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Ghidoni C, van der Stouwe JG, Würzburger L, Wiech P, Vontobel J, Bohm P, Moser G, Petrasch G, Rossi VA, Schmied CM, Caselli S, Niederseer D. Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase. Eur J Clin Invest 2024:e14285. [PMID: 38994816 DOI: 10.1111/eci.14285] [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: 03/04/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE. METHODS 800 patients aged 17-90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre-existent hypertension. RESULTS Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9-11.1]) and diastolic (2.4 [0.4-4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2-9.4]) and diastolic BP (4.5 [1.9-7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1-7.5]) and fully adjusted (5.5 [1.1-10.0]) models. There was no difference in maximum diastolic BP between groups. CONCLUSION In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.
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Affiliation(s)
- Céline Ghidoni
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Gerrit van der Stouwe
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Laura Würzburger
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick Wiech
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Philipp Bohm
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Georg Moser
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gloria Petrasch
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Valentina A Rossi
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian M Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - Stefano Caselli
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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2
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Cozgarea A, Cozma D, Teodoru M, Lazăr-Höcher AI, Cirin L, Faur-Grigori AA, Lazăr MA, Crișan S, Gaiță D, Luca CT, Văcărescu C. Heart Rate Recovery: Up to Date in Heart Failure-A Literature Review. J Clin Med 2024; 13:3328. [PMID: 38893039 PMCID: PMC11173322 DOI: 10.3390/jcm13113328] [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: 04/06/2024] [Revised: 05/15/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
The rising prevalence of cardiovascular disease underscores the growing significance of heart failure (HF). Pathophysiological insights into HF highlight the dysregulation of the autonomic nervous system (ANS), characterized by sympathetic overactivity and diminished vagal tone, impacting cardiovascular function. Heart rate recovery (HRR), a metric measuring the heart's ability to return to its baseline rate post-exertion, plays a crucial role in assessing cardiovascular health. Widely applied across various cardiovascular conditions including HF, coronary artery disease (CAD), and arterial hypertension (HTN), HRR quantifies the difference between peak and recovery heart rates. Given its association with elevated sympathetic tone and exercise, HRR provides valuable insights into the perspective of HF, beyond effort tolerance, reaching toward prognostic and mortality indicators. Incorporating HRR into cardiovascular evaluations enhances our understanding of autonomic regulation in HF, offering potential implications for prognostication and patient management. This review addresses the significance of HRR in HF assessment, analyzing recently conducted studies, and providing a foundation for further research and clinical application.
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Affiliation(s)
- Andreea Cozgarea
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Dragoș Cozma
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Minodora Teodoru
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania
| | - Alexandra-Iulia Lazăr-Höcher
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Liviu Cirin
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Adelina-Andreea Faur-Grigori
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
| | - Mihai-Andrei Lazăr
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Simina Crișan
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Dan Gaiță
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Constantin-Tudor Luca
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Cristina Văcărescu
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
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Wulterkens BM, Hermans LWA, Fonseca P, Janssen HCJP, van Hirtum PV, Overeem S, van Gilst MM. Heart rate response to cortical arousals in patients with isolated obstructive sleep apnea and with comorbid insomnia (COMISA). Sleep Breath 2024; 28:735-744. [PMID: 38062226 DOI: 10.1007/s11325-023-02954-6] [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: 09/08/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 05/31/2024]
Abstract
PURPOSE Comorbid insomnia often occurs in patients with obstructive sleep apnea (OSA), referred to as COMISA. Cortical arousals manifest as a common feature in both OSA and insomnia, often accompanied by elevated heart rate (HR). Our objective was to evaluate the heart rate response to nocturnal cortical arousals in patients with COMISA and patients with OSA alone. METHODS We analyzed data from patients with COMISA and from patients with OSA matched for apnea-hypopnea index. Sleep staging and analysis of respiratory events and cortical arousals were performed using the Philips Somnolyzer automatic scoring system. Beat-by-beat HR was analyzed from the onset of the cortical arousal to 30 heartbeats afterwards. HR responses were divided into peak and recovery phases. Cortical arousals were separately evaluated according to subtype (related to respiratory events and spontaneous) and duration (3-6 s, 6-10 s, 10-15 s). RESULTS A total of 72 patients with COMISA and 72 patients with OSA were included in this study. There were no overall group differences in the number of cortical arousals with and without autonomic activation. No significant differences were found for spontaneous cortical arousals. The OSA group had more cortical arousals related to respiratory events (21.0 [14.8-30.0] vs 16.0 [9.0-27.0], p = 0.016). However, the COMISA group had longer cortical arousals (7.2 [6.4-7.8] vs 6.7 [6.2-7.7] s, p = 0.024) and the HR recovery phase was prolonged (52.5 [30.8-82.5] vs 40.0 [21.8-55.5] beats/min, p = 0.017). Both the peak and the recovery phase for longer cortical arousals with a duration of 10-15 s were significantly higher in patients with COMISA compared to patients with OSA (47.0 [27.0-97.5] vs 34.0 [21.0-71.0] beats/min, p = 0.032 and 87.0 [47.0-132.0] vs 71.0 [43.0-103.5] beats/min, p = 0.049, respectively). CONCLUSIONS The HR recovery phase after cortical arousals related to respiratory events is prolonged in patients with COMISA compared to patients with OSA alone. This response could be indicative of the insomnia component in COMISA.
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Affiliation(s)
- Bernice M Wulterkens
- Department of Electrical Engineering, Eindhoven University of Technology, PO BOX 513, Eindhoven, 5600 MB, The Netherlands.
- Philips Research, Eindhoven, The Netherlands.
| | | | - Pedro Fonseca
- Department of Electrical Engineering, Eindhoven University of Technology, PO BOX 513, Eindhoven, 5600 MB, The Netherlands
- Philips Research, Eindhoven, The Netherlands
| | | | | | - Sebastiaan Overeem
- Department of Electrical Engineering, Eindhoven University of Technology, PO BOX 513, Eindhoven, 5600 MB, The Netherlands
- Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands
| | - Merel M van Gilst
- Department of Electrical Engineering, Eindhoven University of Technology, PO BOX 513, Eindhoven, 5600 MB, The Netherlands
- Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands
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4
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Niu C, Wen G, Ventus D, Jern P, Nyman TJ, Li Y, Santtila P. High-intensity interval training (HIIT) and slow breathing interventions alleviate premature ejaculation (PE) symptoms. Int J Clin Health Psychol 2024; 24:100457. [PMID: 38623145 PMCID: PMC11017278 DOI: 10.1016/j.ijchp.2024.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
Background Physical exercise may alleviate premature ejaculation symptoms, a prevalent male sexual dysfunction linked to a series of negative outcomes for men and their partners. Objective We investigated the effectiveness of high-intensity interval training (HIIT) and slow breathing interventions on premature ejaculation symptoms and their relation to autonomic activity and attention regulation. Method Chinese adult men (N = 76, M = 21.89, SD = 3.32) with premature ejaculation completed one of the two-week interventions in their homes or as participants in a normal breathing control group; they reported their age, height, weight, physical activity level, premature ejaculation symptoms, and attention regulation. In the HIIT group, 26 participants engaged in a 7-minute HIIT each day. In the slow breathing group, 25 participants performed 7-minute slow breathing exercises per day while the 25 participants in the normal breathing group similarly performed normal breathing exercises. All participants measured their heart rate once before and five times (with one-minute intervals) after the intervention. When participants had penile-vaginal sex with their partners, they measured their heart rate once after ejaculation. Results Time × Intervention interaction was significant with lower levels of premature ejaculation symptoms on Days 12, 13, and 14 in the HIIT group (M ± SD = 16.19 ± 3.45, 15.96 ± 3.43, and 15.15 ± 3.62) compared to the normal breathing group (M ± SD = 17.68 ± 3.06, 17.68 ± 3.15, and 17.44 ± 3.25). Higher levels of attention regulation were associated with fewer premature ejaculation symptoms. We also found that a larger increase in heart rate from resting to after sex was associated with fewer premature ejaculation symptoms. Conclusion Compared to the control group, the efficacy of two weeks of HIIT exercise in mitigating PE symptoms suggests its potential as a novel treatment for PE.
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Affiliation(s)
- Caoyuan Niu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Guangju Wen
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Daniel Ventus
- Experience Lab, Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Patrick Jern
- Department of Psychology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Thomas J. Nyman
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Yansong Li
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, People's Republic of China
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, People's Republic of China
- Institute for Brain Sciences, Nanjing University, Nanjing, People's Republic of China
| | - Pekka Santtila
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
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5
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Carrasco-Poyatos M, López-Osca R, Martínez-González-Moro I, Granero-Gallegos A. HRV-guided training vs traditional HIIT training in cardiac rehabilitation: a randomized controlled trial. GeroScience 2024; 46:2093-2106. [PMID: 37853188 PMCID: PMC10828341 DOI: 10.1007/s11357-023-00951-x] [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: 07/10/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023] Open
Abstract
High-intensity interval training is the gold standard for cardiac rehabilitation although current revascularization therapy focuses on the recovery of autonomic nervous system balance through heart rate variability (HRV). The main objective was to analyze the effect of HRV-guided training versus high-intensity interval training on cardiorespiratory fitness, heart rate variability, quality of life, and training volume at high intensity, as well as exercise adherence, safety, and feasibility in ischemic patients. This is an 8-week cluster randomized controlled trial with an HRV-based training group (HRV-G) and a traditional HIIT group (HIIT-G). Maximal oxygen consumption, heart rate, and blood pressure were measured during the Bruce protocol treadmill test. HRV was measured with the HRV4Training application, and quality of life with the MacNew QLMI. The repeated measures ANCOVA was used with the age and the baseline scores as covariables. Forty-six patients (mean age 55 ± 11.03 years) were randomized and assigned either to HRV-G (n = 23) or HIIT-G (n = 23). Both groups improved maximal oxygen consumption and METS (P > .05). However, the resting systolic blood pressure was lower in HRV-G (4.3 ± 1.2 mmHg, P = .05). In HRV-G, the resting diastolic, maximal diastolic, and systolic blood pressure decreased (5.4 ± 5.96 mmHg, P = .007; 11.4 ± 12.46 mmHg, P = .005; and 5 ± 5.98 mmHg, P = .013, respectively) whereas the recovery heart rate increased significantly (-21.5 ± 23.16 beats/min, P = .003). The LnrMSSDcv ([LnrMSSDSD/LnrMSSDMEAN] × 100) was lower in HRV-G (1.23 ± 0.91 mmHg, P = .03) while the training volume at high intensity was higher in HIIT-G (31.4 ± 29.2 min, P = .024). HRV-guided training presents a better cardioprotective effect than HIIT-G at a lower high-intensity training volume.
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Affiliation(s)
- María Carrasco-Poyatos
- Department of Education, Health and Public Administration Research Center, University of Almería, Carretera Sacramento s/n. 04120, La Cañada de San Urbano, Almería, Spain.
| | - Rut López-Osca
- Department of Education, Health and Public Administration Research Center, University of Almería, Carretera Sacramento s/n. 04120, La Cañada de San Urbano, Almería, Spain
| | - Ignacio Martínez-González-Moro
- Department of Physiotherapy, Physical Exercise and Human Performance Research Group, University of Murcia, Avda. Teniente Flomesta, 5, 30003, Murcia, Spain
| | - Antonio Granero-Gallegos
- Department of Education, Health and Public Administration Research Center, University of Almería, Carretera Sacramento s/n. 04120, La Cañada de San Urbano, Almería, Spain
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Lu L, Wu X, Zhong J, Chen Q, Lin H, Luo Y. Association between serum uric acid and cardiovascular fitness among US adults: A cross-sectional study. Heliyon 2024; 10:e27169. [PMID: 38486725 PMCID: PMC10937687 DOI: 10.1016/j.heliyon.2024.e27169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 01/24/2024] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
Background While serum uric acid (SUA) is known as a cardiovascular disease risk factor and is associated with increased cardiovascular mortality, the relationship between SUA and cardiovascular adaptability under exercise stress remains unclear. Aims This study aims to elucidate the relationship between SUA levels and cardiovascular fitness, particularly as manifested during cardiopulmonary exercise testing. Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, this study included 5765 participants aged 12-49 years. Heart rate recovery (HRR) during cardiopulmonary exercise testing was measured as an indicator of cardiovascular fitness. Multivariate linear regression analysis was used to explore the association between SUA levels and heart rate recovery at 1 min (HRR1) and 2 min (HRR2) post-exercise. Results After adjusting for potential confounders, an inverse relationship was found between SUA levels and both HRR1 and HRR2. Multivariate adjusted smoothing spline plots demonstrated a decrease in HRR1 and HRR2 with increasing SUA levels. This negative correlation was observed across nearly all subgroups. Conclusions Elevated SUA levels are indicative of poorer cardiovascular adaptability in the adult US population.
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Affiliation(s)
- Liping Lu
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Xilin Wu
- Department of Neurology, Fujian Medical University Union Hospital Fujian Key Laboratory of Molecular Neurology, Fuzhou, Fujian, 350001, China
| | - Jiaxin Zhong
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Qin Chen
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Huizhong Lin
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
| | - Yukun Luo
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China
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D'Souza AW, Yoo JK, Bhai S, Sarma S, Anderson EH, Levine BD, Fu Q. Attenuated peripheral oxygen extraction and greater cardiac output in women with posttraumatic stress disorder during exercise. J Appl Physiol (1985) 2024; 136:141-150. [PMID: 38031720 PMCID: PMC11219012 DOI: 10.1152/japplphysiol.00161.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is associated with an increased risk of developing cardiovascular disease, especially in women. Evidence indicates that men with PTSD exhibit lower maximal oxygen uptake (V̇o2max) relative to controls; however, whether V̇o2max is blunted in women with PTSD remains unknown. Furthermore, it is unclear what determinants (i.e., central and/or peripheral) of V̇o2max are impacted by PTSD. Therefore, we evaluated the central (i.e., cardiac output; Q̇c) and peripheral (i.e., arteriovenous oxygen difference) determinants of V̇o2max in women with PTSD; hypothesizing that V̇o2max would be lower in women with PTSD compared with women without PTSD (controls), primarily due to smaller increases in stroke volume (SV), and therefore Q̇c. Oxygen uptake (V̇o2), heart rate (HR), Q̇c, SV, and arteriovenous oxygen difference were measured in women with PTSD (n = 14; mean [SD]: 43 [11] yr,) and controls (n = 17; 45 [11] yr) at rest, and during an incremental maximal treadmill exercise test, and the Q̇c/V̇o2 slope was calculated. V̇o2max was not different between women with and without PTSD (24.3 [5.6] vs. 26.4 [5.0] mL/kg/min; P = 0.265). However, women with PTSD had higher Q̇c [P = 0.002; primarily due to greater SV (P = 0.069), not HR (P = 0.285)], and lower arteriovenous oxygen difference (P = 0.002) throughout exercise compared with controls. Furthermore, the Q̇c/V̇o2 slope was steeper in women with PTSD relative to controls (6.6 [1.4] vs. 5.7 [1.0] AU; P = 0.033). Following maximal exercise, women with PTSD exhibited slower HR recovery than controls (P = 0.046). Thus, despite attenuated peripheral oxygen extraction, V̇o2max is not reduced in women with PTSD, likely due to larger increases in Q̇c.NEW & NOTEWORTHY The current study indicates that V̇o2max is not different between women with and without PTSD; however, women with PTSD exhibit blunted peripheral extraction of oxygen, thus requiring an increase in Q̇c to meet metabolic demand during exercise. Furthermore, following exercise, women with PTSD demonstrate impaired autonomic cardiovascular control relative to sedentary controls. We interpret these data to indicate that women with PTSD demonstrate aberrant cardiovascular responses during and immediately following fatiguing exercise.
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Affiliation(s)
- Andrew W D'Souza
- Neurovascular Research Laboratory, School of Kinesiology, Western University, London, Ontario, Canada
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jeung-Ki Yoo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Salman Bhai
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Elizabeth H Anderson
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
- Veterans Affairs North Texas Health Care System, Dallas, Texas, United States
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
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8
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Cornell DJ, Flees RJ, Shemelya CM, Ebersole KT. Influence of Cardiorespiratory Fitness on Cardiac Autonomic Recovery Among Active-Duty Firefighters. J Strength Cond Res 2024; 38:66-73. [PMID: 37815269 DOI: 10.1519/jsc.0000000000004581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Abstract
Cornell, DJ, Flees, RJ, Shemelya, CM, and Ebersole, KT. Influence of cardiorespiratory fitness on cardiac autonomic recovery among active-duty firefighters. J Strength Cond Res 38(1): 66–73, 2024—It has been suggested that an inability of the autonomic nervous system (ANS) to recover after strenuous events is a potential cause of sudden cardiac death among firefighters. The purpose of this study was to examine the influence of cardiorespiratory fitness (CRF) on the heart rate recovery (HRR) kinetics of firefighters. Thirty-seven male career active-duty firefighters completed both a submaximal step test and a maximal treadmill graded exercise test. A monoexponential curve was fit to postexercise submaximal and maximal HRR data of each subject. Subjects were placed into Low CRF (n = 13) and High CRF (n = 24) groups based on the standard peak aerobic capacity (V̇O2peak) criterion of <42 ml·kg−1·minute−1 and ≥42 ml·kg−1·minute−1, respectively. After controlling for age and body mass index, CRF was significantly (p < 0.05) correlated with the decay rate (
) and asymptote (
) after submaximal exercise (r
sp = −0.556; r
sp = −0.637, respectively), as well as the
,
, and amplitude (
) after maximal exercise (r
sp = −0.353; r
sp = −0.416; r
sp = 0.603, respectively). High CRF firefighters demonstrated a significantly faster
after both submaximal (p = 0.003) and maximal exercise (p = 0.043), a lower
after submaximal exercise (p = 0.002), and a higher
after maximal exercise (p = 0.001), than Low CRF firefighters. Greater CRF was associated with enhanced HRR kinetics after submaximal and maximal exertion, suggesting that CRF may positively influence the ANS recovery of firefighters.
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Affiliation(s)
- David J Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, Massachusetts
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Robert J Flees
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; and
| | - Corey M Shemelya
- Department of Electrical and Computer Engineering, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Kyle T Ebersole
- Human Performance and Sport Physiology Laboratory, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; and
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9
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Hamasaki H. The Effect of Exercise on Cardiovascular Autonomic Nervous Function in Patients with Diabetes: A Systematic Review. Healthcare (Basel) 2023; 11:2668. [PMID: 37830705 PMCID: PMC10572826 DOI: 10.3390/healthcare11192668] [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: 09/08/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Diabetic neuropathy, including autonomic neuropathy, is a severe complication in patients with poorly controlled diabetes. Specifically, cardiovascular autonomic neuropathy (CAN) plays a significant prognostic role in cardiovascular morbidity and mortality. Exercise, an essential component of diabetes treatment, may have a therapeutic effect on patients with diabetes complicated by CAN. However, it remains unclear whether exercise has a therapeutic or protective effect in diabetes patients with CAN. METHODS The author conducted a systematic search of PubMed/MEDLINE, Embase, and The Cochrane Library, resulting in the identification of eight eligible randomized controlled trials for this review. RESULTS Exercise, including aerobic exercise combined with resistance training (RT), high-intensity interval training, and progressive RT, has shown a beneficial effect on cardiac autonomic function (CAF) in patients with type 2 diabetes, as measured by heart rate variability, heart rate recovery, and baroreflex sensitivity. However, most studies had low quality. Moreover, there were no relevant studies examining the effect of exercise on CAF in older patients, patients with poorly controlled diabetes, and patients with type 1 diabetes. CONCLUSIONS Exercise has the potential to manage patients with CAN by balancing sympathetic and parasympathetic nervous system functions; however, further studies are warranted in the future.
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10
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Uzawa H, Akiyama K, Furuyama H, Takeuchi S, Nishida Y. Autonomic responses to aerobic and resistance exercise in patients with chronic musculoskeletal pain: A systematic review. PLoS One 2023; 18:e0290061. [PMID: 37578955 PMCID: PMC10424875 DOI: 10.1371/journal.pone.0290061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/01/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND It is unknown whether patients with chronic musculoskeletal pain (CMP) show autonomic dysregulation after exercise, and the interventional effects of exercise on the autonomic dysregulation have not been elucidated. The objectives of this study were to reveal acute autonomic responses after aerobic and resistance exercises and the interventional effects of both exercises on autonomic dysregulation in patients with CMP. METHODS A systematic search using nine electronic databases was performed based on three key search terms: "chronic musculoskeletal pain," "autonomic nervous system," and "exercise." Data were extracted from measurements of the autonomic nervous system and pain. RESULTS We found a total of 1170 articles; 17 were finally included, incorporating 12 observational and five interventional studies. Although a comparator has not been specified, healthy controls were compared to patients with CMP in observational studies. Three of five interventional studies were pre-post study with healthy controls as a comparator or no controls. The other two interventional studies were randomized controlled trial with a different treatment e.g., stretching. There were four good, 10 fair, and three poor-quality articles. The total number of participants was 617, of which 551 were female. There was high heterogeneity among the five disease conditions and nine outcome measures. Following one-time exposure to aerobic and resistance exercises, abnormal autonomic responses (sympathetic activation and parasympathetic withdrawal), which were absent in healthy controls, were observed in patients with CMP. The effects of aerobic and resistance exercise as long-term interventions were unclear since we identified both positive effects and no change in the autonomic activities in patients with CMP. CONCLUSIONS This study indicates dysfunctional autonomic responses following one-time exposure to exercise and inconsistent interventional effects in the autonomic activities in patients with CMP. Appropriate therapeutic dose is necessary for studying the management of autonomic regulation and pain after exercise.
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Affiliation(s)
- Hironobu Uzawa
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Chiba, Japan
| | - Kazuya Akiyama
- Rehabilitation Center, International University of Health and Welfare Narita hospital, Narita, Chiba, Japan
| | - Hiroto Furuyama
- Rehabilitation Center, International University of Health and Welfare Narita hospital, Narita, Chiba, Japan
| | - Shinta Takeuchi
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Chiba, Japan
| | - Yusuke Nishida
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Chiba, Japan
- Rehabilitation Center, International University of Health and Welfare Narita hospital, Narita, Chiba, Japan
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11
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Petek BJ, Al-Alusi MA, Moulson N, Grant AJ, Besson C, Guseh JS, Wasfy MM, Gremeaux V, Churchill TW, Baggish AL. Consumer Wearable Health and Fitness Technology in Cardiovascular Medicine: JACC State-of-the-Art Review. J Am Coll Cardiol 2023; 82:245-264. [PMID: 37438010 PMCID: PMC10662962 DOI: 10.1016/j.jacc.2023.04.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 07/14/2023]
Abstract
The use of consumer wearable devices (CWDs) to track health and fitness has rapidly expanded over recent years because of advances in technology. The general population now has the capability to continuously track vital signs, exercise output, and advanced health metrics. Although understanding of basic health metrics may be intuitive (eg, peak heart rate), more complex metrics are derived from proprietary algorithms, differ among device manufacturers, and may not historically be common in clinical practice (eg, peak V˙O2, exercise recovery scores). With the massive expansion of data collected at an individual patient level, careful interpretation is imperative. In this review, we critically analyze common health metrics provided by CWDs, describe common pitfalls in CWD interpretation, provide recommendations for the interpretation of abnormal results, present the utility of CWDs in exercise prescription, examine health disparities and inequities in CWD use and development, and present future directions for research and development.
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Affiliation(s)
- Bradley J Petek
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA; Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Mostafa A Al-Alusi
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nathaniel Moulson
- Division of Cardiology and Sports Cardiology BC, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aubrey J Grant
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Cyril Besson
- Swiss Olympic Medical Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Institute for Sport Science, University of Lausanne (ISSUL), Lausanne, Switzerland
| | - J Sawalla Guseh
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Meagan M Wasfy
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Vincent Gremeaux
- Swiss Olympic Medical Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Institute for Sport Science, University of Lausanne (ISSUL), Lausanne, Switzerland
| | - Timothy W Churchill
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aaron L Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA; Swiss Olympic Medical Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Institute for Sport Science, University of Lausanne (ISSUL), Lausanne, Switzerland.
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12
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Giga V, Boskovic N, Djordjevic-Dikic A, Beleslin B, Nedeljkovic I, Stankovic G, Tesic M, Jovanovic I, Paunovic I, Aleksandric S. Heart Rate Recovery as a Predictor of Long-Term Adverse Events after Negative Exercise Testing in Patients with Chest Pain and Pre-Test Probability of Coronary Artery Disease from 15% to 65. Diagnostics (Basel) 2023; 13:2229. [PMID: 37443623 DOI: 10.3390/diagnostics13132229] [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: 05/17/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The prognosis of patients with chest pain after a negative exercise test is good, but some adverse events occur in this low-risk group. The aim of our study was to identify predictors of long-term adverse events after a negative exercise test in patients with chest pain and a lower intermediate (15-65%) pre-test probability of coronary artery disease (CAD) and to assess the prognostic value of exercise electrocardiography and exercise stress echocardiography in this group of patients. METHODS We identified from our stress test laboratory database 862 patients with chest pain without previously known CAD and with a pre-test probability of CAD ranging from 15 to 65% (mean 41 ± 14%) who underwent exercise testing. Patients were followed for the occurrence of death, non-fatal myocardial infarction (MI) and clinically guided revascularization. RESULTS During the median follow-up of 94 months, 87 patients (10.1%) had an adverse event (AE). A total of 30 patients died (3.5%), 23 patients suffered non-fatal MI (2.7%) and 34 patients (3.9%) had clinically guided revascularization (20 patients percutaneous and 14 patients surgical revascularizations). Male gender, age, the presence of diabetes and a slow heart rate recovery (HRR) in the first minute after exercise were independently related to the occurrence of AEs. Adverse events occurred in 10.3% of patients who were tested by exercise stress echocardiography and in 10.0% of those who underwent stress electrocardiography (p = 0.888). CONCLUSION The risk of AEs after negative exercise testing in patients with a pre-test probability of CAD of 15-65% is low. Male patients with a history of diabetes and slow HRR in the first minute after exercise have an increased risk of an adverse outcome.
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Affiliation(s)
- Vojislav Giga
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nikola Boskovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Branko Beleslin
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Ivana Nedeljkovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Goran Stankovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milorad Tesic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivana Jovanovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivana Paunovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Srdjan Aleksandric
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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13
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Laurino MJL, da Silva AKF, Santos LA, Vanderlei LCM. Water drinking during aerobic exercise improves the recovery of non-linear heart rate dynamics in coronary artery disease: crossover clinical trial. Front Neurosci 2023; 17:1147299. [PMID: 37424997 PMCID: PMC10323825 DOI: 10.3389/fnins.2023.1147299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The post-exercise recovery is a period of vulnerability of the cardiovascular system in which autonomic nervous system plays a key role in cardiovascular deceleration. It is already known that individuals with coronary artery disease (CAD) are at greater risk due to delayed vagal reactivation in this period. Water ingestion has been studied as a strategy to improve autonomic recovery and mitigate the risks during recovery. However, the results are preliminary and need further confirmation. Therefore, our aim was to investigate the influence of individualized water drinking on the non-linear dynamics of heart rate during and after aerobic exercise in CAD subjects. Methods 30 males with CAD were submitted to a control protocol composed of initial rest, warming up, treadmill exercise, and passive recovery (60 min). After 48 hours they performed the hydration protocol, composed of the same activities, however, with individualized water drinking proportional to the body mass lost in the control protocol. The non-linear dynamics of heart rate were assessed by indices of heart rate variability extracted from the recurrence plot, detrended fluctuation analysis, and symbolic analysis. Results and discussion During exercise, the responses were physiological and similar in both protocols, indicating high sympathetic activity and reduced complexity. During recovery, the responses were also physiological, indicating the rise of parasympathetic activity and the return to a more complex state. However, during hydration protocol, the return to a more complex physiologic state occurred sooner and non-linear HRV indices returned to resting values between the 5th and 20th minutes of recovery. In contrast, during the control protocol, only a few indices returned to resting values within 60 minutes. Despite that, differences between protocols were not found. We conclude that the water drinking strategy accelerated the recovery of non-linear dynamics of heart rate in CAD subjects but did not influence responses during exercise. This is the first study to characterize the non-linear responses during and after exercise in CAD subjects.
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14
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Bhati P, Hussain ME, Deepak KK, Masood S, Anand P. Progressive resistance training ameliorates deteriorating cardiac autonomic dysfunction, subclinical inflammation and endothelial dysfunction in type 2 diabetes mellitus: A randomized control trial. Diabetes Metab Syndr 2023; 17:102778. [PMID: 37178513 DOI: 10.1016/j.dsx.2023.102778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 04/11/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND AND AIMS To investigate the effect of resistance training (RT) on outcomes of cardiac autonomic control, biomarkers of subclinical inflammation, endothelial dysfunction, and angiotensin II in T2DM patients with CAN. METHODS Fifty six T2DM patients with CAN were recruited in the present study.After baseline assessment of all outcome variables, patients were randomly allocated into two groups - RT (n = 28) and Control (n = 28). The experimental group underwent 12 weeks of RT and the control group received usual care. RT was performed at an intensity of 65%-75% of 1 RM, 3 times/week for 12 weeks. RT program included 10 exercises of major muscle groups in the body. Cardiac autonomic control parameters, subclinical inflammation and endothelial dysfunction biomarkers, and serum angiotensin II concentration were assessed at baseline and after 12 weeks. RESULTS Parameters of cardiac autonomic control showed significant improvement after RT (p < 0.05). Interleukin-6, interleukin-18 were significantly reduced while endothelial nitric oxide synthase was significantly increased post-RT (p < 0.05). CONCLUSIONS Findings of the present study suggest that RT has the potential to enhance deteriorating cardiac autonomic function in T2DM patients with CAN. RT also seems to have an anti-inflammatory role and it may also play some role in vascular remodeling in these patients. TRIAL REGISTRATION CTRI/2018/04/013321, Registered prospectively on 13th April 2018, Clinical Trial Registry, India.
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Affiliation(s)
- Pooja Bhati
- Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, 122505, India; Diabetes Research Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
| | - M Ejaz Hussain
- Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, 122505, India; Diabetes Research Group, Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
| | - K K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sarfaraz Masood
- Department of Computer Engineering, Faculty of Engineering, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
| | - Pooja Anand
- Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, 122505, India.
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15
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Mashayekhi B, Mohseni-Badalabadi R, Hosseinsabet A, Ahmadian T. Correlation between Heart rate recovery and Left Atrial phasic functions evaluated by 2D speckle-tracking Echocardiography after Acute Myocardial infarction. BMC Cardiovasc Disord 2023; 23:164. [PMID: 36991359 PMCID: PMC10061796 DOI: 10.1186/s12872-023-03194-y] [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: 08/12/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Heart rate recovery (HRR) in the exercise test is the index of cardiac autonomic system function and sympathovagal balance impaired in patients with myocardial infarction (MI). An instance is left atrial (LA) phasic function, which is impaired in such patients. In this study, we investigated the role of HRR in predicting LA phasic functions in patients with MI. METHODS The present study recruited 144 consecutive patients with ST-elevation MI. A symptom-limited exercise test was performed about 5 weeks after MI, with echocardiography conducted just before the exercise test. The patients were divided into abnormal and normal HRR at 60 s (HRR60) and again into abnormal and normal HRR at 120 s (HRR120) after the exercise test. LA phasic functions, evaluated by 2D speckle-tracking echocardiography, were compared between the 2 groups. RESULTS Patients with abnormal HRR120 had lower LA strain values and strain rates during the reservoir, conduit, and contraction phases, while those with abnormal HRR60 had lower LA strain values and strain rates during the reservoir and conduit phases. The differences were lost after adjustments for possible confounders, except for LA strain and strain rate during the conduit phase, in patients with abnormal HRR120. CONCLUSIONS Abnormal HRR120 in the exercise test can independently predict decreased LA conduit function in patients with ST-elevation MI.
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Affiliation(s)
- Behruz Mashayekhi
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Karegar Shomali Street, Tehran, I.R. of Iran
| | - Reza Mohseni-Badalabadi
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Karegar Shomali Street, Tehran, I.R. of Iran
| | - Ali Hosseinsabet
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Karegar Shomali Street, Tehran, I.R. of Iran.
| | - Tahereh Ahmadian
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, I.R. of Iran
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16
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Dewar A, Kass L, Stephens RCM, Tetlow N, Desai T. Heart Rate Recovery Assessed by Cardiopulmonary Exercise Testing in Patients with Cardiovascular Disease: Relationship with Prognosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4678. [PMID: 36981587 PMCID: PMC10048507 DOI: 10.3390/ijerph20064678] [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: 12/19/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The use of exercise testing has expanded in recent decades and there is a wealth of information examining the prognostic significance of exercise variables, such as peak oxygen consumption or ventilatory measures whilst exercising. However, a paucity of research has investigated the use of recovery-derived parameters after exercise cessation. Heart rate recovery (HRR) has been considered a measure of the function of the autonomic nervous system and its dysfunction is associated with cardiovascular risk. OBJECTIVES We aim to provide an overview of the literature surrounding HRR and its prognostic significance in patients with cardiovascular disease undertaking an exercise test. DATA SOURCES In December 2020, searches of PubMed, Scopus, and ScienceDirect were performed using key search terms and Boolean operators. STUDY SELECTION Articles were manually screened and selected as per the inclusion criteria. RESULTS Nineteen articles met inclusion criteria and were reviewed. Disagreement exists in methodologies used for measuring and assessing HRR. However, HRR provides prognostic mortality information for use in clinical practice. CONCLUSIONS HRR is a simple, non-invasive measure which independently predicts mortality in patients with heart failure and coronary artery disease; HRR should be routinely incorporated into clinical exercise testing.
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Affiliation(s)
- Amy Dewar
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Lindsy Kass
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Robert C. M. Stephens
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London NW1 2PG, UK
| | - Nicholas Tetlow
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, London NW1 2PG, UK
| | - Terun Desai
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
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17
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Validity and sensitivity of field tests' heart-rate recovery assessment in recreational football players. PLoS One 2023; 18:e0282058. [PMID: 36857396 PMCID: PMC9977042 DOI: 10.1371/journal.pone.0282058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/06/2023] [Indexed: 03/02/2023] Open
Abstract
We aimed at examining the criterion validity and sensitivity of heart-rate recovery (HRRec) in profiling cardiorespiratory fitness in male recreational football players in the untrained and trained status, using endurance field-tests. Thirty-two male untrained subjects (age 40 ± 6 years, VO2max 41.7 ± 5.7 ml·kg-1·min-1, body mass 82.7 ± 9.8 kg, stature 173.3 ± 7.4 cm) participated in a 12-week (2‒3 sessions per week) recreational football intervention and were tested pre- and post-intervention (i.e. untrained and trained status). The participants performed three intermittent field tests for aerobic performance assessment, namely Yo-Yo intermittent endurance level 1 (YYIE1) and level 2 (YYIE2) tests, and Yo-Yo intermittent recovery level 1 (YYIR1) test. VO2max was assessed by performing a progressive maximal treadmill test (TT) and maximal HR (HRmax) determined as the maximal value across the testing conditions (i.e., Yo-Yo intermittent tests or TT). HRRec was calculated as the difference between Yo-Yo tests' HRpeak or HRmax and HR at 30 s (HR30), 60 s (HR60) and 120 s (HR120) and considered as beats·min-1 (absolute) and as % of tests' HRpeak or HRmax values. Significant post-intervention improvements (p<0.0001) were shown in VO2max (8.6%) and Yo-Yo tests performance (23-35%). Trivial to small (p>0.05) associations were found between VO2max and HRRec (r = -0.05-0.27, p>0.05) across the Yo-Yo tests, and training status either expressed as percentage of HRpeak or HRmax. The results of this study do not support the use of field-test derived HRRec to track cardiorespiratory fitness and training status in adult male recreational football players.
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18
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Aktas H, Gul M, Inci S, Yildirim O, Turgut M. The effect of insulin resistance on the heart rate recovery in healthy individuals with a low-to-moderate cardiovascular disease risk profile. J Investig Med 2023; 71:482-488. [PMID: 36825620 DOI: 10.1177/10815589231158040] [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: 02/25/2023]
Abstract
The association between insulin resistance (IR) and heart rate recovery index (HRRI) has been reported previously, but the cardiovascular disease (CVD) risk profile of the subjects was unclear in these studies. Therefore, we evaluated the association between IR and HRRI in apparently healthy individuals without metabolic syndrome who had a low-to-moderate CVD risk profile. A total of 182 eligible subjects were retrospectively included in the study. The subjects were divided into two groups according to the homeostasis model assessment of IR (HOMA-IR) value. HOMA-IR ≥2.5 was defined as IR (+) group (92 subjects), and <2.5 as IR (-) group (88 subjects). HRRI-2 was found by subtracting the heart rate at the second minute in the post-exercise recovery period from the maximum heart rate. Abnormal HRRI was defined as HRRI-2 that is ≤42 beats. The mean age of the patients was 41.91 ± 8.64 and 49.4% of them were female. Abnormal HRRI rates were significantly higher in the IR (+) group (37.2% vs 18.2%; p = 0.004). A negative correlation was detected between HRRI-2 and HOMA-IR (r = -0.416; p < 0.001). HOMA-IR (Odds Ratio (OR) = 1.57; confidence interval (CI) = 1.10-2.23; p = 0.013) and maximum heart rate during exercise (OR = 0.95; CI = 0.91-0.99; p = 0.013) as independent variables of abnormal HRRI. The HOMA-IR value of 2.82 was identified as an effective cutoff point for the prediction of abnormal HRRI (area under the curve: 0.658; CI: 0.570-0.746; p = 0.001). In this study, it was shown that IR without metabolic syndrome reduces HRRI in healthy individuals with a low-to-moderate CVD risk profile.
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Affiliation(s)
- Halil Aktas
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Murat Gul
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Sinan Inci
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Oguz Yildirim
- Department of Cardiology, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Mustafa Turgut
- Department of Internal Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Fathieh S, Grieve SM, Negishi K, Figtree GA. Potential Biological Mediators of Myocardial and Vascular Complications of Air Pollution-A State-of-the-Art Review. Heart Lung Circ 2023; 32:26-42. [PMID: 36585310 DOI: 10.1016/j.hlc.2022.11.014] [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: 03/09/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 12/29/2022]
Abstract
Ambient air pollution is recognised globally as a significant contributor to the burden of cardiovascular diseases. The evidence from both human and animal studies supporting the cardiovascular impact of exposure to air pollution has grown substantially, implicating numerous pathophysiological pathways and related signalling mediators. In this review, we summarise the list of activated mediators for each pathway that lead to myocardial and vascular injury in response to air pollutants. We performed a systematic search of multiple databases, including articles between 1990 and Jan 2022, summarising the evidence for activated pathways in response to each significant air pollutant. Particulate matter <2.5 μm (PM2.5) was the most studied pollutant, followed by particulate matter between 2.5 μm-10 μm (PM10), nitrogen dioxide (NO2) and ozone (O3). Key pathogenic pathways that emerged included activation of systemic and local inflammation, oxidative stress, endothelial dysfunction, and autonomic dysfunction. We looked at how potential mediators of each of these pathways were linked to both cardiovascular disease and air pollution and included the overlapping mediators. This review illustrates the complex relationship between air pollution and cardiovascular diseases, and discusses challenges in moving beyond associations, towards understanding causal contributions of specific pathways and markers that may inform us regarding an individual's exposure, response, and likely risk.
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Affiliation(s)
- Sina Fathieh
- Kolling Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Stuart M Grieve
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Department of Radiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Kazuaki Negishi
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Department of Cardiology, Graduate School of Medicine, Gunma University, Maebashi, Gunma, Japan; Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Nepean Hospital, Sydney, NSW, Australia
| | - Gemma A Figtree
- Kolling Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia.
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Almas SP, Werneck FZ, Coelho EF, Teixeira PFS, Vaisman M. Endurance training improves heart rate on-kinetics in women with subclinical hypothyroidism: a preliminary study. J Endocrinol Invest 2023; 46:51-57. [PMID: 35918630 DOI: 10.1007/s40618-022-01882-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/25/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of the study was to evaluate the effect of endurance training on heart rate (HR) on-kinetics in patients with subclinical hypothyroidism (SH). METHODS Eighteen women were randomly assigned to trained group (TG) or control group (CG). Both groups performed three tests at 50 W in a cycle ergometer for 6 min. HR kinetics was obtained during the tests and the mean response time (MRT), which is equivalent to the time taken to reach 63% of the HR at steady state, was extracted. The TG was then submitted to 12 weeks of endurance training (50 min, 3x/week, intensity between 70 and 85% of the maximum HR predicted for the age). Statistical analysis was performed by the mixed analysis of variance. RESULTS At baseline, TG and CG were similar for TSH (7.7 ± 3.1 vs. 6.9 ± 3.3 mUI/L, p = 0.602, respectively) and FT4 (12.31 ± 1.51 vs. 12.20 ± 1.89 pmol/L, p = 0.889, respectively). After adjustment for body mass index and age, interactions between moment (baseline or after 12 weeks) and group (trained or control) were only significant for MRT (TG: 39.6 ± 10 to 28.9 ± 8.4 s, CG: 53.6 ± 20.3 to 55 ± 19.7 s, p = 0.001) and physical activity level (CG: 7.3 ± 0.7 to 8 ± 0.9, CG: 6.8 ± 0.8 in both moments, p = 0.005). CONCLUSION The preliminary results suggest that 12 weeks of endurance training improve HR on-kinetics and physical activity level in SH.
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Affiliation(s)
- S P Almas
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
| | - F Z Werneck
- Escola de Educação Física, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - E F Coelho
- Escola de Educação Física, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - P F S Teixeira
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - M Vaisman
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Saari A, Ma X, Clasey J, Bollinger L, Abel M. Heart rate dynamics during a simulated fireground test: The influence of physical characteristics and fitness1. Work 2023; 76:251-262. [PMID: 36806532 DOI: 10.3233/wor-220216] [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] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Firefighting is a physiologically demanding occupation and there is a need to evaluate physical and fitness characteristics that are related to attenuated physiological stress during fireground tasks. Previous studies have not measured associations between heart rate responses during simulated fireground tasks with a standardized work rate. OBJECTIVE The purpose of this study was to examine associations between heart rate during a standardized pace simulated fireground test (SFGT) and heart rate recovery and variability following the SFGT. In addition, this study sought to evaluate associations between heart rate measures versus physical and fitness characteristics in structural firefighter recruits. METHODS Twenty-one fire academy recruits performed a standardized pace SFGT while mean heart rate reserve (HRRes) during the SFGT, change in heart rate variability from rest to post-SFGT (LnRMSSDRest-Post), and 60-second post-SFGT heart rate recovery (HRR60) were measured. Regression analyses were conducted between HRRes, LnRMSSDRest-Post and HRR60 and between heart rate measures versus physical and fitness characteristics while accounting for differences in SFGT completion time. RESULTS HRRes was associated with LnRMSSDRest-Post, but not HRR60. Height and pull-ups explained most of the variance in HRRes, height explained most of the variance in LnRMSSDRest-Post and push-ups and 1.5-mile run explained most of the variance in HRR60. CONCLUSION Greater cardiovascular stress during fireground tasks is associated with greater depression of post-SFGT heart rate variability, but not heart rate recovery. Physical and fitness characteristics are important to consider in relation to firefighters' ability to cope with physical stress on the fireground.
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Affiliation(s)
- Anssi Saari
- Finnish Institute of High Performance Sport KIHU, Jyväskylä, Finland
| | - Xin Ma
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Jody Clasey
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Lance Bollinger
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Mark Abel
- College of Education, University of Kentucky, Lexington, KY, USA
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22
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Pouriamehr S, Dabidi Roshan V, Shirani F. Does long-term exposure to air pollution suppress parasympathetic reactivation after incremental exercise among healthy males and females? Inhal Toxicol 2023; 35:14-23. [PMID: 36416472 DOI: 10.1080/08958378.2022.2149905] [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: 11/25/2022]
Abstract
PURPOSE As consequences of industrial processes, air pollution has led to increased cardiovascular diseases resulting in mortality. However, there are few pieces of evidence expressing physical fitness and gender impacts in such environments. Regarding long-term exposure to air pollution, this study aimed to determine the effect of physical fitness on post-exercise cardiac parasympathetic reactivation among healthy males and females. METHODS 120 individuals (46 ± 5 years) participated and were categorized into two main groups (n = 60; EG, CG); (1) The experimental group included individuals living in an air-polluted environment; (2) The control group included the citizens of a clean air region; and two physical fitness status subgroups (n = 30; active vs. sedentary) across both sexes. The heart rate (HR) changes at different timing after performing an incremental exercise, and T30 were calculated as metrics of cardiac parasympathetic reactivation. RESULTS The heart rate recovery values were substantially lower in EG in comparison to CG (p < 0.001) at different timing, while, T30 was significantly greater in residents of the air-polluted city compared to CG (p < 0.001). As for heart rate recovery at the 5th minute, the values were significantly lower in the steady-female group in comparison to the active females living in the air-polluted city (p < 0.01). CONCLUSION Based on our findings, although physical fitness modifies the adverse impacts of long-term exposure to air pollution on post-exercise cardio-parasympathetic reactivation, it appears to parallel the acute/intermediate recovery of the thermoregulatory and vascular systems, among both sexes, it does not prevent them.
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Affiliation(s)
- Sara Pouriamehr
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Valiollah Dabidi Roshan
- Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran.,Athletic Performance and Health Research Center, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Farimah Shirani
- Ph.D. Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
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Yang S, Xi R, Li BB, Wang XC, Song LW, Ji TX, Ma HZ, Lu HL, Zhang JY, Li SJ, Wu ZF. The incremental significance of heart rate recovery as a predictor during exercise-stress myocardial perfusion SPECT imaging in individuals with suspected coronary artery disease. Front Cardiovasc Med 2023; 10:1082019. [PMID: 37034341 PMCID: PMC10074983 DOI: 10.3389/fcvm.2023.1082019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Background Major adverse cardiac events (MACE) are more likely to occur when abnormal heart rate recovery (HRR). This study aimed to assess the incremental predictive significance of HRR over exercise stress myocardial perfusion single-photon emission computed tomography (MPS) results for MACE in individuals with suspected coronary artery disease (CAD). Methods Between January 2014 and December 2017, we continually gathered data on 595 patients with suspected CAD who received cycling exercise stress MPS. HRR at 1, 2, 3, and 4 min were used as study variables to obtain the optimal cut-off values of HRR for MACE. The difference between the peak heart rate achieved during exercise and the heart rate at 1, 2, 3, and 4 min was used to calculate the HRR, as shown in HRR3. Heart rate variations between two locations in time, such as HRR2 min-1 min, were used to establish the slope of HRR. All patients were followed for a minimum of 4 years, with MACE as the follow-up goal. The associations between HRR and MACE were assessed using Cox proportional hazards analyses. Results Patients with MACE were older (P = 0.001), and they also had higher rates of hypertension, dyslipidemia, diabetes, abnormal MPS findings (SSS ≥ 5%), medication history (all P < 0.001), and lower HRR values (all P < 0.01). Patients with and without MACE did not significantly vary in their HRR4 min-3 min. The optimal cut-off of HRR1, 2, and 3 combined with SSS can stratify the risk of MACE in people with suspected CAD (all P < 0.001). HRR 1, 2, and 3 and its slope were linked to MACE in multivariate analysis, where HRR3 was the most significant risk predictor. With a global X2 increase from 101 to 126 (P < 0.0001), HRR3 demonstrated the greatest improvement in the model's predictive capacity, incorporating clinical data and MPS outcomes. Conclusions HRR at 3 min has a more excellent incremental prognostic value for predicting MACE in patients with suspected CAD following cycling exercise stress MPS. Therefore, incorporating HRR at 3 min into known predictive models may further improve the risk stratification of the patients.
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Affiliation(s)
- Shuai Yang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Rui Xi
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Bing-Bing Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin-Chao Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Li-Wei Song
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Department of General Medical Dept, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Tian-Xiong Ji
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hui-Zhu Ma
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hai-Li Lu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jing-Ying Zhang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Si-Jin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, China
- Correspondence: Si-Jin Li Zhi-Fang Wu
| | - Zhi-Fang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Correspondence: Si-Jin Li Zhi-Fang Wu
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Forton K, Lamotte M, Gillet A, Chaumont M, van de Borne P, Faoro V. Beta-Adrenergic Receptor Blockade Effects on Cardio-Pulmonary Exercise Testing in Healthy Young Adults: A Randomized, Placebo-Controlled Trial. SPORTS MEDICINE - OPEN 2022; 8:150. [PMID: 36538192 PMCID: PMC9768047 DOI: 10.1186/s40798-022-00537-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Beta-blockers are increasingly prescribed while the effects of beta-adrenergic receptor blockade on cardio-pulmonary exercise test (CPET)-derived parameters remain under-studied. METHODS Twenty-one young healthy adults repeated three CPET at the same time with an interval of 7 days between each test. The tests were performed 3 h after a random, double-blind, cross-over single-dose intake of placebo, 2.5 mg or 5.0 mg bisoprolol, a cardio-selective beta1-adrenoreceptor antagonist. Gas exchange, heart rate (HR) and blood pressure (BP) were measured at rest and during cyclo-ergometric incremental CPET. RESULTS Maximal workload and VO2max were unaffected by the treatment, with maximal respiratory exchange ratio > 1.15 in all tests. A beta-blocker dose-dependent effect reduced resting and maximal BP and HR and the chronotropic response to exercise, evaluated by the HR/VO2 slope (placebo: 2.9 ± 0.4 beat/ml/kg; 2.5 mg bisoprolol: 2.4 ± 0.5 beat/ml/kg; 5.0 mg bisoprolol: 2.3 ± 0.4 beat/ml/kg, p < 0.001). Ventilation efficiency measured by the VE/VCO2 slope and the ventilatory equivalent for CO2 at the ventilatory threshold were not affected by beta1-receptor blockade. Post-exercise chronotropic recovery measured after 1 min was enhanced under beta1-blocker (placebo: 26 ± 7 bpm; 2.5 mg bisoprolol: 32 ± 6 bpm; 5.0 mg bisoprolol: 33 ± 6 bpm, p < 0.01). CONCLUSION The present results suggest that a single dose of bisoprolol does not affect metabolism, respiratory response and exercise capacity. However, beta-adrenergic blockade dose dependently reduces exercise hemodynamic response by lowering BP and the chronotropic response.
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Affiliation(s)
- Kevin Forton
- grid.4989.c0000 0001 2348 0746Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus CP 604, 808 Lennik Road, 1070 Brussels, Belgium ,grid.4989.c0000 0001 2348 0746Department of Cardiology, Erasmus University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Michel Lamotte
- grid.4989.c0000 0001 2348 0746Department of Cardiology, Erasmus University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexis Gillet
- grid.4989.c0000 0001 2348 0746Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus CP 604, 808 Lennik Road, 1070 Brussels, Belgium ,grid.4989.c0000 0001 2348 0746Department of Cardiology, Erasmus University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Martin Chaumont
- grid.4989.c0000 0001 2348 0746Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus CP 604, 808 Lennik Road, 1070 Brussels, Belgium ,grid.4989.c0000 0001 2348 0746Department of Cardiology, Erasmus University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe van de Borne
- grid.4989.c0000 0001 2348 0746Department of Cardiology, Erasmus University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Vitalie Faoro
- grid.4989.c0000 0001 2348 0746Cardio-Pulmonary Exercise Laboratory, Faculty of Motor Sciences, Université Libre de Bruxelles, Erasme Campus CP 604, 808 Lennik Road, 1070 Brussels, Belgium
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de Freitas VH, Mariano IM, Amaral AL, Rodrigues ML, Carrijo VHV, Nakamura FY, Puga GM. Blood Pressure and Heart Rate Variability Responses to High-Intensity Interval Training in Untrained Postmenopausal Women. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:749-757. [PMID: 34709130 DOI: 10.1080/02701367.2021.1917756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/09/2021] [Indexed: 06/13/2023]
Abstract
Purpose: The aim of this study was to analyze the blood pressure (BP) and heart rate variability (HRV) responses in untrained postmenopausal women submitted to acute single sessions of high-intensity interval training (HIT). Method: Sixteen postmenopausal women (59.9 ± 5.6 years, 26.7 ± 3.0 kg/m2) participated in a random order of two acute sessions in a balanced crossover format: control without exercise in sitting position or HIT session. BP and heart rate (HR) were recorded before and during 60 min following the sessions. Results: Diastolic (DBP), mean BP (MBP), and double product (DPO) showed interaction (p < .01). DBP, MBP, and DPO increased (p < .01) after HIT but not after the control session. The area under the curve (AUC) of DBP (p = .02) and DPO (p < .01) were different between conditions. Time and frequency indices of HRV presented interaction (p < .05) which impaired these indices post-HIT, but not post-control. The AUC of time and frequency HRV indices were different between conditions. Conclusions: A single session of HIT may increase BP and cardiac stress and cause perturbation of the autonomic function in untrained postmenopausal women.
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Cardiac autonomic responses to high-intensity kettlebell training in untrained young women: A pilot study. J Bodyw Mov Ther 2022. [DOI: 10.1016/j.jbmt.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Casanova-Lizón A, Manresa-Rocamora A, Flatt AA, Sarabia JM, Moya-Ramón M. Does Exercise Training Improve Cardiac-Parasympathetic Nervous System Activity in Sedentary People? A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113899. [PMID: 36360777 PMCID: PMC9656115 DOI: 10.3390/ijerph192113899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 05/13/2023]
Abstract
The aim of this study was to investigate the training-induced effect on cardiac parasympathetic nervous system (PNS) activity, assessed by resting heart rate variability (HRV) and post-exercise heart rate recovery (HRR), in sedentary healthy people. Electronic searches were carried out in PubMed, Embase, and Web of Science. Random-effects models of between-group standardised mean difference (SMD) were estimated. Heterogeneity analyses were performed by means of the chi-square test and I2 index. Subgroup analyses and meta-regressions were performed to investigate the influence of potential moderator variables on the training-induced effect. The results showed a small increase in RMSSD (SMD+ = 0.57 [95% confidence interval (CI) = 0.23, 0.91]) and high frequency (HF) (SMD+ = 0.21 [95% CI = 0.01, 0.42]) in favour of the intervention group. Heterogeneity tests reached statistical significance for RMSSD and HF (p ≤ 0.001), and the inconsistency was moderate (I2 = 68% and 60%, respectively). We found higher training-induced effects on HF in studies that performed a shorter intervention or lower number of exercise sessions (p ≤ 0.001). Data were insufficient to investigate the effect of exercise training on HRR. Exercise training increases cardiac PNS modulation in sedentary people, while its effect on PNS tone requires future study.
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Affiliation(s)
- Antonio Casanova-Lizón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Agustín Manresa-Rocamora
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Alicante, Spain
- Department of Sport Sciences, Alicante Institute for Health and Biomedical Research (ISABIAL), Miguel Hernandez University, 03010 Alicante, Spain
| | - Andrew A. Flatt
- Department of Health Sciences and Kinesiology, Georgia Southern University—Armstrong Campus, Savannah, GA 31419, USA
| | - José Manuel Sarabia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Alicante, Spain
- Department of Sport Sciences, Alicante Institute for Health and Biomedical Research (ISABIAL), Miguel Hernandez University, 03010 Alicante, Spain
| | - Manuel Moya-Ramón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Alicante, Spain
- Department of Sport Sciences, Alicante Institute for Health and Biomedical Research (ISABIAL), Miguel Hernandez University, 03010 Alicante, Spain
- Correspondence: ; Tel.: +34-9666-52-046
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Manresa-Rocamora A, Sarabia JM, Guillen-Garcia S, Pérez-Berbel P, Miralles-Vicedo B, Roche E, Vicente-Salar N, Moya-Ramón M. Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10463. [PMID: 36078179 PMCID: PMC9518028 DOI: 10.3390/ijerph191710463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The objective of this research was to investigate whether heart rate variability (HRV)-guided training improves mortality predictors to a greater extent than predefined training in coronary artery disease patients. Twenty-one patients were randomly allocated to the HRV-guided training group (HRV-G) or the predefined training group (PRED-G). They measured their HRV at home daily and trained three times a week for six weeks. Resting heart rate, isolated vagal-related HRV indices (i.e., RMSSD, HF, and SD1), weekly averaged RMSSD, heart rate recovery, and maximum oxygen uptake were assessed before and after the training period. There was a statistically significant difference (p = 0.034) in the change in weekly averaged RMSSD in favor of the HRV-G, while no differences were found in the remaining analyzed variables (p > 0.050). Regardless of the training prescription method, exercise training decreased resting heart rate (p = 0.001; -4.10 [95% CI = -6.37--1.82] beats per minute (bpm)), and increased heart rate recovery at 2 min (p = 0.010; 4.33 [95% CI = 1.15-7.52] bpm) and maximum oxygen uptake (p < 0.001; 3.04 [95% CI = 1.70-4.37] mL·kg-1·min-1). HRV-guided training is superior to predefined training in improving vagal-related HRV when methodological factors are accounted for.
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Affiliation(s)
- Agustín Manresa-Rocamora
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
| | - José Manuel Sarabia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
| | | | - Patricio Pérez-Berbel
- Department of Cardiology, Hospital Clínico Universitario San Juan, 03550 San Juan de Alicante, Spain
- Department of Cardiology, Hospital Universitario del Vinalopó, 03293 Elche, Spain
| | | | - Enrique Roche
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University of Elche, 03202 Elche, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Néstor Vicente-Salar
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Manuel Moya-Ramón
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche, Spain
- Institute for Health and Biomedical Research of Alicante (ISABIAL), 03010 Alicante, Spain
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Tabachnikov V, Saliba W, Aker A, Zafrir B. Heart Rate Response to Exercise and Recovery: INDEPENDENT PROGNOSTIC MEASURES IN PATIENTS WITHOUT KNOWN MAJOR CARDIOVASCULAR DISEASE. J Cardiopulm Rehabil Prev 2022; 42:E34-E41. [PMID: 35383665 DOI: 10.1097/hcr.0000000000000679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Heart rate response during exercise testing (ET) provides valuable prognostic information. Limited data are available regarding the prognostic interplay of heart rate (HR) measured at rest, exercise and recovery phases of ET, and its ability to predict risk beyond exercise capacity. METHODS Retrospective analysis of treadmill ETs was performed by the Bruce protocol in patients aged 35-75 yr without known cardiovascular disease (CVD; n = 13 887; 47% women). Heart rate recovery at 2 min (HRR2; defined abnormal <42 beats) and chronotropic index (CI; defined abnormal <80%, determined as age-predicted HR reserve) were analyzed in association with the risk of developing myocardial infarction, stroke, or death (major adverse cardiovascular event [MACE]) during median follow-up of 6.5 yr. RESULTS The HRR2 <42 beats and CI <80% were each associated with increased risk of MACE: adjusted hazard ratios with 95% confidence interval 1.47: 1.27-1.72 and 1.66: 1.42-1.93, P < .001, respectively, evident also when analyzed as continuous variables. Strength of association of HRR2 and CI with outcome was attenuated but remained significant with further adjustment for exercise duration and metabolic equivalents. Having both HRR2 and CI abnormal compared with only one measure abnormal was associated with hazard ratios with 95% confidence interval of 1.66: 1.38-2.00 and 1.48: 1.22-1.79 for MACE, before and after adjustment for cardiorespiratory fitness (CRF). The degree of CRF (low vs mid/high) did not modify the prognostic effect of HRR2 and CI (P-for-interaction nonsignificant). CONCLUSIONS Both HRR2 and CI provide independent prognostic information beyond CRF in patients without CVD referred for ET. The predictive ability is more pronounced when both abnormal HR measures coexist.
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Affiliation(s)
- Vsevolod Tabachnikov
- Departments of Cardiology (Drs Tabachnikov, Aker, and Zafrir) and Community Medicine and Epidemiology (Dr Saliba), Lady Davis Carmel Medical Center, Haifa, Israel; and Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel (Drs Saliba and Zafrir)
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Eyyupkoca F, Kocak A, Yildirim O, Altintas MS, Ercan K, Sabanoglu C, Okutucu S. Is there a relationship between heart rate recovery and blood pressure in white coat hypertension? KARDIOLOGIIA 2022; 62:55-63. [PMID: 35569164 DOI: 10.18087/cardio.2022.4.n1897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/14/2021] [Accepted: 11/26/2021] [Indexed: 06/15/2023]
Abstract
Aim Increasing evidence suggests that autonomic dysfunction may be involved in the etiology of white coat hypertension (WCH). The aim of this study was to evaluate cardiac autonomic function by using heart rate recovery (HRR) indices in patients with WCH classified according to their circadian rhythm type of blood pressure (BP).Material and methods This cross-sectional study included 120 participants over the age of 18 yrs, including 50 patients diagnosed with WCH and 70 healthy controls with normal in- and out-of-office BP and without any known disease. Circadian rhythm types, i.e., dippers and non-dippers, were identified using ambulatory BP monitoring. The HRR indices were calculated by subtracting the 1st-minute (HRR1), 2nd-minute (HRR2), and 3rd-minute (HRR3) heart rates from the maximal heart rate recorded during stress testing.Results The lesser decline in nighttime BP (6.4±2.14 and 13.3±2.2 mmHg, respectively; p<0.001) and the smaller mean HRR1 (25.5±3.0 and 30.3±3.1 beats / min, respectively; p<0.001) were evident in WCH non-dippers compared to WCH dippers. Linear regression analysis showed that HRR1 (β±SE=0.43±0.11; p<0.001) and diastolic BP at maximum exercise (β±SE=0.14±0.07; p=0.040) are independent risk factors for the blunted decline in nighttime BP.Conclusion Delayed recovery of heart rate after an exercise stress test is associated with non-dipper type of circadian rhythm of BP. This was more pronounced in WCH patients, and these patients are at risk of autonomic dysfunction.
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Exercise Training and Interventions for Coronary Artery Disease. J Cardiovasc Dev Dis 2022; 9:jcdd9050131. [PMID: 35621842 PMCID: PMC9146277 DOI: 10.3390/jcdd9050131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 12/22/2022] Open
Abstract
Coronary artery disease (CAD) may be considered a main cause of mortality and the prevalence of CAD is increasing nowadays, leading to high health costs in many countries. Despite the fact of the regression of the atherosclerotic plaque, the decrease in blood viscosity and the growth of collateral vessels have been proposed as improvements that CAD patients may obtain under exercise performance. Thus, the present narrative review aimed to carry out a brief specific analysis of the results achieved when performing endurance, strength or inspiratory muscle training. Exercise attenuates certain pathophysiological processes of this disease, such as endothelial dysfunction or the vulnerability of atherosclerotic plaques, and produces improvements in functional capacity and muscle strength, among others. Within the different exercise modalities, the most important parameter to be considered seems to be the total caloric expenditure, and not so much the modality itself. As such, in cardiac rehabilitation, when prescribing exercise, we should possibly focus on the modality that obtains more adherence in patients. To conclude, it must be highlighted that total caloric expenditure is not being taken into account when comparing interventions and this relevant information should be considered in future studies.
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Rial-Vázquez J, Rúa-Alonso M, Fariñas J, Aracama A, Tufano J, Iglesias-Soler E. Heart Rate Responses and Cardiovascular Adaptations to Resistance Training Programs Differing in Set Configuration: A Randomized Controlled Trial. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-10. [PMID: 35394413 DOI: 10.1080/02701367.2021.2008293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/13/2021] [Indexed: 06/14/2023]
Abstract
Purpose: This study explored the changes in blood pressure and cardiac autonomic modulation after training programs differin in set configuration. Methods: Thirty-nine individuals were randomly assigned to a traditional, rest-redistribution, or control group. Throughout five weeks, the traditional and rest-redistribution groups performed 10 sessions of four exercises with the same load, number of repetitions, and total rest time, but with different inter-set rest duration and frequency (traditional group: 4 sets of 8 repetitions, 10 repetition maximum load, 5 min rest between sets and exercises; rest-redistribution group: 16 sets of 2 repetitions, 1 min rest between sets, 5 min rest between exercises). Heart rate and heart rate recovery were recorded during each training session, and heart rate variability, baroreflex sensitivity and effectiveness, blood pressure, and blood pressure variability were evaluated at rest bedore and after the interventions. Results: During the sessions, traditional sets entailed greater peak heart rate compared to rest-redistribution (P = .018) but mean heart rate, minimum heart rate, and heart rate recovery were similar between training programs (P >.05). Baroreflex effectiveness was reduced after the traditional intervention (P = .013). No changes were detected for the rest of the cardiovascular variables obtained at rest after intervention (P > .05). Conclusions: Despite some differences in heart rate response during exercise, neither traditional nor rest-redistribution resistance training protocols produced changes in cardiac autonomic modulation, sympathetic vasomotor tone, and cardiac baroreflex sensitivity of young healthy active individuals. However, traditional sets affected the baroreflex effectiveness.
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CORAZZA IVAN, MORRONE MARIAFRANCESCA, OLIVIERI MICHELA, ZECCHI MARGHERITA, ZANNOLI ROMANO. TEST OF PHYSIOLOGICAL PERFORMANCE: RATIONALE AND FEASIBILITY. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rigorous clinical evaluation of the physiological performance is currently performed with complex and long procedures which need expensive technology and skilled operators. In a wide range of situations (frail patients, daily clinical practice, etc.), these approaches are difficult to be applied and simpler tests, with a lack of scientific background, are mandatory. To avoid these problems, we propose a test (test of physiological performance (TOPP)) to evaluate the physiological behavior of a subject, in a really easy and safe clinical setting, measuring only the heart rate. The subject is submitted to an active standing-up test and then two submaximal exercises (with a low power load) on a cycle-ergometer. The heart rate modifications due to each submaximal step are analyzed by exponential interpolation to calculate the ascending and descending time constants and evaluate the way each subject adapts his heart rate to work. The standard deviation of the RR for each stationary phase (warm-up, load, recovery) was calculated as an index of short-term variability. Then a standard Fourier analysis of the stationary periods of the standing-up procedures allows to quickly and easily evaluate the autonomic nervous activation. We tested the protocol on five healthy subjects to verify the feasibility and the acceptance of the procedure. The five subjects demonstrated a good tolerance of the entire procedure. The standing-up showed a behavior of the autonomic system consistent with the physiology (with an increase in sympathetic activation in the passage to standing position). The analysis of the two submaximal steps highlights how younger and trained subjects present lower heart rates (both in the ascending phase and in the recovery) with a quicker adaptation ability (smaller time constants) consistent with what is expected. The short-term variability of heart rate is greater in young and trained subjects, thus confirming how the sympatho-vagal balance, in these subjects, is more dynamic. The proposed test is well tolerated by the subjects and the results, albeit in a small cohort of healthy volunteers, are consistent with what is expected from physiology and is already present in the literature. Our work aims to be a proposal with a feasibility check of a method for evaluating performance. The work to be done for the clinical validation of the TOPP is still long, but we are aware that it can give important results and that the TOPP can become an effective tool for the assessment of the physiological performance even of fragile subjects.
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Affiliation(s)
- IVAN CORAZZA
- Medical Physics Coordination Centre, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - MARIA FRANCESCA MORRONE
- Medical Physics Coordination Centre, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - MICHELA OLIVIERI
- Medical Physics Coordination Centre, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - MARGHERITA ZECCHI
- Medical Physics Coordination Centre, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - ROMANO ZANNOLI
- Medical Physics Coordination Centre, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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A New Approach for Evaluation of Cardiovascular Fitness and Cardiac Responses to Maximal Exercise Test in Master Runners: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11061648. [PMID: 35329974 PMCID: PMC8955590 DOI: 10.3390/jcm11061648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to analyze the cardiac autonomic function at rest, at maximum exercise, and in recovery after exercise and to determine sex-specific and age-specific values for resting heart rate (RHR), hear rate (HR)-peak, HR recovery (HRR), and HR variability at rest in master runners. Fifty endurance runners (21 women) participated in this study (43.28 ± 5.25 years). The subjects came from different athletic clubs in Andalusia (Spain), and the testing protocol was performed in-season. A 3-km running test was performed and the cardiovascular response was monitored. Regarding sex, no significant differences were found regarding cardiovascular autonomic function at rest, during exercise, and following maximal exercise, only at rest, the standard deviation of all R-R intervals and low frequency values displayed significantly (p < 0.05) lower scores in women. 46% of athletes showed an RHR < 60 bpm. Additionally, HR-peak showed a significant correlation with age (r = −0.369; p = 0.009) and HRR5min (r = 0.476, p = 0.001). Also, endurance performance was inversely associated with obesity traits and cardiometabolic risk factors. In summary, age, sex, fitness, or anthropometrics characteristics did not show a relevant influence on cardiovascular autonomic modulation in master runners. However, the 3-km performance displayed a significant negative association with several factors of cardiometabolic risk.
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de Freitas VH, Mariano IM, Amaral AL, Rodrigues ML, Carrijo VHV, Puga GM. Effects of light-emitting diode therapy on cardiovascular and salivary nitrite responses in postmenopausal women submitted to a single bout of high-intensity interval training. Lasers Med Sci 2022; 37:2655-2665. [PMID: 35235082 DOI: 10.1007/s10103-022-03533-z] [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: 11/10/2021] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to analyze the effects of light-emitting diode therapy (LEDT) on cardiovascular effort during a single bout of high-intensity interval training (HIIT) and on blood pressure (BP), salivary nitrite, and heart rate variability (HRV) responses after the exercise session in postmenopausal women. Sixteen postmenopausal women between 50 and 70 years of age participated in the present study. The intervention comprised two sessions: placebo plus HIIT and LEDT plus HIIT, with a 14-day interval between sessions. The oxygen uptake (VO2), heart rate (HR), and rating of perceived exertion (RPE) were monitored throughout the HIIT sessions. Salivary samples were taken before, immediately post, and 30' and 60' post-HIIT sessions for nitric oxide (NO) analysis. In addition, HR and BP were checked before, 15 min, 30 min, 45 min, and 60 min post-HIIT sessions. HR data were used to calculate the HRV indices. Cardiovascular parameters during HIIT and BP, HRV, and NO responses were not different between placebo and LEDT conditions (p > 0.05). BP responses increased after compared to pre-exercise (p < 0.01). HRV was impaired post- compared to pre-exercise (p < 0.05). LEDT did not improve physiological performance during HIIT and did not accelerate the recovery of BP and autonomic modulation or change the NO release after exercise in postmenopausal women.
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Affiliation(s)
- Victor Hugo de Freitas
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil.,Department of Physical Education, Federal University of Bahia, Salvador, BA, Brazil
| | - Igor Moraes Mariano
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil
| | - Ana Luiza Amaral
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil
| | - Mateus Lima Rodrigues
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil
| | - Victor Hugo Vilarinho Carrijo
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil
| | - Guilherme Morais Puga
- Faculty of Physical Education, Federal University of Uberlandia, Rua Benjamin Constant, 1286, Bairro: Aparecida, MG, 38400-678, Uberlândia, Brazil.
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Sun W, Liu G, Liu B. Association between Circulating Adiponectin and Heart Rate Recovery in Women with Polycystic Ovarian Syndrome. Endocr Res 2022; 47:56-63. [PMID: 34866535 DOI: 10.1080/07435800.2021.2011908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONTEXT Adiponectin (APN) is reported to be correlated closely with autonomic nervous function in different clinical settings. Heart rate recovery (HRR) is a noninvasive and readily obtainable indicator, which reflects the coordinated interplay between parasympathetic reactivation and sympathetic withdrawal. OBJECTIVE This study aimed to investigate the relationship between serum APN and HRR in polycystic ovarian syndrome (PCOS) women. DESIGN Eighty-nine PCOS women were enrolled and divided into two groups. Women with HRR values slower than 12 beats were defined as Blunted HRR Group. APN levels were compared between Blunted HRR Group and Normal HRR Group. Multivariate logistic regression analysis and multiple linear regression analysis were performed to determine which clinical variables were independently associated with HRR and APN levels, respectively. RESULTS Twenty-three women were categorized into Blunted HRR Group, in which APN level was significantly lower than Normal HRR Group. Age, body mass index, hypertension, and APN were independent factors of attenuated HRR in PCOS women. Meanwhile, multiple linear regression analysis showed age, dyslipidemia, and homeostasis model assessment-insulin resistance (HOMA-IR) were closely associated with APN levels in PCOS women. CONCLUSIONS Our findings suggested that decreased APN concentration was closely associated with HRR blunt in PCOS women. Further studies are needed to explore the underlying interactions between APN and autonomic nervous function.
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Affiliation(s)
- Wenjiang Sun
- Department of Rehabilitation, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guanghui Liu
- Department of Endocrinology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bin Liu
- Department of Neurology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
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Association of cardiac autonomic neuropathy assessed by heart rate response during exercise with intradialytic hypotension and mortality in hemodialysis patients. Kidney Int 2022; 101:1054-1062. [DOI: 10.1016/j.kint.2022.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022]
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Oeschger R, Roos L, Wyss T, Buller MJ, Veenstra BJ, Gilgen-Ammann R. Influence of Soldiers' Cardiorespiratory Fitness on Physiological Responses and Dropouts During a Loaded Long-distance March. Mil Med 2022; 188:usab540. [PMID: 35015894 PMCID: PMC10363014 DOI: 10.1093/milmed/usab540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/27/2021] [Accepted: 12/20/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION In military service, marching is an important, common, and physically demanding task. Minimizing dropouts, maintaining operational readiness during the march, and achieving a fast recovery are desirable because the soldiers have to be ready for duty, sometimes shortly after an exhausting task. The present field study investigated the influence of the soldiers' cardiorespiratory fitness on physiological responses during a long-lasting and challenging 34 km march. MATERIALS AND METHODS Heart rate (HR), body core temperature (BCT), total energy expenditure (TEE), energy intake, motivation, and pain sensation were investigated in 44 soldiers (20.3 ± 1.3 years, 178.5 ± 7.0 cm, 74.8 ± 9.8 kg, body mass index: 23.4 ± 2.7 kg × m-2, peak oxygen uptake ($\dot{\rm{V}}$O2peak): 54.2 ± 7.9 mL × kg-1 × min-1) during almost 8 hours of marching. All soldiers were equipped with a portable electrocardiogram to record HR and an accelerometer on the hip, all swallowed a telemetry pill to record BCT, and all filled out a pre- and post-march questionnaire. The influence of aerobic capacity on the physiological responses during the march was examined by dividing the soldiers into three fitness groups according to their $\dot{\rm{V}}$O2peak. RESULTS The group with the lowest aerobic capacity ($\dot{\rm{V}}$O2peak: 44.9 ± 4.8 mL × kg-1 × min-1) compared to the group with the highest aerobic capacity ($\dot{\rm{V}}$O2peak: 61.7 ± 2.2 mL × kg-1 × min-1) showed a significantly higher (P < .05) mean HR (133 ± 9 bpm and 125 ± 8 bpm, respectively) as well as peak BCT (38.6 ± 0.3 and 38.4 ± 0.2 °C, respectively) during the march. In terms of recovery ability during the break, no significant differences could be identified between the three groups in either HR or BCT. The energy deficit during the march was remarkably high, as the soldiers could only replace 22%, 26%, and 36% of the total energy expenditure in the lower, middle, and higher fitness group, respectively. The cardiorespiratory fittest soldiers showed a significantly higher motivation to perform when compared to the least cardiorespiratory fit soldiers (P = .002; scale from 1 [not at all] to 10 [extremely]; scale difference of 2.3). A total of nine soldiers (16%) had to end marching early: four soldiers (21%) in the group with the lowest aerobic capacity, five (28%) in the middle group, and none in the highest group. CONCLUSION Soldiers with a high $\dot{\rm{V}}$O2peak showed a lower mean HR and peak BCT throughout the long-distance march, as well as higher performance motivation, no dropouts, and lower energy deficit. All soldiers showed an enormous energy deficit; therefore, corresponding nutritional strategies are recommended.
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Affiliation(s)
- Regina Oeschger
- Swiss Federal Institute of Sport Magglingen SFISM, Magglingen CH-2532, Switzerland
| | - Lilian Roos
- Swiss Federal Institute of Sport Magglingen SFISM, Magglingen CH-2532, Switzerland
| | - Thomas Wyss
- Swiss Federal Institute of Sport Magglingen SFISM, Magglingen CH-2532, Switzerland
| | - Mark J Buller
- U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Bertil J Veenstra
- Institute of Training Medicine & Training Physiology, Royal Netherlands Army, Utrecht 3584 AB, The Netherlands
| | - Rahel Gilgen-Ammann
- Swiss Federal Institute of Sport Magglingen SFISM, Magglingen CH-2532, Switzerland
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Jin Q, Li X, Zhang Y, Zhao Z, Zhao Q, Yan L, Duan A, Luo Q, Liu Z. Heart Rate Recovery at 1 Min after Exercise Is a Marker of Disease Severity and Prognosis in Chronic Thromboembolic Pulmonary Hypertension. Respiration 2021; 101:455-464. [PMID: 34903700 DOI: 10.1159/000520314] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/08/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Attenuated heart rate recovery at 1 min (HRR1) was demonstrated to correlate with poor prognosis in patients with pulmonary arterial hypertension, whereas its role in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. OBJECTIVES The aim of this study was to investigate the correlations between HRR1 and functional status, echocardiography, hemodynamics, and prognosis of CTEPH. METHODS We retrospectively enrolled patients with CTEPH who underwent right heart catheterization and cardiopulmonary exercise test between June 2014 to October 2020 in Fuwai hospital. The primary outcome was clinical worsening. Linear regression was performed to assess the association between HRR1 and established markers of CTEPH severity. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff of HRR1. Cox regression models were used to assess the association between HRR1 and clinical worsening. RESULTS A total of 211 patients with CTEPH were included in the study. After adjusting for confounders, HRR1 positively correlated with 6-min walk distance, mixed venous oxygen saturation, and peak oxygen consumption, and negatively correlated with NT-proBNP, pulmonary vascular resistance, and ventilatory equivalent of carbon dioxide. Compared with patients with HRR1 ≥16 beats, patients with HRR1 <16 beats had approximately a 3-fold risk of experiencing clinical worsening and the risk escalated with time. CONCLUSION HRR1 could reflect disease severity and was independently associated with prognosis in patients with CTEPH.
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Affiliation(s)
- Qi Jin
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin Li
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Zhang
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhihui Zhao
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Zhao
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Yan
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Anqi Duan
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qin Luo
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhihong Liu
- Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Lopes-Silva JP, Soares GDSS, Rocha JCC, Rocha ALSD, Correia-Oliveira CR. Caffeine Delays Parasympathetic Reactivation After a High-Intensity Intermittent Exercise in Handball Players. J Caffeine Adenosine Res 2021. [DOI: 10.1089/caff.2021.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- João Paulo Lopes-Silva
- Applied Research Group to Performance and Health, CESMAC University Center, School of Physical Education, Maceió, Brazil
| | | | - Julio Cesar Correia Rocha
- Applied Research Group to Performance and Health, CESMAC University Center, School of Physical Education, Maceió, Brazil
| | - André Luiz Silva da Rocha
- Applied Research Group to Performance and Health, CESMAC University Center, School of Physical Education, Maceió, Brazil
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Aberrant autonomic pattern during the post-exercise recovery phase in long QT syndrome patients. Auton Neurosci 2021; 236:102897. [PMID: 34775217 DOI: 10.1016/j.autneu.2021.102897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/03/2021] [Accepted: 10/09/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES It is well-established that the autonomic nervous system (ANS) plays a central role in arrhythmogenesis. During and after exercise the ANS is particularly active, and since long QT syndrome (LQTS) patients have an increased risk of lethal arrhythmias during physical activity, it is important to investigate the autonomic function in these patients. In this study we investigate the ANS response during and after exercise in LQTS patients and healthy age and sex matched controls. METHODS Forty-four genotype-verified adult LQTS patients and forty-four healthy age- and sex-matched controls performed a submaximal bicycle exercise stress test. Heart rate recovery (HRR) and heart rate variability (HRV) were analyzed from registered electrocardiogram (ECG) and vector electrocardiogram (VCG) recordings collected throughout rest, exercise and in the post-exercise phase. RESULTS LQTS patients had a slower HRR than controls at 1- and 4-min post-exercise (p < 0.001). During the post-exercise phase, LQTS patients had a lower total power (p < 0.001), low frequency power (p < 0.001) and high frequency power (p < 0.001) than controls. In the same phase, LQTS patients off betablocker (BB) treatment showed a lower high frequency power (p = 0.01) and different low frequency/high frequency ratio (p = 0.003) when comparing with LQTS patients on BB treatment. CONCLUSIONS The parasympathetic effect on both HRR and HRV after exercise appears depressed in this LQTS patient cohort compared to healthy controls. This indicates an aberrant ANS response during the post-exercise phase which might be compensated by BB treatment. Our findings emphasize the importance of performing further investigations to identify the role of the ANS in LQTS arrhythmogenesis.
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Font-Farré M, Farche ACS, de Medeiros Takahashi AC, Guerra-Balic M, Figueroa A, Oviedo GR. Cardiac Autonomic Modulation Response Before, During, and After Submaximal Exercise in Older Adults With Intellectual Disability. Front Physiol 2021; 12:702418. [PMID: 34721053 PMCID: PMC8554113 DOI: 10.3389/fphys.2021.702418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
The analysis of the heart rate variability (HRV) consists of changes in the time intervals between consecutive R waves. It provides information on the autonomic nervous system regulation and it is a predictor of adverse cardiovascular events. Several studies analyzed this parameter in youth and adults with Intellectual Disability (ID). Nevertheless, there is a lack of information regarding the HRV before, during, and after exercise in older adults with ID. Therefore, we aimed to describe and compare the cardiac autonomic modulation before, during, and after the six-minute walk test (6MWT) in older adults with and without ID. Twenty-four volunteers with ID and 24 without ID (non-ID) participated in this study. HRV was assessed by R-R intervals at rest, during and after the 6MWT. At rest and recovery periods, the participants remained sited. The symbolic analysis was used to evaluate non-linear HRV components. The recovery HR kinetics was assessed by the mean response time, which is equivalent to time constant (τ)+time delay (TD). Between groups differences in HRV variables were not significant. During the recovery period, HR kinetics time variables showed significant better results in non-ID participants (TD: 6±5s vs. 15±11s; τ: 19±10s vs. 35±17s; and MRT: 25±9s vs. 50±11s, all p<0.050). In conclusion, our results suggest that the HRV in older adults with and without ID is similar during rest, exercise, and recovery. Recovery HR kinetics after the 6MWT was slower in older adults with ID. The reason for these results may be a reduced post-exercise vagal rebound in older adults with ID.
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Affiliation(s)
- Manel Font-Farré
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | | | | | - Myriam Guerra-Balic
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Guillermo R Oviedo
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain.,School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain
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Leonardi-Figueiredo MM, de Queiroz Davoli GB, Avi AE, Crescêncio JC, Moura-Tonello SC, Manso PH, Júnior LG, Martinez EZ, Catai AM, Mattiello-Sverzut AC. Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida. Int J Sports Med 2021; 42:1113-1121. [PMID: 33890263 DOI: 10.1055/a-1393-6472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We aimed to analyse cardiac autonomic control by assessing the post-exercise heart rate recovery (HRR) and physical fitness in children and adolescents with spina bifida (SB), compared to participants with typical development. A total of 124 participants, 42 with spina bifida (SB group) and 82 typical developmental controls (CO group) performed the arm cranking exercise test with a gas analysis system. HRR was determined at the first (HRR_1) and second (HRR_2) minute at recovery phase. Data are shown as [mean difference (95% CI)]. The SB group showed reduced HR reserve [14.5 (7.1-22.0) bmp, P<0.01], slower HRR_1 [12.4 (7.4-17.5) bpm, P<0.01] and HRR_2 [16.3 (10.6-21.9) bpm; P<0.01], lower VO2peak [VO2peak relative: 7.3 (4.2-10.3) mL·min-1·kg-1, P<0.01; VO2peak absolute: 0.42 (0.30-0.54) L·min-1, P<0.01], and lower O2 pulse [2.5 (1.8-3.2) mL·bpm, P<0.01] and ventilatory responses [13.5 (8.8-18.1) L·min-1, P<0.01] than the CO group. VE/VO2 was not different between groups [-2.82 (-5.77- -0.12); P=0.06], but the VE/VCO2 [-2.59 (-4.40-0.78); P<0.01] and the values of the anaerobic threshold corrected by body mass [-3.2 (-5.8- -0.6) mL·min-1·kg-1, P=0.01] were higher in the SB group than in the CO group. We concluded that children and adolescents with SB have reduced physical fitness and a slower HRR response after maximal effort.
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Affiliation(s)
| | | | - Amanda Evangelista Avi
- Departamento Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Julio Cesar Crescêncio
- Departamento Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Paulo Henrique Manso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Lourenço Gallo Júnior
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Edson Zangiacomi Martinez
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Aparecida Maria Catai
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Ana Claudia Mattiello-Sverzut
- Departamento Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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44
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Kim Y, Jeung J, Song Y, Ko H, Park S, Park H, Jeon G, Chung Y. A Wearable System for Heart Rate Recovery Evaluation with Real-Time Classification on Exercise Condition. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7609-7612. [PMID: 34892851 DOI: 10.1109/embc46164.2021.9629673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Heart rate recovery (HRR) is a convenient index to assess a cardiovascular autonomic function response to physical exercise. HRR monitoring during daily exercise can be an effective way to verify cardiorespiratory performance. Because HRR varies depending on exercise intensity and resting condition, an exercise condition needs to be acquired for a reliable HRR analysis. This study presents a wearable system for HRR evaluation with automatic labeling of exercise conditions using real-time activity classification. We developed an activity classification algorithm using two features from accelerometer sensor: an acceleration peak and an angle tilt peak. The classification algorithm was applied to a chest-attached wearable device with an embedded electrocardiogram sensor and accelerometer sensors. We classified daily activities such as running, walking, and postural transitions performed under supervised conditions. The wearable device system accurately detected activities with a sensitivity of 99.2 % and posture transitions with a sensitivity of 92 % and specificity of 93.3 % for seven healthy subjects. The proposed wearable system can help monitor HRR during exercise training by labeling the exercise condition simultaneously.
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45
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Marciniak RA, Wahl CA, Ebersole KT. Autonomic Nervous System Response to Far-Infrared Sauna Exposure in Firefighters. Ann Work Expo Health 2021; 66:356-367. [PMID: 34632485 DOI: 10.1093/annweh/wxab088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/26/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Fire departments have employed far-infrared sauna (FIRS) use as part of post-fire call protocols to address concerns related to carcinogens. The inability of the autonomic nervous system (ANS) to fully recover following an emergency call, as demonstrated by heightened sympathetic nervous system activity and delayed parasympathetic nervous system reactivation, has been implicated as a potential factor related to sudden cardiac death. The use of a sauna post-fire call, which has been demonstrated to elevate body temperature, may interfere with the ability of the ANS to fully recover. The purpose of this study was to examine ANS responses to FIRS exposure in firefighters (FFs) with (EX) and without (NONEX) prior maximal exercise. METHODS Sixteen career FFs participated in this study. Body temperature (TEMP), heart rate (HR), heart rate variability (HRV), blood pressure (BP), and blood lactate (La─) were measured at the start of each testing session, following a maximal exercise test (EX only), and immediately after a 15-min FIRS exposure for NONEX and EX. RESULTS In NONEX, TEMP increased (P < 0.001); however, there was no change in HR, HRV, BP, or La─. In EX, BP remained unchanged while TEMP, HR, and La─ were significantly (P < 0.001) greater than baseline following FIRS exposure and HRV was significantly (P = 0.018) lower than baseline. CONCLUSIONS These findings indicate that FIRS following maximal exercise did support some ANS recovery, but may interfere with restoration of body temperature and parasympathetic nervous system reactivation, potentially influencing post-call cardiovascular risk in FFs.
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Affiliation(s)
- Rudi A Marciniak
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
| | - Carly A Wahl
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
| | - Kyle T Ebersole
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Suite 350, 3409 N. Downer Ave, Milwaukee, WI, USA
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46
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Kanegusuku H, Cucato GG, Longano P, Okamoto E, Piemonte MEP, Correia MA, Ritti-Dias RM. Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease. Int J Sports Med 2021; 43:177-182. [PMID: 34380151 DOI: 10.1055/a-1529-6480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Parkinson's disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson's disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1-3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60-80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson's disease patients.
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Affiliation(s)
| | - Gabriel Grizzo Cucato
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Northumbria University, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Paulo Longano
- Universidade Nove de Julho - Campus Vergueiro, São Paulo, Brazil
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47
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Independent influence of age on heart rate recovery after flywheel exercise in trained men and women. Sci Rep 2021; 11:12011. [PMID: 34103623 PMCID: PMC8187710 DOI: 10.1038/s41598-021-91565-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 05/13/2021] [Indexed: 11/08/2022] Open
Abstract
The present study examined whether differences in the heart rate recovery following flywheel exercise cessation were associated with differences in maximal oxygen uptake (\documentclass[12pt]{minimal}
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\begin{document}$${\dot{\text{V}}}$$\end{document}V˙O2 max.), age and sex in trained adults. Eleven men (age range 22–49 years, \documentclass[12pt]{minimal}
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\begin{document}$${\dot{\text{V}}}$$\end{document}V˙O2 max. = 43.6 ± 7.6 mL kg min−1) and ten women (age range 20—53 years, \documentclass[12pt]{minimal}
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\begin{document}$${\dot{\text{V}}}$$\end{document}V˙O2 max. = 38.0 ± 5.7 mL kg min−1) were randomly assigned to complete a squat-exercise on the flywheel ergometer set at three different moments of inertia, while their cardiovascular responses were continuously monitored. During the flywheel exercise the mean arterial pressure rose by ~ 35 to 40% (p = .001), and the increment was more robust in men than women. The cardiac index was two-fold greater across both sexes compared to the baseline (p = .001), while the rise in heart rate (~ 144 bpm) was more pronounced in women to compensate for their load-dependent stroke index decline (p = .001). The load-independent time-course changes in heart rate recovery markers were comparable between the sexes. When these indicators were pooled, a stepwise regression revealed age as the only relevant predictor of both fast and slow components of the heart rate recovery (~ 30% of the shared variance explained, p = .014). The present data suggest that the heart rate recovery declines with age, irrespective of sex, or well-preserved cardiorespiratory fitness in moderately-trained adults.
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48
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Paulo Lopes-Silva J, Panissa VLG, Julio UF, Franchini E. Influence of Physical Fitness on Special Judo Fitness Test Performance: A Multiple Linear Regression Analysis. J Strength Cond Res 2021; 35:1732-1738. [PMID: 30418327 DOI: 10.1519/jsc.0000000000002948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Lopes-Silva, JP, Panissa, VLG, Julio, UF, and Franchini, E. Influence of physical fitness on Special Judo Fitness Test performance: a multiple linear regression analysis. J Strength Cond Res 35(6): 1732-1738, 2021-The purpose of this study was to identify the physical fitness variables that best predict Special Judo Fitness Test (SJFT) performance. Thirty-five male experienced judo athletes took part in this study. All athletes performed 5 tests: upper- and lower-body cycle ergometer graded exercise tests; upper- and lower-body Wingate tests; and SJFT. The peak oxygen consumption (V̇o2peak), maximum heart rate (HRmax), maximum aerobic power, and the variables corresponding to onset blood lactate accumulation (OBLA) were determined during the graded exercise tests. For the Wingate tests, peak power (PP) and mean power were used. Furthermore, the total number of throws, heart rate (HR) immediately and 1 minute after, and SJFT index were calculated. Four separated forward multiple linear regressions (forward model) were used to identify the physical fitness variables that best explained the SJFT variables. Upper-body V̇o2peak (ml·min-1·kg-1) explained 27% of variance in the total number of throws, whereas an additional 7% was explained by upper-body PP. Upper-body HRmax explained 46% of the variance in the HR immediately after the SJFT, whereas lower-body HR at OBLA accounted for an additional 8%. Lower-body HRmax explained 21% of the variance in the HR 1 minute after the SJFT, whereas peak lactate ([La-]peak) after the lower-body graded exercise test accounted for an additional 12%. Upper-body V̇o2peak (ml·min-1·kg-1) alone accounted for 15% of the variance in the SJFT index. Based on these results, the data suggest that physical fitness variables, derived from upper- and lower-body aerobic and anaerobic tests, have a small ability to predict the SJFT variables.
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Affiliation(s)
- João Paulo Lopes-Silva
- Martial Arts and Combat Sports Research Group, Sport Department, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- School of Physical Education, Cesmac University Center, Maceió, Alagoas, Brazil ; and
- UNINASSAU, Maceió, Alagoas, Brazil
| | | | - Ursula Ferreira Julio
- Martial Arts and Combat Sports Research Group, Sport Department, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Emerson Franchini
- Martial Arts and Combat Sports Research Group, Sport Department, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Combat Center, Australian Institute of Sport, Canberra, Australia
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49
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Laurino MJL, da Silva AKF, Santos LA, Ribeiro F, Vanzella LM, Corazza DAG, Vanderlei LCM. Vagal reactivation after a cardiac rehabilitation session associated with hydration in coronary artery disease patients: crossover clinical trial. Sci Rep 2021; 11:10482. [PMID: 34006912 PMCID: PMC8131702 DOI: 10.1038/s41598-021-89840-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 04/30/2021] [Indexed: 02/03/2023] Open
Abstract
This study aimed to investigate the hydration influence on the autonomic responses of coronary artery disease subjects in the immediate recovery period after a cardiovascular rehabilitation session, in view of the risks of a delayed autonomic recovery for this population. 28 males with coronary artery disease were submitted to: (I) Maximum effort test; (II) Control protocol (CP), composed by initial rest, warm-up, exercise and passive recovery; (III) Hydration protocol (HP) similar to CP, but with rehydration during exercise. The recovery was evaluated through the heart rate (HR) variability, HR recovery and by the rate of perceived exertion and recovery. The main results revealed that the vagal reactivation occurred at the first 30 s of recovery in HP and after the first minute in CP. A better behavior of the HR at the first minute of recovery was observed in HP. The rate of perceived exertion had a significant decrease in the first minute of recovery in HP, while in CP this occurred after the third minute. In conclusion, despite an anticipated vagal reactivation found at HP, these results should be analyzed with caution as there were no significant differences between protocols for all variables and the effect sizes were small.
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Affiliation(s)
- Maria Júlia Lopez Laurino
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil.
| | - Anne Kastelianne França da Silva
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Lorena Altafin Santos
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Felipe Ribeiro
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Laís Manata Vanzella
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Dayane Andrade Genoni Corazza
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Luiz Carlos Marques Vanderlei
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
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50
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Kim JW, Seok HS, Shin H. Is Ultra-Short-Term Heart Rate Variability Valid in Non-static Conditions? Front Physiol 2021; 12:596060. [PMID: 33859568 PMCID: PMC8042416 DOI: 10.3389/fphys.2021.596060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/10/2021] [Indexed: 11/20/2022] Open
Abstract
In mobile healthcare, heart rate variability (HRV) is increasingly being used in dynamic patient states. In this situation, shortening of the measurement time is required. This study aimed to validate ultra-short-term HRV in non-static conditions. We conducted electrocardiogram (ECG) measurements at rest, during exercise, and in the post-exercise recovery period in 30 subjects and analyzed ultra-short-term HRV in time and frequency domains by ECG in 10, 30, 60, 120, 180, and 240-s intervals, and compared the values to the 5-min HRV. For statistical analysis, null hypothesis testing, Cohen’s d statistics, Pearson’s correlation coefficient, and Bland-Altman analysis were used, with a statistical significance level of P < 0.05. The feasibility of ultra-short-term HRV and the minimum time required for analysis showed differences in each condition and for each analysis method. If the strict criteria satisfying all the statistical methods were followed, the ultra-short-term HRV could be derived from a from 30 to 240-s length of ECG. However, at least 120 s was required in the post-exercise recovery or exercise conditions, and even ultra-short-term HRV was not measurable in some variables. In contrast, according to the lenient criteria needed to satisfy only one of the statistical criteria, the minimum time required for ultra-short-term HRV analysis was 10–60 s in the resting condition, 10–180 s in the exercise condition, and 10–120 s in the post-exercise recovery condition. In conclusion, the results of this study showed that a longer measurement time was required for ultra-short-term HRV analysis in dynamic conditions. This suggests that the existing ultra-short-term HRV research results derived from the static condition cannot applied to the non-static conditions of daily life and that a criterion specific to the non-static conditions are necessary.
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Affiliation(s)
- Jin Woong Kim
- Department of Biomedical Engineering, Chonnam National University, Yeosu-si, South Korea
| | - Hyeon Seok Seok
- Department of Biomedical Engineering, Chonnam National University, Yeosu-si, South Korea
| | - Hangsik Shin
- Department of Biomedical Engineering, Chonnam National University, Yeosu-si, South Korea
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