Acute Effects of Exercise Mode on Arterial Stiffness and Wave Reflection in Healthy Young Adults: A Systematic Review and Meta-Analysis

Abstract

Background: This systematic review and meta-analysis quantified the effect of acute exercise mode on arterial stiffness and wave reflection measures including carotid-femoral pulse wave velocity (cf-PWV), augmentation index (AIx), and heart rate corrected AIx (AIx75).Methods: Using standardized terms, database searches from inception until 2017 identified 45 studies. Eligible studies included acute aerobic and/or resistance exercise in healthy adults, pre- and post-intervention measurements or change values, and described their study design. Data from included studies were analyzed and reported in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. Meta-analytical data were reported via forest plots using absolute differences with 95% confidence intervals with the random effects model accounting for between-study heterogeneity. Reporting bias was assessed via funnel plots and, individual studies were evaluated for bias using the Cochrane Collaboration's tool for assessing risk of bias. A modified PEDro Scale was applied to appraise methodological concerns inherent to included studies.Results: Acute aerobic exercise failed to change cf-PWV (mean difference: 0.00 ms−1 [95% confidence interval: −0.11, 0.11], p = 0.96), significantly reduced AIx (−4.54% [−7.05, −2.04], p = 0.0004) and significantly increased AIx75 (3.58% [0.56, 6.61], p = 0.02). Contrastingly, acute resistance exercise significantly increased cf-PWV (0.42 ms−1 [0.17, 0.66], p = 0.0008), did not change AIx (1.63% [−3.83, 7.09], p = 0.56), and significantly increased AIx75 (15.02% [8.71, 21.33], p < 0.00001). Significant heterogeneity was evident within all comparisons except cf-PWV following resistance exercise, and several methodological concerns including low applicability of exercise protocols and lack of control intervention were identified.Conclusions: Distinct arterial stiffness and wave reflection responses were identified following acute exercise with overall increases in both cf-PWV and AIx75 following resistance exercise potentially arising fromcardiovascular and non-cardiovascular factors that likely differ from those following aerobic exercise. Future studies should address identified methodological limitations to enhance interpretation and applicability of arterial stiffness and wave reflection indices to exercise and health.

Changes in circulating microRNA and arterial stiffness following high‐intensity interval and moderate intensity continuous exercise

“…AIx may change independently of arterial stiffness and gives an indication of afterload imposed on the left ventricle due to wave reflection (Kim & Braam, 2013). AIx generally decreases immediately after exercise, however this is likely mediated by increased HR (Mutter et al., 2017; Pierce et al., 2018). When normalized to a HR of 75 bpm, AIx75 typically increases immediately after exercise (Mutter et al., 2017; Pierce et al., 2018).…”

“…AIx generally decreases immediately after exercise, however this is likely mediated by increased HR (Mutter et al., 2017; Pierce et al., 2018). When normalized to a HR of 75 bpm, AIx75 typically increases immediately after exercise (Mutter et al., 2017; Pierce et al., 2018). In the present study AIx75 was similarly increased 10 min after both MOD and HII exercise.…”

“…The minimization of arterial stiffening is a major target for the prevention of CVDs, though the cellular and molecular mechanisms underlying changes in arterial stiffness are not completely understood. Exercise can elicit acute alterations in arterial stiffness (Mutter, Cooke, Saleh, Gomez, & Daskalopoulou, 2017; Pierce, Doma, & Leicht, 2018), providing a useful model to study potential underlying mechanisms. Both long term changes with aging and acute exercise‐induced changes in arterial stiffness may result from a combination of altered hemodynamics, sympathetic stimulation, inflammatory factors, reactive oxygen species (ROS), vascular tone, and other circulating factors (Atkinson, Carter, et al, 2015; Atkinson, Lewis, et al, 2015; Dawson, Green, & Cable, 2013,; Heffernan, Edwards, Rossow, Jae, & Fernhall, 2007; Johnson & Wallace, 2012; Mutter et al., 2017; Seals, Nagy, & Moreau, 2019; Shirwany & Zou, 2010).…”

“…High‐intensity endurance exercise results in greater and unique changes in many of these stimuli, which are proposed to explain the larger impairment in endothelial function often observed immediately after higher intensity compared to low‐moderate intensity exercise (Antunes et al., 2019; Birk et al., 2013; Dawson et al., 2013,; Johnson, Mather, Newcomer, Mickleborough, & Wallace, 2012; McClean, Harris, Brown, Brown, & Davison, 2015; Peake et al., 2005). It is less clear whether there are exercise intensity‐dependent changes in arterial stiffness and what factors may potentially contribute to such differences (Mutter et al., 2017; Pierce et al., 2018).…”

<p>The effect of pre-seasonal strength training on central hemodynamics and cardiac function in elite powerlifting athletes</p>

“…14 It is still under discussion whether chronic increase in afterload may lead to concentric ventricular hypertrophy. 15 Recent meta-analysis 16 revealed that acute resistance training has an adverse effect on arterial stiffness due to cardiovascular as well as non-cardiovascular mechanisms. In regard to systematic strength training, available studies have shown stiffer arteries in strengthtrained athletes, 17,18 while other data have shown a beneficial effect of resistance training on aortic stiffness.…”