce the risks of type 2 diabetes and associated cardiovascular complications.

Atherosclerosis, a major contributor to cardiovascular diseases (CVD), remains a leading cause of global mortality and morbidity. The pathogenesis of atherosclerosis involves a complex interplay of endothelial dysfunction, chronic inflammation, lipid accumulation, and arterial stiffness. Among the various preventive strategies, physical activity has emerged as a highly effective, non-pharmacological intervention. This review examines the preventive effects of different types of exercise-specifically aerobic exercise, resistance training, and combined training-on atherosclerosis development. Drawing on evidence from landmark studies, we explore the underlying mechanisms by which these exercise modalities improve endothelial function, reduce systemic inflammation, and enhance lipid profiles, thereby mitigating the progression of atherosclerosis. Additionally, the review discusses the dose-response relationship between physical activity and cardiovascular health, the differential effects of exercise intensities, and the potential risks associated with high-intensity training. The synergistic benefits of combined aerobic and resistance training are highlighted, particularly in populations with metabolic syndrome or other high-risk conditions. Emerging trends in personalized exercise medicine and the use of wearable technology for monitoring physical activity are also addressed, underscoring the potential for tailored exercise prescriptions to maximize cardiovascular health. By integrating current research findings, this review provides insights into effective exercise strategies for reducing cardiometabolic risk and emphasizes the importance of personalized approaches in exercise interventions.

Central arterial stiffness, a predictor of cardiovascular risk, attenuates with endurance-exercise in ageing populations. However, in young individuals, this effect is inconsistent and emerging evidence suggests resistance-exercise may increase arterial stiffness. Two-dimensional (2D)-Strain imaging of the common carotid artery (CCA) is more sensitive at detecting endurance-training induced alterations in CCA stiffness than conventional methods, but has not been used to examine CCA stiffness in young resistance-trained individuals. Therefore, we compared CCA 2D-Strain parameters at rest, during acute exercise and recovery between resistance-trained, endurance-trained, and untrained young men.

Short-axis CCA ultrasound images were obtained from 12 endurance-trained [27yrs (95%CI; 24-29)], 14 resistance-trained [24yrs (23-26)] and 12 untrained [23yrs (22-24] men at rest, during isometric handgrip (IHG) exercise and recovery. 2D-Strain analysis quantified CCA peak circumferential strain (PCS) and systolic (S-SR) and diastolic (D-SR) strain rates. Conventional stiffness indices included aortic pulse-wave velocity, CCA β-stiffness (β1) and Petersons elastic modulus (Ep).

Resting conventional stiffness indices were not different between groups (P > 0.05). Resting PCS and S-SR were comparable between resistance- [11.6% (10.6-12.5) and 1.46 s-1 (1.37-1.55), respectively] and endurance-trained [11.4% (10.7-12.2) and 1.5 s-1 (1.38-1.62)] men and superior to untrained men [9.5% (9.19-9.9); P < 0.004 and 1.24 s-1 (1.17 - 1.31); P < 0.018)]. Both trained groups displayed comparable reductions in PCS and S-SR during IHG, which returned to resting values during recovery (P < 0.001), whereas these parameters remained unchanged in untrained men. D-SR decreased during IHG in all groups (P < 0.001), but to a lesser extent in endurance-trained men (P < 0.023), whereas β1 and Ep increased to a similar magnitude in all groups and returned to resting values during recovery (P < 0.001).

Resistance- and endurance-trained men display comparable CCA 2D-Strain parameters that are superior to untrained men, which contends previous reports that resistance-training increases CCA stiffness.

Passive heat therapy is gaining popularity as an intervention to promote cardiovascular, physiological, and, to a lesser degree, thermoregulatory adaptations in patients with cardiovascular disease. Despite this, the efficacy of heat therapy to elicit these adaptations remains unknown. We searched five databases for original research, screening 2913 studies and identifying 18 eligible studies. Heat therapies included Waon therapy, balneotherapy, water perfused trousers, Finnish sauna, and foot immersion. Interventions were administered across various time frames (20-90 min) and performed 3-7 times per week, for durations of 2-8 weeks. The studies collectively involved a diverse population (mean age: 67 (10) years) with cardiovascular diseases. Heat therapy was consistently shown to improve ejection fraction, flow-mediated dilation, brain natriuretic peptide levels, New York Heart Association classification, and 6 min walk distance. However, positive effects on resting heart rate and blood pressure were infrequently observed, and thermoregulatory responses scarcely reported. Heat therapy may increase sweat rate during heat exposure and reduce resting core temperature, but adaptive skin blood flow responses were not observed. Passive heat therapy shows promising utility in patients with cardiovascular disease, while secondary benefits such as markers of thermoregulatory adaptation may also be observed, these require further investigation.

Cardiac rehabilitation, a comprehensive exercise-based lifestyle and medical management, is effective in decreasing morbidity and improving life quality in patients with coronary heart disease. Endothelial function, an irreplaceable indicator in coronary heart disease progression, is measured by various methods in traditional cardiac rehabilitation pathways, including medicinal treatment, aerobic training, and smoking cessation. Nevertheless, studies on the effect of some emerging cardiac rehabilitation programs on endothelial function are limited. This article briefly reviewed the endothelium-beneficial effects of different cardiac rehabilitation pathways, including exercise training, lifestyle modification and psychological intervention in patients with coronary heart disease, and related experimental models, and summarized both uncovered and potential cellular and molecular mechanisms of the beneficial roles of various cardiac rehabilitation pathways on endothelial function. In exercise training and some lifestyle interventions, the enhanced bioavailability of nitric oxide, increased circulating endothelial progenitor cells (EPCs), and decreased oxidative stress are major contributors to preventing endothelial dysfunction in coronary heart disease. Moreover, the preservation of endothelial-dependent hyperpolarizing factors and inflammatory suppression play roles. On the one hand, to develop more endothelium-protective rehabilitation methods in coronary heart disease, adequately designed and sized randomized multicenter clinical trials should be advanced using standardized cardiac rehabilitation programs and existing assessment methods. On the other hand, additional studies using suitable experimental models are warranted to elucidate the relationship between some new interventions and endothelial protection in both macro- and microvasculature.

The purpose of this research was to investigate the use of time to peak temperature (TTP) as a metric for characterizing skin adaptation in prothesis users. Two experiments were conducted. A static pressure was applied to a participant's transtibial residual limb for 10 min, then a thermal imaging camera was used to capture the time-varying temperature response. The TTP, time to reach 70 % of the maximum temperature, was shorter at locations adapted to mechanical stress, the patellar tendon and anterior lateral distal region (mean 41.5 s and 47.2 s, respectively), than at mid-limb locations (127.1 s). In the second experiment, an able-bodied participant rubbed a towel across the anterior proximal aspect of his lower limb each day for 5 min per day for 11 days. His mean TTP in the region decreased from 68.5 s at Day 1 to 47.2 s at Day 11. The results suggest that a short TTP reflects skin well adapted to mechanical stress and a long TTP reflects skin not well adapted to mechanical stress. Investigations characterizing relationships between TTP and health outcomes should be pursued.

Contrary to cardiovascular risk reductions by aerobic exercise, arterial stiffness, as assessed by brachial-ankle pulse wave velocity (PWV), is higher in swimmers and controls than in other aerobically trained individuals. The main muscles actively recruited in swimming are in the upper limbs, so this study aimed to investigate heart-brachial PWV in swimmers and to compare arterial stiffness indices between modes and measurement localities. Subjects comprised 60 individuals (18-22 years), including 20 untrained controls (Con), 20 aerobically trained cyclists (Aero), and 20 swimmers (Swim). Characteristics and strength did not differ, but peak oxygen uptake was significantly higher in Aero and Swim than in Con. Brachial-ankle PWV was significantly lower in Aero than in Con and Swim and no significant difference was observed between Con and Swim (Con, 1070 ± 115; Aero, 916 ± 109; Swim, 1035 ± 91 cm/s). Nevertheless, heart-brachial PWV was significantly lower in Swim than in Con and tended to be lower in Swim than in Aero (Con, 344 ± 25; Aero, 330 ± 41; Swim, 308 ± 31 cm/s). Heart-ankle PWV was significantly lower in both Swim and Aero than in Con (Con, 618 ± 47; Aero, 580 ± 54; Swim, 576 ± 43 cm/s). Therefore, these findings indicate that swimmers can develop segment-specific reductions in heart-brachial arterial stiffness, unlike aerobically trained cyclists.

Long-term exercise intolerance and functional limitations are common after an episode of acute pulmonary embolism (PE), despite 3 to 6 months of anticoagulation. These persistent symptoms are reported in more than half of the patients with acute PE and are referred as "post-PE syndrome." Although these functional limitations can occur from persistent pulmonary vascular occlusion or pulmonary vascular remodeling, significant deconditioning can be a major contributing factor. Herein, the authors review the role of exercise testing to elucidate the mechanisms of exercise limitations to guide next steps in management and exercise training for musculoskeletal deconditioning.

Our study investigated the effects of acute high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) on endothelial function and its associated biomarkers in sedentary young individuals.

Fifteen subjects (10M / 5F; 22 ± 2 years; BMI: 23.07 ± 4.12 kg/m2) participated in a crossover trial including three experimental conditions: HIIE, MICE, and a control session of rest (CON) in random order separated by a 7-day washout period. Endothelial function was assessed using flow-mediated dilation (FMD), mean shear rate (MSR), and circulating levels of blood lactate, VEGF, IGF-1, and irisin.

Both HIIE and MICE significantly enhanced FMD% (both P < 0.001 and P < 0.01, respectively), lactate (both P < 0.001), VEGF (P < 0.001 and P < 0.01, respectively), IGF-1 (both P < 0.001), and irisin (P < 0.001 and P < 0.05, respectively), with a greater extent after HIIE compared to MICE in FMD% (P < 0.001), MSR (P < 0.05), lactate (P < 0.001), VEGF (P < 0.05), and IGF-1 (P < 0.05). Additionally, change (post-pre) in FMD% was positively correlated with changes in MSR, lactate, and VEGF in both HIIE and MICE conditions. Change in MSR was positively associated with changes in lactate and VEGF in both HIIE and MICE conditions. Furthermore, enhancement in lactate was correlated with enhancements in VEGF in both HIIE and MICE conditions.

Acute HIIE is a more effective method than MICE at improving endothelial function in sedentary young individuals and increases in lactate and its mediated VEGF release, attributed to increase in shear rate after exercise, are involved in regulatory mechanisms.