Exercise training induces vascular adaptations that improve oxygen kinetics and exercise capacity, while nitrate supplementation further enhances vascular and aerobic function in health and disease.
How do vascular function, exercise training, and nitrate supplementation affect exercise capacity in health and disease?
This review highlights the critical role of vascular function, exercise training, and nitrate supplementation in determining exercise capacity and oxygen transport in both health and disease.
Abstract Three sentinel parameters of aerobic performance are the maximal oxygen uptake ( ), critical power (CP) and speed of the kinetics following exercise onset. Of these, the latter is, perhaps, the cardinal test of integrated function along the O 2 transport pathway from lungs to skeletal muscle mitochondria. Fast kinetics demands that the cardiovascular system distributes exercise‐induced blood flow elevations among and within those vascular beds subserving the contracting muscle(s). Ideally, this process must occur at least as rapidly as mitochondrial metabolism elevates . Chronic disease and ageing create an O 2 delivery (i.e. blood flow × arterial O 2 , ) dependency that slows kinetics, decreasing CP and , increasing the O 2 deficit and sowing the seeds of exercise intolerance. Exercise training, in contrast, does the opposite. Within the context of these three parameters (see Graphical Abstract), this brief review examines the training‐induced plasticity of key elements in the O 2 transport pathway. It asks how structural and functional vascular adaptations accelerate and redistribute muscle and thus defend microvascular O 2 partial pressures and capillary blood–myocyte O 2 diffusion across a ∼100‐fold range of muscle values. Recent discoveries, especially in the muscle microcirculation and ‐to‐ heterogeneity, are integrated with the O 2 transport pathway to appreciate how local and systemic vascular control helps defend kinetics and determine CP and in health and how vascular dysfunction in disease predicates exercise intolerance. Finally, the latest evidence that nitrate supplementation improves vascular and therefore aerobic function in health and disease is presented. image
Poole et al. (Fri,) conducted a review in Exercise capacity in health and disease. Exercise training and nitrate supplementation was evaluated. Exercise training induces vascular adaptations that improve oxygen kinetics and exercise capacity, while nitrate supplementation further enhances vascular and aerobic function in health and disease.
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