Efficacy of Exercise and Testosterone to Mitigate Atrophic Cardiovascular Remodeling

Purpose Early and consistent evaluation of cardiac morphology and function throughout an atrophic stimulus is critically important for the design and optimization of interventions. This randomized, controlled trial was designed to: 1) characterize the time course of unloading-induced morpho-functional remodeling, and 2) to examine the effects of exercise with and without low dose testosterone supplementation on cardiac biomarker, structural, and functional parameters during unloading. Methods Twenty six subjects completed 70 days of head down tilt bed rest (BR): 9 were randomized to exercise training (Ex), 8 to EX and low dose testosterone (ExT), and 9 remained sedentary (CONT). Exercise consisted of high intensity, continuous, and resistance exercise. Cardiac morphology (left ventricular mass; LVM) and mechanics (longitudinal, radial, and circumferential strain and twist), cardiovascular biomarkers, and cardiorespiratory fitness (VO2peak) were assessed before, during, and following BR. Results Sedentary BR resulted in a progressive decline in LVM, longitudinal, radial, and circumferential strain in CONT, while Ex and ExT mitigated decreases in LVM and function. Twist was increased throughout bed rest in sedentary BR, while after an initial increase at BR7, there were no further changes in twist in Ex and ExT. HDL cholesterol was significantly decreased in all groups compared to pre-bed rest (p

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