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Xi Y, Li Y, Ren W, Bo W, Ma Y, Pan S, Gong DAW, Tian Z. ELABELA-APJ-Akt/YAP Signaling Axis: A Novel Mechanism of Aerobic Exercise in Cardioprotection of Myocardial Infarction Rats. Med Sci Sports Exerc 2023; 55:1172-1183. [PMID: 36878020 DOI: 10.1249/mss.0000000000003143] [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: 03/08/2023]
Abstract
PURPOSE The aim of this study was to investigate the function and mechanisms of ELABELA (ELA) in the aerobic exercise-induced antiapoptosis and angiogenesis of ischemic heart. METHODS The myocardial infarction (MI) model of Sprague-Dawley rat was established by the ligation of the left anterior descending coronary artery. MI rats underwent 5 wk of Fc-ELA-21 subcutaneous injection and aerobic exercise training using a motorized rodent treadmill. Heart function was evaluated by hemodynamic measures. Cardiac pathological remodeling was evaluated by Masson's staining and the calculation of left ventricular weight index. Cell proliferation, angiogenesis, and Yes-associated protein (YAP) translocation were observed by immunofluorescence staining. Cell apoptosis was analyzed by TUNEL. Cell culture and treatment were used to elucidate the molecular mechanism of ELA. Protein expression was detected by Western blotting. Angiogenesis was observed by tubule formation test. One-way or two-way ANOVA and Student's t -test were used for statistical analysis. RESULTS Aerobic exercise stimulated the endogenous ELA expression. Exercise and Fc-ELA-21 intervention significantly activated APJ-Akt-mTOR-P70S6K signaling pathway, kept more cardiomyocytes alive, and increased angiogenesis, so as to inhibit the cardiac pathological remodeling and improved the heart function of MI rats. Fc-ELA-32 also had the cellular and functional cardioprotective activities in vivo . In vitro , ELA-14 peptide regulated the phosphorylation and nucleoplasmic translocation of YAP and activated the APJ-Akt signaling pathway so as to increase the proliferation of H9C2 cells. Moreover, the antiapoptosis and the tubule formation of HUVECs were also enhanced by ELA-14, whereas the inhibition of Akt activity weakened such effects. CONCLUSIONS ELA is a potential therapeutic member that plays a key role through APJ-Akt/YAP signaling axis in aerobic exercise-induced cardioprotection of MI rats.
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Affiliation(s)
| | - Yongxia Li
- College of Life Sciences, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
| | - Wujing Ren
- Institute of Sports and Exercise Biology, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
| | - Wenyan Bo
- Institute of Sports and Exercise Biology, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
| | - Yixuan Ma
- Institute of Sports and Exercise Biology, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
| | - Shou Pan
- Institute of Sports and Exercise Biology, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
| | - DA-Wei Gong
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Zhenjun Tian
- Institute of Sports and Exercise Biology, Shaanxi Normal University, Xi'an, Shaanxi, P.R. CHINA
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Chen Y, Huang Q, Feng Y. Exercise improves cardiac function in the aged rats with myocardial infarction. Physiol Res 2023; 72:27-35. [PMID: 36545879 PMCID: PMC10069814 DOI: 10.33549/physiolres.934966] [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: 03/22/2023] Open
Abstract
Exercise can improve the cardiovascular health. However, the mechanism contributing to its beneficial effect on elderly patients with myocardial infarction is obscure. 20-month-old male Sprague-Dawley rats were used to establish myocardial infarction (MI) model by permanent ligation of the left anterior descending coronary artery (LAD) of the heart, followed by 4-week interval exercise training on a motor-driven rodent treadmill. The cardiac function, myocardial fibrosis, apoptosis, oxidative stress, and inflammatory responses were determined by using pressure transducer catheter, polygraph physiological data acquisition system, Masson's trichrome staining, and ELISA to evaluate the impact of post-MI exercise training on MI. Western blot were performed to detect the activation of AMPK/SIRT1/PGC-1alpha signaling in the hearts of aged rats. Exercise training significantly improved cardiac function and reduced the cardiac fibrosis. In infarcted heart, the apoptosis, oxidative stress, and inflammation were significantly reduced after 4-week exercise training. Mechanistically, AMPK/SIRT1/PGC-1alpha pathway was activated in the myocardial infarction area after exercise training, which might participate in the protection of cardiac function. Exercise training improves cardiac function in MI rats through reduction of apoptosis, oxidative stress, and inflammation, which may mediate by the activation of AMPK/SIRT1/PGC-1alpha signaling pathway.
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Affiliation(s)
- Y Chen
- Department of Geriatric Medicine, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China, Department of Cardiology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
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Kushwaha P, Moiz JA, Mujaddadi A. Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis. Egypt Heart J 2022; 74:67. [PMID: 36138168 PMCID: PMC9500144 DOI: 10.1186/s43044-022-00306-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exercise training improves cardiac autonomic function is still debatable in patients with coronary artery bypass grafting (CABG). The aim of the present review is to assess the effect of exercise on CABG patient's heart rate variability (HRV) and heart rate recovery (HRR) parameters. MAIN BODY Databases (PubMed, Web of Science and PEDro) were accessed for systematic search from inception till May 2022. Eleven potential studies were qualitatively analyzed by using PEDro and eight studies were included in the quantitative synthesis. Meta-analysis was conducted by using a random-effect model, inverse-variance approach through which standardized mean differences (SMDs) were estimated. The analysis of pooled data showed that exercise training improved HRV indices of standard deviation of the R-R intervals (SDNN) [SMD 0.44, 95% CI 0.17, 0.71, p = 0.002], square root of the mean squared differences between adjacent R-R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08, p = 0.0008], high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98, p = 0.005] and low frequency-to-high frequency (LF/HF) ratio [SMD - 0.34, 95% CI - 0.65, - 0.02, p = 0.03]. CONCLUSIONS Exercise training enhances cardiac autonomic function in CABG patients. Owing to the methodological inconsistencies in assessing HRV, the precise effect on autonomic function still remains conflicted. Future high-quality trials are needed focusing on precise methodological approach and incorporation of various types of exercise training interventions will give clarity regarding autonomic adaptations post-exercise training in CABG. Trial registration CRD42021230270 , February 19, 2021.
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Affiliation(s)
- Purnima Kushwaha
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
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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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Pimenta T, Rocha JA. Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers? Rev Port Cardiol 2021; 40:947-953. [PMID: 34922702 DOI: 10.1016/j.repce.2021.11.013] [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: 08/18/2020] [Accepted: 01/11/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Clinical use of chronotropic response has been limited due to lack of consensus on the appropriate formula for chronotropic index (Ci) calculation and the definition of chronotropic incompetence. OBJECTIVES To assess the effects of cardiac rehabilitation programs (CRP) on Ci, irrespective of betablockers (BB) use and dosage. Assess the relative contribution of change in Ci on improvement in functional capacity. METHODS Retrospective analysis of a sample of patients admitted to a CRP after acute coronary syndrome, with at least 12 months of follow-up. Ci was calculated using the conventional (CCi) and the Brawner formula (BCi) for age-predicted maximum heart rate. Ci and functional capacity were estimated at three time points: T1 and T2, before and at the end of the CRP, and T3, at 12 months. The sample was categorized according to BB dosage modification between T1 and T3: G1 - reduced; G2 - no change; G3 - increased. RESULTS In G1, CCi increased from 63.5% in T1 to 77.9% in T3; in G2, from 67.3% to 77.9%; in G3, from 71.2% to 75.4%. In G1, BCi increased from 110.4% to 140.0%; in G2, from 122.8% to 140.1%; in G3, from 133.3% to 139.2%. An average increase in 1.0% in CCi was associated with an average increase in functional capacity of 0.37 METS. CONCLUSIONS Chronotropic index significantly improves with CRP, irrespective of BB dose changes. CCi is more closely related with improvement in functional capacity than BCi. Improvement of Ci is an important predictor of functional capacity and prognosis in cardiovascular disease patients.
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Affiliation(s)
- Tiago Pimenta
- Department of Physical Medicine & Rehabilitation, Centro Hospitalar e Universitário de São João, Porto, Portugal.
| | - J Afonso Rocha
- Department of Physical Medicine & Rehabilitation, Centro Hospitalar e Universitário de São João, Porto, Portugal
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Pimenta T, Rocha JA. Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers? Rev Port Cardiol 2021. [DOI: 10.1016/j.repc.2021.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chronotropic Responses to Exercise and Recovery in Myocardial Infarction Patients Taking β-Blockers Following Aerobic High-Intensity Interval Training: AN INTERFARCT STUDY. J Cardiopulm Rehabil Prev 2021; 42:22-27. [PMID: 34793361 DOI: 10.1097/hcr.0000000000000607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The objectives of this study were to compare the effects of two different high-intensity interval training (HIIT) programs (low-volume vs high-volume) on chronotropic responses during exercise and recovery, and to contrast the results of the HIIT groups together to only physical activity recommendations in post-myocardial infarction (MI) patients taking β-blockers. METHODS Resting heart rate (HRrest), peak HR (HRpeak), HR reserve (HRreserve = HRpeak-HRrest), HR recovery (HRR) as the difference between HRpeak and post-exercise HR, and chronotropic incompetence were assessed in 70 patients (58 ± 8 yr) following MI with a cardiopulmonary exercise test to peak exertion before and after a 16-wk exercise intervention period. All participants were randomized to either attention control (AC) (physical activity recommendations) or one of the two supervised HIIT groups (2 d/wk). RESULTS After the intervention, no significant between-HIIT group differences were observed. The HRpeak increased (P < .05) in low- (Δ= 8 ± 18%) and high-volume HIIT (Δ= 6 ± 9%), with a small decrease in AC (Δ=- 2 ± 12%, P > .05) resulting in large differences (P < .05) between HIIT and AC. The HRreserve increased (P < .05) in high-volume HIIT. The HRR slightly increased (P < .05) in low-volume (5th min, Δ= 19 ± 31%) and high-volume HIIT (2nd min, Δ= 15 ± 29%, and 5th min, Δ= 19 ± 28%). CONCLUSION These findings suggest that both low- and high-volume HIIT elicit similar improvements in chronotropic responses after MI, independent of β-blocker treatment. Supervised HIIT was more effective than giving physical activity recommendations alone. Low-volume HIIT is presented as a potent and time-efficient exercise strategy that could enhance the sympathovagal balance in this population.
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Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis. Clin Auton Res 2020; 31:187-203. [PMID: 32270406 DOI: 10.1007/s10286-020-00687-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The effects of exercise-based cardiac rehabilitation (CR) on parasympathetic modulation are controversial. This systematic review and meta-analysis aims to (a) determine the effect of exercise-based CR on heart-rate-derived indices associated with cardiac parasympathetic modulation in resting and post-exercise conditions in coronary artery disease (CAD) patients and (b) identify the possible moderator variables of the effect of exercise-based CR on parasympathetic modulation. METHODS We searched CENTRAL and Web of Science up to November 2018 for the following terms: adult CAD patients, controlled exercise-based CR interventions and parasympathetic modulation measured in resting (vagal-related heart rate variability [HRV] indices of the root mean square of the differences in successive in RR interval [RMSSD] and high frequency [HF]) and post-exercise (heart rate recovery [HRR]) pre- and post-intervention. We estimated a random-effects model of standardised mean difference (SMD) and mean difference (MD) for vagal-related HRV indices and HRR, respectively. We assessed the influence of categorical and continuous variables. RESULTS The overall effect size showed significant differences in RMSSD (SMD+ = 0.30; 95% confidence interval [CI] = 0.12-0.49) and HRR (MD+ = 5.35; 95% CI = 4.08-6.61 bpm) in favour of the exercise-based CR group. The overall effect size showed no differences in HF between groups (SMD+ = 0.14; 95% CI, -0.12-0.40). Heterogeneity analyses reached statistical significance, with high heterogeneity for HF (p < 0.001; I2 = 70%) and HRR (p < 0.001; I2 = 85%). Analysis of the moderator variables showed that the effect on HRR is greater in young patients (p = 0.008) and patients treated with percutaneous intervention (p = 0.020). CONCLUSIONS Exercise-based CR improves the post-exercise parasympathetic function, with greater effects in younger CAD patients and in those who were revascularised with percutaneous intervention. The effects on resting parasympathetic function are more controversial due to methodological inconsistencies in measuring HRV, with the use of RMSSD recommended instead of HF because its results show higher consistency. Future studies involving women, focusing on methodological issues, and performing other training methods are needed to increase our knowledge about this topic.
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Effect of different doses of supervised aerobic exercise on heart rate recovery in inactive adults who are overweight or obese: results from E-MECHANIC. Eur J Appl Physiol 2019; 119:2095-2103. [PMID: 31367909 DOI: 10.1007/s00421-019-04198-3] [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: 04/15/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Heart rate recovery (HRR) after exercise is an independent risk factor for cardiovascular disease and mortality. Regular aerobic exercise can improve HRR, yet little is known regarding the dose necessary to promote increases. The aim was to assess the impact of different doses of vigorous-intensity aerobic exercise on HRR in individuals with overweight/obesity. METHODS Data from 137 sedentary adults with overweight/obesity from E-MECHANIC were analyzed. Participants were randomized to either a moderate-dose exercise group (8 kcal/kg body weight/week; KKW), a high-dose exercise group (20 KKW), or a non-exercise control group. HRR was defined as the difference between peak heart rate (HR) during a graded exercise test and the HR after exactly 1 min of active recovery at 1.5 mph and level grade. RESULTS Change in HRR did not differ significantly by exercise group; therefore, the data from both exercise groups were combined. The combined exercise group showed an improvement in HRR of 2.7 bpm (95% CI 0.1, 5.4; p = 0.04) compared to the control group. Those participants who lost more weight during the intervention (non-compensators) increased HRR by 6.2 bpm (95% CI 2.8, 9.5; p < 0.01) compared to those who lost less weight (compensators). Multiple linear regression models indicated that improvements in HRR are independently associated with increases in VO2peak (β = 0.4; 95% CI 0.1, 0.7; p = 0.04) but also influenced by concomitant weight loss (β = 0.6; 95% CI 0.2, 1.1; p = 0.01). CONCLUSION Exercise-induced improvements in 1-min HRR are likely due to increases in cardiorespiratory fitness as well as concomitant weight loss.
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Li X, Wang Y, Mi X, Qiao Z, Liang Y. Impaired heart rate recovery as a predictor for poor health-related quality in patients with transient ischemic attack. Medicine (Baltimore) 2019; 98:e16938. [PMID: 31441885 PMCID: PMC6716722 DOI: 10.1097/md.0000000000016938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We aimed to investigate heart rate recovery (HRR) in patients with transient ischemic attack (TIA) and the relationship between HRR and health-related quality of life (HRQOL).All available patients were enrolled during the enrollment period. A total of 120 patients with TIA and 120 healthy controls were included in this study. A treadmill stress test was performed to calculate the HRR. The HRR were calculated as follows: HRR 1, 2, 3, and 5 minutes = heart rate at peak during exercise - heart rate at 1, 2, 3, and 5 minutes at rest. All patients enrolled were asked to fill in the Short Form 36 Health Survey to calculate HRQOL.We found that the maximum heart rate of TIA patients was significantly higher than that of healthy controls (166 ± 11 vs. 162 ± 14 beats/min, P = .015). Similarly, maximum systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in TIA group compared with healthy control group (SBP: 172 ± 15 vs. 165 ± 14 mm Hg, P < .001; DBP: 102 ± 12 vs. 93 ± 16 mm Hg, P < .001). The HRR were significantly lower in TIA group compared with control group (TIA vs. controls, HRR1: 17 ± 7 vs. 30 ± 8 beats/min, HRR2: 32 ± 11 vs. 49 ± 9 beats/min, HRR3: 43 ± 13 vs. 63 ± 12 beats/min, HRR5: 54 ± 16 vs. 73 ± 15 beats/min, all P < .001). Multivariate analysis showed that older age (P = .03) and high BMI (P = .04) were risk factors associated with abnormal HRR in patients with TIA. With regard to HRQOL, we found that role limitations due to physical problems, general health, vitality, and role limitations due to emotional problems were significantly lower in patients with abnormal HRR compared with patients with normal HRR. Multivariate analysis showed that older age (P = .04) and abnormal HRR (P = .03) were predictors for poor HRQOL in TIA patients.HRR was impaired in patients with TIA. In addition, TIA patients with abnormal HRR suffered from a significantly poorer HRQOL. Hence, given the prognostic value of HRR, patients with TIA should be monitored to prevent cardiovascular events and to improve HRQOL.
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Melo JRD, Feitoza MDS, Cucato GG, Medeiros WM, Stelmach R, Cukier A, Carvalho CRFD, Mendes FAR. Efeito agudo do salbutamol no sistema cardiovascular durante o exercício físico em pacientes com asma moderada ou grave: estudo aleatorizado, duplo-cego e cruzado. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/17007725022018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Salbutamol é um β2-agonista de curta duração frequentemente utilizado em pacientes com asma para prevenir os sintomas durante ou após exercício físico. Alterações hemodinâmicas em repouso estão bem descritas. Contudo são escassos os dados sobre os efeitos na frequência cardíaca (FC) e pressão arterial (PA) durante o exercício e na fase de recuperação em pacientes com asma moderada ou grave. Foi realizado um estudo aleatorizado, duplo-cego e cruzado, em que foram inclusos 15 indivíduos com asma moderada e grave, com média de idade de 46,4±9,3 anos. Os pacientes realizaram um teste de esforço máximo em dois dias não consecutivos, com administração de 400mcg de salbutamol ou 4 “puffs” de placebo. Durante todo o protocolo foi monitorada a FC, a PA, a percepção de esforço e o pico de fluxo expiratório (PFE). Após o uso do salbutamol, o valor do PFE aumentou em média de 28,0±47,7L/m, permanecendo maior nos tempos de 5, 10 e 15 minutos de recuperação passiva em relação ao placebo (p<0,05). As variáveis FC, PA e percepção de esforço foram semelhantes entre as intervenções em todas as fases do protocolo (p>0,05). Esses resultados sugerem que o uso de salbutamol é seguro, e que a FC não necessita de ser ajustada para prescrever a intensidade do exercício após a administração de salbutamol em indivíduos com asma moderada ou grave.
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Exercise therapy and autonomic function in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2017; 23:91-108. [DOI: 10.1007/s10741-017-9662-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Feitoza MDS, Melo JRD, Medeiros WM, Cucato GG, Stelmach R, Cukier A, Carvalho CRFD, Mendes FAR. Effect of salbutamol on the cardiovascular response in healthy subjects at rest, during physical exercise, and in recovery phase: a randomized, double-blind, crossover study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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