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Cerebrovascular haemodynamics during isometric resistance exercise with and without the Valsalva manoeuvre

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Abstract

Purpose

To examine the interactive effects of VM and isometric resistance exercise on cerebral haemodynamics.

Methods

Eleven healthy participants (mean ± SD 28 ± 9 years; 2 females) completed 20-s bilateral isometric leg extension at 50% of maximal voluntary contraction with continued ventilation (RE), a 20-s VM at mouth pressure of 40 mmHg (VM), and a combination (RE + VM), in randomised order. Mean beat-to-beat blood velocity in the posterior (PCAvmean) and middle cerebral arteries (MCAvmean), vertebral artery blood flow, end-tidal partial pressure of CO2 and mean arterial pressure (MAP) were measured. RE data were time aligned to RE + VM and analysed according to standard VM phases.

Results

Interaction effects (VM phase × condition) were observed for MCAvmean, PCAvmean, vertebral artery blood flow and MAP (all ≤ 0.010). Phase I MCAvmean was greatest for RE [88 ± 19, vs. 71 ± 11 and 78 ± 12 cm s−1 for VM (P = 0.008) and RE + VM (P = 0.021), respectively]. Greater increases in MCAvmean than PCAvmean occurred in phase I of RE only (24 ± 15% vs. 16 ± 16%, post hoc P = 0.044). In phase IIb, MAP was lower in RE than RE + VM (115 ± 15 vs. 138 ± 21 mmHg, P = 0.004), but did not reduce MCAvmean (78 ± 8 vs. 79 ± 9 cm s−1, P = 0.579) or PCAvmean (45 ± 11 vs .46 ± 11 cm s−1, P = 0.617). Phase IIb MCAvmean and PCAvmean was lowest in VM (66 ± 6 and 39 ± 8 cm s−1, respectively, all P < 0.001), whereas in Phase IV, MCAvmean, PCAvmean and MAP were greater in VM than in RE and RE + VM (all P < 0.020).

Conclusion

RE and RE + VM produce similar cerebrovascular responses despite different MAP profiles. However, the VM produced the greatest cerebrovascular challenge afterward.

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Abbreviations

ABP:

Arterial blood pressure

DMCAv:

Diastolic middle cerebral artery blood velocity

DPCAv:

Diastolic posterior cerebral artery blood velocity

CCP:

Critical closing pressure

CPP:

Cerebral perfusion pressure

CVCi:

Cerebrovascular conductance index

DBP:

Diastolic blood pressure

HR:

Heart rate

ICA:

Internal carotid artery

ICP:

Intracranial pressure

MAP:

Mean arterial pressure

MCA:

Middle cerebral artery

MCAv:

Middle cerebral artery blood velocity

MCAvmean :

Mean middle cerebral artery blood velocity

MVC:

Maximal voluntary contraction

PCA:

Posterior cerebral artery

PCAv:

Posterior cerebral artery blood velocity

PCAvmean :

Mean posterior cerebral artery blood velocity

PETCO2 :

Partial pressure of end tidal carbon dioxide

Pi:

Pulsatility index

PI:

Phase 1

PII:

Phase 2

PIIa:

Phase 2a

PIII:

Phase 3

PIV:

Phase IV

RE:

Resistance exercise

RE + VM:

Resistance exercise with concurrent Valsalva manoeuvre

SMCAv:

Systolic middle cerebral artery blood velocity

SPCAv:

Systolic posterior cerebral artery blood velocity

VA:

Vertebral artery

VM:

Valsalva manoeuvre

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Funding

This study was funded by the Massey University School of Health Sciences.

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Authors and Affiliations

  1. School of Health Sciences, Massey University, PO Box 756, Wellington, 6140, New Zealand

    Blake G. Perry

  2. School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand

    Tom De Hamel, Travis D. Gibbons & James D. Cotter

  3. Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Luke C. Wilson & Travis D. Gibbons

  4. Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Kate N. Thomas & Travis D. Gibbons

Authors
  1. Blake G. Perry
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  2. Tom De Hamel
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  3. Kate N. Thomas
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  4. Luke C. Wilson
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  5. Travis D. Gibbons
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  6. James D. Cotter
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Contributions

Experiment was performed at the School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand. BGP, TD, KNT, LW, and JC were involved in conception and design of research. All authors were involved in conducting the research. BGP, KNT, LW, TDG, and JC were involved in data analysis and interpretation. All authors edited and revised manuscript with all authors approving the final version.

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Correspondence to Blake G. Perry.

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The authors declare that they have no conflict of interest.

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Communicated by Keith Phillip George.

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Perry, B.G., De Hamel, T., Thomas, K.N. et al. Cerebrovascular haemodynamics during isometric resistance exercise with and without the Valsalva manoeuvre. Eur J Appl Physiol 120, 467–479 (2020). https://doi.org/10.1007/s00421-019-04291-7

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  • DOI: https://doi.org/10.1007/s00421-019-04291-7

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