Lothar Röcker

Immediate physiological responses of healthy volunteers to different types of music: cardiovascular, hormonal and mental changes

A group of 20 healthy volunteers [10 women, 10 men; median age 25 (20–33) years] were examined by means of pulsed wave Doppler echocardiography, blood sample analysis and psychological testing before and after listening to three different examples of music: a waltz by J. Strauss, a modern classic by H. W. Henze, and meditative music by R. Shankar. To assess small haemodynamic changes, mitral flow, which reflects left ventricular diastolic behaviour, was measured by Doppler ultrasound. Heart rate, arterial blood pressure and plasma concentrations of adrenocorticotropic hormone, cortisol, prolactin, adrenaline, noradrenaline, atrial natriuretic peptide (ANP) and tissue plasminogen activator (t-PA) were determined simultaneously. Transmitral flow profile is characterized by early E-wave and late atrial induced A-wave. Velocity-time integrals were measured and the atrial filling fraction was calculated. The mental state was measured by using a psychological score (Zerssen) with low values (minimum 0) for enthusiastic and high values (maximum 56) for depressive patterns. Music by J. Strauss resulted in an increase of atrial filling fraction (AFF; 29% vs 26%;P<0.05) and ANP (63 pg·ml−1 vs 60 pg·ml−1;P<0.05). The mental state was improved (Zerssen: 6.5 vs 11 points;P<0.05). After the music of H. W. Henze prolactin values were lowered (7.7 ng·ml−1 vs 9.1 ng·ml−1;P<0.01). The music of R. Shankar led to a decrease of cortisol concentrations (57 ng·ml−1 vs 65 ng·ml−1;P<0.001), noradrenaline concentrations (209 μg·l−1 vs 256 μg·l−1;P<0.01) andt-PAantigen concentrations (1.1 ng·ml−1 vs 1.4 ng·ml−1;P<0.05). Heart rate and blood pressure remained unchanged during the whole experiment. We concluded that different types of music induced changes of left ventricular diastolic function and plasma hormone concentrations. After rhythmic music (Strauss) AFF and ANP increased significantly, the mental state being improved. Meditative music (Shankar) lowered plasma cortisol, noradrenaline and t-PA concentrations; the observed increase of early left ventricular filling was not statistically significant. Prolactin concentrations decreased after modern music (Henze). Thus, it would seem to be possible to detect cardiovascular changes following different types of music by Doppler ultrasound and hormone analysis, meditative music having promising therapeutic implications in the treatment of conditions of stress.

Effect of prolonged physical exercise on the fibrinolytic system

SummaryThe effect of a test marathon race on plasma fibrinolytic activity (FA) was studied in 16 endurance athletes before, immediately after, 3 h, and 31 h after the run. Tissue plasminogen activator (t-PA) activity increased about 31-fold immediately after the run. Similar increases were found in t-PA antigen concentration. Plasminogen activator inhibitor (PAI) was not detectable immediately after the race and was significantly decreased 3 h (P < 0.05) and 31 h (P < 0.01) later. Bβ15–42 peptide increased by 0.63 pmol · ml−1 (P<0.001),d-dimer by 68.3 ng · ml−1 (P< 0.05). Euglobulin lysis time (ELT) was reduced from 109 to 18 min (P<0.001). The increased t-PA activity and t-PA antigen concentration disappeared in the course of the first 3 h after exertion. ELT also reached its pre-exercise levels at this time. Thirty-one hours after the race ELT and t-PA antigen levels were slightly but significantly reduced (P<0.05), whereas Bβ15–42 peptide remained increased (P<0.05). t-PA activity was unchanged compared with pre-exercise values. It seems that the exercise-induced FA is mainly caused by the marked increase of t-PA antigen and t-PA activity.

Influence of prolonged physical exercise on the erythropoietin concentration in blood

SummaryErythropoietin (EPO) and red blood cells were studied in 15 well-trained men before and several times after a marathon run. Changes in red blood cells reflected changes of plasma volume. Immediately after the run, red blood cells were increased due to haemoconcentration, whereas 31 h later the values were decreased due to haemodilution. The EPO concentration was increased 3 h, and more impressive 31 h, after the run. This long-lasting increase in EPO concentration after the marathon run would seem to be responsible for the increased red blood cell mass in long distance runners.

The effect of different exercise intensities on the fibrinolytic system

SummaryThe effects of moderate 30-min cycle ergometer exercise (aerobic metabolism) followed by short-term exercise at maximal capacity (anaerobic metabolism) on fibrinolytic activity were investigated in ten female and ten male healthy, untrained subjects. The following parameters of fibrinolytic activity were measured initially (t0), at the end of the aerobic phase (t1), at the end of the anaerobic phase (t2) and after a 30-min recovery period (t3): tissue plasminogen activator (PAt) activity, PAt concentration, plasminogen activator inhibitor (PAi) activity, and D-Dimer concentration. Moderate long-term exercise caused a slight but significant increase in PAt concentration and PAt activity (t1; P<0.01), whereas short-term exercise at maximal capacity (t2) produced a substantial elevation in both these parameters (P<0.01). This would suggest that PAt was not inhibited totally by PAi which would itself seem to be consumed during exercise. In addition, a slight exercise intensity-dependent increase in D-Dimer concentration was measured — circumstancial evidence not only for elevated fibrinolytic potential, but also for an actual increase in fibrin degradation (t2: P<0.01). After t3 both PAt activity and D-Dimer concentration were still slightly but significantly increased. The results obtained in the tests of fibrinolytic activity showed no significant difference between the men and the women. It would seem that the release of PAt is more markedly stimulated by short-term intense physical exercise than by long-term moderate exercise and actually causes increased fibrin degradation.

Blood platelet activation and increase in thrombin activity following a marathon race

SummaryTo see whether strenuous prolonged exertion increases blood platelet activation and thrombin activity in healthy well-trained men, 16 male amateur runners (mean age 31,8) were studied. A marathon race (mean time 2 h 44 min 30 s) caused a significant increase in plasma Β-thromboglobulin (Β-TG), platelet factor 4 (PF4), fibrinopetide A (FPA) and factor VIII (F VIII) activity. Sixty min after exertion Β-TG and F VIII activity were still significantly elevated. FPA continued to rise, reaching peak values 60 min after the run. 22 h after finishing the race F VIII activity was still significantly elevated. The study has demonstrated the great inter-individual variability of marathon race-induced haemostatic changes. The elevation of Β-TG varied from 42% to 156%, F VIII from 112% to 625%, and in three runners FPA reached more than 900% of its pre-exercise value. In some individuals the haemostatic changes observed could be potentially unfavourable for coronary heart disease prevention.

Erythropoietin production during flights with pressurised aircrafts.

416 Vol 348 • August 10, 1996 SIR—James emphasises the importance of hypoxia as a risk factor for older passengers engaged in long-haul air travel. A cabin altitude of 8000 ft (2438 m), which is equivalent to a cabin ambient pressure of 75·8 kPa, is regarded as the maximum acceptable cabin altitude of modern airliners cruising at altitudes up to 43 000 ft (13 106 m). We have measured oxygen saturation of haemoglobin (SaO 2 ; ear pulse-oximetry) in 15 resting healthy individuals seated in a hypobaric chamber with an inside ambient pressure of 75·8 kPa. Mean SaO 2 was 90% (SD 1·9; range 85–93) after 30 min of exposure. There is considerable interindividual variation in the responses to a lowered partial O 2 pressure. Responses to hypoxic hypoxia include an increase in pulmonary ventilation, which is evident even at 6600 ft (2012 m). However, immobility, cramped seating conditions, and drowsiness might hinder proper respiratory activities. Moreover, the lower ambient pressure in the cabin leads to gastrointestinal distension, which might limit downward movements of the diaphragm. In those who were dozing off in our hypobaric chamber we found much lower SaO 2 levels (80%) at cabin altitudes of 8000 ft (2438 m). when they were stimulated to respire properly, SaO 2 levels increased substantially. Therefore, if airlines’ advice on routine in-flight exercise were also to address proper pulmonary ventilation, both important hypoxia and venous thrombosis might be prevented. For older people, these exercises should not be too strenuous, because strenuous activities might lower their SaO 2 even further. Airlines’ advice should also include recommendations on adequate fluid intake, because the low relative humidity in the cabin could lead to dehydration. The cabin relative humidity from outside fresh air is less than 1%. Moisture from passengers and crew will cause it to increase, depending on the passenger load factor, ventilation rate, temperature, and pressure. During 16 long-haul flights (Boeing 747–400) we found cabin values ranged between 7 and 14% (mean 10%), which is in accord with studies in other types of aircraft, We undertook a pilot study, in which six healthy people were exposed for 8 h to a simulated altitude of 8000 ft and relative humidity of 8–10% and were instructed to drink 2 L in that time. Compared with the control condition (sea level; relative humidity 30–40%), we found an increase of mean plasma osmolality, mean urine osmolality, and urine specific gravity, indicating dehydration. Because dehydration is a risk factor in long-haul air travel, airlines should instruct passengers to take adequate fluids, while avoiding alcohol (diuretic action, cellular dehydration, drowsiness) and carbonated beverages (gastrointestinal distension).

Vascular endothelial growth factor in exercising humans under different environmental conditions

Abstract It was the aim of this study to investigate the time course of changes in the serum concentrations of vascular endothelial growth factor (VEGF) during a regular survival training programme combined with food and fluid deprivation and during a high altitude marathon run. We studied soldiers of the Austrian Special Forces performing survival training at sea-level and marathon runners of the Posta Atletica who crossed the border between Chile and Argentina at altitudes up to 4722 m. Baseline data collected before the 1-week of survival training showed that the soldiers had normal VEGF [n=8, 246.7 (SD 118.5) pg · ml−1] serum concentrations which remained unchanged during the course of the study. Before the high altitude marathon the subjects showed normal VEGF serum concentrations [178 (SD 84.5) pg · ml−1]. After the run VEGF concentrations were found to be significantly decreased [41.0 (SD 41.6) pg · ml−1, P < 0.01]. It was concluded that prolonged physical stress during normobaric-normoxia did not alter the VEGF concentrations whereas during severe hypobaric-hypoxia decreased VEGF serum concentrations were measured, at least temporarily, after prolonged physical exercise which might have been due to changes in production, release, removal and/or binding of circulating VEGF.

Effect of prolonged physical exercise on fluid regulating hormones

SummarySixteen well-trained young men performed a test marathon to study the behaviour of atrial natriuretic peptide (ANP) and its second messenger cyclic guanosine monophosphate (cGMP) in relation to changes in plasma volume (PV) and plasma proteins, arginine vasopressin (AVP), renin, aldosterone, potassium and sodium. Blood samples were drawn under standardized conditions before and immediately after the run, as well as 3 h and 31 h after the run. Directly after the run, a two-and-a-half fold increase of plasma ANP and a twofold increase of plasma cGMP level were found, whereas PV decreased significantly by 7.4%. At this time renin-, aldosterone- and AVP-secretion were much stimulated. Thirty-one hours after the run, PV was markedly greater (10%) than before the race, whereas plasma proteins had returned to pre-exercise values. The ANP and cGMP were not significantly altered compared to the pre-race values. We have concluded that ANP and the other volume-regulating hormones may play an important role during and immediately after prolonged physical exercise but not in the longer recovery period. It seems that an influx of plasma proteins into the vascular space is responsible for the increased PV at this time.

Erythropoietin in 29 men during and after prolonged physical stress combined with food and fluid deprivation

The study investigated the influence of prolonged physical stress during survival training with food and fluid deprivation on the serum concentrations of erythropoietin (EPO). A group of 29 male subjects [mean age 22.2 (SD 2.8) years, height 1.78 (SD 0.06) m, and body mass (mb) 73.5 (SD 8.6) kg] were studied for 5 days of multifactorial stress including restricted water intake (1] H2O · day−1) and food intake (628 kJ day−1) combined with physical exercise (estimated energy expenditure approximately 24 000 kJ · day−1) and sleep deprivation (20h within 5 days). Blood samples were taken before (T1), after 72 h (T2) and 120h (T3) of physical stress, and after 48h, (T4) and 72 h (T5) of recovery. The samples were analysed for EPO, and concentrations of serum iron (Fe), haptoglobin (Hapto), transferrin (Trans), ferritin (Fer), haemoglobin (Hb) and packed cell volume (PCV). The mb had decreased by 6.77 kg at T3 (P <0.01) and 0.68 kg at T5. The EPO and Hapto decreased during the survival training (P <0.01) and increased during the recovery period (P <0.01). The Fe increased during the survival training (P <0.01) and remained above the control concentrations during recovery (P <0.01). The Hapto decreased during the survival training (P <0.01) and remained below control concentration at T4 and T5 (P <0.01). The Trans decreased continuously over the week (P <0.01). The Fer increased during the survival training (P <0.01) and returned to control concentration at T5. The Hb increased from T1 to T2 (P <0.01) and had decreased significantly at T5 (P <0.01). The PCV increased from T1 to T2 (P <0.01) and remained below control levels afterwards (P <0.01). From our study it was concluded that, in humans, prolonged physical stress with food and fluid deprivation induces a marked EPO decrease, which is followed by a rapid increase during recovery to restore the reduced OZ transport capacity.

Fluid distribution and tissue thickness changes in 29 men during 1 week at moderate altitude (2,315 m)

To quantify fluid distribution at a moderate altitude (2,315 m) 29 male subjects were studied with respect to tissue thickness changes [front (forehead), sternum, tibia], changes of total body water, changes of plasma volume, total protein concentrations (TPC), colloid osmotic pressure (COP), and electrolytes. Tissue thickness at the forehead showed a significant increase from 4.14 mm to 4.41 mm 48 h after ascent to the Rudolfshuette (2,315 m) (P < 0.05). At 96 h after ascent the tissue thickness at the tibia was decreased to 1.33 mm compared to the control value of 1.59 mm (P < 0.01). Body mass increased from 75.5 kg (control) to 76.2 kg on the last day (P < 0.05) and body water from 44.21 to 45.01 during the week (P < 0.01). The accumulation fluid in the upper part of the body was paralleled by a decrease in TPC and COP. At 48 h after the ascent COP dropped from 29.5 mmHg to 27.5 mmHg (P < 0.01). After 96 h at moderate altitude COP was still significantly decreased compared to the control level. At 1.5 h after the return from the Rudolfshuette in Saalfelden (744m) COP was back to the control values. The TPC also showed an initial drop from 7.75 g · dl−1 to 7.48 g · dl−1 after 48 h at altitude and remained below the control value during the whole week (P < 0.01). It seems from our study that even with exposure to moderate altitude measurable fluid shifts to the upper part of the body occurred which were detected by our ultrasound method.