Metabolic demands of a simulated smoke-diving drill.

The main goal of this study was to update the Finnish smoke-diving drill (FSDD) and to measure the physical strain of and recovery from the drill. Furthermore, the aim was to compare the physical strain of contract and professional firefighters and effect of floor materials. The associations between aerobic capacity and physical strain were also studied. The updates made included an added hose pull task and updating the equipment used. Heart rate (HR), oxygen consumption (V̇O2), and blood lactate concentration ([La-]) of 32 professional and 5 contract firefighters were measured before, during, and 10 and 30 min after the updated drill. The mean HR during the drill was 78% and V̇O2 59% of maximum. HR and [La-] had not recovered to baseline levels after 30-minute recovery period. Physical strain was higher among contract firefighters and [La-] accumulation on rough floor surfaces. Better aerobic capacity was associated with reduced physical strain.

The purpose of this study was to update the Finnish smoke-diving drill. This paper describes the process of updating the drill, and the experimental measurements regarding the metabolic demands of the updated drill. The updates made included adding a hose pull task and updating the equipment used during the drill.

Efficacy of essential oil from ginger (Zingiber officinale) for anesthesia and transport sedation of pacu (Piaractus mesopotamicus).

This study evaluated the anesthetic and sedative effects of the essential oil of Zingiber officinale (EOZO) on juvenile pacu (Piaractus mesopotamicus). Experiment 1 evaluated concentrations of 0, 50, 100, 200 and 400 mg L-1 EOZO for times of induction and recovery from anesthesia. Furthermore, hematological responses and residual components of EOZO in plasma were determined immediately after anesthesia. Experiment 2 evaluated the effect of 0, 10, 20 and 30 mg L-1 EOZO on water quality, blood variables and residual components of EOZO in plasma and tissues (muscle and liver) immediately after 2 h of transport. Survival was 100%. The three main compounds of EOZO [zingiberene (32.27%), ß-sesquiphellandrene (18.42%) and ß-bisabolene (13.93%)] were observed in animal plasma and tissues (muscle and liver) after anesthesia and transport, demonstrating a direct linear effect among the evaluated concentrations. The concentration of 200 mg L-1 EOZO promoted surgical anesthesia of pacu and prevented an increase in monocyte and neutrophil levels, yet did not alter other hematological parameters. The use of 30 mg L-1 EOZO has a sedative effect on juvenile pacu, thereby reducing oxygen consumption during transport. Furthermore, the use of 30 mg L-1 EOZO in transport water prevented an increase in hemoglobin and hematocrit, with minimal influences on other blood variables.

SPECTRA Phase 2b Study: Impact of Sotatercept on Exercise Tolerance and Right Ventricular Function in Pulmonary Arterial Hypertension.

BACKGROUND: This study aims to assess the impact of sotatercept on exercise tolerance, exercise capacity, and right ventricular function in pulmonary arterial hypertension. METHODS: SPECTRA (Sotatercept Phase 2 Exploratory Clinical Trial in PAH) was a phase 2a, single-arm, open-label, multicenter exploratory study that evaluated the effects of sotatercept by invasive cardiopulmonary exercise testing in participants with pulmonary arterial hypertension and World Health Organization functional class III on combination background therapy. The primary end point was the change in peak oxygen uptake from baseline to week 24. Cardiac magnetic resonance imaging was performed to assess right ventricular function. RESULTS: Among the 21 participants completing 24 weeks of treatment, there was a significant improvement from baseline in peak oxygen uptake, with a mean change of 102.74 mL/min ([95% CIs, 27.72-177.76]; P=0.0097). Sotatercept demonstrated improvements in secondary end points, including resting and peak exercise hemodynamics, and 6-minute walk distance versus baseline measures. Cardiac magnetic resonance imaging showed improvements from baseline at week 24 in right ventricular function. CONCLUSIONS: The clinical efficacy and safety of sotatercept demonstrated in the SPECTRA study emphasize the potential of this therapy as a new treatment option for patients with pulmonary arterial hypertension. Improvements in right ventricular structure and function underscore the potential for sotatercept as a disease-modifying agent with reverse-remodeling capabilities. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03738150.

Correlations of Aerobic Capacity with External and Internal Load of Young Football Players during Small-Sided Games.

Aerobic capacity plays a crucial role in football performance, making it a focal point in training processes. Small-sided games (SSGs) are widely used in football training, but the relationship between aerobic capacity and running performance during SSGs remains unclear. The aim of this study was to investigate possible correlations between maximum oxygen uptake (VO2max) and running performance in youth football players in SSGs (4:4, 3:3, 2:2, 1:1) with three different pitch sizes per player (150, 100, 75 m2/player). Sixteen male U15 football players participated in the study. Players underwent the Yo-Yo intermittent recovery test level 1, and their VO2max was estimated based on their performance. Subsequently, players participated in SSGs wearing GPS devices to measure internal and external load. Pearson or Spearman correlation was applied for statistical analysis depending on the normal distribution of the data. The results reveal that, for 4:4 and 3:3 relationships, larger pitches led to a greater impact of aerobic capacity (total distance (TD): 4:4, 150 m2/pl, r = 0.715, p = 0.002; 100 m2/pl, r = 0.656, p = 0.006; 75 m2/pl, r = 0.586, p = 0.017). In the 2:2 relationship, the opposite was observed, with more correlations appearing on smaller pitches (TD: 2:2, 100 m2/pl, r = 0.581, p = 0.018; 75 m2/pl, r = 0.747, p < 0.001). In the 1:1 relationship, correlations with VO2max, total distance, and speed were observed only on the larger pitch. In conclusion, the aerobic capacity of young football players can influence running performance indicators in SSGs. Therefore, aerobic capacity could serve as a criterion for team composition, making SSGs more competitive. Additionally, the variation in correlations in the 2:2 relationship and their limited presence in the 1:1 relationship may be attributed to technical-tactical factors, such as increased ball contacts and one-on-one situations typically occurring in smaller setups.

Near-InfraRed Spectroscopy Provides a Reproducible Estimate of Muscle Aerobic Capacity, but Not Whole-Body Aerobic Power.

Near-infrared spectroscopy (NIRS) during repeated limb occlusions is a noninvasive tool for assessing muscle oxidative capacity. However, the method's reliability and validity remain under investigation. This study aimed to determine the reliability of the NIRS-derived mitochondrial power of the musculus vastus lateralis and its correlation with whole-body (cycling) aerobic power (V̇O2 peak). Eleven healthy active men (28 ± 10 y) twice (2 days apart) underwent repeated arterial occlusions to induce changes in muscle oxygen delivery after 15 s of electrical muscle stimulation. The muscle oxygen consumption (mV̇O2) recovery time and rate (k) constants were calculated from the NIRS O2Hb signal. We assessed the reliability (coefficient of variation and intraclass coefficient of correlation [ICC]) and equivalency (t-test) between visits. The results showed high reproducibility for the mV̇O2 recovery time constant (ICC = 0.859) and moderate reproducibility for the k value (ICC = 0.674), with no significant differences between visits (p > 0.05). NIRS-derived k did not correlate with the V̇O2 peak relative to body mass (r = 0.441, p = 0.17) or the absolute V̇O2 peak (r = 0.366, p = 0.26). In conclusion, NIRS provides a reproducible estimate of muscle mitochondrial power, which, however, was not correlated with whole-body aerobic capacity in the current study, suggesting that even if somewhat overlapping, not the same set of factors underpin these distinct indices of aerobic capacity at the different (peripheral and whole-body systemic) levels.

Mitochondrial respiration atlas reveals differential changes in mitochondrial function across sex and age.

Organ function declines with age, and large-scale transcriptomic analyses have highlighted differential aging trajectories across tissues. The mechanisms underlying shared and organ-selective functional changes across the lifespan, however, still remains poorly understood. Given the central role of mitochondria in powering cellular processes needed to maintain tissue health, we therefore undertook a systematic assessment of respiratory activity across 33 different tissues in young (2.5 months) and old (20 months) mice of both sexes. Our high-resolution mitochondrial respiration atlas reveals: 1) within any group of mice, mitochondrial activity varies widely across tissues, with the highest values consistently seen in heart, brown fat, and kidney; 2) biological sex is a significant but minor contributor to mitochondrial respiration, and its contributions are tissue-specific, with major differences seen in the pancreas, stomach, and white adipose tissue; 3) age is a dominant factor affecting mitochondrial activity, especially across different fat depots and skeletal muscle groups, and most brain regions; 4) age-effects can be sex- and tissue-specific, with some of the largest effects seen in pancreas, heart, adipose tissue, and skeletal muscle; and 5) while aging alters the functional trajectories of mitochondria in a majority of tissues, some are remarkably resilient to age-induced changes. Altogether, our data provide the most comprehensive compendium of mitochondrial respiration and illuminate functional signatures of aging across diverse tissues and organ systems.

The troglitazone derivative EP13 disrupts energy metabolism through respiratory chain complex I inhibition in breast cancer cells and potentiates the antiproliferative effect of glycolysis inhibitntriors.

BACKGROUND: The metabolism of cancer cells generally differs from that of normal cells. Indeed, most cancer cells have a high rate of glycolysis, even at normal oxygen concentrations. These metabolic properties can potentially be exploited for therapeutic intervention. In this context, we have developed troglitazone derivatives to treat hormone-sensitive and triple-negative breast cancers, which currently lack therapeutic targets, have an aggressive phenotype, and often have a worse prognosis than other subtypes. Here, we studied the metabolic impact of the EP13 compound, a desulfured derivative of Δ2-troglitazone that we synthetized and is more potent than its parent compounds. METHODS: EP13 was tested on two triple-negative breast cancer cell lines, MDA-MB-231 and Hs578T, and on the luminal cell line MCF-7. The oxygen consumption rate (OCR) of the treated cell lines, Hs578T mammospheres and isolated mitochondria was measured using the XFe24 Seahorse analyser. ROS production was quantified using the MitoSOX fluorescent probe. Glycolytic activity was evaluated through measurement of the extracellular acidification rate (ECAR), glucose consumption and lactate production in extracellular medium. The synergistic effect of EP13 with glycolysis inhibitors (oxamate and 2-deoxyglucose) on cell cytotoxicity was established using the Chou-Talalay method. RESULTS: After exposure to EP13, we observed a decrease in the mitochondrial oxygen consumption rate in MCF7, MDA-MB-231 and Hs578T cells. EP13 also modified the maximal OCR of Hs578T spheroids. EP13 reduced the OCR through inhibition of respiratory chain complex I. After 24 h, ATP levels in EP13-treated cells were not altered compared with those in untreated cells, suggesting compensation by glycolysis activity, as shown by the increase in ECAR, the glucose consumption and lactate production. Finally, we performed co-treatments with EP13 and glycolysis inhibitors (oxamate and 2-DG) and observed that EP13 potentiated their cytotoxic effects. CONCLUSION: This study demonstrates that EP13 inhibits OXPHOS in breast cancer cells and potentiates the effect of glycolysis inhibitors.

Determination of gas flux and animal performance test duration of growing cattle in confined conditions.

Data from three experiments was analyzed to determine the number of visits and days to assess gas flux (CH4, CO2, and O2), dry matter intake (DMI), and average daily gain (ADG) from growing animals under confined conditions. In experiment 1, 213 animals (461 ±â€…91 kg initial body weight [BW]) were fed a backgrounding diet and evaluated for 60 d. In experiment 2, 169 steers (488 ±â€…37 kg initial BW) were fed a finishing diet and assessed for 70 d. In experiment 3, 64 steers (514 ±â€…42 kg initial BW) were fed a finishing diet and evaluated for 80 d. In each experiment, animals were placed in one pen with one Greenfeed and five SmartFeeds to collect gas flux and feed intake simultaneously. Gas flux was analyzed using data from 161 animals from the three experiments with 100 visits for 2 or more min or 3 or more min. Also, metabolic heat production (MHP) was estimated using the individual gas flux. Daily DMI was calculated as the daily feed intake corrected by the dry matter concentration. ADG was computed as the slope of the regression of the shrunk BW (96% BW) throughout each of the experimental periods. The mean gas flux and MHP were estimated for increasing or decreasing 5-visit intervals starting with the first or the last 5 visits and increasing or decreasing until the full 100-visit dataset was utilized, respectively. Intervals of DMI were estimated for increasing or decreasing 5-d intervals starting with the first or the last 5 d and increasing or decreasing until the end of the experimental period, respectively. Intervals of ADG were estimated for increasing or decreasing measurement period intervals until the end of the experimental period, respectively. Pearson and Spearman correlations were computed between the maximum visits or days and each shortened visit or day interval. The minimum number of visits and days was determined when correlations with the total visits were greater than 0.95. The results indicated that the minimum number of visits needed to quantify CO2, O2, and MHP accurately was 40, while CH4 was 60. A visitation length of 2 min or more or 3 min or more did not modify the gas flux determination. Thus, based on the average daily visitation in these experiments, gas flux data could be collected for 25 d. Additionally, the required days to determine DMI was 30, while ADG could not be assessed in a shorter than 60-d period.

Net Heart Rate for Estimating Oxygen Consumption in Active Adults.

The aim of this study was to verify the accuracy of predicting oxygen consumption (O2) in predominantly aerobic activities based on net heart rate (netHR), sex, and body mass index (BMI) in active adults. NetHR is the value of the difference between the resting HR (HRrest) and the average HR value obtained during a given session or period of physical activity. These activities must be continuous, submaximal, and of a stabilized intensity. The magnitude of the netHR depends mainly on the intensity of the exercise. The HR is measured in beats per minute (bpm). A total of 156 participants, 52 women and 104 men, between the ages of 18 and 81, had their netHR and net oxygen intake (netVO2) assessed. There were 79 participants in group 1 (prediction sample) (52 males and 27 females). There were 77 people in group 2 (validation sample) (52 males and 25 females). The results of the multiple linear regression showed that netVO2 (R2 = 85.2%, SEE = 3.38) could be significantly predicted by sex (p < 0.001), netHR (p < 0.001), and BMI (p < 0.001). The Bland-Altman plots satisfied the agreement requirements, and the comparison of the measured and estimated netVO2 revealed non-significant differences with a trivial effect size. We calculated the formula NetVO2 (mL/(kg·min)) = 16 + 3.67 (sex) + 0.27 (netHR) - 0.57 (BMI) to predict netVO2, where netVO2 is the amount of oxygen uptake (mL/(kg·min)) above the resting value, netHR is the heart rate (beats per minute) above the resting value measured during exercise, sex is equal to zero for women and one for men, and BMI is the body mass index. In addition, based on the knowledge of VO2, it was possible to estimate the energy expenditure from a particular training session, and to determine or prescribe the exercise intensity in MET (metabolic equivalent of task).

Cardiopulmonary exercise testing in clinical practice: Principles, applications, and basic interpretation.

Cardiopulmonary exercise testing (CPET) provides a noninvasive and integrated assessment of the response of the respiratory, cardiovascular, and musculoskeletal systems to exercise. This information improves the diagnosis, risk stratification, and therapeutic management of several clinical conditions. Additionally, CPET is the gold standard test for cardiorespiratory fitness quantification and exercise prescription, both in patients with cardiopulmonary disease undergoing cardiac or pulmonary rehabilitation programs and in healthy individuals, such as high-level athletes. In this setting, the relevance of practical knowledge about this exam is useful and relevant to several medical specialties other than cardiology. However, despite its multiple established advantages, CPET remains underused. This article aims to increase awareness of the value of CPET in clinical practice and to inform clinicians about its main indications, applications, and basic interpretation.

Scanning electrochemical microscopy for determining oxygen consumption rates of cells in hydrogel fibers fabricated using an extrusion 3D bioprinter.

Three-dimensional (3D)-cultured cells have attracted the attention of researchers in tissue engineering- and drug screening-related fields. Among them, 3D cellular fibers have attracted significant attention because they can be stacked to prepare more complex tissues and organs. Cellular fibers are widely fabricated using extrusion 3D bioprinters. For these applications, it is necessary to evaluate cellular activities, such as the oxygen consumption rate (OCR), which is one of the major metabolic activities. We previously reported the use of scanning electrochemical microscopy (SECM) to evaluate the OCRs of cell spheroids. However, the SECM approach has not yet been applied to hydrogel fibers prepared using the bioprinters. To the best of our knowledge, this is the first study to evaluate the OCR of cellular fibers printed by extrusion 3D bioprinters. First, the diffusion theory was discussed to address this issue. Next, diffusion models were simulated to compare realistic models with this theory. Finally, the OCRs of MCF-7 cells in the printed hydrogel fibers were evaluated as a proof of concept. Our proposed approach could potentially be used to evaluate the OCRs of tissue-engineered fibers for organ transplantation and drug screening using in-vitro models.

Seasonal Variation and the Effect of the Transition Period on Physical Fitness Parameters in Youth Female Soccer Players.

This study examined seasonal variation and the effect of the transition period on physical fitness parameters in female youth soccer players. Twenty-four players (13-17 years old) were assessed through field and laboratory testing. They completed laboratory testing three times: (1) at the beginning of the season (post-preseason), (2) at the end of the regular season (postseason), and (3) following the transition period (preseason). Field testing was conducted post-preseason and postseason. Results indicated that weight and body fat significantly increased from post-preseason to postseason and following the transition period. A paired samples T-test revealed that the players performed significantly better in the vertical jump and 30 m sprint test (all p < 0.01) postseason compared to post-preseason. Also, it was indicated that torque production for the right quadriceps, left quadriceps, and right hamstring (all p < 0.01) was significantly reduced after the transition period by 10%, 11.8%, and 10.5%, respectively. Cardiorespiratory measurements demonstrated that performance on an incremental cardiopulmonary treadmill test, maximal oxygen consumption, velocity at the first ventilatory threshold, velocity at the second ventilatory threshold, and velocity at maximal oxygen consumption (all p < 0.01) were significantly reduced postseason and following the transition period. Based on the results, coaches and trainers should primarily focus on maintaining the aerobic capacity of the players during the season, as it has been indicated to be reduced from the beginning to the end of the competitive period (VO2max reduced by 3.3%). In addition, they should focus on maintaining lower body strength and aerobic capacity during the transition period.

Evaluation of renal tubular function by multiparametric functional MRI in early diabetes.

Purpose To evaluate the tubular function in an alloxan-induced type 1 diabetes mellitus (DM) rabbit model measured by renal oxygenation (R2*), oxygen extraction fraction (OEF), and renal blood flow (RBF) using blood oxygenation level dependent, asymmetric spin echo, and arterial spin labeling MRI. Methods Twenty-six rabbits were randomized into the 3-day DM group (n = 13) and the 7-day DM group (n = 13). We performed pairs of multiparametric MRIs (before and after furosemide injection) at baseline and 3/7 days post-DM, and scored pathological kidney injury. We performed statistical analyses using non-parametric, chi-square, and Spearman correlation tests. Results At baseline, medullary R2* significantly decreased by 24.97% and 16.74% in the outer and inner stripes of the outer medulla (OS and IS, p = 0.006 and 0.003, respectively) after furosemide administration. While the corresponding OEF decreased by 15.91% for OS and 16.67% for IS (both p = 0.003), and no significant change in medullary RBF was observed (p > 0.05). In the 3-day DM group, the decrease of medullary R2* and OEF post-furosemide became unremarkable, suggesting tubular dysfunction. We noticed similar changes in the 7-day DM group. Correlation analysis showed pathological tubular injury score significantly correlated with medullary ∆R2* (post-furosemide - pre-furosemide difference, r = 0.82 for OS and 0.82 for IS) and ∆OEF (r = 0.82 for OS and 0.82 for IS) (p < 0.001, respectively). Conclusion: The combination of medullary OEF and R2* in response to furosemide could detect renal tubular dysfunction in early DM.

A practical and robust method to evaluate metabolic fluxes in primary pancreatic islets.

OBJECTIVE: Evaluation of mitochondrial oxygen consumption and ATP production is important to investigate pancreatic islet pathophysiology. Most studies use cell lines due to difficulties in measuring primary islet respiration, which requires specific equipment and consumables, is expensive and poorly reproducible. Our aim was to establish a practical method to assess primary islet metabolic fluxes using standard commercial consumables. METHODS: Pancreatic islets were isolated from mice/rats, dispersed with trypsin, and adhered to pre-coated standard Seahorse or Resipher microplates. Oxygen consumption was evaluated using a Seahorse Extracellular Flux Analyzer or a Resipher Real-time Cell Analyzer. RESULTS: We provide a detailed protocol with all steps to optimize islet isolation with high yield and functionality. Our method requires a few islets per replicate; both rat and mouse islets present robust basal respiration and proper response to mitochondrial modulators and glucose. The technique was validated by other functional assays, which show these cells present conserved calcium influx and insulin secretion in response to glucose. We also show that our dispersed islets maintain robust basal respiration levels, in addition to maintaining up to 89% viability after five days in dispersed cultures. Furthermore, OCRs can be measured in Seahorse analyzers and in other plate respirometry systems, using standard materials. CONCLUSIONS: Overall, we established a practical and robust method to assess islet metabolic fluxes and oxidative phosphorylation, a valuable tool to uncover basic ß-cell metabolic mechanisms as well as for translational investigations, such as pharmacological candidate discovery and islet transplantation protocols.

Hypoxic adaptation of mitochondria and its impact on tumor cell function.

Mitochondria are the major sink for oxygen in the cell, consuming it during ATP production. Therefore, when environmental oxygen levels drop in the tumor, significant adaptation is required. Mitochondrial activity is also a major producer of biosynthetic precursors and a regulator of cellular oxidative and reductive balance. Because of the complex biochemistry, mitochondrial adaptation to hypoxia occurs through multiple mechanisms and has significant impact on other cellular processes such as macromolecule synthesis and gene regulation. In tumor hypoxia, mitochondria shift their location in the cell and accelerate the fission and quality control pathways. Hypoxic mitochondria also undergo significant changes to fundamental metabolic pathways of carbon metabolism and electron transport. These metabolic changes further impact the nuclear epigenome because mitochondrial metabolites are used as enzymatic substrates for modifying chromatin. This coordinated response delivers physiological flexibility and increased tumor cell robustness during the environmental stress of low oxygen.

Adaptation to Living at High Altitude in Patients with COPD. Comparative Study of Exercise Capacity and Ventilatory Variables between Patients Residing at High and Low Altitudes in the Andes.

González-García, Mauricio and Luis Ernesto Téllez. Adaptation to living at high altitude in patients with COPD. Comparative study of exercise capacity and ventilatory variables between patients residing at high and low altitudes in the Andes. High Alt Med Biol. 00:000-000, 2024. Introduction: Although some variables related to oxygen transport and utilization such as ventilation, pulmonary vascular responses to hypoxia, heart rate (HR), cardiac output, hemoglobin (Hb), and oxygen saturation (SpO2) are used to compare adaptation to altitude between populations, peak oxygen consumption (VO2) constitutes an integrative measure of total oxygen transport that may reflect successful adaptation to altitude. We designed this study to make a direct comparison of VO2 in a cardiopulmonary exercise test (CPET) between chronic obstructive pulmonary disease (COPD) patients residing at high altitude (Bogotá, Colombia: 2,640 m) (COPD-HA) and those living at low altitude (Bucaramanga, Colombia: 959 m) (COPD-LA). Methods: All patients performed a CPET with measurements of VO2, minute ventilation (VE), HR, oxygen pulse (VO2/HR), ventilatory equivalents (VE/VCO2), and SpO2. Unpaired T-test or Mann-Whitney U test were used for comparisons between COPD-HA and COPD-LA. Results: We included 71 patients with COPD, 53 COPD-HA, and 18 COPD-LA. There were no differences between groups in age, sex, or forced expiratory volume in 1 second. The means ± SD of Hb, g/dl was slightly higher in COPD-HA (15.9 ± 1.9 vs. 14.7 ± 1.8, p = 0.048), without differences in VO2, % pred (71.6 ± 17.9 vs. 69.0 ± 17.0, p = 0.584), VO2/HR, % pred (92.1 ± 22.0 vs. 89.7 ± 19.8, p = 0.733) or VE/MVV, % (75.5 ± 14.1 vs. 76.5 ± 14.3, p = 0.790) at peak exercise between groups. Median (IQR) of VE/VCO2 nadir [38.0 (37.0-42.0) vs. 32.5 (31.0-39.0), p = 0.005] was significantly higher, and SpO2, % at rest [88.0 (86.0-91.0) vs. 95.0 (94.0-96.0), p < 0.001] and at peak exercise [84.0 (77.0-90.0) vs. 93.0 (92.0-95.0), p < 0.001] were significantly lower in COPD-HA. Conclusions: Despite higher desaturation at rest and during exercise in COPD-HA, there were no differences in VO2 peak between COPD-HA and COPD-LA, suggesting a potential altitude adaptation in those patients chronically exposed to hypoxia.

Changes in rate-pressure product associated with pregnancy.

BACKGROUND: In nonpregnant individuals, the rate-pressure product, the product of heart rate and systolic blood pressure, is used as a noninvasive surrogate of myocardial O2 consumption during cardiac stress testing. Pregnancy is considered a physiological cardiovascular stress test. Evidence describing the impact of pregnancy on myocardial O2 demand, as assessed by the rate-pressure product, is limited. OBJECTIVE: This study aimed to describe changes in the rate-pressure product for each pregnancy trimester, during labor and delivery, and the postpartum period among low-risk pregnancies. STUDY DESIGN: This was a retrospective cohort study that assessed uncomplicated pregnancies delivered vaginally at term. We collected rate-pressure product (heart rate × systolic blood pressure) values preconception, during pregnancy for each trimester (at ≤13 weeks + 6/7 days, at 14 weeks + 0/7 days through 27 weeks + 6/7 days, and at ≥28 weeks + 0/7 days), during the labor and delivery encounter (hospital admission until complete cervical dilation, complete cervical dilation until placental delivery, and after placental delivery until hospital discharge), and during the outpatient postpartum visit at 2 to 6 weeks after delivery. We calculated the percentage change at each time point from the preconception rate-pressure product (delta rate-pressure product). We used a mixed-linear model to analyze differences in the mean delta rate-pressure product over time and the influence of prepregnancy age, prepregnancy body mass index, and neuraxial anesthesia status during labor and delivery on these estimates. RESULTS: Our cohort comprised 316 patients. The mean rate-pressure product increased significantly from preconception starting at the third trimester of pregnancy and during labor and delivery (P≤.05). The mean delta rate-pressure product peaked at 12% and 38% in the third trimester and during labor and delivery, respectively. Prepregnancy body mass index was inversely correlated with the mean delta rate-pressure product changes (estimate, -0.308; 95% confidence interval, -0.536 to -0.80; P=.008). In contrast, neither the prepregnancy age, nor neuraxial anesthesia status during labor had a significant influence on this parameter. CONCLUSION: This study validates the transient but significant increase in the rate-pressure product, a clinical estimate of myocardial O2 demand, during uncomplicated pregnancies delivered vaginally at term. Pregnant individuals with lower prepregnancy body mass index experienced a sharper increase in this parameter. Patients who receive neuraxial anesthesia during labor and delivery experience similar changes in the rate-pressure product as those who did not.

Oxygen uptake during the last bouts of exercise incorporated into high-intensity intermittent cross-exercise exceeds the V˙ O2max of the same exercise mode.

Oxygen uptake (V˙ O2) was measured during a non-exhaustive high-intensity intermittent cross-exercise (HIICE) protocol consisting of four alternating bouts of 20 â€‹s running (R) and three bouts of bicycle exercise (BE) at ∼160% and ∼170% maximal oxygen uptake (V˙ O2max), respectively, with 10 â€‹s between-bout rests (sequence R-BE-R-BE-R-BE-R). The V˙ O2 during the last BE ([52.2 â€‹± â€‹5.0] mL·kg-1·min-1) was significantly higher than the V˙ O2max of the BE ([48.0 â€‹± â€‹5.4] mL·kg-1·min-1, n â€‹= â€‹30) and similar to that of running. For clarifying the underlying mechanisms, a corresponding HIICE-protocol with BE and arm cranking ergometer exercise (AC) was used (sequence AC-AC-BE-AC-BE-AC-AC-BE). In some experiments, thigh blood flow was occluded by a cuff around the upper thigh. Without occlusion, the V˙ O2 during the AC ([39.2 â€‹± â€‹7.1] mL·kg-1·min-1 [6th bout]) was significantly higher than the V˙ O2max of AC ([30.2 â€‹± â€‹4.4] mL·kg-1·min-1, n â€‹= â€‹7). With occlusion, the corresponding V˙ O2 ([29.8 â€‹± â€‹3.9] mL·kg-1·min-1) was reduced to that of the V˙ O2max of AC and significantly less than the V˙ O2 without occlusion. These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise, probably because it is a summation of the V˙ O2 for the ongoing exercise plus excess post-oxygen consumption (EPOC) produced by the previous exercise with a higher V˙ O2max.

Determinants of Impaired Peak Oxygen Uptake in Breast Cancer Survivors: JACC: CardioOncology Primer.

•Exercise intolerance is common among breast cancer survivors.•Exercise intolerance in breast cancer survivors is related to cardiac, vascular, and skeletal muscle impairments.•Holistic rehabilitation or pharmacological therapies are needed to address these impairments.