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Kösemen DS, Çetin S, Demirci D, Babaoğlu K. Evaluation of the Left Ventricular Myocardium Using Layer-Specific Strain Analysis in Adolescent Athletes Performing High-Intensity Interval Training. Pediatr Cardiol 2024; 45:770-779. [PMID: 38347232 DOI: 10.1007/s00246-024-03411-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/05/2024] [Indexed: 03/24/2024]
Abstract
High-intensity interval training (HIIT) has been demonstrated to be an efficient way of improving physical performance in adolescent athletes compared to conventional training modalities. The objective of this study was to evaluate the impact of HIIT on the myocardial function of adolescent athletes, specifically focusing on left ventricular (LV) function, using conventional echocardiography and layer-specific strain (LSS) analysis. A total of 19 male adolescent athletes (with mean age of 16.83 ± 1.29 years) participating in various football clubs were recruited for this study. During the course of 8 weeks, these adolescent male athletes engaged in HIIT program centered around running. Upon completion of HIIT program, a treadmill exercise test was conducted. Subsequently, conventional and LSS echocardiography were conducted to acquire the evaluation of LV myocardial function. Interventricular septum thickness and ventricular mass index were significantly increased post high-intensity interval training (p < 0.005). After the HIIT, the treadmill exercise test demonstrated a significant increase in test duration and metabolic equivalent compared to the pre-training values (p < 0.005). Post high-intensity interval training, LSS analysis revealed significantly improved LV circumferential strain values in the basal and mid-segments of the left ventricle when compared to the pre-training measurements (p < 0.005). The implementation of high-intensity interval training led to an enhancement of circumferential LSS in the LV, indicating a favorable physiological adaptation and improved efficiency of the myocardium.
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Affiliation(s)
| | - Süha Çetin
- Department of Cardiology, Okan University Hospital, Icmeler Mah. Aydinli Yolu Cad. Nr 2, Icmeler, 34947, Tuzla, Istanbul, Turkey.
| | - Deniz Demirci
- Department of Health Sciences, Uskudar University, Uskudar, Istanbul, Turkey
| | - Kadir Babaoğlu
- Department of Pediatric Cardiology, Kocaeli University, Kocaeli, Turkey
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Luti S, Militello R, Pinto G, Illiano A, Marzocchini R, Santi A, Becatti M, Amoresano A, Gamberi T, Pellegrino A, Modesti A, Modesti PA. Chronic lactate exposure promotes cardiomyocyte cytoskeleton remodelling. Heliyon 2024; 10:e24719. [PMID: 38312589 PMCID: PMC10835305 DOI: 10.1016/j.heliyon.2024.e24719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
We investigated the effect of growing on lactate instead of glucose in human cardiomyocyte assessing their viability, cell cycle activity, oxidative stress and metabolism by a proteomic and metabolomic approach. In previous studies performed on elite players, we found that adaptation to exercise is characterized by a chronic high plasma level of lactate. Lactate is considered not only an energy source but also a signalling molecule and is referred as "lactormone"; heart is one of the major recipients of exogenous lactate. With this in mind, we used a cardiac cell line AC16 to characterize the lactate metabolic profile and investigate the metabolic flexibility of the heart. Interestingly, our data indicated that cardiomyocytes grown on lactate (72 h) show change in several proteins and metabolites linked to cell hypertrophy and cytoskeleton remodelling. The obtained results could help to understand the effect of this metabolite on heart of high-performance athletes.
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Affiliation(s)
- Simone Luti
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Rosamaria Militello
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Gabriella Pinto
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Anna Illiano
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Riccardo Marzocchini
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Alice Santi
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Matteo Becatti
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Angela Amoresano
- Department of Chemical Sciences, University of Naples Federico II, Naples, Italy
| | - Tania Gamberi
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Alessio Pellegrino
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandra Modesti
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
| | - Pietro Amedeo Modesti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Kuehl R, Feyer J, Limbach M, Pahl A, Stoelzel F, Beck H, Wegner A, Rosenberger F, Dreger P, Luft T, Wiskemann J. Prehabilitative high-intensity interval training and resistance exercise in patients prior allogeneic stem cell transplantation. Sci Rep 2023; 13:22069. [PMID: 38086868 PMCID: PMC10716116 DOI: 10.1038/s41598-023-49420-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Physical capacity prior allogeneic stem cell transplantation (allo-HCT) has been shown as a relevant prognostic factor for survival after transplant. Therefore, we evaluated feasibility and preliminary efficacy of a high-intensity interval training (HIIT) and moderate to high-intensity resistance exercise (RE) to increase physical capacity in patient's prior allo-HCT. In this multicentre single arm pilot study, a supervised exercise program was performed twice weekly for 4-12 weeks prior allo-HCT, depending on the individual time remaining. Outcomes were feasibility (recruitment, adherence, safety), physical capacity (cardiorespiratory fitness [VO2peak], muscle strength) and patient reported outcomes (physical functioning, fatigue). Thirty patients were intended, 16 could be included, and 14 completed post intervention assessment (75% male, 55 ± 11 years). The study was stopped early due to a low recruitment rate. Nine patients (64%) reached the initial minimum planned number of eight exercise sessions. Individual adherence was high with 92% for HIIT and 85% for RE. 87% of all performed exercise sessions were completed without complaints and VO2peak increased significantly from 20.4 to 23.4 ml/kg/min. The low recruitment rate suggests that initiation of the intervention concept immediately before allo-HCT is feasible only in a small number of patients. In particular, the timeframe directly prior allo-HCT seems too short for exercise interventions, although the exercise program was designed to improve outcomes in a very short time frame. HIIT and RE were feasible, effective and well accepted by the included patients.
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Affiliation(s)
- Rea Kuehl
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Jule Feyer
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Matthias Limbach
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Antonia Pahl
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center -University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Friederike Stoelzel
- Prevention Center of the National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany
| | - Heidrun Beck
- Department of Sports Medicine, University Center for Orthopedics, Trauma and Plastic Surgery, Dresden, Germany
| | - Annika Wegner
- Medical Clinic II, Hematology-Oncology, University Clinic Frankfurt, University Cancer Center (UCT) Frankfurt, Frankfurt, Germany
| | - Friederike Rosenberger
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- Division of Health Sciences, German University of Applied Sciences for Prevention and Health Management, Saarbrucken, Germany
| | - Peter Dreger
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Luft
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
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Rohmansyah NA, Ka Praja R, Phanpheng Y, Hiruntrakul A. High-Intensity Interval Training Versus Moderate-Intensity Continuous Training for Improving Physical Health in Elderly Women. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231172870. [PMID: 37158072 PMCID: PMC10184247 DOI: 10.1177/00469580231172870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In elderly women, a lack of regular physical exercise may result in faster decreases in general health and functional performance. Although high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have been effectively applied in young and clinical groups, there is no evidence to support their use in elderly women to achieve health benefits. Thus, the major goal of this study was to investigate how HIIT affected health-related outcomes in elderly women. Twenty-four inactive elderly women agreed to participate in the 16-week HIIT and MICT intervention. Body composition, insulin resistance, blood lipids, functional capacity, cardiorespiratory fitness, and quality of life were all measured before and after the intervention. The number of differences between groups was determined using Cohen's effect sizes, and the pre-post intra-group changes were compared using paired t-tests. Using 2 × 2 ANOVA, the time × group interaction effects between HIIT and MICT were evaluated. Body fat percentage, sagittal abdominal diameter, waist circumference, and hip circumference all were improved significantly in the 2 groups. HIIT substantially improved fasting plasma glucose and cardiorespiratory fitness as compared to the MICT. HIIT improved the lipid profile and functional ability more significantly compared to the MICT group. These findings show that HIIT is a useful exercise for improving elderly women's physical health.
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Affiliation(s)
| | - Rian Ka Praja
- Universitas Palangka Raya, Central Kalimantan, Indonesia
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Zare Karizak S, Kashef M, Gaeini AA, Nejatian M. Impact of high intensity interval and moderate continuous training on plasma ratios of ProBNP 1-108/BNP 1-32 and NT-pro-BNP 1-76/BNP 1-32 after coronary artery bypass grafting surgery. Front Physiol 2023; 14:1114813. [PMID: 36960152 PMCID: PMC10030057 DOI: 10.3389/fphys.2023.1114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Background: ProBNP1-108/BNP1-32, and NT-pro-BNP1-76/BNP1-32 ratios are significant indices for predicting complications after coronary artery bypass grafting (CABG) surgery. However, the effect of aerobic training types on these biomarkers has not been fully understood. So, the current study aimed to determine the impact of aerobic interval and continuous training programs on plasma ratios of ProBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 after coronary artery bypass grafting surgery. Method: 36 patients were selected purposive (27 men and 9 women with mean of age 60.32 ± 5.81 years, height 164.64 ± 9.25 cm, weight 73.86 ± 14.23 kg, fat 32.30 ± 4.28, SBP 142.67 ± 6.49, DBP 84.5 ± 5.16 mmHg in seated position at rest situation and functional capacity of 7.08 ± 2.49 METs) and then divided randomly into three groups: control (C) group (without training program) moderate continuous training (MCT) and high intensity interval training (HIIT) (exercise training program was performed 3 days/week for 8 weeks) with intensities 65%-80% and 80%-95% of reserve heart rate in order. Blood samples were taken 48 h before the first session and 48 h after the last training session to measure the plasma levels of ProBNP1-108, corin enzyme, BNP1-32, and NT-pro-BNP1-76 using the enzyme-linked immunosorbent assay (ELISA) technique. Wilcoxin and kruskal wallis tests were used for analyzing data. Results: The plasma corin enzyme was increased, and the ratios of proBNP1-108/BNP1-32 and NT-pro-BNP1-76/BNP1-32 were reduced in both training groups in compared with control group (p = 0.004, p = 0000, p = 0.016, p = 0.003, p = 0.009, and p = 0.016) when there was no significant difference was found between training groups (p = 0.074, p = 450, and p = 0.295). Conclusion: Both high intensity interval training and moderate continuous training in compared with inactivity have positive effects on ratios of ProBNP1-108/BNP1-32, NT-pro-BNP1-76/BNP1-32 and could be effective to promote the health of coronary arteries and prevention of HF in post-CABG patients.
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Affiliation(s)
- Sara Zare Karizak
- Sport Science Department, Faculty of Literature and Humanities, Persian Gulf University, Boushehr, Iran
- *Correspondence: Sara Zare Karizak,
| | - Majid Kashef
- Exercise Physiology Department, Sport Science Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Abbas Ali Gaeini
- Exercise Physiology Department, Sport Science Faculty, Tehran University, Tehran, Iran
| | - Mostafa Nejatian
- Cardiac Rehabilitation Specialist and Head of Rehabilitation Clinic of Tehran Heart Center Hospital, Tehran, Iran
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The impact of different forms of exercise on endothelial progenitor cells in healthy populations. Eur J Appl Physiol 2022; 122:1589-1625. [PMID: 35305142 PMCID: PMC9197818 DOI: 10.1007/s00421-022-04921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
Circulating endothelial progenitor cells (EPCs) contribute to vascular healing and neovascularisation, while exercise is an effective means to mobilise EPCs into the circulation. OBJECTIVES to systematically examine the acute and chronic effects of different forms of exercise on circulating EPCs in healthy populations. METHODS Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. RESULTS thirty-one articles met the inclusion criteria including 747 participants aged 19 to 76 years. All included trials used flow cytometry for identification of circulating EPCs. Eight and five different EPC phenotypes were identified in the acute and chronic trials, respectively. In the acute trials, moderate intensity continuous (MICON), maximal, prolonged endurance, resistance and high intensity interval training (HIIT) exercise protocols were utilised. Prolonged endurance and resistance exercise had the most profound effect on circulating EPCs followed by maximal exercise. In the chronic trials, MICON exercise, HIIT, HIIT compared to MICON and MICON compared to exergame (exercise modality based on an interactive video game) were identified. MICON exercise had a positive effect on circulating EPCs in older sedentary individuals which was accompanied by improvements in endothelial function and arterial stiffness. Long-stage HIIT (4 min bouts) appears to be an effective means and superior than MICON exercise in mobilising circulating EPCs. In conclusion, both in acute and chronic trials the degree of exercise-induced EPC mobilisation depends upon the exercise regime applied. In future, more research is warranted to examine the dose-response relationship of different exercise forms on circulating EPCs using standardised methodology and EPC phenotype.
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Bei Y, Wang L, Ding R, Che L, Fan Z, Gao W, Liang Q, Lin S, Liu S, Lu X, Shen Y, Wu G, Yang J, Zhang G, Zhao W, Guo L, Xiao J. Animal exercise studies in cardiovascular research: Current knowledge and optimal design-A position paper of the Committee on Cardiac Rehabilitation, Chinese Medical Doctors' Association. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:660-674. [PMID: 34454088 PMCID: PMC8724626 DOI: 10.1016/j.jshs.2021.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/09/2021] [Accepted: 07/11/2021] [Indexed: 05/02/2023]
Abstract
Growing evidence has demonstrated exercise as an effective way to promote cardiovascular health and protect against cardiovascular diseases However, the underlying mechanisms of the beneficial effects of exercise have yet to be elucidated. Animal exercise studies are widely used to investigate the key mechanisms of exercise-induced cardiovascular protection. However, standardized procedures and well-established evaluation indicators for animal exercise models are needed to guide researchers in carrying out effective, high-quality animal studies using exercise to prevent and treat cardiovascular diseases. In our review, we present the commonly used animal exercise models in cardiovascular research and propose a set of standard procedures for exercise training, emphasizing the appropriate measurements and analysis in these chronic exercise models. We also provide recommendations for optimal design of animal exercise studies in cardiovascular research, including the choice of exercise models, control of exercise protocols, exercise at different stages of disease, and other considerations, such as age, sex, and genetic background. We hope that this position paper will promote basic research on exercise-induced cardiovascular protection and pave the way for successful translation of exercise studies from bench to bedside in the prevention and treatment of cardiovascular diseases.
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Affiliation(s)
- Yihua Bei
- Institute of Geriatrics, Affiliated Nantong Hospital of Shanghai University, Sixth People's Hospital of Nantong, School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Lei Wang
- Department of Rehabilitation Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Rongjing Ding
- Department of Cardiology, Peking University People's Hospital, Beijing 100044, China
| | - Lin Che
- Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai 200065, China
| | - Zhiqing Fan
- Department of Cardiology, Daqing Oilfield General Hospital, Daqing 163000, China
| | - Wei Gao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
| | - Qi Liang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Shenghui Lin
- School of Medicine, Huaqiao University, Quanzhou 362021, China
| | - Suixin Liu
- Division of Cardiac Rehabilitation, Department of Physical Medicine and Rehabilitation, Xiangya Hospital of Central South University, Changsha 410008, China
| | - Xiao Lu
- Department of Rehabilitation Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuqin Shen
- Department of Cardiology, Tongji Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai 200065, China
| | - Guifu Wu
- Department of Cardiology, Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518033, China; Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Sun Yat-Sen University, Shenzhen 518033, China; NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou 510080, China
| | - Jian Yang
- Department of Rehabilitation Medicine, Shanghai Xuhui Central Hospital, Shanghai 200031, China
| | - Guolin Zhang
- Cardiac Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Wei Zhao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
| | - Lan Guo
- Cardiac Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
| | - Junjie Xiao
- Institute of Geriatrics, Affiliated Nantong Hospital of Shanghai University, Sixth People's Hospital of Nantong, School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China.
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Karatzanos E, Ferentinos P, Mitsiou G, Dimopoulos S, Ntalianis A, Nanas S. Acute Cardiorespiratory Responses to Different Exercise Modalities in Chronic Heart Failure Patients-A Pilot Study. J Cardiovasc Dev Dis 2021; 8:jcdd8120164. [PMID: 34940519 PMCID: PMC8708548 DOI: 10.3390/jcdd8120164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to compare the acute cardiorespiratory responses and time spent above different %VO2peak intensities between three "iso-work" protocols: (a) a high intensity interval training protocol (HIIT), (b) a higher intensity continuous protocol (CON70) and (c) a lower intensity continuous protocol (CON50) in patients with chronic heart failure (CHF). Ten male CHF patients (aged 55.1 ± 16.2 years) performed in separate days a single session of a HIIT protocol consisted of 4 sets × 4 min cycling at 80% VO2peak with 3 min of recovery at 50% VO2peak, a CON70 protocol corresponding to 70% VO2peak and a CON50 protocol corresponding to 50% VO2peak. Cardiopulmonary data were collected by an online gas analysis system. The HIIT and CON70 elicited higher cardiorespiratory responses compared to CON50 with no differences between them (p > 0.05). In HIIT and CON70, patients exercised longer at >80% and >90% VO2peak. The completion rate was 100% for the three protocols. Not any adverse events were observed in either protocol. Both HIIT and CON70 elicited a stronger physiological stimulus and required shorter time than CON50. Both HIIT and CON70 also induced comparable hemodynamic responses and ventilatory demand.
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Affiliation(s)
- Eleftherios Karatzanos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, School of Medicine, National and Kapodistrian University of Athens, 106 75 Athens, Greece; (G.M.); (S.D.); (S.N.)
- Correspondence: or ; Tel.: +30-2132043385
| | | | - Georgios Mitsiou
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, School of Medicine, National and Kapodistrian University of Athens, 106 75 Athens, Greece; (G.M.); (S.D.); (S.N.)
| | - Stavros Dimopoulos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, School of Medicine, National and Kapodistrian University of Athens, 106 75 Athens, Greece; (G.M.); (S.D.); (S.N.)
| | - Argyrios Ntalianis
- Heart Failure and Cardio-Oncology Unit, Alexandra Hospital, 115 28 Athens, Greece;
| | - Serafeim Nanas
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, School of Medicine, National and Kapodistrian University of Athens, 106 75 Athens, Greece; (G.M.); (S.D.); (S.N.)
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Giallauria F. Editorial to 'The effect of high-intensity interval training on exercise capacity in post-myocardial infarction patients: a systematic review and meta-analysis'. Eur J Prev Cardiol 2021; 29:473-474. [PMID: 34089586 DOI: 10.1093/eurjpc/zwab072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Francesco Giallauria
- Department of Translational Medical Sciences, "Federico II" University of Naples, Naples, Italy
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Jiménez-García JD, Hita-Contreras F, de la Torre-Cruz MJ, Aibar-Almazán A, Achalandabaso-Ochoa A, Fábrega-Cuadros R, Martínez-Amat A. Effects of HIIT and MIIT Suspension Training Programs on Sleep Quality and Fatigue in Older Adults: Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1211. [PMID: 33572909 PMCID: PMC7908512 DOI: 10.3390/ijerph18031211] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022]
Abstract
Poor sleep quality lessens general health quality and is related to physical and mental problems. Moreover, fatigue is one of the foremost common complaints in medical care and plays a role in the decreasing quality of life of the older population. For these reasons, the objective of this study was to examine the effect of high- and moderate-intensity interval training programs (HIIT vs. MIIT)-both consisting of twelve weeks of TRX training-on the sleep quality and fatigue levels of the elderly. A randomized controlled clinical trial (NCT03404830) was conducted. A total of 82 subjects were randomized to either a HIIT group (n = 28) that performed a main squat activity with a suspension system, comprising four four-minute intervals between 90-95% of the maximum heart rate (HR), an MIIT group (n = 27) with an intensity of 70% of the maximum HR, and a control group (CG) (n = 27) that continued their daily lifestyle. The two exercise groups trained twice a week for 12 weeks, with each session lasting 45 min. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI), and fatigue was assessed using the fatigue severity scale (FSS). Outcomes were measured before the intervention and after the intervention period. Post-intervention sleep quality measurements revealed a statistically significant interaction regarding group × time (p < 0.005) and fatigue (p = 0.002). Specifically, fatigue decreased in the HIIT group between both measurement moments (p = 0.003). In addition, differences were obtained in the post-intervention measure between the HIIT and MIIT groups (p = 0.013) and HIIT and control (p = 0.029). Our analysis indicates that a population of the elderly showed improvements in sleep quality and fatigue after performing a high-intensity intervention using suspension training (TRX), with markedly better results in the HIIT group.
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Affiliation(s)
- José Daniel Jiménez-García
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11003 Cádiz, Spain;
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11003 Cádiz, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (F.H.-C.); (A.A.-O.); (R.F.-C.); (A.M.-A.)
| | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (F.H.-C.); (A.A.-O.); (R.F.-C.); (A.M.-A.)
| | - Alexander Achalandabaso-Ochoa
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (F.H.-C.); (A.A.-O.); (R.F.-C.); (A.M.-A.)
| | - Raquel Fábrega-Cuadros
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (F.H.-C.); (A.A.-O.); (R.F.-C.); (A.M.-A.)
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (F.H.-C.); (A.A.-O.); (R.F.-C.); (A.M.-A.)
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Kendall BJ, Siekirk NJ, Lai Q. Acute high-intensity interval training improves motor skill acquisition. J Sports Med Phys Fitness 2020; 60:1065-1071. [PMID: 32955832 DOI: 10.23736/s0022-4707.20.10580-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND It is well established that acute exercise improves cognitive function. However, less is known about the effects of exercise on motor skill acquisition. Therefore, this study investigated the effects of acute high-intensity interval training (HIIT) on motor skill acquisition. METHODS Sixty individuals (27 males, 33 females) between 18 and 40 years of age participated in two testing sessions separated by one week. During visit 1, participants performed one block of a continuous tracking, force control task to establish baseline ability. Participants were then randomized to either an aerobic-only HIIT group (HIIT-A), an aerobic/resistance HIIT group (HIIT-AR), or a resting control group. Both exercise groups performed a 20-minute, digital versatile disc (DVD)-delivered HIIT exercise protocol during visit 2. Following exercise or rest, all participants performed five blocks of the same force control task to assess skill acquisition. RESULTS On visit 2, the HIIT-A group had a significantly lower total performance error (E) compared to the control group (P<0.05). Both exercise groups (HIIT-A and HIIT-AR) had a significantly lower peak amplitude error (PE) following exercise compared to the control group (P<0.05). No significant group differences were observed for temporal error (TE). Additionally, no significant differences were observed between the exercise groups (P>0.05). CONCLUSIONS These findings suggest that acute HIIT-A improves motor skill acquisition compared to rest. Furthermore, improvements in acquisition appeared to be a result of improved spatial accuracy. Therefore, performing HIIT-A prior to practicing a motor task may help reduce total error during the motor skill acquisition phase.
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Affiliation(s)
- Bradley J Kendall
- Department of Kinesiology, Taylor University, Upland, CA, USA - .,Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI, USA -
| | - Nicholas J Siekirk
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI, USA.,Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, USA
| | - Qin Lai
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI, USA
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12
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Calverley TA, Ogoh S, Marley CJ, Steggall M, Marchi N, Brassard P, Lucas SJE, Cotter JD, Roig M, Ainslie PN, Wisløff U, Bailey DM. HIITing the brain with exercise: mechanisms, consequences and practical recommendations. J Physiol 2020; 598:2513-2530. [PMID: 32347544 DOI: 10.1113/jp275021] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/15/2020] [Indexed: 01/30/2023] Open
Abstract
The increasing number of older adults has seen a corresponding growth in those affected by neurovascular diseases, including stroke and dementia. Since cures are currently unavailable, major efforts in improving brain health need to focus on prevention, with emphasis on modifiable risk factors such as promoting physical activity. Moderate-intensity continuous training (MICT) paradigms have been shown to confer vascular benefits translating into improved musculoskeletal, cardiopulmonary and cerebrovascular function. However, the time commitment associated with MICT is a potential barrier to participation, and high-intensity interval training (HIIT) has since emerged as a more time-efficient mode of exercise that can promote similar if not indeed superior improvements in cardiorespiratory fitness for a given training volume and further promote vascular adaptation. However, randomised controlled trials (RCTs) investigating the impact of HIIT on the brain are surprisingly limited. The present review outlines how the HIIT paradigm has evolved from a historical perspective and describes the established physiological changes including its mechanistic bases. Given the dearth of RCTs, the vascular benefits of MICT are discussed with a focus on the translational neuroprotective benefits including their mechanistic bases that could be further potentiated through HIIT. Safety implications are highlighted and components of an optimal HIIT intervention are discussed including practical recommendations. Finally, statistical effect sizes have been calculated to allow prospective research to be appropriately powered and optimise the potential for detecting treatment effects. Future RCTs that focus on the potential clinical benefits of HIIT are encouraged given the prevalence of cognitive decline in an ever-ageing population.
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Affiliation(s)
- Thomas A Calverley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Shigehiko Ogoh
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK.,Department of Biomedical Engineering, Faculty of Engineering, Toyo University, Saitama, Japan
| | - Christopher J Marley
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Martin Steggall
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - Nicola Marchi
- Cerebrovascular and Glia Research Laboratory, Department of Neuroscience, Institute of Functional Genomics, Montpellier, France
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Marc Roig
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Philip N Ainslie
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK.,Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia-Okanagan Campus, Kelowna, BC, Canada
| | - Ulrik Wisløff
- The Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
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13
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Carvalho TD, Milani M, Ferraz AS, Silveira ADD, Herdy AH, Hossri CAC, Silva CGSE, Araújo CGSD, Rocco EA, Teixeira JAC, Dourado LOC, Matos LDNJD, Emed LGM, Ritt LEF, Silva MGD, Santos MAD, Silva MMFD, Freitas OGAD, Nascimento PMC, Stein R, Meneghelo RS, Serra SM. Brazilian Cardiovascular Rehabilitation Guideline - 2020. Arq Bras Cardiol 2020; 114:943-987. [PMID: 32491079 PMCID: PMC8387006 DOI: 10.36660/abc.20200407] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Tales de Carvalho
- Clínica de Prevenção e Reabilitação Cardiosport , Florianópolis , SC - Brasil
- Universidade do Estado de Santa Catarina (Udesc), Florianópolis , SC - Brasil
| | | | | | - Anderson Donelli da Silveira
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre , RS - Brasil
- Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul (HCPA/UFRGS), Porto Alegre , RS - Brasil
- Vitta Centro de Bem Estar Físico , Porto Alegre , RS - Brasil
| | - Artur Haddad Herdy
- Clínica de Prevenção e Reabilitação Cardiosport , Florianópolis , SC - Brasil
- Instituto de Cardiologia de Santa Catarina , Florianópolis , SC - Brasil
- Unisul: Universidade do Sul de Santa Catarina (UNISUL), Florianópolis , SC - Brasil
| | | | | | | | | | | | - Luciana Oliveira Cascaes Dourado
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), Rio de Janeiro , RJ - Brasil
| | | | | | - Luiz Eduardo Fonteles Ritt
- Hospital Cárdio Pulmonar , Salvador , BA - Brasil
- Escola Bahiana de Medicina e Saúde Pública , Salvador , BA - Brasil
| | | | - Mauro Augusto Dos Santos
- ACE Cardiologia do Exercício , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia , Rio de Janeiro , RJ - Brasil
| | | | | | - Pablo Marino Corrêa Nascimento
- Universidade Federal Fluminense (UFF), Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia , Rio de Janeiro , RJ - Brasil
| | - Ricardo Stein
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre , RS - Brasil
- Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul (HCPA/UFRGS), Porto Alegre , RS - Brasil
- Vitta Centro de Bem Estar Físico , Porto Alegre , RS - Brasil
| | - Romeu Sergio Meneghelo
- Instituto Dante Pazzanese de Cardiologia , São Paulo , SP - Brasil
- Hospital Israelita Albert Einstein , São Paulo , SP - Brasil
| | - Salvador Manoel Serra
- Instituto Estadual de Cardiologia Aloysio de Castro (IECAC), Rio de Janeiro , RJ - Brasil
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14
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The effects of human sera conditioned by high-intensity exercise sessions and training on the tumorigenic potential of cancer cells. Clin Transl Oncol 2020; 23:22-34. [DOI: 10.1007/s12094-020-02388-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/10/2020] [Indexed: 02/07/2023]
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15
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Takada S, Sabe H, Kinugawa S. Abnormalities of Skeletal Muscle, Adipocyte Tissue, and Lipid Metabolism in Heart Failure: Practical Therapeutic Targets. Front Cardiovasc Med 2020; 7:79. [PMID: 32478098 PMCID: PMC7235191 DOI: 10.3389/fcvm.2020.00079] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/15/2020] [Indexed: 12/21/2022] Open
Abstract
Chronic diseases, including heart failure (HF), are often accompanied with skeletal muscle abnormalities in both quality and quantity, which are the major cause of impairment of the activities of daily living and quality of life. We have shown that skeletal muscle abnormalities are a hallmark of HF, in which metabolic pathways involving phosphocreatine and fatty acids are largely affected. Not only in HF, but the dysfunction of fatty acid metabolism may also occur in many chronic diseases, such as arteriosclerosis, as well as through insufficient physical exercise. Decreased fatty acid catabolism affects adenosine triphosphate (ATP) production in mitochondria, via decreased activity of the tricarboxylic acid cycle; and may cause abnormal accumulation of adipose tissue accompanied with hyperoxidation and ectopic lipid deposition. Such impairments of lipid metabolism are in turn detrimental to skeletal muscle, which is hence a chicken-and-egg problem between skeletal muscle and HF. In this review, we first discuss skeletal muscle abnormalities in HF, including sarcopenia; particularly their association with lipid metabolism and adipose tissue. On the other hand, the precise mechanisms involved in metabolic reprogramming and dysfunction are beginning to be understood, and an imbalance of daily nutritional intake of individuals has been found to be a causative factor for the development and worsening of HF. Physical exercise has long been known to be beneficial for the prevention and even treatment of HF. Again, the molecular mechanisms by which exercise promotes skeletal muscle as well as cardiac muscle functions are being clarified by recent studies. We propose that it is now the time to develop more “natural” methods to prevent and treat HF, rather than merely relying on drugs and medical interventions. Further analysis of the basic design of and molecular mechanisms involved in the human body, particularly the inextricable association between physical exercise and the integrity and functional plasticity of skeletal and cardiac muscles is required.
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Affiliation(s)
- Shingo Takada
- Faculty of Lifelong Sport, Department of Sports Education, Hokusho University, Ebetsu, Japan.,Department of Molecular Biology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hisataka Sabe
- Department of Molecular Biology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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16
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Cardiac Rehabilitation Increases SIRT1 Activity and β-Hydroxybutyrate Levels and Decreases Oxidative Stress in Patients with HF with Preserved Ejection Fraction. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7049237. [PMID: 31885811 PMCID: PMC6900956 DOI: 10.1155/2019/7049237] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/14/2019] [Accepted: 10/22/2019] [Indexed: 12/20/2022]
Abstract
Purpose Exercise training induces beneficial effects also by increasing levels of Sirtuin 1 (Sirt1) and β-hydroxybutyrate (βOHB). Up to date, no studies investigated the role of exercise training-based cardiac rehabilitation (ET-CR) programs on βOHB levels. Therefore, the present study is aimed at investigating whether a supervised 4-week ET-CR program was able to induce changes in Sirt1 activity and βOHB levels and to evaluate the possible relationship between such parameters, in Heart Failure with preserved Ejection Fraction (HFpEF) patients. Methods A prospective longitudinal observational study was conducted on patients consecutively admitted to the Cardiology and Cardiac Rehabilitation Units of “San Gennaro dei Poveri” Hospital in Naples, Italy. In fifty elderly patients affected by HFpEF, in NYHA II and III class, Sirt1 activity, Trolox Equivalent Antioxidant Capacity (TEAC), βOHB, and Oxidized Low-Density Lipoprotein (Ox-LDL) levels were measured before and at the end of the ET-CR program. A control group of 20 HFpEF patients was also recruited, and the same parameters were evaluated 4 weeks after the beginning of the study. Results ET-CR induced an increase of Sirt1 activity, βOHB levels, and antioxidant capacity. Moreover, it was associated with a rise in NAD+ and NAD+/NADH ratio levels and a reduction in Ox-LDL. No changes affected the controls. Conclusion The characterization of the ET-CR effects from a metabolic viewpoint might represent an important step to improve the HFpEF management.
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17
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Garcia-Retortillo S, Gacto M, O'Leary TJ, Noon M, Hristovski R, Balagué N, Morris MG. Cardiorespiratory coordination reveals training-specific physiological adaptations. Eur J Appl Physiol 2019; 119:1701-1709. [PMID: 31187282 DOI: 10.1007/s00421-019-04160-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/07/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effects of high-intensity interval training (HIIT) and moderate-intensity training (CONT), matched for total work, on cardiorespiratory coordination and aerobic fitness. METHODS This is a two-arm parallel group single-blind randomised study. Twenty adults were assigned to 6 weeks of HIIT or volume-matched CONT. Participants completed a progressive maximal cycling test before and after the training period. Principal component (PC) analysis was performed on the series of cardiorespiratory variables to evaluate dimensionality of cardiorespiratory coordination, before and after lactate turnpoint. PC1 eigenvalues were compared. RESULTS Both HIIT and CONT improved aerobic fitness (main effects of time, p < 0.001, [Formula: see text] ≥ 0.580), with no differences between groups. CONT decreased the number of PCs from two to one at intensities both below and above the lactate turnpoint; PC1 eigenvalues increased after CONT both below (Z = 2.08; p = 0.04; d = 0.94) and above the lactate turnpoint (Z = 2.10; p = 0.04; d = 1.37). HIIT decreased the number of PCs from two to one after the lactate turnpoint only; PC1 eigenvalues increased after HIIT above the lactate turnpoint (Z = 2.31; p = 0.02; d = 0.42). CONCLUSIONS Although CONT and HIIT improved aerobic fitness to a similar extent, there were different patterns of change for cardiorespiratory coordination. These changes appear training-intensity specific and could be sensitive to investigate the individual response to endurance training.
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Affiliation(s)
- S Garcia-Retortillo
- University School of Health and Sport (EUSES), University of Girona, C. Francesc Macià 65, 17190, Girona, Spain.,Complex Systems in Sport, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Avda. de l'Estadi 12-22, 08038, Barcelona, Spain
| | - M Gacto
- University School of Health and Sport (EUSES), University of Girona, C. Francesc Macià 65, 17190, Girona, Spain
| | - T J O'Leary
- Army Personnel Research Capability, HQ Army, Andover, UK
| | - M Noon
- School of Life Sciences, Coventry University, Whitefriars Street, Coventry, UK
| | - R Hristovski
- Faculty of Physical Education, Sport and Health, Ss Cyril and Methodius University of Skopje, Zeleznicka BB, 1000, Skopje, Republic of Macedonia
| | - N Balagué
- Complex Systems in Sport, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Avda. de l'Estadi 12-22, 08038, Barcelona, Spain
| | - M G Morris
- School of Life Sciences, Coventry University, Whitefriars Street, Coventry, UK. .,Oxford Brookes University, Gipsy Lane, Oxford, UK.
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18
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Santa-Clara H, Abreu A, Melo X, Santos V, Cunha P, Oliveira M, Pinto R, Carmo MM, Fernhall B. High-intensity interval training in cardiac resynchronization therapy: a randomized control trial. Eur J Appl Physiol 2019; 119:1757-1767. [DOI: 10.1007/s00421-019-04165-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/23/2018] [Indexed: 12/31/2022]
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19
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Lee LS, Tsai MC, Oh PI, Brooks D. The Effectiveness of Progressive Aerobic Interval Training in Cardiac Rehabilitation. Med Sci Sports Exerc 2019; 50:881-888. [PMID: 29257009 DOI: 10.1249/mss.0000000000001526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Aerobic interval training (AIT) has recently emerged as a more effective strategy than moderate-intensity continuous exercise (MICE) for improving peak oxygen consumption (V˙O2peak) in coronary artery disease (CAD) patients. The primary purpose of this retrospective study was to describe the change in V˙O2peak, and cardiovascular (CV) risk profile characteristics (secondary outcomes) after progressive AIT practiced in the largest, outpatient cardiac rehabilitation (CR) program in North America compared with usual care CR involving MICE. METHODS Electronic database records were retrieved from consecutively enrolled patients with CAD who attended the Toronto Rehabilitation Institute, between January 1, 2005, and December 31, 2015. Patients were then separated into two, age and sex propensity score-matched groups: 772 patients were prescribed 26 wk of MICE (60%-80% of V˙O2peak, five times per week) as per usual care CR (56.0 ± 9.2 yr; 12% female/88% male; V˙O2peak: 20.8 ± 5.9 mL·kg·min), and 772 patients were prescribed 26 wk of progressive walk/jog intervals (15 min·mile walking pace, 12 min·mile jogging pace, five times per week) (55.9 ± 9.3 yr; 12% female/88% male; V˙O2peak: 24.8 ± 5.7 mL·kg ·min). Treatment effect analysis of AIT on V˙O2peak and CV risk profile characteristics was performed using multiple regression with baseline values as covariates. RESULTS Treatment effect analysis revealed a 3.84-mL·kg·min superior improvement in V˙O2peak in the AIT group compared to usual care MICE group (P < 0.001). Furthermore, AIT significantly improved BMI, triglycerides, hip and abdominal girth, and depression score compared with MICE (P < 0.023 for all). CONCLUSIONS Progressive AIT performed in a standard, outpatient CR program appears to be superior to usual care MICE for improving V˙O2peak, CV risk profile characteristics, and depression score in stable CAD patients. These findings may have important implications for exercise training guidelines in the rehabilitation setting, and in future studies.
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Affiliation(s)
- Leanna S Lee
- Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA.,Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA
| | - Ming-Chang Tsai
- Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA.,Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA
| | - Paul I Oh
- Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA
| | - Dina Brooks
- Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA.,Institute of Medical Science, University of Toronto, Toronto, Ontario, CANADA
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20
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Short-Duration High-Intensity Interval Exercise Training Is More Effective Than Long Duration for Blood Pressure and Arterial Stiffness But Not for Inflammatory Markers and Lipid Profiles in Patients With Stage 1 Hypertension. J Cardiopulm Rehabil Prev 2019; 39:50-55. [DOI: 10.1097/hcr.0000000000000377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Wilhelm M. [Exercise Training and Physical Activity in Patients with Heart Failure]. PRAXIS 2018; 107:951-958. [PMID: 30131027 DOI: 10.1024/1661-8157/a003050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Exercise Training and Physical Activity in Patients with Heart Failure Abstract. Heart failure is a clinical syndrome with different etiologies and phenotypes. For all forms, supervised exercise training and individual physical activity are class IA recommendations in current guidelines. Exercise training can start in the hospital, immediately after stabilization of acute heart failure (phase I). After discharge, it can continue in a stationary or ambulatory prevention and rehabilitation program (phase II). Typical components are endurance, resistance and respiratory training. Health insurances cover costs for three to six months. Patients with implantable cardioverter defibrillators or left ventricular assist devices may train in experienced centers. Besides muscular reconditioning, a major goal of phase II is to increase health literacy to improve long-term adherence to physical activity. In phase III, heart groups offer support.
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Affiliation(s)
- Matthias Wilhelm
- 1 Interdisziplinäres Zentrum für Sport- und Bewegungsmedizin, Universitätsklinik für Kardiologie, Inselspital, Universitätsspital Bern
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22
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Engel FA, Ackermann A, Chtourou H, Sperlich B. High-Intensity Interval Training Performed by Young Athletes: A Systematic Review and Meta-Analysis. Front Physiol 2018; 9:1012. [PMID: 30100881 PMCID: PMC6072873 DOI: 10.3389/fphys.2018.01012] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/09/2018] [Indexed: 12/25/2022] Open
Abstract
Background: High-intensity interval training (HIIT) is as a time-efficient alternative to moderate- or low-intensity continuous exercise for improving variables related to endurance and anaerobic performance in young and adolescent athletes. Objectives: To assess original research about enhancement of endurance and anaerobic exercise performance in young and adolescent athletes performing HIIT. Method: Relevant articles published in peer-reviewed journals were retrieved from the electronic databases PubMed and SPORTDiscus in December 2017. Inclusion criteria were: (i) controlled trials (HIIT vs. alternative training protocol) with pre-post design; (ii) healthy young athletes (≤18 years); (iii) assessing variables related to endurance and exercise performance. Hedges' g effect size (ES), and associated 95% confidence intervals were calculated for comparison of any outcome between experimental (HIIT) and alternative training protocol. Results: Twenty four studies, involving 577 athletes (mean age: 15.5 ± 2.2 years), were included in this review. HIIT exerted no or small positive mean ES on peak oxygen uptake (VO2peak), running performance, repeated sprint ability, jumping performance and submaximal heart rate. Although the mean ES for changes in VO2peak with HIIT is small (mean g = 0.10±0.28), the average increase in VO2peak from pre to post HIIT-interventions were 7.2 ± 6.9% vs. 4.3 ± 6.9% with any other alternative intervention. HIIT largely and positively affected running speed and oxygen consumption at various lactate- or ventilatory-based thresholds, as well as for sprint running performance. Calculations showed negative mean ES for change-of-direction ability (large), and peak blood lactate concentrations (small). Mean duration per training session for HIIT was shorter than for control interventions (28 ± 15 min vs. 38 ± 24 min). Conclusion: The present findings suggest that young athletes performing HIIT may improve certain important variables related to aerobic, as well as anaerobic, performance. With HIIT, most variables related to endurance improved to a higher extent, compared to alternative training protocols. However, based on ES, HIIT did not show clear superiority to the alternative training protocols. Nevertheless, young athletes may benefit from HIIT as it requires less time per training session leaving more time for training sport specific skills.
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Affiliation(s)
- Florian Azad Engel
- Department Movement and Training Science, Institute of Sport and Sport Science, Heidelberg University, Heidelberg, Germany
| | - Alexander Ackermann
- Department Movement and Training Science, Institute of Sport and Sport Science, Heidelberg University, Heidelberg, Germany
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Billy Sperlich
- Department of Sport Science, Integrative and Experimental Training Science, Würzburg University, Würzburg, Germany
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23
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Alavizadeh NS, Rashidlamir A, Hejazi SM. Effect of Eight Weeks Aerobic and Combined Training on Serum Levels of Sirtuin 1 and PGC-1α in Coronary Artery Bypass Graft Patients. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.5.50] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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24
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Viana RB, de Lira CAB, Naves JPA, Coswig VS, Del Vecchio FB, Ramirez-Campillo R, Vieira CA, Gentil P. Can We Draw General Conclusions from Interval Training Studies? Sports Med 2018; 48:2001-2009. [DOI: 10.1007/s40279-018-0925-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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25
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High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure. Heart Vessels 2018; 33:752-759. [DOI: 10.1007/s00380-018-1120-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/05/2018] [Indexed: 12/25/2022]
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26
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Barcelos GT, Rossato DD, Perini JL, Pinheiro LP, Carvalho C, Jaenisch RB, Rhoden CR, Lago PD, Nunes RB. Effects of l-arginine supplementation associated with continuous or interval aerobic training on chronic heart failure rats. Metabolism 2017; 76:1-10. [PMID: 28987235 DOI: 10.1016/j.metabol.2017.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 06/01/2017] [Accepted: 06/29/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Chronic heart failure (CHF) is related with exercise intolerance and impaired nitric oxide (NO) production, which can lead to several functional capacity alterations. Considering the possible superiority of aerobic interval training compared to continuous training and the capacity of l-arginine to restore the NO pathway, the aim of the present study was to investigate whether these treatments are beneficial to exercise capacity, muscle mass preservation and hemodynamic, inflammatory and oxidative stress parameters in CHF rats. METHODS Thirty-eight male Wistar rats post 6weeks of myocardial infarction (MI) surgery were randomly assigned into 6 CHF groups: sedentary (SED, n=6); SED+Arg (n=7); ACT (n=8); ACT+Arg (n=5); AIT (n=7); AIT+Arg (n=5). Exercise test capacity (ETC) was performed pre and post 8weeks of intervention. Supplemented rats received Arg (1g/kg) by oral gavage (7×/week). Exercise training was performed on a rat treadmill (5×/week). Hemodynamic variables, tissue collection, congestion, inflammatory cytokines, and oxidative parameters were evaluated at the end of protocols. RESULTS All trained groups showed a superior exercise capacity compared to SED groups on the post-intervention test (p<0.0001). Pulmonary congestion was attenuated in AIT and AIT+Arg compared with the SED group (p<0.05). Left ventricular end-diastolic pressure (LVEDP) was lower in ACT+Arg, AIT, and AIT+Arg groups than SED group (p<0.05). Association of AIT with Arg supplementation was able to improve hemodynamic responses (left ventricular systolic pressure (LVSP), systolic blood pressure (SBP), +dP/dtmax, and -dP/dtmax (p<0.05), likewise, decrease muscular and renal lipid peroxidation and tumor necrosis factor (TNF)-α, and increase interleukin (IL)-10/TNF-α plasmatic levels (p<0.01). Groups that associated aerobic exercise with Arg supplementation (ACT+Arg and AIT+Arg) revealed higher gastrocnemius mass compared to the SED group (p<0.01). CONCLUSIONS Both aerobic training protocols were capable to improve aerobic capacity, and the association with Arg supplementation was important to attenuate muscle loss. Moreover, interval training associated with Arg supplementation elicits greater improvements in hemodynamic parameters, contributing to reduction in pulmonary congestion, and demonstrated particular responses in the inflammatory profile and in the antioxidant status.
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Affiliation(s)
- Giovanna Tedesco Barcelos
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil; Post-Graduation Program in Rehabilitation Sciences, (UFCSPA), Porto Alegre, RS, Brazil
| | - Douglas Dalcin Rossato
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil
| | - Júlia Luiza Perini
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil; Post-Graduation Program in Rehabilitation Sciences, (UFCSPA), Porto Alegre, RS, Brazil
| | - Lucas Pereira Pinheiro
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil
| | - Carol Carvalho
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil
| | - Rodrigo Boemo Jaenisch
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil
| | - Cláudia Ramos Rhoden
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Air Pollution, Porto Alegre, RS, Brazil
| | - Pedro Dal Lago
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil; Post-Graduation Program in Rehabilitation Sciences, (UFCSPA), Porto Alegre, RS, Brazil
| | - Ramiro Barcos Nunes
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Laboratory of Experimental Physiology, Porto Alegre, RS, Brazil; Post-Graduation Program in Rehabilitation Sciences, (UFCSPA), Porto Alegre, RS, Brazil.
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Osuka Y, Matsubara M, Hamasaki A, Hiramatsu Y, Ohshima H, Tanaka K. Development of low-volume, high-intensity, aerobic-type interval training for elderly Japanese men: a feasibility study. Eur Rev Aging Phys Act 2017; 14:14. [PMID: 28855969 PMCID: PMC5571578 DOI: 10.1186/s11556-017-0184-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 08/09/2017] [Indexed: 12/11/2022] Open
Abstract
Background The purposes of this study were to identify 1) the feasibility of a novel exercise protocol (elderly Japanese male version of high-intensity interval aerobic training: EJ-HIAT) and 2) its preliminary data (%V̇O2peak, rating of perceived exertion) in comparison with traditional moderate-intensity continuous aerobic training (MICT). Results Twenty-one sedentary elderly men, aged 60–69 years, performed two exercise protocols: EJ-HIAT, consisting of 3 sets of 2−3-min cycling at 75−85%V̇O2peak with 1−2-min active rests at 50%V̇O2peak between sets, and MICT, consisting of 40-min cycling at 65%V̇O2peak. The completion rate, defined as the rate of participants who 1) did not demand withdrawal, 2) were not interrupted by the tester, and 3) did not change the workload during either exercise protocol, of EJ-HIAT was similar to that of MICT (EJ-HIAT: 100%, MICT: 95.2%). Maximal perceived exertion ratings assessed by Borg scale were also similar between EJ-HIAT and MICT. However, objectively measured maximal intensity assessed by %V̇O2peak was higher for EJ-HIAT than for MICT (EJ-HIAT: 86.0 ± 5.6%, MICT: 67.1 ± 6.4%). Conclusion These results suggested that EJ-HIAT has good feasibility and perceived exertion similar to MICT despite having higher objectively measured intensity than MICT. An intervention aimed as identifying the effects of EJ-HIAT on exercise tolerance should be performed in the future. Trial registration UMIN000021185 (February 26, 2016).
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo Japan.,Space Biomedical Research Group, Astronaut and Operation Control Unit, Japan Aerospace Exploration Agency, Tsukuba, Ibaraki Japan
| | - Muneaki Matsubara
- Faculty of Medicine, Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Ai Hamasaki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Yuji Hiramatsu
- Faculty of Medicine, Department of Cardiovascular Surgery, University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Hiroshi Ohshima
- Space Biomedical Research Group, Astronaut and Operation Control Unit, Japan Aerospace Exploration Agency, Tsukuba, Ibaraki Japan
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki Japan
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Reed JL, Blais AZ, Keast ML, Pipe AL, Reid RD. Performance of Fixed Heart Rate Increment Targets of 20 vs 30 Beats per Minute for Exercise Rehabilitation Prescription in Outpatients With Heart Failure. Can J Cardiol 2017; 33:777-784. [DOI: 10.1016/j.cjca.2017.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 01/06/2017] [Accepted: 01/24/2017] [Indexed: 12/31/2022] Open
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High Intensity Interval Training for Maximizing Health Outcomes. Prog Cardiovasc Dis 2017; 60:67-77. [PMID: 28385556 DOI: 10.1016/j.pcad.2017.03.006] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 02/08/2023]
Abstract
Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT.
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The anti-ageing molecule sirt1 mediates beneficial effects of cardiac rehabilitation. IMMUNITY & AGEING 2017; 14:7. [PMID: 28331525 PMCID: PMC5353800 DOI: 10.1186/s12979-017-0088-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/24/2017] [Indexed: 12/28/2022]
Abstract
Background An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in heart failure (HF), nevertheless it is underutilized, especially in the elderly. While the functional and hemodynamic effects of CRP are well known, its underlying molecular mechanisms have not been fully clarified. The present study aims to evaluate the effects of a well-structured 4-week CRP in patients with stable HF from a molecular point of view. Results A prospective longitudinal observational study was conducted on patients consecutively admitted to cardiac rehabilitation. In fifty elderly HF patients with preserved ejection fraction (HFpEF), levels of sirtuin 1 (Sirt1) in peripheral blood mononuclear cells (PBMCs) and of its targets, the antioxidants catalase (Cat) and superoxide dismutase (SOD) in serum were measured before (Patients, P) and at the end of the CRP (Rehabilitated Patients, RP), showing a rise of their activities after rehabilitation. Endothelial cells (ECs) were conditioned with serum from P and RP, and oxidative stress was induced using hydrogen peroxide. An increase of Sirt1 and Cat activity was detected in RP-conditioned ECs in both the absence and presence of oxidative stress, together with a decrease of senescence, an effect not observed during Sirt1 and Cat inhibition. Conclusions In addition to the improvement in functional and hemodynamic parameters, a supervised exercise-based CRP increases Sirt1 activity and stimulates a systemic antioxidant defence in elderly HFpEF patients. Moreover, CRP produces antioxidant and anti-senescent effects in human endothelial cells mediated, at least in part, by Sirt1 and its target Cat.
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Ahmadizad S, Nouri-Habashi A, Rahmani H, Maleki M, Naderi N, Lotfian S, Salimian M. Platelet activation and function in response to high intensity interval exercise and moderate continuous exercise in CABG and PCI patients. Clin Hemorheol Microcirc 2017; 64:911-919. [DOI: 10.3233/ch-168010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sajad Ahmadizad
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Akbar Nouri-Habashi
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hiwa Rahmani
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Majid Maleki
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Naderi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Lotfian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Salimian
- Platelet Research Laboratory, Kashan University of Medical Sciences, Kashan, Iran
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Blumberg Y, Ertracht O, Gershon I, Bachner-Hinenzon N, Reuveni T, Atar S. High-Intensity Training Improves Global and Segmental Strains in Severe Congestive Heart Failure. J Card Fail 2017; 23:392-402. [PMID: 28069473 DOI: 10.1016/j.cardfail.2016.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/27/2016] [Accepted: 12/29/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND High-intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle-tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. METHODS AND RESULTS After baseline physiologic assessment, CHF was induced by means of coronary artery ligation in Sprague-Dawley rats. Repeated measurements confirmed the presence of CHF (ejection fraction 52 ± 10%, global circumferential strain (GCS) 10.5 ± 4, and maximal oxygen uptake (V˙O2max) 71 ± 11 mL⋅min-1⋅kg-1; P < .001 vs baseline for all). Subsequently, rats were divided into training protocols: sedentary (SED), MAT, or HIT. After the training period, rats underwent the same measurements and were killed. Training intensity improved V˙O2max (73 ± 13 mL⋅min-1⋅kg-1 in MAT [P < .01 vs baseline] and 82 ± 6 mL⋅min-1⋅kg-1 in HIT [P < .05 vs baseline or SED] and ejection fraction (50 ± 21% in MAT [P < .001 vs baseline] and 66 ± 7% in HIT [P > .05 vs baseline]). In addition, strains of specific segments adjacent to the infarct zone regained basal values (P > .05 vs baseline), whereas global cardiac functional parameters as assessed with the use of 2-dimensional echocardiography did not improve. CONCLUSIONS High-intensity exercise training improved function in myocardial segments remote from the scar, which resulted in compensatory cardiac remodeling. This effect is prominent, yet it could be detected only with the use of STE.
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Affiliation(s)
- Yair Blumberg
- Eliachar Research Laboratory, Galilee Medical Center, Nahariya, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Offir Ertracht
- Eliachar Research Laboratory, Galilee Medical Center, Nahariya, Israel.
| | - Itai Gershon
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | | | - Tali Reuveni
- Eliachar Research Laboratory, Galilee Medical Center, Nahariya, Israel
| | - Shaul Atar
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; Department of Cardiology, Galilee Medical Center, Nahariya, Israel
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Ahmadizad S, Bassami M, Hadian M, Eslami M. Influences of two high intensity interval exercise protocols on the main determinants of blood fluidity in overweight men. Clin Hemorheol Microcirc 2016; 64:827-835. [PMID: 27802216 DOI: 10.3233/ch-168009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute effects of continuous exercise on the markers of blood fluidity have been addressed in different populations and the changes are intensity related. However, the effect of different high intensity interval exercise (HIIE) on these variables is unclear. OBJECTIVE This study is designed to determine the effects of two different HIIE with different work/rest ratios but the same energy expenditure on the main determinants of blood fluidity. METHODS Ten overweight men (age, 26.3±1.7 yrs) completed two HIIE protocols on two separate occasions with one week intervening. The two HIIE encompassed performing: 1) 6 intervals of 2 min activity at 85% of VO2max interspersed by 2 min active recovery at 30% of VO2max (ratio 1 to 1, HIIE1/1), and 2) 6 intervals of 30 s activity at 110% of VO2max interspersed by 4 min active recovery at 40% of VO2max (ratio 1 to 8, HIIE1/8). Each exercise trial was followed by 30 min rest. Venous blood samples were obtained before exercise, immediately after exercise and after recovery and analyzed for blood and plasma viscosity, fibrinogen and red blood cell indices. RESULTS The HIIE1/1 protocol led to higher reduction (P < 0.01) in plasma volume changes compared to HIIE1/8 (9.9% vs 5.7%). Moreover, increases in blood viscosity, plasma viscosity, hematocrit, RBC count and mean arterial blood pressure observed following HIIE1/1 were significantly (P < 0.05) higher than HIIE1/8 ; whereas, the changes in fibrinogen concentration neither were significant in response to both trials nor were significantly different between two protocols (P > 0.05). However, the changes in all variables during exercise were transient and returned to the baseline levels after 30 min recovery. CONCLUSIONS It is concluded that the HIIE protocol with lower intensity and shorter rest intervals (higher work to rest ratio) clearly results in more physiological strain than HIIE with higher intensity but longer rest intervals (lower work to rest ratio) in overweight individuals, and that the work to rest ratio could be as important as exercise intensity when considering the hemorheological variables during HIIE.
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Affiliation(s)
- Sajad Ahmadizad
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Minoo Bassami
- Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Mohsen Hadian
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
| | - Maryam Eslami
- Department of Sport and Exercise Physiology, Faculty of Sports Sciences, Shahid Beheshti University, Tehran, Iran
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High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease. Cardiol Rev 2016; 24:273-281. [DOI: 10.1097/crd.0000000000000124] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Besnier F, Labrunée M, Pathak A, Pavy-Le Traon A, Galès C, Sénard JM, Guiraud T. Exercise training-induced modification in autonomic nervous system: An update for cardiac patients. Ann Phys Rehabil Med 2016; 60:27-35. [PMID: 27542313 DOI: 10.1016/j.rehab.2016.07.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/01/2016] [Accepted: 07/07/2016] [Indexed: 12/14/2022]
Abstract
Patients with cardiovascular disease show autonomic dysfunction, including sympathetic activation and vagal withdrawal, which leads to fatal events. This review aims to place sympathovagal balance as an essential element to be considered in management for cardiovascular disease patients who benefit from a cardiac rehabilitation program. Many studies showed that exercise training, as non-pharmacologic treatment, plays an important role in enhancing sympathovagal balance and could normalize levels of markers of sympathetic flow measured by microneurography, heart rate variability or plasma catecholamine levels. This alteration positively affects prognosis with cardiovascular disease. In general, cardiac rehabilitation programs include moderate-intensity and continuous aerobic exercise. Other forms of activities such as high-intensity interval training, breathing exercises, relaxation and transcutaneous electrical stimulation can improve sympathovagal balance and should be implemented in cardiac rehabilitation programs. Currently, the exercise training programs in cardiac rehabilitation are individualized to optimize health outcomes. The sports science concept of the heart rate variability (HRV)-vagal index used to manage exercise sessions (for a goal of performance) could be implemented in cardiac rehabilitation to improve cardiovascular fitness and autonomic nervous system function.
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Affiliation(s)
- Florent Besnier
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France
| | - Marc Labrunée
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Department of Rehabilitation, Toulouse University Hospital, Toulouse, France
| | - Atul Pathak
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Unit of Hypertension, Risk Factors and Heart Failure, Clinique Pasteur, Toulouse, France
| | - Anne Pavy-Le Traon
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Céline Galès
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Jean-Michel Sénard
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France
| | - Thibaut Guiraud
- Institute of Cardiovascular and Metabolic Diseases, National Institute of Health and Medical Research (INSERM), UMR-1048, Toulouse, France; Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville, France.
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Comparison of Carbohydrate and Lipid Oxidation During Different High-Intensity Interval Exercise in Patients with Chronic Heart Failure. Am J Phys Med Rehabil 2016; 96:50-54. [PMID: 27175565 DOI: 10.1097/phm.0000000000000545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Substrate oxidation was compared during different high-intensity intermittent exercise (HIIE) protocols in patients with heart failure and reduced ejection fraction (HFREF). Eighteen males with HFREF (58.8 ± 9 years) were randomly assigned to 4 different HIIEs: 30 seconds (A and B) or 90 seconds (C and D) at 100% peak power output, with passive (A and C) or active recovery (50% of peak power output; B and D). Each HIIE protocol was separated by 1 week. Substrate oxidation (carbohydrate [CHO] and lipid: in g/min and in %) was calculated with gas exchange analysis. A 2-way analysis of variance and Bonferroni post hoc test were used (P ≤ 0.05) to compare CHO and lipid oxidation during the 4 HIIEs. Protocols with passive recovery (A and C) resulted in significantly lower quantitative CHO oxidation (g/min) (interaction, P < 0.001) compared to modes with active recovery (B and D). Quantitative lipid oxidation (g/min) was significantly lower in protocol C compared to the 3 other HIIE protocols (interaction, P < 0.001). In patients with HFREF, shorter HIIE bouts with passive recovery oxidize less CHO and more lipids (quantitatively) compared to the other HIIE protocols. This might be taken into account the exercise training prescription and might influence muscle metabolism adaptations.
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Reed JL, Pipe AL. Practical Approaches to Prescribing Physical Activity and Monitoring Exercise Intensity. Can J Cardiol 2016; 32:514-22. [DOI: 10.1016/j.cjca.2015.12.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 01/20/2023] Open
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Gayda M, Ribeiro PAB, Juneau M, Nigam A. Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit? Can J Cardiol 2016; 32:485-94. [PMID: 26927863 DOI: 10.1016/j.cjca.2016.01.017] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 12/12/2022] Open
Abstract
In this review, we discuss the most recent forms of exercise training available to patients with cardiac disease and their comparison or their combination (or both) during short- and long-term (phase II and III) cardiac rehabilitation programs. Exercise training modalities to be discussed include inspiratory muscle training (IMT), resistance training (RT), continuous aerobic exercise training (CAET), and high-intensity interval training (HIIT). Particular emphasis is placed on HIIT compared or combined (or both) with other forms such as CAET or RT. For example, IMT combined with CAET was shown to be superior to CAET alone for improving functional capacity, ventilatory function, and quality of life in patients with chronic heart failure. Similarly, RT combined with CAET was shown to optimize benefits with respect to functional capacity, muscle function, and quality of life. Furthermore, in recent years, HIIT has emerged as an alternative or complementary (or both) exercise modality to CAET, providing equivalent if not superior benefits to conventional continuous aerobic training with respect to aerobic fitness, cardiovascular function, quality of life, efficiency, safety, tolerance, and exercise adherence in both short- and long-term training studies. Finally, short-interval HIIT was shown to be useful in the initiation and improvement phases of cardiac rehabilitation, whereas moderate- or longer-interval (or both) HIIT protocols appear to be more appropriate for the improvement and maintenance phases because of their high physiological stimulus. We now propose progressive models of exercise training (phases II-III) for patients with cardiac disease, including a more appropriate application of HIIT based on the scientific literature in the context of a multimodal cardiac rehabilitation program.
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Affiliation(s)
- Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute and University of Montréal, Québec, Canada; Research Center, Montréal Heart Institute and University of Montréal, Montréal, Québec, Canada; Department of Medicine, University of Montréal, Montréal, Québec, Canada.
| | - Paula A B Ribeiro
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute and University of Montréal, Québec, Canada; Research Center, Montréal Heart Institute and University of Montréal, Montréal, Québec, Canada; Department of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute and University of Montréal, Québec, Canada; Research Center, Montréal Heart Institute and University of Montréal, Montréal, Québec, Canada; Department of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute and University of Montréal, Québec, Canada; Research Center, Montréal Heart Institute and University of Montréal, Montréal, Québec, Canada; Department of Medicine, University of Montréal, Montréal, Québec, Canada
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Comparative effects of high intensity interval training versus moderate intensity continuous training on quality of life in patients with heart failure: Study protocol for a randomized controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.ctrsc.2015.11.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Larouche JF, Yu C, Luo X, Farhat N, Guiraud T, Lalongé J, Gayda M, Juneau M, Lambert J, Thorin-Trescases N, Thorin E, Nigam A. Acute High-Intensity Intermittent Aerobic Exercise Reduces Plasma Angiopoietin-Like 2 in Patients With Coronary Artery Disease. Can J Cardiol 2015; 31:1232-9. [DOI: 10.1016/j.cjca.2015.01.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/27/2015] [Accepted: 01/27/2015] [Indexed: 01/17/2023] Open
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Physiological and health-related adaptations to low-volume interval training: influences of nutrition and sex. Sports Med 2015; 44 Suppl 2:S127-37. [PMID: 25355187 PMCID: PMC4213388 DOI: 10.1007/s40279-014-0259-6] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Interval training refers to the basic concept of alternating periods of relatively intense exercise with periods of lower-intensity effort or complete rest for recovery. Low-volume interval training refers to sessions that involve a relatively small total amount of exercise (i.e. ≤10 min of intense exercise), compared with traditional moderate-intensity continuous training (MICT) protocols that are generally reflected in public health guidelines. In an effort to standardize terminology, a classification scheme was recently proposed in which the term 'high-intensity interval training' (HIIT) be used to describe protocols in which the training stimulus is 'near maximal' or the target intensity is between 80 and 100 % of maximal heart rate, and 'sprint interval training' (SIT) be used for protocols that involve 'all out' or 'supramaximal' efforts, in which target intensities correspond to workloads greater than what is required to elicit 100 % of maximal oxygen uptake (VO2max). Both low-volume SIT and HIIT constitute relatively time-efficient training strategies to rapidly enhance the capacity for aerobic energy metabolism and elicit physiological remodeling that resembles changes normally associated with high-volume MICT. Short-term SIT and HIIT protocols have also been shown to improve health-related indices, including cardiorespiratory fitness and markers of glycemic control in both healthy individuals and those at risk for, or afflicted by, cardiometabolic diseases. Recent evidence from a limited number of studies has highlighted potential sex-based differences in the adaptive response to SIT in particular. It has also been suggested that specific nutritional interventions, in particular those that can augment muscle buffering capacity, such as sodium bicarbonate, may enhance the adaptive response to low-volume interval training.
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Marko C, Danzinger G, Käferbäck M, Lackner T, Müller R, Zimpfer D, Schima H, Moscato F. Safety and efficacy of cardiac rehabilitation for patients with continuous flow left ventricular assist devices. Eur J Prev Cardiol 2014; 22:1378-84. [DOI: 10.1177/2047487314558772] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/16/2014] [Indexed: 12/24/2022]
Affiliation(s)
| | - Georg Danzinger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
| | - Michael Käferbäck
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
| | | | | | - Daniel Zimpfer
- Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
- Department of Cardiac Surgery, Medical University of Vienna, Austria
| | - Heinrich Schima
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
- Department of Cardiac Surgery, Medical University of Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Austria
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Provocative issues in heart disease prevention. Can J Cardiol 2014; 30:S401-9. [PMID: 25444498 DOI: 10.1016/j.cjca.2014.09.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 12/25/2022] Open
Abstract
In this article, new areas of cardiovascular (CV) prevention and rehabilitation research are discussed: high-intensity interval training (HIIT) and new concepts in nutrition. HIIT consists of brief periods of high-intensity exercise interspersed by periods of low-intensity exercise or rest. The optimal mode according our work (15-second exercise intervals at peak power with passive recovery intervals of the same duration) is associated with longer total exercise time, similar time spent near peak oxygen uptake (VO2 peak) VO2 peak, and lesser perceived exertion relative to other protocols that use longer intervals and active recovery periods. Evidence also suggests that compared with moderate-intensity continuous exercise training, HIIT has superior effects on cardiorespiratory function and on the attenuation of multiple cardiac and peripheral abnormalities. With respect to nutrition, a growing body of evidence suggests that the gut microbiota is influenced by lifestyle choices and might play a pivotal role in modulating CV disease development. For example, recent evidence linking processed (but not unprocessed) meats to increased CV risk pointed to the gut microbial metabolite trimethylamine N-oxide as a potential culprit. In addition, altered gut microbiota could also mediate the proinflammatory and cardiometabolic abnormalities associated with excess added free sugar consumption, and in particular high-fructose corn syrup. Substantially more research is required, however, to fully understand how and which alterations in gut flora can prevent or lead to CV disease and other chronic illnesses. We conclude with thoughts about the appropriate role for HIIT in CV training and future research in the role of gut flora-directed interventions in CV prevention.
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Young DW. Self-measure of heart rate variability (HRV) and arrhythmia to monitor and to manage atrial arrhythmias: personal experience with high intensity interval exercise (HIIE) for the conversion to sinus rhythm. Front Physiol 2014; 5:251. [PMID: 25071596 PMCID: PMC4085876 DOI: 10.3389/fphys.2014.00251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 06/17/2014] [Indexed: 12/01/2022] Open
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High versus moderate intensity running exercise to impact cardiometabolic risk factors: the randomized controlled RUSH-study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:843095. [PMID: 24738073 PMCID: PMC3967804 DOI: 10.1155/2014/843095] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/11/2014] [Accepted: 01/30/2014] [Indexed: 11/24/2022]
Abstract
Aerobic exercise positively impacts cardiometabolic risk factors and diseases; however, the most effective exercise training strategies have yet to be identified. To determine the effect of high intensity (interval) training (HI(I)T) versus moderate intensity continuous exercise (MICE) training on cardiometabolic risk factors and cardiorespiratory fitness we conducted a 16-week crossover RCT with partial blinding. Eighty-one healthy untrained middle-aged males were randomly assigned to two study arms: (1) a HI(I)T-group and (2) a sedentary control/MICE-group that started their MICE protocol after their control status. HI(I)T focused on interval training (90 sec to 12 min >85–97.5% HRmax) intermitted by active recovery (1–3 min at 65–70% HRmax), while MICE consisted of continuous running at 65–75% HRmax. Both exercise groups progressively performed 2–4 running sessions/week of 35 to 90 min/session; however, protocols were adjusted to attain similar total work (i.e., isocaloric conditions). With respect to cardiometabolic risk factors and cardiorespiratory fitness both exercise groups demonstrated similar significant positive effects on MetS-Z-Score (HI(I)T: −2.06 ± 1.31, P = .001 versus MICE: −1.60 ± 1.77, P = .001) and (relative) VO2max (HI(I)T: 15.6 ± 9.3%, P = .001 versus MICE: 10.6 ± 9.6%, P = .001) compared with the sedentary control group. In conclusion, both exercise programs were comparably effective for improving cardiometabolic indices and cardiorespiratory fitness in untrained middle-aged males.
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Behrens K, Hottenrott K, Weippert M, Montanus H, Kreuzfeld S, Rieger A, Lübke J, Werdan K, Stoll R. [Individualization of exercise load control for inpatient cardiac rehabilitation. Development and evaluation of a HRV-based intervention program for patients with ischemic heart failure]. Herz 2014; 40 Suppl 1:61-9. [PMID: 24441395 DOI: 10.1007/s00059-013-4037-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 10/30/2013] [Accepted: 12/08/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND The effective use of rehabilitation programs is of primary importance in order to improve the physical performance of cardiac disease patients. A modular program has been developed which is intended to structure and individualize conventional, exercise-based rehabilitation programs according to the individual needs and physical condition of each patient. The individualization of the program is based on detailed diagnostics before patients enter the program and daily measurements of heart rate variability (HRV) during cardiac rehabilitation. METHODS A total of 30 patients with ischemic heart disease were randomly assigned either to the intervention group (IG), completing the modular individualized rehabilitation program [n=15, mean age 54.4±4.2 years and mean left ventricular ejection fraction (LVEF) 28.53±6.25%) or to the control group (CG) taking part in the conventional rehabilitation program (n=15, mean age 56.4±4.4 years and mean LVEF 27.63±5.62). Before and after the intervention, cardiorespiratory fitness was assessed by measurement of maximal oxygen consumption (relative VO2max) during bicycle ergometry and the 6-minute walk test (6-MWT). Pre-post comparisons of cardiorespiratory fitness indicators were used to evaluate the effectiveness of the rehabilitation program. In addition to the results of the basic clinical investigations and the cardiorespiratory testing, results of standardized HRV measurements of 10 min at morning rest served as criteria for program individualization. RESULTS The relative VO2max increased significantly (p<0.05) in the IG whereas no change was found in the CG. Similar results were found for maximum power output during bicycle ergometry (p<0.01) and for 6-MWT distance (p<0.001). Although patients in the IG completed less aerobic exercise sessions than those in the CG (p<0.001) the physical performance of the IG improved significantly. DISCUSSION The results prove the effectiveness and efficacy of the modular individualized rehabilitation program. They further suggest the need for an individual program matrix instead of a maximum performance matrix in cardiac rehabilitation. Individualization should be based on clinical and performance diagnostics before and accompanying assessments of training condition, e.g. by HRV measurements, during rehabilitation programs. Each patient should only perform those intervention programs which match the results of the basic clinical investigation and additional analyses during rehabilitation.
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Affiliation(s)
- K Behrens
- Institut für Präventivmedizin, Universitätsmedizin Rostock, St.-Georg-Str. 108, 18055, Rostock, Deutschland,
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Moe GW, Ezekowitz JA, O'Meara E, Howlett JG, Fremes SE, Al-Hesayen A, Heckman GA, Ducharme A, Estrella-Holder E, Grzeslo A, Harkness K, Lepage S, McDonald M, McKelvie RS, Nigam A, Rajda M, Rao V, Swiggum E, Virani S, Van Le V, Zieroth S, Arnold JMO, Ashton T, D'Astous M, Dorian P, Giannetti N, Haddad H, Isaac DL, Kouz S, Leblanc MH, Liu P, Ross HJ, Sussex B, White M. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization. Can J Cardiol 2013; 30:249-63. [PMID: 24480445 DOI: 10.1016/j.cjca.2013.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 10/09/2013] [Accepted: 10/09/2013] [Indexed: 12/25/2022] Open
Abstract
The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.
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Affiliation(s)
- Gordon W Moe
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
| | | | - Eileen O'Meara
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | | | - Steve E Fremes
- Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | - Abdul Al-Hesayen
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Anique Ducharme
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | | | - Adam Grzeslo
- Joseph Brant Memorial Hospital, Burlington, Ontario, Canada; Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Harkness
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Serge Lepage
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michael McDonald
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Robert S McKelvie
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Anil Nigam
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | - Miroslaw Rajda
- QE II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vivek Rao
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Sean Virani
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Vy Van Le
- Centre Hospitalier Universitaire de l'Université de Montréal, Québec, Canada
| | - Shelley Zieroth
- Cardiac Sciences Program, St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | | | | | | | - Paul Dorian
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Simon Kouz
- Centre Hospitalier Régional de Lanaudière, Joliette, and Université Laval, Québec, Canada
| | | | - Peter Liu
- Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Heather J Ross
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Sussex
- Health Sciences Centre, St John's, Newfoundland, Canada
| | - Michel White
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
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Conraads VM, Van Craenenbroeck EM, Pattyn N, Cornelissen VA, Beckers PJ, Coeckelberghs E, De Maeyer C, Denollet J, Frederix G, Goetschalckx K, Hoymans VY, Possemiers N, Schepers D, Shivalkar B, Vanhees L. Rationale and design of a randomized trial on the effectiveness of aerobic interval training in patients with coronary artery disease: The SAINTEX-CAD study. Int J Cardiol 2013; 168:3532-6. [DOI: 10.1016/j.ijcard.2013.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/20/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
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