The Effect of Handgrip Exercise Duty Cycle on Brachial Artery Flow Mediated Dilation

Abstract

Shear stress is the frictional force exerted on the vascular wall by blood flowing through an artery. It is a major regulator of endothelial cell function, which is essential for vasoprotection and local regulation of vascular tone. Using handgrip exercise (HGEX) to increase shear stress is an increasingly popular method for assessing brachial artery (BA) endothelial cell function via flow-mediated dilation (FMD, dilation which increases with improved endothelial function). However, different exercise duty-cycles (ratio of handgrip relaxation to contraction in seconds) produce different patterns of BA shear stress with different anterograde and retrograde flow magnitudes. PURPOSE: To determine the impact of HGEX duty-cycle on BA %FMD while maintaining a constant mean shear stress. METHODS: N=16 healthy males. BA diameter (BAD) and blood velocity (BV) were assessed via echo and Doppler ultrasound. Shear stress was estimated as shear rate (SR=BV/BAD) and reported as mean SR during the last minute of baseline (target 10 s 1) and each minute of HGEX (75 s-1). Subjects performed 3 six minute HGEX trials on each of 2 separate days (like trials averaged). Each trial was one of 3 randomly ordered HGEX duty-cycles (1:1, 3:1, 5:1). %FMD was calculated as the increase in BAD from baseline to the end of HGEX and at each minute (subset N=10) during HGEX. RESULTS: Data are means ± SD. As intended, mean SR was similar between duty-cycles (main effect, p=0.835), despite significant differences in anterograde and retrograde SR (P<0.001). There was no impact of duty cycle on blood pressure (p=0.188) or heart rate (p=0.131) responses. End exercise %FMD (4.0 ± 1.3%, 4.1 ± 2.2%, 4.2 ± 1.4%, p=0.860) and minute by minute %FMD (main effect p=0.939; interaction, p=0.545) were also not different between duty-cycles. CONCLUSION: Distinct HGEX duty-cycles create markedly different shear stress patterns in the BA. However, duty cycle had no impact on %FMD magnitude suggesting that mean shear stress is the most important stimulus for FMD in the BA. Using a 5:1 duty cycle may yield the best vessel image and diameter measurement quality due to the long period of arm stability between contractions.