A. Impaired central hemodynamic response and exaggerated vasoconstriction during muscle metaboreflex activation in heart failure patients.

We hypothesized that the role of stroke volume (SV) in the metaboreflex-induced cardiac output (CO) increase was blunted when the metaboreflex was stimulated by exercise muscle ischemia (EMI) compared with post-exercise muscle ischemia (PEMI), because during EMI heart rate (HR) increases and limits diastolic filling. Twelve healthy volunteers were recruited and their hemodynamic responses to the metaboreflex evoked by EMI, PEMI, and by a control dynamic exercise were assessed. The main finding was that the blood pressure increment was very similar in the EMI and PEMI settings. In both conditions the main mechanism used to raise blood pressure was a CO elevation. However, during the EMI test CO was increased as a result of HR elevation whereas during the PEMI test CO was increased as a result of an increase in SV. These results were explainable on the basis of the different HR behavior between the two settings, which in turn led to different diastolic time and myocardial performance.

Muay Thai is a martial art that requires complex skills and tactical excellence for success. However, the energy demand during a Muay Thai competition has never been studied. This study was devised to obtain an understanding of the physiological capacities underlying Muay Thai performance. To that end, the aerobic energy expenditure and the recruitment of anaerobic metabolism were assessed in 10 male athletes during a simulation match of Muay Thai. Subjects were studied while wearing a portable gas analyzer, which was able to provide data on oxygen uptake, carbon dioxide production, and heart rate (HR). The excess of CO2 production (CO2 excess) was also measured to obtain an index of anaerobic glycolysis. During the match, group energy expenditure was, on average (mean +/- standard error of the mean), 10.75 +/- 1.58 kcal.min-1, corresponding to 9.39 +/- 1.38 metabolic equivalents. Oxygen uptake and HRs were always above the level of the anaerobic threshold assessed in a preliminary incremental test. CO2 excess showed an abrupt increase in the first round, and reached a value of 636 +/- 66.5 mL.min-1. This parameter then gradually decreased throughout the simulation match. These data suggest that Muay Thai is a physically demanding activity with great involvement of both the aerobic metabolism and anaerobic glycolysis. In particular, it appears that, after an initial burst of anaerobic glycolysis, there was a progressive increase in the aerobic energy supply. Thus, training protocols should include exercises that train both aerobic and anaerobic energetic pathways.