Vascular Function in Exercise-Trained Women


Augustine, J., Lefferts, W., Martin, E., Spartano, N., Heffernan, K. Syracuse University, Syracuse, NY

Cardiovascular disease (CVD) is a leading cause of death in women. Chronic exercise in combination with low energy availability may lead to lack of menses in women. This amenorrheic state has been associated with endothelial dysfunction, considered the first step in the atherosclerosis process. Currently it is unknown whether functional changes in the vessel wall lead to further structural changes, such as arterial stiffening and vascular remodeling (i.e. altered lumen diameter and increased wall thickness) in exercise-trained amenorrheic (ExAm) women. Purpose: To examine endothelial function, arterial stiffness and vascular remodeling in ExAm women to gain insight into the extent and severity of subclinical atherosclerosis risk. Methods: 43 women participated in this cross sectional study: 10 ExAm women (Age 21 ± 3 years, BMI 21.5 ± 2.0 kg/m2), 18 exercise-trained eumenorrheic (ExEu) women (Age 22 ± 3 years, BMI 22.9 ± 2.4 kg/m2), 15 sedentary eumenorrheic (SedEu) women (Age 23 ± 4 years, BMI 23.9 ± 3.2 kg/m2). Flow mediated dilation (FMD) of the brachial artery was used to measure endothelial function using ultrasonography. Carotid-femoral Pulse Wave Velocity (PWV) was taken as a measure of aortic arterial stiffness using applanation tonometry. Diameters and intima media thickness (IMT) of the superficial femoral artery (SFA) were taken as measures of vascular remodeling, using ultrasonography. Results: A one-way ANOVA indicated FMDin ExAm was significantly lower versus both ExEu and SedEu groups (6.91 mm ± 1.33 vs. 10.97 mm ± 0.98 vs. 10.57mm ± 1.11, P = 0.05), after adjusting for the shear stress stimulus. Aortic PWV in ExAm was not significantly different from ExEu and SedEu groups (5.0 ± 1.0 m/s, 4.6 ± 0.5 m/s, vs. 5.4 ± 0.8 m/s, P = 0.03). SFA diameter in ExAm and ExEu was significantly higher versus SedEu (5.70 ± 0.72 mm vs. 5.68 ± 0.70 mm vs. 5.10 ± 0.63 mm, P = 0.03), while SFA IMT in ExAm was significantly lower versus SedEu (0.31 ± 0.03 mm vs. 0.38 ± 0.07 mm, P = 0.01). SFA IMT was similar between ExAm and ExEu (0.31 ± 0.03 mm vs. .35 ± 0.06 mm). Conclusions: Despite presence of endothelial dysfunction, aortic stiffness in ExAm is not different from ExEu, and SedEu. ExAm women demonstrate similar favorable remodeling of the SFA compared to ExEu women. Vascular dysfunction in young ExAm women may not extend beyond the endothelium.

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