Blood Lactate Levels Research Articles

Does Transcranial Direct Current Stimulation reduce central and peripheral muscle fatigue in recreational runners? A triple-blind, sham-controlled, randomized, crossover clinical study

BackgroundRunners seek health benefits and performance improvement. However, fatigue might be considered a limiting factor. Transcranial Direct Current Stimulation (tDCS) has been investigated to improve performance and reduce fatigue in athletes. While some studies showing that tDCS may improve a variety of physical measures, other studies failed to show any benefit. ObjectiveTo evaluate the acute effects of tDCS on central and peripheral fatigue compared to a sham intervention in recreational runners. MethodsThis is a triple-blind, controlled, crossover study of 30 recreational runners who were randomized to receive one of the two interventions, anodal or sham tDCS, after the fatigue protocol. The interventions were applied to the quadriceps muscle hotspot for 20 min. Peak torque, motor-evoked potential, and perceived exertion rate were assessed before and after the interventions, and blood lactate level was assessed before, during, and after the interventions. A generalized estimated equation was used to analyze the peak torque, motor-evoked potential, and blood lactate data, and the Wilcoxon test was used for perceived exertion rate data. ResultsOur findings showed no difference between anodal tDCS and sham tDCS on peak torque, motor-evoked potential, blood lactate, and perceived exertion rate. ConclusionThe tDCS protocol was not effective in improving performance and reducing fatigue compared to a sham control intervention. Brazilian Clinical Trials RegistryRBR-8zpnxz.

Exclusion of sulfide:quinone oxidoreductase from mitochondria causes Leigh-like disease in mice by impairing sulfide metabolism.

Leigh syndrome is the most common inherited mitochondrial disease in children and is often fatal within the first few years of life. In 2020, mutations in the gene encoding sulfide:quinone oxidoreductase (SQOR), a mitochondrial protein, were identified as a cause of Leigh syndrome. Here, we report that mice with a mutation in the gene encoding SQOR (SqorΔN/ΔN mice), which prevented SQOR from entering mitochondria, had clinical and pathological manifestations of Leigh syndrome. SqorΔN/ΔN mice had increased blood lactate levels that were associated with markedly decreased complex IV activity and increased hydrogen sulfide (H2S) levels. Because H2S is produced by both gut microbiota and host tissue, we tested whether metronidazole (a broad-spectrum antibiotic) or a sulfur-restricted diet rescues SqorΔN/ΔN mice from developing Leigh syndrome. Daily treatment with metronidazole alleviated increased H2S levels, normalized complex IV activity and blood lactate levels, and prolonged the survival of SqorΔN/ΔN mice. Similarly, a sulfur-restricted diet normalized blood lactate levels and inhibited the development of Leigh syndrome. Taken together, these observations suggest that mitochondrial SQOR is essential to prevent systemic accumulation of H2S. Metronidazole administration and a sulfur-restricted diet may be therapeutic approaches to treatment of patients with Leigh syndrome caused by mutations in SQOR.

Seasonal energy investment and metabolic patterns in a farmed fish

The present research focuses on the seasonal changes in the energy content and metabolic patterns of red porgy (Pagrus pagrus) sampled in a fish farm in North Evoikos Gulf (Greece). The study was designed in an effort to evaluate the influence of seasonality in several physiological feauteres of high commercial importance that may affect feed intake and growth. We determined glycogen, lipids and proteins levels, and cellular energy allocation (CEA) as a valuable marker of exposure to stress, which integrates available energy (Ea) and energy consumption (Ec). Metabolic patterns and aerobic oxidation potential were based on the determination of glucose transporter (GLU), carnitine transporter (CTP), L-lactate dehydrogenase (L-LDH), citrate synthase (CS), cytochrome C oxidase subunit IV isoform 1 (COX1) and 3-hydroxyacyl CoA dehydrogenase (HOAD) relative gene expression. To integrate metabolic patterns and gene expression, L-LDH, CS, COX and HOAD activities were also determined. For further estimation of biological stores oxidized during seasonal acclimatization, we determined the blood levels of glucose, lipids and lactate. The results indicated seasonal changes in energy content, different patterns in gene expression and reorganization of metabolic patterns during cool acclimatization with increased lipid oxidation. During warm acclimatization, however, energy consumption was mostly based on carbohydrates oxidation. The decrease of Ec and COX1 activity in the warm exposed heart seem to be consistent with the OCLTT hypothesis, suggesting that the heart may be one of the first organs to be limited during seasonal warming. Overall, this study has profiled changes in energetics and metabolic patterns occurring at annual temperatures at which P. pagrus is currently farmed, suggesting that this species is living at the upper edge of their thermal window, at least during summer.

Blood Lactate Levels during Therapeutic Hypothermia and Neurodevelopmental Outcome or Death at 18–24 Months of Age in Neonates with Moderate and Severe Hypoxic-Ischemic Encephalopathy

Introduction: Blood lactate levels in neonates with hypoxic-ischemic encephalopathy (HIE) vary, and their impact on neurodevelopmental outcome is unclear. We assessed blood lactate course over time in neonates with HIE during therapeutic hypothermia (TH) and investigated if blood lactate values were associated with neurodevelopmental outcome at 2 years of age. Methods: This is a retrospective cohort study of neonates with HIE born between 2013 and 2019, treated at the University Children’s Hospital Zurich. We recorded blood lactate values over time and calculated time until lactate was ≤2 mmol/L. Neurodevelopmental outcome was assessed at 18–24 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), and categorized as favorable or unfavorable. We investigated associations between blood lactate values and outcome using logistic regression and adjusted for Sarnat stage. Results: 33/45 neonates (69%) had a favorable and 14 (31%) an unfavorable neurodevelopmental outcome. Mean initial lactate values were lower in the favorable (13.9 mmol/L, standard deviation [SD]: 2.9) versus unfavorable group (17.1 mmol/L, SD 3.2; p = 0.002). Higher initial and maximal blood lactate levels were associated with unfavorable outcome, also when adjusted for Sarnat stage (adjusted odds ratio [aOR]: 1.37, 95% CI: 1.01–1.88, p = 0.046, and aOR: 1.35, 95% CI: 1.01–1.81, p = 0.041, respectively). Conclusion: In neonates with HIE receiving TH, initial and maximal blood lactate levels were associated with neurodevelopmental outcome at 18–24 months of age, also when adjusted for Sarnat stage. Further investigations to analyze blood lactate as a biomarker for prognostic value are needed.

Carotid Arterial Compliance during Different Intensities of Submaximal Endurance Exercise.

Background: The purpose of this investigation was to determine the elastic characteristics of the common carotid artery (CCA) during endurance exercise at 3 different intensities. Methods: Twenty young healthy participants (10 males and 10 females) participated in this quasi-experimental cross-sectional study. Participants were tested in two sessions: (1) we took resting measurements of the elastic characteristics of the CCA and performed a cardiopulmonary exercise test (CPET) on a cycle ergometer to determine submaximal exercise intensities, and we conducted (2) measurements of the elastic characteristics of the CCA while exercising in a cycle ergometer at 3 intensities based on blood lactate levels of low (<2 mmol/L), moderate (2-4 mmol/L), and high (>4 mmol/L). Beta stiffness was calculated using CCA diameters during systole and diastole, measured with high-definition ultrasound imaging, and CCA systolic and diastolic pressures were measured via applanation tonometry. Results: Overall, there were no differences between males and females in terms of any of the studied variables (p > 0.05). In addition, no significant changes were found in the CCA beta stiffness and vessel diameter (p > 0.05) between exercise intensities. There was a significant exercise intensity effect on CCA systolic pressure (p < 0.05), but not on CCA diastolic pressure (p > 0.05). Conclusions: The biomechanical characteristics of the CCA, determined via compliance and beta-stiffness, do not change during cyclical aerobic exercise, regardless of exercise intensity.

Comparison of Apgar scores and cord blood gas parameters in fetuses with isolated congenital heart disease and healthy controls.

This retrospective study aimed to investigate how congenital heart disease (CHD) affects early neonatal outcomes by comparing Apgar scores and umbilical cord blood gas parameters between fetuses with structural cardiac anomalies and healthy controls. Additionally, within the CHD group, the study explored the relationship between these parameters and mortality within six months. Data from 68 cases of prenatally diagnosed CHD were collected from electronic medical records, excluding cases with missing data or additional comorbidities. Only patients delivered by elective cesarean section, without any attempt at labor, were analyzed to avoid potential confounding factors. A control group of 147 healthy newborns was matched for delivery route, maternal age, and gestational week. Apgar scores at 1, 5, and 10 minutes, as well as umbilical cord blood pH, base deficit, and lactate levels, were recorded. Maternal age, gestational week at delivery, and birth weight were similar between the CHD and control groups. While Apgar score distribution was significantly lower at 1st, 5th, and 10th minutes in the CHD group, umbilical cord blood gas parameters did not show significant differences between groups. Within the CHD group, lower umbilical cord blood pH and larger base deficit were associated with mortality within six months. Newborns with CHD exhibit lower Apgar scores compared to healthy controls, suggesting potential early neonatal challenges. Furthermore, umbilical cord blood pH and base deficit may serve as predictors of mortality within six months in CHD cases. Prospective studies are warranted to validate these findings and integrate them into clinical practice, acknowledging the study's retrospective design and limitations.

The Relationship of Blood Lactate Level and Swimming Performance with MCT1 after Critical Velocity

The Relationship of Blood Lactate Level and Swimming Performance with MCT1 after Critical Velocity

The Effect of Dıfferent Rest Perıods on Blood Lactate Levels Durıng Cırcuıt Traınıng

Aim: Circular training is thought to have a motivating feature by distracting the individual from routine and boring training practices with different exercise methods. In this context, the aim of this study was to investigate the effect of different rest periods applied during circular training on blood lactate levels. Method: The pretest-posttest model was used in the study. The sample of the study consisted of 24 (Xage =20,00±1,79; Xheight =171,75 ± 6,22; Xweight =75,01± 6,39) volunteer male basketball athletes. Lactate measurements were taken before, during and after circular training with different rest periods. The data was analyzed in the SPSS 24.0 package program, with a 95% confidence interval and a 0.05 significance level, and normality analysis was performed with the Shapiro-Wilk test. Since the data were not normally distributed, nonparametric tests were applied. The change in heart rate averages and lactate levels of the research group according to resting times were evaluated by Wilcoxon Test. Results: In general, it was determined that the circular training program with different rest intervals caused significant differences in the measurement parameters (Heart Rate, and Lactate) of the participants (p&lt;0.05). It was observed that the average heart rate and lactate values reached during training decreased as the rest period of the research group increased. On the other hand, the effects of long-term circular training programs with different rest intervals on aerobic-anaerobic energy metabolism will contribute to the literature.

Kinematic and Physiological Analysis of Medieval Combat Sport Using Motion Analysis, Blood Lactate Measurement, and Heart Rate Monitoring: A Case Study.

Medieval combat sport is a form of mixed martial art in which combatants engage in fighting using offensive and defensive equipment while dressed in full armor. The sport is considered extremely taxing, making it nearly impossible to maintain the same level of performance. However, this form of sport has not been thoroughly analyzed, and its impact on human physical response is largely unknown. To address this gap, the study reported here aimed to introduce and test a procedure for analyzing human physical responses within the framework of the sport. To accomplish this, two experienced combatants were asked to engage in a series of strikes, performed in the form of a set duel simulating a professional fight competition. The kinematic aspect of the procedure was examined using motion analysis with the help of an IMU suit, while the physiological aspect was evaluated based on blood lactate levels and heart rate measurements. Furthermore, an ergometer test conducted in a laboratory setting aimed to determine the lactate threshold. The duel results showed noticeable decreases in the kinematic aspects of the strikes, such as the velocity of impact, and a dramatic rise in physiological aspects, such as heart rate and blood lactate levels. During the duel sets, the blood lactate surpassed the threshold level, and at the end, the heart rate exceeded the maximum age-related level. Practicing medieval combat sport has been shown to impose an extreme physical load on the bodies of combatants, noticeably affecting their performance levels.

Metabolic flexibility associated with flight time among combat pilots of the Brazilian air force.

Fighter pilots must support the effects of many stressors, including physical and psychological exertion, circadian disturbance, jet lag, and environmental stress. Despite the rigorous selection of military pilots, those factors predispose to failures in physiological compensatory mechanisms and metabolic flexibility. We compared through NMR-based metabolomics the metabolic profile of Brazilian F5 fighter pilots with different flight experiences vs. the control group of non-pilots. We hypothesized that combat pilots have metabolic flexibility associated with combat flight time. We evaluated for the first time 34 Brazilian fighter pilots from Santa Cruz Air Base (Rio de Janeiro, RJ) allocated into three groups: pilots with lower total accumulated flight experience < 1,100h (PC1, n = 7); pilots with higher total accumulated flight experience ≥ 1,100h (PC2, n = 6); military non-pilots (CONT, n = 21). Data collection included anthropometric measurements, total blood count, lipidogram, markers of oxidative stress, and serum NMR-based metabolomics. In comparison with controls (p < 0.05), pilots exhibited decreased levels of white blood cells (-13%), neutrophils (-15%), lymphocytes (-20%), alfa-glucose (-13%), lactate (-26%), glutamine (-11%), histidine (-20%), and tyrosine (-11%), but higher isobutyrate (+ 10%) concentrations. Significant correlations were found between lactate vs. amino acids in CONT (r = 0.55-0.68, p < 0.001), and vs. glutamine in PC2 (r = 0.94, p = 0.01). Fighter pilots with lower experience showed a dysregulation in immune-metabolic function in comparison with controls, which seemed to be counteracted by the accumulation of flight hours. Those findings might have implications for the health preservation and operational training of fighter pilots.

#2053 The third-day blood lactate levels and APACHE III are important for predicting mortality in intensive care unit patients: Physionet data

Abstract Background and Aims Intensive care patients had higher mortality and SOFA score is used for mortality prediction. The SOFA score was developed more than 25 years ago to monitor organ dysfunction. Nowadays, blood lactate levels indicate septic shock and work as a new vital sign. This study aimed to evaluate the blood lactate levels for prediction mortality and search for the best predictors for mortality. Method Physionet data (MIMIC3) were used for this retrospective analysis. A total of 13,357 intensive care unit patients were enrolled, they were admitted to the intensive care unit over 24 hours and aged 20 years old, were initially checked for blood lactate levels. We also analyzed 2,748 patients who were checked for blood lactate levels at baseline, the second day, and the third day. We classified patients into three groups according to initial blood lactate levels (group 0: &amp;lt;4 mmol/L, group 1: 4-7.99 mmol/L, group 2: &amp;gt;8 mmol/L). Results The total mortality rate (60.3% vs. 24.4%), 7-day mortality rate, and 30-day mortality rate were the highest in group 2 compared to group 0 among 13,357 intensive care patients. Charlson-comorbidity index, SOFA score, and APACHE III score were the highest in group 2 compared to group 0 among 13357 intensive care patients. The arterial pH, pC02, systolic blood pressure, and GFR were the lowest in group 2 compared to group 0 among 13357 intensive care patients. These findings were similarly found in 2,748 intensive care patients. The third-day blood lactate levels and APACHE III score showed a higher area under the ROC curves predicting total mortality, 7-day mortality, and 30-day mortality than initial blood lactate levels and SOFA score. The third-day blood lactate levels, third-day/initial blood lactate ratio, and APACHE III score were independently associated with total mortality, seven-day and 30-day mortality in 2,748 intensive care patients, but GFR, ventilator care and SOFA score were not. Conclusion The third-day blood lactate levels and APACHE III score were the best predictors for mortality in intensive care unit patients. Therefore, intensive care for reducing blood lactate levels is important to increase survival.

Early acute kidney injury in sepsis and septic shock

ABSTRACT Background: Acute kidney injury is one of the severe conditions in hospitalized patients. Acute kidney injury can develop early from admission, usually within the first 24 hours of ICU admission. In Vietnam, there have been limited studies monitoring the progression of acute kidney injury in the early stages. This study aims to investigate the incidence, severity, clinical, laboratory characteristics, and progression of acute kidney injury in patients with sepsis and septic shock within the first 48 hours. Methods: This study is a cross-sectional descriptive analysis of 101 patients who are 15 or older and have been diagnosed with severe infection and septic shock. These patients were treated in the Intensive Care Unit of Hue Central Hospital. The patient had treatment in accordance with a standardized protocol while being closely observed. Samples were collected for diagnostic testing, and the patient’s urine output and blood creatinine levels were diligently checked. Results: The prevalence of acute renal injury (AKI) was 60.40%, with stage 1 accounting for 50.82% of cases, stage 2 accounting for 22.95%, and stage 3 accounting for 26.23%. The cohort of individuals diagnosed with AKI exhibited an advanced age, with a mean age of 60.72 ± 17.41 years, and predominantly consisted of male subjects. Patients diagnosed with acute kidney injury showed a statistically significant decrease in urine output and an increased incidence of shock (p &lt; 0.05). Additionally, these patients demonstrated lower levels of Hct, blood pH, and bicarbonate while exhibiting higher levels of blood urea, blood creatinine, AST, ALT, total bilirubin, PCT, and blood lactate (p &lt; 0.05) compared to individuals without AKI. Patients with AKI had significantly elevated SOFA and APACHE II scores compared to individuals without AKI, as indicated by statistical analysis (p &lt; 0.05). Upon admission, a significant proportion of patients, precisely 81.97%, experienced the development of AKI. Furthermore, a observation was made about the prompt recovery of these patients within the initial 24 and 48 hours following admission. Conclusion: The prevalence of AKI was accounted for 60.40%. Among the cases of AKI, stage 1 accounted for 50.82%, while stage 2 and stage 3 accounted for 22.95% and 26.23%, respectively. There were observed variations in urine output and rates of shock among individuals diagnosed with AKI. Additionally, SOFA and APACHE II scores were elevated. The percentage of AKI was 81.97% of patients upon their initial hospital admission, with a significant proportion seeing early recovery within the first 24 to 48 hours.

The effect of caffeine on running performance in performance triathletes

Background and purpose In an endurance sport such as triathlon, coaches at the elite level strive to select an appropriate nutritional strategy prior to performance in addition to optimizing the training process. Based on this, the research in question was designed with the aim to verify the effect of caffeine on the running performance of performance triathletes during the preparation period. Purpose is to determine the effect of caffeine on running performance in triathletes. Material and methods The study sample consisted of 8 performance triathletes from the TRIAN club of ŠK UMB Banská Bystrica, whose age was 16.7 ± 0.67 years. Diagnostics were run on InSPORTline Condi T6000i treadmill with the aim of detecting lactate and blood sugar levels (mmol/l) before the performance and within 10 seconds after the performance. The blood lactate level was detected with the portable device Lactate Scout+ and the blood glucose level was measured with the Wellion CALLA light glucose meter. The running pace at which the participants performed the test was at anaerobic threshold and they attempted to cover a distance of 1,500 m at a constant incline of 3%. The testing took place 1 time per week in the morning hours (08:00-08:30). On the second day after the initial testing from 01.03.2023 to 14.03.2023, the participants started taking placebo (magnesii lactas) on a daily basis in form of capsules. The participants took 2 capsules (200 mg magnesium) which they consumed with 200 mL of water 45 to 60 minutes before each morning workout/test. This was followed by the administration of caffeine capsules, which they consumed for an additional 2 weeks from 03.15.2023 to 03.28.2023. The participants consumed caffeine capsules at 5 mg/kg body weight 45 to 60 minutes before each morning workout/test. The intervention programme lasted 5 weeks. Results When administering caffeine capsules at a dose of 5 mg/kg body weight, there was a significant reduction of approximately 26% in the average blood lactate level of the participants after the 1,500 m run. The participants' mean blood glucose levels increased by approximately 4.9% after the 1500 m run. Conclusions Based on the results we can claim that for ergogenic effects on performance we recommend supplementing with 5mg/kg body weight of caffeine approximately 45 to 60 minutes before training.

The Utility of High-Intensity, Intermittent Exercise Protocols to Induce Fatigue for Screening Purposes in Jump-Landing Sports.

Short-term fatigue protocols simulating sports participation are scarce and not well-documented in jump-landing sports. Therefore, this study investigated physiological and physical responses following high-intensity, intermittent exercise protocols (HIIPs) with a standardized level of subjective exhaustion (Borg ≥18/20) and a modified fixed version of five circuits (HIIP-5) for future inclusion in biomechanical screening protocols. Twenty male volleyball and basketball players participated in this study to complete the HIIP and the HIIP-5. Physiological and physical variables were assessed before and up to 30 min after cessation of both protocols. Regarding physiological variables, heart rate values increased (+104 bpm, p < 0.001) and remained elevated up to 30 min (+34 bpm, p < 0.001), and blood lactate levels increased (+17 mmol/l, p < 0.001) compared to baseline. Regarding physical variables, decreased jump height (-4 cm, p = 0.001-0.009) and quadriceps muscle strength (p = 0.001-0.050) were observed up to 30 min compared to baseline. The type of the fatigue protocol did not have an effect on the investigated variables (p > 0.05). To conclude, both the HIIP and the HIIP-5 seem valuable tools to induce acute and long-lasting responses, providing a sufficiently large time window of 30 min within which biomechanical markers of injury can be assessed under fatigued conditions in future risk factor screenings. In practice, the fatigue protocol can be terminated after only five circuits if athletes had not yet been stopped at that point due to exhaustion (Borg ≥18/20).

All lactate are not equal substudy of the BOX trial

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The BOX trial was supported by a grant (NNF17OC0028706) from the Novo Nordisk Foundation. Dr. Hassager's work is funded by a grant (R186-2015-2132) from the Lundbeck Foundation. Background Lactate levels following out-of-hospital cardiac arrest (OHCA) are associated with arrest duration (time to ROSC) and mortality. However, given the complexity of lactate generation and clearance, lactate levels assessed at hospital arrival represent not only time to ROSC but also the quality of resuscitation, circulatory stability following ROSC, dose of epinephrine administered, kidney, liver, and mitochondrial function in the early post-cardiac arrest phase. Accordingly, we describe the lactate levels at hospital arrival according to time to ROSC and one-year mortality. Method In this sub-study of the randomized clinical BOX trial, blood lactate levels were measured immediately at hospital arrival. Time to ROSC was registered in the medical records. Patients were divided into two groups according to median time to ROSC (≤ 18 min or &amp;gt; 18 min). The primary outcome was one-year mortality. Results The study included 768 (97% of the randomized population) patients of which 386 (50%) patients had ≤ 18 min and 382 (50%) patients had &amp;gt; 18 min to ROSC. The median age (64 (54-73) years) and sex distribution (81% men) was similar in both groups. One-year mortality was 76 (20%) and 199 (52%) in the ≤ 18 min and &amp;gt; 18 min to ROSC groups respectively. Mean lactate levels were 3.8 mmol/L (95%CI: 3.5-4.1) and 5.9 mmol/L (95%CI: 5.4-6.2), respectively. Lactate levels differed significantly between one-year survivors and non-survivors in the patients with ≤ 18 min to ROSC (mean difference: 1.9 mmol/L, 95%CI: 1.0 - 2.8) but not for patients with &amp;gt; 18 min to ROSC (mean difference: 0.6 mmol/L, 95%CI: -0.1-1.3), Figure 1. Further, lactate’s ability to predict one-year mortality was fair in the ≤ 18 min group with an Area Under Receiver Operating Characteristic Curve (AUC) of 0.68 (95%CI: 0.62-0.75) but poor for the &amp;gt; 18 min groups with an AUC of 0.55 (95%CI: 0.50-0.61) (DeLong's test for two ROC curves, p = 0.004), Figure 2. Conclusion Lactate's predictive value for one-year mortality decreases with increasing time to ROSC in OHCA. This highlights the importance of individualized clinical approaches based on lactate dynamics in OHCA patients.Figure 1Figure 2

Acute-on-chronic heart failure leading to cardiogenic shock: any role for intra-aortic balloon pump? Results from a multicenter retrospective data collection

Abstract Funding Acknowledgements None. Background Intra-aortic balloon pump (IABP) implantation has been significantly reduced since IABP-SHOCK II trial did not show any clinical benefit in acute myocardial infarction (AMI)-related cardiogenic shock (CS)(1). For a long time, AMI has been recognized as the first cause of CS; however, in the last years, acute-on-chronic heart failure (HF)-CS has become predominant. We hypothesized that in HF-CS population the IABP may decrease mortality having a role in decreasing left ventricular afterload and improving peripheral perfusion(2). Purpose To investigate whether, in this phenotypical category of cardiogenic shock, IABP could improve 28-days mortality. Methods Multicenter retrospective observational study including adult HF-CS patients admitted in cardiac or general intensive care units in 3rd level centers. Hemodynamic variables before (T0) and after IABP implantation (T1), pharmacological support and outcome data were collected. Independent samples t-test was applied to assess any difference between IABP and non-IABP group; Kaplan-Meier and Cox’s regression (forward stepwise method) were performed as survival analysis on 28-days mortality. Results 160 patients (35.6% female, 61 [47-74] years-old) were included from three centers; overall mortality was 42.5%. 50% received IABP support; amongst IABP patients, 24 received further MCS with VA-ECMO (p &amp;lt;0.001) and 4 with Impella (p 0.120). Patients’ baseline characteristics are shown in Figure 1-A. IABP patients had lower 28-days mortality. Patients who received IABP were younger, had lower systolic blood pressure (SBP), pulse pressure (PP) and lactate levels at T0. In reference to catecholaminergic drugs, patients supported with IABP had lower norepinephrine doses and vasoactive inotropic score (VIS) at baseline. After IABP implantation, no significant difference between the two groups in the time variation of these parameters was observed (Figure 1-B). Survival analysis graphs are shown in Figure 2. At Cox’s regression, a significant effect on 28-days mortality was found for IABP (HR 0.510 [0.293-0.887], p 0.017), SCAI classification-stage D (HR 2.582 [1.315-5.072], p 0.006), VIS-T0 above 15 (HR 2.348 [1.407-3.921], p 0.001) and SBP-T0 above 95 mmHg (HR 1.361 [1.016-1.823], p 0.039); no significant association was found for age above 61 years (overall median value) (p 0.091), mechanical ventilation (p 0.367), PP-T0 (0 0.081) and lactate-T0 (p 0.227). Conclusions Considering the specific pathophysiology of HF-CS, IABP may have a role in reducing mortality. These retrospective data need to be validated and compared with those deriving from ongoing randomized controlled trials(3).

Evaluating the impact of sportswear with different fabric properties on comfort and physiological response during running

ABSTRACT Comfort is vital in sportswear design. Previous research focused on the thermo-physiological comfort of modal blended fabric by examining its physical and thermal properties, neglecting comprehensive wear trials. This study compared the perceived comfort of two sportswear samples: polyester fabric and modal blended fabric. Ten participants (mean age = 22.4) wore the samples in random order during two trials. Each trial involved 25 min of treadmill running at a self-selected speed in a laboratory with a room temperature of 23.5 ± 1°C and 50% humidity. Heart rate, blood lactate level, skin temperature, perceived exertion, self-reported comfort, sportswear weight change, and fabric properties were recorded. Results showed that the blended fabric offered superior comfort despite the polyester fabric demonstrating better moisture transfer. This suggests that fabric composition and absorbency contribute to comfort and moisture transmission. Future studies should explore fabric structures and their impact on comfort in modal blended fabric using comprehensive human trials.

Resistance Exercise Sessions Comprising Multijoint vs. Single-Joint Exercises Result in Similar Metabolic and Hormonal Responses, But Distinct Levels of Muscle Damage in Trained Men.

Barbosa, PH, Bueno de Camargo, JB, Jonas de Oliveira, J, Reis Barbosa, CG, Santos da Silva, A, Dos-Santos, JW, Verlengia, R, Barreira, J, Braz, TV, and Lopes, CR. Resistance exercise sessions comprising multijoint vs. single-joint exercises result in similar metabolic and hormonal responses, but distinct levels of muscle damage in trained men. J Strength Cond Res 38(5): 842-847, 2024-Resistance-type exercise (RE) elicits distinct acute metabolic and hormonal responses, which can be modulated by the manipulation of training variables. The purpose of this study was to compare the metabolic (blood lactate and estimated lactic anaerobic system energy expenditure) and hormonal (growth hormone [GH]) responses to RE sessions composed exclusively of multijoint (MULTI) or single-joint (SINGLE) exercises. Assessments of creatine kinase (CK) levels were also performed. In a crossover design, 10 recreationally resistance-trained men (age: 26.9 ± 3.0 years, total body mass: 83.2 ± 13.8 kg; height: 176 ± 7.0 cm; training experience: 5.5 ± 2.4 years) were randomly submitted to both protocols. Blood collections were made pre, 3 minutes after, and 36 hours after each experimental session. No significant difference between MULTI vs. SINGLE was observed for the rises in blood lactate (p = 0.057) and GH (p = 0.285) levels. For CK, a significant difference between the protocols was noted, in which MULTI resulted in significant rises after 3 minutes (p = 0.017) and 36 hours (p = 0.043) compared with SINGLE. In conclusion, the findings of this study suggest that resistance-trained individuals display similar metabolic and hormonal responses when performing MULTI and SINGLE exercise protocols. Also, RE sessions comprising MULTI exercises induce a higher magnitude of muscle damage, which may require a longer recovery period compared with SINGLE.

Endothelial PPARD regulates nutrient transport and exercise endurance in mice

Vascular endothelial cell function is important for regulating vascular perfusion, which is increased in the skeletal muscle during exercise. Our previous research identified endothelial selective PPARD, a transcription factor, which is critical for endothelial cell function and homeostasis. Loss of PPARD in endothelium enhances vascular inflammation and disrupts endothelial integrity. In the present study, we aims to investigate whether endothelial PPARD is involved in nutrient transport in the muscle endothelial cells and whether it is involved in exercise endurance and training effcacy. The Cdh5-Cre driven deletion of the floxed Ppard allele was used for making the endothelium selective Ppard knockout (PpardEC-KO) mice and wild type littermates (PpardEC-WT). Human endothelial cells were used to examine glucose and fatty acid uptake and its transport to myocytes. Treadmill exercise with incremental speed and inclination was used. Both PpardEC-WT and PpardEC-KO mice were viable and did not show abnormalities at baseline. Both PpardEC-WT and PpardEC-KO mice were put on treadmill to test their running endurance. Deletion of Ppard in endothelium resulted in early exhaustion, shortened distance, and less speed. Running exercise for 4 weeks partially improved endurance in the PpardEC-KO mice. PpardEC-KO mice had less oxidative muscle fibers both at baseline and after training. Higher blood lactate level and less glucose preservation were found in PpardEC-KO mice after running the same distance as PpardEC-WT mice. In human endothelial cells, PPARD knockdown resulted in less glucose and fatty acid uptake. Glucose transport to myocyte from endothelial cells was also attenuated with PPARD knockdown. PPARD may act through SGK1 responsible for GLUT1 expression and glucose uptake. Our study showed an important role of endothelial cell in regulating nutrient transport into skeletal muscle during physical exercise. Impaired endothelial transport of glucose and fatty acid reduces exercise endurance. This study is funded by the General Research Funds 14107822 and 14105321 from the Hong Kong University Grant Council. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Central venous oxygen saturation changes as a reliable predictor of the change of CI in septic shock: To explore potential influencing factors

PurposeAssessing fluid responsiveness relying on central venous oxygen saturation (ScvO2) yields varied outcomes across several studies. This study aimed to determine the ability of the change in ScvO2 (ΔScvO2) to detect fluid responsiveness in ventilated septic shock patients and potential influencing factors. MethodsIn this prospective, single-center study, all patients conducted from February 2023 to January 2024 received fluid challenge. Oxygen consumption was measured by indirect calorimetry, and fluid responsiveness was defined as an increase of cardiac index (CI) ≥ 10% measured by transthoracic echocardiography. Multivariate linear regression analysis was conducted to evaluate the impact of oxygen consumption, arterial oxygen saturation, CI, and hemoglobin on ScvO2 and its change before and after fluid challenge. ResultsAmong 49 patients (31 men, aged (59 ± 18) years), 27 were responders. The patients had an acute physiology and chronic health evaluation II score of 24 ± 8, a sequential organ failure assessment score of 11 ± 4, and a blood lactate level of (3.2 ± 3.1) mmol/L at enrollment. After the fluid challenge, the ΔScvO2 (mmHg) in the responders was greater than that in the non-responders (4 ± 6 vs. 1 ± 3, p = 0.019). Multivariate linear regression analysis suggested that CI was the only independent influencing factor of ScvO2, with R2 = 0.063, p = 0.008. After the fluid challenge, the change in CI became the only contributing factor to ΔScvO2 (R2 = 0.245, p < 0.001). ΔScvO2 had a good discriminatory ability for the responders and non-responders with a threshold of 4.4% (area under the curve = 0.732, p = 0.006). ConclusionΔScvO2 served as a reliable surrogate marker for ΔCI and could be utilized to assess fluid responsiveness, given that the change of CI was the sole contributing factor to the ΔScvO2. In stable hemoglobin conditions, the absolute value of ScvO2 could serve as a monitoring indicator for adequate oxygen delivery independent of oxygen consumption.