Impact of respiratory muscle training and nitrate therapy on exercise tolerance in hypoxia

/Abstract The proposed project investigates the combined effects of respiratory muscle training (RMT) and dietary nitrate supplementation on exercise performance at sea level and under conditions of simulated moderate altitude. Recognizing the increased workload on respiratory muscles in various patient populations, which is simulated by high-altitude ascent, and the resulting diversion of blood flow from locomotor muscles to the diaphragm, this study aims to address the subsequent reduction in oxygen availability for locomotion, leading to impaired exercise tolerance. The study will focus on young, healthy adults to explore how RMT and nitrate supplementation can improve muscle oxygenation, vascular function, and exercise tolerance. This approach is driven by the need to develop effective interventions that can ultimately enhance physical capacity in various populations, including critically ill patients recovering from mechanical ventilation and individuals at risk of acute mountain sickness (AMS) during high-altitude exposure. Aim 1 will assess the impact of five weeks of RMT on muscle tissue oxygenation and exercise performance at sea level and simulated moderate altitude (~4000 meters) in young adults. Aim 2 will examine the effects of five weeks of dietary nitrate supplementation alone and combined with RMT on vascular endothelial function and exercise performance under similar conditions. This research will heavily involve undergraduate students, providing them with valuable hands-on experience in advanced clinical research techniques. The findings are expected to pave the way for future interventions to enhance physical capacity in ICU patients, reduce the incidence of AMS in high-altitude environments, and improve exercise performance in various populations. This work will significantly impact patient populations by laying the groundwork for larger-scale research projects investigating the efficacy of RMT and nitrate-based therapies in patient populations, including those with chronic respiratory and cardiovascular conditions. Ultimately, this project aims to develop non-invasive therapies to improve health outcomes related to respiratory muscle function and exercise tolerance, thereby advancing health science and patient care. Project Number: 1R15HL173855-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Heart Lung and Blood Institute (NHLBI) | Principal Investigator: Scott Ferguson | Institution: EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, DAYTONA BEACH, FL | Award Amount: $538,125 | Activity Code: R15 | Study Section: Special Emphasis Panel[ZRG1 RCCS-D (80)] View on NIH RePORTER: https://reporter.nih.gov/project-details/1R15HL17385501A1