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Purpose: This study tested the hypothesis that the magnitude of cardiovascular (CV) drift and decrease in maximal oxygen uptake (V[spacing dot above]O2max) would be greater at 35[degrees]C than at 22[degrees]C. Methods: The increase in HR and decrease in stroke volume (SV) between 15 and 45 min of cycling at 59.2 +/- 1.9% V[spacing dot above]O2max (CV drift) was measured in hot (HEAT, 35[degrees]C) and cool (COOL, 22[degrees]C) ambient temperatures in 10 endurance-trained men (age = 23 +/- 3 yr, V[spacing dot above]O2max = 64.7 +/- 8.7 mL[middle dot]kg-1[middle dot]min-1). V[spacing dot above]O2max was measured immediately after the 45 min of cycling and again under both ambient temperature conditions on separate days after 15 min of cycling. This design permitted assessment of V[spacing dot above]O2max between the same time points that CV drift occurred. Fluid to replace sweat losses was provided during all trials. Results: CV drift and the associated decrease in V[spacing dot above]O2max was greater (P < 0.05) in HEAT versus COOL. HR increased 11% (P < 0.05), SV decreased 11% (P < 0.05), and V[spacing dot above]O2max fell 15% (P < 0.05) between 15 and 45 min in HEAT, whereas HR and SV changed less (+2% and -2% for HR and SV, respectively, P < 0.05), and there was no significant decrease in V[spacing dot above]O2max (5%, P > 0.05) between 15 and 45 min in COOL. Conclusion: These data demonstrate the magnitude of CV drift during prolonged submaximal exercise, and the accompanying decrease in V[spacing dot above]O2max measured immediately thereafter is greater in a hot than in a cool environment. [ABSTRACT FROM AUTHOR]

INTRODUCTION/PURPOSE: This study investigated whether manipulation of cardiovascular drift (CV drift) by changing exercise duration or by fluid ingestion is associated with altered peak oxygen uptake VO(2peak). METHODS: VO(2peak) was measured in 11 trained men immediately after they cycled at 60% control VO(2max) in 30 degrees C, 40% relative humidity for 15, 60, and 120 min with no fluid (15 NF, 60 NF, 120 NF) or 120 min with fluid (120 F). Stroke volume (SV), heart rate (HR), and related measures were measured in 120 NF and 120 F at 15, 60, and 120 min. RESULTS: Body mass decreased 0.7, 2.3, and 3.7% in 120 F, 60 NF, and 120 NF. SV at the end of submaximal exercise and VO(2peak) measured immediately thereafter were reduced significantly (P < 0.05) from 15-min values in 120 NF (13.8 and 8.7%) but not in 60 NF (4.6 and 1.2%) or 120 F (2.1 and 1.9%). CONCLUSIONS: The progressive decline in SV during prolonged, constant-rate submaximal exercise in a warm environment, reflective of increased cardiovascular strain associated with hyperthermia, dehydration, and other changes that occur over time, reduces VO(2peak). Fluid ingestion improves performance in prolonged exercise, in part, by mitigating the decline in SV and its determinants, and preserving VO(2peak). [ABSTRACT FROM AUTHOR]

INTRODUCTION/PURPOSE: This study investigated whether the progressive rise in heart rate (HR) and fall in stroke volume (SV) during prolonged, constant-rate, moderate-intensity exercise (cardiovascular drift, CVdrift) in a hot environment is associated with a reduction in VO(2max). METHODS: CVdrift was measured in nine male cyclists between 15 and 45 min of cycling at 60% VO(2max) in 35 degrees C that was immediately followed by measurement of VO(2max). VO(2max) also was measured after 15 min of cycling on a separate day, so that any change in VO(2max) between 15 and 45 min could be associated with the CVdrift that occurred during that time interval. This protocol was performed under one condition in which fluid was ingested and there was no significant body weight change (0.3 +/- 0.4%), and under another in which no fluid was ingested and dehydration occurred (2.5 +/- 1%, P < 0.05). RESULTS: Fluid ingestion did not affect CVdrift or change in VO(2max). A 12% increase in HR (151 +/- 9 vs 169 +/- 10 bpm, P < 0.05) and 16% decrease in SV (120 +/- 12 vs 101 +/- 10 mL.beat(-1), P < 0.05) between 15 and 45 min was accompanied by a 19% decrease in VO(2max) (4.4 +/- 0.6 vs 3.6 +/- 0.4 L.min(-1), P < 0.05) despite attainment of a higher maximal HR (P < 0.05) at 45 min (194 +/- 5 bpm) vs 15 min (191 +/- 5 bpm). Submaximal VO(2) increased only slightly over time, but VO(2max) increased from 63 +/- 5% at 15 min to 78 +/- 8% at 45 min (P < 0.05). CONCLUSION: We conclude CVdrift during 45 min of exercise in the heat is associated with decreased VO(2max) and increased relative metabolic intensity. The results support the validity of using changes in HR to reflect changes in relative metabolic intensity during prolonged exercise in a hot environment in which CVdrift occurs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine if pre-exercise hydration with and without glycerol differentially affects physiologic and performance responses during mountain-bike races in the heat. DESIGN AND SETTING: Testing (random, crossover, double-blind design) included the following 3 treatments administered in conjunction with a 30-mile mountain-bike race consisting of three 10-mile (16-km) loops: (1) no water during exercise (NE): water consumed before the race and no water consumed during the race, (2) glycerol (G): mixture of water and glycerol consumed before the race and water via 2 water bottles consumed during the race, and (3) water (W): water consumed before the race and water via 2 water bottles consumed during the race. Subjects stopped for 8 minutes after each 10-mile loop for collection of data. SUBJECTS: Twelve heat-acclimated male mountain bikers with age = 24.5 +/- 1.1 years, percentage of body fat = 14.3 +/- 1.0%, mass = 76.9 +/- 1.9 kg, height = 179 +/- 2 cm. MEASUREMENTS: We measured body weight, percentage of body fat, rectal temperature, blood lactate, blood glucose, urine volume, urine color, urine specific gravity, thirst sensation, thermal sensation, rating of perceived exertion, fluid consumption, heart rate, and sweat rate. Each subject completed the Environmental Symptoms Questionnaire. RESULTS: The G trial was less dehydrated than the NE and W trials postexercise. Pre-exercise urine volume was less in the G trial than in the NE and W trials, and postexercise thirst was less in the G trial than the NE and W trials. Postexercise Environmental Symptoms Questionnaire scores were lower in the G trial than the NE or W trials. It is noteworthy that, although not significant, the G trial performed 5 minutes faster on loop 3 than the NE and W trials. CONCLUSIONS: Lower Environmental Symptoms Questionnaire scores and percentage of dehydration may indicate decreased signs and symptoms of heat strain in the G trial. Based on the NE trial performance, adequate pre-exercise hydration, even without glycerol, may limit the detrimental effects of dehydration. [ABSTRACT FROM AUTHOR]

Introduction: Higher work rates may be sustainable when maintaining target rating of perceived exertion (RPE) compared to maintaining target heart rate (THR) during high-intensity interval training (HIIT) exercise in hot conditions, but may also result in greater thermal strain and cardiovascular drift, as well as greater decrements in maximal oxygen uptake ( V ˙ O 2max )., Purpose: To test the hypotheses that maintaining target RPE compared to THR during HIIT in the heat results in 1) smaller work rate adjustments, 2) greater thermal and cardiovascular strain, and 3) larger decreases in V ˙ O 2max ., Methods: Eight adults (4 women) completed a graded exercise test on a cycle ergometer in 22°C and then 4 cycling trials in 35°C, consisting of an 8-min warm-up at 70% maximal heart rate (HR max ) or 12 RPE followed by 1 (15 HR and 15 RPE ) or 5 (43 HR and 43 RPE ) rounds of HIIT (1 round = 4 min work at 90% HR max or 17 RPE and 3 min recovery at 70% HR max or 12 RPE) totaling 15 min or 43 min of exercise, respectively. Each trial ended with a GXT to measure V ˙ O 2max ., Results: In the 43-min trials work rate decreased from the first to the fifth work interval in both conditions, but by a non-significant, yet moderately larger (ES = 0.53) amount during 43 HR (46 ± 29 W) compared to 43 RPE (30 ± 28 W). From the first to fifth work interval HR increased over time by 12 b⋅min -1 in 43 RPE ( p < 0.001), but did not increase during 43 HR ( p = 0.36). Rectal temperature increases were not different between conditions (43 HR = 0.7°C, p < 0.001; 43 RPE = 0.8°C, p < 0.001). V ˙ O 2max decreased 15.6% (ES = 0.41) between 15 RPE and 43 RPE ( p = 0.005), but it was not different over time during the HR-based trials [6.5%, ES = 0.16 (α adjusted for multiple comparisons = 0.0125) p = 0.03]., Conclusion: Maintaining target RPE and THR require considerable declines in work rate during HIIT in the heat, with ∼53% larger declines needed to maintain THR. The mitigation of cardiovascular drift in the THR trial may have contributed to the preservation of V ˙ O 2max ., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Yoder, Mulholland, MacDonald and Wingo.)

Introduction/purpose: The purpose of this study was to test the hypothesis that cardiovascular (CV) drift and associated decrements in maximal oxygen uptake (V̇O 2max ) are greater in high-fit compared with low-fit women during exercise at the same %V̇O 2max , but comparable at the same rate of metabolic heat production., Methods: Six high-fit (HI) and six low-fit (LO) women cycled in 35°C for 15 or 45 min at the same relative intensity (60% V̇O 2max ; 15REL and 45REL) or fixed rate of heat production (500 W; 15FX and 45FX), immediately followed by a graded exercise test to measure V̇O 2max . The separate 15- and 45-min trials permitted measurements of V̇O 2max over the same time interval as CV drift., Results: During 45REL, higher heat production in HI (496 ± 51 vs 364 ± 44 W in LO) resulted in greater end-exercise core temperature (38.7°C ± 0.4°C vs 38.2°C ± 0.1°C, P = 0.03), greater increases in HR (15 bpm (10%) vs 10 bpm (6%), P = 0.03) and decreases in stroke volume (11 mL per beat (16%) vs 5 mL per beat (8%), P = 0.001), and larger reductions in V̇O 2max (16% vs 5%, P = 0.04) compared with LO. During 45FX, temperature responses, CV drift, and decreased V̇O 2max were not different between groups (all P > 0.05), despite differences in %V̇O 2max (60% vs 75% for HI and LO, respectively)., Conclusions: We conclude metabolic heat production modulates the CV drift-V̇O 2max relationship, independent of fitness level. These results support previous findings showing the magnitude of CV drift is proportional to reductions in V̇O 2max ., (Copyright © 2024 by the American College of Sports Medicine.)

Resisted sprint (RS) training, such as sled or parachute towing, is commonly used for sprint training among field sport athletes. While RS training is frequently employed by athletes and coaches, there is little research on its benefits, especially compared to unresisted running (UR) training programs with similar training volumes. This systematic review and meta-analysis compared the effectiveness of RS training on acceleration compared to UR training. Potential sources were limited to peer-reviewed articles published in English prior to June 12, 2022, and gathered from the EBSCOhost, PubMed, and Web of Science online databases identified using combinations of the following terms: towing , sled , " resisted sprint ," " sprint acceleration ," " sprint performance ," and " sprint speed ." The search returned 1,159 sources, from which 15 were eligible for inclusion. Fifty effects were used to estimate the impact of RS training on initial sprint speed. Based on the cumulative results from these studies, RS training yielded a small improvement in acceleration but was not different from same volume of UR training (Hedges' d Effect Size=0.11, 95% CI: -0.01 to 0.23; p=0.08). These results do not support the use of RS training over UR training for improving initial sprint speed; however, further research should be conducted.

Heart rate drifts upward over time during interval exercise and during exercise in hot conditions. As such, work rate must be lowered to maintain target heart rate. The purpose was to characterize acute work rate adjustments during high-intensity interval training based on target heart rate. Seven humans (three females) completed five study visits: a graded exercise test on a cycle ergometer to measure maximal heart rate (HR max ) in ∼22 °C and four trials performed in ∼22 °C (TEMP) or ∼35 °C (HOT), consisting of an 8 min warm-up at 70% HR max followed by one (15 TEMP and 15 HOT ) or five (43 TEMP and 43 HOT ) rounds of high-intensity interval training (one round = 4 min work at 90% HR max and 3 min recovery at 70% HR max ) totaling 15 min or 43 min of exercise, respectively. Work rate was lowered 33 ± 20 W ( p  = 0.005) in 43 TEMP and 56 ± 30 W ( p  = 0.003) in 43 HOT between the first and fifth work intervals. Thermal strain (0.2 °C higher rectal temperature, p  = 0.01) and cardiovascular strain (6 beats·min -1 larger increase in heart rate from first to fifth recovery interval, p  = 0.01) were greater in 43 HOT versus 43 TEMP . Using target heart rate during high-intensity interval training may reduce the training stimulus, especially in hot environments, but it may also limit thermal strain and enable participants to complete the prescribed workout despite the heat., Competing Interests: The authors declare there are no competing interests.

Objectives: Certain occupations are associated with greater risk of triggering a sudden cardiac event because of high levels of physical exertion and extreme thermal environments in which they occur. The extent to which sports officials--particularly high school (HS) American football referees--experience these conditions is unknown. Forty-six male HS officials (72% White/Caucasian; age = 48 ± 12 years, body mass index = 31.7 ± 6.6 kg·m -2 ) were studied to quantify the physiological strain and physical demands of officiating., Methods: Referee demographics (e.g., experience, habitual exercise), pre-game urine specific gravity (U SG ), thermal (peak core temperature [T core ]) and cardiovascular (average heart rate [HR]) strain, kinematic activity (e.g., total distance, speed, mechanical intensity), and environmental conditions were measured during 10 regular season varsity HS football games (≈2.5 h each) in the Southeastern United States (average wet bulb globe temperature and relative humidity: 18.9 ± 6.0 °C and 78.2% ± 12.1%). Analyses included descriptive statistics, bivariate correlations, and linear regression., Results: Referees covered 5.2 ± 1.2 km per game, eliciting average HR and peak T core of 71.5% ± 8.0% HR max and 38.3 ± 0.5 °C, respectively; 38% began games dehydrated (U SG  = 1.026 ± 0.004). Multiple regression analyses revealed that obesity ( β  = 0.34), not participating in regular exercise ( β  = -0.36), and officiating at lower mechanical intensity ( β  = -0.33) predicted greater cardiovascular strain (all p ≤ 0.03). White/Caucasian race/ethnicity ( β  = 0.59), younger age ( β  = -0.46), and obesity ( β  = 0.28) predicted greater thermal strain (all p ≤ 0.01)., Conclusion: HS football referees experienced elevated levels of physiological strain while officiating, with individual factors modulating the magnitude of strain. Strategies aimed at reducing obesity, increasing exercise participation, and improving cardiovascular health should be emphasized to mitigate strain and prevent cardiac events.

Abstract: Ng, J and Wingo, JE. Effect of ice slurry beverages on voluntary fluid intake and exercise performance. J Strength Cond Res 37(6): e376-e383, 2023-Voluntary intake of cold fluid is greater than warm fluid as a result of more favorable palatability, resulting in better maintenance of hydration status and improved exercise performance. It remains unclear whether voluntary ingestion of ice slurry beverages compared with cold fluid during exercise yields superior results. Eight recreationally active subjects (mean ± SD ; age = 24 ± 4 years, height = 175.2 ± 7.8 cm, mass = 79.6 ± 11.2 kg, body fat = 13.0 ± 5.2%) completed a pretest in 22° C to determine maximal workload (W max ). Then, in 2, separate, counterbalanced trials, they cycled for 60 minutes at 50%W max in 35° C and 40% relative humidity with either ad libitum ice slurry (-1.3 ± 0.3° C) or cold fluid (11.1 ± 2.4° C) ingestion. This was immediately followed by a 15-minute cycling time trial. Subjects avoided 2% body mass loss in both conditions but ingested twice as much cold fluid as ice slurry (fluid: 1,074.7 ± 442.1 g, ice slurry: 526.9 ± 214.1 g; p = 0.001). Nonetheless, neither 15-minute performances (cold fluid: 119.5 ± 34.8 kJ, ice slurry: 114.6 ± 20.9 kJ; p = 0.59) nor whole-body sweat rates (fluid: 1,370 ± 311 ml·h -1 , ice slurry: 1,242 ± 191 ml·h -1 ; p = 0.20) were different between the conditions. Despite ingesting half as much ice slurry as cold fluid, subjects experienced similar physiological responses and thus had similar performances under heat stress while avoiding excessive hypohydration. Under the conditions of this study, ice slurry ingestion was an effective alternative form of exercise hydration., (Copyright © 2022 National Strength and Conditioning Association.)

Cardiovascular drift-a progressive increase in heart rate (HR) and decrease in stroke volume (SV) during prolonged exercise-is exacerbated by heat stress and thermal strain, and often accompanied by a decrease in work capacity (indexed as maximal oxygen uptake [V.O 2max ]). To attenuate physiological strain during work in the heat, use of work:rest ratios is recommended by the National Institute for Occupational Safety and Health. The purpose of this study was to test the hypothesis that during moderate work in hot conditions, utilizing the recommended 45:15 min work:rest ratio would result in cardiovascular drift 'accumulating' over consecutive work:rest cycles and accompanying decrements in V.O 2max . Eight people (5 women; (mean ± SD) age = 25 ± 5 y; body mass = 74.8 ± 11.6 kg; V.O 2max = 42.9 ± 5.6 mL·kg -1 ·min -1 ) performed 120 min of simulated moderate work (201-300 kcal·h -1 ) in hot conditions (indoor wet-bulb globe temperature = 29.0 ± 0.6 °C). Participants completed two 45:15 min work:rest cycles. Cardiovascular drift was evaluated at 15 and 45 min of each work bout; V.O 2max was measured after 120 min. On a separate day, V.O 2max was measured after 15 min under identical conditions for comparison before and after cardiovascular drift occurred. HR increased 16.7% (18 ± 9 beats·min -1 , p = 0.004) and SV decreased 16.9% (-12.3 ± 5.9 mL, p = 0.003) between 15 and 105 min, but V.O 2max was unaffected after 120 min ( p = 0.14). Core body temperature increased 0.5 ± 0.2 °C ( p = 0.006) over 2 h. Recommended work:rest ratios preserved work capacity but did not prevent the accumulation of cardiovascular and thermal strain.

Objective: To provide best-practice recommendations for developing and implementing heat-acclimatization strategies in secondary school athletics., Data Sources: An extensive literature review on topics related to heat acclimatization and heat acclimation was conducted by a group of content experts. Using the Delphi method, action-oriented recommendations were developed., Conclusions: A period of heat acclimatization consisting of ≥14 consecutive days should be implemented at the start of fall preseason training or practices for all secondary school athletes to mitigate the risk of exertional heat illness. The heat-acclimatization guidelines should outline specific actions for secondary school athletics personnel to use, including the duration of training, the number of training sessions permitted per day, and adequate rest periods in a cool environment. Further, these guidelines should include sport-specific and athlete-specific recommendations, such as phasing in protective equipment and reintroducing heat acclimatization after periods of inactivity. Heat-acclimatization guidelines should be clearly detailed in the secondary school's policy and procedures manual and disseminated to all stakeholders. Heat-acclimatization guidelines, when used in conjunction with current best practices surrounding the prevention, management, and care of secondary school student-athletes with exertional heat stroke, will optimize their health and safety., (© by the National Athletic Trainers' Association, Inc.)

Aim: Compared to other modulators of physiological strain associated with exercise heat stress, hyperthermia results in the greatest magnitude of cardiovascular (CV) drift and associated decrements in maximal oxygen uptake ([Formula: see text])., Purpose: To determine if elevated core temperature in the luteal phase (LP) of the menstrual cycle results in greater CV drift and reductions in [Formula: see text] versus the follicular phase (FP)., Methods: Seven women performed 15- and 45-min cycling bouts on separate occasions (60% [Formula: see text], 35 °C) followed by a [Formula: see text] test during the FP and LP. CV drift was measured between 15 and 45 min during the 45-min bout, and the 15-min bout was for measuring [Formula: see text] over the same time interval that CV drift occurred., Results: Core temperature during LP was ~ 0.3 °C higher than FP (P < 0.05), but changes from rest during exercise were similar between phases (all P > 0.05). Heart rate increased significantly over time but was not different between phases (P = 0.78). Stroke volume decreased more over time during LP compared to FP (P = 0.02), but the values were similar at the end of exercise between phases (both time points P > 0.05). [Formula: see text] decrements for FP (13%) and LP (16%) were also comparable (P = 0.97)., Conclusions: The LP-FP difference in core temperature in this study was not sufficient to amplify CV strain and decrements in [Formula: see text]. Greater differences in core temperature may be required to independently modulate CV drift and accompanying decrements in [Formula: see text] during prolonged exercise heat stress.

Introduction: Greater cardiovascular (CV) drift occurs during cycling compared to running in temperate conditions. CV drift also corresponds to proportional reductions in maximal oxygen uptake (V˙O2max) during heat stress. Whether exercise mode differentially affects CV drift-and accompanying declines in V˙O2max-during heat stress is uncertain. The purpose of this study was to test the hypothesis that a greater magnitude of CV drift, accompanied by a greater decrement in V˙O2max, occurs during cycling compared to running in hot conditions., Methods: 7 active men (mean ± SD; age = 25 ± 6 yr, percent body fat = 11.9% ± 2.4%) completed a control graded exercise test (GXT) on a cycle ergometer and treadmill. Then on separate, counterbalanced occasions they completed 15 or 45 min of cycling or running at 60% V˙O2max in 35°C, immediately followed by a GXT to measure V˙O2max (4 trials total). The separate 15- and 45-min trials were designed to measure CV drift and V˙O2max over the same time interval., Results: Heart rate increased 19% and 17% and stroke volume decreased 20% and 15% between 15 and 45 min during running and cycling, respectively, but modes were not different (all P > 0.05). Despite a 1.8°C larger core-to-skin thermal gradient during running, decrements in V˙O2peak were not different between exercise modes (95% CI for difference in change scores between 15 and 45 min: -0.2, 0.3)., Conclusions: CV strain (indexed as CV drift) during prolonged exercise in the heat corresponds to reduced V˙O2max, irrespective of exercise mode or the thermal gradient. As such, the upward drift in heart rate associated with CV drift reflects increased relative metabolic intensity (%V˙O2max) during prolonged cycling or running in the heat.

Cardiovascular (CV) drift, the progressive increase in heart rate (HR) and decrease in stroke volume (SV) during constant rate, moderate intensity exercise, is related to reduced maximal oxygen uptake (V̇O 2max ) during heat stress. Once it has already occurred, it is unknown whether the detrimental effects of CV drift on V̇O 2max can be reversed. This study tested the hypothesis that fan cooling after CV drift has occurred attenuates decrements in V̇O 2max associated with CV drift. Eight men completed a control graded exercise test (GXT) in 22°C to measure V̇O 2max . Then on separate, counterbalanced occasions, they completed one 15-min (15MIN) and two 45-min bouts (45NF and 45FAN) of cycling in 35°C, 40% RH at 60% V̇O 2max , each immediately followed by a GXT to measure V̇O 2max . For one of the 45-min trials (45FAN), fan airflow (4.5 m/s) was directed at participants beginning ~5 min before the GXT and continuing throughout the remainder of exercise. The purpose of the separate 15- and 45-min trials was to measure V̇O 2max during the same time interval that CV drift occurred. HR increased (13.8% and 11.4%) and SV decreased (14.4% and 14.1%) for 45NF and 45FAN, respectively; trials were not different (all P > 0.05). Despite a decrease in mean skin temperature of ~1°C with fan use, V̇O 2max decreased similarly between conditions (17% vs. 15% for 45NF and 45FAN, P = 0.54). Fan cooling after CV drift was insufficient to reverse the negative consequences of CV drift on V̇O 2max after prolonged exercise in a hot environment. Abbreviations : 15MIN: 15-min trial; 45FAN: 45-min, fan trial; 45NF: 45-min, no fan trial; ANOVA: Analysis of variance; CV: Cardiovascular; GXT: Graded exercise test; HR: Heart rate; SV: Stroke volume; T̅ b : Mean body temperature; T re : Rectal temperature; T̅ sk : Mean skin temperature; V̇O 2max : Maximal oxygen uptake., (© 2019 Informa UK Limited, trading as Taylor & Francis Group.)

Background: Research comparing bioimpedance spectroscopy (BIS) to dual-energy X-ray absorptiometry (DXA) is limited, especially with newer BIS devices that take measures in a standing position instead of the traditional supine position., Purpose: The purpose of this study was to compare a standing BIS device (BIS STA ) and a supine BIS device (BIS SUP ) to DXA for measuring body fat percentage (BF%), fat mass (FM) and fat-free mass (FFM) in a cohort of male and female subjects displaying a wide range of ages and BMI levels., Methods: Ninety-five subjects (30 ± 15 years, 170 ± 8·0 cm, 72·6 ± 14·8 kg) participated in the study. Body composition measures were taken from BIS STA , BIS SUP and DXA during a single visit to the laboratory following an 8- to 12-h fast in a euhydration state., Results: Supine BIS device and BIS STA produced r-values >0·91 and low SEE values for all measurements compared to DXA. Effect sizes were 'trivial' for FFM comparing both BIS SUP and BIS STA to DXA (<0·1) and 'small' for FM and BF% (<0·39). Compared to DXA, BIS STA resulted in lower total (TE) and constant errors/mean differences (CE) (TE < 3·6 kg, CE < -1·82 kg) versus BIS SUP (TE < 4·35 kg, CE < -3·10 kg) for FFM., Conclusion: Fat-free mass values for BIS STA resulted in the most comparable measurements to DXA with no mean differences and the lowest total error and effect size. However, the findings indicated both BIS devices may be acceptable alternatives to DXA for BF%, FM and FFM in clinical practice., (© 2019 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

External body cooling by fan airflow mitigates the decrease in maximal oxygen uptake (V˙O2max) associated with cardiovascular (CV) drift during cycling in hot conditions. It remains unknown whether internal body cooling via ice slurry ingestion elicits a similar response., Purpose: This study aimed to test the hypothesis that ice slurry ingestion attenuates the magnitude of CV drift and accompanying decrement in V˙O2max during heat stress., Methods: Eight men completed a graded exercise test on a cycle ergometer in 22°C to measure V˙O2max. Then on three separate occasions (in randomly assigned counterbalanced treatment orders), they cycled at 60% V˙O2max in hot conditions (35°C, 40% RH) for 15 min, 45 min with tepid (23°C) fluid ingestion (45FL), or 45 min with ice (-1°C) slurry ingestion (45ICE), followed immediately by measurement of V˙O2max. The purpose of the separate 15- and 45-min trials was to measure CV drift and V˙O2max over the same time interval., Results: The increase in heart rate between 15 and 45 min was twice as large in 45FL (8.6%) compared with 45ICE (4.6%; P = 0.02). Stroke volume declined by 6.2% in 45FL but was maintained with 45ICE (P = 0.02). V˙O2peak decreased from 15 to 45 min by 8.6% and 9.0% in 45FL and 45ICE, respectively, but was not different between conditions (P = 0.79)., Conclusion: Although ice slurry ingestion attenuated CV drift more than fluid ingestion, it did not mitigate the decline in V˙O2max. Contrary to previous findings, when ice slurry is ingested, changes in heart rate may not reflect changes in relative metabolic intensity during prolonged exercise in the heat.

Flatt, AA, Esco, MR, Allen, JR, Robinson, JB, Earley, RL, Fedewa, MV, Bragg, A, Keith, CM, and Wingo, JE. Heart rate variability and training load among National Collegiate Athletic Association Division 1 college football players throughout spring camp. J Strength Cond Res 32(11): 3127-3134, 2018-The purpose of this study was to determine whether recovery of cardiac-autonomic activity to baseline occurs between consecutive-day training sessions among positional groups of a collegiate football team during Spring camp. A secondary aim was to evaluate relationships between chronic (i.e., 4-week) heart rate variability (HRV) and training load parameters. Baseline HRV (lnRMSSD&#95;BL) was compared with HRV after ∼20 hours of recovery before next-day training (lnRMSSDpost20) among positional groups composed of SKILL (n = 11), MID-SKILL (n = 9), and LINEMEN (n = 5) with a linear mixed model and effect sizes (ES). Pearson and partial correlations were used to quantify relationships between chronic mean and coefficient of variation (CV) of lnRMSSD (lnRMSSD&#95;chronic and lnRMSSDcv, respectively) with the mean and CV of PlayerLoad (PL&#95;chronic and PL&#95;cv, respectively). A position × time interaction was observed for lnRMSSD (p = 0.01). lnRMSSD&#95;BL was higher than lnRMSSDpost20 for LINEMEN (p < 0.01; ES = large), whereas differences for SKILL and MID-SKILL were not statistically different (p > 0.05). Players with greater body mass experienced larger reductions in lnRMSSD (r = -0.62, p < 0.01). Longitudinally, lnRMSSDcv was significantly related to body mass (r = 0.48) and PL&#95;chronic (r = -0.60). After adjusting for body mass, lnRMSSDcv and PL&#95;chronic remained significantly related (r = -0.43). The ∼20-hour recovery time between training sessions on consecutive days may not be adequate for restoration of cardiac-parasympathetic activity to baseline among LINEMEN. Players with a lower chronic training load throughout camp experienced greater fluctuation in lnRMSSD (i.e., lnRMSSDcv) and vice versa. Thus, a capacity for greater chronic workloads may be protective against perturbations in cardiac-autonomic homeostasis among American college football players.

The purpose of this study was to validate single-frequency hand-to-foot bioelectrical impedance analysis (HFBIA) for estimating bone mineral content (BMC) using dual-energy X-ray absorptiometry as the criterion measure in healthy men and women aged 18-40 years. A total of 80 men and women participated in this study. BMC was estimated on the same day using HFBIA and dual-energy X-ray absorptiometry. The HFBIA device provided higher mean BMC values in men and the entire sample, but not in women. A smaller standard error of estimate was observed in women (0.20, corresponding to 8% of the mean reference BMC values) compared with men (0.39, corresponding to 12% of the mean reference BMC values) and the combined sample (0.31). HFBIA provided a smaller constant error and individual estimation error indicated by the 95% limits of agreement in women (-0.05 ± 0.39) compared with men (-0.16 ± 0.78) and the entire sample (-0.10 ± 0.63). In conclusion, although BMC values were found to be more accurate in women, HFBIA overestimated BMC compared with dual-energy X-ray absorptiometry, especially in individuals with lower values. Given these results, using HFBIA to measure BMC would be inappropriate for diagnostic purposes.

Objectives: The purpose of this study was to test the hypothesis that cooling the upper body during a warm-up enhances performance during a subsequent 16.1-km simulated cycling time trial in a hot environment., Design: Counterbalanced, repeated measures design., Methods: Eight trained, male cyclists (peak oxygen uptake=57.8±5.0mLkg -1 min -1 ) completed two simulated 16.1-km time trials in a hot environment (35.0±0.5°C, 43.8±2.0% relative humidity) each separated by 72h. Treatments were counterbalanced; participants warmed up for 20min while either wearing head and neck ice wraps and an ice vest (COOLING) or no cooling apparatus (CONTROL)., Results: Following the warm-up mean skin temperature (T¯ sk ), mean body temperature (T¯ b ) and rating of thermal comfort were significantly lower than baseline following the COOLING trial (all P<0.05); however, rectal temperature was unaffected (P=0.35). Because the effects of precooling on T¯ sk and T¯ b were not sustained during exercise, values for COOLING and CONTROL were not different throughout the time trial (P=0.38). Nonetheless, time to completion was significantly faster following the COOLING intervention when compared to the CONTROL (29.3±3.6min, vs. 30.3±3.1min; P=0.04)., Conclusions: These data suggest that in short distance time trials in hot conditions cyclists may benefit from utilizing a cooling modality during the warm-up., (Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Weight-bearing physical activity can optimize bone mass early in life and prevent the development of osteoporosis. However, less is known about the potential benefits of non-weight-bearing activities. The purpose of this study was to assess the efficacy of structured physical activity classes on bone metabolism. Twenty-eight premenopausal women, aged 18-35 years who were either enrolled in a yoga class (n=14) or cardio-kickboxing class (n=14) voluntarily consented to participate. Both classes were introductory classes meeting twice per week for 50 min per session for 12 weeks. Anteroposterior spine (L1-L4), hip (dual femur), and total body bone mineral density (BMD) was measured in both groups pre and post intervention using dual-energy X-ray absorptiometry (DXA). Pre and post blood samples were drawn for measurement of serum osteocalcin (OC) by enzyme-linked immunosorbent assay (ELISA) in each group. Baseline subject characteristics including age, height, weight, body fat percentage, and lean body mass did not differ between groups. BMD levels did not increase but were held stable over the course of the intervention. Yoga increased OC by 68% (P < 0.001) and cardio-kickboxing increased OC by 67% (P < 0.001) over the course of the 12-week classes. While 12 weeks of yoga and cardio-kickboxing were insufficient to induce BMD changes, OC levels reflect the bone formation process was initiated, but not yet complete. Increased OC levels suggest the selected physical activity classes provided enough of a stimulus to precipitate a future response of bone growth, assuming exercise training remains constant.

Introduction: Precooling with ice slurry ingestion attenuates the increase in rectal temperature (Tre) during subsequent running and cycling. It remains unclear how this cooling method affects physiological strain during work while wearing protective garments. This study investigated the effect of ice slurry ingestion on physiological strain during work in hot conditions while wearing firefighter protective clothing., Methods: In three counterbalanced trials, eight men (mean ± SD; age = 21 ± 2 yr, height = 179.5 ± 3.5 cm, mass = 79.1 ± 4.1 kg, body fat = 11.4 ± 3.7%) wore firefighter protective clothing and walked (4 km · h-1, 12% incline, ∼7 METs) for 30 min in hot conditions (35°C, 40% RH). Every 2.5 min, subjects ingested 1.25 g · kg-1 (relative total: 15 g · kg-1, absolute total: 1186.7 ± 61.3 g) of a tepid (22.4 ± 1.7°C), cold (7.1 ± 1.5°C), or ice slurry (-1.3 ± 0.2°C) beverage., Results: Heart rates (HR) were lower with ice slurry ingestion compared to both fluid trials starting 5 min into exercise (tepid = 158 ± 14, cold = 157 ± 11, ice slurry = 146 ± 13 bpm) and persisting for the remainder of the bout (min 30: tepid = 196 ± 10, cold = 192 ± 10, ice slurry = 181 ± 13 bpm). Tre was lower with ice slurry ingestion compared to cold and tepid trials (min 5: tepid = 37.17 ± 0.38, cold = 37.17 ± 0.39, ice slurry = 37.05 ± 0.43°C; min 30: tepid = 38.15 ± 0.29, cold = 38.31 ± 0.36, ice slurry = 37.95 ± 0.32°C). The physiological strain index (PSI) was lower with ice slurry ingestion compared to fluid trials starting at min 5 (tepid = 3.8 ± 0.7, cold = 3.8 ± 0.6, ice slurry = 3.0 ± 0.5) and remained lower throughout exercise (min 30: tepid = 8.2 ± 0.6, cold = 8.3 ± 0.9, ice slurry = 6.9 ± 1.2)., Discussion: A large quantity of ice slurry ingested under non-compensable heat stress conditions mitigated physiological strain during exercise by blunting the rise in heart rate and rectal temperature.Ng J, Wingo JE, Bishop PA, Casey JC, Aldrich EK. Ice slurry ingestion and physiological strain during exercise in non-compensable heat stress. Aerosp Med Hum Perform. 2018; 89(5):434-441.

Background: Heat stress limits endurance exercise performance. Combining precooling and warm-up prior to endurance exercise in the heat may exploit the benefits of both strategies while avoiding the potential negative consequences of each. This study tested the hypothesis that precooling combined with warm-up improves time trial cycling performance in the heat relative to either treatment alone., Methods: Nine healthy men completed three 16.1-km time trials in 33°C after: 1) precooling (ice slurry and ice vest) alone (PREC); 2) warm-up alone (WU); or 3) PREC plus WU (COMBO)., Results: Tre was lower after PREC compared to WU throughout exercise and lower than COMBO for the first 12 km; COMBO was lower than WU for the first 4 km. Tsk during PREC was lower than COMBO and WU for the first 8 km, and lower in COMBO than WU for the first 4 km. PREC lowered pre-exercise heart rate relative to COMBO and WU (68 ± 10, 106 ± 12, 101 ± 13 bpm, respectively), but it increased similarly during exercise. Local sweat rate (SR) was lower in PREC (0.1 ± 0.1 mg · cm-2 · min-1) than COMBO (0.5 ± 0.2 mg · cm-2 · min-1) and WU (0.6 ± 0.2 mg · cm-2 · min-1) for the first 4 km. Treatments did not differentially affect performance (PREC = 31.9 ± 1.9 min, COMBO = 32.6 ± 2.7 min, WU = 33.1 ± 2.9 min)., Discussion: We conclude precooling alone or with warm-up mitigated thermal strain during exercise, but did not significantly improve 16.1-km cycling time trial performance.Al-horani RA, Wingo JE, Ng J, Bishop P, Richardson M. Precooling and warm-up effects on time trial cycling during heat stress. Aerosp Med Hum Perform. 2018; 89(2):87-93.

The purpose was to determine if pull-up performance was affected by the use of chalk (100% magnesium carbonate) during open-handed and pinch grip weight-assisted pull-ups (WAPU) in recreationally-trained rock climbers. Furthermore, the reliability of open-handed and pinch grip WAPU was also investigated. Recreationally-active volunteers (n = 9) completed six counterbalanced trials. Participants used chalk during four trials to determine the reliability (test-retest) of the open-handed and pinch grips. While two of the six trials were used to determine if open-handed and pinch grip WAPU performance was affected without using chalk. Three of the six trials included one set of open-handed WAPU, while the remaining trails included one set of pinch grip WAPU. Sets were performed until failure and consisted of either the open-handed or pinch grip pull-ups assisted by a 50% reduction of body weight. Heart rate, ratings of perceived exertion, perceived recovery scale and session-RPE were not significantly different (p > 0.05) among trials. Intraclass correlations (ICC's) for test-retest of the open-handed (R = 0.99) and pinch grip (R = 0.96) WAPU evidenced reliable values. When compared to the non-chalked trials, chalk improved both openhanded (mean = 22.8 ± 4.53 vs. mean no chalk = 19.7 ± 4.39 reps; p = 0.006,) and pinch grip (mean = 14.4 ± 4.47 vs. mean no chalk = 9.1 ± 4.83 reps; p = 0.007) WAPU. ICC's indicated a reliable measurement, while chalk improved performance for both open-handed and pinch grip WAPU when compared to no chalk trials.

Nickerson, BS, Esco, MR, Bishop, PA, Schumacker, RE, Richardson, MT, Fedewa, MV, Wingo, JE, and Welborn, BA. Impact of measured vs. predicted residual lung volume on body fat percentage using underwater weighing and 4-compartment model. J Strength Cond Res 31(9): 2519-2527, 2017-The purpose of this study was to compare underwater weighing (UWW) and 4-compartment (4C) model body fat percentage (BF%) for predicted vs. simultaneously measured residual lung volume (RLV). Forty-seven women and 33 men (age = 22 ± 5 years) had UWW and 4C model BF% determined using Boren et al. (RLVBOREN), Goldman and Becklake (RLVGB), and Miller et al. (RLVMILLER) RLV prediction equations. Criterion UWW BF% included body density (BD) values with simultaneous RLV. Criterion 4C model BF% included BD through UWW with simultaneous RLV, total body water through bioimpedance spectroscopy, and bone mineral content through dual-energy x-ray absorptiometry. The standard error of estimate (SEE) for UWW and 4C model BF% determined through RLV prediction equations varied from 2.0 to 2.6% and from 1.3 to 1.5%, respectively. The constant error (CE) was significantly different for UWW BF% when using RLVBOREN, RLVGB, and RLVMILLER (all p < 0.016; CE = 0.7, -2.0, 1.0%, respectively). However, the CEs for RLVBOREN and RLVMILLER were not significant in the 4C model (p = 0.73 and 0.11; CE = 0.1 and 0.2%, respectively), whereas RLVGB remained significantly different (p < 0.001; CE = -1.5%). The 95% limits of agreement were less than ±5.2% for UWW BF% and less than ±3.1% for the 4C model when using the 3 RLV equations. When used in a 4C model, the RLV equations yielded a smaller CE, SEE, and 95% limits of agreement than UWW BF% results. However, because of the range of individual error shown in the current study, caution should be employed when using the 4C model as a criterion method with predicted RLV.

Nickerson, BS, Esco, MR, Bishop, PA, Schumacker, RE, Richardson, MT, Fedewa, MV, Wingo, JE, and Welborn, BA. Validity of selected bioimpedance equations for estimating body composition in men and women: a four-compartment model comparison. J Strength Cond Res 31(7): 1963-1972, 2017-The purpose of this study was to compare body fat percentage (BF%) and fat-free mass (FFM) values from bioelectrical impedance analysis (BIA) equations to values determined from a 4-compartment (4C) model. Eighty-two adults (42 men and 40 women) volunteered to participate (age = 23 ± 5 years). Body fat percentage and FFM were estimated from previously developed BIA equations by Chumlea et al. (BIACH), Deurenberg et al. (BIADE), Kyle et al. (BIAKYLE), and Sun et al. (BIASUN). Four-compartment model body composition was derived from underwater weighing for body density, dual-energy X-ray absorptiometry for bone mineral content, and bioimpedance spectroscopy for total body water. The standard error of estimate (SEE) for group BF% and FFM ranged from 3.0 to 3.8% and 2.1 to 2.7 kg, respectively. The constant error (CE) was significantly higher and lower for BF% and FFM (p < 0.001), respectively, for 3 BIA equations (BIACH, CE = 3.1% and -2.2 kg; BIADE, CE = 3.7% and -2.9 kg; BIAKYLE, CE = 2.3% and -1.9 kg), but was not significant for BF% (p = 0.702) and FFM (p = 0.677) for BIASUN (CE = -0.1% and 0.1 kg). The 95% limits of agreement were narrowest for BIACH (±5.9%; ±4.2 kg) and largest for BIADE (±7.4%; ±6.2 kg). The significant CE yielded by BIACH, BIADE, and BIAKYLE indicates these equations tend to overpredict group BF% and underestimate group FFM. However, all BIA equations produced low SEEs and fairly narrow limits of agreement. When the use of a 4C model is not available, practitioners might consider using one of the selected BIA equations, but should consider the associated CE.

The influence of thermoreceptors in human facial skin on thermoeffector responses is equivocal; furthermore, the presence of thermoreceptors in the respiratory tract and their involvement in thermal homeostasis has not been elucidated. This study tested the hypothesis that hot air directed on the face and inhaled during whole body passive heat stress elicits an earlier onset and greater sensitivity of cutaneous vasodilation and sweating than that directed on an equal skin surface area away from the face. Six men and two women completed two trials separated by ∼1 wk. Participants were passively heated (water-perfused suit; core temperature increase ∼0.9°C) while hot air was directed on either the face or on the lower leg (counterbalanced). Skin blood flux (laser-Doppler flowmetry) and local sweat rate (capacitance hygrometry) were measured at the chest and one forearm. During hot-air heating, local temperatures of the cheek and leg were 38.4 ± 0.8°C and 38.8 ± 0.6°C, respectively (P = 0.18). Breathing hot air combined with facial heating did not affect mean body temperature onsets (P = 0.97 and 0.27 for arm and chest sites, respectively) or slopes of cutaneous vasodilation (P = 0.49 and 0.43 for arm and chest sites, respectively), or the onsets (P = 0.89 and 0.94 for arm and chest sites, respectively), or slopes of sweating (P = 0.48 and 0.65 for arm and chest sites, respectively). Based on these findings, respiratory tract thermoreceptors, if present in humans, and selective facial skin heating do not modulate thermoeffector responses during passive heat stress., (Copyright © 2015 the American Physiological Society.)

Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Exercise intensity can be prescribed using a variety of indices, such as rating of perceived exertion, heart rate, levels of absolute intensity (e.g., metabolic equivalents), and levels of relative intensity [e.g., percentage of maximal aerobic capacity (% V ˙ O 2 m a x ) or percentage of oxygen uptake reserve (% V ˙ O 2 R )]. Heart rate has a linear relationship with oxygen uptake, is easy to measure, and requires relatively inexpensive monitoring equipment, so it is commonly used to monitor exercise intensity. During heat stress, however, cardiovascular adjustments - including a rise in heart rate that is disproportionate to absolute intensity - result in diminished aerobic capacity and performance. These adjustments include cardiovascular drift, the progressive rise in heart rate and fall in stroke volume over time during prolonged, constant-rate exercise. A variety of factors have been shown to modulate the magnitude of cardiovascular drift, e.g., hyperthermia, dehydration, exercise intensity, and ambient temperature. Regardless of the mode of manipulation, decreases in stroke volume with cardiovascular drift are associated with proportionally similar decreases in V ˙ O 2 m a x , which affects the relationship between heart rate and relative metabolic intensity (% V ˙ O 2 m a x or % V ˙ O 2 R ). This review summarizes the current state of knowledge regarding the influence of cardiovascular drift and reduced V ˙ O 2 m a x on exercise intensity prescription in hot conditions., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: We assessed the impact of completing the Hotter'n Hell Hundred (HHH), an annual 164 km road cycling event performed in a hot environment, on hemostatic balance in men., Methods: Sixteen men who completed the ride in <6 h were included in this study. Plasma samples were collected on that morning of the ride (PRE) and immediately on the completion of the ride (IP). Primary hemostasis was assessed by platelet count and von Willebrand factor antigen (vWF:Ag). Coagulation was assessed by measuring prothrombin fragment 1 + 2 (PTF 1 + 2) and thrombin-antithrombin complex (TAT), whereas fibrinolysis was assessed by plasminogen activator inhibitor antigen (PAI-1 Ag), tissue plasminogen activator (tPA Ag), and D-Dimer analyses., Results: Compared to PRE, increases (p < 0.001) were observed at IP for platelets (39 %), vWF:Ag (65 %), PTF 1 + 2 (47 %), TAT (81 %), tPA Ag (231 %), PAI-1 Ag (148 %), and D-Dimer (54 %). PRE PAI-1 Ag concentrations were directly related to BMI and waist circumference (p < 0.05). D-Dimer concentrations at IP correlated positively with age (p < 0.05)., Conclusions: Completing the HHH activated the coagulation and fibrinolytic systems in balance. Age was positively correlated with IP D-Dimer concentrations. Additionally, participants displaying a larger BMI and waist circumference exhibited a positive correlation with PRE PAI-1 Ag concentrations.

Background: This study compared the effects of ingesting water (W), a flavored carbohydrate-electrolyte (CE) or a flavored non-caloric electrolyte (NCE) beverage on mood, ratings of perceived exertion (RPE), and sprint power during cycling in recreational exercisers., Methods: Men (n = 23) and women (n = 13) consumed a 24-h standardized diet and reported 2-4 h post-prandial for all test sessions. After a familiarization session, participants completed 50 min of stationary cycling in a warm environment (wet bulb globe temperature = 25.0°C) at ~ 60-65% of heart rate reserve (146 ± 4 bpm) interspersed with 5 rest periods of 2 min each. During exercise, participants consumed W, CE, or NCE, served in a counterbalanced cross-over design. Beverage volume was served in 3 aliquots equaling each individual's sweat losses (mean 847 ± 368 mL) during the familiarization session. Profiles of Mood States questionnaires (POMS) were administered and blood glucose levels were determined pre- and post- sub-maximal cycling. Following sub-maximal exercise, participants completed 3 30-s Wingate anaerobic tests (WAnT) with 2.5 min rest between tests to assess performance., Results: Blood glucose was higher (p <  0.05) after 50 min of submaximal cycling just prior to the WAnT for CE (6.1 ± 1.7 mmol/L) compared to W (4.9 ± 1.5 mmol/L) and NCE (4.6 ± 1.2 mmol/L). Nonetheless, there were no differences among treatments in peak (642 ± 153, 635 ± 143, 650 ± 141 watts for W, NCE, and CE, respectively; p  =  0.44) or mean (455 ± 100, 458 ± 95, 454 ± 95 watts for W, NCE, and CE, respectively; p = 0.62) power for the first WAnT or mean (414 ± 92, 425 ± 85, 423 ± 82 watts, respectively; p = 0.13) power output averaged across all 3 WAnT. Likewise, RPE during submaximal exercise, session RPE, and fatigue and vigor assessed by POMS did not differ among beverage treatments (p > 0.05)., Conclusions: Carbohydrate ingestion consumed by recreational exercisers during a 1-h, moderate-intensity aerobic workout did not alter mood or perceived exertion, nor did it affect subsequent anaerobic performance under the conditions of this study. Drinking caloric sport beverages does not benefit recreational exercisers in a non-fasted state.

Introduction: Different muscle recruitment patterns during cycling and walking may influence the magnitude of cardiovascular drift (CV drift) during these respective modes of exercise, but whether this also influences the magnitude of reduced maximal oxygen uptake (Vo2max) associated with CV drift is unknown.This study tested the hypothesis that cycling results in greater CV drift and a greater decrement in Vo2max than walking in a temperate environment., Methods: CV drift was measured in nine recreationally active women (ages = 23 +/- 2 yr, Vo2max = 43.0 +/- 5.5 ml x kg(-1) x min(-1)) between 15 and 45 min of cycling or walking at 60% Vo2max on Separate occasions in 22 degrees C, 44% relative humidity. A graded exercise test to measure Vo2max was performed immediately after the submaximal exercise bout with no cessation of exercise. During separate trials involving each exercise mode, Vo2max was measured after 15 min of submaximal exercise so that changes in Vo2max between 15 and 45 min of exercise could be assessed between the same points in time in which CV drift occurred., Results: Across both conditions, heart rate (HR) increased 5.4% and stroke volume (SV) decreased 11% from 15 to 45 min, but Vo2max was not significantly affected (7% reduction; 2.70 +/- 0.5 L min(-1) vs. 2.52 +/- 0.6 L min(-1))., Conclusion: In a temperate environment, a small CV drift corresponds to a small, non-significant decrease in Vo2max, regardless of whether the exercise performed is cycling or walking.

The purpose of this study was to examine 2 recovery modalities (with and without an ice bag treatment) on closed-handed and open-handed weight-assisted pull-ups in recreationally-trained rock climbers. Healthy and recreationally active volunteers (n = 9) completed 4 counterbalanced trials separated by 72 hours. Trials included 3 sets of closed-handed and open-handed weight-assisted pull-ups supported by 50% of body weight, until failure. Between each set, participants sat quietly in a chair and engaged in approximately 20 minutes of either passive or ice bag treatment. Ice bags were placed on the participants' arms and shoulders. Heart rate (HR), ratings of perceived exertion (RPE), session-RPE (S-RPE), and perceived recovery were also assessed. Hand-grip strength pretrial and posttrial was not different between ice bag conditions. Also, there were no differences between treatments for HR, RPE, perceived recovery, S-RPE, or comfort ratings. The overall number of open-handed pull-ups (mean ± SD = 19 ± 5) was lower than closed-handed pull-ups (34 ± 14; p < 0.001). Ice bag recovery attenuated the decrease in open-handed pull-up performance for sets 2 (22 ± 5; p = 0.004) and 3 (22 ± 5; p = 0.003) relative to set 3 using passive recovery only (i.e., no ice bag; 17 ± 6). There were no differences (p = 0.31) between treatments for closed-handed pull-ups. The findings support the recommendations to use ice bags for recovery between bouts of rock climbing that involve a predominantly open-handed grip to maintain performance.

Cardiovascular drift, the progressive increase in heart rate and decrease in stroke volume that begins after approximately 10 min of prolonged moderate-intensity exercise, is associated with decreased maximal oxygen uptake, particularly during heat stress. Consequently, the increased heart rate reflects an increased relative metabolic intensity during prolonged exercise in the heat when cardiovascular drift occurs, which has implications for exercise prescription.

Despite the rapid growth of mass participation road cycling, little is known about the dietary, metabolic, and behavioral responses of ultraendurance cyclists. This investigation describes physiological responses, perceptual ratings, energy balance, and macronutrient intake of 42 men (mean ± SD; age, 38 ± 6 years; height, 179.7 ± 7.1 cm; body mass, 85.85 ± 14.79 kg) and 6 women (age, 41 ± 4 years; height, 168.0 ± 2.9 cm; body mass, 67.32 ± 7.21 kg) during a summer 164-km road cycling event. Measurements were recorded 1 day before, and on the Event Day (10.5 hours) at the start (0 km), at 2 aid stations (52 and 97 km), and at the finish line (164 km). The ambient temperature was >39.0° C during the final 2 hours of exercise. The mean finish times for men (9.1 ± 1.2 hours) and women (9.0 ± 0.2 hours) were similar, as were mean gastrointestinal temperature (TGI), 4 hydration biomarkers, and 5 perceptual (e.g., thermal, thirst, pain) ratings. Male cyclists consumed enough fluids on the Event Day (5.91 ± 2.38 L; 49% water) to maintain body mass within 0.76 kg, start to finish, despite a sweat loss of 1.13 ± 0.54 L·h(-1) and calculated energy expenditure of 3,115 kcal·10.5·h(-1). However, men voluntarily underconsumed food energy (deficit of 2,594 kcal, 10.9 MJ) and specific macronutrients (carbohydrates, 106 ± 48 g; protein, 8 ± 7 g; and sodium, 852 ± 531 mg) between 0530 and 1400 hours. Also, a few men exhibited extreme final values (i.e., urine specific gravity of 1.035-1.038, n = 5; body mass loss >4 kg, n = 2; T(GI), 39.4 and 40.2°C). We concluded that these findings provide information regarding energy consumption, macronutrient intake, hydration status, and the physiological stresses that are unique to ultraendurance exercise in a hot environment.

Context: The behaviors and beliefs of recreational runners with regard to hydration maintenance are not well elucidated., Objective: To examine which beverages runners choose to drink and why, negative performance and health experiences related to dehydration, and methods used to assess hydration status., Design: Cross-sectional study., Setting: Marathon registration site., Patients or Other Participants: Men (n = 146) and women (n = 130) (age = 38.3 ± 11.3 years) registered for the 2010 Little Rock Half-Marathon or Full Marathon., Intervention(s): A 23-item questionnaire was administered to runners when they picked up their race timing chips., Main Outcome Measure(s): Runners were separated into tertiles (Low, Mod, High) based on z scores derived from training volume, expected performance, and running experience. We used a 100-mm visual analog scale with anchors of 0 (never) and 100 (always). Total sample responses and comparisons between tertile groups for questionnaire items are presented., Results: The High group (58±31) reported greater consumption of sport beverages in exercise environments than the Low (42 ± 35 mm) and Mod (39 ± 32 mm) groups (P < .05) and perceived sport beverages to be superior to water in meeting hydration needs (P < .05) and improving performance during runs greater than 1 hour (P < .05). Seventy percent of runners experienced 1 or more incidents in which they believed dehydration resulted in a major performance decrement, and 45% perceived dehydration to have resulted in adverse health effects. Twenty percent of runners reported monitoring their hydration status. Urine color was the method most often reported (7%), whereas only 2% reported measuring changes in body weight., Conclusions: Greater attention should be paid to informing runners of valid techniques to monitor hydration status and developing an appropriate individualized hydration strategy.

We and others have shown that moderate passive whole body heating (i.e., increased internal temperature ∼0.7°C) increases muscle (MSNA) and skin sympathetic nerve activity (SSNA). It is unknown, however, if MSNA and/or SSNA continue to increase with more severe passive whole body heating or whether these responses plateau following moderate heating. The aim of this investigation was to test the hypothesis that MSNA and SSNA continue to increase from a moderate to a more severe heat stress. Thirteen subjects, dressed in a water-perfused suit, underwent at least one passive heat stress that increased internal temperature ∼1.3°C, while either MSNA (n = 8) or SSNA (n = 8) was continuously recorded. Heat stress significantly increased mean skin temperature (Δ∼5°C, P < 0.001), internal temperature (Δ∼1.3°C, P < 0.001), mean body temperature (Δ∼2.0°C, P < 0.001), heart rate (Δ∼40 beats/min, P < 0.001), and cutaneous vascular conductance [Δ∼1.1 arbitrary units (AU)/mmHg, P < 0.001]. Mean arterial blood pressure was well maintained (P = 0.52). Relative to baseline, MSNA increased midway through heat stress (Δ core temperature 0.63 ± 0.01°C) when expressed as burst frequency (26 ± 14 to 45 ± 16 bursts/min, P = 0.001), burst incidence (39 ± 13 to 48 ± 14 bursts/100 cardiac cyles, P = 0.03), or total activity (317 ± 170 to 489 ± 150 units/min, P = 0.02) and continued to increase until the end of heat stress (burst frequency: 61 ± 15 bursts/min, P = 0.01; burst incidence: 56 ± 11 bursts/100 cardiac cyles, P = 0.04; total activity: 648 ± 158 units/min, P = 0.01) relative to the mid-heating stage. Similarly, SSNA (total activity) increased midway through the heat stress (normothermia; 1,486 ± 472 to mid heat stress 6,467 ± 5,256 units/min, P = 0.03) and continued to increase until the end of heat stress (11,217 ± 6,684 units/min, P = 0.002 vs. mid-heat stress). These results indicate that both MSNA and SSNA continue to increase as internal temperature is elevated above previously reported values.

The extent to which heat stress compromises blood pressure control is variable among individuals, with some individuals becoming very intolerant to a hypotensive challenge, such as lower body negative pressure (LBNP) while heat stressed, while others are relatively tolerant. Heat stress itself reduces indexes of ventricular filling pressure, including central venous pressure, which may be reflective of reductions in tolerance in this thermal condition. This study tested the hypothesis that the magnitude of the reduction in central venous pressure in response to heat stress alone is related to the subsequent decrement in LBNP tolerance. In 19 subjects, central hypovolemia was imposed via LBNP to presyncope in both normothermic and heat-stress conditions. Tolerance to LBNP was quantified using a cumulative stress index (CSI), and the difference between normothermic CSI and heat-stress CSI was calculated for each individual. The eight individuals with the greatest CSI difference between normothermic and heat-stress tolerances (LargeDif), and the eight individuals with the smallest CSI difference (SmallDif), were grouped together. By design, the difference in CSI between thermal conditions was greater in the LargeDif group (969 vs. 382 mmHg × min; P < 0.001). Despite this profound difference in the effect of heat stress in decreasing LBNP tolerance between groups, coupled with no difference in the rise in core body temperatures to the heat stress (LargeDif, 1.4 ± 0.1°C vs. SmallDif, 1.4 ± 0.1°C; interaction P = 0.89), the reduction in central venous pressure during heat stress alone was similar between groups (LargeDif: 5.7 ± 1.9 mmHg vs. SmallDif: 5.2 ± 2.0 mmHg; interaction P = 0.85). Contrary to the proposed hypothesis, differences in blood pressure control during LBNP are not related to differences in the magnitude of the heat-stress-induced reductions in central venous pressure.

Sweat rate (SR) is reduced in locally cooled skin, which may result from decreased temperature and/or parallel reductions in skin blood flow. The purpose of this study was to test the hypotheses that decreased skin blood flow and decreased local temperature each independently attenuate sweating. In protocols I and II, eight subjects rested supine while wearing a water-perfused suit for the control of whole body skin and internal temperatures. While 34°C water perfused the suit, four microdialysis membranes were placed in posterior forearm skin not covered by the suit to manipulate skin blood flow using vasoactive agents. Each site was instrumented for control of local temperature and measurement of local SR (capacitance hygrometry) and skin blood flow (laser-Doppler flowmetry). In protocol I, two sites received norepinephrine to reduce skin blood flow, while two sites received Ringer solution (control). All sites were maintained at 34°C. In protocol II, all sites received 28 mM sodium nitroprusside to equalize skin blood flow between sites before local cooling to 20°C (2 sites) or maintenance at 34°C (2 sites). In both protocols, individuals were then passively heated to increase core temperature ~1°C. Both decreased skin blood flow and decreased local temperature attenuated the slope of the SR to mean body temperature relationship (2.0 ± 1.2 vs. 1.0 ± 0.7 mg·cm(-2)·min(-1)·°C(-1) for the effect of decreased skin blood flow, P = 0.01; 1.2 ± 0.9 vs. 0.07 ± 0.05 mg·cm(-2)·min(-1)·°C(-1) for the effect of decreased local temperature, P = 0.02). Furthermore, local cooling delayed the onset of sweating (mean body temperature of 37.5 ± 0.4 vs. 37.6 ± 0.4°C, P = 0.03). These data demonstrate that local cooling attenuates sweating by independent effects of decreased skin blood flow and decreased local skin temperature.

Skin blood flow responses in the human forearm, assessed by three commonly used technologies-single-point laser-Doppler flowmetry, integrated laser-Doppler flowmetry, and laser-Doppler imaging-were compared in eight subjects during normothermic baseline, acute skin-surface cooling, and whole body heat stress (Δ internal temperature=1.0±0.2 degrees C; P<0.001). In addition, while normothermic and heat stressed, subjects were exposed to 30-mmHg lower-body negative pressure (LBNP). Skin blood flow was normalized to the maximum value obtained at each site during local heating to 42 degrees C for at least 30 min. Furthermore, comparisons of forearm blood flow (FBF) measures obtained using venous occlusion plethysmography and Doppler ultrasound were made during the aforementioned perturbations. Relative to normothermic baseline, skin blood flow decreased during normothermia+LBNP (P<0.05) and skin-surface cooling (P<0.01) and increased during whole body heating (P<0.001). Subsequent LBNP during whole body heating significantly decreased skin blood flow relative to control heat stress (P<0.05). Importantly, for each of the aforementioned conditions, skin blood flow was similar between the three measurement devices (main effect of device: P>0.05 for all conditions). Similarly, no differences were identified across all perturbations between FBF measures using plethysmography and Doppler ultrasound (P>0.05 for all perturbations). These data indicate that when normalized to maximum, assessment of skin blood flow in response to vasoconstrictor and dilator perturbations are similar regardless of methodology. Likewise, FBF responses to these perturbations are similar between two commonly used methodologies of limb blood flow assessment.

Cutaneous vasodilation associated with whole-body heat stress occurs via withdrawal of adrenergic vasoconstriction and engagement of cholinergic "active" vasodilation, the latter of which attenuates cutaneous vasoconstrictor responsiveness. However, the precise neurotransmitter(s) responsible for this sympatholytic-like effect remain unknown. In skeletal muscle, ATP inhibits adrenergically mediated vasoconstriction. ATP also may be responsible for attenuating cutaneous vasoconstriction since it is co-released from cholinergic neurons. The effect of ATP on cutaneous vasoconstrictor responsiveness, however, has not been investigated. Accordingly, this study tested the hypothesis that ATP inhibits adrenergically mediated cutaneous vasoconstriction. To accomplish this objective, four microdialysis probes were inserted in dorsal forearm skin of 11 healthy individuals (mean +/- SD; 35 +/- 11 years). Local temperature at each site was clamped at 34 degrees C throughout the protocol. Skin blood flow was indexed by laser-Doppler flowmetry and was used to calculate cutaneous vascular conductance (CVC; laser-Doppler-derived flux/mean arterial pressure), which was normalized to peak CVC achieved with sodium nitroprusside infusion combined with local skin heating to approximately 42 degrees C. Two membranes were perfused with 30 mM ATP, while the other two membranes were flow matched via administration of 2.8 mM adenosine to serve as control sites. After achieving stable baselines, 1 x 10(-4) M tyramine was administered at all sites, while ATP and adenosine continued to be infused at their respective sites. ATP and adenosine infusion increased CVC from baseline by 35 +/- 26% CVC(peak) units and by 36 +/- 15% CVC(peak) units, respectively (P = 0.75). Tyramine decreased CVC similarly (by about one-third) at all sites (P < 0.001 for main effect and P = 0.32 for interaction). These findings indicate that unlike in skeletal muscle, ATP does not attenuate tyramine-stimulated vasoconstriction in human skin.

Impaired cerebral autoregulation during marked reductions in arterial blood pressure may contribute to heat stress-induced orthostatic intolerance. This study tested the hypothesis that passive heat stress attenuates dynamic cerebral autoregulation during pronounced swings in arterial blood pressure. Mean arterial blood pressure (MAP) and middle cerebral artery blood velocity were continuously recorded for approximately 6 min during normothermia and heat stress (core body temperature = 36.9 +/- 0.1 degrees C and 38.0 +/- 0.1 degrees C, respectively, P < 0.001) in nine healthy individuals. Swings in MAP were induced by 70-mmHg oscillatory lower body negative pressure (OLBNP) during normothermia and at a sufficient lower body negative pressure to cause similar swings in MAP during heat stress. OLBNP was applied at a very low frequency ( approximately 0.03 Hz, i.e., 15 s on-15 s off) and a low frequency ( approximately 0.1 Hz, i.e., 5 s on-5 s off). For each thermal condition, transfer gain, phase, and coherence function were calculated at both frequencies of OLBNP. During very low-frequency OLBNP, transfer function gain was reduced by heat stress (0.55 +/- 0.20 and 0.31 +/- 0.07 cm x s(-1) x mmHg(-1) during normothermia and heat stress, respectively, P = 0.02), which is reflective of improved cerebrovascular autoregulation. During low-frequency OLBNP, transfer function gain was similar between thermal conditions (1.19 +/- 0.53 and 1.01 +/- 0.20 cm x s(-1) x mmHg(-1) during normothermia and heat stress, respectively, P = 0.32). Estimates of phase and coherence were similar between thermal conditions at both frequencies of OLBNP. Contrary to our hypothesis, dynamic cerebral autoregulation during large swings in arterial blood pressure during very low-frequency (i.e., 0.03 Hz) OLBNP is improved during heat stress, but it is unchanged during low-frequency (i.e., 0.1 Hz) OLBNP.

The venoarteriolar response (VAR) increases vascular resistance upon increases in venous transmural pressure in cutaneous, subcutaneous, and muscle vascular beds. During orthostasis, it has been proposed that up to 45% of the increase in systemic vascular tone is due to VAR-related local mechanism(s). The objective of this project was to test the hypothesis that heat stress attenuates VAR-mediated cutaneous and whole leg vasoconstriction. During normothermic conditions, measurements of cutaneous blood flow (laser-Doppler flowmetry) and femoral artery blood flow (Doppler ultrasound) were obtained from both legs during supine and leg-dependent conditions. These measurements were repeated following a whole body heat stress (increase in internal temperature of 1.4 +/- 0.2 degrees C). Before leg dependency, cutaneous (CVC) and femoral vascular conductances (FVC) were significantly elevated in both legs during heat stress relative to normothermia (P < 0.001). During leg dependency the absolute decrease in CVC was attenuated during heat stress (P < 0.01) while the absolute decrease in FVC was unaffected (P = 0.90). When CVC and FVC data were analyzed as a relative change from their respective baseline values, heat stress significantly attenuated the magnitude of vasoconstriction due to leg dependency in the cutaneous and femoral circulations (P < 0.001 for both variables). These data suggest that an attenuated local vasoconstriction, evoked via the venoarteriolar response, may contribute to reduced blood pressure control and thus reduced orthostatic tolerance that occurs in heat-stressed individuals.

Passive heat stress reduces arterial carbon dioxide partial pressure (P(aCO2)) as reflected by 3 to 5 Torr reductions in end-tidal carbon dioxide tension (P(ETCO2)). Heat stress also reduces cerebrovascular conductance (CBVC) by up to 30%. While is a strong regulator of CBVC, it is unlikely that the relatively small change in during heating is solely responsible for the reductions in CBVC. This study tested the hypothesis that P(aCO2), referenced by P(ETCO2), is not the sole mechanism for reductions in CBVC during heat stress. Mean arterial blood pressure (MAP), P(ETCO2), middle cerebral artery blood velocity (MCA V(mean)), and calculated CBVC (MCA V(mean)/MAP) were assessed in seven healthy individuals, during three separate conditions performed sequentially: (1) normothemia, (2) control passive heat stress and (3) passive heat stress with P(ETCO2) clamped at the normothermic level (using a computer-controlled sequential gas delivery breathing circuit). MAP was similar in the three thermal conditions (P = 0.55). Control heat stress increased internal temperature approximately 1.3 degrees C, which resulted in decreases in P(ETCO2), MCA V(mean) and calculated CBVC (P < 0.001 for all variables). During heat stress + clamp conditions internal temperature remained similar to that during the control heat stress condition (P = 0.31). Heat stress + clamp successfully restored to the normothermic level (P = 0.99) and increased MCA V(mean) (P = 0.002) and CBVC (P = 0.008) relative to control heat stress. Despite restoration of P(ETCO2), MCA V(mean) (P = 0.005) and CBVC (P = 0.03) remained reduced relative to normothermia. These results indicate that heat stress-induced reductions in , as referenced by P(ETCO2), contribute to the decrease in MCA V(mean) and CBVC; however, other factors (e.g. perhaps elevated sympathetic nerve activity) are also involved in mediating this response.

This study tested the hypothesis that passive heating impairs cerebral autoregulation. Transfer function analyses of resting arterial blood pressure and middle cerebral artery blood velocity (MCA V(mean)), as well as MCA V(mean) and blood pressure responses to rapid deflation of previously inflated thigh cuffs, were examined in nine healthy subjects under normothermic and passive heat stress (increase core temperature 1.1 +/- 0.2 degrees C, P < 0.001) conditions. Passive heating reduced MCA V(mean) [change (Delta) of 8 +/- 8 cm/s, P = 0.01], while blood pressure was maintained (Delta -1 +/- 4 mmHg, P = 0.36). Coherence was decreased in the very-low-frequency range during heat stress (0.57 +/- 0.13 to 0.26 +/- 0.10, P = 0.001), but was >0.5 and similar between normothermia and heat stress in the low- (0.07-0.20 Hz, P = 0.40) and high-frequency (0.20-0.35 Hz, P = 0.12) ranges. Transfer gain was reduced during heat stress in the very-low-frequency (0.88 +/- 0.38 to 0.59 +/- 0.19 cm.s(-1).mmHg(-1), P = 0.02) range, but was unaffected in the low- and high-frequency ranges. The magnitude of the decrease in blood pressure (normothermia: 20 +/- 4 mmHg, heat stress: 19 +/- 6 mmHg, P = 0.88) and MCA V(mean) (13 +/- 4 to 12 +/- 6 cm/s, P = 0.59) in response to cuff deflation was not affected by the thermal condition. Similarly, the rate of regulation of cerebrovascular conductance (CBVC) after cuff release (0.44 +/- 0.22 to 0.38 +/- 0.13 DeltaCBVC units/s, P = 0.16) and the time for MCA V(mean) to recover to precuff deflation baseline (10.0 +/- 7.9 to 8.7 +/- 4.9 s, P = 0.77) were not affected by heat stress. Counter to the proposed hypothesis, similar rate of regulation responses suggests that heat stress does not impair the ability to control cerebral perfusion after a rapid reduction in perfusion pressure, while reduced transfer function gain and coherence in the very-low-frequency range during heat stress suggest that dynamic cerebral autoregulation is improved during spontaneous oscillations in blood pressure within this frequency range.

During a whole body heat stress, stroke volume is either maintained or slightly elevated despite reduced ventricular filling pressures and central blood volume, suggestive of improved cardiac diastolic and/or systolic function. Heat stress improves cardiac systolic and diastolic function in patients with congestive heart failure, although it remains unknown whether similar responses occur in healthy individuals, which is the hypothesis to be tested. Nine male volunteers underwent a whole body heat stress. Echocardiographic indexes of diastolic and systolic function were performed following a supine resting period, and again following an increase in internal temperature of approximately 1.0 degrees C via passive heat stress. Despite previous reports of heat stress-induced decreases in ventricular filling pressures and central blood volume, no changes in indexes of diastolic function were identified during heating [i.e., unchanged early diastolic mitral annular tissue velocity (E'), mitral inflow during the early diastolic phase (E), the E/E' ratio, and isovolumetric relaxation time]. Heat stress increased late diastolic septal (P = 0.03) and lateral (P = 0.01) mitral annular tissue velocities (A'), mitral inflow velocity during atrial contraction (P < 0.001), and the relative contribution of atrial contraction to left ventricular filling during diastole (P = 0.01), all indicative of improved atrial systolic function. Furthermore, indexes of ventricular systolic function were increased by heat stress [i.e., increased septal (P = 0.001) and lateral (P = 0.01) mitral annular systolic velocities and isovolumic acceleration at the septal (P = 0.03) and lateral (P < 0.001) mitral annulus]. These data are suggestive of improved atrial and ventricular systolic function by the heat stress. Together these data support previous findings, which used the less precise measure of ejection fraction, that heat stress improves indexes of systolic function, while diastolic function is maintained.