Intensity Exercise Training Research Articles

Train Smart Study: protocol for a randomised trial investigating the role of exercise training dose on markers of brain health in sedentary middle-aged adults

IntroductionRegular aerobic exercise is associated with improved cognitive function, implicating it as a strategy to reduce dementia risk. This is reinforced by the association between greater cardiorespiratory fitness and larger...

Effects of varied‑intensity endurance exercise training on oxidative and antioxidant factors in the liver of rats with valproic acid‑induced autism.

Autism spectrum disorders are complex behavioral disorders that can be caused by exposure to valproic acid (VPA) during pregnancy. A therapeutic role for exercise training has been reported in many neurological diseases and problems, including autism. We aimed to evaluate various intensities of endurance exercise training and investigate its effects on oxidative and antioxidant factors in the liver of young males in a rat model of autism. Female rats were divided into a treatment (autism) and a control group. The autism group received VPA intraperitoneally on day 12.5 of pregnancy and the control pregnant females received saline. On the 30th day post‑birth, a social interaction test was performed on the offspring to confirm autistic‑like behavior. Offspring were divided into three subgroups: no exercise, mild exercise training, and moderate exercise training. Then the oxidative index of malondialdehyde (MDA) and the antioxidant indices of superoxide dismutase (SOD), total antioxidant capacity (TAC), and catalase in liver tissue were examined. The results of this study showed that both indices of sociability and social novelty decreased in the autism group. MDA levels in the liver of the autistic group increased, and moderate exercise training was shown to reduce the levels. Catalase and SOD activity as well as TAC levels decreased in the autism group, and moderate‑intensity exercise training was shown to increase the values. Parameters of hepatic oxidative stress were altered in VPA‑induced autism, and moderate‑intensity endurance exercise training was demonstrated to have beneficial effects on hepatic oxidative stress factors by modul ating the antioxidant/oxidant ratio.

Low intensity exercise training in patients with amyotrophic lateral sclerosis – factors influencing eligibility and compliance to the clinical trial

ABSTRACT Background To date, there are no evidence-based recommendations for physical therapy in amyotrophic lateral sclerosis (ALS). The reason is a low number of related clinical trials (CTs), restricted sample sizes and a high dropout rate. It may influence the profile of the participants, while the final results might not translate to the general ALS population. Objective To analyze factors affecting the ALS patients’ enrollment and retention to the study, and to describe a profile of participants as compared to the eligible group. Methods A total of 104 ALS patients were offered participation in a CT of low-intensity exercises at home. Forty-six patients were recruited. Demographic and clinical data (El Escorial criteria, site of onset, diagnosis delay, disease duration, amyotrophic lateral sclerosis functional rating scale – revised [ALSFRS-R], Medical Research Council [MRC], hand-held dynamometry) were analyzed every 3 months. Results Male gender, younger age and a higher ALSFRS predicted enrollment, while male gender, higher ALSFRS-R and MRC predicted retention in the study. A long commute to the study site and a fast disease progression were the main reasons influencing both enrollment and retention. Despite a high dropout rate, study participants were representative for the general ALS population. Conclusion The above demographic, clinical and logistic factors need to be considered when designing studies in ALS population.

The effect of 6 weeks of intensive intermittent exercise training with fenugreek supplementation on lipid profile and body composition indices in overweight and obese women

The effect of 6 weeks of intensive intermittent exercise training with fenugreek supplementation on lipid profile and body composition indices in overweight and obese women

Optimal Intensity of Aerobic Exercise Training for Patient With Chronic Obstructive Pulmonary Disease (COPD): Systematic Review and Meta-Analysis

Background: Intensity for aerobic exercise is unclear in patient with COPD. Previous systematic review comparing effects of different levels of training intensity was done in 2011 and did not reach any conclusion. We conducted this systematic review to see the differences in aerobic training intensity on various aspects of health in COPD patients with updated information. Method: We included RCTs, comparing the differences in intensity of aerobic training between groups. The primary search was done through Pubmed, Scopus, Science Direct, Proquest, and PEdro. The PEdro scale and Risk of Bias 2 tool was used to rate the studies. Lastly, we also rate the certainty of evidence using GRADE approach. The assessment was carried out by two reviewers independently. Data were extracted by one reviewer then evaluated by second reviewer. Results: We found and analysed data from four studies with total of 472 patients. The primary outcomes extracted were Disease-specific Health-Related Quality of Life (HRQoL), Activities of Daily Living (ADL), Functional exercise capacity, Dyspnea symptoms. There was a significant difference only in St George’s Respiratory Questionnaire (SGRQ) symptoms domain for HRQoL outcome (MD=5.53; 95% CI=1.08-9.97), favoured lower intensity group. No other significant results were found for any other outcomes/ outcome measures. According to GRADE, quality of the studies was very low to moderate. Conclusion: The evidence we collected is very limited and difficult to evaluate. Further research comparing higher intensity with lower intensity of aerobic training is needed.

Long-term intensive endurance exercise training is associated to reduced markers of cellular senescence in the colon mucosa of older adults

Regular endurance exercise training is an effective intervention for the maintenance of metabolic health and the prevention of many age-associated chronic diseases. Several metabolic and inflammatory factors are involved in the health-promoting effects of exercise training, but regulatory mechanisms remain poorly understood. Cellular senescence—a state of irreversible growth arrest—is considered a basic mechanism of aging. Senescent cells accumulate over time and promote a variety of age-related pathologies from neurodegenerative disorders to cancer. Whether long-term intensive exercise training affect the accumulation of age-associated cellular senescence is still unclear. Here, we show that the classical senescence markers p16 and IL-6 were markedly higher in the colon mucosa of middle-aged and older overweight adults than in young sedentary individuals, but this upregulation was significantly blunted in age-matched endurance runners. Interestingly, we observe a linear correlation between the level of p16 and the triglycerides to HDL ratio, a marker of colon adenoma risk and cardiometabolic dysfunction. Our data suggest that chronic high-volume high-intensity endurance exercise can play a role in preventing the accumulation of senescent cells in cancer-prone tissues like colon mucosa with age. Future studies are warranted to elucidate if other tissues are also affected, and what are the molecular and cellular mechanisms that mediate the senopreventative effects of different forms of exercise training.

Rehabilitation Efficacy of Core Stability Training Combined with All-Round Intensive Exercise Training on Children with Spastic Cerebral Palsy

Rehabilitation Efficacy of Core Stability Training Combined with All-Round Intensive Exercise Training on Children with Spastic Cerebral Palsy

Characteristics of the gut microbiome in esports players compared with those in physical education students and professional athletes.

Esports is a category of competitive video games that, in many aspects, may be similar to traditional sports; however, the gut microbiota composition of players has not been yet studied. Here, we investigated the composition and function of the gut microbiota, as well as short chain fatty acids (SCFAs), and amino acids, in a group of 109 well-characterized Polish male esports players. The results were compared with two reference groups: 25 endurance athletes and 36 healthy students of physical education. DNA and metabolites isolated from fecal samples were analyzed using shotgun metagenomic sequencing and mass spectrometry, respectively. Physical activity and nutritional measures were evaluated by questionnaire. Although anthropometric, physical activity and nutritional measures differentiated esports players from students, there were no differences in bacterial diversity, the Bacteroidetes/Firmicutes ratio, the composition of enterotype clusters, metagenome functional content, or SCFA concentrations. However, there were significant differences between esports players and students with respect to nine bacterial species and nine amino acids. By contrast, all of the above-mentioned measures differentiated professional athletes from esports players and students, with 45 bacteria differentiating professional athletes from the former and 31 from the latter. The only species differentiating all three experimental groups was Parabacteroides distasonis, showing the lowest and highest abundance in esports players and athletes, respectively. Our study confirms the marked impact of intense exercise training on gut microbial structure and function. Differences in lifestyle and dietary habits between esports players and physical education students appear to not have a major effect on the gut microbiota.

Effects of exercise training on metabolic syndrome risk factors in post-menopausal women – A systematic review and meta-analysis of randomised controlled trials

Alterations in the hormonal profiles as women transition to the menopause predisposes individuals to the metabolic syndrome (MetS). In post-menopausal women, this can be exacerbated by sedentary behaviour and physical inactivity. Physical activity can convey many health benefits including improvement in MetS risk factors. However, it remains to be elucidated how differing exercise intensities and its mode of delivery can ameliorate MetS risk factors and resultant progression amongst post-menopausal women. The purpose of this systematic review and meta-analysis was to investigate the effects and efficacy of exercise training on MetS risk factors in post-menopausal women. Database searches using PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were conducted from inception to December 2021 for randomised controlled studies (RCTs) investigating exercise training (>8 weeks) in at least one of the MetS risk factors in post-menopausal women. Utilising the random-effects model, appropriate standardised mean differences (SMD) or mean differences (MD) with 95% confidence interval (CI) for each MetS risk factor were used to calculate the overall effect size between the exercise and control groups. Sub-group analyses were performed for exercise intensity, modality, and duration for each risk factor. Meta-regression was performed for categorical (health status) and continuous (body mass index) covariates. 39 RCTs (40 studies) involving 2132 participants were identified as eligible. Overall, the meta-analysis shows that exercise training significantly improved all MetS risk factors: waist circumference (WC) [MD:-2.61cm; 95% CI:-3.39 to-1.86cm; p<0.001; 21 studies]; triglycerides (TG) [SMD:-0.40mmol/L; 95% CI:-0.71 to-0.09mmol/L; p=0.01; 25 studies]; high-density lipoprotein (HDL) [SMD: 0.84mmol/L(95% CI: 0.41-1.27mmol/L; p<0.001; 26 studies]; fasting glucose (BG) [SMD:-0.38mmol/L (95% CI:-0.60 to-0.16mmol/L; p<0.001; 20 studies]; systolic blood pressure (SBP) [MD:-5.95mmHg (95% CI:-7.98 to-3.92mmHg; p<0.001; 23 studies]; and diastolic blood pressure (DBP) [MD:-4.14mmHg (95% CI:-6.19 to-2.08mmHg; p<0.001; 23 studies]. Furthermore, sub-group analyses identified that moderate intensity and combined exercise training significantly improved MetS risk factors (p<0.05) except for HDL, with combined exercise being the most effective. Long duration (≥12 weeks) training also significantly improved MetS risk factors except for TG. Meta-regression revealed no moderating effects on any MetS risk variables. This study reinforces the importance of regular physical activity as a non-pharmacological tool in the reduction of MetS risk in post-menopausal women, with significant metabolic improvements seen in interventions spanning 8-10 weeks. Moderate intensity and combined training significantly benefitted abdominal obesity, dyslipidaemia, dysglycaemia and hypertension in post-menopausal women. Improvements in at least one MetS risk were also seen with other exercise modalities and intensities.

Exercise Volume Versus Intensity and the Progression of Coronary Atherosclerosis in Middle-Aged and Older Athletes: Findings From the MARC-2 Study.

Physical activity and exercise training are associated with a lower risk for coronary events. However, cross-sectional studies in middle-aged and older male athletes revealed increased coronary artery calcification (CAC) and atherosclerotic plaques, which were related to the amount and intensity of lifelong exercise. We examined the longitudinal relationship between exercise training characteristics and coronary atherosclerosis. Middle-aged and older men from the MARC-1 (Measuring Athlete's Risk of Cardiovascular Events 1) study were invited for follow-up in MARC-2 (Measuring Athlete's Risk of Cardiovascular Events 2) study. The prevalence and severity of CAC and plaques were determined by coronary computed tomography angiography. The volume (metabolic equivalent of task [MET] hours/week) and intensity (moderate [3 to 6 MET hours/week]; vigorous [6 to 9 MET hours/week]; and very vigorous [≥9 MET hours/week]) of exercise training were quantified during follow-up. Linear and logistic regression analyses were performed to determine the association between exercise volume/intensity and markers of coronary atherosclerosis. We included 289 (age, 54 [50 to 60] years [median (Q1 to Q3)]) of the original 318 MARC-1 participants with a follow-up of 6.3±0.5 years (mean±SD). Participants exercised for 41 (25 to 57) MET hours/week during follow-up, of which 0% (0 to 19%) was at moderate intensity, 44% (0 to 84%) was at vigorous intensity, and 34% (0 to 80%) was at very vigorous intensity. Prevalence of CAC and the median CAC score increased from 52% to 71% and 1 (0 to 32) to 31 (0 to 132), respectively. Exercise volume during follow-up was not associated with changes in CAC or plaque. Vigorous intensity exercise (per 10% increase) was associated with a lesser increase in CAC score (β, -0.05 [-0.09 to -0.01]; P=0.02), whereas very vigorous intensity exercise was associated with a greater increase in CAC score (β, 0.05 [0.01 to 0.09] per 10%; P=0.01). Very vigorous exercise was also associated with increased odds of dichotomized plaque progression (adjusted odds ratio [aOR], 1.09 [1.01 to 1.18] per 10%; aOR, 2.04 [0.93 to 4.15] for highest versus lowest very vigorous intensity tertiles, respectively), and specifically with increased calcified plaques (aOR, 1.07 [1.00 to 1.15] per 10%; aOR, 2.09 [1.09 to 4.00] for highest versus lowest tertile, respectively). Exercise intensity but not volume was associated with progression of coronary atherosclerosis during 6-year follow-up. It is intriguing that very vigorous intensity exercise was associated with greater CAC and calcified plaque progression, whereas vigorous intensity exercise was associated with less CAC progression.

Training, detraining and retraining effects of moderate vs. high intensity exercise training programme on cardiovascular risk factors.

The aim of the present study was to analyse the effect of 12 weeks of training, 7 weeks of detraining and 16 weeks of retraining using a moderate or high intensity training programme on cardiovascular risk factors in hypertensive patients. Thirty-four patients took part in the study. The intensity training was 80-90% of maximum heart rate for the high-intensity training (HIT) group ( n = 15) and at 50-70% of maximum heart rate for the moderate training (MT) group ( n = 19). Blood pressure, body composition, lipid profile, fasting glucose, strength and cardiovascular fitness were analysed. The first training period did not decrease blood pressure, but the second training period saw significant decreases in blood pressures in HIT group. Moreover, 12 weeks of MT or HIT did not decrease body mass, body mass index or fat mass. However, after 7 weeks of detraining, the inclusion of a second training period using HIT saw decreases in these body composition variables. Both training periods and intensities improved high-density lipoprotein and low-density lipoprotein, but only HIT decreased total cholesterol. In addition, after 7 weeks of detraining, the lipid profile variables returned to baseline values. Additionally, 16 weeks of retraining with HIT or MT decreased blood glucose significantly. Moreover, MT and HIT training programmes in both periods improved cardiorespiratory fitness, but with 7 weeks of detraining, it returned to baseline values. Our data demonstrated the effectiveness of the inclusion of a MT or HIT programme as adjuvant therapy in hypertensive patients.

PS-BPC09-6: THE IMPACT OF LOW VERSUS HIGH INTENSITY ISOMETRIC HANDGRIP EXERCISE TRAINING ON REDUCTION OF BLOOD PRESSURE IN INDIVIDUALS WITH HYPERTENSION-A RANDOMIZED DOUBLE BLINDED CONTROLLED TRIAL

Title: The Impact of Low Versus High Intensity Isometric Handgrip Exercise Training on Reduction of Blood Pressure in Individuals with Hypertension: A Randomized Double Blinded Controlled Trial Objectives: The primary objectives of the study are to investigate the effects of low and high-intensity isometric handgrip training in the reduction of blood pressure in individuals with hypertension and to identify which one out of three-intensity isometric handgrip training has a greater effect on blood pressure reduction. A secondary objective is to evaluate the extent of adherence to IHG exercise training among the three IHG training groups. Design and Method: Randomized controlled with parallel group, multiple arm trial. Participants and therapists were blinded to group allocations, with the allocation concealment handled by a Sequentially numbered, sealed opaque envelope method. Randomization with computer generated random number table was done into three IHG training groups. A total of 75 Individuals with hypertension were randomized into the following three isometric handgrip exercise groups: Group A 5% MVC (Control group) (n = 25), Group B 30% MVC (Intervention group) (n = 25), Group C 90% MVC (Intervention group) (n = 25). Participants were given 4-week of IHG exercise training at their homes by the therapist. At baseline and the end of 4 weeks, B/L blood pressure was measured and compared between groups. Adherence to the IHG exercise training was recorded in the exercise log after each exercise session. Trial Registration: CTRI/2022/01/039346 [Registered on: 12/01/2022] - Trial Registered Prospectively Results: A total of 60 participants completed the 4-weeks of IHG training and at baseline, they were similar (p &gt; 0.05). From baseline to 4-weeks we have found statistical and clinically significant changes of &gt; 7 mmHg in SBP and &gt; 4 mmHg in DBP in all three groups. However, there was no significant difference was obtained between groups. For exercise adherence, 87% to 92% of participants completed the sessions. Conclusion: According to the findings of our study, Isometric handgrip exercise is effective in reducing blood pressure for individuals with hypertension but there is no significant difference in blood pressure for different intensities of IHG exercise training

Resveratrol attenuated high intensity exercise training-induced inflammation and ferroptosis via Nrf2/FTH1/GPX4 pathway in intestine of mice.

Moderate exercise has beneficial effects for human health and is helpful for the protection against several diseases. However, high intensity exercise training caused gastrointestinal syndrome. Resveratrol, a plant extract, plays a vital role in protecting various organs. However, whether resveratrol protected mice against high intensity exercise training-induced intestinal damage remains unclear. In this study, our objective was to investigate the protective effects and mechanism of resveratrol in high intensity exercise training-treated mice. Mice were treated with swimming exercise protocol and/or resveratrol (15 mg/kg/day) for 28 consecutive days. Then, the mice were sacrificed, and a series of evaluation indicators, including inflammatory factors and intestinal permeability of the gut, were measured based on this model. The expressions of inflammatory factors (tumor necrosis factor (TNF)-α; interferon (IFN)-γ, interleukin (IL)-6 and IL-10), oxidative stress (Nrf2, glutathione (GSH), hydrogen peroxide (H2 O2), catalase (CAT) and malondialdehyde(MDA)), intestinal barrier (gut permeability, ZO-1, Occludin and Claudin-1 as well as ferroptosis (Fe2+, Fe3+, SLC7A11, glutathioneperoxidase 4 (GPX4) and ferritin heavy chain 1 (FTH1)) were measured, respectively. High intensity exercise training induced colon damage, manifested as inflammation (increased TNF-α, IFN-γ and IL-6 concentrations, and decreased IL-10 concentration), oxidative stress (the increase of H2O2 and MDA concentration, and the reduced CAT and GSH activities), intestinal barrier injury (increased gut permeability and intestinal fatty-acid binding protein concentration,and inhibited ZO-1, Occludin and Claudin-1 expressions) and ferroptosis (the increased of Fe2+ and Fe3+ concentrations, and suppressed phosphorylated Nrf2, SLC7A11, GPX4 and FTH1), which was relieved by resveratrol treatment in mice. Resveratrol attenuated high intensity exercise training-induced inflammation and ferroptosis through activating Nrf2/ FTH1/GPX4 pathway in mouse colon, which providing new ideas for the prevention and treatment of occupational disease in athlete.

The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review

Irisin is a myokine considered to be a potential mediator of exercise-induced energy metabolism and its secretion is known to promote the browning of beige fat cells in white adipose tissue. However, it is currently not known which exercise protocol is the best to enhance irisin concentration in patients with type 2 diabetes (T2D). The purpose of this study is to provide a review investigating the irisin response to different exercise training modalities and intensities in T2D. A systematic literature search was performed in May 2022. After the selection process from 938 articles, six studies were included. Selected papers presented different exercise training interventions regarding intensity and modality. One study reported no significant differences in serum irisin levels after exercise training, whereas the other five showed a higher increase in serum irisin levels after exercise training with higher differences in irisin secretion after high-intensity training (HIT). No consideration was possible on exercise modalities. The impact of training intensity and modality was found to be partly discordant but data seem to suggest that HIT promotes greater irisin secretion. Despite the limited evidence, HIT, both in interval and continuous modalities, could be suggested as valid exercise training to increase circulating irisin in patients with T2D.

The Impact of Exercise Training Intensity on Physiological Adaptations and Insulin Resistance in Women with Abdominal Obesity.

Abdominal obesity has emerged globally as a major public health issue due to its high prevalence and morbidity. The benefits of physical exercise among the obese population are well documented. However, the optimal exercise intensity for reducing body fat and preventing insulin resistance and metabolic disorders is still under debate. This study aimed to examine the effects of three different intensities of combined endurance and strength training programs on anthropometric variables, physiological and muscular adaptations, and insulin sensitivity. Forty-three obese young women (age 26.4 ± 4.7 years, BMI 33.1 ± 2.5 kg/m2) were randomly assigned to one of four groups: a control group (G0), a moderate-intensity training group (G50, exercising brisk walking at 50% heart rate reserve HRR), a high-intensity training group (G75, exercise jogging at 75% HRR), and an alternated-intensity training group (G50/75, exercise brisk-walking/jogging at 50−75% HRR) with additional strength training once a week for each group. Body composition, waist circumference (WC), fasting blood glucose, insulin sensitivity and resistance (Homa-IR), resting heart rate (RHR), 6-min walk distance (6MWD), 1-repetition maximum (1-RM), and time to exhaustion (TTE) at 45% and 75% maximal voluntary contraction (MVC) for both the flexor and extensor muscle groups of the knees, were recorded before and after three months of exercise training. All training groups showed significant decreases in body mass, BMI, total body fat, body fat percentage, WC, abdominal and visceral mass (p < 0.001), with a greater reduction of body mass and BMI in G75 (p < 0.05). Lean mass increased significantly only in G50/75 (p < 0.05). The insulin sensitivity and Homa-IR decreased in the three training groups (p < 0.01), with greater enhanced resistance in G50 compared to G75 and G50/75 (p < 0.05). In contrast, there were no pre-post changes in all groups for fasting blood glucose (p > 0.05). 1-RM and TTE of the knee flexor and extensor muscles were improved in the three groups (p < 0.01), with greater improvement in G50/75 for 1RM and G75 in most of the TTE parameters (p < 0.05). RHR decreased and 6MWD increased significantly in the three training groups (p < 0.01), with greater 6MWD improvement in G75 (p < 0.05). In conclusion, the three training intensities seem to generate benefits in terms of body composition, physiological and muscular adaptations, and insulin resistance. High training intensity resulted in greater improvements in body mass, BMI, and endurance and strength, whereas moderate training intensity resulted in greater improvements of insulin resistance and homo-IR. Following alternate-intensity training, greater improvements were observed in lean mass and maximal strength performance.

Role of Physiotherapy in Weaning of Patients from Mechanical Ventilation in the Intensive Care Unit

Admission to an Intensive Care Unit (ICU) initiates an interprofessional and interdisciplinary approach to bring the patient back to health with normal or near normal function. Physiotherapists play a vital role in restoring function to the patient. The role of physiotherapy (PT) in the ICU has moved from primarily being one of only respiratory care to one that also encompasses early rehabilitation and exercise training. Early mobilization in the ICU has gained prominence in the recent years and is becoming standard practice across many centers. However, the impact on weaning with these interventions is not known. This review highlights the dysfunctions from an ICU admission and the rationale for instituting early PT in the ICU. In addition, evidence from systematic reviews and meta-analysis is reviewed to determine the impact of PT interventions on weaning. Evidence suggests the benefit of active mobilization and inspiratory muscle training in facilitating weaning. In addition, these interventions along with neuromuscular electrical stimulation further improve physical function and reduce the risk of critical illness polyneuromyopathy. Therefore, early PT does have significant functional benefits to ICU patients. However, more studies are required to determine how various interventions and intensities of exercise training improve weaning outcomes.

Detailed characterization of balanced intense exercise training induced right ventricular alterations reveals physiological myocardial hypertrophy with improved contractility in a rodent model

Detailed characterization of balanced intense exercise training induced right ventricular alterations reveals physiological myocardial hypertrophy with improved contractility in a rodent model

Effects of Statins on Fat Oxidation Improvements After Aerobic Exercise Training.

Statins blunt cardiorespiratory fitness improvements after exercise training and may affect fat oxidation adaptations to training. To determine if long-term statin use in dyslipidemic individuals restricts the improvements in fat oxidation typically observed after an intense exercise-training program. A total of 106 metabolic syndrome individuals either chronically medicated with statins (ie, statin group; n = 46) or statin naive (ie, control group; n = 60) completed a 16-week supervised high-intensity interval training program. Maximal rates of oxygen consumption (V˙O2MAX), fat oxidation (FOMAX), and the shape of the workload-fat oxidation curve were assessed before and 48 hours after training in an overnight fasted state. Starting from a similar value at baseline, both groups increased V˙O2MAX after training, but the increase was larger in the control than in the statin group (19.4% vs 12.6%; P = .013). Before training, FOMAX in the statin group was lower (0.19 ± 0.08 vs 0.23 ± 0.07 g·min-1; P = .023) and took place at a lower workload (33 ± 21 vs 37 ± 19 W; P = .015) than in the control group. After training, FOMAX improved similarly in both groups (0.06 ± 0.08; 95% CI, 0.03-0.08 g·min-1 and 0.05 ± 0.09; 95% CI, 0.03-0.07 g·min-1, for statin and control groups, respectively; (P < .001). Still, after training, FOMAX occurred at a 28% lower workload in the statin group (38 ± 26 vs 53 ± 32 W; P = .048). The V˙O2-workload slope decreased after training in both groups (both P < .001) along with reductions in the respiratory exchange ratio-workload slope. Fat oxidation increased at all workloads after training regardless of the use of statins. Long-term statin treatment is associated with blunted exercise fat oxidation before exercise training. However, statin use does not attenuate the improvements in exercise fat oxidation (FOMAX) derived from intense aerobic exercise training. This finding should encourage statin users to exercise-train to benefit from increased fat oxidation once their fitness level improves.

Abstract 12741: Effect of One Year of Exercise Training on Left Ventricular Relaxation in Patients With Stage B Heart Failure

Introduction: Left ventricular hypertrophy (LVH) is a risk factor for developing heart failure (HF). Exercise training decreases LV stiffness in individuals with LVH, but the effects of exercise training on LV relaxation in these individuals are unknown. Methods: Patients with LVH (&gt; 11 mm) and elevated cardiac biomarkers (N-terminal pro- B-type natriuretic peptide [&gt;40 pg/mL] or high-sensitivity troponin T [&gt;0.6 pg/mL]) were randomized 2:1 to 1 year of monitored exercise training 4-5 days a week, including high intensity intervals, and 1-2 days of strength training or an attention control. Isovolumetric relaxation time (IVRT) was measured with pulse wave Doppler echocardiography and pulmonary capillary wedge pressure (PCWP) was consecutively measured with right heart catheterization before and after intervention. LV relaxation time constant, Tau, was estimated by Tau = IVRT / (Ln End-systolic pressure (ESP) - Ln PCWP) (Figure). Maximal oxygen uptake (VO 2 Max; Douglas bags) was measured with an incremental treadmill test. LV Stiffness was significantly improved in exercise arm, previously reported. Results: Thirty-one participants completed the study (Control: n=11, 51±6 years, 55% men, Exercise: n=20 53±6, 65% men). VO 2 Max increased by 18.2% in the exercise arm (2.2±0.6 L/min to 2.5±0.6, but not in controls; group x time p&lt;0.001). Exercise training did not change Tau (exercise 38.2±6.5 to 39.8±8.7 ms) compared to control(40.3 ± 5.9 to 39.2±6.8 ms, group x time p = 0.84, Figure ). Exercise training resulted in no significant changes in IVRT (p = 0.35), SBP (p=0.89) or PCWP (p=0.69). Conclusions: In patients with LVH at risk for HF, one year of high intensity exercise training did not improve LV relaxation despite significant improvement in ventricular stiffness and exercise capacity. These results suggest the primary mechanism for HF risk reduction with exercise training is by lowering LV stiffness, and not necessarily altering LV relaxation.

ODP081 Bisphosphonates: To Give or Not to Give, that is the Question – A case of prolonged hypercalcemia in a patient with severe rhabdomyolysis complicated by bilateral foot drop

Abstract Rhabdomyolysis has an initial oliguric stage characterized by hypocalcemia and a recovery stage characterized by hypercalcemia. The latter can be severe, and cause altered mental status, arrhythmias and even death. Immobilization can also contribute to hypercalcemia, as in this patient with severe rhabdomyolysis with complication of bilateral foot drop and prolonged hypercalcemia after renal function recovered. We present a 19-year-old male with history of sickle cell trait and G6PD deficiency, admitted to ICU for acute renal failure and hemolytic crisis after intense exercise training. Labs were pertinent for: K 6.9 mmol/L(n=3.5-4.7), lactate 34.8 mmol/L(n=0.5-2.2), phosphorus 17.5mg/dL(n=2.5-4.9), CPK 5420U/L(n=39-308), magnesium 5. 0 mg/dL(n=1.7-2.4), calcium 5.3 mg/dL(n=8.5-10.1), albumin 3.1 g/dL(n=3.4-5), ionized calcium 0.86 nmol/L(n=1.13-1.32), Cr 1.9 mg/dL(n=0.67-1.17), AST 15064 U/L(n=10-37), ALT 3687 U/L(n-10-65), myoglobin 240000mcg/L(n=&amp;lt;95). Creatine peaked to 7.9mh/dL. He required 8 weeks of hemodialysis, multiple pRBC transfusions, calcium supplementation, and high dose steroids. Once off hemodialysis, he steadily became hypercalcemic over the span of 40 days (10.1–11.9 mg/dL). Endocrinology was consulted: PTH was 2 pg/mL (n=18.4-80.1); Calcitriol &amp;lt;8pg/ml (n=18-72); 25-OH vit D &amp;lt;4.2 ng/mL (n=30-100). IVFs were started and the cause of hypercalcemia was thought to be calcium release from recovering muscles. Notably, patient had bilateral foot drop from rhabdomyolysis-associated muscle edema and mobility was limited. Due to prolonged hypercalcemia of &amp;gt;30 days. which became worse after IVFs were discontinued (peaked to 12.9 mg/dL corrected calcium), endocrinology was reconsulted: A whole body bone scan showed stress-related bone changes but no pockets of calcium deposit in muscle. C-telopeptide was 1603 pg/mL (n=87-1200). Immobilization-related hypercalcemia was then considered, and IVFs were restarted. As calcium remained &amp;lt;12 after discontinuing IVFs for one week and as patient was participating in frequent physical therapy, it was decided to hold off on bisphosphonate therapy. Rare causes of hypercalcemia were also excluded [IGF-1 240 ng/mL(n=10-548), AM-cortisol 12.92 ug/dL (n=5.3-22.5), ACTH 42 pg/mL (n=0-47), PTHrP 13 pg/mL (n=11-20)]. In rhabdomyolysis, cell death due to various stress insults (eg crush injury, ischemia, infection) causes release of phosphorus contributing to initial hypocalcemia from formation of calcium phosphate deposits. In the recovery phase of AKI, these deposits mobilize from muscle causing hypercalcemia. The average duration of hypercalcemia phase is 10 days. However, in our case the patient had prolonged hypercalcemia of more than one month, which caused concern for immobilization hypercalcemia. A bone scan was helpful in differentiating between the two entities as rhabdomyolysis-related hypercalcemia may have revealed calcium pockets in muscle. The elevated C-telopeptide also reinforced this diagnosis. Presentation: No date and time listed