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Development and Application of CPX-CMR protocol for Cardiopulmonary Evaluation of Acute Exercise, Physical Training Response, and Ketogenic Diet Interventions in Healthy Humans, Athletes, and Military Personnel

LaFountain, Richard A

Abstract Details

2018, Doctor of Philosophy, Ohio State University, Kinesiology.
Cardiopulmonary function and heart health are influenced by a variety of factors across the spectrum of health and disease. Diet and exercise can have dramatic effects on the performance of the human heart. Technological advancement in evaluation of the human heart via magnetic resonance imaging has accelerated in recent years. Despite enhanced capabilities many questions about cardiac structure, tissue characteristics, and function remain. Purpose: Utilize CPX-CMR protocol to A) evaluate the human heart in vivo including samples from a range of healthy individuals with varied fitness and training experience; B) examine effects of extended ketogenic diet and physical training intervention on heart function, fat content, and tissue characteristics. Methods: Participants were grouped based upon their fitness level and military status. MRI scanning was performed using a 1.5-T magnet. Elapsed time from cessation of maximal exercise to start Cine image acquisition was less than 40 seconds. Cardiopulmonary exercise testing was completed via MRI-compatible treadmill. Gas exchange measures and indirect calorimetry data were collected using a ParvoMedics metabolic cart modified for MRI. Cardiac magnetic resonance (CMR) measures of global function (end-diastolic volume, end-systolic volume, cardiac output, stroke volume, and ejection fraction), left ventricular myocardial mass, fat content, as well as T1 and T2 were all collected to examine the heart. Ketogenic diet and training intervention was implemented in a representative sample of military personnel for approximately 12 weeks. iii Cardiopulmonary stress testing and CMR evaluation of heart function were completed at baseline and post-intervention time points. Results: VO2peak was significantly higher in elite trained endurance athletes (64.7 ± 9.9 ml/kg/min) versus all other participant groups untrained (35.8 ± 7.8 ml/kg/min, P<0.001), recreationally trained (47.6 ± 5.5 ml/kg/min, P=0.004), and military (45.9 ± 8.2 ml/kg/min, P=0.001). Mean left ventricular myocardial mass (LVMM) was assessed in untrained (108.9±22.7), recreationally trained (91.3±15.3), elite (129.9±40.6), and military (108.0±11.6) groups at rest. No statistical significance in CO was detected between groups at rest or following maximal treadmill exercise stress at baseline. Blood glucose and ketone concentrations tracked daily in KD participants resulted in a 97% reporting rate. Average daily blood glucose was 87 mg/dL while average daily blood ketone concentration was 1.2 mmol/L in KD participants. Ejection fraction was increased significantly at stress for KD participants from baseline to post intervention (72.3 ± 6.3% to 78.2 ± 5.3%, p=0.013). Conclusion: CPX-CMR protocol was utilized to evaluate the human heart in a variety of healthy individuals. Adherence to a well-formulated ketogenic diet guided by daily blood ketone measures does not appear to have adverse effects on myocardial tissue indices nor functional measures of cardiac performance in healthy military personnel. Select measures of heart function including stroke volume and ejection fraction were enhanced at post-intervention compared with baseline.
Jeff Volek, Ph.D. (Advisor)
Simonetti Orlando, Ph.D. (Committee Member)
Brian Focht, Ph.D. (Committee Member)
Carl Maresh, Ph.D. (Committee Member)
William Kraemer, Ph.D. (Committee Member)
201 p.

Recommended Citations

Citations

  • LaFountain, R. A. (2018). Development and Application of CPX-CMR protocol for Cardiopulmonary Evaluation of Acute Exercise, Physical Training Response, and Ketogenic Diet Interventions in Healthy Humans, Athletes, and Military Personnel [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1534323074156873

    APA Style (7th edition)

  • LaFountain, Richard. Development and Application of CPX-CMR protocol for Cardiopulmonary Evaluation of Acute Exercise, Physical Training Response, and Ketogenic Diet Interventions in Healthy Humans, Athletes, and Military Personnel. 2018. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1534323074156873.

    MLA Style (8th edition)

  • LaFountain, Richard. "Development and Application of CPX-CMR protocol for Cardiopulmonary Evaluation of Acute Exercise, Physical Training Response, and Ketogenic Diet Interventions in Healthy Humans, Athletes, and Military Personnel." Doctoral dissertation, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1534323074156873

    Chicago Manual of Style (17th edition)