The effect of mesenchymal stromal cells of various origins on mortality and neurologic deficit in acute ischemia-reperfusion in rats

Stroke is a global epidemic issue and the second leading cause of death in the world and in Ukraine. According to official statistics, every year 100-110 thousand Ukrainians suffer acute cerebrovascular disorders. One third of such patients are of working age, up to 50 % will have a disability, and only one in ten will fully return to full life. So far, promising experimental data on the treatment of neurological dysfunction using mesenchymal stromal cells (MSCs) have been obtained. The aim of study is to compare the effect of MSCs of different origins on mortality and neurologic deficit in rats with acute cerebral ischemia-reperfusion injury (CIRI). Materials and methods. Transient bilateral 20-minute occlusion of internal carotid arteries was modeled in male Wistar rats aged 4 months and animals were injected intravenously with MSCs derived from human umbilical cord Wharton's-jelly (hWJ-MSC), human and rat adipose tissue. Other groups of experimental animals were injected intravenously with rat fetal fibroblasts and cell lysate from hWJ-MSC. The last group of rats received Citicoline at a dose of 250 mg/kg as a reference drug. Control animals were injected intravenously with normal saline. The cerebroprotective effect of therapy was assessed by mortality and neurologic deficit in rats on the McGraw's stroke index score. Results. After 12 hours of observation in the crucial period in the development of experimental acute cerebrovascular disorders with the administration of hWJ-MSC, mortality was only 10 % against 45 % of animals in the control group. The use of rat fetal fibroblasts reduced the mortality of animals compare to the control group by an average of 25 %. CIRI in rats caused severe neurologic deficits: paralysis, paresis, ptosis, circling behavior. On the 7th day of observation in the control group of animals, the mean score on the McGrow's stroke index indicated severe neurological disorders. On the 14th day of observation in this group of animals there was no complete recovery of lost central nervous system functions. Compared with the control group of animals, all the treatment agents for acute CIRI (MSCs of various origins, MSC's lysate and Citicoline) contributed to a significant regression of neurologic deficit. Conclusions. Thus, transplantation of human Wharton's jelly-derived MSCs and rat fetal fibroblasts reduced mortality and alleviated neurological symptoms in rats with experimental ischemic stroke. hWJ-MSC, rat fetal fibroblasts, and rat adipose-derived MSCs reduced the incidence of neurological disorders better than Citicoline, which was accompanied by a regression of neurologic deficit dynamics on the 14th day of follow-up. The ability of stem cells of different origins to reduce neurologic deficit indicates the feasibility of their use in experimental acute cerebral ischemia.

Relevance of a Sprint Interval Swim Training Set to the 100‐Meter Freestyle Event Based on Blood Lactate and Kinematic Variables

Sprint interval training (SIT) sets are commonly used by coaches in the training routine of swimmers competing in short-distance events; however, data regarding their relevance to competitive events are scarce. The aim of this study was to examine whether performance variables differed or correlated between a 4 × 50-m maximal swimming set (with a work-to-rest ratio of 1:4) and the 100-m freestyle event. Eleven male and 16 female competitive swimmers aged 16.1 ± 1.1 years participated in the study. All swimmers trained at least six times a week and had training experience of more than 4 years. They completed the two freestyle tests on different days, in random and counterbalanced order. In each test, speed, blood lactate, stroke rate (SR), and stroke index (SI) were measured. Speed, blood lactate, and SR were higher at the 4 × 50 m compared to the 100 m and were positively correlated between tests (p < 0.001). The SI did not differ significantly, but was positively correlated between tests. Males were faster and had a higher SI than females, but genders did not differ in lactate. Since performance variables were better in the SIT set and correlated with those in the 100-m bout, we suggest that the 4 × 50-m set can be used to improve performance in the 100-m freestyle event. Moreover, this set can help coaches identify which swimmers will swim fastest in the event.

Relationship between Swimming Performance, Biomechanical Variables and the Calculated Predicted 1-RM Push-up in Competitive Swimmers

One repetition maximum (1RM) push-ups, based upon the load–velocity relationship, are able to predict the maximum upper body strength. The aim of the present study was to examine the relationship between the predicted 1RM push-up based upon the load–velocity relationship and swimming performance and kinematical variables in competitive swimmers. Thirty-three competitive male swimmers (age = 16.46 ± 0.59 years, body mass = 72.82 ± 8.41 kg, body height = 180.56 ± 5.69 cm) performed push-up exercises without a weight vest and with a 10, 20 and 30 kg weight vests. A load–velocity relationship was established as a product of the load and velocity of the push-up per participant, and the equation was used to establish a predicted 1RM. Our findings showed a predicted 1RM push-up of 82.98 ± 9.95 kg. Pearson correlations revealed a nearly perfect relationship between the 1RM push-up and the 25 or 50 m front crawl (r = −0.968, r = −0.955), and between 1RM push-up and the 25 or 50 m front crawl with arms (r = −0.955, r = x0.941). Similarly, our results revealed significant near-perfect correlations between 1RM push-up and kinematical variables (r = 0.93–0.96) except the stroke index, which had a large relationship (r = 0.56). This study suggests that swimming performance and kinematical variables are correlated with the predicted 1RM push-up. The 1RM push-up based upon the load–velocity relationship is a low cost and time-effective alternative for swimmers and coaches to predict maximum upper body strength to optimize swimming performance in short races.

Hypovolemic Status in Older Hip Fracture Patients Elucidated by Preoperative Transthoracic Echocardiography

Older patients undergoing hip fracture surgery often experience intraoperative hemodynamic instability despite maintaining cardiac function. Although preoperative hemodynamics in such patients have been demonstrated mainly through invasive monitoring, few studies have addressed hemodynamics based on noninvasively measured parameters. We aimed to investigate preoperative hemodynamic states in older hip fracture patients using transthoracic echocardiography (TTE). The TTE data of patients aged >75 years who underwent hip fracture surgery or elective total hip arthroplasty (THA) between April 1, 2019, and March 31, 2021, were collected. In addition to the baseline characteristics, the TTE data from hip fracture patients were compared with the data of those who underwent THA. The hip fracture patients (n = 167) were significantly older and had lower stroke volume (45.6 vs. 50.9 ml; p < 0.01 ) and stroke index (33.7 vs. 36.6 ml/m2; p < 0.01 ) compared to those who underwent elective THA (n = 44). However, the cardiac output (3.51 vs. 3.48 L/min; p = 0.273 ) and cardiac index (2.6 vs. 2.47 L/min/m2; p = 0.855 ) for both groups were almost identical due to the increase in heart rate in the hip fracture group. Regarding other parameters including ejection fraction, fractional shortening, E/E′, and inferior vena cava diameter, there were no significant differences between the two groups. Our noninvasive TTE investigations suggested that hip fracture patients were volume-depleted, and the hypovolemic status activated the sympathetic nervous system, compensating for their cardiac output. Anesthesiologists must focus on the TTE-assessed parameters reflecting the volume status along with the cardiac function.

Cushing’s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography

BackgroundCushing’s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing’s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing’s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing’s disease. The purpose of this study was to assess the hemodynamic profile of Cushing’s disease patients and compare it with that in the control group.Material and MethodsThis observational prospective clinical study aimed to compare 54 patients with Cushing’s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).ResultsThe Cushing’s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 vs. 79.1 mmHg, p=0.045; and 41.1 vs. 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing’s disease group showed: lower values of SI (42.1 vs. 52.8 ml/m2; p ≤ 0.0001), CI (2.99 vs. 3.64 l/min/m2; p ≤ 0,0001), VI (42.9 vs. 52.1 1/1000/s; p=0.001), ACI (68.7 vs. 80.5 1/100/s2; p=0,037), HI (13.1 vs. 15.2 Ohm/s2; p=0.033), and TFC (25.5 vs. 27.7 1/kOhm; p=0.006) and a higher SVRI (2,515 vs. 1,893 dyn*s*cm-5*m2; p ≤ 0.0001) than those in the control group.ConclusionsCushing’s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing’s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.

Disparate Information Provided by Pulse Wave Velocity versus Other Measures of Aortic Compliance in End-Stage Renal Disease

<b><i>Introduction:</i></b> Unfavorable changes in cardiac and arterial function are related to poor prognosis in chronic kidney disease (CKD). We compared hemodynamic profiles between subjects with end-stage renal disease and 2 control groups with corresponding pulse wave velocities (PWVs). <b><i>Methods:</i></b> Noninvasive hemodynamics were recorded during passive head-up tilt in CKD stage 5 patients (<i>n</i> = 35), patients with primary hypertension (<i>n</i> = 35, <i>n</i> = 30 with antihypertensive medications), and subjects without cardiovascular or renal diseases and cardiovascular medications (<i>n</i> = 70). The groups were selected to have corresponding age, sex, body mass index, and PWV. Hemodynamic data were captured using whole-body impedance cardiography and radial tonometric pulse wave analysis. <b><i>Results:</i></b> Supine blood pressure did not differ between the groups, but upright diastolic blood pressure was lower in CKD patients than in the 2 control groups (<i>p</i> ≤ 0.001 for both, RANOVA). Despite similar PWV, supine aortic pulse pressure was higher in CKD patients versus nonmedicated subjects (<i>p</i> = 0.029). Two additional measures indicated reduced aortic compliance in CKD patients versus both control groups: lower ratio of stroke index to aortic pulse pressure (<i>p</i> ≤ 0.023) and higher aortic characteristic impedance (<i>p</i> ≤ 0.003). The subendocardial viability ratio was lower in the CKD group than in both control groups (<i>p</i> ≤ 0.039). <b><i>Conclusion:</i></b> In the absence of differences in PWV, higher aortic pulse pressure and characteristic impedance, and lower ratio of stroke index to aortic pulse pressure, suggest reduced aortic compliance and impaired left ventricular function in CKD patients. A lower subendocardial viability ratio predisposes the CKD patients to impaired cardiac oxygen supply versus hypertensive patients and nonmedicated controls.

A Randomized Crossover Trial on the Acute Cardiovascular Demands During Flywheel Exercise

In a randomized crossover trial, we examined whether age plays a role in the mean arterial pressure (MAP) response during a vigorous flywheel exercise of varying load. We hypothesized that the magnitude of increase in the MAP during the flywheel exercise would increase in proportion to advancing age, thereby imposing a significant challenge to the cardiovascular system. A total of 30 participants of both sexes (age range from 20–55 y, 37% women) underwent a detailed medical examination, and their maximal oxygen uptake was determined. They performed a squat exercise (2 sets × 7 repetitions) on a flywheel ergometer at three randomly assigned moments of inertia set at 0.025, 0.05, and 0.075 kg m2, while the cardiovascular response was continuously recorded via a Task force monitor. Compared to the resting values, robust rises in the MAP were observed during all three flywheel loads, reaching the highest value of 179 ± 4 mmHg (p = 0.001) during the highest load. In parallel, the cardiac index (cardiac output normalized by the body surface area) was two-fold greater during all the flywheel loads compared to rest, and at a high load, exclusively, the total peripheral resistance increased by 11% (p = 0.001). The rise in heart rate compensated for a load-dependent drop in the stroke index (stroke volume normalized by the body surface area). In our study population, no correlations were observed between the relative increase in the MAP and the participants’ age for the three flywheel loads. The present findings suggest that the larger moments of inertia impose a substantial burden to the cardiovascular system, without apparent associated age-differences of the relative magnitude of MAP rise throughout the exercise.

Independent influence of age on heart rate recovery after flywheel exercise in trained men and women

The present study examined whether differences in the heart rate recovery following flywheel exercise cessation were associated with differences in maximal oxygen uptake ($${\dot{\text{V}}}$$ V ˙ O2 max.), age and sex in trained adults. Eleven men (age range 22–49 years, $${\dot{\text{V}}}$$ V ˙ O2 max. = 43.6 ± 7.6 mL kg min−1) and ten women (age range 20—53 years, $${\dot{\text{V}}}$$ V ˙ O2 max. = 38.0 ± 5.7 mL kg min−1) were randomly assigned to complete a squat-exercise on the flywheel ergometer set at three different moments of inertia, while their cardiovascular responses were continuously monitored. During the flywheel exercise the mean arterial pressure rose by ~ 35 to 40% (p = .001), and the increment was more robust in men than women. The cardiac index was two-fold greater across both sexes compared to the baseline (p = .001), while the rise in heart rate (~ 144 bpm) was more pronounced in women to compensate for their load-dependent stroke index decline (p = .001). The load-independent time-course changes in heart rate recovery markers were comparable between the sexes. When these indicators were pooled, a stepwise regression revealed age as the only relevant predictor of both fast and slow components of the heart rate recovery (~ 30% of the shared variance explained, p = .014). The present data suggest that the heart rate recovery declines with age, irrespective of sex, or well-preserved cardiorespiratory fitness in moderately-trained adults.

Biological Age in Relation to Somatic, Physiological, and Swimming Kinematic Indices as Predictors of 100 m Front Crawl Performance in Young Female Swimmers

Background: Some swimmers reach high performance level at a relatively young age. The purpose of this study is to determine the relationship between adolescent female swimmers’ 100 m front crawl race (Vtotal100) and several anthropometry, body composition, and physiological and specific strength indices. Methods: Nineteen adolescent female swimmers were examined for biological age (BA) and body composition. Oxygen uptake was measured during water-flume stage-test front crawl swimming with ventilatory thresholds examination. Specific strength indices were assessed during 30 s of tethered swimming. Stroke rate (SR), stroke length (SL), and stroke index (SI) were also examined. Results: BA was strongly correlated with anthropometrics and tethered swimming strength indices, and showed moderate to strong correlation with ventilatory thresholds. Speed of swimming in the race was moderately to largely correlated with speed at V˙O2 max−VV˙O2max (r = 0.47–0.55; p < 0.05)—ventilatory thresholds (VAT, VRCP) (r = 0.50–0.85; p < 0.05), SL (r = 0.58–0.62; p < 0.05), and SI (r = 0.79–0.81; p < 0.01). Conclusion: Results confirmed a significant role of biological maturation mediation on body composition and body size, ventilatory indices, and specific strength indices. BA was not a significant mediation factor influencing the swimming kinematics (SL, SI) and speeds of VAT, VRCP or VV˙O2 max, which were strong predictors of the 100 m race.

Spatial-temporal variables for swimming coaches: A comparison study between video and TritonWear sensor

The main aim of this study was to evaluate the validity and the reliability of a swimming sensor to assess swimming performance and spatial-temporal variables. Six international male open-water swimmers completed a protocol which consisted of two training sets: a 6×100m individual medley and a continuous 800 m set in freestyle. Swimmers were equipped with a wearable sensor, the TritonWear to collect automatically spatial-temporal variables: speed, lap time, stroke count (SC), stroke length (SL), stroke rate (SR), and stroke index (SI). Video recordings were added as a “gold-standard” and used to assess the validity and the reliability of the TritonWear sensor. The results show that the sensor provides accurate results in comparison with video recording measurements. A very high accuracy was observed for lap time with a mean absolute percentage error (MAPE) under 5% for each stroke (2.2, 3.2, 3.4, 4.1% for butterfly, backstroke, breaststroke and freestyle respectively) but high error ranges indicate a dependence on swimming technique. Stroke count accuracy was higher for symmetric strokes than for alternate strokes (MAPE: 0, 2.4, 7.1 & 4.9% for butterfly, breaststroke, backstroke & freestyle respectively). The other variables (SL, SR & SI) derived from the SC and the lap time also show good accuracy in all strokes. The wearable sensor provides an accurate real time feedback of spatial-temporal variables in six international open-water swimmers during classical training sets (at low to moderate intensities), which could be a useful tool for coaches, allowing them to monitor training load with no effort.