Effects of normoxic and hypoxic exercise regimens on cardiac, muscular, and cerebral hemodynamics suppressed by severe hypoxia in humans.

Hypoxic preconditioning prevents cerebrovascular/cardiovascular disorders by increasing resistance to acute ischemic stress, but severe hypoxic exposure disturbs vascular hemodynamics. This study compared how various exercise regimens with/without hypoxia affect hemodynamics and oxygenation in cardiac, muscle, and cerebral tissues during severe hypoxic exposure. Sixty sedentary males were randomly divided into five groups. Each group (n = 12) received one of five interventions: 1) normoxic (21% O(2)) resting control, 2) hypoxic (15% O(2)) resting control, 3) normoxic exercise (50% maximum work rate under 21% O(2); N-E group), 4) hypoxic-relative exercise (50% maximal heart rate reserve under 15% O(2); H-RE group), or 5) hypoxic-absolute exercise (50% maximum work rate under 15% O(2); H-AE group) for 30 min/day, 5 days/wk, for 4 wk. A recently developed noninvasive bioreactance device was used to measure cardiac hemodynamics, and near-infrared spectroscopy was used to assess perfusion and oxygenation in the vastus lateralis (VL)/gastrocnemius (GN) muscles and frontal cerebral lobe (FC). Our results demonstrated that the H-AE group had a larger improvement in aerobic capacity compared with the N-E group. Both H-RE and H-AE ameliorated the suppression of cardiac stroke volume and the GN hyperemic response (Delta total Hb/min) and reoxygenation rate by acute 12% O(2) exposure. Simultaneously, the two hypoxic interventions enhanced perfusion (Delta total Hb) and O(2) extraction [Delta deoxyHb] of the VL muscle during the 12% O(2) exercise. Although acute 12% O(2) exercise decreased oxygenation (Delta O(2)Hb) of the FC, none of the 4-wk interventions influenced the cerebral perfusion and oxygenation during normoxic/hypoxic exercise tests. Therefore, we conclude that moderate hypoxic exercise training improves cardiopulmonary fitness and increases resistance to disturbance of cardiac hemodynamics by severe hypoxia, concurrence with enhancing O(2) delivery/utilization in skeletal muscles but not cerebral tissues.

[1]  G. Neufeld,et al.  Interleukin 6 Induces the Expression of Vascular Endothelial Growth Factor (*) , 1996, The Journal of Biological Chemistry.

[2]  Thomas J Barstow,et al.  Muscle capillary blood flow kinetics estimated from pulmonary O2 uptake and near-infrared spectroscopy. , 2005, Journal of applied physiology.

[3]  B. Levine,et al.  Increased serum erythropoietin but not red cell production after 4 wk of intermittent hypobaric hypoxia (4,000-5,500 m). , 2006, Journal of applied physiology.

[4]  P. Lévy,et al.  Acute intermittent hypoxia improves rat myocardium tolerance to ischemia. , 2005, Journal of applied physiology.

[5]  R. Pozos,et al.  Skin blood flow affects in vivo near-infrared spectroscopy measurements in human skeletal muscle. , 2005, The Japanese journal of physiology.

[6]  M. Wong,et al.  Chronic intermittent hypoxia modulates eosinophil- and neutrophil-platelet aggregation and inflammatory cytokine secretion caused by strenuous exercise in men. , 2007, Journal of applied physiology.

[7]  R. Lehmann,et al.  Hypoxia-Inducible Factor-1 Is Central to Cardioprotection: A New Paradigm for Ischemic Preconditioning , 2008, Circulation.

[8]  H B Nielsen,et al.  Cerebral desaturation during exercise reversed by O2 supplementation. , 1999, American journal of physiology. Heart and circulatory physiology.

[9]  D. Ward,et al.  Accuracy of a Cerebral Oximeter in Healthy Volunteers under Conditions of Isocapnic Hypoxia , 1998, Anesthesiology.

[10]  W. Colier,et al.  Performance of near-infrared spectroscopy in measuring local O(2) consumption and blood flow in skeletal muscle. , 2001, Journal of applied physiology.

[11]  P. Thompson,et al.  ACSM's Guidelines for Exercise Testing and Prescription , 1995 .

[12]  Albert Gjedde,et al.  Capillary-Oxygenation-Level-Dependent Near-Infrared Spectrometry in Frontal Lobe of Humans , 2007, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[13]  Lars Nybo,et al.  Inadequate Cerebral Oxygen Delivery and Central Fatigue during Strenuous Exercise , 2007, Exercise and sport sciences reviews.

[14]  B. Berglund High-Altitude Training , 1992, Sports medicine.

[15]  S. Bertuglia Intermittent hypoxia modulates nitric oxide-dependent vasodilation and capillary perfusion during ischemia-reperfusion-induced damage. , 2008, American journal of physiology. Heart and circulatory physiology.

[16]  R. Goldsmith,et al.  Exercise and autonomic function in health and cardiovascular disease. , 2001, Cardiology clinics.

[17]  P. Lévy,et al.  Intermittent hypoxia-induced delayed cardioprotection is mediated by PKC and triggered by p38 MAP kinase and Erk1/2. , 2007, Journal of molecular and cellular cardiology.

[18]  M. Matsuzaki,et al.  Ischemic Preconditioning Attenuates Cardiac Sympathetic Nerve Injury via ATP-Sensitive Potassium Channels During Myocardial Ischemia , 2001, Circulation.

[19]  Takuya Osada,et al.  Brain and central haemodynamics and oxygenation during maximal exercise in humans , 2004, The Journal of physiology.

[20]  M. Burtscher,et al.  Intermittent hypoxia increases exercise tolerance in elderly men with and without coronary artery disease. , 2004, International journal of cardiology.

[21]  M. Wong,et al.  Effects of moderate and severe intermittent hypoxia on vascular endothelial function and haemodynamic control in sedentary men , 2007, European Journal of Applied Physiology.

[22]  S. Kuno,et al.  Comparative analysis of NMR and NIRS measurements of intracellular PO2 in human skeletal muscle. , 1999, The American journal of physiology.

[23]  Olaf B. Paulson,et al.  Unchanged Cerebral Blood Flow and Oxidative Metabolism after Acclimatization to High Altitude , 2002, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[24]  J. Wang,et al.  Effects of Exercise Training and Deconditioning on Platelet Aggregation Induced by Alternating Shear Stress in Men , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[25]  M. Wong,et al.  Systemic hypoxia affects cardiac autonomic activity and vascular hemodynamic control modulated by physical stimulation , 2009, European Journal of Applied Physiology.

[26]  M. Essop Cardiac metabolic adaptations in response to chronic hypoxia , 2007, The Journal of physiology.

[27]  D. Lübbers,et al.  Oxygen transport to tissue--V , 1984 .

[28]  T D Noakes,et al.  Evidence that a central governor regulates exercise performance during acute hypoxia and hyperoxia. , 2001, The Journal of experimental biology.

[29]  P. Squara,et al.  Noninvasive cardiac output monitoring (NICOM): a clinical validation , 2007, Intensive Care Medicine.

[30]  S. Arridge,et al.  Experimentally measured optical pathlengths for the adult head, calf and forearm and the head of the newborn infant as a function of inter optode spacing. , 1992, Advances in experimental medicine and biology.

[31]  M. Cheng,et al.  Vitamin E Suppresses Enhancement of Factor VIII-Dependent Thrombin Generation by Systemic Hypoxia , 2009, Stroke.

[32]  H. Hoppeler,et al.  Exercise training in normobaric hypoxia in endurance runners. III. Muscular adjustments of selected gene transcripts. , 2006, Journal of applied physiology.

[33]  D. Burkhoff,et al.  Cardiac output and cardiopulmonary responses to exercise in heart failure: application of a new bio-reactance device. , 2007, Journal of cardiac failure.

[34]  F. Kolář,et al.  Adaptation to high altitude hypoxia protects the rat heart against ischemia-induced arrhythmias. Involvement of mitochondrial K(ATP) channel. , 1999, Journal of molecular and cellular cardiology.

[35]  H. Hoppeler,et al.  Exercise training in normobaric hypoxia in endurance runners. II. Improvement of mitochondrial properties in skeletal muscle. , 2006, Journal of applied physiology.

[36]  J. Gidday,et al.  Hypoxic Preconditioning-Induced Cerebral Ischemic Tolerance: Role of Microvascular Sphingosine Kinase 2 , 2009, Stroke.

[37]  H. Hoppeler,et al.  Exercise training in normobaric hypoxia in endurance runners. I. Improvement in aerobic performance capacity. , 2006, Journal of applied physiology.

[38]  Christopher J. Schofield,et al.  Oxygen sensing by HIF hydroxylases , 2004, Nature Reviews Molecular Cell Biology.

[39]  J A Neubauer,et al.  Physiological and Genomic Consequences of Intermittent Hypoxia Invited Review: Physiological and pathophysiological responses to intermittent hypoxia , 2001 .

[40]  Andrew C. Dimmen,et al.  Effects of acute hypoxia on cerebral and muscle oxygenation during incremental exercise. , 2007, Journal of applied physiology.

[41]  D. Delpy,et al.  Optical pathlength measurements on adult head, calf and forearm and the head of the newborn infant using phase resolved optical spectroscopy. , 1995, Physics in medicine and biology.

[42]  D. Nieman Frontal and motor cortex oxygenation during maximal exercise in normoxia and hypoxia , 2010 .

[43]  Marco Ferrari,et al.  Muscle oxygenation and pulmonary gas exchange kinetics during cycling exercise on-transitions in humans. , 2003, Journal of applied physiology.

[44]  R. Boushel,et al.  Association between regional quadriceps oxygenation and blood oxygen saturation during normoxic one-legged dynamic knee extension , 2005, European Journal of Applied Physiology.

[45]  A. Subudhi,et al.  Cerebrovascular responses to incremental exercise during hypobaric hypoxia: effect of oxygenation on maximal performance. , 2008, American journal of physiology. Heart and circulatory physiology.

[46]  Daniel Burkhoff,et al.  Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance. , 2007, American journal of physiology. Heart and circulatory physiology.