How does Physical Activity Exert Beneficial Effects on Atherosclerosis and Coronary Artery Disease?

This post describes an update seminar delivered by Harold Laughlin, Professor at the University of Missouri at the 2017 HAPS Annual Conference in Salt Lake City.


Update Seminar VII was given by Harold Laughlin.  In this talk, the benefits of exercise on cardiovascular health were clearly documented.  I’m sure we’ve all heard the sobering stats before.  Cardiovascular disease, largely due to atherosclerosis, is the leading cause of death in the USA, accounting for ~ 1/3rd of all deaths.  As our President-Elect Ron Gerrits announced, we were all left feeling very inspired to getting fit for the HAPS conference Fun Run next year!  

For those interested in a great review article on the regulation of coronary blood flow during exercise, Harold mentioned the Physiology Review article by Duncker and Bache (2008).   In particular, here is list of some of the things we know so far regarding coronary blood flow during exercise:

  • During exercise, heart rate and myocardial contraction increase to meet the increased oxygen demands of the body and heart itself.
  • In order to meet increased metabolic demand, coronary blood flow increases (~5 fold) and there is also a small increase in oxygen extraction.
  • An increase in heart rate, will increase the relative time spent in systole, which affects (impedes) coronary blood flow.
  • There are many factors which regulate coronary vessel dilation (neurohormones, endothelial factors, and myocardial factors)
  • During exercise, coronary vasodilation appears to be induced by many factors including: exercise-induced ischemia, shear stress, increased arterial pressure, tangential wall stress, higher levels of endogenous NO, and β-adrenergic activity.
  • Exercise training results in coronary microvascular adaptations including: the formation of new capillaries, increased arteriolar diameters, increased adrenergic receptor responsiveness, and increased endothelium-dependent vasodilation (as a result of increased expression of endothelial NO synthase (eNOS), increased NO production, and increased Kv (potassium voltage) channel activity).

In his talk, Harold brought up some current data from his experiments with swine vasculature (Simmons et al., 2012).  He noted that healthy individuals typically have good vasomotor tone, and express low levels of the inflammatory markers and adhesion molecules (e.g. E-selectin and vascular cell adhesion molecule-1, VCAM-1) that are associated with atherosclerosis.  It has been previously found that endothelial cells located at bifurcations and other points of turbulence, are more at risk for developing atherosclerotic plaques than straight conduit arteries (Davies et al. 2010).  Laughlin et al. (2012) decided to investigate the straight conduit arteries and veins in six different regions of the swine to determine whether there were any differences in susceptibility to the development of atherosclerosis.  Overall, they found conduit arteries expressed higher levels of both pro- and anti-atherogenic markers than veins.  Also as one might expect, vessels of healthy individuals that lack atherosclerosis, are the most responsive to exercise.

In this talk, the improvements in vasculature as a result of exercise training were specifically addressed (Green et al. 2017).  The exercise-induced effects on vasculature is actually remarkable.  It is estimated that physical activity increases longevity, and reduces the risk of cardiovascular mortality by 42-44%.  The positive effect of exercise is noted to have dose-dependent curve and exercise training has been found to be on par with contemporary drug interventions (Green et al. 2017).  Exercise induces structural and functional adaptations in the vascular walls that reduce the risk of atherosclerotic plaque formation.  In addition increased capillary density and formation of additional collateral circulation is observed, as exercise induces the release of VEGF (Vascular Endothelial Growth Factor) (Green et. al. 2017).  Also, exercise was found to increase endothelial progenitor cell (EPC) activity which contributes to the growth of new vessels as well as repair.

It is important to note that exercise training increases cardiac output and oxygen uptake, without increasing mean arterial pressure.  This is because as cardiac output increases, peripheral vasodilation occurs (reducing afterload).  Exercise training improves vasodilation capabilities through structural changes.  During exercise, the increased systolic pressure stimulates vascular endothelial and smooth muscle cells to grow and align in response to stress, allowing for greater vasodilation.  In addition, vessel wall stretching induces vasodilation through increased eNOS activity (which produces the vasodilator NO) and activation of Kv channels (which causes smooth muscle cells to hyperpolarize and relax).  In addition, increased blood flow, has been found to increase both acetylcholine and prostacyclin levels which have been shown to induce vasodilation.  Conversely, low levels of shear stress, has been found to increase expression of adhesion molecules (ICAM-1 and VCAM-1) and reduce levels of the endogenous vasodilator NO (Green et al. 2017).

Thankfully for those of us looking to improve vasodilatory function in our conduit arteries and increase our capillary density, improvements through exercise can be seen in as little as 1-4 weeks of exercise and of course continue with longer training sessions.  So with that in mind, I’ll be sure to grab my running shoes and sign my kids up for sports, as fewer than 30% of females and 50% of males get the recommended 60 minutes 5-7 days/ week of exercise!  Yikes-arama!  Time to unplug and play…

A big thank you to Harold Laughlin for a highly motivating talk!


Post from Dr. Zoë Soon, School of Health and Exercise Sciences, University of British Columbia Okanagan, BC, Canada


Davies, P.F., Civelek, M., Fang, Y., Guerraty, M.A. Passerini, A.G. (2010). Endothelial heterogeneity associated with regional athero-susceptiblity and adaptation to disturbed blood flow in vivo. Semin. Thromb. Hemost. 36, 265-275.

Duncker, D.J. and Bache, R.J. (2008). Regulation of coronary blood flow during exercise. Physiol. Rev. 88, 1009-1086.

Green, D.J., Hopman, M.T.E., Padilla, J., Laughlin, M.H., Thijssen, D.H.J. (2017). Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Phsiol. Rev. 97, 495-528.

Simmons, G.H., Padilla, J., and Laughlin, M.H. (2012). Heterogeneity of endothelial cell phenotype within and amongst conduit vessels of the swine vasculature. Exp. Physiol. 97(9), 1074-1082.

The President’s Medal

The President’s medal is an award that recognizes a HAPS member who has provided exemplary service to HAPS. The recipient of the award is chosen by the current HAPS President and  is announced at the Annual General Membership Meeting.  Terry Thompson explains below why she chose Carol Veil as the 2017 President’s Medal recipient.

Carol Veil (l) receives the President’s Medal from President Terry Thompson (r)

I had the pleasure of presenting this year’s medal to Carol Veil in Salt Lake City.  Because the choice is kept secret, I first shared a “hint” with the audience in the form of a special chocolate Oscar-like statue.  I think most everyone in the room got the hint, except Carol.  In true humility, as she was dutifully taking minutes from the Annual Membership meeting, Carol looked up and thought, “Gee, there must be someone else here that likes chocolate as much as I do”.

Carol served on the Steering Committee as chair of the Curriculum & Instruction Committee from 2005 to 2009.  During that time she coordinated 35 faculty from 18 different states to develop the HAPS Anatomy & Physiology Learning Outcomes, which continues to be one of our organization’s most valuable members resources.  The Learning Outcomes are used by faculty to develop and assess their courses, by publishers to organize textbooks, and by the HAPS Testing Committee to write questions for the HAPS Exam. The coordination and organization of this major project is even more amazing when we think back to the limited technology that was available at that time for collaboration only by email attachments and multiple versions of documents.

In her 19 years as a HAPS member, Carol has given individual and team workshops at 20 annual conferences and at 5 regional conferences, often presenting some of both at the same conference.  Many of us have gleaned new teaching tips and strategies from the various workshops presented in partnership with Javni Mody, such as the popular Awesome Analogies or Mnifty Mnemonics, as well as learned so much about the physiology of chocoholics from a connoisseur.  She also served on conference planning committees for the 2009 Baltimore Annual conference and two regional conferences. Carol also involved her students in the pilot study for the A&P 1 only version of the HAPS Exam.

Most recently, Carol was elected to the Board of Directors as Secretary for two terms since 2013, serving with four HAPS presidents.  As a result, she played a role in the initial development and the mid-term review of the HAPS 2014 – 2019 Strategic Plan that provides the great vision and process to lead HAPS successfully into the future.  Carol was chosen for this award based on her work in these many roles as she ends her term as HAPS secretary and retires from Anne Arundel Community College (AACC) near Annapolis, MD.  She has already committed to continuing her involvement with HAPS with initial plans for a team workshop in Columbus OH and agreeing to serve as Chair-in-Training under Don Kelly as the next co-chair of the Foundation Oversight committee for Grants and Scholarships.

It was my honor to present Carol with this well-deserved recognition and we all look forward to her continued HAPS contributions as a retired emerita member.

2017 HAPS-Thieme Award for Excellence in Teaching

Each year Thieme supports great teaching by supporting one of the largest scholarships that HAPS awards.  This is always a very difficult award to give, because HAPS is full of amazing educators.  This year’s winner was also the 2017 Conference Chair and hosted the conference at the University of Utah.  We all congratulate Mark Nielsen on his amazing teaching.  You can read more about Mark below.

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Anne Kaiser of Thieme and HAPS President Terry Thompson with Mark Nielsen (center)

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Mark Nielsen is a professor of anatomical sciences at the University of Utah where he has taught a wide variety of anatomy courses for the past thirty years. His teaching expertise includes comparative vertebrate anatomy, embryology, neuroanatomy, human anatomy, histology, and the history of anatomy. He has taught anatomy to over 30,000 students, which include undergraduates, medical students, physician assistant students, and massage therapy students. In teaching this diverse population of students he has been recognized as one of the outstanding teachers at the University, where he has received every recognized teaching award from both students and colleagues, some of them multiple times. He has also received a number of national teaching awards. He teaches demanding courses that exact high expectations of his students, but he teaches them how to navigate the details of anatomy through an understanding of principles and patterns of developmental and comparative anatomy. He loves to see students eyes light up as they learn to consume large quantities of information with the elegant patterns he shares with them. He has trained approximately 1,500 teaching assistants through his anatomy teaching program, many who have gone on to become outstanding teachers. He is also the author of numerous nationally and internationally recognized anatomy textbooks and software programs.

 


Don’t forget that as part of their support for HAPS members, Thieme offers 30% off and free shipping on their products using the code HAPS30 at checkout

2017 Gail Jenkins Award for Teaching and Mentoring

With the support of Wiley, the Gail Jenkins Award recognizes an A&P instructor who inspires students and colleagues alike.  This year the winner was first-time conference attendee Richelle Monaghan.   You can read more about Richelle below.

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Maria Guarascio from Wiley, Richelle Monaghan, and HAPS President Terry Thompson

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Richelle Monaghan joined Wilfrid Laurier University as an Assistant Professor in 2012 as the Head of Science Programming for the Bachelor of Arts and Science (BASc) in Public Health, and was cross-appointed with the Department of Biology in 2014. Richelle completed her Ph.D. in Biology at the University of Waterloo in 2011 by developing cell culture models to study intracellular fungal parasites. She is currently the elected Chair of Parasitism, Immunity and Environment (PIE) for the Canadian Society of Zoologists. Prior to graduate school, Richelle was in private practice for 15 years as a regulated health care provider with a clinical focus on pain management. In this role, she gained strategies to explain anatomical and physiological concepts to her patients in ways that were relevant to them, and has continued to use these techniques for her students over the years. Richelle is an avid canoeist and enjoys traveling with her family.

2017 Sam Drogo Award winners

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Wes Colgan, Arianna Boulet, and Rachel House from ADInstruments with the award winners

In 2017 ADInstruments funded three Sam Drogo Awards, supporting excellence in the classroom.  As usual, the ADInstruments team came out in force to support HAPS and this amazing group of instructors who have distinguished themselves with their use of technology in the classroom.

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DayLESLIE DAY earned her B.S. in Exercise Physiology from UMass Lowell, an M.S. in Applied Anatomy & Physiology from Boston University, and a Ph.D. in Biology from Northeastern University. She currently works as an Associate Clinical Professor in the Department of Physical Therapy, Movement and Rehabilitation Sciences at Northeastern University with her main teaching role in upper level Gross Anatomy and Neuroanatomy courses, but still loves teaching her introductory anatomy course. She has received five teaching awards at the university, including the coveted University Excellence in Teaching Award. She is also a digital author for the Hole’s Anatomy & Physiology and  Hole’s Essentials of Anatomy &  Physiology textbooks. Her current research focuses on the effectiveness of different teaching pedagogies, including the flipped-classroom and various technology. She brings her love for anatomy and quest for trying new technology into the classroom to make for a dynamic evidence-based teaching style that is friendly to all students.

HurtBarbekka (Barb) Hurtt received her Ph.D. in Neuroscience from the University of Colorado, where I first gained experience teaching undergraduates. Since then, I’ve worked both in and out of academia, largely focused on technology integration and implementation into undergraduate natural sciences content. I am currently an Assistant Professor-Teaching in the University of Denver Biological Sciences department, although I’ve also taught at the medical school and graduate health professions levels as well. Throughout my career I’ve utilized numerous different technologies in my courses and labs, with the aim of integrating constructive and meaningful resources to improve the educational process for students and faculty alike. My current technology undertaking focuses on student-directed 3D simulation in the human anatomy labs as one component of a multi-modality lab education experience. We use the Visible Body Human Anatomy Atlas in the zSpace 3D system on a weekly basis, in addition to dissection and modeling in the labs. Students drive the 3D simulations during the learning experience, and additionally use them to “peer-teach” the other students in their lab sections. The purpose of implementing the 3D system is multi-faceted, but overall has received positive reviews from students. An IRB approved educational research study is underway to evaluate the impact of this technology on student learning, retention, and educational engagement.

LiuHe Liu is an assistant professor at Gannon University. He teaches Animal Physiology and lab, introductory Molecular and Cellular Biology, and Research Methods in Biology courses in the Biology Department. His research is on the molecular basis of learning and memory, and physiological effects of environmental contaminants.

After the Annual – Utah Mountain Biking!

Bonneville Shore Trail
A message from HAPS Western Regional Director, Jon Jackson (left). Kerry Hull and Murray Jensen photobomb-ing.
A message from HAPS Western Regional Director, Jon Jackson (left). Photobomb by Kerry Hull and Murray Jensen.

Utah Mountain Biking is a bucket list option for interested HAPSters!

Although mountain biking is generally thought to have originated in the Marin County hills north of San Francisco, there is arguably no finer place to ride than Utah. If you have the time and inclination to hit the mountain trails and ride, there are lots of options awaiting you near the HAPS Conference this Spring.  Murray Jensen, Kerry Hull and I went out a day before the mid-year meeting to explore some biking options (and spend some time in Mark Nielsen’s lab). Here’s what we found.

Jon enforces a rest break...because rest breaks are cool.
Jon enforces a rest break…because rest breaks are cool.

Within a 10-15 minute walk up the hill from the Salt Palace (site of the HAPS Conference) you’ll find a number of shops that rent out mountain bikes.  For around $40, you will be able to rent a $2500 mountain bike for the afternoon!  Full suspensions, 29-inch wheels, and even more options can be had.  If you’re thinking or riding up in the foothills surrounding the city, you’ll have about a 20-minute uphill ride to hit the mountain trailheads that run along what was once the shore of glacial Lake Bonneville. The elevation gain from the hotel to the Bonneville Shelf is about 600-800 feet. The landscape is nothing short of spectacular, even on days with a smog layer.

Local Badger

The entire Great Basin opens up as you switch back up the foothills; it’s quiet enough that you can even surprise some locals along the way.  The uphill climbing ranges from mild to clutch-your-chest strenuous. [I suffered in particular because I was serving as the “untrained control subject,” trying to keep up with Kerry and Murray.] The altitude provided wondrous panoramic views and a kick-your-butt workout, but most importantly, it meant some SWEET downhill action.  On our segment of the Bonneville Shore Trail, the single-track path was 90-95% packed solid, and offered up a mostly smooth ride. But for those who have left their common sense behind, and seek a greater challenge, there are several advanced/expert routes down the hill that will rattle bones, loosen ligaments, and likely raise your health insurance deductibles more than Paul Ryan could.

5 Moose
Local Moose

But no fears, there are many moderate trails that can bring you back to town. Our ride lasted just under three hours, and left us euphoric, thirsty, and with a trace of sunburn (even in October).

 

6 Mid MountainIf the moderate to high euphoria levels of the HAPS meeting aren’t going to be enough — the next level up of mountain biking literally brings you up out of the Wasatch Valley to the mountains surrounding Park City, one of the nation’s premier mountain biking destinations. Lots of shops cater to people giving this level of biking a try, and so you’ll have no trouble finding a “29er” with full suspension. The uphill is even more strenuous, although some riding parks have ski-lifts 7 Elevationto take you up the mountainside. [I’m all for that, as it follows the law of conservation of energy.] This world famous Mid-Mountain Trail is definitely not for novices, but if you’re a reasonably solid mountain biker, this place is as good as it gets. Weather permitting, the miles of traversing trails running over these wooded ski hills will provide a relatively moderate-level (elevation-wise) riding experience. But the downhill can get tricky: you’re a mile and a half above sea-level, and “down” is long, long way away.

Olympic-level bikers who train in Park City power down the hills pedaling, and at high speed. Fortunately for those of us who don’t want to over-use our sympathetic nervous systems, we’re able to find more moderate slopes on which to descend.  Either way, though, it will be full-on fatigue at the finish. It was great that our intrepid riders had a “sag-wagon” to come and fetch them.

Tom Lehman joins post-ride
Tom Lehman joins post-ride

You too will probably may want to arrange for a ride, as you could be too tired and sore to drive back to SLC.  All in all, the beauty of the terrain and the challenge of the hills is a something for every mountain biker’s bucket list.  We’ll have some of the info from the bike places we used for our gear at this year’s annual conference.  We hope to see you there!

 

 


Author Jon Jackson is the HAPS Western Regional Director.

A full list of recommended post-conference activities is available on the HAPS website

The 2017 Lab Instructor Survey Report is Now Available!

David Brashinger has engineered the 2014 and 2017 HAPS lab instructor survey reports.

Hot off the digital press…the results of the 2017 HAPS laboratory instructor survey are now available to HAPS members in a Special Edition of HAPS Educator. My thanks to all of you who participated in either the 2014 or the 2017 surveys. This year, we received over 560 submissions from 470 institutions over a two-month period. That’s more than four times the number of participants and more than five times the number of institutions than we had in 2014, and in half the time! Special thanks to the ADInstruments team for their suggested survey improvements and sponsoring the Amazon gift card drawing for our survey participants.

The report, Instructional Goals and Practices in the Introductory Undergraduate Pre-Health Professions Anatomy and Physiology Laboratory, contains all the 2016 survey data alongside the quantitative results from the 2014 report. The report is hefty with 21 data tables; however, it was important to share all the data we collected in a peer-reviewed and published format rather than just summarizing a few key findings. The report includes data on the participant population, institutional and program practices, and the instructional goals and practices in the A&P laboratory. I expect you’ll find the data in this report very helpful if you are needing to benchmark your current laboratory practices against the national trends. I also see the report as a foundation for our discussions on what our laboratory practices should be in the future.

I look forward to discussing the survey results and our next steps with y’all in Salt Lake City. I’ll be at the poster session during the update seminar portion of the annual meeting and I’m leading a workshop later in the conference. If you won’t be at the annual conference, please feel free to reach out to me by email with your questions and ideas.

In closing, I also wanted to take a moment and thank all the HAPS committee members, board members, and administrative staff who worked on the lab survey project over the last three years. This project started with a question I asked Ron Gerrits in 2013. I was still very new to HAPS and it was my first annual conference. Looking back reminds me how welcoming we are as an organization and how much we accomplish as volunteers in HAPS. If you’re not already on a HAPS committee, review the committee list on the HAPS website and consider joining one of these fantastic teams. The committees meet in person at the annual conference, but you can still get involved even if you’re not headed to Salt Lake City this year. Just reach out to the corresponding committee chair using their contact information on the HAPS website.

Survey conducted in partnership with ADInstruments