Сapillaroscopic tests of elite athletes to rate individual metabolism in microcirculation system

ˑ: 

Dr.Hab., Professor G.N. Gretz1
Dr.Biol., Professor, Department of Biological Sciences T.M. Bruk1
Dr.Biol., Professor F.B. Litvin1
PhD V.V. Baranov2
1 Smolensk State Academy of Physical Culture, Sport and Tourism, Smolensk
2 Central Scientific Research Institute of Stomatology and Maxillofacial Surgery of RMPH, Moscow       

 

Keywords: computer capillaroscopy, capillary, metabolism, physical load, individualized tests.

Background

Capillary blood flow rating studies have always been of highest interest both for the theoretical science – as they provide the data for better understanding of the tissue metabolism control mechanisms – and for practical applications as they may give an insight to the athletes’ individual blood flow specifics under physical loads [4, 5]. Elite sports require the athletic training process being designed on an individualized basis with due consideration for the athlete’s genetic background, individual morphological and functional specifics, mental and learning qualities and social aspects of the living standards. The individualized diagnostics will be designed to identify the individual body response specifics under loads to shape up and adjust the individual training methodologies, manage the individual nutrition programs, and provide timely and professional pharmacological, physiotherapeutic and immune-response modulating services in the fatigue-prevention and rehabilitation process [1, 2, 6].

Objective of the study was to identify the individual peaks in competitive fitness based on the capillaroscopic tests of statistical, dynamic and kinematic parameters of metabolic processes on the micro-system level.

Methods and structure of the study. Subject to the capillaroscopic tests were 5 athletes qualified Masters of Sport in ski races and ski sprint. Capillaries of the right-hand cuticle were tested at rest following 30-second anaerobic cycle ergometer exercise using a computerized KK4-01 Capillaroscope made by “Analis Veshestv” [“Material Analysis”] Centre, a national closed joint-stock company. The following rates and parameters were used to characterize the capillary network, microcirculation and trans-capillary metabolism: capillary network density (%); morphology of capillaries; pericapillary zone size (mc); capillary diameters (mc) rated by the vascular subsystems (arterial subsystem AS, transient subsystem TS and venous subsystem VS); linear velocity of the AS/ VS capillary blood flow (mc/s); volume velocity of the AS/ VS capillary blood flow (mc3/s); perfusion balance PB (mc3/s); linear velocity acceleration rates of the AS/ VS capillary blood flow (mc/s2); capillary blood flow stasis (stoppage); and counts of the aggregated erythrocytes and white blood corpuscles (1/с).

Study results and discussion. Analysis under the study was based on the individual rates of three ski racers different in the functional capacities of their blood microcirculation systems at rest versus maximal anaerobic exercise. For convenience of the study data processing, the subject athletes are referred to herein as the Athletes 1, 2 and 3. Based on the capillaroscopic data obtained at relative rest, Athlete 1 was tested with the capillary system being in the best condition, with the lowest share of capillaries (4.20%) being active at rest thereby creating a highest functionality reserve for the training loads (see Table 1 hereunder). The capillary diameters by vascular subsystems were found falling within the standard range [4], i.e. optimal for diffusion of fluids and gases through the endothelial barrier.

Table 1. Capillary system comparative condition rates of the subject ski racers at rest

Rate

Subjects

Standard

Athlete 1

Athlete 2

Athlete 3

Density of the capillary network,  %

 

 

4,20

6,70

7,48

5-10

Capillary diameters by the vascular subsystems, mc

 

AS

TS

VS

7,3

13,7

11,0

10,0

18,8

14,3

10,5

14,5

12,5

8-14

8-18

9-16

Linear velocity of the capillary blood flow, mc/s

 

AS

VS

528,3

356,0

278,3

263,0

380,3

338,2

500-900

250-500

Volume velocity of the AS/ VS capillary blood flow, mc3/s

 

AS

VS

23687,1

33762,7

21229,3

43065,8

36030,0

44430,8

100000-150000

100000-150000

Balance of volume velocities, mc3/s

 

AS/ VS

-10084,5

-21836,5

-9521,3

±20000

Pericapillary zone size, mc

 

 

92,0

115,5

122,8

80-110

White inclusions, 1/s

 

 

-

0,66

1,87

1

Good morphological rates of the capillary system were found associating with the optimal dynamic rates. As found by the Athlete 1 tests, the maximal linear velocities of the AS/ VS capillary blood flow fall within the optimal range of velocities favourable for diffusion of oxygenated haemoglobin [2, 6]. Higher balancing rates of the diffusion/ re-absorption processes in the capillary blood system need to be specially mentioned. Rheological dynamic rates were found indicative of the homogenous uninterrupted blood flow free of aggregates and inclusions. The optimal rest condition of Athlete 1 is further verified by the post-aerobic-exercise capillaroscopy (see Table 2 hereunder). The athletes’ body responded to the exercise by the growing density of the capillary network, with the diameters of the capillaries growing too to expand the surface for metabolic processes. The AS, TS and VS diameters, for instance, were found to grow by 100%, 25% and 33%, respectively, with the total capacity of the system found to increase more than 5 times (by 562%) in the AS capillaries and 2 times (by 207%) in the VS capillaries.

Physical loads force the type of metabolism being changed with the growing plasma filtration from the AS, falling re-absorption rates in the VS capillaries and the growing pericapillary zone size. On the whole, Athlete 1 was diagnosed with high functional mobility and expressed reactivity of endothelium in capillaries to ensure high adaptive capability of the local hemodynamic processes and the optimal haemostasis being maintained in the tissue region [4]. The linear velocity of the blood flow was found to grow (within the optimal range of values) by 66% in the AS and 73% in the VS capillaries. The post-exercise test rates were indicative of the homogenous blood flow structure with the blood being fee of aggregates and inclusions. No adhesion of blood corpuscles to the capillary walls were found by the tests.

Athlete 2 was diagnosed with some rates of rest state metabolism being optimal and others indicative of high-stress operation mode of the capillary system. It should be noted that the metabolic surface of the capillary system was initially increased by the reserve capillaries being highly active with all the capillary sections being expressly dilated (broadened). As demonstrated by the morphological analysis, some capillaries were highly sinuous with local expansions of the vessels. All the three subject athletes were tested with the linear blood flow velocities falling to the minimum values. Despite the dilated capillaries, the AS perfusion rates were found low that is indicative of the endothelium dysfunction – that may in its turn be due to the chronic hypoxia as a result of the under-recovered body systems being exposed to high physical loads [1]. The trans-capillary metabolism type is changed to force evacuation of the excessive inter-tissue fluids from the interstice with the volume blood flow velocities coming to the maximums. Episodically found in the blood flow are some granular structures, temporal aggregates of erythrocytes and white inclusions of leucocytes and blood discs (0.66 s-1). First indications of leucocytes adhesion to the micro-vessel walls are viewed as predictors of the forming hypoxia. As demonstrated by some studies for the last few years, the adhesion of leucocytes in the microcirculation system may be interpreted as one of the forms of an oxygen debt [3, 7, 8].

Table 2. Variability of post-anaerobic-exercise rates versus rest state rates of the microcirculation system, %

Rate

Subjects

Athlete 1

Athlete 1

Athlete 1

Density of the capillary network, %

                                                                 

+11

+4

+25

Capillary diameters by the vascular subsystems, mc

AS

TS

VS

+100

+25

+33

-20

-43

-64

-25

-9

+6

Linear velocity of the capillary blood flow, mc/s

AS

VS

+66

+73

-21

-27

+18

-14

Volume velocity of the AS/ VS capillary blood flow, mc3/s

AS

VS

+562

+207

-74

-246

-33

-2

Perfusion balance, mc3/s

AS/ VS

714

2850

31

Pericapillary zone size, mc

 

+8

+8

-6

White inclusions, 1/s

 

0

0

0

Athlete’s 2 blood microcirculation system was found to adequately respond to the physical loads by 4% of the reserve capillaries being engaged in the work. The other process rates were indicative of a paradox response by the capillary diameters constricting by 20% in the AS, 43% in the TS and 64% in the VS. The linear blood flow velocity was found to fall by 21% in the AS and 27% in the VS. The volume blood flow velocity was found to drop by 74% in the AS and 246% in the VS. Rheological profiles were found positive in terms of no aggregates of erythrocytes being found albeit the blood flow showed some granulation.

Athlete 3 was diagnosed with the every section of capillaries being modestly broadened at rest with the density of the capillary network coming to a maximum. The linear blood circulation velocity in the AS and VS was found lower than that of Athlete 1 but higher than that of Athlete 2. The capillary system was tested with the increased endothelium permeability rates. As a result, the volume of plasma transmitted from the AS capillary blood to the intercellular space was found 1.52 and 1.70 times higher than that of Athletes 1 and 2, respectively. The volume blood flow velocity in the VS was also found close to maximum. The perfusion balance rate was found to fall that may be indicative of an excessive volume of inter-tissue fluids. The pericapillary service zone was found to expand to the maximum in an attempt to compensate for the above effects. The blood rheological tests showed high rates of white inclusions in the blood flow. The blood flow was tested as mostly homogenous with short slowdown periods when the blood flow showed somewhat granulated structure.

Conclusion. The athletes’ blood microcirculation system studies at rest versus the post-exercise state gave us the data to identify individual differences in the athletes’ functional, adaptive and reserve body capabilities. On the whole, the initial capillary blood flow rating and post-exercise response rating and profiling data make it possible to design individualized training systems for the athletes. The proposed method to monitor the metabolic process condition in the blood microcirculation system may be described as an efficient non-invasive, demonstrative, sensitive and reactive tool beneficial for the individualized athletic training systems being designed for the short- and longer-term applications.

References                                                                                                                 

  1. Baranov V.V., Neborskiy S.A. Kapillyaroskopicheskie innovatsii v sporte vysokikh dostizheniy (Capillaroscopic innovations in elite sport) / V.V. Baranov, S.A. Neborskiy // Angiologiya i sosudistaya khirurgiya. – 2012. – P. 18. Appendix. – P. 12.
  2. Baranov V.V. Fiziologichny sposob intensifikatsii obmena veshchestv (fiziologichnye dopingi) «Klinicheskaya gemostaziologiya» (Physiological metabolism boosters (physiological dope) "Clinical Hemostasis") / V.V. Baranov, V.V. Baranov, K.V. Sukhov, A.L. Tveritin / V Vseros. konf. po klinicheskoy gemostaziologii i gemoreologii v serdechno-sosudistoy khirurgii (s mezhdunarodnyim uchastiem) 3-5 fevralya 2011 (V Russian conf.  of clinical hemostasis and hemorheology in cardiovascular surgery (with international participation), February 3-5, 2011). – Moscow, 2011. – P. 53–54. 
  3. Ivanov K.P. Leykotsitoz i adgeziya leykotsitov pri razvitii ishemii mozga (Leukocytosis and leukocyte adhesion in development of cerebral ischemia) / K.P. Ivanov // Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya. – 2009. – P. 8. – № 1. – P. 46–49.
  4. Kozlov V.I. Razvitie sistemy mikrotsirkulyatsii: monografiya (Development of system of microcirculation: monograph) / V.I. Kozlov. – Moscow: RUDN, 2012. – 314 p.
  5. Murav'ev A.V. Mikrotsirkulyatsiya v kozhe pri myshechnoy nagruzke kak model' dlya izucheniya obshchikh mekhanizmov izmeneniya mikrokrovotoka (Skin microcirculation under muscular load as a model to study general mechanisms of microcirculatory changes) / A.V. Murav'ev, A.A. Akhapkina, P.V. Mikhaylov, A.A. Murav'ev // Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya. – 2014. – № 2. – P. 64–68.
  6. Bollinger А., Fagrell. Clinical Capillaroscopy / Toronto, 1990. – 166 p.
  7. Harlan J.M. Leukocyte-endothelial interaction: clinical trials of anti-adhesion therapy / J. M. Harlan, R. K. Winn // Crit. Care Med. – 2002. – Vol. 30. – N5. – P. 214-219.
  8. Ritter L.S. Leukocyte accumulation and hemodynamic changes after stroke / L.S. Ritter [et al] // Stroke. – 2000. – Vol. 31. – P. 1153-1161.

Corresponding author: bf-litvin@yandex.ru

 

Abstract

Objective of the study was to determine the individual fitness of athletes to achieve record results based on capillaroscopic analysis of static, dynamic and kinetic parameters of metabolic processes at the micro level.

Computer capillaroscopy method using a domestic capillaroscope KK4-01 was applied to examine the state of right-hand cuticle capillaries in 5 masters of sport in cross-country skiing (sprint) at rest and after maximal anaerobic exercise of 30 seconds long.

The status of the capillary network, microcirculation and transcapillary exchange was assessed based on morphological, hemodynamic and rheological characteristics. The individual variability of indicators at rest, being basis for prediction of the functionality level of exchange during exercise, was proved high.

Hemodynamic indicators at rest were proved to be most variative. In response to the maximal anaerobic load adaptive capabilities are ensured mainly by improving hemodynamic and rheological indicators.