Review
Influence of exercise training mode on arterial diameter: A systematic review and meta-analysis

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Abstract

Objectives

To examine whether differences in arterial diameter exist between athletes participating in endurance, resistance or mixed exercise training.

Design

A systematic review with meta-analysis.

Methods

Random effects meta-analyses of the weighted mean difference in aortic, carotid, brachial and femoral arterial diameters, height and body mass were conducted on data from 16 peer-reviewed studies indexed on PubMed, MEDLINE, SCOPUS and Sport Discus. Effect sizes were calculated as the standardised difference in means (δ), and used to compare endurance (n = 163), resistance (n = 192), and mixed trained athletes (n = 360), with controls (n = 440).

Results

Compared to controls, endurance athletes displayed the greatest difference in diameter in the brachial artery (δ = 1.84, 95% CI: 0.59, 3.09, p < 0.01), whereas for mixed athletes, the greatest difference in diameter occurred in the femoral artery (δ = 3.65, 95% CI: 2.21, 5.10, p < 0.01), despite there being no differences in height or body mass between these groups. Resistance athletes had a significantly greater body mass (p = 0.047) and aortic diameter (δ = 1.81, 95% CI: 1.58, 2.05, p < 0.01) than controls, however differences in other vessels could not be determined through meta-analysis due to insufficient data.

Conclusions

Our results provide evidence for localised arterial differences, which occur more extensively in peripheral vessels (brachial and femoral). Chronically, vascular remodelling may occur as a result of the specific haemodynamic conditions within each vessel, which likely differs depending on the mode of exercise. In the future, empirical research is needed to understand the effect of resistance training on chronic vascular remodelling, as this is not well documented.

Introduction

Chronic vascular remodelling, including changes in arterial wall thickness,1 diameter2 and wall-to-lumen ratio,3 in response to exercise training has been widely debated. Whilst the majority of research supports differences in arterial diameter in athletes compared to sedentary or recreationally active controls,1, 2, 3, 4, 5, 6, 7, 8, 9 it remains unclear whether the mode of exercise training (endurance, resistance or mixed) plays a role in these differences. This may be due, in part, to the examination of different arteries and the wide range of sports studied. Previously, both blood flow and shear stress patterns have been shown to vary depending on exercise modality,10 and chronic vascular remodelling has been suggested as a mechanism to reduce exercise-specific shear stress.7 Structural properties, such as the distribution of collagen and elastin, differs significantly between central and peripheral arteries11 such that arteries located distally to the heart are stiffer than those located more proximal.12 Therefore it is conceivable that arterial remodelling in response to chronic exercise training may differ in each vascular bed; occurring more extensively in peripheral arteries and specifically in response to the blood flow and shear stress patterns to which each vessel is exposed during exercise.

The current disparity in results makes it difficult to ascertain whether arterial remodelling occurs regionally in response to a specific type of exercise stimulus or whether remodelling occurs consistently in all vascular beds. Longitudinal studies that have examined arterial diameter following a period of resistance exercise training have reported increases in brachial,3, 6 carotid and femoral13 diameter, yet others report no change.3, 14 Studies of endurance athletes have also reported larger carotid and femoral diameters compared to controls,2, 15 and conflict exists in relation to brachial3, 16, 17 and aortic diameters.2, 15 Assimilating all available data, and grouping current studies according to the mode of exercise, would yield the large sample sizes needed to draw high powered statistical conclusions about the existence of differences in arterial diameter between athletes engaged with endurance, resistance and mixed training. A meta-analysis of such data would also help in evaluating the current state of research, providing future direction for empirical studies and determining whether the mode of exercise training is a potential moderator of arterial adaptation.

Section snippets

Methods

A literature search for peer-reviewed publications published before June 2013, and examining the arterial adaptations to exercise training was conducted using the PubMed, MEDLINE, SCOPUS and Sport Discus databases. The keywords and phrases used in the online search were aortic root, artery, arterial, athletes, diameter, exercise, structure, training, and vascular remodelling. In addition to the online search, reference lists from recently published experimental studies, review papers and

Results

Egger's regression test did not achieve statistical significance for diameter (p = 0.55), suggesting no presence of publication bias. A significant Q statistic of 121.8 (p < 0.01) and an I2 statistic of 87.7 indicated that heterogeneity between the 16 studies was great enough to apply sub-group analysis for the identification of potential moderators. Sub-group analysis revealed that both endurance and mixed athletes had significantly larger brachial and femoral arterial diameters compared to

Discussion

The purpose of this meta-analysis was to investigate if the mode of exercise training is associated with region-specific differences in arterial diameter. Our meta-analysis of 715 athletes and 440 controls suggests that adaptations in arterial diameter vary significantly between those completing different modes of exercise training, and may also be specific to individual vessels providing support for localised differences in arterial diameter, following chronic exposure to an exercise stimulus.

Conclusion

Our analysis supports that differences in arterial diameter are related to the specific mode of exercise training. Additionally localised differences in arterial diameter exist for each mode of exercise, which appear to be greater in peripheral vessels (brachial and femoral). This may be associated with the specific haemodynamic conditions within each vessel during exercise. Empirical research investigating arterial remodelling in response to resistance exercise is lacking and requires further

Acknowledgements

There is no funding, financial support or technical assistance to be declared in relation to this study and the authors have no conflict of interest to report.

References (60)

  • M. Miyachi et al.

    Effects of endurance training on the size and blood flow of the arterial conductance vessels in humans

    Acta Physiol Scand

    (1998)
  • M. Rakobowchuk et al.

    Endothelial function of young healthy males following whole body resistance training

    J Appl Physiol

    (2005)
  • R.F. Zoeller et al.

    Vascular remodeling in response to 12 wk of upper arm unilateral resistance training

    Med Sci Sports Exerc

    (2009)
  • M. Welsch et al.

    Comparison of brachial artery vasoreactivity in elite power athletes and age-matched controls

    PLOS ONE

    (2013)
  • F.A. Dinenno et al.

    Regular endurance exercise induces expansive arterial remodelling in the trained limbs of healthy men

    J Physiol

    (2001)
  • D.H. Thijssen et al.

    Brachial artery blood flow responses to different modalities of lower limb exercise

    Med Sci Sports Exerc

    (2009)
  • G. Fischer et al.

    Collagen and elastin content in canine arteries selected from functionally different vascular beds

    Circ Res

    (1966)
  • G. McVeigh et al.

    Arterial compliance, Chapter 85, in Cardiovascular Medicine

    (2000)
  • G. Stebbings et al.

    Resting arterial diameter and blood flow changes with resistance training and detraining in healthy young individuals

    J Athl Train

    (2013)
  • M. Miyachi et al.

    Unfavourable effects of resistance training on central arterial compliance. A randomized intervention study

    Circulation

    (2004)
  • P. Zeppilli et al.

    Echocardiographic size of conductance vessels in athletes and sedentary people

    Int J Sports Med

    (1995)
  • T. Tinken et al.

    Time course of change in vasodilator function and capacity in response to exercise training in humans

    J Physiol

    (2008)
  • J. Libonati

    Aerobic run training improves brachial artery flow-mediated dilation

    J Strength Cond Res

    (2007)
  • M.R. Williams et al.

    Variations in endothelial function and arterial compliance during the menstrual cycle

    J Clin Endocrinol Metab

    (2001)
  • O. Rognmo et al.

    Endothelial function in highly endurance-trained men: effects of acute exercise

    J Strength Cond Res

    (2008)
  • K.L. Moreau et al.

    Habitual aerobic exercise is associated with smaller femoral artery intima-media thickness with age in healthy men and women

    Eur J Cardiovasc Prev Rehabil

    (2006)
  • H. Tanaka et al.

    Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men

    J Appl Physiol

    (2002)
  • L. Carlsson et al.

    Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise

    Eur J Appl Physiol

    (2011)
  • A. Dzudie et al.

    Ultrasonographic study of left ventricular function at rest in a group of highly trained black African handball players

    Eur J Echocardiogr

    (2007)
  • M. Florescu et al.

    Supranormal cardiac function in athletes related to better arterial and endothelial function

    Echocardiography

    (2010)
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