Efficacy of INtensive Treatment Versus Standard Treatment of COmpound DanshEn Dripping Pills in Refractory Angina Patients With Incomplete Revascularization (INCODER Study): Study Protocol for a Multicenter, Double-blind, Randomized Controlled, Superiority Trial

Introduction: Patients with incomplete revascularization (ICR) tend to develop refractory angina despite optimal medical therapy. Compound Danshen Dripping Pills (CDDP) is a widely used antianginal drug in China and is showed to significantly alleviate myocardial ischemia. Previous studies showed dose-efficacy tendency when increasing doses of CDDP. The study is aim to investigate the efficacy and safety of intensive doses of CDDP in patients with refractory angina with ICR.Methods and Analysis: The INCODER study is a multicenter, double-blind, randomized controlled, superiority trial. We plan to recruit 250 patients aged 18 to 85 years with a diagnosis of refractory angina with ICR. Patients will be randomized (1:1) to intensive treatment group (CDDP 20 pills three times per day) or control group (10 pills CDDP and 10 pills placebo three times per day). Patients will have a 6-week medication period and be followed up every two weeks. The primary end point is the change of total exercise time from baseline to week 6 as assessed by cardiopulmonary exercise testing (CPET). Secondary end points include changes in frequency of angina, Canadian Cardiovascular Society angina class, nitroglycerin use, Seattle Angina Questionnaire scores, O2 uptake kinetics and other parameters as measured by CPET, and levels of plasma C-reactive protein, homocysteine and N-terminal pro-B-type natriuretic peptide. Safety events related to CDDP use will be monitored.Ethics and dissemination: The research had been approved by the Clinical research and laboratory animal ethics committee of the First Affiliated Hospital, Sun Yat-sen University ([2019]65). The results will be reported through peer-reviewed journals, seminars and conference presentations.Trial registration number: www.chictr.org.cn (ChiCTR2000032384). Registered on 27 April 2020.

Sucrose-Sweetened Drinks Reduce the Physical Performance and Increase the Cardiovascular Risk in Physically Active Males

Introduction. The intake of sugar-sweetened beverages (SSBs) has increased rapidly, but the effects of this habit on health and physical performance are unknown. This study assessed the effect of excessive SSB intake on biochemical, physical performance, and biochemical and cardiovascular parameters of physically active males. Methods. Seventeen volunteers consumed a placebo drink (Pd; carbohydrate free) and an excessive SSB drink (eSSBd = Pd plus 300 g sucrose). In a blind randomized crossover study, the subjects were assigned to Pd or eSSBd groups for 15 days. After an interval of 7 days, subjects were reassigned to the other condition. Results. After eSSBd intake, there was an increase in weight (69.34 ± 13.71 vs. 70.62 ± 14.06), body mass index (24.49 ± 4.01 vs. 24.97 ± 4.13), waist circumference (75.33 ± 11.22 vs. 76.79 ± 11.51), VLDL (19.54 ± 9.50 vs. 25.52 ± 11.18), triglycerides (78.94 ± 23.79 vs. 114.77 ± 43.65), and peak systolic blood pressure (178.57 ± 26.56 vs. 200.71 ± 24.64). The cardiorespiratory response to exercise (VO2max) (48.15 ± 10.42 vs. 40.98 ± 11.20), peak heart rate (186.64 ± 8.00 vs. 179.64 ± 6.28), total exercise time (15.02 ± 1.57 vs. 14.00 ± 2.18), and mechanical work (15.83 ± 4.53 vs. 13.68 ± 5.67) decreased after eSSBd intake (all values expressed in initial mean ± DP vs. final). The rates of perceived exertion were higher (1.300 vs.1.661 slope and −0.7186 vs. −1.118 y-intercept) after eSSBd intake. Conclusion. The present study shows that 15 days of eSSBd intake may negatively modulate biochemical parameters associated with cardiovascular risk. In addition, this overintake can impair the physical performance and cardiovascular responses to physical exercise.

The Relationship between Physical Exercise and Cognitive Function in Korean Middle Aged and Elderly Adults without Dementia

This study investigated the association between physical exercise and cognitive function in Koreans aged 45 years or above without dementia. Data from the 2006 to 2018 Korean Longitudinal Study of Aging (KLoSA) were used. The general characteristics of the study population were investigated using analysis of variance (ANOVA). The association between total exercise time per week and cognitive function, measured based on the Mini-Mental State Examination (MMSE) scores, was investigated using the generalized estimating equation (GEE) model. Subgroup analysis was conducted based on age, educational level, and marital status. A total of 8888 participants were investigated, of which 5173 (58.2%) individuals did not exercise regularly. Among participants who did exercise, 676 (7.6%) individuals were categorized into the Q1, 1157 (13.0%) into the Q2, 908 (10.2%) into the Q3, and 974 (11.0%) into the Q4 group. The mean MMSE score was 26.81 ± 3.17. Compared to the ‘no’ exercise group, better MMSE scores were found in the Q1 (β: 0.3523, p ≤ 0.0001), the Q2 (β: 0.2011, p ≤ 0.0001), the Q3 (β: 0.4075, p ≤ 0.0001), and the Q4 groups (β: 0.3144, p ≤ 0.0001) after adjustment. The magnitude of this association was stronger in participants aged 65 years or above and in single or separated individuals. The findings of this study confirm a positive association between physical exercise and MMSE scores in the middle aged and elderly.

THE VALUE OF TREADMILL EXERCISE TEST PARAMETERS TO PREDICT THE MARATHON PERFORMANCE OF YOUNG AND MIDDLE-AGED RECREATIONAL ATHLETES IN CHINA

Objectives: This study will evaluate the results of parameters measured during a treadmill exercise test to predict marathon performances. Methods: We studied 171 Chinese recreational athletes who participated in marathons or half-marathons (42.2[Formula: see text]k or 21.1[Formula: see text]k, respectively) between October 2016 and December 2017. The participants completed a survey that included questions about demographics and training, and they underwent a treadmill exercise test according to the Bruce protocol. The number of years in training, mean weekly hours of training, mean weekly training volume, and performance time in subsequent marathon events were recorded and analyzed in this study. Results: The total exercise times achieved on the treadmill test were significantly longer for men compared to women ([Formula: see text]). The performance times in the half-marathons were significantly shorter for men compared to women ([Formula: see text]). Training volume was the only independent predictor of total exercise time on the treadmill and performance time in marathons and half-marathons (all [Formula: see text]). The value of the total exercise time on the treadmill to predict performance times in half-marathons ([Formula: see text]) was superior to full marathons ([Formula: see text]) and significantly better in study subjects aged 30–39 years ([Formula: see text], [Formula: see text]) and 40–49 years ([Formula: see text], [Formula: see text]) compared to study subjects aged 20–29 years and 50–59 years. The percentage of decrease in the maximal heart rate (MHR) at the end of one minute of recovery time was negatively correlated with performance times in marathons. Conclusions: The total exercise time achieved during an exhaustive treadmill exercise test and percentage of decrease in the MHR at the end of one minute of recovery time are accessible parameters that can help athletes manage their expectations and adjust their training plans. A large study that includes additional countries is needed to confirm the value of treadmill exercise test results for predicting marathon performance.

Angiotensin-(1-7) oral formulation improves physical performance in mountain bike athletes: a double-blinded crossover study

Objective This study examined the effects of HPβ-CD-Ang-(1–7) oral supplement on performance of mountain bike (MTB) athletes. Methods Fourteen recreational athletes, involved in training programs for at least one year, participated in this crossover design study. Subjects underwent two days of testing with a seven-day interval. HPβ-CD-Ang-(1–7) (1.75 mg) and HPβCD-Placebo were provided in capsules three hours prior to tests. To determine the safety of the HPβ-CD-Ang-(1–7) formulation associated with physical effort, cardiovascular parameters heart rate (HR) and blood pressure (BP) were analyzed. Physical performance was measured using maximal oxygen uptake (VO2), total exercise time (TET), mechanical work (MW), mechanical efficiency (ME), and rating of perceived exertion (RPE). Respiratory exchange coefficient (REC), lactate and non-esterified fatty acids (NEFAs) were measured. Maximal incremental tests were performed on a progressively loaded leg cycle ergometer. Results There were no significant differences in terms of HR or BP at rest and maximum effort between the Ang-(1–7) and placebo groups. The VO2max showed significant differences (p = 0.04). It was higher in the Ang-(1–7)condition (66.15 ml/kg/min) compared to the placebo (60.72 ml/kg/min). This was also observed for TET (Ang-(1–7) 39.10 min vs. placebo 38.14 min; p = 0.04), MW (Ang-(1–7) 156.7 vs. placebo 148.2; p = 0.04), and at the lowest RPE (Ang-(1–7) vs. placebo; p = 0.009). No significant differences were observed for REC, NEFAs, or Lactate. Conclusion These results suggest that HPβ-CD-Ang-(1–7) improves the physical performance of MTB recreational athletes and could be a promising supplement.

Comparison of Core Muscle Activation Between a Prone Bridge and 6-RM Back Squats

The purpose of this study was to compare core muscle activation during a prone bridge (plank) until failure and 6-RM back squats. Twelve resistance-trained males (age 23.5 ± 2.6 years, body mass 87.8 ± 21.3 kg, body height 1.81 ± 0.08 m) participated in this study. Total exercise time and EMG activity of the rectus abdominis, external abdominal oblique and erector spinae were measured during 6-RM back squats and a prone bridge with a weight of 20% of participants’ body mass on their lower back. The main findings showed non-significant differences between the exercises in the rectus abdominis or external oblique, but greater erector spinae activation in squatting. Furthermore, in contrast to the prone bridge, the erector spinae and rectus abdominis demonstrated increasing muscle activation throughout the repetitions while squatting, whereas the prone bride demonstrated increasing external oblique activation between the beginning and the middle of the set. It was concluded that since squatting resulted in greater erector spine activation, but similar rectus abdominis and oblique external activation as the prone bridge, high-intensity squats rather than isometric low intensity core exercises for athletes would be recommended.

Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations

This systematic review examines the efficacy of carbohydrate (CHO) supplementation on exercise performance of varying durations. Included studies utilized an all-out or endurance-based exercise protocol (no team-based performance studies) and featured randomized interventions and placebo (water-only) trial for comparison against exclusively CHO trials (no other ingredients). Of the 61 included published performance studies (n = 679 subjects), 82% showed statistically significant performance benefits (n = 50 studies), with 18% showing no change compared with placebo. There was a significant (p = 0.0036) correlative relationship between increasing total exercise time and the subsequent percent increase in performance with CHO intake versus placebo. While not mutually exclusive, the primary mechanism(s) for performance enhancement likely differs depending on the duration of the exercise. In short duration exercise situations (∼1 h), oral receptor exposure to CHO, via either mouthwash or oral consumption (with enough oral contact time), which then stimulates the pleasure and reward centers of the brain, provide a central nervous system-based mechanism for enhanced performance. Thus, the type and (or) amount of CHO and its ability to be absorbed and oxidized appear completely irrelevant to enhancing performance in short duration exercise situations. For longer duration exercise (>2 h), where muscle glycogen stores are stressed, the primary mechanism by which carbohydrate supplementation enhances performance is via high rates of CHO delivery (>90 g/h), resulting in high rates of CHO oxidation. Use of multiple transportable carbohydrates (glucose:fructose) are beneficial in prolonged exercise, although individual recommendations for athletes should be tailored according to each athlete’s individual tolerance.

Oral Creatine Supplementation’s Decrease of Blood Lactate During Exhaustive, Incremental Cycling

Purpose:To determine the effects of creatine supplementation on blood lactate during incremental cycling exercise.Methods:Thirteen male subjects (M ± SD 23 ± 2 yr, 178.0 ± 8.1 cm, 86.3 ± 16.0 kg, 24% ± 9% body fat) performed a maximal, incremental cycling test to exhaustion before (Pre) and after (Post) 6 d of creatine supplementation (4 doses/d of 5 g creatine + 15 g glucose). Blood lactate was measured at the end of each exercise stage during the protocol, and the lactate threshold was determined as the stage before achieving 4 mmol/L. Lactate concentrations during the incremental test were analyzed using a 2 (condition) × 6 (exercise stage) repeated-measures ANOVA. Differences in power at lactate threshold, power at exhaustion, and total exercise time were determined by paired t tests and are presented as M ± SD.Results:Lactate concentrations were reduced during exercise after supplementation, demonstrating a significant condition effect (p = .041). There was a tendency for increased power at the lactate threshold (Pre 128 ± 45 W, Post 143 ± 26 W; p = .11). Total time to fatigue approached significant increases (Pre 22.6 ± 3.2 min, Post 23.3 ± 3.3 min; p = .056), as did maximal power output (Pre 212.5 ± 32.5 W, Post 220 ± 34.6 W; p = .082).Conclusions:Our findings demonstrate that creatine supplementation decreases lactate during incremental cycling exercise and tends to raise lactate threshold. Therefore, creatine supplementation could potentially benefit endurance athletes.