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PurposeThe aim of this study was to determine the effects of high-intensity aerobic interval training (AIT) on exercise hemodynamics in metabolic syndrome (MetS) volunteers. Methods Thirty-eight, MetS participants were randomly assigned to a training (TRAIN) or to a non-training control (CONT) group. TRAIN consisted of stationary interval cycling alternating bouts at 70–90% of maximal heart rate during 45 min day−1 for 6 months. ResultsCONT maintained baseline physical activity and no changes in cardiovascular function or MetS factors were detected. In contrast, TRAIN increased cardiorespiratory fitness (14% in VO2PEAK; 95% CI 9–18%) and improved metabolic syndrome (−42% in Z score; 95% CI 83–1%). After TRAIN, the workload that elicited a VO2 of 1500 ml min−1 increased 15% (95% CI 5–25%; P < 0.001). After TRAIN when subjects pedaled at an identical submaximal rate of oxygen consumption, cardiac output increased by 8% (95% CI 4–11%; P < 0.01) and stroke volume by 10% (95% CI, 6–14%; P < 0.005) being above the CONT group values at that time point. TRAIN reduced submaximal exercise heart rate (109 ± 15–106 ± 13 beats min−1; P < 0.05), diastolic blood pressure (83 ± 8–75 ± 8 mmHg; P < 0.001) and systemic vascular resistances (P < 0.01) below CONT values. Double product was reduced only after TRAIN (18.2 ± 3.2–17.4 ± 2.4 bt min−1 mmHg 10−3; P < 0.05). Conclusions The data suggest that intense aerobic interval training improves hemodynamics during submaximal exercise in MetS patients. Specifically, it reduces diastolic blood pressure, systemic vascular resistances, and the double product. The reduction in double product, suggests decreased myocardial oxygen demands which could prevent the occurrence of adverse cardiovascular events during exercise in this population. Clinicaltrials.gov identifierNCT03019796.
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Eur J Appl Physiol (2017) 117:2065–2073
DOI 10.1007/s00421-017-3697-7
ORIGINAL ARTICLE
Aerobic interval training reduces vascular resistances
duringsubmaximal exercise inobese metabolic syndrome
individuals
RicardoMora‑Rodriguez1 · V.E.Fernandez‑Elias2· F.Morales‑Palomo1·
J.G.Pallares3· M.Ramirez‑Jimenez1· J.F.Ortega1
Received: 4 March 2017 / Accepted: 2 August 2017 / Published online: 12 August 2017
© Springer-Verlag GmbH Germany 2017
Double product was reduced only after TRAIN (18.2±3.2–
17.4±2.4btmin−1mmHg10−3; P<0.05).
Conclusions The data suggest that intense aerobic interval
training improves hemodynamics during submaximal exer-
cise in MetS patients. Specifically, it reduces diastolic blood
pressure, systemic vascular resistances, and the double prod-
uct. The reduction in double product, suggests decreased
myocardial oxygen demands which could prevent the occur-
rence of adverse cardiovascular events during exercise in
this population.
Clinicaltrials.gov identifier NCT03019796.
Keywords Vascular resistance· Exercise training·
Cardiac output· Metabolic syndrome X
Abbreviations
BMI Body mass index
CVD Cardiovascular disease
CRF Cardiorespiratory fitness
DBP Diastolic blood pressure
DP Double product
GXT Graded exercise testing
MetS Metabolic syndrome
SBP Systolic blood pressure
WMAX Maximal power output
VO2PEAK Peak oxygen consumption rate
Introduction
Metabolic syndrome (MetS) is a cluster of conditions com-
piling elevated waist circumference, blood lipids and glu-
cose and blood pressure that increases the risk of developing
cardiovascular disease (i.e., CVD; Ingelsson etal. 2007).
In intervention trials, it has been established that aerobic
Abstract
Purpose The aim of this study was to determine the effects
of high-intensity aerobic interval training (AIT) on exercise
hemodynamics in metabolic syndrome (MetS) volunteers.
Methods Thirty-eight, MetS participants were randomly
assigned to a training (TRAIN) or to a non-training con-
trol (CONT) group. TRAIN consisted of stationary interval
cycling alternating bouts at 70–90% of maximal heart rate
during 45minday−1 for 6months.
Results CONT maintained baseline physical activity and
no changes in cardiovascular function or MetS factors were
detected. In contrast, TRAIN increased cardiorespiratory fit-
ness (14% in VO2PEAK; 95% CI 9–18%) and improved meta-
bolic syndrome (−42% in Z score; 95% CI 83–1%). After
TRAIN, the workload that elicited a VO2 of 1500mlmin−1
increased 15% (95% CI 5–25%; P<0.001). After TRAIN
when subjects pedaled at an identical submaximal rate of
oxygen consumption, cardiac output increased by 8% (95%
CI 4–11%; P<0.01) and stroke volume by 10% (95% CI,
6–14%; P<0.005) being above the CONT group values at
that time point. TRAIN reduced submaximal exercise heart
rate (109±15–106±13beatsmin−1; P<0.05), diastolic
blood pressure (83±8–75±8mmHg; P<0.001) and sys-
temic vascular resistances (P<0.01) below CONT values.
Communicated by Carsten Lundby.
* Ricardo Mora-Rodriguez
ricardo.mora@uclm.es
1 Exercise Physiology Laboratory atToledo, University
ofCastilla-La Mancha, 45071Toledo, Spain
2 Physical Activity andSports Department, Universidad
Europea de Madrid, Madrid, Spain
3 Human Performance andSport Science Laboratory,
University ofMurcia, Murcia, Spain
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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Individuals with metabolic syndrome (MetS; i.e., three of five of the following risk factors (RFs): elevated blood pressure, waist circumference, triglycerides, blood glucose, or reduced HDL) are thought to be prone to serious cardiovascular disease and there is debate as to whether the disease begins in the peripheral vasculature or centrally. This study investigates hemodynamics, cardiac function/morphology, and mechanical properties of the central (heart, carotid artery) or peripheral [total peripheral resistance (TPR), forearm vascular bed] vasculature in individuals without (1-2 RFs: n = 28), or with (≥3 RFs: n = 46) MetS. After adjustments for statin and blood pressure medication use, those with MetS had lower mitral valve E/A ratios (<3 RFs: 1.24 ± 0.07; ≥3 RFs: 1.01 ± 0.04; P = 0.025), and higher TPR index (<3 RFs: 48 ± 2 mmHg/L/min/m(2); ≥3 RFs: 53 ± 2 mmHg/L/min/m(2); P = 0.04). There were no differences in heart size, carotid artery measurements, cardiovagal baroreflex, pulse-wave velocity, stroke volume index, or cardiac output index due to MetS after adjustments for statin and blood pressure medication use. The use of statins was associated with increased inertia in the brachial vascular bed, increased HbA1c and decreased LDL cholesterol. The independent use of anti-hypertensive medication was associated with decreased predicted [Formula: see text] triglycerides, diastolic blood pressure, interventricular septum thickness, calculated left ventricle mass, left ventricle posterior wall thickness, and left ventricle pre-ejection period, but increased carotid stiffness, HDL cholesterol, and heart rate. These data imply that both a central cardiac effect and a peripheral effect of vascular resistance are expressed in MetS. These data also indicate that variance in between-group responses due to pharmacological treatments are important factors to consider in studying cardiovascular changes in these individuals.
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Purpose: The health benefits of a training program are largely influenced by the exercise dose and intensity. We sought to determine if during a training bout of continuous vs. interval exercise the workload needs to be reduced to maintain the prescribed target heart rate. Methods: Fourteen obese (31±4 kg·m) middle-age (57±8 y) individuals with metabolic syndrome, underwent two exercise training bouts matched by energy expenditure (i.e., 70±5 min of continuous exercise; CE or 45 min of interval exercise; HIIT). All subjects completed both trials in a randomized order. Heart rate (HR), power output (W), percent dehydration, intestinal and skin temperature (TINT and TSK), mean blood pressure (MAP), cardiac output (CO), stroke volume (SV) and blood lactate concentration (La) were measured at the initial and latter stages of each trial to assess time-dependent drift. Results: During the HIIT trial power output was lowered by 30±16 W to maintain the target HR while a 10±11 W reduction was needed in the CE trial (P<0.05). Energy expenditure, cardiac output and stroke volume declined with exercise time only in the HIIT trial (15%, 10% and 13%, respectively). During HIIT, percent dehydration, TINT and TSK increased more than during the CE trial (all P=0.001). MAP and La were higher in HIIT without time drift in any trial. Conclusion: Our findings suggests that while CE results in mild power output reductions to maintain target HR, the increasingly popular HIIT results in significant reductions in power output, energy expenditure and cardiac output (21%; 15% and 10%, respectively). HIIT based on target HR may result in lower than expected training adaptations due to workload adjustments to avoid HR drift.
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Our purpose in this study was to investigate efficient and sustainable combinations of exercise and diet-induced weight loss (DIET), in order to combat obesity in metabolic syndrome (MetS) patients. We examined the impact of aerobic interval training (AIT), followed by or concurrent to a DIET on MetS components. 36 MetS patients (54±9 years old; 33±4 BMI; 27 males and 9 females) underwent 16 weeks of AIT followed by another 16 weeks without exercise from the fall of 2013 to the spring of 2014. Participants were randomized to AIT without DIET (E CON, n=12), AIT followed by DIET (E-then-D, n=12) or AIT concurrent with DIET (E+D, n=12) groups. Body weight decreased below E CON similarly in the E-then-D and E+D groups (~5%). Training improved blood pressure and cardiorespiratory fitness (VO2peak) in all groups with no additional effect of concurrent weight loss. However, E+D improved insulin sensitivity (HOMA) and lowered plasma triglycerides and blood cholesterol below E CON and E-then-D (all P<0.05). Weight loss in E-then-D in the 16 weeks without exercise lowered HOMA to the E+D levels and maintained blood pressure at trained levels. Our data suggest that a new lifestyle combination consisting of aerobic interval training followed by weight loss diet is similar, or even more effective on improving metabolic syndrome factors than concurrent exercise plus diet. © Georg Thieme Verlag KG Stuttgart · New York.
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Background and Aims Exercise training can improve health of patients with metabolic syndrome (MetS). However, which MetS factors are most responsive to exercise training remains unclear. We studied the time-course of changes in MetS factors in response to training and detraining. Methods and Results Forty eight MetS patients (52±8.8 yrs old; 33±4 BMI) underwent 4 months (3 days/week) of supervised aerobic interval training (AIT) program. After 1 month of training, there were progressive increases in high density lipoprotein cholesterol (HDL-c) and reductions in waist circumference and blood pressure (12±3%, -3.9±0.4, and -12±1, respectively after 4 months; all P<0.05). However, fasting plasma concentration of triglycerides and glucose were not reduced by training. Insulin sensitivity (HOMA), cardiorespiratory fitness (VO2peak) and exercise maximal fat oxidation (FOMAX) also progressively improved with training (-17±5; 21±2 and 31±8%, respectively, after 4 months; all P<0.05). Vastus lateralis samples from seven subjects revealed that mitochondrial O2 flux was markedly increased with training (71±11%) due to increased mitochondrial content. After 1 month of detraining, the training-induced improvements in waist circumference and blood pressure were maintained. HDL-c and VO2peak returned to the values found after 1-2 months of training while HOMA and FOMAX returned to pre-training values. Conclusions The health related variables most responsive to aerobic interval training in MetS patients are waist circumference, blood pressure and the muscle and systemic adaptations to consume oxygen and fat. However, the latter reverse with detraining while blood pressure and waist circumference are persistent to one month of detraining.
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Purpose: The purpose of this study was to determine the magnitude of changes in cardiac output (Qc), stroke volume (SV), and arterial-mixed venous oxygen difference (a-vO2 diff) during submaximal exercise following a 20-wk endurance training program, with the primary focus on identifying differences in response by race, sex, and age. Methods: The participants in this study (N = 631) were healthy and previously sedentary men (N = 277) and women (N = 354) of varying age (17-65 yr) and race (blacks, N = 217; whites, N = 414) who had completed the HERITAGE Family Study protocol. After baseline measurements, participants trained on cycle ergometers 3 d x wk(-1) for a total of 60 exercise sessions starting at the HR associated with 55% of maximal oxygen uptake (VO2max) for 30 min/session and building to the HR associated with 75% of VO2max for 50 min/session, which was maintained during the last 6 wk. HR, Qc (CO2 rebreathing), and SV (Qc/HR) were determined in duplicate at 50 W and at 60% of VO2max on two different days both before and after training. Results: After training, there were significant decreases in HR and Qc, and significant increases in SV and a-vO2 diff at 50 W (except for no change in a-vO2 diff in black men). The changes in HR differed by sex and age, and the changes in SV, Qc, and a-vO2 diff differed by race. Qc decreased by 0.6 L x min(-1) at 50 W for the total sample, consistent with the decrease in VO2 at this power output. At 60% of VO2max HR decreased, and SV, Q, and a-VO2 diff increased. There were small differences in response by sex (HR and SV), race (HR), and age (HR and Qc). Conclusion: It is concluded that the cardiovascular systems of men and women, blacks and whites, and younger and older subjects are not limited in their ability to adapt to endurance training.