Giampiero Merati

Effects of sleep deprivation on cardiac autonomic and pituitary-adrenocortical stress reactivity in rats

A demanding life style, often associated with restricted time for sleep, is a growing problem in our society and may become a major health issue in the near future. Since the physiological stress system plays a critical role in coping with a challenge, it is important to know whether this system is affected by sleep loss. Although some information is available concerning the effect of sleep loss on the basal activity of the two main limbs of the stress system, the sympathetic-adrenomedullary (SAM) and the hypothalamic-pituitary-adrenocortical (HPA) axes, little is known about the effect of sleep loss on the subsequent response to a stressor. This study investigated the effects of sleep deprivation on cardiac autonomic and HPA axis (re)activity, under baseline conditions and in response to an acute emotional stressor (15-min of restraint). Rats were subjected to 48 h of sleep deprivation by placing them in slowly rotating wheels. Electrocardiographic recordings were performed via radiotelemetry and autonomic balance was quantified via time-domain indexes of heart rate variability. HPA axis activity was examined by collecting blood samples which were analyzed for plasma ACTH and corticosterone concentrations. The results show that sleep deprivation produced a tonic increase of heart rate and HPA axis activity. When the animals in a state of sleep debt were exposed to an acute restraint stress, a blunted parasympathetic antagonism was observed following sympathetic activation, together with an increased susceptibility to cardiac arrhythmias. The HPA axis response to restraint stress was also altered, but while pituitary ACTH response was attenuated, adrenal corticosterone release was unchanged, indicating an increased adrenocortical sensitivity to ACTH. The data show that sleep deprivation not only affects the baseline activity of the stress system, but it also alters its response to a subsequent stressor.

Assessment of the autonomic control of heart rate variability in healthy and spinal-cord injured subjects: contribution of different complexity-based estimators

We investigated how complexity-based estimators of heart rate variability can detect changes in cardiovascular autonomic drive with respect to traditional measures of variability. This was done by analyzing healthy subjects and paraplegic patients with different autonomic impairment due to low (vascular impairment only) or high (cardiac and vascular impairment) spinal cord injury, during progressive autonomic activations. While traditional techniques only quantified the effects of the autonomic activation, not distinguishing the effects of the lesion level, some recently proposed complexity estimators could also reveal the pathologic alterations in the autonomic control of heart rate. These estimators included the detrended fluctuation analysis coefficient (sensitive to both low and high autonomic lesions), sample entropy (sensitive to low-level lesions) and the largest Lyapunov exponent (sensitive to high-level lesions). Thus complexity-based methods provide information on the autonomic function from the heart rate dynamics that cannot be obtained by traditional techniques. This finding supports the combined use of both complexity-based and traditional methods to investigate the autonomic cardiovascular control from a more comprehensive perspective.

Effects of Trimetazidine on Metabolic and Functional Recovery of Postischemic Rat Hearts

The objective of this study was to test the hypothesis that the beneficial effect of trimetazidine during reflow of ischemic hearts is mediated by energy sparing and ATP pool preservation during ischemia. Isolated rat hearts (controls and rats treated with 10−6 M trimetazidine, n = 17 per group) underwent the following protocol: baseline perfusion at normal coronary flow (20 minutes), low-flow ischemia at 10% flow (60 minutes), and reflow (20 minutes). We measured contractile function, O2 uptake, lactate release, venous pH and PCO2, and the tissue content of high-energy phosphates and their metabolites. During baseline, trimetazidine induced higher venous pH and lower PCO2 without influencing performance and metabolism. During low-flow ischemia, trimetazidine reduced myocardial performance (P = 0.04) and ATP turnover (P = 0.02). During reflow, trimetazidine improved performance (91 ± 6% versus. 55 ± 6% of baseline), prevented the development of diastolic contracture and coronary resistance, and reduced myocardial depletion of adenine nucleotides and purines. ATP turnover during low-flow ischemia was inversely related to recovery of the rate-pressure product (P = 0.002), end-diastolic pressure (P = 0.007), and perfusion pressure (P = 0.05). We conclude that trimetazidine-induced protection of ischemic-reperfused hearts is also mediated by energy sparing during ischemia, which presumably preserves the ATP pool during reflow.

A wearable system for the seismocardiogram assessment in daily life conditions

Seismocardiogram (SCG) is the recording of the minute body accelerations induced by the heart activity, and reflects mechanical aspects of heart contraction and blood ejection. So far, most of the available systems for the SCG assessment are designed to be used in a laboratory or in controlled behavioral and environmental conditions. In this paper we propose a modified version of a textile-based wearable device for the unobtrusive recording of ECG, respiration and accelerometric data (the MagIC system), to assess the 3d sternal SCG in daily life. SCG is characterized by an extremely low magnitude of the accelerations (in the order of g × 10−3), and is masked by major body accelerations induced by locomotion. Thus in daily life recordings, SCG can be measured whenever the subject is still. We observed that about 30 seconds of motionless behavior are sufficient for a stable estimate of the average SCG waveform, independently from the subjects posture. Since it is likely that during spontaneous behavior the subject may stay still for at least 30 seconds several times in a day, it is expected that the SCG could be repeatedly estimated and tracked over time through a prolonged data recording. These observations represent the first testing of the system in the assessment of SCG out of a laboratory environment, and open the possibility to perform SCG studies in a wide range of everyday conditions without interfering with the subjects activity tasks.

ACUTE EFFECTS OF STATIC STRETCHING ON SQUAT JUMP PERFORMANCE AT DIFFERENT KNEE STARTING ANGLES

La Torre, A, Castagna, C, Gervasoni, E, Cè, E, Rampichini, S, Ferrarin, M, and Merati, G. Acute effects of static stretching on squat jump performance at different knee starting angles. J Strength Cond Res 24(3): 687-694, 2010-The purpose of this study was to examine the effects of static stretching on leg extensor muscles during squat jump (SJ) at different knee starting angles. Seventeen male subjects (23 ± 3 years, 179 ± 5 cm, and 74 ± 6 kg) performed on a force platform 2 series (preceded or not [control condition] by 10-minute static stretching of quadriceps and triceps surae muscles) of SJs at different knee starting angles: 50°, 70°, 90°, and 110°. Squat jump height, peak force, maximal acceleration, velocity, and power were calculated for each jump. The angle that maximized power development was obtained from the power-angle relationship. The SJ height, peak force, and maximal velocity increased according to angle amplitude in both control and stretching conditions (p < 0.01), performance being significantly lower in the stretching condition (p < 0.01). Peak power was obtained at 90° in both control and stretching conditions, but was significantly lower (p < 0.01) after stretching. These results suggest that an acute bout of static stretching reduces power and force development during SJ, decrements being significantly higher at lower knee starting angles. Therefore, the use of static stretching may be questionable in those power activities requiring maximal power output at knee angles near full extension.

Relationship between push phase and final race time in skeleton performance

The aim of this study was to examine the relationship between push-time and final race time in skeleton participants during a series of major international competitions to determine the importance of the push phase in skeleton performance. Correlations were computed from the first and second heat split data measured during 24 men and 24 women skeleton competitions. Body mass, height, age, and years of experience of the first 30 men and women athletes of the skeleton, bobsleigh and luge 2003–2004 World Cup ranking were used for the comparison between sliding sports. Moderate but significant correlations (p < 0.05) were found between push-time and final race time in men (rmean = 0.48) and women (rmean = 0.63). No correlations were found between changes in the individual push-time between the first and second heat with the corresponding changes in final race time. The bobsleigh sliders are heavier than the athletes of the other sliding disciplines. Luge athletes have more experience and are younger than bobsleigh and skeleton sliders. The results of this study suggest that a fast push phase is a prerequisite to success in competition and confirms that the selection of skeleton athletes based on the ability to accelerate to a maximum speed quickly could be valid. However, a good or improved push-time does not ensure a placement in the top finishing positions. On the basis of these results, we suggest that strength and power training is necessary to maintain a short push-time but additional physical training aimed to enhance the push phase might not reflect performance improvements. The recruitment of younger athletes and an increase of youthful competitive activity may be another effective way to reach international competitive results.

Genetics of Renal Damage in Primary Hypertension

Little is known of the genetics of glomerular damage in essential hypertension in humans. The prevalence of end-stage renal disease due to primary hypertension varies from 20% to 30% of all cases of renal failure to as low as 0.002%. This depends not only on differences in diagnostic criteria but also on different racial susceptibility to the disease as well as on different genetic backgrounds in different subsets of individuals of the same race. A review of the literature is provided, together with an example of how a point mutation that causes hypertension in Milan hypertensive rats can provide a model to analyze this issue correctly.

Energy consumption of locomotion with orthosis versus Parastep-assisted gait: A single case study

Study design: Single case study.Objectives: To evaluate the energy expenditure during ambulation with the Advanced Reciprocating Gait Orthosis (ARGO), with and without functional electrical stimulation (FES), and with the Parastep system in a single subject, in order to avoid the effect of inter-subject variability.Setting: The Centre of Sport Medicine and Bioengineering Centre ‘Don C Gnocchi’ Foundation ONLUS IRCCS, Milano, Italy.Methods: A single patient (lesion level T5–T6) was trained specifically for each walking system and was evaluated after each training period. The effects of FES on muscle conditioning, spasticity and bone density were also evaluated. The HR/[Vdot ]O2 relationship and the energy cost of locomotion were measured during wheelchair (WHCH) use, during locomotion with ARGO (with and without FES) and Parastep system at different speeds.Results: The following was observed at the end of the whole training: (a) circumferences of both lower limbs and quadriceps forces were increased, whereas fatigue index was slightly decreased, spasticity and bone density were unchanged; (b) compared to WHCH locomotion, the slope of HR/VO2 curves with ARGO was higher (slope difference=51.1 b 1O2 −1), with ARGO+FES was similar (slope difference=−5.3 b 1O2 −1) and with Parastep was smaller (slope difference=−55.6 b 1O2 −1); (c) HR increased linearly with all locomotion systems, but did not rise above 125 bpm with Parastep; (d) the cost of locomotion was higher with Parastep than with ARGO (with and without FES), tested at each velocity; (e) Parastep appears to be easier to use for the subject.Conclusions: (a) FES can improve ambulation with orthosis, but the cost of locomotion remains very high; (b) the Parastep assisted gait elicits a higher energy expenditure than other orthoses, probably due to the lower speed of locomotion and to the high isometric effort of the stimulated muscles.Sponsorship: This work has been partially supported by the Italian Minister of Public Health (Ricerca Finalizzata IRCCS no ICS030.7/RF97.25).

Trunk muscular strength in pre-pubertal children with and without back pain.

Objective: While in adulthood there is no proven relationship between back pain and trunk muscle strength, in pre-pubertal subjects this topic has been poorly studied. The aim of the study was to evaluate isometric and isokinetic trunk muscle strength in children with or without previous back pain.  Methods: The recent occurrence of back pain (last 6 months) among 144 children (77 males, 67 females, age 11.9 ± 0.3 years) was assessed using a questionnaire. Extensor and flexor trunk muscle strength was measured through isometric and isokinetic (60, 90, 120°/s) tests. Peak torque (PT), PT angle, PT flexor/PT extensor ratio and intra-session coefficient of variation (COV) were determined.  Results: Flexor and extensor muscle PT, but not PT angle, were significantly higher in males than in females, irrespective of back pain occurrence. PT flexor/PT extensor ratio at 90° angular velocities increased significantly only in males with back pain, compared with males without back pain. The COV trend was similar for flexor and extensor muscles.  Conclusions: Isometric and isokinetic trunk muscle strength probably play a minor role in back pain occurrence in children. The isokinetic testing velocity may be important in determining trunk strength differences between children with and without back pain.

Sleep quality and high intensity interval training at two different times of day: A crossover study on the influence of the chronotype in male collegiate soccer players

ABSTRACT The influence of the chronotype on the sleep quality in male collegiate soccer players in response to acute high intensity interval training (HIIT) performed at two different times of day was evaluated. The sleep quality was poorer in the morning-type than in the evening-type players after the evening HIIT session, whereas no significant changes in the sleep quality of the two chronotypes after the morning HIIT session was observed. The results suggest that an athlete’s chronotype should be taken into account when scheduling training sessions and to promote faster recovery processes.