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Michou V, Nikodimopoulou M, Liakopoulos V, Anifanti M, Papagianni A, Zembekakis P, Deligiannis A, Kouidi E. Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus. Life (Basel) 2023; 13:1394. [PMID: 37374177 DOI: 10.3390/life13061394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 ± 11.3 years old, CAN and type II Diabetes Mellitus (DM-II)), were randomly assigned into two groups: A (n1 = 13 KTRs), who underwent a home-based exercise training program for 6 months, and B (n2 = 12 KTRs), who were assessed at the end of the study. A cardiopulmonary exercise testing (CPET), sit-to-stand test in 30 s (30-s STS), isokinetic muscle strength dynamometry, and 24-h electrocardiographic monitoring were applied to all participants, both at the baseline and at the end of the clinical trial. At first, there were no statistically significant differences between groups. After 6 months, group A showed higher values in exercise time by 8.7% (p = 0.02), VO2peak by 7.3% (p < 0.05), 30-s STS by 12.0% (p < 0.05), upper limb strength by 46.1% (p < 0.05), and lower limb strength by 24.6% (p = 0.02), respectively, compared to the B group. Furthermore, inter-group changes at the end of the 6-month study indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 30.3% (p = 0.01), root mean square of successive differences between normal heartbeats (rMSSD) by 32.0% (p = 0.03), number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (pNN50) by 29.0% (p = 0.04), high frequency (HF (ms2)) by 21.6% (p < 0.05), HF (n.u.) by 48.5% (p = 0.01), and turbulence slope (TS) by 22.5% (p = 0.02), and decreased the low frequency (LF (ms2)) by 13.2% (p = 0.01), LF (n.u.) by 24.9% (p = 0.04), and LF/HF ratio by 24% (p = 0.01), compared to group B. Linear regression analysis after the 6-month study showed that there was a strong positive correlation between VO2peak and SDNN (r = 0.701, p < 0.05) in group A. Moreover, multiple regression analysis showed that KTRs' participation in the exercise program showed favorable modifications to sympathovagal balance and aerobic capacity, as measured with SDNN and VO2peak, respectively. To summarize, diabetic KTRs' cardiac autonomic function and functional capacity can be improved after a home-based long-term exercise training program.
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Affiliation(s)
- Vassiliki Michou
- Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece
| | - Maria Nikodimopoulou
- Transplant Surgery Clinic of Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, Greece
| | - Maria Anifanti
- Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece
| | - Aikaterini Papagianni
- Department of Nephrology, Hippokration Hospital, Aristotle University, 54642 Thessaloniki, Greece
| | - Pantelis Zembekakis
- Division of Internal Medicine, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, Greece
| | - Asterios Deligiannis
- Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece
| | - Evangelia Kouidi
- Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece
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de Andrade PE, Zangirolami-Raimundo J, Morais TC, De Abreu LC, Siqueira CE, Sorpreso ICE, Soares Júnior JM, Raimundo RD. Cardiac Behavior and Heart Rate Variability in Elderly Hypertensive Individuals during Aerobic Exercise: A Non-Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1292. [PMID: 36674046 PMCID: PMC9859152 DOI: 10.3390/ijerph20021292] [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: 10/26/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND High blood pressure is an important public health problem due to its high prevalence, the difficulty to control it, and its high contribution to morbidity. A series of changes may be linked to the aging process, compromising cardiac conduction, and reducing cardiovascular baroreceptor function. Advancing age promotes a decline in heart rate variability and this decrease can increase the probability of cardiovascular disease. The aim of this study was to analyze the autonomic modulation of heart rate in hypertensive elderly individuals during and after a session of aerobic exercise, and to compare it with elderly individuals without cardiovascular or metabolic disease. Our study was a non-randomized controlled study with hypertensive elderly (HBP group) and elderly without cardiovascular and/or metabolic diseases (control group). Data on blood pressure and heart rate variability (HRV) were collected before, during, and after 30 min of aerobic physical exercise on a treadmill. There was a reduction in HF (ms2) and SD1 (ms) in the 5 min of recovery for the elderly in the control group. The elderly in the control group also had greater RMSSD and SD1 30 min post-exercise when compared to the initial mins of recovery. We concluded that there was no difference in autonomic modulation and global heart rate variability between elderly individuals without cardiovascular and metabolic diseases and hypertensive individuals after a bout of aerobic exercise. Elderly individuals without metabolic diseases showed a decrease in parasympathetic modulation and global variability between the time of rest and 5 min of recovery. However, up to 30 min of post-exercise recovery, they restored parasympathetic activity.
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Affiliation(s)
- Paulo Evaristo de Andrade
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, São Paulo 09060-590, Brazil
| | - Juliana Zangirolami-Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, São Paulo 09060-590, Brazil
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05508-060, Brazil
| | - Tassiane Cristina Morais
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitoria 29045-402, Brazil
| | - Luiz Carlos De Abreu
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (UFES), Vitória 29040-090, Brazil
| | - Carlos Eduardo Siqueira
- Department of Urban Planning and Community Development, School for the Environment, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Isabel Cristina Esposito Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05508-060, Brazil
| | - José Maria Soares Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05508-060, Brazil
| | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, São Paulo 09060-590, Brazil
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05508-060, Brazil
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Abidi AM, Mujaddadi A, Raza S, Moiz JA. Effect of Physical Exercise on Cardiac Autonomic Modulation in Hypertensive Individuals: A Systematic Review and Meta-analysis. Curr Hypertens Rev 2023; 19:149-172. [PMID: 37563821 DOI: 10.2174/1573402119666230803090330] [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: 04/21/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Cardiac autonomic dysfunction is associated with hypertension and exercise training (ET) in healthy individuals is found to improve cardiac autonomic modulation (CAM). However, the effects of physical exercise on CAM in hypertensive individuals are under debate. OBJECTIVE The aim of the review is to systematically evaluate the literature on the effects of physical exercise on CAM in hypertensive individuals and analyse comparative differences in the effects of exercise between hypertensive and normotensive individuals. METHODS Electronic databases, such as Pubmed, PEDro, Scopus, and Web of Science, were systematically searched from inception up to February, 2022, evaluating the effect of ET on CAM either by heart rate variability (HRV), baroreflex sensitivity or heart rate recovery. Fifteen studies were included in the review. The risk of bias was assessed using the Cochrane risk of bias tool version 2 and the risk of bias in studies of intervention (ROBINS-I) tool. The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation approach. Ten studies were included in the quantitative analysis. The meta-analysis and sensitivity analysis were performed using review manager 5.4.1; publication bias was assessed using Jamovi 2.2.5 software. RESULTS The qualitative analysis revealed low to moderate certainty of evidence for ET and moderate for aerobic training. For the effect of overall ET, the analysis revealed that the standardized mean differences (SMD) showed a significant effect of ET on HF (SMD 1.76, p = 0.04) and RMSSD (SMD 1.19, p < 0.0001) and a significant decrease in LF (SMD -1.78, p = 0.04). Aerobic training revealed nonsignificant improvement in HRV parameters. In the comparative analysis, ET did not show a significant difference in improvement between hypertensive and normotensive individuals. CONCLUSION This review suggests an improvement in CAM with physical exercise in hypertensive individuals, but the overall effect of ET in hypertensive individuals must be interpreted with caution as the robustness of the data is compromised in the sensitivity analysis of the trials. High-quality future trials focusing on different modes of ET interventions are needed to strengthen the findings of the present review.
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Affiliation(s)
- Ayesha Miraj Abidi
- Center for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Aqsa Mujaddadi
- Center for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Shahid Raza
- Center for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Jamal Ali Moiz
- Center for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
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França da Silva AK, Santos LA, Laurino MJL, Vanzella LM, Ribeiro F, Rozan GB, Vanderlei LCM. Hydration Influence on the Autonomic Recovery of the Coronary Diseases Patient: Geometric Indices Analysis. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:230-239. [PMID: 32976086 DOI: 10.1080/02701367.2020.1818672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Purpose: To evaluate the recovery period of autonomic modulation, through geometric indices of heart rate variability (HRV), on coronary artery disease (CAD) patients submitted to a cardiovascular rehabilitation session (CR), associated with hydration. Methods: Thirty male participants of a CR program, diagnosed with CAD were submitted to the control (CP) and hydration protocol (HP) characterized by a CR session. Only during HP were the participants given 8 equal portions of water. The water amount was determined through the hydric loss measured at the CP. During the protocols, the heart rate was measured beat-by-beat at rest (5-10 minutes[M1]) and at recovery (0-5 minutes [M2], 5-10 minutes [M3], 15-20 minutes [M4], 25-30 minutes [M5], 40-45 minutes [M6], 55-60 minutes [M7]) for the HRV analysis, performed by the geometric indices: TINN, RRTRI, SD1, SD2 and SD1/SD2 ratio. Results: Statistically significant differences were observed between the protocols (SD1, pvalue = 0.022), moments (TINN, pvalue = 0.001; SD1, pvalue = 0.019; SD2, pvalue = 0.001; SD1/SD2, pvalue = 0.001) and moments vs. protocol interaction (SD1, pvalue = 0.019). The SD1 index pointed to acceleration of parasympathetic recovery in the first minutes after exercising (HP recovery after M3 [86.07 ± 32.31%] vs. CP recovery after M5[86.43 ± 24.56]) and increase in global variability (TINN-HP remained increased in longer, until M5 (M1 83.10 ± 55.76 ms to M5 116.82 ± 67.54 ms) vs. CP that remained increased for a short time, until M2 (M1 77.93 ± 68.56 ms to M2 134.82 ± 56.08 ms). Conclusions: In CAD patients, hydration promoted a more efficient recovery on parasympathetic autonomic modulation and increased the global HRV in the recovery period.
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Punia S, Singh V, Joshi S, Malik M, Saini M. Effects of walking in individuals with prehypertension and stage 1 hypertension in India: a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2020.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Physical activity, such as walking, is a cheap approach with a low risk of injury that can be used in daily life. The aim of this study was to determine the effects of low impact aerobic exercise training on resting blood pressure in patients with prehypertension and stage 1 hypertension specifically for people in India. Methods A total of 63 sedentary adults with prehypertension and stage 1 hypertension participated in the study. All sedentary adults were randomly allocated to either the study group (aerobic training) (n=30) or the control group (n=33). Those in the study group walked for 30 minutes, three times a week for 8 weeks at an intensity of 60–75% of their target heart rate. The control group received no training but followed their usual prescribed medication and diet. The primary outcomes of systolic blood pressure and diastolic blood pressure were measured at the end of every 2 weeks for 8 weeks. Secondary outcomes of pulse pressure, mean arterial pressure and pulse rate were calculated. Results Significant changes in various outcome measures in the study group were noted (systolic blood pressure=7.30 mmHg (95% confidence interval [CI] 2.14 to 3.00; P=0.001); diastolic blood pressure=6.50 mmHg (95% CI 1.23 to 4.04; pulse pressure=0.000; mean arterial pressure=6.77 mmHg (95% CI 1.46 to 3.84; P=0.000) and pulse rate=6.90 bpm (95% CI 1.73 to 3.43; P=0.000) when compared with those in the control group, who had non-significant changes. Conclusions The findings of the present study concluded that aerobic exercise training improves blood pressure.
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Affiliation(s)
- Sonu Punia
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Varun Singh
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Shabnam Joshi
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Manoj Malik
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Minaxi Saini
- Mother Terasa Saket College of Physiotherapy, Panchkula, India
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de Paula Facioli T, Vieira Philbois S, Augusto Aguilar B, Catarine Veiga A, Celso Dutra de Souza H. Combined effects of angiotensin receptor blocker use and physical training in hypertensive men. Clin Exp Hypertens 2022; 44:372-381. [PMID: 35343339 DOI: 10.1080/10641963.2022.2055763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Pharmacological (angiotensin II receptor type 1 receptor blocker use) and non-pharmacological treatment (physical aerobic exercise) are important strategies to reduces blood pressure and control arterial hypertension; however, only few clinical studies have evaluated their combined effects on autonomic cardiovascular control. Therefore, we investigated the effect of a combination intervention that involved losartan administration and physical aerobic training on autonomic cardiovascular control. METHODS Thirty-two men (aged 40 to 60 years) were assigned into two groups: normotensive group, without any pharmacological treatment (NG, N = 16), or hypertensive group, with losartan administration (HG, N = 16). They underwent a physical aerobic training for 16 weeks, thrice a week. Hemodynamic parameters, heart rate variability (HRV), blood pressure variability, and spontaneous baroreflex sensitivity (BRS) were measured before and after training. RESULTS Before training, both the groups showed similar values of hemodynamic parameters. However, the HG showed decreased BRS and HRV, characterized by reduction in sympathetic (p = .02) and vagal (p < .001) modulation. After training, the NG exhibited decreased heart rate (HR) at rest (p < .001), whereas the HG showed decreased HR at rest (p < .001) and blood pressure (BP) (p = .001). The HG showed decreased sympathetic modulation (p = .02) and increased BRS (p < .001) and vagal modulation (p < .001), but HRV (p < .001) and BRS gain (p < .001) remained significantly lower when compared to the NG. CONCLUSIONS Physical aerobic training was essential to improve the BRS and HRV cardiac autonomic modulation in the HG. However, it was not sufficient to normalize the analyzed autonomic parameters.
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Affiliation(s)
- Tábata de Paula Facioli
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Stella Vieira Philbois
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Bruno Augusto Aguilar
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ana Catarine Veiga
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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Marino FE, Vargas NT, Skein M, Hartmann T. Metabolic and inflammatory health in SARS-CoV-2 and the potential role for habitual exercise in reducing disease severity. Inflamm Res 2022; 71:27-38. [PMID: 34719732 PMCID: PMC8558095 DOI: 10.1007/s00011-021-01517-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The rapid emergence and spread of SARS-CoV-2 in late 2019 has infected millions of people worldwide with significant morbidity and mortality with various responses from health authorities to limit the spread of the virus. Although population-wide inoculation is preferred, currently, there is large variation and disparity in the acquisition, development, and deployment of vaccination programs in many countries. Even with availability of a vaccine, achieving herd immunity does not guarantee against reinfection from SARS-CoV-2. Emerging evidence indicates that vaccines do not eliminate infection but protect against severe disease and potential hospitalisation. Therefore, additional strategies which strengthen the immune system should be strongly considered to assist in reducing the overall health care burden and stem the rate of infection. There is now substantial evidence that SARS-CoV-2 disease severity and death are linked to existing comorbidities such as cardiovascular disease, obesity, and metabolic disorders. PURPOSE In this review, we discuss the potential medium-to-long-term strategy of habitual exercise and its relationship to targeted comorbidities and underlying inflammation as a protective mechanism against SARS-CoV-2 disease severity. CONCLUSION We conclude that engagement in habitual physical activity and exercise could be a strategy to mitigate the development of comorbidities and improve the response of the immune system, potentially reducing the risk of symptoms and life-threatening complications if infected.
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Affiliation(s)
- Frank E Marino
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia.
| | - Nicole T Vargas
- Thermal Ergonomics Laboratory, Discipline of Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Melissa Skein
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Tegan Hartmann
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia
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Shchekolova NB, Astashina NB, Martyusheva MV, Mudrova OA, Malginov NN, Arutyunov AS. [Psychoneurological and degenerative-dystrophic disorders in patients with pathology of the temporomandibular joint]. STOMATOLOGIIA 2022; 101:37-42. [PMID: 36268918 DOI: 10.17116/stomat202210105137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim of the study is to detail neuropsychiatric and degenerative-dystrophic disorders in patients with dysfunctional TMJ syndrome and develop principles for their correction. MATERIAL AND METHODS 84 patients with complaints of impaired TMJ function were examined: 14 men (16.67%) and 70 women (83.33%) aged 18 to 74 years. The average age of the patients was 63.22±18.82 years. The analysis of the dental status was carried out, the state of the musculoskeletal system and somatic status in patients with dysfunctional TMJ syndrome was studied. Methods of diagnosis of autonomic dysfunction syndrome were used to assess the state of neuropsychiatric status. Occlusive disorders were evaluated in relation to the peculiarities of maintaining posture and autonomic joint dysfunction. RESULTS Occlusive disorders were assessed in relation to the peculiarities of posture maintenance and autonomic dysfunction of the joint. Pathology of the temporomandibular region was accompanied by psychovegetative disorders in 80% of patients. At the same time, autonomic dysfunction was diagnosed with pathological changes in the autonomic index, the formation of anxiety and depression. CONCLUSION The adequacy of rehabilitation measures was associated with the preparation of rehabilitation programs, considering the severity of dental pathology, the state of the somatic and emotional-volitional spheres. Elimination of musculo-articular dysfunctions and pain syndrome was of leading importance in the rehabilitation of patients.
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Affiliation(s)
- N B Shchekolova
- Perm state medical University named after academician E.A. Wagner, Perm, Russia
| | - N B Astashina
- Perm state medical University named after academician E.A. Wagner, Perm, Russia
| | - M V Martyusheva
- Perm state medical University named after academician E.A. Wagner, Perm, Russia
| | - O A Mudrova
- Perm state medical University named after academician E.A. Wagner, Perm, Russia
| | - N N Malginov
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - A S Arutyunov
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Souza HCD, Philbois SV, Veiga AC, Aguilar BA. Heart Rate Variability and Cardiovascular Fitness: What We Know so Far. Vasc Health Risk Manag 2021; 17:701-711. [PMID: 34803382 PMCID: PMC8598208 DOI: 10.2147/vhrm.s279322] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/05/2021] [Indexed: 12/15/2022] Open
Abstract
Fluctuation analysis in intervals between heartbeats provides important indices related to autonomic modulation of heart rate variability (HRV). These indices are considered predictors of morbidity and mortality as they are frequently altered in patients with chronic degenerative diseases, especially in those with cardiovascular and metabolic diseases. Similarly, a reduction in HRV is common with aging. In all cases, cardiovascular fitness is often reduced to below the predicted values. In turn, increases in cardiovascular fitness through regular physical exercise, especially aerobic exercise, represent an important therapeutic tool capable of promoting positive adjustments in cardiac autonomic modulation. These adjustments are characterized by reduced sympathetic modulatory influence and/or increased vagal modulatory influence on the heart, increasing the HRV. Therefore, several methodological tools have been used to assess the degree of impairment of autonomic modulation and the therapeutic effects of physical exercise. In contrast, establishment of strict protocols in experimental design is a main challenge in establishing HRV analysis as a robust parameter for evaluating cardiovascular homeostasis. Thus, this review aimed to contribute to the understanding of autonomic modulation of HRV and its relationship with cardiovascular fitness, highlighting the advances made thus far, the applicability of analysis tools, and the confounding factors observed frequently.
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Affiliation(s)
- Hugo Celso Dutra Souza
- Department of Health Science, Ribeirão Preto Medical School of University of São Paulo, São Paulo, Brazil
| | - Stella Vieira Philbois
- Department of Health Science, Ribeirão Preto Medical School of University of São Paulo, São Paulo, Brazil
| | - Ana Catarine Veiga
- Department of Health Science, Ribeirão Preto Medical School of University of São Paulo, São Paulo, Brazil
| | - Bruno Augusto Aguilar
- Department of Health Science, Ribeirão Preto Medical School of University of São Paulo, São Paulo, Brazil
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Gardim CB, Veiga AC, Aguilar BA, Philbois SV, Souza HCD. Effects of chronic cholinergic stimulation associated with aerobic physical training on cardiac morphofunctional and autonomic parameters in spontaneously hypertensive rats. Sci Rep 2021; 11:17141. [PMID: 34433865 PMCID: PMC8387354 DOI: 10.1038/s41598-021-96505-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/04/2021] [Indexed: 02/04/2023] Open
Abstract
We investigated hemodynamic, cardiac morphofunctional, and cardiovascular autonomic adaptations in spontaneously hypertensive rats (SHRs) after aerobic physical training associated with chronic cholinergic stimulation. Fifty-four SHRs were divided into two groups: trained and untrained. Each group was further subdivided into three smaller groups: vehicle, treated with pyridostigmine bromide at 5 mg/kg/day, and treated with pyridostigmine bromide at 15 mg/kg/day. The following protocols were assessed: echocardiography, autonomic double pharmacological blockade, heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS). Physical training and pyridostigmine bromide reduced BP and HR and increased vagal participation in cardiac autonomic tonic balance. The associated responses were then potentialized. Treatment with pyridostigmine bromide increased HRV oscillation of both low frequency (LF: 0.2-0.75 Hz) and high frequency (HF: 0.75-3 Hz). However, the association with physical training attenuated HF oscillations. Additionally, treatment with pyridostigmine bromide also increased LF oscillations of BPV. Both treatment groups promoted morphofunctional adaptations, and associated increased ejection volume, ejection fraction, cardiac output, and cardiac index. In conclusion, the association of pyridostigmine bromide and physical training promoted greater benefits in hemodynamic parameters and increased vagal influence on cardiac autonomic tonic balance. Nonetheless, treatment with pyridostigmine bromide alone seems to negatively affect BPV and the association of treatment negatively influences HRV.
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Affiliation(s)
- Camila B Gardim
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Catarine Veiga
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Bruno A Aguilar
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Stella V Philbois
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Hugo C D Souza
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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Picard M, Tauveron I, Magdasy S, Benichou T, Bagheri R, Ugbolue UC, Navel V, Dutheil F. Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis. PLoS One 2021; 16:e0251863. [PMID: 33999947 PMCID: PMC8128270 DOI: 10.1371/journal.pone.0251863] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cardiac autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), that can be measured through heart rate variability (HRV)–known to be decreased in T2DM. Physical exercise can improve HRV in healthy population, however results are under debate in T2DM. We conducted a systemic review and meta-analysis to assess the effects of physical exercise on HRV in T2DM patients. Method PubMed, Cochrane, Embase, and ScienceDirect databases were searched for all studies reporting HRV parameters in T2DM patients before and after exercise training, until September 20th 2020, without limitation to specific years. We conducted random-effects meta-analysis stratified by type of exercise for each of the HRV parameters: RR–intervals (or Normal to Normal intervals–NN), standard deviation of RR intervals (SDNN), percentage of adjacent NN intervals varying by more than 50 milliseconds (pNN50), root mean square of successive RR-intervals differences (RMSSD), total power, Low Frequency (LF), High Frequency (HF) and LF/HF ratio. Sensitivity analyses were computed on studies with the highest quality. Results We included 21 studies (9 were randomized) for a total of 523 T2DM patients: 472 had an exercise training and 151 were controls (no exercise). Intervention was endurance (14 studies), resistance (2 studies), endurance combined with resistance (4 studies), and high intensity interval training (HIIT) (4 studies). After exercise training, all HRV parameters improved i.e. an increase in SDNN (effect size = 0.59, 95%CI 0.26 to 0.93), RMSSD (0.62, 0.28 to 0.95), pNN50 (0.62, 0.23 to 1.00), HF (0.58, -0.16 to 0.99), and a decrease in LF (-0.37, -0.69 to -0.05) and LF/HF (-0.52, -0.79 to -0.24). There were no changes in controls. Stratification by type of exercise showed an improvement in most HRV parameters (SDNN, RMSSD, pNN50, LF, HF, LF/HF) after endurance training, whereas mostly LF/HF was improved after both resistance training and HIIT. Supervised training improved most HRV parameters. Duration and frequency of training did not influence the benefits on HRV. Conclusion Exercise training improved HRV parameters in T2DM patients which may reflect an improvement in the activity of the autonomic nervous system. The level of proof is the highest for endurance training. Supervised training seemed beneficial.
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Affiliation(s)
- Mathilde Picard
- Endocrinology Diabetology and Metabolic Diseases, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont-Ferrand, France
| | - Igor Tauveron
- Endocrinology Diabetology and Metabolic Diseases, Université Clermont Auvergne, GReD, CNRS, INSERM, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont–Ferrand, France
| | - Salwan Magdasy
- Endocrinology Diabetology and Metabolic Diseases, Université Clermont Auvergne, GReD, CNRS, INSERM, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont–Ferrand, France
| | - Thomas Benichou
- Endocrinology Diabetology and Metabolic Diseases, CHU Clermont–Ferrand, University Hospital of Clermont–Ferrand, Clermont-Ferrand, France
| | - Reza Bagheri
- Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Ukadike C. Ugbolue
- Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, University of Strathclyde, Glasgow, Scotland, United Kingdom
| | - Valentin Navel
- Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, Université Clermont Auvergne, CNRS, INSERM, GReD, University Hospital of Clermont-Ferrand, Ophthalmology, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont–Ferrand, CHU Clermont–Ferrand, Occupational and Environmental Medicine, WittyFit, Clermont–Ferrand, France
- * E-mail:
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12
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Study of heart rate recovery and cardiovascular autonomic modulation in healthy participants after submaximal exercise. Sci Rep 2021; 11:3620. [PMID: 33574441 PMCID: PMC7878503 DOI: 10.1038/s41598-021-83071-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
Heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) provide important information on cardiovascular autonomic control. However, little is known about the reorganization of HRV, BPV, and BRS after aerobic exercise. While there is a positive relationship between heart rate (HR) recovery rate and cardiorespiratory fitness, it is unclear whether there is a relationship between cardiorespiratory fitness and reorganization of cardiovascular autonomic modulation during recovery. Thus, this study aimed to investigate whether cardiorespiratory fitness influences the cardiovascular autonomic modulation recovery, after a cardiopulmonary exercise test. Sixty men were assigned into groups according to their cardiorespiratory fitness: low cardiorespiratory fitness (LCF = VO2: 22–38 mL kg−1 min−1), moderate (MCF = VO2: 38–48 mL kg−1 min−1), and high (HCF = VO2 > 48 mL kg−1 min−1). HRV (linear and non-linear analysis) and BPV (spectral analysis), and BRS (sequence method) were performed before and after a cardiopulmonary exercise test. The groups with higher cardiorespiratory fitness had lower baseline HR values and HR recovery time after the cardiopulmonary exercise test. On comparing rest and recovery periods, the spectral analysis of HRV showed a decrease in low-frequency (LF) oscillations in absolute units and high frequency (HF) in absolute and normalized units. It also showed increases in LF oscillations of blood pressure. Nonlinear analysis showed a reduction in approximate entropy (ApEn) and in Poincare Plot parameters (SD1 and SD2), accompanied by increases in detrended fluctuation analysis (DFA) parameters α1 and α2. However, we did not find differences in cardiovascular autonomic modulation parameters and BRS in relation to cardiorespiratory fitness neither before nor after the cardiopulmonary test. We concluded that cardiorespiratory fitness does not affect cardiovascular autonomic modulations after cardiopulmonary exercise test, unlike HR recovery.
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13
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Price J, Escheik C, Weinstein A, Winter P, Gerber L, Younossi Z. Abnormal cardiac and metabolic measures correlate significantly with lower performance and activity in overweight chronic liver disease. J Clin Hypertens (Greenwich) 2020; 22:1915-1923. [PMID: 32941676 DOI: 10.1111/jch.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/13/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
People with Hepatitis C (HCV) and non-alcoholic fatty liver disease (NAFLD) in the United States follow national trends toward a sedentary lifestyle and are increasingly at risk for hypertension. The intent of this study was to identify potential correlates of exercise tolerance in people with two types of chronic liver disease (CLD)-NAFLD and HCV. Measures included cardiac output, oxygen consumption and stroke volume, blood pressure, distance walked in 6 minutes, clinical laboratory tests, and medications influencing the autonomic nervous system, patient self-reports of activity, fatigue, and health-related quality of life (HRQL). A total of 67 patients completed the 6-minute walk test [45.1% Female, Age 51.7 ± 8.0 years, Body Mass Index 32.8 ± 5.9, 60% HCV]. At baseline, 70% had either diastolic (DBP) or systolic blood pressure outside normal range. Performance and cardiorespiratory measures correlated strongly with one another, but not with activity. Patients with abnormal DBP reported significantly lower maximum activity (MAS; r = -.254, P = .041, CI = -0.51 to -0.010; MAS 70.6 vs 82.5), significantly higher DBP post-6-minute walk test (r = .524, P = .0001, CI = 0.287-0.762) and significantly lower overall HRQL items related to physical domains (r = .273, P = .029, CI = -0.518 to -0.029). Mental-domain HRQL and depression measures did not correlate significantly with blood pressure. This study reports a significant correlation between both pre-hypertensive and hypertensive DBP, poor physical-domain self-reports, HRQL, and performance in CLD patients.
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Affiliation(s)
- Jillian Price
- Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA
| | - Carey Escheik
- Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA.,Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Ali Weinstein
- Center for Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, USA
| | - Patrice Winter
- Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA.,Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Lynn Gerber
- Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA
| | - Zobair Younossi
- Inova Health System, Betty and Guy Beatty Center for Integrated Research, Falls Church, VA, USA.,Department of Medicine, Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA
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14
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Oliveira-Dantas FF, Brasileiro-Santos MDS, Thomas SG, Silva AS, Silva DC, Browne RAV, Farias-Junior LF, Costa EC, Santos ADC. Short-Term Resistance Training Improves Cardiac Autonomic Modulation and Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial. J Strength Cond Res 2020; 34:37-45. [PMID: 31877119 DOI: 10.1519/jsc.0000000000003182] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Oliveira-Dantas, FF, Brasileiro-Santos, MdS, Thomas, SG, Silva, AS, Silva, DC, Browne, RAV, Farias-Junior, LF, Costa, EC, and Santos, AdC. Short-term resistance training improves cardiac autonomic modulation and blood pressure in hypertensive older women: a randomized controlled trial. J Strength Cond Res 34(1): 37-45, 2020-This randomized controlled trial investigated the efficacy of short-term resistance training (RT) on cardiac autonomic modulation and peripheral hemodynamic parameters in hypertensive older women. Twenty-five hypertensive older women who were insufficiently active (64.7 ± 4.7 years) participated in this study. Subjects were randomly allocated to a 10-week RT program (2 d·wk in the first 5 weeks; 3 d·wk in the last 5 weeks) or a nonexercise control group. Linear reverse periodization was used for the RT program. Cardiac autonomic modulation, mean blood pressure (MBP), peripheral vascular resistance (PVR), and resting heart rate (RHR) were measured before and after 10 weeks. The RT group reduced cardiac sympathetic modulation (0V%; B = -6.6; 95% confidence interval [CI]: -12.9 to -0.2; p = 0.045; Cohen's d = 0.88) and showed a trend for increased parasympathetic modulation (2V%; B = 12.5; 95% CI: 0-25; p = 0.050; Cohen's d = 0.87) compared with the control group. The RT group reduced MBP (B = -8.5 mm Hg; 95% CI: -13.6 to -3.4; p = 0.001; Cohen's d = 1.27), PVR (B = -14.1 units; 95% CI: -19.9 to -8.4; p < 0.001; Cohen's d = 1.86), and RHR (B = -8.8 b·min; 95% CI: -14.3 to -3.3; p = 0.002; Cohen's d = 1.20) compared with the control group. In the RT group, the changes in 2V% patterns and low-frequency components showed a correlation with changes in MBP (r = -0.60; p = 0.032) and RHR (r = 0.75; p = 0.0003). In conclusion, 10 weeks of RT improved cardiac autonomic modulation and reduced MBP and PVR in hypertensive older women. These results reinforce the importance of RT for this population.
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Affiliation(s)
- Filipe F Oliveira-Dantas
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | - Maria do Socorro Brasileiro-Santos
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada; and
| | - Alexandre S Silva
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil
| | - Douglas C Silva
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil
| | - Rodrigo A V Browne
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luiz F Farias-Junior
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Eduardo C Costa
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Amilton da Cruz Santos
- Graduate Associate Program in Physical Education, Federal University of Paraiba/University of Pernambuco, João Pessoa, Paraiba, Brazil.,Research Laboratory for Physical Training Applied to Health, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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15
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Ambulatory blood pressure reduction following 2 weeks of high-intensity interval training on an immersed ergocycle. Arch Cardiovasc Dis 2019; 112:680-690. [DOI: 10.1016/j.acvd.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 01/16/2023]
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16
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The blood pressure variability and baroreflex sensitivity in healthy participants are not determined by sex or cardiorespiratory fitness. Blood Press Monit 2019; 23:260-270. [PMID: 29994926 DOI: 10.1097/mbp.0000000000000338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Heart rate (HR) and blood pressure (BP) autonomic modulation and baroreflex sensitivity (BRS) are important indexes of cardiovascular homeostasis. However, methodological errors are often observed, such as joint analysis of men and women. Another important aspect is that we still do not know whether cardiorespiratory fitness influences these autonomic parameters in healthy individuals. OBJECTIVES This study aimed to investigate whether sex can affect BRS, autonomic modulation of HR and BP variabilities (HRV and BPV, respectively), as well as the influence of cardiorespiratory fitness on these autonomic parameters. METHODS Healthy men and women (N=120) were assigned to groups according to the peak oxygen consumption (VO2 peak) obtained in the cardiorespiratory test: low cardiorespiratory fitness (VO2 peak: 22-38 ml/kg/min), moderate cardiorespiratory fitness (VO2 peak: 38-48 ml/kg/min), and high cardiorespiratory fitness (VO2 peak>48 ml/kg/min). HRV and BPV evaluations were performed for all groups in the frequency domain by spectral analysis. Spontaneous BRS was assessed using the sequence method. RESULTS Women presented lower BP values compared with men. HR did not differ between sexes, but showed an inverse relationship with cardiorespiratory performance. The HRV analysis showed greater sympathetic modulation for men and greater vagal modulation for women. Men and women presented similar results for systolic BPV and BRS, and cardiorespiratory performance did not influence any of the autonomic parameters evaluated. CONCLUSION Cardiorespiratory fitness does not interfere with HRV and BPV autonomic modulation or BRS. However, the cardiac modulatory balance differs between sexes, with a greater influence of the autonomic vagal component in women and the sympathetic component in men.
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Cunha Silva C, Fontes MAP. Cardiovascular reactivity to emotional stress: The hidden challenge for pets in the urbanized environment. Physiol Behav 2019; 207:151-158. [PMID: 31100295 DOI: 10.1016/j.physbeh.2019.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 01/16/2023]
Abstract
Emotional stress is currently considered an important risk factor for cardiovascular diseases. Experimental evidence clearly shows robust autonomic cardiovascular effects in animals exposed to stress stimuli. Considering the remarkable variability of stressors, the urban environment can pose a severe challenge to cardiovascular control. Interestingly, pet ownership is indicated as an efficient non-pharmacological therapy to attenuate stress effects that can reduce the risk of cardiovascular disease. However, the risk of cardiovascular diseases in pets themselves living in urban environment has not received attention it deserves. Here, we review the central mechanisms involved in the autonomic cardiovascular response to emotional stress. Next, we discuss experimental evidence showing the cardiovascular effects produced by emotional stressors in animals, aiming to establish a parallel with common urban stressors. Association of additional risk factors such as sedentarism, obesity and ambient temperature are also considered. Our aim is to identify and raise awareness of the risk of cardiovascular disease in pets exposed to quotidian emotional stressors present in the urban environment.
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Affiliation(s)
- Carina Cunha Silva
- Department of Physiology & Biophysics, Institute of Biological Sciences Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marco Antônio Peliky Fontes
- Department of Physiology & Biophysics, Institute of Biological Sciences Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
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18
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Exercise Frequency Determines Heart Rate Variability Gains in Older People: A Meta-Analysis and Meta-Regression. Sports Med 2019; 49:719-729. [DOI: 10.1007/s40279-019-01097-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Cierpka-Kmieć K, Hering D. Tachycardia: The hidden cardiovascular risk factor in uncomplicated arterial hypertension. Cardiol J 2019; 27:857-867. [PMID: 30799548 DOI: 10.5603/cj.a2019.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/04/2019] [Indexed: 12/30/2022] Open
Abstract
Early detection and management of elevated blood pressure is crucial in reducing the burden of cardiovascular disease (CVD). The importance of an absolute risk assessment and patient risk stratification has been highlighted in the European hypertension guidelines since 2003. Amongst numerous risk factors influencing patient prognosis, elevated heart rate (HR) has been indicated as important predictor of future risk of hypertension, coronary heart disease, sudden cardiac death, heart failure, CVD, stroke, total cancer and mortality. Given that resting HR can be easily determined in clinical practice and modified by lifestyle changes as well as beta-blocker therapy, it seems reasonable that lowering resting HR should be a potential target to reduce disease burden and premature mortality. However, there is a lack of outcome studies of HR lowering in tachycardia-related hypertension. This review outlines the underlying mechanisms of early course hypertension pathophysiology with the critical role of the sympathetic nervous system activation, the prognostic significance of fast HR and the mechanistic rationale for the use of non-pharmacological approaches and/or highly long-acting cardioselective beta-blockers with some consideration given to betaxolol properties.
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Affiliation(s)
| | - Dagmara Hering
- Medical University of Gdansk, Poland, Debinki 7, 80-952 Gdansk, Poland.
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20
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Ghardashi-Afousi A, Holisaz MT, Shirvani H, Pishgoo B. The effects of low-volume high-intensity interval versus moderate intensity continuous training on heart rate variability, and hemodynamic and echocardiography indices in men after coronary artery bypass grafting: A randomized clinical trial study. ARYA ATHEROSCLEROSIS 2018; 14:260-271. [PMID: 31143227 PMCID: PMC6527148 DOI: 10.22122/arya.v14i6.1781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/22/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Heart rate variability (HRV) declines after coronary artery bypass grafting (CABG). The purpose of this study was to evaluate the effect of low-volume high-intensity interval training (LV-HIIT) and moderate-intensity continuous training (MICT) on HRV as well as, hemodynamic and echocardiography indices. METHODS Forty-two men after CABG (55.12 ± 3.97 years) were randomly assigned into LV-HIIT, MICT, and control (CTL) groups. The exercise training in LV-HIIT consisted of 2-minute interval at 85-95 percent of maximal heart rate (HRmax), 2-minute interval at 50% of HRmax and 40-minute interval at 70% of HRmax in MICT for three sessions in a week, for 6-weeks. HRV parameters were evaluated by 24-hour Holter electrocardiography (ECG) recording, and echocardiography parameters at baseline and end of intervention were measured in all 3 groups. RESULTS At the end of the intervention, left ventricular ejection fraction (LVEF) significantly increased in LV-HIIT group (58.53 ± 7.26 percent) compared with MICT (52.26 ± 7.91 percent) and CTL (49.68 ± 7.27 percent) groups (P < 0.001). Furthermore, mean R-R interval, root mean square successive difference (RMSSD) of R-R interval, and standard deviation of R-R interval (SDRR) in LV-HIIT group considerably increased compared with MICT group (P < 0.001). High-frequency power (HF) significantly increased in LV-HIIT and MICT groups compared with CTL group (P < 0.001). On the other hand, low frequency (LF) and LF/HF ratio significantly decreased in LV-HIIT group in comparison with MICT group (P < 0.010). CONCLUSION These results suggest that LV-HIIT has a greater effect on improvement of cardiac autonomic activities by increasing R-R interval, SDRR, RMSSD, and HF, and decreasing LF and LF/HF ratio in patients after CABG.
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Affiliation(s)
- Alireza Ghardashi-Afousi
- PhD Candidate, Department of Exercise Physiology, School of Physical Education and Exercise Sciences, University of Tehran AND Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Holisaz
- Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hossein Shirvani
- Assistant Professor, Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Bahram Pishgoo
- Associate Professor, Atherosclerosis Research Center, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Trevizani GA, Seixas MB, Benchimol-Barbosa PR, Vianna JM, da Silva LP, Nadal J. Effect of Resistance Training on Blood Pressure and Autonomic Responses in Treated Hypertensives. J Strength Cond Res 2018; 32:1462-1470. [DOI: 10.1519/jsc.0000000000001995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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22
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Masroor S, Bhati P, Verma S, Khan M, Hussain ME. Heart Rate Variability following Combined Aerobic and Resistance Training in Sedentary Hypertensive Women: A Randomised Control Trial. Indian Heart J 2018; 70 Suppl 3:S28-S35. [PMID: 30595274 PMCID: PMC6310694 DOI: 10.1016/j.ihj.2018.03.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 03/17/2018] [Accepted: 03/20/2018] [Indexed: 02/07/2023] Open
Abstract
Objective To investigate the effect of combined aerobic and resistance training (CART) on heart rate variability in sedentary, hypertensive women. Participants A total of twenty-eight hypertensive (Stage 1 and 2) sedentary women (Age 40.54 ± 4.2 yrs; Height 155.14 ± 5.4 cm; Weight 70.96 ± 10.2 kg; BMI 29.6 ± 4.4; Duration of HTN: 6.43 ± 2.5 yrs) were recruited for the study. Methods Participants were randomly assigned to either the CART group that performed combined aerobic and resistance exercise of moderate intensity [aerobic exercise 50–80% of HRmax (maximum heart rate) and resistance exercises at 50–80% of 1 Repetition Maximum (RM)], 5 times/week for 4 weeks, or to the control group that followed conventional treatment without any supervised exercise intervention. Main outcome measures Resting blood pressure was measured and standard heart rate variability (HRV) indices were calculated using time domain (SDNN, pNN50, RMSSD) and frequency domain (LFnu, HFnu, LF/HF and TP) analysis. Results CART group demonstrated an increase in HFnu, TP, SDNN, and RMSSD, (p < 0.05) along with a significant decrease in LFnu, LF/HF ratio, systolic blood pressure, and diastolic blood pressure (p < 0.05). Conclusion CART showed significant improvement in HRV parameters indicating vagal dominance in middle-aged hypertensive women. Therefore, exercise training in combined form (aerobic and resistance) may be incorporated in the management programs of the patients suffering from hypertension in order to augment improvement in their cardiac autonomic control.
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Affiliation(s)
- Sidra Masroor
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Pooja Bhati
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Shalini Verma
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Monis Khan
- Deen Dayal Upadhyay Kaushal Kendra, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - M Ejaz Hussain
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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23
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Utzinger ML. Enhancing Heart Rate Variability. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bhati P, Shenoy S, Hussain ME. Exercise training and cardiac autonomic function in type 2 diabetes mellitus: A systematic review. Diabetes Metab Syndr 2018; 12:69-78. [PMID: 28888482 DOI: 10.1016/j.dsx.2017.08.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/20/2017] [Indexed: 02/07/2023]
Abstract
Cardiac autonomic neuropathy (CAN) is a common complication of type 2 diabetes mellitus (T2DM). It has been found to independently predict all cause and cardiovascular disease (CVD) mortality. It remains unclear whether exercise training could improve autonomic control in T2DM patients. The purpose of this study was to systematically review the effects of exercise training on cardiac autonomic function in T2DM patients. Electronic databases (MEDLINE, CENTRAL, PEDro, Scopus and Web of science) were systematically searched to retrieve relevant evidence. Clinical trials administering exercise training for at least 4 weeks and examining either heart rate variability (HRV), baroreflex sensitivity (BRS), heart rate recovery (HRR) as outcome measures were eligible. Eighteen articles were found to be relevant and were then assessed for characteristics and quality. Fifteen studies out of 18 found that exercise training leads to positive improvements in autonomic function of T2DM patients. Exercise participation enhances cardiac autonomic function of type 2 diabetics and therefore should be implemented in their management programs.
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Affiliation(s)
- Pooja Bhati
- DiabetResearch Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India.
| | - Shweta Shenoy
- DiabetResearch Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India.
| | - M Ejaz Hussain
- DiabetResearch Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India.
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Chronic treatment with angiotensin-converting enzyme inhibitor increases cardiac fibrosis in young rats submitted to early ovarian failure. Auton Neurosci 2017; 206:28-34. [PMID: 28712539 DOI: 10.1016/j.autneu.2017.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND We investigated whether the treatment with enalapril maleate, combined with aerobic physical training, promotes positive effects on the autonomic balance, the morphology and the cardiac function in female rats submitted to early ovarian failure. METHODS Thirty-five female Wistar rats, ovariectomized at 10weeks of age, were assigned into Ovariectomized rats (OVX) and Ovariectomized rats treated with enalapril maleate (OVX-EM, 10mg-1·kg-1·d-1) Each group was subdivided into sedentary and trained (aerobic swimming training for 10weeks). All animals were submitted to a) double pharmacological autonomic blockade, b) study of morphology and cardiac function by echocardiography, and c) analysis of cardiac fibrosis. RESULTS The OVX-EM sedentary group showed a significant increase in cardiac fibrosis, relative heart weight, interventricular septum thickness and increased sympathetic participation and reduced participation of the vagal tone in the determination of the basal heart rate when compared to the OVX sedentary group. Physical training reduced cardiac fibrosis in both groups, however, with less intensity in the OVX-EM group. It also increased the absolute and relative heart weight and the end-systolic volume. Finally, the OVX-EM trained group showed higher values for left ventricular end-systolic volume and lower values for ejection fraction and shortening fraction than the sedentary OVX-EM group. CONCLUSION Enalapril maleate exacerbated cardiac fibrosis and increased sympathetic participation in the basal heart rate determination, without significantly affecting the cardiac function. Aerobic physical training did not change the cardiac autonomic control, but reduced cardiac fibrosis and had little effect on the cardiac function.
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Post-exercise hypotension and heart rate variability response after water- and land-ergometry exercise in hypertensive patients. PLoS One 2017; 12:e0180216. [PMID: 28658266 PMCID: PMC5489191 DOI: 10.1371/journal.pone.0180216] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/12/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND systemic arterial hypertension is the most prevalent cardiovascular disease; physical activity for hypertensive patients is related to several beneficial cardiovascular adaptations. This paper evaluated the effect of water- and land-ergometry exercise sessions on post-exercise hypotension (PEH) of healthy normotensive subjects versus treated or untreated hypertensive patients. METHODS Forty-five older women composed three experimental groups: normotensive (N, n = 10), treated hypertensive (TH, n = 15) and untreated hypertensive (UH, n = 20). The physical exercise acute session protocol was performed at 75% of maximum oxygen consumption (VO2max) for 45 minutes; systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure were evaluated at rest, peak and at 15, 30, 45, 60, 75 and 90 minutes after exercise cessation. Additionally, the heart rate variability (HRV) was analyzed by R-R intervals in the frequency domain for the assessment of cardiac autonomic function. RESULTS In both exercise modalities, equivalent increases in SBP were observed from rest to peak exercise for all groups, and during recovery, significant PEH was noted. At 90 minutes after the exercise session, the prevalence of hypotension was significantly higher in water- than in the land-based protocol. Moreover, more pronounced reductions in SBP and DBP were observed in the UH patients compared to TH and N subjects. Finally, exercise in the water was more effective in restoring HRV during recovery, with greater effects in the untreated hypertensive group. CONCLUSION Our data demonstrated that water-ergometry exercise was able to induce expressive PEH and improve cardiac autonomic modulation in older normotensive, hypertensive treated or hypertensive untreated subjects when compared to conventional land-ergometry.
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Felix ACS, Dutra SGV, Gastaldi AC, Bonfim PC, Vieira S, de Souza HCD. Physical training promotes similar effects to the blockade of angiotensin-converting enzyme on the cardiac morphology and function in old female rats subjected to premature ovarian failure. Exp Gerontol 2017; 109:90-98. [PMID: 28408160 DOI: 10.1016/j.exger.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/05/2017] [Accepted: 04/08/2017] [Indexed: 02/07/2023]
Abstract
We investigated the effects of angiotensin-converting enzyme (ACE) inhibition and aerobic physical training on the heart of old female rats (82-wk-old) submitted to premature ovarian failure (10-wk.-old). We used different approaches: morphology and function by echocardiography, reactivity of the coronary bed and left ventricular contractibility (Langendorff Technique). Female Wistar ovariectomized (OVX) rats (n=42) were assigned to one of four groups: OVX, vehicle treated only; OVX-EM, Enalapril Maleate only (EM, 10mg·kg-1·d-1); OVX-T, aerobic trained only; and OVX-EMT, treated with Enalapril Maleate and aerobic trained. Both Enalapril Maleate treatment and aerobic training were done in the last 20weeks of the experimental protocol. When compared to the OVX group, the OVX-EM group showed lower values of wall thickness and left ventricular (LV) mass, lower values of coronary bed reactivity and reduced maximum response of LV contractility to dobutamine, while the OVX-T group showed lower values of LV wall thickness, increase in end-systolic volume, reduced maximum response of LV contractility to dobutamine, and left intraventricular pressure due to increased flow. The combination of treatments (EM and aerobic physical training) did not promote additional important effects on the parameters evaluated. Our results suggest similar beneficial effects of physical training and EM treatment on the morphology and cardiac function in old female rats submitted to premature ovarian failure. Although the causes of these benefits are still unknown, both treatments have promoted a decrease in cardiac contractility, and the reduced β1-adrenergic sensitivity suggests that both treatments may attenuate the sympathetic effect on the heart.
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Affiliation(s)
- Ana Carolina S Felix
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sabrina G V Dutra
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ada C Gastaldi
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pâmela C Bonfim
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Suenimeire Vieira
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Physical training associated with Enalapril but not to Losartan, results in better cardiovascular autonomic effects. Auton Neurosci 2017; 203:33-40. [DOI: 10.1016/j.autneu.2016.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/04/2016] [Accepted: 12/06/2016] [Indexed: 01/13/2023]
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Amlodipine and enalapril promote distinct effects on cardiovascular autonomic control in spontaneously hypertensive rats: the role of aerobic physical training. J Hypertens 2016; 34:2383-2392. [PMID: 27607457 DOI: 10.1097/hjh.0000000000001112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND We compared the autonomic and hemodynamic cardiovascular effects of amlodipine and enalapril treatment associated with an aerobic physical training program on spontaneously hypertensive rats. METHODS Eighteen-week-old (n = 48) spontaneously hypertensive rats were assigned to one of two groups: sedentary (n = 24) and trained (n = 24) through a 10-week swimming training program. Each group was subdivided into three groups (n = 8): control (vehicle group), amlodipine (amlodipine group; 10 mg/kg per day) and enalapril (enalapril group; 10 mg/kg per day) (both for 10 weeks). We cannulated the femoral artery and vein of all animals for recording arterial pressure and injecting drugs, respectively. Autonomic assessment was performed by double blockade with propranolol and atropine, analysis of heart rate variability (HRV), systolic arterial pressure variability and baroflex sensitivity. RESULTS Arterial pressure reduction was more prominent in the sedentary and trained enalapril groups. Amlodipine sedentary group presented important autonomic adjustments characterized by a predominance of vagal tone in cardiac autonomic balance, increased HRV associated with sympathetic autonomic modulation reduction and increased vagal autonomic modulation, and increased baroflex sensitivity. All findings were not potentialized by physical training. In turn, the enalapril trained group, but not its sedentary counterpart, also had vagal tone prevalence in cardiac autonomic balance, increased HRV, increased baroflex sensitivity and decreased low-frequency band in systolic arterial pressure variability. CONCLUSION Amlodipine was more effective in promoting beneficial autonomic cardiovascular adaptations in sedentary animals. In contrast, enalapril achieved better autonomic results only when combined with aerobic physical training.
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Posada-Quintero HF, Florian JP, Orjuela-Cañón ÁD, Chon KH. Highly sensitive index of sympathetic activity based on time-frequency spectral analysis of electrodermal activity. Am J Physiol Regul Integr Comp Physiol 2016; 311:R582-91. [PMID: 27440716 DOI: 10.1152/ajpregu.00180.2016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/14/2016] [Indexed: 11/22/2022]
Abstract
Time-domain indices of electrodermal activity (EDA) have been used as a marker of sympathetic tone. However, they often show high variation between subjects and low consistency, which has precluded their general use as a marker of sympathetic tone. To examine whether power spectral density analysis of EDA can provide more consistent results, we recently performed a variety of sympathetic tone-evoking experiments (43). We found significant increase in the spectral power in the frequency range of 0.045 to 0.25 Hz when sympathetic tone-evoking stimuli were induced. The sympathetic tone assessed by the power spectral density of EDA was found to have lower variation and more sensitivity for certain, but not all, stimuli compared with the time-domain analysis of EDA. We surmise that this lack of sensitivity in certain sympathetic tone-inducing conditions with time-invariant spectral analysis of EDA may lie in its inability to characterize time-varying dynamics of the sympathetic tone. To overcome the disadvantages of time-domain and time-invariant power spectral indices of EDA, we developed a highly sensitive index of sympathetic tone, based on time-frequency analysis of EDA signals. Its efficacy was tested using experiments designed to elicit sympathetic dynamics. Twelve subjects underwent four tests known to elicit sympathetic tone arousal: cold pressor, tilt table, stand test, and the Stroop task. We hypothesize that a more sensitive measure of sympathetic control can be developed using time-varying spectral analysis. Variable frequency complex demodulation, a recently developed technique for time-frequency analysis, was used to obtain spectral amplitudes associated with EDA. We found that the time-varying spectral frequency band 0.08-0.24 Hz was most responsive to stimulation. Spectral power for frequencies higher than 0.24 Hz were determined to be not related to the sympathetic dynamics because they comprised less than 5% of the total power. The mean value of time-varying spectral amplitudes in the frequency band 0.08-0.24 Hz were used as the index of sympathetic tone, termed TVSymp. TVSymp was found to be overall the most sensitive to the stimuli, as evidenced by a low coefficient of variation (0.54), and higher consistency (intra-class correlation, 0.96) and sensitivity (Youden's index > 0.75), area under the receiver operating characteristic (ROC) curve (>0.8, accuracy > 0.88) compared with time-domain and time-invariant spectral indices, including heart rate variability.
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Affiliation(s)
| | - John P Florian
- Navy Experimental Diving Unit, Panama City, Florida; and
| | | | - Ki H Chon
- University of Connecticut, Storrs, Connecticut;
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Walking Capacity Is Positively Related with Heart Rate Variability in Symptomatic Peripheral Artery Disease. Eur J Vasc Endovasc Surg 2016; 52:82-9. [DOI: 10.1016/j.ejvs.2016.03.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/30/2016] [Indexed: 01/16/2023]
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Sumin AN, Shushunova OV, Arkhipov OG. [The results of rehabilitation of the patients presenting with arterial hypertension: the types of adaptation, the vegetative status, and intracardial hemodynamics]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2016; 93:10-17. [PMID: 27271827 DOI: 10.17116/kurort2016310-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM The objective the present work was to study the changes of the types of adaptation in the patients presenting with arterial hypertension under the influence of the spa and health resort-based rehabilitative treatment. MATERIAL AND METHODS The study included 50 patients with essential hypertension at the age from 54.0 to 62.0 (mean 58.0) years given a course of the spa and health resort-based rehabilitative treatment. All the patients underwent electrocardiographic and echocardiographic examination for the assessment of the systolic and diastolic left ventricular functions. Cardiointervalography with the use of the ORTO Expert diagnostic system was performed in the patients at rest and during the active orthostatic test (AOT); the types of the adaptation were evaluated. The patients were divided into 2 groups depending on the results of repeated AOT obtained after rehabilitation. Group 1 was comprised of the patients showing the improvement of adaptation (n=24), group 2 consisted of the patients in whom the level of adaptation remained unaltered (n=26). RESULTS The structural characteristics of echocardiography estimated in both groups were not significantly different. The number of patients in group 1 showing the satisfactory level of adaptation intensity in the absence of its failures increased significantly. In group 2, a significant decrease of the following AOT parameters was documented: the tension index of the regulatory system (p=0.02), the standard deviation of NN-intervals (SDNN) (p=0.03), and root mean square of successive differences (RMSSD) (p=0.02). The multiple logistic regression analysis showed that the factors associated with the positive effect of rehabilitation were the normal and low degree of regulatory system tension (p=0.01) and the initially adequate or reduced response in the orthostatic test (p=0.04). CONCLUSION The improvement of rehabilitation of the adaptive capacity was documented in as many as 48% of the patients who had undergone the spa and health resort-based rehabilitative treatment. The absence of positive dynamics or deterioration of adaptation were associated with the increase of the sympathetic activity at rest and in response to the AOT. The beneficial effect of rehabilitation was observed in the patients with the initially normal or low tension of regulatory systems and with the adequate or reduced baseline response in AOT.
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Affiliation(s)
- A N Sumin
- Federal state budgetary institution of science 'Research Institute of Complex Problems of Cardiovascular Diseases', Kemerovo, Russia
| | - O V Shushunova
- Federal budgetary institution 'Centre for Rehabilitation of the Topaz Social Insurance Foundation', Myski, Russia
| | - O G Arkhipov
- Federal budgetary institution 'Centre for Rehabilitation of the Topaz Social Insurance Foundation', Myski, Russia
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Ferreira MJ, Zanesco A. Heart rate variability as important approach for assessment autonomic modulation. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-65742016000200001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Angelina Zanesco
- Universidade Estadual Paulista "Julio de Mesquita Filho", Brazil
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Time sequence of autonomic changes induced by daily slow-breathing sessions. Clin Auton Res 2014; 25:95-104. [DOI: 10.1007/s10286-014-0255-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 08/21/2014] [Indexed: 12/12/2022]
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Dutra SGV, Pereira APM, Tezini GCSV, Mazon JH, Martins-Pinge MC, Souza HCD. Cardiac autonomic modulation is determined by gender and is independent of aerobic physical capacity in healthy subjects. PLoS One 2013; 8:e77092. [PMID: 24098577 PMCID: PMC3789672 DOI: 10.1371/journal.pone.0077092] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 08/29/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Aerobic physical capacity plays an important role in reducing morbidity and mortality rates in subjects with cardiovascular diseases. This action is often related to an improvement in the autonomic modulation of heart rate variability (HRV). However, controversies remain regarding the effects of physical training on cardiac autonomic control in healthy subjects. Therefore, our objective was to investigate whether aerobic capacity interferes with the autonomic modulation of HRV and whether gender differences exist. METHODS Healthy men and women (N=96) were divided into groups according to aerobic capacity: low (VO2: 22-38 ml/kg(-1) min(-1)), moderate (VO2: 38-48 ml/kg(-1) min(-1)) and high (VO2 >48 ml/kg(-1) min(-1).) We evaluated the hemodynamic parameters and body composition. The autonomic modulation of HRV was investigated using spectral analysis. This procedure decomposes the heart rate oscillatory signal into frequency bands: low frequency (LF=0.04-0.15Hz) is mainly related to sympathetic modulation, and high frequency (HF=0.15-0.5Hz) corresponds to vagal modulation. RESULTS Aerobic capacity, regardless of gender, determined lower values of body fat percentage, blood pressure and heart rate. In turn, the spectral analysis of HRV showed that this parameter did not differ when aerobic capacity was considered. However, when the genders were compared, women had lower LF values and higher HF values than the respective groups of men. CONCLUSION The results suggest that aerobic physical capacity does not interfere with HRV modulation; however, the cardiac modulatory balance differs between genders and is characterized by a greater influence of the autonomic vagal component in women and by the sympathetic component in men.
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Affiliation(s)
- Sabrina G. V. Dutra
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ana Paula M. Pereira
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Geisa C. S. V. Tezini
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José H. Mazon
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marli C. Martins-Pinge
- Department of Physiological Sciences, State University of Londrina, Londrina, Paraná, Brazil
| | - Hugo C. D. Souza
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Oliveira NL, Ribeiro F, Alves AJ, Teixeira M, Miranda F, Oliveira J. Heart rate variability in myocardial infarction patients: Effects of exercise training. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oliveira NL, Ribeiro F, Alves AJ, Teixeira M, Miranda F, Oliveira J. Heart rate variability in myocardial infarction patients: effects of exercise training. Rev Port Cardiol 2013; 32:687-700. [PMID: 23993292 DOI: 10.1016/j.repc.2013.02.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 02/04/2013] [Indexed: 12/18/2022] Open
Abstract
Heart rate variability (HRV) is a simple and noninvasive measure that estimates cardiac autonomic modulation, mainly the parasympathetic contribution. Increased sympathetic and/or decreased parasympathetic nervous activity is seen in post-myocardial infarction (MI) patients. Consequently, these patients present reduced HRV, which has been associated with increased risk of adverse events and mortality. Exercise training, recommended as a complementary therapy for patients with cardiovascular disease, has shown numerous beneficial effects. The main aim of the present manuscript was to provide a critical review of studies investigating the effects of exercise training on cardiac autonomic modulation, through HRV, in MI patients and the possible mechanisms involved. Despite conflicting evidence, exercise training appears to be a useful therapeutic intervention to improve the unbalanced autonomic function of MI patients. Finally, the mechanisms involved are not yet well understood, but nitric oxide bioavailability and angiotensin II levels seem to play an important role.
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Affiliation(s)
- Nórton Luís Oliveira
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
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Malekzadeh MM, Etemadi A, Kamangar F, Khademi H, Golozar A, Islami F, Pourshams A, Poustchi H, Navabakhsh B, Naemi M, Pharoah PD, Abnet CC, Brennan P, Boffetta P, Dawsey SM, Esteghamati A, Malekzadeh R. Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population. J Hypertens 2013; 31:1364-71; discussion 1371. [PMID: 23673348 PMCID: PMC3766446 DOI: 10.1097/hjh.0b013e3283613053] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is considerable variation in hypertension prevalence and awareness, and their correlates, across different geographic locations and ethnic groups. We performed this cross-sectional analysis on data from the Golestan Cohort Study (GCS). METHODS Enrollment in this study occurred in 2004-2008, and included 50,045 healthy individuals from Golestan Province in northeastern Iran. Hypertension was defined as a SBP at least 140 mmHg, a DBP at least 90 mmHg, a prior diagnosis of hypertension, or the use of antihypertensive drugs. Potential correlates of hypertension and its awareness were analyzed by logistic regression adjusted for sex, age, BMI, place of residence, literacy, ethnicity, physical activity, smoking, black and green tea consumption and wealth score. RESULTS Of the total cohort participants, 21,350 (42.7%) were hypertensive. Age-standardized prevalence of hypertension, using the 2001 WHO standard world population, was 41.8% (95% confidence interval: 38.3-45.2%). Hypertension was directly associated with female sex, increased BMI, Turkmen ethnicity, and lack of physical activity, and inversely associated with drinking black tea and wealth score. Among hypertensive patients, 46.2% were aware of their disease, 17.6% were receiving antihypertensive medication, and 32.1% of the treated patients had controlled hypertension. Hypertension awareness was greater among women, the elderly, overweight and obese patients, and those with a higher wealth score. CONCLUSION Hypertension is highly prevalent in rural Iran, many of the affected individuals are unaware of their disease, and the rate of control by antihypertensive medications is low. Increasing hypertension awareness and access to health services, especially among less privileged residents are recommended.
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Affiliation(s)
- Masoud M Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Effects of physical training on autonomic cardiac modulation in hypertension: assessment by heart rate variability analysis. Hypertens Res 2011; 35:25-7. [DOI: 10.1038/hr.2011.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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