Khan M Rafique, Boyes Natasha G, Luchkanych Adam M S, Jurrissen Thomas J, Al-Mouaiad Al-Azem Ibrahim, Erlandson Marta C, Wright Kristi D, Pockett Charissa, Olver T Dylan, Tomczak Corey R
Department of Psychology, College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Department of Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Am J Physiol Regul Integr Comp Physiol. 2025 Jul 1;329(1):R170-R179. doi: 10.1152/ajpregu.00285.2024. Epub 2025 Jun 4.
Young patients with congenital heart disease (CHD) often display impaired peripheral vascular function, yet evidence of the effects of exercise is limited. This study tested the hypothesis that brachial artery reactivity and forearm microvascular function would be impaired in young patients with CHD and acute isometric handgrip (IHG) exercise would improve brachial artery reactivity and forearm microvascular function in young patients with CHD. Brachial artery flow-mediated dilation (FMD) and the reactive hyperemic response [mean brachial artery blood flow area under the curve (AUC)] were tested in young patients with CHD ( = 19; 13 (4) yr; 12 male, 7 female) and healthy age-matched controls ( = 21; 13 (4) yr, 12 male, 9 female) pre- and postacute IHG exercise. Pre-IHG exercise brachial artery FMD [4.0 (3.1) vs. 5.8 (3.9)%, = 0.348] and reactive hyperemia [139 (69) vs. 167 (82) AUC, = 0.449] were not different between controls and young patients with CHD, respectively. In controls, acute IHG exercise increased FMD [4.0 (3.1) to 5.9 (2.5)%, = 0.016] and reactive hyperemia [139 (69) to 175 (75) AUC, = 0.017]. However, in young patients with CHD, acute IHG exercise only increased reactive hyperemia [167 (82) to 187 (65) AUC, = 0.017], but not FMD [5.8 (3.9) vs. 4.9 (2.9)%, = 0.426]. Endothelial-dependent vasodilation is intact in young patients with CHD, but acute exercise may alter local regulatory mechanisms such that endothelial-dependent vasodilation fails to augment. Microvascular function is unaltered with CHD. Although young healthy control participants realize augmented brachial artery flow-mediated dilation following acute isometric handgrip exercise, young patients with congenital heart disease (CHD) fail to do so. Forearm microvascular function remains intact in congenital heart disease and is enhanced similarly to control participants following acute isometric handgrip exercise. Acute exercise may alter local regulatory mechanisms such that conduit artery endothelial-dependent vasodilation is not augmented, providing evidence of stress-induced vascular impairment in young patients with CHD.
患有先天性心脏病（CHD）的年轻患者常常表现出外周血管功能受损，然而运动效果的证据却很有限。本研究检验了以下假设：患有CHD的年轻患者肱动脉反应性和前臂微血管功能会受损，急性等长握力（IHG）运动将改善患有CHD的年轻患者的肱动脉反应性和前臂微血管功能。在急性IHG运动前后，对患有CHD的年轻患者（n = 19；13（4）岁；12名男性，7名女性）和年龄匹配的健康对照者（n = 21；13（4）岁，12名男性，9名女性）进行肱动脉血流介导的舒张（FMD）和反应性充血反应[肱动脉平均血流曲线下面积（AUC）]测试。在进行IHG运动前，对照者和患有CHD的年轻患者的肱动脉FMD[4.0（3.1）%对5.8（3.9）%，P = 0.348]和反应性充血[139（69）对167（82）AUC，P = 0.449]并无差异。在对照者中，急性IHG运动增加了FMD[从4.0（3.1）%至5.9（2.5）%，P = 0.016]和反应性充血[从139（69）至175（75）AUC，P = 0.017]。然而，在患有CHD的年轻患者中，急性IHG运动仅增加了反应性充血[从167（82）至187（65）AUC，P = 0.017]，但未增加FMD[5.8（3.9）%对..4.9（2.9）%，P = 0.426]。患有CHD的年轻患者内皮依赖性血管舒张功能完好，但急性运动可能会改变局部调节机制，导致内皮依赖性血管舒张功能无法增强。微血管功能在CHD患者中未改变。尽管年轻健康对照者在急性等长握力运动后肱动脉血流介导的舒张增强，但患有先天性心脏病（CHD）的年轻患者却未能如此。先天性心脏病患者的前臂微血管功能保持完好，并且在急性等长握力运动后与对照者类似地增强。急性运动可能会改变局部调节机制，使传导动脉的内皮依赖性血管舒张功能未增强，这为患有CHD的年轻患者应激诱导的血管损伤提供了证据。
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