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Oursler KK, Briggs BC, Lozano AJ, Harris NM, Parashar A, Ryan AS, Marconi VC. Association of chronotropic incompetence with reduced cardiorespiratory fitness in older adults with HIV. AIDS 2024; 38:825-833. [PMID: 38578959 PMCID: PMC11003719 DOI: 10.1097/qad.0000000000003840] [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] [Indexed: 04/07/2024]
Abstract
OBJECTIVE Understanding the physiological drivers of reduced cardiorespiratory fitness in people with HIV (PWH) will inform strategies to optimize healthspan. Chronotropic incompetence is common in heart failure and associated with low cardiorespiratory fitness yet is understudied in PWH. The objective was to determine the prevalence of chronotropic incompetence and its relationship with cardiorespiratory fitness. DESIGN Participants were PWH at least 50 years of age with no prior history of heart failure or coronary heart disease who were enrolled in a randomized exercise trial. Baseline cardiopulmonary exercise testing (CPET) was used to measure cardiorespiratory fitness as peak oxygen consumption (VO2peak) and calculate the chronotropic index from heart rate values. Chronotropic incompetence was defined as an index less than 80%. RESULTS The 74 participants were on average 61 years old, 80% Black or African American, and 93% men. Chronotropic incompetence was present in 31.1%. VO2peak was significantly lower among participants with chronotropic incompetence compared with participants without chronotropic incompetence [mean (SD) ml/min/kg: 20.9 (5.1) vs. 25.0 (4.5), P = 0.001]. Linear regression showed that chronotropic incompetence and age were independent predictors of VO2peak, but smoking and comorbidity were not. The chronotropic index correlated with VO2peak (r = 0.48, P < 0.001). CONCLUSION Among older PWH without heart failure or coronary heart disease, chronotropic incompetence was present in approximately one-third of individuals and was associated with clinically relevant impaired cardiorespiratory fitness. Investigation of chronotropic incompetence in large cohorts which includes PWH and heart failure may contribute to strategies that promote healthy aging with HIV infection and offer a preclinical window for intervention.
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Affiliation(s)
- Krisann K Oursler
- Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke
- Geriatrics Extended Care, Salem Veterans Affairs Healthcare System, Salem, VA
| | - Brandon C Briggs
- Geriatrics Extended Care, Salem Veterans Affairs Healthcare System, Salem, VA
- Department of Health and Human Performance, Concordia University Chicago, Chicago, IL
| | - Alicia J Lozano
- Department of Statistics, Virginia Polytechnic Institute and State University, Roanoke, VA
| | - Nadine M Harris
- Department of Medicine, Emory University School of Medicine, Atlanta
- Infectious Diseases, VA Atlanta Healthcare System, Decatur, GA
| | - Amitabh Parashar
- Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke
- Geriatrics Extended Care, Salem Veterans Affairs Healthcare System, Salem, VA
| | - Alice S Ryan
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
- Baltimore Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center at the Veterans Affairs Maryland Healthcare System, Baltimore, MD
| | - Vincent C Marconi
- Department of Medicine, Emory University School of Medicine, Atlanta
- Infectious Diseases, VA Atlanta Healthcare System, Decatur, GA
- Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Jayo-Montoya JA, Jurio-Iriarte B, Aispuru GR, Villar-Zabala B, Blanco-Guzman S, Maldonado-Martin S. Impact of Aerobic High-Intensity Interval Training Intervention and Mediterranean Diet Recommendations on Health-Related Quality of Life and Lifestyle Modification in Post-Myocardial Infarction Patients: Results From the INTERFARCT Surveys. Am J Lifestyle Med 2024; 18:389-402. [PMID: 38737886 PMCID: PMC11082858 DOI: 10.1177/15598276221087628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
This study aims to determine the impact of 2 (low vs high volume) high-intensity interval training (HIIT) programs with Mediterranean diet (MedDiet) recommendations on health-related quality of life (HRQoL) and lifestyle modification, and to examine the relationships between the changes in anxiety and depression with HRQoL and lifestyle variables after myocardial infarction (MI). Participants (n = 80) were randomized to attention control or one of the two supervised HIIT groups (2 d/weeks). Surveys before and after intervention (16 weeks): HRQoL (SF-36), anxiety and depression (HADS), MedDiet adherence (MEDAS), and physical activity (PA) and sedentary behavior (SB) levels. After intervention, there were improvements (P < .05) in HRQoL, HADS scores, and MedDiet adherence, with higher PA level in both HIIT groups with no between-HIIT group differences. The HADS score decline correlated (P < .05) with both the increase in physical component of SF-36 (r = .42), the overall metabolic expenditure (r = .26), and adherence to the MedDiet (r = .24), and the reduction in the SB (r = .35). HIIT exercise intervention with MedDiet recommendations improved HRQoL, along with reduced anxiety and depression symptoms, and a healthier lifestyle after MI. Better mental health was related to higher values of PA and MedDiet adherence.
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Affiliation(s)
- Jon A. Jayo-Montoya
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Borja Jurio-Iriarte
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Gualberto R. Aispuru
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Beatriz Villar-Zabala
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Sonia Blanco-Guzman
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
| | - Sara Maldonado-Martin
- Faculty of Education and Sport-Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (JJ-M, BJ-I); Primary Care Administration of Burgos, Health Service of the Castile & Leon Community (Sacyl), Spain (GA, BV-Z); Internal Medicine Department, Santiago Apóstol Hospital, Miranda de Ebro, Burgos (SB-G); Faculty of Education and Sport- Physical Activity and Sport Sciences Section, Department of Physical Education and Sport, GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society, Sports, and Physical Exercise Research Group, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain (SM-M); and Physical Activity, Exercise and Health Group, Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain (SM-M)
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Gao H, Li Z, Gan L, Chen X. The Role and Potential Mechanisms of Rehabilitation Exercise Improving Cardiac Remodeling. J Cardiovasc Transl Res 2024:10.1007/s12265-024-10498-7. [PMID: 38558377 DOI: 10.1007/s12265-024-10498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/08/2024] [Indexed: 04/04/2024]
Abstract
Rehabilitation exercise is a crucial non-pharmacological intervention for the secondary prevention and treatment of cardiovascular diseases, effectively ameliorating cardiac remodeling in patients. Exercise training can mitigate cardiomyocyte apoptosis, reduce extracellular matrix deposition and fibrosis, promote angiogenesis, and regulate inflammatory response to improve cardiac remodeling. This article presents a comprehensive review of recent research progress, summarizing the pivotal role and underlying mechanism of rehabilitation exercise in improving cardiac remodeling and providing valuable insights for devising effective rehabilitation treatment programs. Graphical Abstract.
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Affiliation(s)
- Haizhu Gao
- Colleague of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Zhongxin Li
- Colleague of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Lijun Gan
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, No.89 Guhuai Road, Jining, 272029, Shandong, China
| | - Xueying Chen
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, No.89 Guhuai Road, Jining, 272029, Shandong, China.
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
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