Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Am J Physiol Heart Circ Physiol. 2024 Jun 1;326(6):H1462-H1468. doi: 10.1152/ajpheart.00132.2024. Epub 2024 Apr 19.
It is unclear whether muscle blood flow (MBF) is altered in long-term Hodgkin lymphoma (HL) survivors. We tested the hypothesis that ) MBF response during mental stress (MS) is impaired in long-term HL survivors and ) aerobic exercise training combined with local strength exercise (ET) restores MBF responses during MS in these survivors. Eighteen 5-year HL survivors and 10 aged-paired healthy subjects (HC) were studied. Twenty HL survivors were randomly divided into two groups: exercise-trained (HLT, = 10) and untrained (HLUT, = 10). Maximal aerobic capacity was evaluated by a cardiopulmonary exercise test and forearm blood flow (FBF) by venous occlusion plethysmography. MS was elicited by Stroop color and word test. ET was conducted for 4 mo, 3/wk for 60 min each session. The aerobic exercise intensity corresponded to anaerobic threshold up to 10% below the respiratory compensation point. The strength exercises consisted of two to three sets of chest press, pulley and squat exercises, 12-15 repetitions each exercise at 30-50% of the maximal voluntary contraction. Baseline was similar in HL survivors and HC, except peak oxygen consumption (peak V̇o, = 0.013) and FBF ( = 0.006) that were lower in the HL survivors. FBF responses during MS were lower in HL survivors ( < 0.001). ET increased peak V̇o (11.59 ± 3.07%, = 0.002) and FBF at rest (33.74 ± 5.13%, < 0.001) and during MS (24 ± 5.31%, = 0.001). Further analysis showed correlation between the changes in peak V̇o and the changes in FBF during MS (r = 0.711, = 0.001). In conclusion, long-term HL survivors have impaired MBF responses during MS. ET restores MBF responses during MS. Long-term Hodgkin lymphoma (HL) survivors have impaired muscle blood flow responses during mental stress and decreased maximal aerobic capacity. Supervised aerobic exercise training combined with local strength exercises restores muscle blood flow responses during mental stress and maximal aerobic capacity in these survivors. These findings provide evidence of safety and effectiveness of exercise training in HL survivors. Moreover, they highlight the importance of exercise training in the treatment of this set of patients.
目前尚不清楚长期霍奇金淋巴瘤（HL）幸存者的肌肉血流（MBF）是否发生改变。我们检验了以下假说：在长期 HL 幸存者中，精神应激（MS）期间的 MBF 反应受损，而有氧运动训练联合局部力量训练（ET）可恢复这些幸存者在 MS 期间的 MBF 反应。18 名 5 年 HL 幸存者和 10 名年龄匹配的健康受试者（HC）参与了研究。20 名 HL 幸存者随机分为两组：运动训练组（HLT，n=10）和未训练组（HLUT，n=10）。通过心肺运动试验评估最大有氧能力，通过静脉闭塞容积描记法评估前臂血流（FBF）。MS 通过 Stroop 颜色和单词测试诱发。ET 持续 4 个月，每周 3 次，每次 60 分钟。有氧运动强度对应于无氧阈以下 10%的呼吸补偿点。力量训练包括两组到三组的卧推、滑轮和深蹲运动，每组 12-15 次，最大自主收缩的 30-50%。HL 幸存者和 HC 的基线相似，除了峰值摄氧量（peak V̇o，P=0.013）和 FBF（P=0.006）较低。MS 期间的 FBF 反应在 HL 幸存者中较低（P<0.001）。ET 增加了 peak V̇o（11.59±3.07%，P=0.002）和休息时的 FBF（33.74±5.13%，P<0.001）以及 MS 期间的 FBF（24±5.31%，P=0.001）。进一步的分析表明，peak V̇o 的变化与 MS 期间 FBF 的变化之间存在相关性（r=0.711，P=0.001）。总之，长期 HL 幸存者在 MS 期间的 MBF 反应受损。ET 恢复了 MS 期间的 MBF 反应。长期霍奇金淋巴瘤（HL）幸存者在精神应激期间的肌肉血流反应受损，最大有氧能力降低。监督下的有氧运动训练联合局部力量训练可恢复这些幸存者在精神应激和最大有氧能力期间的肌肉血流反应。这些发现为 HL 幸存者的运动训练的安全性和有效性提供了证据。此外，它们强调了运动训练在治疗这一组患者中的重要性。
