Effects of short supramaximal exercise on hemorheology in sickle cell trait carriers

Connes, Philippe; Sara, Fagnété; Hardy‐Dessources, Marie‐Dominique; Marlin, Laurent; Etienne, Frantz; Larifla, Laurent; Saint‐Martin, C.; Hue, Olivier

doi:10.1007/s00421-006-0155-3

Cited by 48 publications

(50 citation statements)

References 30 publications

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“…Effects of incremental exercise. In the present study, maximal exercise performance was not affected by SCT and SCTAT, and P peak values were in the range of P peak found in the literature for these populations (10,18). In all athletes, this exercise test did not affect the plasma concentrations of sICAM-1 and TNF-␣ as demonstrated by several previous studies using the same type of exercise (4,31).…”

Section: Discussionsupporting

confidence: 63%

Effects of progressive and maximal exercise on plasma levels of adhesion molecules in athletes with sickle cell trait with or without α-thalassemia

Monchanin¹,

Serpero²,

Connes³

et al. 2007

Journal of Applied Physiology

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The aim of the study was to examine the effects of exercise on soluble vascular cell adhesion molecule-1 (sVCAM-1) and intercellular adhesion molecule-1 (sICAM-1) in sickle cell trait (SCT) athletes with or without α-thalassemia. Six athletes with SCT, seven athletes with both SCT and α-thalassemia (SCTAT), and seven control athletes (Cont) performed an incremental and maximal test on cycloergometer. Levels of sICAM-1 and sVCAM-1 were assessed at rest, immediately after the end of exercise, and 1, 2, and 24 h after exercise. Although Cont and SCTAT groups exhibited similar basal plasma levels of inflammatory and adhesion molecules, the SCT group had higher sVCAM-1 basal concentrations. Incremental exercise resulted in a significant increase of sVCAM-1 in all subjects, which remained elevated only in the SCT group during the recovery period. In conclusion, as sVCAM-1 increased with exercise and during the recovery period, our findings support the concept that SCT athletes might be at risk for microcirculatory disturbances and adhesive phenomena developing at rest and several hours after exercise. α-Thalassemia might be considered protective among exercising SCT subjects.

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Section: Discussionsupporting

confidence: 63%

Effects of progressive and maximal exercise on plasma levels of adhesion molecules in athletes with sickle cell trait with or without α-thalassemia

Monchanin¹,

Serpero²,

Connes³

et al. 2007

Journal of Applied Physiology

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“…An immediate consequence of these microvascular blood flow alterations in SCT would include disturbances in oxygen delivery to the tissues (45,51). In agreement with this hypothesis, Connes et al (19) found a lower index of oxygen supply to peripheral tissues in SCT carriers. Conversely, the higher oxygen content in venous blood of SCT carriers during exercise (28) in the absence of any alterations in arterial blood oxygen tension could also be indicative of decreased oxygen supply to the tissues due to inadequate capillary blood flow.…”

supporting

confidence: 66%

“…Blood flow is also deeply affected by blood apparent viscosity (Poiseuille's law). Several studies have thus far shown the presence of lower RBC deformability and higher blood apparent viscosity among SCT carriers compared with HbAA control (C) subjects (9,18,19,47). Furthermore, the lower RBC deformability of SCT carriers could lead to endothelial damage, activation of endothelial cells, and thus promote endothelial cell-blood cell interactions, leading to inflammation.…”

mentioning

confidence: 99%

Remodeling of skeletal muscle microvasculature in sickle cell trait and α-thalassemia

Vincent

Féasson

Oyono-Enguéllé

et al. 2010

American Journal of Physiology-Heart and Circulatory Physiology

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The influence of sickle cell trait and/or α-thalassemia on skeletal muscle microvascular network characteristics was assessed and compared with control subjects [hemoglobin (Hb) AA] in 30 Cameroonian residents [10 HbAA, 5 HbAA α-thalassemia (α-t), 6 HbAS, and 9 HbASα-t] matched for maximal work capacity and daily energy expenditure. Subjects performed an incremental exercise to exhaustion and underwent a muscle biopsy. Muscle fiber type and surface area were not different among groups. However, sickle cell trait (SCT) was associated with lower capillary density ( P < 0.05), lower capillary tortuosity ( P < 0.001), and enlarged microvessels ( P < 0.01). SCT carriers had reduced counts of microvessels <5-μm diameter, but a higher percentage of broader microvessels, i.e., diameter >10 μm ( P < 0.05). α-Thalassemia seemed to be characterized by a higher capillary tortuosity and unchanged capillary density and diameter. Thus, while SCT is a priori clinically benign, we demonstrate for the first time that significant remodeling of the microvasculature occurs in SCT carriers. These modifications may possibly reflect protective adaptations against hemorheological and microcirculatory dysfunction induced by the presence of HbS. The remodeling of the microvascular network occurs to a lesser extent in α-thalassemia. In α-thalassemic subjects, increased capillary tortuosity would promote oxygen supply to muscle tissues and might compensate for the lower Hb content often reported in those subjects.

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“…10,13,[27][28][29][30][31] In contrast, our results do not demonstrate differences in baseline or longitudinal changes in fitness by SCT status, which is consistent with other studies that have also shown no difference in maximal oxygen uptake or key determinants of fitness, including lactate production and ventilatory threshold, in individuals with and without SCT. [32][33][34][35] We also found no difference in autonomic nervous system function by SCT status, using our measure of heart rate recovery after exercise.…”

Section: Discussionsupporting

confidence: 90%

Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA

Liem

Chan

et al. 2017

Blood

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Key Points• SCT status is not significantly associated with longitudinal changes in fitness among African Americans.• SCT status is not an independent risk factor for hypertension, diabetes, or metabolic syndrome among African Americans.The contribution of sickle cell trait (SCT) to racial disparities in cardiopulmonary fitness is not known, despite concerns that SCT is associated with exertion-related sudden death. We evaluated the association of SCT status with cross-sectional and longitudinal changes in fitness and risk for hypertension, diabetes, and metabolic syndrome over the course of 25 years among 1995 African Americans (56% women, 18-30 years old) in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Overall, the prevalence of SCT was 6.8% (136/1995) in CARDIA, and over the course of 25 years, 46% (738/1590), 18% (288/1631), and 40% (645/1,611) of all participants developed hypertension, diabetes, and metabolic syndrome, respectively. Compared with participants without SCT, participants with SCT had similar baseline measures of fitness in cross-section, including exercise duration (535 vs 540 seconds; P 5 .62), estimated metabolic equivalent of tasks (METs; 11.6 vs 11.7; P 5 .80), maximum heart rate (174 vs 175 beats/min; P 5 .41), and heart rate at 2 minutes recovery (44 vs 43 beats/min; P 5 .28). In our secondary analysis, there was neither an association of SCT status with longitudinal changes in fitness nor an association with development of hypertension, diabetes, or metabolic syndrome after adjustment for sex, baseline age, body mass index, fitness, and physical activity. SCT is not associated with reduced fitness in this longitudinal study of young African American adults, suggesting the increased risk for exertion-related sudden death in SCT carriers is unlikely related to fitness. SCT status also is not an independent risk factor for developing hypertension, diabetes, or metabolic syndrome. (Blood. 2017;129(6):723-728) IntroductionSickle cell trait (SCT) is caused by the inheritance of a single copy of the variant b globin gene, which results in production of abnormal sickle hemoglobin. The coinheritance of 2 copies of the abnormal gene results in sickle cell anemia (SCA), a clinically significant blood disorder seen primarily among individuals of African or Afro-Caribbean descent. Historically, SCT, which is observed in 8% of the African American population in the United States, has been considered a clinically benign condition. Recent studies, however, suggest SCT may confer a higher risk for chronic kidney disease, thrombosis, stroke, and pregnancy-related complications in its carriers.1-6 Importantly, there is growing concern SCT may be associated with sudden death during strenuous physical activity and exercise, leading to the National College Athletics Association to mandate carrier status testing among all student athletes in division I institutions in 2010, and later in all division II and III institutions. [7][8][9] Growing evidence suggests SCT carriers may exh...

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Effects of short supramaximal exercise on hemorheology in sickle cell trait carriers

Cited by 48 publications

References 30 publications

Effects of progressive and maximal exercise on plasma levels of adhesion molecules in athletes with sickle cell trait with or without α-thalassemia

Effects of progressive and maximal exercise on plasma levels of adhesion molecules in athletes with sickle cell trait with or without α-thalassemia

Remodeling of skeletal muscle microvasculature in sickle cell trait and α-thalassemia

Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA

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