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Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart

Heart failure is a major worldwide health concern and is the leading cause of hospitalization among elderly Americans. Approximately 50% of those diagnosed with heart failure have heart failure with preserved ejection fraction (HFPEF). HFPEF presents a therapeutic dilemma because pharmacological strategies that are effective for the treatment of heart failure and reduced ejection fraction have failed to show benefit in HFPEF. Long term moderate intensity exercise programs have been shown to improve diastolic function in patients HFPEF. High intensity interval training (HIIT) has been shown to improve diastolic function in patients with heart failure and reduced ejection fraction. However, the effects of high intensity interval training in patients with HFPEF are unknown. Fourteen patients with HFPEF were randomized to either: (1) a novel program of high-intensity aerobic interval training (n = 8), or (2) a commonly prescribed program of moderate-intensity (MOD) aerobic exercise training (n = 6). Before and after four weeks of exercise training, patients underwent a treadmill graded exercise test for the determination of peak oxygen uptake (VO2peak), a brachial artery reactivity test for assessment of endothelium-dependent flow-mediated dilation (BAFMD), aortic pulse wave velocity assessment as an index of vascular stiffness and two-dimensional echocardiography for assessment of left ventricular diastolic and systolic function. I hypothesized that (1) high-intensity aerobic interval training would result in superior improvements in FMD, aortic pulse wave velocity, VO2peak, diastolic function and, (2) changes in these parameters would be correlated with changes in VO2peak. The principal findings of the study were that a one month long high intensity interval training program resulted in significant improvements in diastolic function as measured by two-dimensional echocardiography [pre diastolic dysfunction (DD) grade - 2.13 + 0.4 vs. post DD grade - 1.25 + 0.7, p = 0.03]. The left atrial volume index was reduced in the HIIT group compared to MOD ( - 4.4 + 6.2 ml/m2 vs. 5.8 + 10.7 ml/m2, p = 0.02). Early mitral flow (E) improved in the HIIT group (pre - 0.93 + 0.2 m/s vs. post - 0.78 + 0.3 m/s, p = 0.03). A significant inverse correlation was observed between change in BAFMD and change in diastolic dysfunction grade (r = - 0.585, p = 0.028) when all the data were pooled. HIIT appears to be a time-efficient and safe strategy for improving diastolic function in patients with heart failure and preserved ejection fraction. These data may have implications for cardiovascular risk reduction in this population.
ContributorsAngadi, Siddhartha (Author) / Gaesser, Glenn A (Thesis advisor) / Mookadam, Farouk (Committee member) / Swan, Pamela (Committee member) / Vega-Lopez, Sonia (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Salmonella enterica is a gastrointestinal (GI) pathogen that can cause systemic diseases. It invades the host through the GI tract and can induce powerful immune responses in addition to disease. Thus, it is considered as a promising candidate to use as oral live vaccine vectors. Scientists have been making great

Salmonella enterica is a gastrointestinal (GI) pathogen that can cause systemic diseases. It invades the host through the GI tract and can induce powerful immune responses in addition to disease. Thus, it is considered as a promising candidate to use as oral live vaccine vectors. Scientists have been making great efforts to get a properly attenuated Salmonella vaccine strain for a long time, but could not achieve a balance between attenuation and immunogenicity. So the regulated delayed attenuation/lysis Salmonella vaccine vectors were proposed as a design to seek this balance. The research work is progressing steadily, but more improvements need to be made. As one of the possible improvements, the cyclic adenosine monophosphate (cAMP) -independent cAMP receptor protein (Crp*) is expected to protect the Crp-dependent crucial regulator, araC PBAD, in these vaccine designs from interference by glucose, which decreases synthesis of cAMP, and enhance the colonizing ability by and immunogenicity of the vaccine strains. In this study, the cAMP-independent crp gene mutation, crp-70, with or without araC PBAD promoter cassette, was introduced into existing Salmonella vaccine strains. Then the plasmid stability, growth rate, resistance to catabolite repression, colonizing ability, immunogenicity and protection to challenge of these new strains were compared with wild-type crp or araC PBAD crp strains using western blots, enzyme-linked immunosorbent assays (ELISA) and animal studies, so as to evaluate the effects of the crp-70 mutation on the vaccine strains. The performances of the crp-70 strains in some aspects were closed to or even exceeded the crp+ strains, but generally they did not exhibit the expected advantages compared to their wild-type parents. Crp-70 rescued the expression of araC PBAD fur from catabolite repression. The strain harboring araC PBAD crp-70 was severely affected by its slow growth, and its colonizing ability and immunogenicity was much weaker than the other strains. The Pcrp crp-70 strain showed relatively good ability in colonization and immune stimulation. Both the araC PBAD crp-70 and the Pcrp crp-70 strains could provide certain levels of protection against the challenge with virulent pneumococci, which were a little lower than for the crp+ strains.
ContributorsShao, Shihuan (Author) / Curtiss, Roy (Thesis advisor) / Arizona State University (Publisher)
Created2012
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Description
PURPOSE: Lean hypertension (HTN) is characterized by a mechanistically different HTN when compared to obese HTN. The purpose of this study is to assess whether body phenotype influences blood pressure (BP) responses following both acute and chronic exercise. METHODS: Obese (body mass index (BMI) > 30 kg/m2) and

PURPOSE: Lean hypertension (HTN) is characterized by a mechanistically different HTN when compared to obese HTN. The purpose of this study is to assess whether body phenotype influences blood pressure (BP) responses following both acute and chronic exercise. METHODS: Obese (body mass index (BMI) > 30 kg/m2) and lean (BMI < 25 kg/m2) men with pre-hypertension (PHTN) (systolic BP (SBP) 120 - 139 or diastolic BP (DBP) 80 - 89 mm Hg) were asked to participate in a two-phase trial. Phase 1 assessed differences in post-exercise hypotension between groups in response to an acute exercise bout. Phase 2 consisted of a two-week aerobic exercise intervention at 65-70% of heart rate (HR) max on a cycle ergometer. Primary outcome measures were: brachial BP, central (aortic) BP, cardiac output (CO), and systemic vascular resistance (SVR) measured acutely after one exercise session and following two weeks of training. RESULTS: There were no differences between groups for baseline resting brachial BP, central BP, age, or VO2 peak (all P > 0.05). At rest, obese PHTN had greater CO compared to lean PHTN (6.3 ± 1 vs 4.7 ± 1 L/min-1, P = 0.005) and decreased SVR compared to lean PHTN (1218 ± 263 vs 1606 ± 444 Dyn.s/cm5, P = 0.003). Average 60-minute post-exercise brachial and central SBP reduced by 3 mm Hg in Lean PHTN in response to acute exercise (P < 0.005), while significantly increasing 4 mm Hg for brachial and 3 mm Hg for central SBP (P < 0.05). SVR had a significantly greater reduction following acute exercise in lean PHTN (-223 Dyn·s/cm5) compared to obese PHTN (-75 Dyn·s/cm5, P < 0.001). In lean subjects chronic training reduced brachial BP by 4 mm Hg and central BP by 3 mm Hg but training had no effect on the BP’s in obese subjects. Resting BP reduction in response to training was accompanied by reductions in SVR within lean (-169 Dyn·s/cm5, P < 0.001), while obese experienced increased SVR following training (47 Dyn·s/cm5, P < 0.001). CONCLUSION: Hemodynamic response to both acute and chronic exercise training differ between obese and lean individuals.
ContributorsZeigler, Zachary (Author) / Swan, Pamela (Thesis advisor) / Gaesser, Glenn (Committee member) / Buman, Matthew (Committee member) / Angadi, Siddhartha (Committee member) / Farouk, Mookadam (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Physical activity is critical for optimal health and has emerged as a viable option to improve sleep. Moderate- and vigorous-intensity physical activity comparisons to improve sleep in non-exercising adults with sleep problems is limited. The purpose was to determine the effects of moderate- or vigorous-intensity exercise on sleep outcomes and

Physical activity is critical for optimal health and has emerged as a viable option to improve sleep. Moderate- and vigorous-intensity physical activity comparisons to improve sleep in non-exercising adults with sleep problems is limited. The purpose was to determine the effects of moderate- or vigorous-intensity exercise on sleep outcomes and peripheral skin temperature compared to a no-exercise control. The exercise intensity preference also was determined.

Eleven women (46.9±7.0 years) not participating in regular exercise and self-reporting insomnia completed a graded maximal exercise test followed by a crossover trial of three randomly assigned conditions separated by a 1-week washout. Participants performed moderate-intensity [MIC, 30 minutes, 65-70% maximum heart rate (HRmax)] or high-intensity (HIT, 20 minutes, 1-minute bouts at 90-95% HRmax alternating with 1-minute active recovery) treadmill walking or a no-exercise control (NEC) on two consecutive weekdays 4-6 hours prior to typical bed time. A dual-function wrist-worn accelerometer/temperature monitor recorded movement and skin temperature from which sleep-onset latency (SOL), sleep maintenance, sleep efficiency, total sleep time (TST), and peripheral skin temperature changes were calculated. Participants self-reported sleep outcomes weekly, enjoyment of exercise the morning after HIT and MIC, and exercise intensity preference upon completing all conditions. Mixed models analysis of variance examined differences between and within conditions controlling for demographic characteristics and habitual physical activity.

HIT resulted in up to a 90-minute TST increase on night four (448 minutes, 95% CI 422.4-474.2) compared to nights one-three. MIC nights three (43.5 minutes, 95% CI 30.4-56.6) and four (42.1 minutes 95% CI 29.0-55.2) showed nearly a 30-minute SOL worsening compared to nights one-two. No other actigraphy-measured sleep parameters differenced within or between conditions. Self-reported sleep outcomes, peripheral skin temperature change, and exercise enjoyment between conditions were similar (p>0.05). More participants preferred lower (n=3) to higher (n=1) intensity activities.

Early evening high-intensity and moderate-intensity exercise had no effect on sleep outcomes compared to a control in non-exercising adults reporting sleep complaints. Sleep benefits from HIT may require exercise on successive days. Participants indicated partiality for lower intensity exercise. More information on timing and mode of physical activity to improve sleep in this population is warranted.
ContributorsKurka, Jonathan M (Author) / Ainsworth, Barbara E (Thesis advisor) / Adams, Marc A (Committee member) / Angadi, Siddhartha (Committee member) / Buman, Matthew P (Committee member) / Youngstedt, Shawn D (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Wearable technology has brought in a rapid shift in the areas of healthcare and lifestyle management. The recent development and usage of wearable devices like smart watches has created significant impact in areas like fitness management, exercise tracking, sleep quality assessment and early diagnosis of diseases like asthma, sleep apnea

Wearable technology has brought in a rapid shift in the areas of healthcare and lifestyle management. The recent development and usage of wearable devices like smart watches has created significant impact in areas like fitness management, exercise tracking, sleep quality assessment and early diagnosis of diseases like asthma, sleep apnea etc. This thesis is dedicated to the development of wearable systems and algorithms to fulfill unmet needs in the area of cardiorespiratory monitoring.

First, a pneumotach based flow sensing technique has been developed and integrated into a face mask for respiratory profile tracking. Algorithms have been developed to convert the pressure profile into respiratory flow rate profile. Gyroscope-based correction is used to remove motion artifacts that arise from daily activities. By using Principal Component Analysis, the follow-up work established a unique respiratory signature for each subject based on the flow profile and lung parameters computed using the wearable mask system.

Next, wristwatch devices to track transcutaneous gases like oxygen (TcO2) and carbon dioxide (TcCO2), and oximetry (SpO2) have been developed. Two chemical sensing approaches have been explored. In the first approach, miniaturized low-cost commercial sensors have been integrated into the wristwatch for transcutaneous gas sensing. In the second approach, CMOS camera-based colorimetric sensors are integrated into the wristwatch, where a part of camera frame is used for photoplethysmography while the remaining part tracks the optical signal from colorimetric sensors.

Finally, the wireless connectivity using Bluetooth Low Energy (BLE) in wearable systems has been explored and a data transmission protocol between wearables and host for reliable transfer has been developed. To improve the transmission reliability, the host is designed to use queue-based re-request routine to notify the wearable device of the missing packets that should be re-transmitted. This approach avoids the issue of host dependent packet losses and ensures that all the necessary information is received.

The works in this thesis have provided technical solutions to address challenges in wearable technologies, ranging from chemical sensing, flow sensing, data analysis, to wireless data transmission. These works have demonstrated transformation of traditional bench-top medical equipment into non-invasive, unobtrusive, ergonomic & stand-alone healthcare devices.
ContributorsTipparaju, Vishal Varun (Author) / Xian, Xiaojun (Thesis advisor) / Forzani, Erica (Thesis advisor) / Blain Christen, Jennifer (Committee member) / Angadi, Siddhartha (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Cardiovascular disease has long been one of the leading causes of morbidity in the world and places a large burden on the health care system. Exercise has been shown to reduce the risk of developing cardiovascular disease and the risk factors associated with it. Much of the focus of research

Cardiovascular disease has long been one of the leading causes of morbidity in the world and places a large burden on the health care system. Exercise has been shown to reduce the risk of developing cardiovascular disease and the risk factors associated with it. Much of the focus of research has been on aerobic exercise modalities and their effect on these risk factors, and less is known in regard to the effect of resistance training. One novel risk factor for cardiovascular disease is arterial stiffness, specifically aortic stiffness. Aortic stiffness can be measured by carotid-femoral pulse wave velocity (PWV) and central pressure characteristics such as central blood pressures and augmentation index. The objective of this study was to assess the effect that two different 12-week long resistance training interventions would have on these measurements in sedentary, overweight and obese men and women (BMI ≥ 25 kg/m2). Twenty-one subjects completed the study and were randomized into one of the following groups: control, a low repetition/high load (LRHL) group which performed 3 sets of 5 repetitions for all exercises, and a high repetition/low load (HRLL) group which performed 3 sets of 15 repetitions for all exercises. Those in the resistance training groups performed full-body exercise routines on 3 nonconsecutive days of the week. Changes in arterial stiffness, central blood pressures, and brachial blood pressures were measured before and after the 12-week intervention period. PWV showed significant group by time interaction (p= 0.024) but upon post hoc testing no significant differences were observed due to the control group confounding (control: 7.6 ± 0.8 vs. 7.1 ± 0.8, LRHL: 6.7 ± 0.5 vs. 6.9 ± 0.5, HRLL: 7.03 ± 0.67 vs. 6.59). No other significant interactions or differences were observed for any of the variables tested. Based on the results of this study a 12-week long resistance intervention training, neither high nor moderate-intensity resistance training, resulted in improvements in indices of vascular stiffness or central and peripheral blood pressures.
ContributorsWeeldreyer, Nathan (Author) / Angadi, Siddhartha (Thesis advisor) / Gaesser, Glenn (Committee member) / Lee, Chong (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Sedentary behavior and excessive weight gain have been proven to deteriorate many characteristics of muscle. Low muscular power and mass with excess fat mass are risk factors for a multitude of chronic conditions and functional disabilities. Resistance training (RT) has long been accepted as a rehabilitative method of maintaining or

Sedentary behavior and excessive weight gain have been proven to deteriorate many characteristics of muscle. Low muscular power and mass with excess fat mass are risk factors for a multitude of chronic conditions and functional disabilities. Resistance training (RT) has long been accepted as a rehabilitative method of maintaining or enhancing muscular performance and composition. There are various methods of determining lower extremity muscular power; however, isokinetic dynamometry has emerged as one of the most accurate and reliable methods in clinical and research settings. Likewise, various methods exist for determining muscle thickness; however, many of those methods are expensive and can expose individuals to radiation. Ultrasonography has emerged as an accurate and reliable alternative to measuring lower extremity muscle thickness. The objective of this study was to assess the effects of high-load/low-volume (HLLV) and low-load/high-volume (LLHV) RT on isokinetic knee extensor and flexor peak power in sedentary, RT naïve, overweight or obese men and women (Body Mass Index ≥ 25 kg/m2). Twenty-one subjects (n = 21) completed this study and were randomized into one of the following groups: control, a HLLV group that performed three sets of 5 repetitions for all exercises until volitional fatigue, and LLHV which performed three sets of 15 repetitions for all exercises until volitional fatigue. Subjects randomized to the RT groups performed full-body exercises routines on three non-consecutive days per week. Changes in isokinetic knee extensor and flexor peak power, quadriceps ultrasound muscle thickness, and right leg segment of dual-energy X-ray absorptiometry (DEXA) scans were measured before and after the 12-week RT intervention. There were no significant differences found in group, time or, group by time interactions for knee extensor and flexor peak power using isokinetic dynamometry. Other than a group interaction for vastus intermedius muscle thickness (P=0.008), no significant interactions or differences were observed for any of the other variables tested. Based on the results of this study, neither high- nor low-load RT resulted in significant differences between intervention groups in peak power of the knee extensors and flexor, muscle thickness changes of the vastus intermedius, and vastus lateralis and, in the right lower extremity segmented body composition measures using DEXA.
ContributorsSarellis, Sofoklis Demetrios (Author) / Ofori, Edward (Thesis advisor) / Angadi, Siddhartha (Committee member) / Gaesser, Glenn (Committee member) / Arizona State University (Publisher)
Created2020
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Description
Obesity is highly prevalence in United States. Obesity can be seen as a positive energy balance, especially a positive fat balance. This may be due in part to how the human body uses energy sources. When a person overconsumes a meal that contains high amounts of both carbohydrate and fat,

Obesity is highly prevalence in United States. Obesity can be seen as a positive energy balance, especially a positive fat balance. This may be due in part to how the human body uses energy sources. When a person overconsumes a meal that contains high amounts of both carbohydrate and fat, carbohydrate will stimulate its own oxidation and suppress fat oxidation. This can result in a positive fat balance, which could eventually lead to obesity. Also, it has been shown that after consuming a meal endothelial function is frequently impaired for several hours during the postprandial period. Long-term endothelial dysfunction is a major cause of different types of cardiovascular disease. Exercise has been shown to stimulate fat oxidation and, when performed the day before meal ingestion, precondition arteries by enhancing endothelial function in the basal state. However, the acute effect of exercise on postprandial period is unknown. The purpose of this study is to examine the effect of high intensity interval exercise (HIIE) on the substrate oxidation and endothelial function in the postprandial period after consumption of “meal” consisting of a sugar-sweetened beverage (SSB) and a candy bar (480 kcal; ~75% sugar). Five subjects (4 males, 1 female; age=25yr, BMI=25 kg/m2) completed two conditions in random order: 1) no exercise control; 2) high-intensity interval exercise on a cycle ergometer: alternating 1-min intervals at 90-95% HRmax separated by 1-min of active recovery at 50W, for a duration sufficient to expend ~480 kcal. Endothelial function was measured by flow-mediated dilation (FMD) at baseline, and at 1, 2 and 4 hours postprandial. Substrate oxidation was measured by indirect calorimetry during the entire first hour postprandial and then during the last 20 min of hours 2-5 postprandial. Absolute postprandial fat oxidation (g/5 hours) was higher in HIIE (exercise: 5.47 ± 9.97, control: -9.78 ± 3.80; p<0.011). Absolute postprandial carbohydrate oxidation (g/5 hours) was higher in control group (control: 27.79 ± 6.20, exercise: -1.48 ± 7.75; p<0.019). Therefore, these results show that HIIE results in greater fat oxidation during the postprandial period in comparison to a no-exercise control condition. For FMD, there was no significant difference between groups, and no group x time interaction. However, there was a significant time effect (p<0.046), with both groups demonstrating a reduction in FMD during the postprandial period. FMD in the control condition decreased from 12% to 7.5% during the first 2 hours postprandial, and from 11.4% to 7.3% in the HIIE condition. These results indicate that HIIE performed 1 hour prior to ingestion of a SSB and candy bar does not prevent postprandial endothelial dysfunction.
ContributorsLin, Chia Yu (Author) / Gaesser, Glenn (Thesis advisor) / Whisner, Corrie (Committee member) / Angadi, Siddhartha (Committee member) / Arizona State University (Publisher)
Created2020