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Li M, Zheng C, Kawada T, Uemura K, Yokota S, Matsushita H, Saku K. Donepezil attenuates progression of cardiovascular remodeling and improves prognosis in spontaneously hypertensive rats with chronic myocardial infarction. Hypertens Res 2024; 47:1298-1308. [PMID: 38485776 DOI: 10.1038/s41440-024-01629-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/25/2024] [Accepted: 02/18/2024] [Indexed: 05/08/2024]
Abstract
The acetylcholinesterase inhibitor donepezil restores autonomic balance, reduces inflammation, and improves long-term survival in rats with chronic heart failure (CHF) following myocardial infarction (MI). As arterial hypertension is associated with a significant risk of cardiovascular death, we investigated the effectiveness of donepezil in treating CHF in spontaneously hypertensive rats (SHR). CHF was induced in SHR by inducing permanent MI. After 2 weeks, the surviving SHR were randomly assigned to sham-operated (SO), untreated (UT), or oral donepezil-treated (DT, 5 mg/kg/day) groups, and various vitals and parameters were monitored. After 7 weeks of treatment, heart rate and arterial hypertension reduced significantly in DT rats than in UT rats. Donepezil treatment improved 50-day survival (41% to 80%, P = 0.004); suppressed progression of cardiac hypertrophy, cardiac dysfunction (cardiac index: 133 ± 5 vs. 112 ± 5 ml/min/kg, P < 0.05; left ventricular end-diastolic pressure: 12 ± 3 vs. 22 ± 2 mmHg, P < 0.05; left ventricular +dp/dtmax: 5348 ± 338 vs. 4267 ± 114 mmHg/s, P < 0.05), systemic inflammation, and coronary artery remodeling (wall thickness: 26.3 ± 1.4 vs. 34.7 ± 0.7 μm, P < 0.01; media-to-lumen ratio: 3.70 ± 0.73 vs. 8.59 ± 0.84, P < 0.001); increased capillary density; and decreased plasma catecholamine, B-type natriuretic peptide, arginine vasopressin, and angiotensin II levels. Donepezil treatment attenuated cardiac and coronary artery remodeling, mitigated cardiac dysfunction, and significantly improved the prognosis of SHR with CHF.
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Affiliation(s)
- Meihua Li
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan.
| | - Can Zheng
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
- New Business Development Group, Business Planning Department, Sanyo Chemical Industries, LTD, Kyoto, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
| | - Kazunori Uemura
- Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
| | - Shohei Yokota
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
| | - Hiroki Matsushita
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
| | - Keita Saku
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
- Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan
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Alacreu-Crespo A, Costa R, Molins F, Abad-Tortosa D, SanMiguel N, Courtet P, Serrano MÁ. Do Decision-Making Styles Predict Vagal Control? The Role of Resting Heart Rate Variability. Behav Sci (Basel) 2024; 14:369. [PMID: 38785860 PMCID: PMC11118769 DOI: 10.3390/bs14050369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Decision-making styles are a habit-based propensity that drive behavior and affect daily life. Rational and intuitive decision-making styles have been associated with good mental health. However, the underlying mechanisms are not clear. In the last decade, high basal levels of heart rate variability (HRV) have been proposed as an index of health and emotional control, and this could be one of the variables involved in the effects of decision making on health. Therefore, the aim of this study is to analyze the capability of decision-making styles to predict resting HRV. A cross-sectional study was conducted in a sample of 199 (119 women) young university students, and a resting ECG was recorded to extract frequency domain HRV variables. Subsequently, participants completed sociodemographic data and the General Decision-Making Style questionnaire (GDMS). Results showed that the intuitive style predicted high-frequency HRV, while the avoidant style predicted less low-frequency HRV. This study presents new data on the relationship between decision-making style and HRV, suggesting that the intuitive style has a cardioprotective effect, while the avoidant style is related to lower HRV, which has been associated with health vulnerability. In conclusion, this study contributes to the understanding of HRV and its potential as a biomarker for cognitive styles that may improve health.
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Affiliation(s)
- Adrián Alacreu-Crespo
- Departamento de Psicología y Sociología, Universidad de Zaragoza, 50009 Zaragoza, Spain;
| | - Raquel Costa
- Departamento de Psicobiología, Universitat de València, 46022 Valencia, Spain; (F.M.); (D.A.-T.); (N.S.); (M.Á.S.)
| | - Francisco Molins
- Departamento de Psicobiología, Universitat de València, 46022 Valencia, Spain; (F.M.); (D.A.-T.); (N.S.); (M.Á.S.)
| | - Diana Abad-Tortosa
- Departamento de Psicobiología, Universitat de València, 46022 Valencia, Spain; (F.M.); (D.A.-T.); (N.S.); (M.Á.S.)
| | - Noemí SanMiguel
- Departamento de Psicobiología, Universitat de València, 46022 Valencia, Spain; (F.M.); (D.A.-T.); (N.S.); (M.Á.S.)
| | - Philippe Courtet
- Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychiatry: Epidemiological and Clinical Research, University of Montpellier, 34090 Montpellier, France;
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, 34295 Montpellier, France
| | - Miguel Ángel Serrano
- Departamento de Psicobiología, Universitat de València, 46022 Valencia, Spain; (F.M.); (D.A.-T.); (N.S.); (M.Á.S.)
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Takeda R, Nojima H, Hirono T, Okudaira M, Nishikawa T, Watanabe K. Impact of subtetanic neuromuscular electrical stimulation on cardiac autonomic nervous system in young individuals. J Sports Med Phys Fitness 2024; 64:78-87. [PMID: 37902806 DOI: 10.23736/s0022-4707.23.15352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Although subtetanic neuromuscular electrical stimulation (NMES) has been proposed as an exercise training and/or rehabilitation tool, the impact of NMES on the autonomic nervous system (ANS) is unclear. Thus, we hypothesized that NMES would alter ANS, i.e., increase sympathetic activity and decrease parasympathetic activity, in young individuals. METHODS Eighteen healthy young individuals (16 males, mean age: 22 [SD: 4] years, Body Mass Index: 21.7 [2.2] kg/m2) volunteered. Blood pressure (BP), heart rate (HR), and R-R intervals were recorded during 6-minute resting, NMES, and recovery conditions. Short-term heart rate variability analysis of R-R intervals was performed for the frequency and time domains during each condition. Time domain indices included the root mean square of successive R-R interval differences (RMSSD), and the percentage of successive R-R intervals differing by more than 50ms (pRR50%). Frequency domain indices (fast Fourier transform) of R-R intervals included total power (TP), low-frequency (LF) power (0.04-0.15 Hz), and high-frequency (HF) power (0.15-0.4 Hz). RESULTS BP was not altered but HR was significantly increased during NMES (P<0.001), and it returned to the resting level at recovery. RMSSD and pRR50 decreased from resting to NMES and returned at recovery conditions (P<0.05, respectively). TP and HF decreased from resting to NMES and returned at recovery conditions (P<0.05, respectively). LF increased from NMES to recovery (P<0.05). The LF/HF ratio showed no significant differences between conditions (P=0.210). CONCLUSIONS Cardiac ANS fluctuated by subtetanic NMES without BP elevation in healthy young individuals. Parasympathetic but not sympathetic activity was affected by NMES stimulation.
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Affiliation(s)
- Ryosuke Takeda
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan -
| | - Hiroya Nojima
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
| | - Tetsuya Hirono
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masamichi Okudaira
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
| | - Taichi Nishikawa
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
- Graduate School of Health and Sport Sciences, Chukyo University, Toyota, Japan
| | - Kohei Watanabe
- School of Health and Sport Science, Laboratory of Neuromuscular Biomechanics, Chukyo University, Toyota, Japan
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Garramona FT, Cunha TF, Vieira JS, Borges G, Santos G, de Castro G, Ugrinowitsch C, Brum PC. Increased sympathetic nervous system impairs prognosis in lung cancer patients: a scoping review of clinical studies. Lung Cancer Manag 2023; 12:LMT63. [PMID: 38239811 PMCID: PMC10794895 DOI: 10.2217/lmt-2023-0006] [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: 07/21/2023] [Accepted: 11/16/2023] [Indexed: 01/22/2024] Open
Abstract
Aim To summarize current knowledge, gaps, quality of the evidence and show main results related to the role of the autonomic nervous system in lung cancer. Methods Studies were identified through electronic databases (PubMed, Scopus, Embase and Cochrane Library) in October 2023, and a descriptive analysis was performed. Twenty-four studies were included, and most were observational. Results Our data indicated an increased expression of β-2-adrenergic receptors in lung cancer, which was associated with poor prognosis. However, the use of β-blockers as an add-on to standard treatment promoted enhanced overall survival, recurrence-free survival and reduced metastasis occurrence. Conclusion Although the results herein seem promising, future research using high-quality prospective clinical trials is required to draw directions to guide clinical interventions.
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Affiliation(s)
- Fabrício T Garramona
- University of Sorocaba, Sao Paulo, 18023-000, Brazil
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
| | - Telma F Cunha
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
- Paulista University, Sao Paulo, 01533-000, Brazil
| | - Janaína S Vieira
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
| | - Gabriela Borges
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
| | - Gabriela Santos
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
| | - Gilberto de Castro
- Cancer Institute of the State of Sao Paulo (ICESP), Clinical Hospital of Medical College - University of Sao Paulo, Sao Paulo, 01246-000, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
| | - Patrícia C Brum
- School of Physical Education & Sport, University of Sao Paulo, Sao Paulo, 05508-30, Brazil
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Chen Z, Wang S, He Z, Tegegne BS, van Roon AM, Holtjer JCS, van der Harst P, Snieder H, Thio CHL. Observational and genetic evidence support a relationship between cardiac autonomic function and blood pressure. Front Cardiovasc Med 2023; 10:1187275. [PMID: 37404742 PMCID: PMC10315649 DOI: 10.3389/fcvm.2023.1187275] [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: 03/15/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Background It is unclear how cardiac autonomic function, as indicated by heart rate (HR), heart rate variability (HRV), HR increase during exercise, and HR recovery after exercise, is related to blood pressure (BP). We aimed to examine the observational and genetic evidence for a potential causal effect of these HR(V) traits on BP. Methods We performed multivariable adjusted linear regression using Lifelines and UK Biobank cohorts to investigate the relationship between HR(V) traits and BP. Linkage disequilibrium score regression was conducted to examine genetic correlations. We used two-sample Mendelian randomization (2SMR) to examine potential causal relations between HR(V) traits and BP. Results Observational analyses showed negative associations of all HR(V) traits with BP, except for HR, which was positively associated. Genetic correlations were directionally consistent with the observational associations, but most significant genetic correlations between HR(V) traits and BP were limited to diastolic blood pressure (DBP). 2SMR analyses suggested a potentially causal relationship between HR(V) traits and DBP but not systolic blood pressure (SBP). No reverse effect of BP on HR(V) traits was found. One standard deviation (SD) unit increase in HR was associated with a 1.82 mmHg elevation of DBP. In contrast, one ln(ms) unit increase of the root mean square of the successive differences (RMSSD) and corrected RMSSD (RMSSDc), decreased DBP by 1.79 and 1.83 mmHg, respectively. For HR increase and HR recovery at 50 s, every additional SD increase was associated with a lower DBP by 2.05 and 1.47 mmHg, respectively. Results of secondary analyses with pulse pressure as outcome were inconsistent between observational and 2SMR analyses, as well as between HR(V) traits, and therefore inconclusive. Conclusion Both observational and genetic evidence show strong associations between indices of cardiac autonomic function and DBP, suggesting that a larger relative contribution of the sympathetic versus the parasympathetic nervous system to cardiac function may cause elevated DBP.
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Affiliation(s)
- Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Siqi Wang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Zhen He
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Balewgizie S. Tegegne
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Neurology, Center for Statistical Genetics, Gertrude H. Sergievsky Center, Columbia University Medical Center, Columbia University, New York, NY, United States
| | - Arie M. van Roon
- Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Judith C. S. Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Division of Heart & Lungs, Department of Cardiology, Utrecht University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chris H. L. Thio
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Hall LG, Thyfault JP, Johnson JD. Exercise and inactivity as modifiers of β cell function and type 2 diabetes risk. J Appl Physiol (1985) 2023; 134:823-839. [PMID: 36759159 PMCID: PMC10042613 DOI: 10.1152/japplphysiol.00472.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Exercise and regular physical activity are beneficial for the prevention and management of metabolic diseases such as obesity and type 2 diabetes, whereas exercise cessation, defined as deconditioning from regular exercise or physical activity that has lasted for a period of months to years, can lead to metabolic derangements that drive disease. Adaptations to the insulin-secreting pancreatic β-cells are an important benefit of exercise, whereas less is known about how exercise cessation affects these cells. Our aim is to review the impact that exercise and exercise cessation have on β-cell function, with a focus on the evidence from studies examining glucose-stimulated insulin secretion (GSIS) using gold-standard techniques. Potential mechanisms by which the β-cell adapts to exercise, including exerkine and incretin signaling, autonomic nervous system signaling, and changes in insulin clearance, will also be explored. We will highlight areas for future research.
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Affiliation(s)
- Liam G Hall
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, British Columbia, Canada
| | - John P Thyfault
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas, United States
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
- KU Diabetes Institute, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - James D Johnson
- Department of Cellular and Physiological Sciences, Life Sciences Institute, The University of British Columbia, Vancouver, British Columbia, Canada
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Meyer-Lindemann U, Moggio A, Dutsch A, Kessler T, Sager HB. The Impact of Exercise on Immunity, Metabolism, and Atherosclerosis. Int J Mol Sci 2023; 24:3394. [PMID: 36834808 PMCID: PMC9967592 DOI: 10.3390/ijms24043394] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/29/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Physical exercise represents an effective preventive and therapeutic strategy beneficially modifying the course of multiple diseases. The protective mechanisms of exercise are manifold; primarily, they are elicited by alterations in metabolic and inflammatory pathways. Exercise intensity and duration strongly influence the provoked response. This narrative review aims to provide comprehensive up-to-date insights into the beneficial effects of physical exercise by illustrating the impact of moderate and vigorous exercise on innate and adaptive immunity. Specifically, we describe qualitative and quantitative changes in different leukocyte subsets while distinguishing between acute and chronic exercise effects. Further, we elaborate on how exercise modifies the progression of atherosclerosis, the leading cause of death worldwide, representing a prime example of a disease triggered by metabolic and inflammatory pathways. Here, we describe how exercise counteracts causal contributors and thereby improves outcomes. In addition, we identify gaps that still need to be addressed in the future.
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Affiliation(s)
- Ulrike Meyer-Lindemann
- Department of Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Aldo Moggio
- Department of Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
| | - Alexander Dutsch
- Department of Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Thorsten Kessler
- Department of Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Hendrik B. Sager
- Department of Cardiology, German Heart Center Munich, Technical University Munich, 80636 Munich, Germany
- DZHK e.V. (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
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Martínez-González-Moro I, Albertus Cámara I, Paredes Ruiz MJ. Influences of Intense Physical Effort on the Activity of the Autonomous Nervous System and Stress, as Measured with Photoplethysmography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16066. [PMID: 36498140 PMCID: PMC9735638 DOI: 10.3390/ijerph192316066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Background: The autonomic nervous system, which is composed of the sympathetic and parasympathetic nervous system, is closely related to the cardiovascular system. The temporal variation between each of the intervals between the consecutive “R” waves of an electrocardiogram is known as heart rate variability. Depending on the type of activity, both systems can be activated, and also influence the interval between “R” waves. Currently, with advancements in technology and electronic devices, photoplethysmography is used. Photoplethysmography detects changes in the intensity of reflected light that allow differentiation between systole and diastole and, therefore, determines the heart rate, its frequency and its variations. In this way, changes in the autonomic nervous system can be detected by devices such as the Max Pulse®. Objective: To determine whether the information provided by Max Pulse® on autonomic balance and stress is modified after intense physical exercise, thereby determining whether there is a relationship with body composition, and also whether there are differences with respect to gender. Materials and Methods: Fifty-three runners (38.9% female) with a mean age of 31.3 ± 8.1 years participated in the study. Two measurements (before and after intense physical effort) were performed with the Max Pulse® device. The flotoplethysmography measurement lasted 3 min, and was performed in the supine position. The exercise test was performed on a treadmill. It was initiated at a speed of 6 and 7 km/h for women and men, respectively. Subjects indicated the end of the test by making a hand gesture when unable to continue the test. Results: Autonomic nervous system activity and mental stress values decreased significantly (p < 0.05) in men and women, while autonomic nervous system balance decreased only in women. Physical stress increased (p < 0.05) in both sexes. Conclusions: Intense exercise causes changes in variables that assess autonomic nervous system balance and stress, as measured by a device based on photoplethysmography. The changes are evident in both sexes, and are not related to body composition.
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Effect of Physical Training on the Morphology of Parasympathetic Atrial Ganglia after Unilateral Vagotomy in Rats. J Cardiovasc Dev Dis 2022; 9:jcdd9110391. [DOI: 10.3390/jcdd9110391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/30/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiac denervation is a serious problem in a number of patients, including patients after heart transplantation. The status of the parasympathetic ganglia after crossing the preganglionic fibers of the vagus nerve has not been enough studied. The aim of our study was to assess the effect of physical training on the morphological parameters of the parasympathetic atrial ganglia and autonomic regulation of heart rate after right- and left-sided vagotomy in rats. Morphometric characteristics of the right atrial ganglia were evaluated using an immunohistochemical method after a study that included a three-time assessment of heart rate variability. It was found that right-sided vagotomy leads to both an increase in the volume of ganglion and autonomic dysfunction. No significant change in the number of nerve cells was found in animals with false and left-sided vagotomy while maintaining preganglionic innervation after the physical training, whereas exercises led to a decrease in the volume of nerve tissue of rats with right-sided denervation. It was also found that in animals with preserved vagal innervation, the volume of atrial ganglion tissue correlates with overall heart rate variability and a normalized parasympathetic component. Therefore, a positive effect from regular physical activity on parasympathetic regulation can be expected only if preganglionic vagal influence is preserved.
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Alfini AJ, Won J, Weiss LR, Nyhuis CC, Zipunnikov V, Spira AP, Liu-Ambrose T, Shackman AJ, Smith JC. Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition. Brain Sci 2022; 12:1360. [PMID: 36291294 PMCID: PMC9599432 DOI: 10.3390/brainsci12101360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to understand the associations of sleep and cardiorespiratory fitness with hippocampal volume and global cognition among older adults (n = 30, age = 65.8 years, female = 73.3%). Wrist actigraphy provided objective measures of nighttime sleep including sleep duration, average wake bout length (WBL; sleep disturbance), and wake-to-sleep transition probability (WTSP; sleep consolidation). Cardiorespiratory fitness was quantified via cycle exercise using a modified heart rate recovery approach. Magnetic resonance imaging was used to determine hippocampal volume and the Mini-Mental State Examination was used to assess global cognition. Fitness moderated associations of sleep with hippocampal volume and cognitive performance, whereby the association of WBL-an index of poor sleep-with hippocampal atrophy was stronger among less-fit individuals, and the association of sleep duration with cognitive performance was stronger among more-fit individuals. Across the fitness levels, a longer WBL was associated with lower cognitive performance, and a higher WTSP-an index of more consolidated sleep-was associated with greater hippocampal volume. Sleep and fitness were unrelated to the volume of an amygdala control region, suggesting a degree of neuroanatomical specificity. In conclusion, higher cardiorespiratory fitness may attenuate sleep disturbance-related hippocampal atrophy and magnify the cognitive benefits of good sleep. Prospective studies are needed to confirm these findings.
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Affiliation(s)
- Alfonso J. Alfini
- National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20817, USA
| | - Junyeon Won
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Lauren R. Weiss
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
| | - Casandra C. Nyhuis
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adam P. Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Alexander J. Shackman
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
| | - J. Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA
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11
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The effect of a home-based coaching program on heart rate variability in subacute stroke patients: a randomized controlled trial. Int J Rehabil Res 2022; 45:201-208. [PMID: 35502452 DOI: 10.1097/mrr.0000000000000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Autonomic imbalance in stroke is characterized by increased sympathetic activity and reduced vagal nerve activity. Physical activity could be a strategy to counteract autonomic control impairments after a stroke. The aim of the study was to evaluate the effect on heart rate variability of a 6-month coaching program in a home setting in subacute stroke patients. Eighty-four stroke patients participated in the study. They were randomly assigned to the experimental group or the control group. The intervention was a coaching program, consisting of physical activity, home visits and a weekly phone call. Patients were evaluated after hospital discharge (T0) and at the end of the 6-month period (T1). Heart rate variability measures were recorded in the supine and orthostatic positions. Time and frequency domain values were treated using Kubios. Distance on 6 minutes walking test (6MWT), Barthel and motricity index and modified functional ambulation categories were evaluated. No effects were found on time and frequency domain values in the supine and orthostatic positions in either group. Walking distance on 6MWT increased significantly between T0 and T1 in experimental group (377 ± 141-448 ± 140 m; P < 0.02) with no effects in control group (373.6 ± 150.6-394.6 ± 176.4 m). No other functional effects were found. A coaching program in a home setting had no effect on heart rate variability, probably due to time of recovery and exercise intensity. Future research is needed to understand the lack of changes in heart rate variability by physical activity in subacute stroke patients.
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Kim YN, Gray N, Jones A, Scher S, Kozlowska K. The Role of Physiotherapy in the Management of Functional Neurological Disorder in Children and Adolescents. Semin Pediatr Neurol 2022; 41:100947. [PMID: 35450664 DOI: 10.1016/j.spen.2021.100947] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022]
Abstract
Children and adolescents with functional neurological (conversion) disorder (FND) present with symptoms of impaired motor and sensory function. FND involves complex interactions between the brain, mind, body, and lived experience of the child. The gold standard for treatment is therefore a holistic, biopsychosocial approach with multimodal interventions delivered by a multidisciplinary team. In this narrative review we examine the role of physiotherapy in managing FND in children. We searched Embase, Medline, PsycINFO, and PubMed (back to 2000) for relevant physiotherapy articles and also manually searched their reference lists. Two review articles and ten observational studies were identified. Data were extracted concerning the type of study, therapies involved, outcome measures, and comorbid mental health outcomes. FND symptoms resolved in 85% to 95% of the patients, and about two-thirds returned to full-time school after completing the multidisciplinary intervention. Ongoing mental health concerns at follow-up were associated with poorer functional outcomes. Key themes included the following: use of psychological interventions embedded in the physiotherapy intervention; integration of play, music, and dance; role of physical exercise in modulating physiological, neural, and endocrine systems; need for FND-specific outcome measures; ethical issues pertaining to randomized trials; and need to develop alternate study methodologies for assessing combined treatments. Clinical vignettes were included to highlight a range of physiotherapy interventions. In conclusion, the emerging literature suggests that physiotherapy for children with FND is a useful intervention for improving motor dysfunction and for addressing other concurrent issues such as physical deconditioning, neuroprotection, chronic pain, disturbed sleep, anxiety and depression, and resilience building.
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Affiliation(s)
- Yu-Na Kim
- Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicola Gray
- Department of Physiotherapy, Sydney Children's Hospital Network, NSW, Australia
| | - Anna Jones
- Advance Rehab Centre, Artarmon, NSW, Australia
| | - Stephen Scher
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA; University of Sydney Medical School, NSW, Australia
| | - Kasia Kozlowska
- Department of Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia; University of Sydney Medical School, NSW, Australia; Westmead Institute for Medical Research, Westmead, NSW, Australia.
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13
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Soltani M, Baluchi MJ, Boullosa D, Daraei A, Doyle-Baker PK, Saeidi A, Knechtle B, Dehbaghi KM, Mollabashi SS, VanDusseldorp TA, Zouhal H. Effect of Intensity on Changes in Cardiac Autonomic Control of Heart Rate and Arterial Stiffness After Equated Continuous Running Training Programs. Front Physiol 2021; 12:758299. [PMID: 34955880 PMCID: PMC8696079 DOI: 10.3389/fphys.2021.758299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/26/2021] [Indexed: 01/13/2023] Open
Abstract
Background: It is well known that exercise training has positive effects on both cardiac autonomic function and arterial stiffness (AS). However, it is not clear that which exercise training variables, intensity or volume, or both, play a crucial role in this regard. This study investigates the chronic effects of high-volume moderate-intensity training (HVMIT) and low-volume high-intensity training (LVHIT) on heart rate variability (HRV) and AS in sedentary adult men. Materials and Methods: Notably, 45 males (age: 42 ± 5.7 years) were randomly assigned to a control (n = 15), HVMIT (n = 15), or LVHIT (n = 15). The HVMIT group ran three times per week on a treadmill at 50–60% of VO2max for 45–60 min, while the LVHIT trained at 70–85% of VO2max for 25–40 min. Both training protocols were equated by caloric expenditure. HRV, pulse wave velocity (PWV), hemodynamic variables, and body composition were measured before and after 12 weeks. Results: Both protocols (i.e., HVMIT and LVHIT) significantly increased the SD of normal sinus beat intervals (SDNN) and high-frequency (HF) bands (p < 0.05) after 12 weeks. Whereas the low-frequency (LF)-HF ratio decreased significantly in both training protocols (p < 0.05); however, these changes were significantly greater in the LVHIT protocol (p < 0.05). Furthermore, the root mean square of successive RR interval differences (RMSSD) significantly increased only in the LVHIT (p < 0.05). Moreover, a significant decrease in LF and PWV was only observed following the LVHIT protocol (p < 0.05). Some measures of HRV and PWV were significantly correlated (r = 0.275–0.559; p < 0.05). Conclusion: These results show that the LVHIT protocol was more efficient for improving HRV variables and PWV than the HVMIT protocol after 12 weeks of continuous running training. Interestingly, changes in some HRV parameters were related to changes in PWV. Further studies should elaborate on the link between central and peripheral cardiovascular adaptations after continuous and intermittent training regimens differing in intensity.
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Affiliation(s)
- Mohammad Soltani
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Masoud Jokar Baluchi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Daniel Boullosa
- Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.,Sport and Exercise Science, James Cook University, Townsville, QLD, Australia
| | - Ali Daraei
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | | | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, University of Kurdistan, Sanandaj, Iran
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University of Zūrich, Zurich, Switzerland
| | | | | | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, United States
| | - Hassane Zouhal
- Laboratoire Mouvement, Sport, Santé - EA 1274, University of Rennes, Rennes, France.,Institut International des Sciences du Sport (2I2S), Irodouer, France
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Font-Farré M, Farche ACS, de Medeiros Takahashi AC, Guerra-Balic M, Figueroa A, Oviedo GR. Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability. Front Physiol 2021; 12:702418. [PMID: 34721053 PMCID: PMC8554113 DOI: 10.3389/fphys.2021.702418] [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: 04/29/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.
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Affiliation(s)
- Manel Font-Farré
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | | | | | - Myriam Guerra-Balic
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Guillermo R Oviedo
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain.,School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain
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15
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Westphal WP, Rault C, Robert R, Ragot S, Neau JP, Fernagut PO, Drouot X. Sleep deprivation reduces vagal tone during an inspiratory endurance task in humans. Sleep 2021; 44:zsab105. [PMID: 33895822 DOI: 10.1093/sleep/zsab105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Sleep deprivation alters inspiratory endurance by reducing inspiratory motor output. Vagal tone is involved in exercise endurance. This study aimed to investigate the effect of sleep deprivation on vagal tone adaptation in healthy subjects performing an inspiratory effort. METHODS Vagal tone was assessed using Heart Rate Variability normalized units of frequency domain component HF (high frequency) before, at the start, and the end of an inspiratory loading trial performed until exhaustion by 16 volunteers after one night of sleep deprivation and one night of normal sleep, where sleep deprivation reduced the inspiratory endurance by half compared to the normal sleep condition (30 min vs 60 min). RESULTS At rest, heart rate was similar in sleep deprivation and normal sleep conditions. In normal sleep condition, heart rate increased during inspiratory loading task; this increase was greater in sleep deprivation condition. In normal sleep condition, vagal tone increased at the beginning of the trial. This vagal tone increase was absent in sleep deprivation condition. CONCLUSIONS Sleep deprivation abolished vagal tone response to inspiratory load, possibly contributing to a higher heart rate during the trial and to a reduced inspiratory endurance. CLINICAL TRIAL REGISTRATION NCT02725190.
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Affiliation(s)
- Willy-Paul Westphal
- Centre d'Investigation Clinique Inserm 1402, Team Acute Lung Injury and VEntilatory support, Centre Hospitalier Universitaire de Poitiers, France
- Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Team Neurodevelopment Neuroadaptation Neurodegeneration, Poitiers, France
| | - Christophe Rault
- Centre d'Investigation Clinique Inserm 1402, Team Acute Lung Injury and VEntilatory support, Centre Hospitalier Universitaire de Poitiers, France
| | - René Robert
- Centre d'Investigation Clinique Inserm 1402, Team Acute Lung Injury and VEntilatory support, Centre Hospitalier Universitaire de Poitiers, France
| | - Stéphanie Ragot
- Centre d'Investigation Clinique Inserm 1402, Team Acute Lung Injury and VEntilatory support, Centre Hospitalier Universitaire de Poitiers, France
| | - Jean-Philippe Neau
- Neurology Department, Centre Hospitalier Universitaire de Poitiers, France
| | - Pierre-Olivier Fernagut
- Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Team Neurodevelopment Neuroadaptation Neurodegeneration, Poitiers, France
| | - Xavier Drouot
- Centre d'Investigation Clinique Inserm 1402, Team Acute Lung Injury and VEntilatory support, Centre Hospitalier Universitaire de Poitiers, France
- Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Team Neurodevelopment Neuroadaptation Neurodegeneration, Poitiers, France
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16
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Koller A, Laughlin MH, Cenko E, de Wit C, Tóth K, Bugiardini R, Trifunovits D, Vavlukis M, Manfrini O, Lelbach A, Dornyei G, Padro T, Badimon L, Tousoulis D, Gielen S, Duncker DJ. Functional and structural adaptations of the coronary macro- and micro-vasculature to regular aerobic exercise by activation of physiological, cellular and molecular mechanisms: Esc Working Group on Coronary Pathophysiology & Microcirculation Position Paper. Cardiovasc Res 2021; 118:357-371. [PMID: 34358290 DOI: 10.1093/cvr/cvab246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/01/2021] [Accepted: 08/04/2021] [Indexed: 11/14/2022] Open
Abstract
Regular aerobic exercise (RAEX) elicits several positive adaptations in all organs and tissues of the body, culminating in improved health and well-being. Indeed, in over half a century, many studies have shown the benefit of RAEX on cardiovascular outcome in terms of morbidity and mortality. RAEX elicits a wide range of functional and structural adaptations in the heart and its coronary circulation, all of which are to maintain optimal myocardial oxygen and nutritional supply during increased demand. Although there is no evidence suggesting that oxidative metabolism is limited by coronary blood flow (CBF) rate in the normal heart even during maximal exercise, increased CBF and capillary exchange capacities have been reported. Adaptations of coronary macro- and microvessels include outward remodeling of epicardial coronary arteries, increased coronary arteriolar size and density, and increased capillary surface area. In addition, there are adjustments in the neural and endothelial regulation of coronary macrovascular tone. Similarly, there are several adaptations at the level of microcirculation, including enhanced smooth muscle dependent pressure-induced myogenic constriction and upregulated endothelium-dependent flow-/shear-stress-induced dilation, increasing the range of diameter change. Alterations in the signaling interaction between coronary vessels and cardiac metabolism have also been described. At the molecular and cellular level, ion channels are key players in the local coronary vascular adaptations to RAEX, with enhanced activation of influx of Ca2+ contributing to the increased myogenic tone (via voltage gated Ca2+ channels) as well as the enhanced endothelium-dependent dilation (via TRPV4 channels). Finally, RAEX elicits a number of beneficial effects on several hemorheological variables that may further improve CBF and myocardial oxygen delivery and nutrient exchange in the microcirculation by stabilizing and extending the range and further optimizing the regulation of myocardial blood flow during exercise. These adaptations also act to prevent and/or delay the development of coronary and cardiac diseases.
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Affiliation(s)
- Akos Koller
- Department of Translational Medicine, Semmelweis University, Budapest, Hungary; Research Center for Sports Physiology, University of Physical Education, Budapest, Hungary; Department of Physiology, New York Medical College, Valhalla, NY, 10595, USA
| | - M Harold Laughlin
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Edina Cenko
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Cor de Wit
- Institut für Physiologie, Universitat zu Lu ¨beck, Lu beck, Germany and15DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lu ¨beck, Lubeck, Germany
| | - Kálmán Tóth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Raffaele Bugiardini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Danijela Trifunovits
- Cardiology Department, Clinical Centre of Serbia and Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Marija Vavlukis
- University Clinic for Cardiology, Medical Faculty, Ss' Cyril andMethodius University, Skopje, Republic of Macedonia
| | - Olivia Manfrini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Adam Lelbach
- Departmental Group of Geriatrics, Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Dr. Rose Private Hospital, Budapest, Hungary
| | - Gabriella Dornyei
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Teresa Padro
- Cardiovascular Program-ICCC, Research Institute Hospital Santa Creu i Sant Pau; IIB-Sant Pau; CiberCV-Institute Carlos III; Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program-ICCC, Research Institute Hospital Santa Creu i Sant Pau; IIB-Sant Pau; CiberCV-Institute Carlos III; Barcelona, Spain
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Stephan Gielen
- Department of Cardiology, Angiology, and Intensive Care Medicine, Klinikum Lippe, Detmold, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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17
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Rogers B, Giles D, Draper N, Mourot L, Gronwald T. Detection of the Anaerobic Threshold in Endurance Sports: Validation of a New Method Using Correlation Properties of Heart Rate Variability. J Funct Morphol Kinesiol 2021; 6:jfmk6020038. [PMID: 33925974 PMCID: PMC8167649 DOI: 10.3390/jfmk6020038] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022] Open
Abstract
Past attempts to define an anaerobic threshold (AnT) have relied upon gas exchange kinetics, lactate testing and field-based evaluations. DFA a1, an index of heart rate (HR) variability (HRV) fractal correlation properties, has been shown to decrease with exercise intensity. The intent of this study is to investigate whether the AnT derived from gas exchange is associated with the transition from a correlated to uncorrelated random HRV pattern signified by a DFA a1 value of 0.5. HRV and gas exchange data were obtained from 15 participants during an incremental treadmill run. Comparison of the HR reached at the second ventilatory threshold (VT2) was made to the HR reached at a DFA a1 value of 0.5 (HRVT2). Based on Bland-Altman analysis and linear regression, there was strong agreement between VT2 and HRVT2 measured by HR (r = 0.78, p < 0.001). Mean VT2 was reached at a HR of 174 (±12) bpm compared to mean HRVT2 at a HR of 171 (±16) bpm. In summary, the HR associated with a DFA a1 value of 0.5 on an incremental treadmill ramp was closely related to that of the HR at the VT2 derived from gas exchange analysis. A distinct numerical value of DFA a1 representing an uncorrelated, random interbeat pattern appears to be associated with the VT2 and shows potential as a noninvasive marker for training intensity distribution and performance status.
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Affiliation(s)
- Bruce Rogers
- College of Medicine, University of Central Florida, 6850 Lake Nona Boulevard, Orlando, FL 32827-7408, USA
- Correspondence:
| | - David Giles
- Lattice Training Ltd., Chesterfield S41 9AT, UK;
| | - Nick Draper
- School of Health Sciences, College of Education, Health and Human Development, University of Canterbury, 8041 Christchurch, New Zealand;
| | - Laurent Mourot
- EA3920 Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, Exercise Performance Health Innovation (EPHI) Platform, University of Bourgogne Franche-Comté, 25000 Besançon, France;
- Division for Physical Education, National Research Tomsk Polytechnic University, Lenin Ave, 30, 634050 Tomsk Oblast, Russia
| | - Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany;
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18
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Ramírez-Vélez R, Tordecilla-Sanders A, Téllez-T LA, Camelo-Prieto D, Hernández-Quiñonez PA, Correa-Bautista JE, Garcia-Hermoso A, Ramírez-Campillo R, Izquierdo M. Effect of Moderate- Versus High-Intensity Interval Exercise Training on Heart Rate Variability Parameters in Inactive Latin-American Adults: A Randomized Clinical Trial. J Strength Cond Res 2021; 34:3403-3415. [PMID: 28198783 DOI: 10.1519/jsc.0000000000001833] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ramírez-Vélez, R, Tordecilla-Sanders, A, Téllez-T, LA, Camelo-Prieto, D, Hernández-Quiñonez, PA, Correa-Bautista, JE, Garcia-Hermoso, A, Ramírez-Campillo, R, and Izquierdo, M. Effect of moderate- versus high-intensity interval exercise training on heart rate variability parameters in inactive Latin-American adults: a randomized clinical trial. J Strength Cond Res 34(12): 3403-3415, 2020-We investigated the effect of moderate versus high-intensity interval exercise training on the heart rate variability (HRV) indices in physically inactive adults. Twenty inactive adults were randomly allocated to receive either moderate-intensity training (MCT group) or high-intensity interval training (HIT group). The MCT group performed aerobic training at an intensity of 55-75%, which consisted of walking on a treadmill at 60-80% of the maximum heart rate (HRmax) until the expenditure of 300 kcal. The HIT group ran on a treadmill for 4 minutes at 85-95% peak HRmax and had a recovery of 4 minutes at 65% peak HRmax until the expenditure of 300 kcal. Supine resting HRV indices (time domain: SDNN = SD of normal-to-normal intervals; rMSSD = root mean square successive difference of R-R intervals and frequency domain: HFLn = high-frequency spectral power; LF = low-frequency spectral power and HF/LF ratio) were measured at baseline and 12 weeks thereafter. The SDNN changes were 3.4 (8.9) milliseconds in the MCT group and 29.1 (7.6) milliseconds in the HIT group {difference between groups 32.6 (95% confidence interval, 24.9 to 40.4 [p = 0.01])}. The LF/HFLn ratio changes were 0.19 (0.03) milliseconds in the MCT group and 0.13 (0.01) milliseconds in the HIT group (p between groups = 0.016). No significant group differences were observed for the rMSSD, HF, and LF parameters. In inactive adults, this study showed that a 12-week HIT training program could increase short-term HRV, mostly in vagally mediated indices such as SDNN and HF/LFLn ratio power. Trial registration. ClinicalTrials.gov NCT02738385 https://clinicaltrials.gov/ct2/show/NCT01796275, registered on March 23, 2016.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, University of Rosario, Bogotá, District Capital, Colombia
| | - Alejandra Tordecilla-Sanders
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, University of Rosario, Bogotá, District Capital, Colombia
| | - Luis A Téllez-T
- GICAEDS Group, Faculty of Physical Culture, Sport and Recreation, Saint Thomas University, Bogotá, District Capital, Colombia
| | - Diana Camelo-Prieto
- GICAEDS Group, Faculty of Physical Culture, Sport and Recreation, Saint Thomas University, Bogotá, District Capital, Colombia
| | - Paula A Hernández-Quiñonez
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, University of Rosario, Bogotá, District Capital, Colombia
| | - Jorge E Correa-Bautista
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, University of Rosario, Bogotá, District Capital, Colombia
| | - Antonio Garcia-Hermoso
- School of Physical Activity, Sport and Health Sciences, University of Santiago, Chile, USACH, Santiago, Chile
| | | | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Center for Biomedical Research in Network (CIBER) of Fragility and Healthy Aging (CB16/10/00315), Pamplona, Navarre, Spain
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Abstract
PURPOSE OF REVIEW Cardiovascular autonomic dysfunction (AD) among cancer survivors is increasingly being recognized. However, the mechanisms and incidence are poorly understood. In this review, the clinical features, diagnostic modalities, proposed mechanisms, and currently available treatments of cardiovascular AD in cancer survivors are described. RECENT FINDINGS Much of our current understanding of cardiovascular AD is based on disease states such as diabetes, multisystem atrophy, and Parkinson's disease. Several non-invasive tests, measurements, and scoring systems have been developed as surrogates for autonomic function, with some even demonstrating associations with all-cause mortality. The mechanism of cardiovascular AD specifically in the cancer population, however, has not been directly studied. The etiology of cardiovascular AD in cancer survivors is likely multifactorial, and proposed mechanisms include direct nerve damage by chemoradiation, the pro-inflammatory state associated with malignancy, and paraneoplastic syndromes. It may also be that cardiovascular AD is an early marker of global cardiomyopathy rather than its own condition. Current pharmacologic options for cardiovascular AD are extrapolated from how it has been treated in other disease processes, and these agents have not been studied in the cancer population or compared head-to-head. Cardiovascular AD in cancer survivors can cause significant debilitation and may be associated with all-cause mortality. Current diagnostic modalities have several limitations, such as standardization and validity. However, given the nonspecific nature of cardiovascular AD, these tools provide an objective marker for diagnosis and tracking treatment response. While the mechanism of cardiovascular AD in cancer survivors has not been directly studied, it may be useful to evoke mechanisms of cardiovascular AD in other disease states such as diabetes, Parkinson's disease, and multisystem atrophy in addition to identifying unique conditions associated with malignancy like a pro-inflammatory state. Until further studies are performed, management of cardiovascular AD as seen in other disease states may serve as a guide for symptom management in cancer survivors.
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20
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Zhao L, Meng X, Zhang QY, Dong XQ, Zhou XL. A narrative review of prehypertension and the cardiovascular system: effects and potential pathogenic mechanisms. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:170. [PMID: 33569472 PMCID: PMC7867937 DOI: 10.21037/atm-20-5482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In 1939, Robinson and Brucer first proposed the concept of prehypertension (PHTN), which was defined as a systolic blood pressure of 120–139 mmHg and/or diastolic blood pressure of 80–89 mmHg. PHTN is a major global health risk that adversely affects human health, especially the cardiovascular system. People with PHTN have a higher risk of developing cardiovascular diseases, including stroke, coronary heart disease, myocardial infarction and total cardiovascular events. However, there are few systematic summaries of the relationship between PHTN and the cardiovascular system. Furthermore, because the definition of ‘normal BP’ and the advantages of more intensive BP control remain unclear, there is no consensus on optimal interventions. In an attempt to provide information for clinicians or professionals who are interested in reducing the risk associated with PHTN, we review the existing studies to provide references for them with the effects of PHTN on the cardiovascular system and the potential pathogenic mechanisms of PHTN, including inflammatory responses, insulin resistance, endothelial dysfunction, sympathovagal imbalance, activation of the renin-angiotensin system and others. PHTN is highly prevalent and has adverse effects on health. An effective public health strategy is important to prevent the progression of PHTN. We envisage that this information will increase the public attention of PHTN and help to provide more strategies to reduce the risk of cardiovascular events.
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Affiliation(s)
- Lin Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiong-Yu Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Qi Dong
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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21
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Vrinceanu T, Lagacé-Lavoie G, Kaushal N, Esmail A, Vu TTM, Berryman N, Nigam A, Bherer L. Mind the Rhythm: ECG QT Dispersion and Cognition in Healthy Older Adults. Front Psychol 2020; 11:566341. [PMID: 33117235 PMCID: PMC7561416 DOI: 10.3389/fpsyg.2020.566341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/14/2020] [Indexed: 12/19/2022] Open
Abstract
Background Autonomic function has been linked to cognitive abilities in aging. Even in non-clinical states, a certain variability in heart rhythm regulation can be measured with QT dispersion (QTcD), an ECG marker of ventricular repolarization which has been linked to autonomic function and cardiovascular health. QTcD has been shown to be higher in individuals with mild cognitive impairment, and the highest in individuals with Alzheimer’s disease. The goal of this study was to see if QTcD is associated with cognitive performance in healthy individuals. Methods Sixty-three healthy inactive older adults (> 60 years) completed an extensive cognitive assessment (including inhibition, divided attention, updating, working memory, and processing speed), a physical fitness assessment, and underwent a resting ECG. Results After controlling for age, sex, and education, QTcD significantly predicted global cognition (MoCA) scores (R2 = 0.17, F(4.58) = 3.00, p < 0.03, β = −0.36). Exploratory analysis on the MoCA subcomponents revealed a significant association between the visual/executive subcomponent and QTcD (R2 = 0.12, F(1.61) = 7.99, p < 0.01, β = −0.34). In individuals with high QTcD, QTcD values were linked to executive functions (R2 = 0.37), processing speed (R2 = 0.34), and dual-task performances (R2 = 0.47). No significant associations were found within the low QTcD group. Conclusion This study shows an association between ventricular repolarization (QTcD) and cognitive performance, in particular speed and executive functions, in healthy older adults. The results provide further support for linking autonomic heart regulation and age-related cognitive changes, and suggest that deviations on ECG, even within-normal range, could help detect early cognitive deficits.
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Affiliation(s)
- Tudor Vrinceanu
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada.,Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | | | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Alida Esmail
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - T T Minh Vu
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Centre de Recherché du CHUM, Montreal, QC, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montreal, QC, Canada
| | - Anil Nigam
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada
| | - Louis Bherer
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada.,Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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22
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Two early rehabilitation training models in male patients after coronary artery bypass surgery: application of continuous walking training as an alternative to interval cycle ergometer training. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 17:87-93. [PMID: 32728371 PMCID: PMC7379224 DOI: 10.5114/kitp.2020.97265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
Abstract
Introduction Walking training is a good alternative to the commonly used cycle ergometer training. It is still necessary to develop rehabilitation programs based on walking characterized by a high degree of safety and effectiveness. Aim Application of continuous walking training as an alternative to interval cycle ergometer training in men after coronary artery bypass graft (CABG) surgery, using the 6-minute walk test (6-MWT) to determine the initial training load. Material and methods Forty-four men aged 45 to 76 years, up to 3 months after CABG surgery, were randomly assigned to continuous training on a treadmill (study group) or interval training on a cycle ergometer (control group), performed 6 times per week (12-15 sessions). Participants underwent the treadmill exercise stress test (TEST) and 6-MWT at the begining and after completion of the rehabilitation program. Before and 3 minutes after the 6th and 12th training session blood lactate concentration was determined. Results Energy expenditure in TEST increased from 4.4 to 6.3 MET in the study group and from 5.0 to 6.5 MET in the control group. Distance walked in 6-MWT increased from 420 to 519 m and from 438 to 510 m, respectively. Resting heart rate (HR) and double product (DP) decreased only in the study group as well as systolic blood pressure (SBP), HR and DP at peak exercise load in baseline TEST. Mean energy expenditure during training sessions was 2.6 MET in the study group and 2.8 MET in the control group (NS). Exercise blood lactate concentration did not exceed 2.0 mmol/l in both groups. Conclusions Both rehabilitation programs were of similar effectiveness and their intensity did not exceed the anaerobic threshold.
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23
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A short set configuration attenuates the cardiac parasympathetic withdrawal after a whole-body resistance training session. Eur J Appl Physiol 2020; 120:1905-1919. [PMID: 32583361 DOI: 10.1007/s00421-020-04424-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE We aimed to analyse the acute effects of set configuration on cardiac parasympathetic modulation and blood pressure (BP) after a whole-body resistance training (RT) session. METHODS Thirty-two participants (23 men and 9 women) performed one control (CON) and two RT sessions differing in the set configuration but with the same intensity (15RM load), volume (200 repetitions) and total resting time (360 s between sets for each exercise and 3 min between exercises): a long set configuration (LSC: 4 sets of 10 repetitions with 2 resting minutes) and a short set configuration session (SSC, 8 sets of 5 repetitions with 51 resting seconds). Heart rate variability, baroreflex sensitivity, the low frequency of systolic blood pressure oscillations (LFSBP), BP and lactatemia were evaluated before and after the sessions and mechanical performance was evaluated during exercise. RESULTS LSC induced greater reductions on cardiac parasympathetic modulation versus SSC after the session and the CON (p < 0.001 to p = 0.024). However, no LFSBP and BP significant changes were observed. Furthermore, LSC caused a higher lactate production (p < 0.001) and velocity loss (p ≤ 0.001) in comparison with SSC. CONCLUSION These findings suggest that SSC attenuates the reduction of cardiac parasympathetic modulation after a whole-body RT, improving the mechanical performance and decreasing the glycolytic involvement, without alterations regarding vascular tone and BP.
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24
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Gronwald T, Hoos O, Hottenrott K. Influence Of Performance Level Of Male Runners On Non-linear Dynamics Of Heart Rate Variability During a 10Km Race. INT J PERF ANAL SPOR 2020. [DOI: 10.1080/24748668.2020.1764746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, MSH Medical School Hamburg, University of Applied Sciences and Medical University , Hamburg, Germany
| | - Olaf Hoos
- Center for Sports and Physical Education, Julius Maximilians University of Wuerzburg , Wuerzburg, Germany
| | - Kuno Hottenrott
- Institute of Sports Science, Martin Luther University of Halle-Wittenberg , Halle, Germany
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25
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Park HY, Jung WS, Kim J, Hwang H, Lim K. Twelve Weeks of Aerobic Exercise at the Lactate Threshold Improves Autonomic Nervous System Function, Body Composition, and Aerobic Performance in Women with Obesity. J Obes Metab Syndr 2020; 29:67-75. [PMID: 32045515 PMCID: PMC7118007 DOI: 10.7570/jomes19063] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 12/19/2022] Open
Abstract
Background The present study examined the effects of a prolonged exercise intervention at the lactate threshold (LT) on body composition, aerobic performance, and the autonomic nervous system (ANS) in women with obesity. Methods A total of 36 obese Korean women aged 36 to 55 years (mean±standard deviation, 44.8±5.2 years) were randomly assigned to a control group (CON, n=18) or an experimental group (EXP, n=18); and EXP underwent aerobic exercise training three times a week at a heart rate corresponding to the LT (HR_LT) for 12 weeks. All dependent variables (body composition, aerobic performance, and ANS function parameters) were evaluated before and after training. Results Compared with the CON group, the EXP group showed significant improvement in body composition (body weight, -4.57 vs. -2.40 kg; body mass index, -1.79 vs. -0.96 kg/m2; %body fat, -4.63 vs. -1.41; fat-free mass, 3.24 vs. -0.08 kg), aerobic performance (oxygen consumption at LT, 5.74 vs. 0.12 mL/kg/min; maximal oxygen consumption, 5.41 vs. 2.14 mL/kg/min; treadmill speed at HR_LT, 1.40 vs. 0.29 km/hr; bicycle load at HR_LT, 18.62 vs. 4.52 w; and ANS function (mean RR, 50.83 vs. -15.04 ms; standard deviation of NN intervals, 5.08 vs. -0.55 ms; root mean square of successive differences, 6.42 vs. 1.87 ms; total power, 0.34 vs. 0.10 ms2; high frequency, 0.32 vs. -0.04 ms2; low frequency/high frequency, -0.09 vs. 0.01). Conclusion Aerobic exercise at the LT for 12 weeks is a practical method of improving body composition, aerobic performance, and ANS function for women with obesity.
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Affiliation(s)
- Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Korea.,Physical Activity and Performance Institute, Konkuk University, Seoul, Korea
| | - Won-Sang Jung
- Physical Activity and Performance Institute, Konkuk University, Seoul, Korea
| | - Jisu Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Korea.,Physical Activity and Performance Institute, Konkuk University, Seoul, Korea
| | - Hyejung Hwang
- Physical Activity and Performance Institute, Konkuk University, Seoul, Korea
| | - Kiwon Lim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Korea.,Physical Activity and Performance Institute, Konkuk University, Seoul, Korea.,Department of Physical Education, Konkuk University, Seoul, Korea
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26
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A 12-month lifestyle intervention does not improve cardiac autonomic function in patients with chronic kidney disease. Auton Neurosci 2020; 224:102642. [DOI: 10.1016/j.autneu.2020.102642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/29/2019] [Accepted: 01/24/2020] [Indexed: 12/29/2022]
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27
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Osibogun O, Ogunmoroti O, Spatz ES, Fashanu OE, Michos ED. Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis. Prev Med 2020; 130:105890. [PMID: 31715219 PMCID: PMC6930349 DOI: 10.1016/j.ypmed.2019.105890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/16/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
Elevated resting heart rate (RHR) is associated with an increased cardiovascular disease (CVD) risk, but little is known about its association with cardiovascular health (CVH), assessed by the Life's Simple 7 (LS7) metrics. We explored whether ideal CVH was associated with RHR in a cohort free from clinical CVD. We conducted a cross-sectional analysis of baseline data (2000-2002) of 6457 Multi-Ethnic Study of Atherosclerosis participants in 2018. Each LS7 metric (smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose) was scored 0-2. Total score ranged from 0 to 14. Scores of 0-8 indicate inadequate, 9-10 average, and 11-14 optimal CVH. RHR was categorized as <60, 60-69, 70-79 and ≥80 bpm. We used multinomial logistic regression to determine associations between CVH score and RHR, adjusting for age, sex, race/ethnicity, education, income, health insurance, and atrioventricular nodal blockers. Mean age of participants (standard deviation) was 62 (10) years; 53% were women; 47% had inadequate CVH, 33% average, and 20% optimal. Favorable CVH was associated with lower odds of having higher RHR. Compared to RHR <60 bpm, participants with optimal CVH had adjusted odds ratio (95% CI) of 0.55 (0.46-0.64) for RHR of 60-69 bpm, 0.34 (0.28-0.43) for 70-79 bpm, and 0.14 (0.09-0.22) for ≥80 bpm. A similar pattern was observed in the stratified analysis by sex, race/ethnicity and age. Favorable CVH was less likely to be associated with elevated RHR irrespective of sex, race/ethnicity and age. More research is needed to explore the usefulness of promoting ideal CVH to reduce elevated RHR, a known risk factor for CVD.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America.
| | - Oluseye Ogunmoroti
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
| | - Erica S Spatz
- Division of Cardiovascular Medicine, Yale University, New Haven, CT, United States of America.
| | - Oluwaseun E Fashanu
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Saint Agnes Healthcare, Baltimore, MD, United States of America.
| | - Erin D Michos
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
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28
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Fikenzer S, Fikenzer K, Laufs U, Falz R, Schulze A, Busse M. Effects of cardioselective beta-blockade on plasma catecholamines and performance during different forms of exercise. J Sports Med Phys Fitness 2019; 60:643-649. [PMID: 31818057 DOI: 10.23736/s0022-4707.19.10225-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Beta-blockers are still frequently used in cardiovascular diseases but may negatively influence the exercise capacity. The aim of the study was to analyze the effect of beta-blockade on physical performance and plasma level of catecholamine during different forms of exercise. METHODS Ten prehypertensive athletes (age: 25.1±2.5 years, BMI: 24.4±2.4 kg/m2) performed repeated incremental exercise and steady-state-tests without and with the cardioselective beta-blocker bisoprolol (5mg/day). The cardiopulmonary, metabolic and the catecholamine responses were monitored. RESULTS Beta-blocker treatment had no effect on maximum power output (Pmax), lactate and the maximal oxygen uptake (VO2max) (Pmax: 269.0±41.5 vs. 269.0±41.5 W; lactate: 8.7±2.6 vs. 8.6±3.2 mmol/L and VO2max: 3110±482 vs. 3077±425 mL/min, respectively; P not significant). Epinephrine and norepinephrine showed a similar exponential increase to maximum load with and without beta-blockade (epinephrinemax 1.92±1.8 vs. 1.93±1.3 nmol/L; P not significant; norepinephrinemax 12.78±7.9 vs. 16.89±12.2 nmol/L; P not significant). Beta-blockade lowered heart rate (HR) and systolic blood pressure (SBP) at rest and under maximum load (ΔHRrest: 10.6±11.1 bpm, P<0.05, ΔHR-Max: 27.8±6.6 bpm, P<0.01; ΔSBPrest: 19.4±9.3 mmHg, P<0.05, ΔSBPmax: 17.7±15.3 mmHg, P<0.01). The maximum oxygen pulse was higher in the tests performed under beta-blockade (IET: ΔVO2/HR: 3.1±2.2 mL/beat, P<0.01; SST: ΔVO2/HR: 3.4±1.4 mL/beat, P<0.001). CONCLUSIONS Despite beta blockade and resulting differences in cardiopulmonary regulation during the exercise tests, the maximal oxygen capacity and the catecholamine concentration was similar. Higher exercise intensities (>50% Pmax) are associated with a marked increase in plasma catecholamines, which are not influenced by treatment with bisoprolol 5 mg/day.
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Affiliation(s)
- Sven Fikenzer
- Cardiology Clinic and Polyclinic Hospital, Leipzig University Hospital, Leipzig, Germany -
| | - Kati Fikenzer
- Cardiology Clinic and Polyclinic Hospital, Leipzig University Hospital, Leipzig, Germany
| | - Ulrich Laufs
- Cardiology Clinic and Polyclinic Hospital, Leipzig University Hospital, Leipzig, Germany
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University of Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Leipzig, Germany
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29
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Brenner IKM, Brown CA, Hains SJM, Tranmer J, Zelt DT, Brown PM. Low-Intensity Exercise Training Increases Heart Rate Variability in Patients With Peripheral Artery Disease. Biol Res Nurs 2019; 22:24-33. [PMID: 31684758 DOI: 10.1177/1099800419884642] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with peripheral artery disease (PAD), consistent with others with atherosclerotic occlusive disorders, have autonomic dysfunction (as measured by low heart rate variability [HRV]) that predisposes them to sympathetically mediated cardiac arrhythmias and sudden death. Exercise therapy has been shown to increase HRV in patients with coronary artery disease by increasing parasympathetic modulation of heart rate. This study quantified the circulatory and autonomic effects of a progressive, 12-week home-based, low-intensity (pain-free walking) exercise program in PAD and intermittent claudication. Participants (N = 33, mean age 67.8 8.1 years) were randomly assigned to either a walking group (n = 18), whose members performed a structured, 12-week, progressive walking program 5 days/week for 12 weeks, or a comparison group (n = 15), whose members performed usual activities. Circulatory measures (heart rate, blood pressure, and rate pressure product) and autonomic measures (HRV) were obtained at the beginning (Week 1) and end (Week 12) of the study. Minimal change in circulatory measures occurred. However, spectral analysis of HRV revealed that autonomic function improved significantly in members of the walking group; specifically, there was an increase in parasympathetic and a decrease in sympathetic modulation. Members of the walking group also significantly increased maximal walking distance. These findings suggest that a structured, low-intensity, high-frequency walking program improves autonomic function by increasing HRV in patients with PAD.
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Affiliation(s)
| | | | - Sylvia J M Hains
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Joan Tranmer
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - David T Zelt
- Division of Vascular Surgery, Queens University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Peter M Brown
- Division of Vascular Surgery, Queens University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
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30
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Subramanian SK, Sharma VK, Arunachalam V, Rajendran R, Gaur A. Comparison of Baroreflex Sensitivity and Cardiac Autonomic Function Between Adolescent Athlete and Non-athlete Boys - A Cross-Sectional Study. Front Physiol 2019; 10:1043. [PMID: 31507430 PMCID: PMC6713997 DOI: 10.3389/fphys.2019.01043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/30/2019] [Indexed: 01/24/2023] Open
Abstract
Introduction: It is well known that regular physical activity improves cardiovascular health, and higher baroreflex sensitivity and heart rate variability are associated with cardiovascular health. Adolescence is the age when an individual's behavior is easily modified; early intervention at this stage in terms of physical conditioning or training prevents future cardiovascular risk. Hence, we conceived the present study to assess and compare the baroreflex sensitivity and autonomic function between adolescent athletes and non-athletes. Methods: We recruited school going athletes (n = 30) and non-athlete boys (n = 30) in the 10-19 age group after obtaining their assent and consent from their parents. We assessed height, weight, heart rate, blood pressure, baroreflex sensitivity, and cardiac autonomic function. Comparison between groups was made using the unpaired t-test for height, weight, body mass index, heart rate, blood pressure, and baroreflex sensitivity and using Mann-Whitney U test for cardiac autonomic function parameters. Results: There was a trend for higher baroreflex sensitivity in athletes. Heart rate variability (total power and SDNN) was higher in athletes. The parasympathetic tone was higher in terms of higher RMSSD, and higher HF power. Parasympathetic reactivity was higher in athletes in terms of higher 30:15 ratio and EI ratio. Conclusion: Athletic level physical conditioning has a positive influence on baroreflex function and autonomic function that may prove beneficial to the adolescents' cardiovascular health.
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Affiliation(s)
- Senthil Kumar Subramanian
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Vijayawada, India
| | - Vivek Kumar Sharma
- Department of Physiology, Government Institute of Medical Sciences, Greater Noida, India
| | | | - Rajathi Rajendran
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Archana Gaur
- Department of Physiology, Chengalpattu Medical College, Chengalpattu, India
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31
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Yang GL, Guo J, Pudasaini B, Yuan P, Gong SG, Wang L, Zhao QH, Yang WL, Jiang R, Zhou C, Liu JM. Value of heart rate recovery in female patients with pulmonary arterial hypertension due to systemic lupus erythematosus. CLINICAL RESPIRATORY JOURNAL 2019; 13:545-554. [PMID: 31295761 DOI: 10.1111/crj.13056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/19/2019] [Accepted: 07/01/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study intended to explore the relation between heart rate recovery at 1 minutes (HRR1) during the recovery phase of cardiopulmonary exercise test (CPET) and exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension (SLE-PAH) patients. METHODS Twenty-one female SLE-PAH patients underwent right heart catheterization (RHC), pulmonary function test (PFT) and CPET. Forty-two healthy subjects matched with SLE-PAH patients in age, sex and BMI were recruited as a control group. The correlations between HRR1 with clinical and CPET parameters were performed. RESULTS Peak HR, ΔHR, HRR1, Peak HR-warm HR1min , Peak HR-warm HR2min and CR were significantly lower in SLE-PAH than in controls (P < .01). Increased incidence of CRI was seen in SLE-PAH. Except for the Peak PET O2 , which was higher in controls, all other CPET parameters were lower in SLE-PAH. SLE-PAH patients with HRR1 ≥ 16 had longer 6MWD, lower NT-proBNP, better percent of predicted gas transfer index or diffusing capacity for carbon monoxide (DLco% pred) as well as better CO and CI. Peak HR, ΔHR, HRR1, Peak HR-warm HR1min , Peak HR-warm HR2min , CR, Peak Load, Peak VO2 , Peak PET CO2 , OUEP and OUES were lower and duration of exercise was shorter in patients with HRR1 < 16. HRR1 had positive correlation with 6MWD, DLco% pred, CO, CI and some key CPET parameters. CONCLUSIONS HRR1 is an easily obtained auxiliary parameter in SLE-PAH patients to reflect an altered autonomic tone. SLE-PAH patients with HRR1 < 16 have more severe hemodynamics, worse clinical findings and marked oxygen uptake inefficiency than those with HRR1 ≥ 16.
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Affiliation(s)
- Guo-Ling Yang
- Medical College, Soochow University, Suzhou, China.,Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Guo
- Medical College, Soochow University, Suzhou, China.,Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bigyan Pudasaini
- Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ping Yuan
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Su-Gang Gong
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lan Wang
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qin-Hua Zhao
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wen-Lan Yang
- Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Rong Jiang
- Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin-Ming Liu
- Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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32
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Groarke JD, Mahmood SS, Payne D, Ganatra S, Hainer J, Neilan TG, Partridge AH, Di Carli MF, Jones LW, Mehra MR, Nohria A. Case-control study of heart rate abnormalities across the breast cancer survivorship continuum. Cancer Med 2018; 8:447-454. [PMID: 30578624 PMCID: PMC6346251 DOI: 10.1002/cam4.1916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/07/2022] Open
Abstract
Background Mechanisms underlying impaired exercise capacity and increased cardiovascular mortality observed in breast cancer (BC) patients remain unclear. The prevalence, functional, and prognostic significance of elevated resting heart rate (HR) and abnormal heart rate recovery (HRR) in breast cancer (BC) requires evaluation. Methods In a single‐center, retrospective, case‐control study of women referred for exercise treadmill testing (ETT), 448 BC patients (62.6 ± 10.0 years) were compared to 448 cancer‐free, age‐matched controls. Elevated resting HR was defined as HR ≥80 bpm at rest. Abnormal HRR at 1‐minute following exercise was defined as ≤12 bpm if active recovery or ≤18 bpm if passive recovery. Association of these parameters with exercise capacity and all‐cause mortality was evaluated. Results Elevated resting HR (23.7% vs 17.0%, P = 0.013) and abnormal HRR (25.9% vs 20.3%, P = 0.048) were more prevalent in BC cohort than controls. In adjusted analyses, BC patients with elevated resting HR (−0.9 METs (SE 0.3); P = 0.0003) or abnormal HRR (−1.3 METs (SE 0.3); P < 0.0001) had significant reductions in metabolic equivalents (METs) achieved during exercise. Elevated resting HR was not associated with mortality. There was a trend toward increased mortality in BC cohort with abnormal HRR (adjusted hazard ratio 2.06 (95% CI 0.95‐4.44, P = 0.07)). Conclusions Women across the BC survivorship continuum, referred for ETT, have an increased prevalence of elevated resting HR and abnormal HRR relative to cancer‐free, age‐matched female controls. These parameters were associated with decreased exercise capacity. Strategies to modulate these abnormalities may help improve functional capacity in this cohort.
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Affiliation(s)
- John D Groarke
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.,Adult Survivorship Program, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Syed S Mahmood
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts.,Cardio-Oncology Program, Massachusetts General Hospital, Boston, Massachusetts
| | - David Payne
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sarju Ganatra
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jon Hainer
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Tomas G Neilan
- Cardio-Oncology Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Ann H Partridge
- Adult Survivorship Program, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Marcelo F Di Carli
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lee W Jones
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Mandeep R Mehra
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Anju Nohria
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts.,Adult Survivorship Program, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
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Kirkham AA, Lloyd MG, Claydon VE, Gelmon KA, McKenzie DC, Campbell KL. A Longitudinal Study of the Association of Clinical Indices of Cardiovascular Autonomic Function with Breast Cancer Treatment and Exercise Training. Oncologist 2018; 24:273-284. [PMID: 30257888 DOI: 10.1634/theoncologist.2018-0049] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cardiovascular autonomic dysfunction is an early marker for cardiovascular disease. Anthracycline chemotherapy and left-sided radiation for breast cancer are associated with negative autonomic function changes. This study's objectives were to characterize changes in, and the association of exercise training with, clinical indices of cardiovascular autonomic function across the trajectory of breast cancer therapy. SUBJECTS, MATERIALS, AND METHODS Seventy-three patients receiving adjuvant chemotherapy participated to varying degrees in supervised aerobic and resistance exercise during chemotherapy ± radiation and for 20 weeks after. Resting heart rate (HRrest) and blood pressure were measured weekly during chemotherapy. HRrest, exercise heart rate recovery (HRrecovery), and aerobic fitness were measured at enrollment, end of chemotherapy ± radiation, and 10 and 20 weeks after treatment. RESULTS During chemotherapy, HRrest increased in a parabolic manner within a single treatment and with increasing treatment dose, whereas systolic and diastolic blood pressure decreased linearly across treatments. Tachycardia and hypotension were present in 32%-51% of participants. Factors associated with weekly changes during chemotherapy included receiving anthracyclines or trastuzumab, days since last treatment, hematocrit, and exercise attendance. Receipt of anthracyclines, trastuzumab, and left-sided radiation individually predicted impairments of HRrest and HRrecovery during chemotherapy ± radiation; however, aerobic fitness change and at least twice-weekly exercise attendance predicted improvement. By 10 weeks after treatment, HRrest and blood pressure were not different from prechemotherapy. CONCLUSION In this study, chemotherapy resulted in increased HRrest and tachycardia, as well as decreased blood pressure and hypotension. Anthracyclines, trastuzumab, and left-sided radiation were associated with HRrest elevations and impairments of HRrecovery, but exercise training at least twice a week appeared to mitigate these changes. IMPLICATIONS FOR PRACTICE This study characterized changes in clinically accessible measures with well-established prognostic value for cardiovascular disease, and investigated associations with cardiotoxic treatments and the positive influence of exercise. The chemotherapy-related incremental increase in resting heart rate, with tachycardia occurring in one third of patients, and decrease in blood pressure, with hypotension occurring in one half of the patients, is relevant to oncology practitioners for clinical examination or patient report of related symptoms (i.e., dizziness). The weekly dose of two 60-minute sessions of moderate-intensity aerobic and resistance exercise that was identified as protective of cardiovascular autonomic impairments can easily be prescribed to patients by oncologists.
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Affiliation(s)
- Amy A Kirkham
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Matthew G Lloyd
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
| | - Victoria E Claydon
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
| | - Karen A Gelmon
- Departments of Medicine, University of British Columbia, Vancouver, Canada
| | - Donald C McKenzie
- Departments of Medicine, University of British Columbia, Vancouver, Canada
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Arvidson E, Dahlman AS, Börjesson M, Gullstrand L, Jonsdottir IH. Exercise training and physiological responses to acute stress: study protocol and methodological considerations of a randomised controlled trial. BMJ Open Sport Exerc Med 2018; 4:e000393. [PMID: 30167319 PMCID: PMC6109819 DOI: 10.1136/bmjsem-2018-000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2018] [Indexed: 01/31/2023] Open
Abstract
Background This paper describes the protocol and methodological prerequisites for a randomised controlled exercise intervention. Selected baseline data from the study are also presented, demonstrating some methodological challenges related to exercise intervention trials. The aim of the trial was to study the effects of exercise training on physiological responses to acute psychosocial stress in untrained individuals. Methods Individuals with a low level of physical activity were invited to participate in an exercise intervention lasting for 6 months. A total of 119 participants were included and went through a peak oxygen uptake test and a psychosocial stress test at baseline. Adrenocorticotropic hormone (ACTH) and cortisol were measured in connection to the stress test to identify the physiological response. Results Almost 90% of the participants reported themselves as untrained, but results from the objectively measured oxygen uptake did not seem to correspond to the reported sedentary lifestyle. The primary outcome measures at baseline varied between individuals. The mean change from pre-test to peak value was 214% for ACTH and 94% for cortisol. Of these, 13 individuals did not respond in ACTH and/or and cortisol. Discussion Supposedly untrained individuals seeking participation in an exercise intervention might not be as untrained as they report, a methodological consideration of importance when evaluating the effects of training. Another important consideration is related to the primary outcome measure, which should be measurable and possible to affect. Absence of reaction at baseline means that changes can only be detected as an increased reaction.
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Affiliation(s)
- Elin Arvidson
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,The Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Anna Sjörs Dahlman
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Mats Börjesson
- The Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.,The Department of Neuroscience and Physiology, Sahlgrenska Academy and Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Lennart Gullstrand
- The Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,The Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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Amoakwa K, Fashanu OE, Tibuakuu M, Zhao D, Guallar E, Whelton SP, O'Neal WT, Post WS, Budoff MJ, Michos ED. Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 273:45-52. [PMID: 29677630 PMCID: PMC5949274 DOI: 10.1016/j.atherosclerosis.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/05/2018] [Accepted: 04/05/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. METHODS RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. RESULTS At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03-1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45-2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. CONCLUSIONS Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression.
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Affiliation(s)
| | - Oluwaseun E Fashanu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Martin Tibuakuu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, St. Luke's Hospital, Chesterfield, MO, USA
| | - Di Zhao
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eliseo Guallar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seamus P Whelton
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Wendy S Post
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Abstract
PURPOSE OF REVIEW Thoracic radiation therapy is an effective treatment for several malignancies, such as Hodgkin's lymphoma and breast cancer. Over the years, however, the incidence of cardiovascular events has increased in these patients, notably in younger survivors who do not have traditional risk factors. This review summarizes the pathology, incidence, clinical presentation, and management of cardiac events after radiation therapy. RECENT FINDINGS Mediastinal radiation therapy accelerates the atherosclerosis process, resulting in early onset coronary artery disease. Valvular disease due to radiation therapy typically affects the left-sided valves, with aortic regurgitation being the most common. Rarely, it may lead to aortic stenosis requiring surgical interventions. Pericardial involvement includes acute and chronic pericardial disease and pericardial effusion. New studies are investigating the prevalence and pathogenesis of autonomic dysfunction in cancer survivors who have undergone mediastinal and neck radiation. Radiation therapy itself causes vascular endothelial dysfunction, resulting in clinical cardiovascular events, manifesting many years after completion of therapy. There remains little guidance regarding screening and therapies to prevent cardiovascular events in this population.
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Affiliation(s)
- Deepa Raghunathan
- University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | | | - Saamir A Hassan
- University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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Hu MX, Lamers F, de Geus EJC, Penninx BWJH. Influences of lifestyle factors on cardiac autonomic nervous system activity over time. Prev Med 2017; 94:12-19. [PMID: 27836526 DOI: 10.1016/j.ypmed.2016.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/08/2016] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in lifestyle factors relate to 2-year changes in cardiac activity. Baseline (n=2618) and 2-year follow-up (n=2010) data of the Netherlands Study of Depression and Anxiety was combined. Baseline data was collected in the Netherlands from 2004-2007. Lifestyle factors were habitual physical activity, frequency of sport activities, alcohol use, and smoking. Indicators of cardiac activity were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) (100min of registration). The results showed that high physical activity (-1.8beats/min compared to low activity), high frequency of sport activities ('couple of times/week': -2.5beats/min compared to 'almost never') and mild/moderate alcohol use (-1.2beats/min compared to non-drinking) were related to low HR. Heavy smoking was related to high HR (>30cigarettes/day: +5.1beats/min compared to non-smoking). High frequency of sport activities was associated with high RSA ('couple of times/week':+1.7ms compared to 'almost never') and moderate smoking with longer PEP (11-20cigarettes/day: +2.8ms compared to non-smoking). Associations were consistent across waves. Furthermore, 2-year change in frequency of sport activities and number of smoked cigarettes/day was accompanied by 2-year change in HR (β=-0.076 and β=0.101, respectively) and RSA (β=0.046 and β=-0.040, respectively). Our findings support consistent effects of lifestyle on HR and parasympathetic activity in the expected direction. Cardiac autonomic dysregulation may be partly mediating the relationship between lifestyle and subsequent cardiovascular health.
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Affiliation(s)
- Mandy Xian Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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38
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Kang SJ, Ko KJ, Baek UH. Effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in type 2 diabetes mellitus patients. J Phys Ther Sci 2016; 28:2088-93. [PMID: 27512271 PMCID: PMC4968512 DOI: 10.1589/jpts.28.2088] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/07/2016] [Indexed: 01/05/2023] Open
Abstract
[Purpose] This study evaluated the effects of 12 weeks combined aerobic and resistance
exercise on heart rate variability in patients with Type 2 diabetes mellitus. [Subjects
and Methods] The subjects were 16 female patients with Type 2 diabetes mellitus selected
among the participants of a chronic disease management exercise class at C Region Public
Health Center in South Korea. Subjects were randomly assigned to the exercise group (n=8;
age, 55.97 ± 7.37) or the control group (n=8; age, 57.53 ± 4.63) The exercise group
performed aerobic and resistance exercises for 60 minutes per day, 3 times per week for 12
weeks. Anthropometric measurements, biochemical markers, physical fitness, and heart rate
variability were examined. [Results] After 12 weeks of exercise, weight, body fat
percentage, waist circumference, blood glucose, insulin resistance, glycated hemoglobin
level, systolic blood pressure, and diastolic blood pressure significantly decreased and
cardiorespiratory fitness and muscular strength significantly increased in the exercise
group. Although heart rate variability measures showed favorable changes with the exercise
program, none were significant. [Conclusion] Although the exercise program did not show
notable changes in heart rate variability in patients with Type 2 diabetes within the
timeframe of the study, exercise may contribute to the prevention and control of
cardiovascular autonomic neuropathy.
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Affiliation(s)
- Seol-Jung Kang
- Department of Physical Education, Changwon National University, Republic of Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Fitness Center, Republic of Korea
| | - Un-Hyo Baek
- Department of Sports Science, College of Natural Science, Kyungnam University, Republic of Korea
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Kao LC, Liu YW, Tzeng NS, Kuo TBJ, Huang SY, Chang CC, Chang HA. Linking an Anxiety-Related Personality Trait to Cardiac Autonomic Regulation in Well-Defined Healthy Adults: Harm Avoidance and Resting Heart Rate Variability. Psychiatry Investig 2016; 13:397-405. [PMID: 27482240 PMCID: PMC4965649 DOI: 10.4306/pi.2016.13.4.397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 09/19/2015] [Accepted: 10/24/2015] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Anxiety trait, anxiety and depression states have all been reported to increase risks for cardiovascular disease (CVD), possibly through altering cardiac autonomic regulation. Our aim was to investigate whether the relationship between harm avoidance (HA, an anxiety-related personality trait) and cardiac autonomic regulation is independent of anxiety and depression states in healthy adults. METHODS We recruited 535 physically and mentally healthy volunteers. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Tri-dimensional Personality Questionnaire. Participants were divided into high or low HA groups as discriminated by the quartile value. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV). We obtained the time and frequency-domain indices of HRV including variance (total HRV), the low-frequency power (LF; 0.05-0.15 Hz), which may reflect baroreflex function, the high-frequency power (HF; 0.15-0.40 Hz), which reflects cardiac parasympathetic activity, as well as the LF/HF ratio. RESULTS The BDI and HA scores showed associations with HRV parameters. After adjustment for the BDI scores and other control variables, HA is still associated with reduced variance, LF and HF power. Compared with the participants with low HA, those with high HA displayed significant reductions in variance, LF and HF power and a significant increase in their LF/HF ratio. CONCLUSION This study highlights the independent role of HA in contributing to decreased autonomic cardiac regulation in healthy adults and provides a potential underlying mechanism for anxiety trait to confer increased risk for CVD.
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Affiliation(s)
- Lien-Cheng Kao
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Wen Liu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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40
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Ding L, Quan XQ, Zhang S, Ruan L, Zhang L, Zheng K, Yu WW, Wu XF, Mi T, Zhang CT, Zhou HL. Correlation between impedance cardiography and 6 min walk distance in atrial fibrillation patients. BMC Cardiovasc Disord 2016; 16:133. [PMID: 27283289 PMCID: PMC4901461 DOI: 10.1186/s12872-016-0297-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 05/21/2016] [Indexed: 11/17/2022] Open
Abstract
Background The correlation between impedance cardiography (ICG) and 6 min walk distance (6MWD) in atrial fibrillation (AF) patients remains unknown. Methods We recruited 49 subjects in the study (21 AF patients and 28 patients without AF) and estimated hemodynamic parameters: cardiac output (CO), stroke volume (SV), stroke volume index (SVI), left stroke work (LSW), left stroke work index (LSWI), stroke systemic vascular resistance (SSVR), stroke systemic vascular resistance index (SSVRI); 6MWD, left ventricle ejection fraction (LVEF), NT-pro brain natriuretic peptide (NT-pro BNP) for the two groups. Results The AF group have apparently lower CO (2.26 ± 0.14 VS 4.11 ± 0.20 L/min, p = 0.039) and distinctly higher SVR (677.60 ± 69.10 VS 344.41 ± 22.98 dynes/cm5, p = 0.001), SSVRI (396.97 ± 36.80 VS 199.01 ± 11.72 dynes/cm5/m2, p < 0.001) than the control group. NT-pro BNP (1409.48 ± 239.90 VS 332.59 ± 68.85 pg/ml, p = 0.001) in the AF group was significantly higher than the control group and 6MWD (264.33 ± 14.55 VS 428.79 ± 29.98 m, p < 0.001) in the AF group was lower than the control group. There was no significant difference in LVEF between the two groups (62.67 ± 7.62 % VS 63.93 ± 5.03 %, p = 0.470). Pearson correlation analysis revealed that CO (R = 0.494, p = 0.023), SV (R = 0.633, p = 0.002), LSW (R = 0.615, p = 0.003) and LSWI (R = 0.491, p = 0.024) significantly correlated positively with 6MWD in AF patients. Conclusions AF patients had lower cardiac output, shorter 6MWD and higher NT-pro BNP than patients with sinus rhythm. The cardiac output measured by impedance cardiography significantly correlated positively with 6MWD in AF patients.
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Affiliation(s)
- Ling Ding
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Qing Quan
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shu Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lei Ruan
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Le Zhang
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kai Zheng
- Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Wei Yu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Fen Wu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tao Mi
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cun-Tai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hong-Lian Zhou
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Wei CY, Kung WM, Chou YS, Wang YC, Tai HC, Wei JCC. Cardiac Autonomic Function in Patients With Ankylosing Spondylitis: A Case-Control Study. Medicine (Baltimore) 2016; 95:e3749. [PMID: 27227940 PMCID: PMC4902364 DOI: 10.1097/md.0000000000003749] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease involing spine and enthesis. The primary aim of this study is to investigate the autonomic nervous system (ANS) function and the association between ANS and the functional status or disease activity in AS.The study included 42 AS patients, all fulfilling the modified New York criteria. All the patients are totally symptom free for ANS involvement and had normal neurological findings. These AS patients and 230 healthy volunteers receive analysis of 5 minutes heart rate variability (HRV) in lying posture. In addition, disease activity and functional status of these AS patients are assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G).Both groups were age and sex-matched. Although the HRV analysis indicates that the peaks of total power (TP, 0-0.5 Hz) and high-frequency power (HF, 0.15-0.40 Hz) are similar in both groups, the activities of low-frequency power (LF, 0.04-0.15 Hz), LF in normalized units (LF%), and the ratio of LF to HF (LF/HF) in AS patients are obviously lower than healthy controls. The erythrocyte sedimentation rate and C-reactive protein revealed negative relationship with HF. The AS patients without peripheral joint disease have higher LF, TP, variance, LF%, and HF than the patients with peripheral joint disease. The AS patients without uvetis have higher HF than the patients with uvetis. The total scores of BASDI, BASFI, and BAS-G do not show any association to HRV parameters.AS patients have significantly abnormal cardiac autonomic regulation. This is closely related with some inflammatory activities. Reduced autonomic function may be one of the factors of high cardiovascular risk in AS patients.
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Affiliation(s)
- Cheng-Yu Wei
- From the Department of Neurology (C-YW), Show Chwan Memorial Hospital; Department of Neurology (C-YW), Chang Bing Show Chwan Memorial Hospital, Changhua; Department of Exercise and Health Promotion (C-YW, W-MK, H-CT), College of Education, Chinese Culture University, Taipei; Department of Neurosurgery (W-MK); Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Luodong, Yilan; Division of Hematology and Oncology (Y-SC), Department of Medicine, Taipei City Hospital, Renai Branch, Taipei; Institute of Clinical Medicine (Y-SC), School of Medicine, National Yang-Ming University, Taipei; Department of Emergency (Y-CW), Min-Sheng General Hospital, Taoyuan; Graduate Institute of Biomedical Informatics (Y-CW), College of Medical Science and Technology, Taipei Medical University, Taipei; Division of Allergy, Immunology, and Rheumatology (JC-CW), Chung Shan Medical University Hospital; Institute of Medicine (JC-CW), Chung Shan Medical University; and Institute of Integrative Medicine (JC-CW), China Medical University, Taichung, Taiwan
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Aladin AI, Al Rifai M, Rasool SH, Keteyian SJ, Brawner CA, Michos ED, Blaha MJ, Al-Mallah MH, McEvoy JW. The Association of Resting Heart Rate and Incident Hypertension: The Henry Ford Hospital Exercise Testing (FIT) Project. Am J Hypertens 2016; 29:251-7. [PMID: 26112864 DOI: 10.1093/ajh/hpv095] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Given that sympathetic tone is associated with hypertension, we sought to determine whether resting heart rate (RHR), as a surrogate for cardiac autonomic function, was associated with incident hypertension. METHODS We analyzed 21,873 individuals without a history of hypertension who underwent a clinically indicated exercise stress test. Baseline RHR was assessed prior to testing and was categorized as <70, 70-85, and >85 beats-per-minute (bpm). Incident hypertension was defined by subsequent diagnosis codes for new-onset hypertension from three or more encounters. We tested for effect modification by age (<60 vs. ≥60 years), sex, race, and history of coronary heart disease (CHD). RESULTS Mean (±SD) age was 49 (±12) years, 55% were men and 21% were Black. Compared to the lowest RHR (<70 bpm) category, patients in the highest category (>85 bpm) were younger, more likely to be female, heavier, diabetic, and achieve lower metabolic equivalents (METS). Over a median of 4 years follow-up, there were 8,179 cases of incident hypertension. Compared to RHR <70 bpm, persons with RHR >85 bpm had increased risk of hypertension after adjustment for CHD risk factors, baseline blood pressure (BP), and METS (hazard ratio = 1.15 (95% confidence interval 1.08-1.23)). Age was an effect modifier (interaction P = 0.02), whereas sex, race, and CHD were not. In age-stratified analyses the relationship remained significant only in those younger than 60 years. CONCLUSION Elevated RHR is an independent risk factor for incident hypertension, particularly in younger persons. Whether lifestyle modification or other strategies to reduce RHR can prevent incident hypertension in high-risk individuals warrants further study.
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Affiliation(s)
- Amer I Aladin
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mahmoud Al Rifai
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Shereen H Rasool
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Steven J Keteyian
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Clinton A Brawner
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mouaz H Al-Mallah
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA; Division of Cardiology and Imaging, King Abdul-Aziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - John W McEvoy
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA;
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Yeh TC, Kao LC, Tzeng NS, Kuo TBJ, Huang SY, Chang CC, Chang HA. Heart rate variability in major depressive disorder and after antidepressant treatment with agomelatine and paroxetine: Findings from the Taiwan Study of Depression and Anxiety (TAISDA). Prog Neuropsychopharmacol Biol Psychiatry 2016. [PMID: 26216863 DOI: 10.1016/j.pnpbp.2015.07.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Evidence from previous studies suggests that heart rate variability (HRV) is reduced in major depressive disorder (MDD). However, whether this reduction is attributable to the disorder per se or to medication, since antidepressants may also affect HRV, is still debated. There is a dearth of information regarding the effects of agomelatine, a novel antidepressant, on HRV. Here, we investigated whether HRV is reduced in MDD and compared the effects of agomelatine and paroxetine on HRV. We recruited 618 physically healthy unmedicated patients with MDD and 506 healthy volunteers aged 20-65 years. Frequency-domain measures of resting HRV were obtained at the time of enrollment for all participants. For patients with MDD, these measures were obtained again after 6 weeks of either agomelatine or paroxetine monotherapy. Compared with healthy subjects, unmedicated patients with MDD exhibited significantly lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV, and a higher LF/HF ratio. Depression severity independently contributed to decreased HRV and vagal tone. Fifty-six patients completed the open-label trial (n=29 for agomelatine, n=27 for paroxetine). Between-group analyses showed a significant group-by-time interaction for LF-HRV and HF-HRV, driven by increases in LF-HRV and HF-HRV only after agomelatine treatment. Within the paroxetine-treated group, there were no significant changes in mean R-R intervals or any HRV indices. We therefore concluded that MDD is associated with reduced HRV, which is inversely related to depression severity. Compared with paroxetine, agomelatine has a more vagotonic effect, suggesting greater cardiovascular safety. Clinicians should consider HRV effects while selecting antidepressants especially for depressed patients who already have decreased cardiac vagal tone.
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Affiliation(s)
- Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Lien-Cheng Kao
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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44
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Bangsbo J, Hansen PR, Dvorak J, Krustrup P. Recreational football for disease prevention and treatment in untrained men: a narrative review examining cardiovascular health, lipid profile, body composition, muscle strength and functional capacity. Br J Sports Med 2016; 49:568-76. [PMID: 25878072 PMCID: PMC4413738 DOI: 10.1136/bjsports-2015-094781] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Over the past 10 years, researchers have studied the effects of recreational football training as a health-promoting activity for participants across the lifespan. This has important public health implications as over 400 million people play football annually. Results from the first randomised controlled trial, published in the BJSM in January 2009, showed that football increased maximal oxygen uptake and muscle and bone mass, and lowered fat percentage and blood pressure, in untrained men, and since then more than 70 articles about football for health have been published, including publications in two supplements of the Scandinavian Journal of Medicine and Science in Sports in 2010 and 2014, prior to the FIFA World Cup tournaments in South Africa and Brazil. While studies of football training effects have also been performed in women and children, this article reviews the current evidence linking recreational football training with favourable effects in the prevention and treatment of disease in adult men.
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Affiliation(s)
- Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Jiri Dvorak
- FIFA-Medical Assessment and Research Centre (F-MARC) and Schulthess Klinik, Zurich, Switzerland
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark Sport and Health Sciences, College of Life and Enviromental Sciences, University of Exeter, Exeter, UK
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Abstract
Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved contractility, and an increase in blood volume, allowing for greater filling of the ventricles and a consequent larger stroke volume. In parallel with the greater maximal cardiac output, the perfusion capacity of the muscle is increased, permitting for greater oxygen delivery. To accommodate the higher aerobic demands and perfusion levels, arteries, arterioles, and capillaries adapt in structure and number. The diameters of the larger conduit and resistance arteries are increased minimizing resistance to flow as the cardiac output is distributed in the body and the wall thickness of the conduit and resistance arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle allowing for an improved capacity for oxygen extraction by the muscle through a greater area for diffusion, a shorter diffusion distance, and a longer mean transit time for the erythrocyte to pass through the smallest blood vessels. The present article addresses the effect of endurance training on systemic and peripheral cardiovascular adaptations with a focus on humans, but also covers animal data.
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Affiliation(s)
- Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Wei GX, Li YF, Yue XL, Ma X, Chang YK, Yi LY, Li JC, Zuo XN. Tai Chi Chuan modulates heart rate variability during abdominal breathing in elderly adults. Psych J 2015; 5:69-77. [PMID: 26377754 DOI: 10.1002/pchj.105] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/10/2015] [Indexed: 11/10/2022]
Abstract
Tai Chi Chuan (TCC) practice is currently intentionally applied in clinical populations, especially those with cardiovascular diseases because of its potential benefits on the autonomic nervous system. The long-term effect of TCC practice on heart rate variability (HRV) remains largely unknown. In this study, we recruited 23 TCC practitioners whose experience averaged approximately 21 years and 19 controls matched by age, sex and education to examine the effect of TCC practice on the autonomic nervous system during a resting state and during an abdominal breathing state. HRV was measured by traditional electrocardiogram (ECG) recording. The results showed that the low frequency, total power frequency, and normalized low frequency components and the low-frequency/high-frequency ratio were significantly higher, whereas the normalized high frequency was significantly lower in the TCC practitioners relative to controls during the abdominal breathing state. However, we did not detect any significant difference in the HRV measures during the resting state between the two groups. Additionally, TCC experience did not correlate with HRV components either in the abdominal state or the resting state in the TCC group. Considering all of these findings, we suggest that TCC improves vagal activity and the balance between sympathetic and parasympathetic activity during the relaxation state. This study also provides direct physiological evidence for the role of TCC practice in relaxation.
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Affiliation(s)
- Gao-Xia Wei
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - You-Fa Li
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing, China
| | - Xiao-Lin Yue
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xiao Ma
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing, China.,Department of Psychology, Beijing Normal University, Beijing, China
| | - Yu-Kai Chang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Long-Yan Yi
- Sport Science Research Center, Beijing Sport University, Beijing, China
| | - Jing-Cheng Li
- Capital University of Physical Education and Sports, Beijing, China
| | - Xi-Nian Zuo
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Ioakeimidis N, Samentzas A, Vlachopoulos C, Aggelis A, Stefanadis C, Tousoulis D. Chronotropic Incompetence and Dynamic Postexercise Autonomic Dysfunction Are Associated with the Presence and Severity of Erectile Dysfunction. Ann Noninvasive Electrocardiol 2015; 21:256-62. [PMID: 26263241 DOI: 10.1111/anec.12304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/07/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Exercise stress testing (EST) is crucial to determine cardiovascular (CV) risk in men with erectile dysfunction (ED). Low exercise workload, a slower rate of recovery following exercise, and an impaired capacity to increase heart rate (HR) during exercise testing (chronotropic incompetence) are independent predictors of adverse CV outcomes. Aim of this study was to investigate the association between ED and EST parameters. METHODS A total of 180 ED patients and 50 men without ED underwent maximal EST. Exercise parameters including exercise capacity (metabolic equivalents, METS), peak exercise time, HR at six METS, peak exercise, HR recovery (HRR) at 1 and 2 minutes and chronotropic index (CI) were evaluated in all individuals. Endothelial function was evaluated with flow-mediated dilatation (FMD) of the brachial artery. RESULTS ED patients had lower peak exercise time and thus lower calculated exercise capacity (P < 0.001) and reduced CI (P < 0.01) compared to men without ED. There was a significant association of ED severity with duration of exercise, peak workload, HRR 2 minutes after exercise, and CI (all P < 0.05). There also was a positive relation of HRR and CI with FMD (all P < 0.05). CONCLUSIONS This study shows interrelationships between exercise capacity, HRR, CI, and ED. Abnormal HRR and CI are associated with systemic endothelial dysfunction. These findings imply pathophysiological links and may have important implications for the estimation of cardiovascular risk in ED patients.
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Affiliation(s)
- Nikolaos Ioakeimidis
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | - Alexios Samentzas
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | - Charalambos Vlachopoulos
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | - Athanassios Aggelis
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | - Christodoulos Stefanadis
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | - Dimitrios Tousoulis
- Peripheral Vessels and Hypertension Units, 1st Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
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The Effect of Park and Urban Environments on Coronary Artery Disease Patients: A Randomized Trial. BIOMED RESEARCH INTERNATIONAL 2015; 2015:403012. [PMID: 26161399 PMCID: PMC4486308 DOI: 10.1155/2015/403012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 12/18/2014] [Indexed: 12/02/2022]
Abstract
Aim. To test the hypothesis that walking in a park has a greater positive effect on coronary artery disease (CAD) patients' hemodynamic parameters than walking in an urban environment. Methods. Twenty stable CAD patients were randomized into two groups: 30-minute walk on 7 consecutive days in either a city park or busy urban street. Wilcoxon signed-rank test was employed to study short-term (30 min) and cumulative changes (following 7 consecutive days of exposure) in resting hemodynamic parameters in different environments. Results. There were no statistically significant differences in the baseline and peak exercise systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), exercise duration, or HR recovery in urban versus park exposure groups. Seven days of walking slightly improved all hemodynamic parameters in both groups. Compared to baseline, the city park group exhibited statistically significantly greater reductions in HR and DBP and increases in exercise duration and HR recovery. The SBP and DBP changes in the urban exposed group were lower than in the park exposed group. Conclusions. Walking in a park had a greater positive effect on CAD patients' cardiac function than walking in an urban environment, suggesting that rehabilitation through walking in green environments after coronary events should be encouraged.
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49
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Acute vascular effects of waterpipe smoking: Importance of physical activity and fitness status. Atherosclerosis 2015; 240:472-6. [DOI: 10.1016/j.atherosclerosis.2015.02.047] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/21/2015] [Accepted: 02/23/2015] [Indexed: 11/18/2022]
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Adams SC, Schondorf R, Benoit J, Kilgour RD. Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study. BMC Cancer 2015; 15:414. [PMID: 25981952 PMCID: PMC4522971 DOI: 10.1186/s12885-015-1418-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 05/05/2015] [Indexed: 11/25/2022] Open
Abstract
Background Preliminary evidence suggests cancer- and chemotherapy-related autonomic nervous system (ANS) dysfunction may contribute to the increased cardiovascular (CV) morbidity- and mortality-risks in cancer survivors. However, the reliability of these findings may have been jeopardized by inconsistent participant screening and assessment methods. Therefore, good laboratory practices must be established before the presence and nature of cancer-related autonomic dysfunction can be characterized. The purpose of this study was to assess the feasibility of conducting concurrent ANS and cardiovascular evaluations in young adult cancer patients, according to the following criteria: i) identifying methodological pitfalls and proposing good laboratory practice criteria for ANS testing in cancer, and ii) providing initial physiologic evidence of autonomic perturbations in cancer patients using the composite autonomic scoring scale (CASS). Methods Thirteen patients (mixed diagnoses) were assessed immediately before and after 4 cycles of chemotherapy. Their results were compared to 12 sex- and age-matched controls. ANS function was assessed using standardized tests of resting CV (tilt-table, respiratory sinus arrhythmia and Valsalva maneuver) and sudomotor (quantitative sudomotor axon reflex test) reactivity. Cardiovascular reactivity during exercise was assessed using a modified Astrand-Ryhming cycle ergometer protocol. Our feasibility criteria addressed: i) recruitment potential, ii) retention rates, iii) pre-chemotherapy assessment potential, iv) test performance/tolerability, and v) identification and minimizing the influence of potentially confounding medication. T-tests and repeated measures ANOVAs were used to assess between- and within-group differences at baseline and follow-up. Results The overall success rate in achieving our feasibility criteria was 98.4 %. According to the CASS, there was evidence of ANS impairment at baseline in 30.8 % of patients, which persisted in 18.2 % of patients at follow-up, compared to 0 % of controls at baseline or follow-up. Conclusions Results from our feasibility assessment suggest that the investigation of ANS function in young adult cancer patients undergoing chemotherapy is possible. To the best of our knowledge, this is the first study to report CASS-based evidence of ANS impairment and sudomotor dysfunction in any cancer population. Moreover, we provide evidence of cancer- and chemotherapy-related parasympathetic dysfunction – as a possible contributor to the pathogenesis of CV disease in cancer survivors.
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Affiliation(s)
- Scott C Adams
- Department of Exercise Science, Concordia University, Montreal, QC, Canada. .,Behavioural Medicine Laboratory, Faculty of Physical Education & Recreation, University of Alberta, Edmonton, AB, Canada.
| | - Ronald Schondorf
- Department of Neurology, Jewish General Hospital, Montreal, QC, Canada.
| | - Julie Benoit
- Department of Neurology, Jewish General Hospital, Montreal, QC, Canada.
| | - Robert D Kilgour
- Department of Exercise Science, Concordia University, Montreal, QC, Canada.
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