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Kunutsor SK, Kurl S, Laukkanen JA. Cardiorespiratory fitness, atrial fibrillation and stroke: a review of the evidence in 2024. Expert Rev Cardiovasc Ther 2024:1-16. [PMID: 39329169 DOI: 10.1080/14779072.2024.2409440] [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: 04/19/2024] [Revised: 09/15/2024] [Accepted: 09/23/2024] [Indexed: 09/28/2024]
Abstract
INTRODUCTION The body of evidence linking cardiorespiratory fitness (CRF) levels with the risk of atrial fibrillation (AF) and stroke - two interconnected cardiovascular conditions - is not entirely consistent. Furthermore, specific CRF thresholds beyond which the risk of AF or stroke might not decrease are not well defined. AREAS COVERED This review summarizes research evidence on the role of CRF in the development of AF and stroke including dose-response relationships in general population participants, explores the biological mechanisms through which CRF may exert its effects, assesses the potential implications for clinical care and population health, identifies gaps in the current evidence, and suggest directions for future research. MEDLINE and Embase were searched from inception until July 2024 to identify observational longitudinal and interventional studies as well as systematic reviews and meta-analyses related to these study designs. EXPERT OPINION In the general population, increasing levels of CRF, achieved through consistent physical activity, can significantly reduce the likelihood of developing AF and stroke. The findings also advocate for a tailored approach to exercise prescriptions, acknowledging the plateau in benefits for AF risk beyond certain CRF levels, while advocating for higher intensity or prolonged activity to further reduce stroke risk.
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Affiliation(s)
- Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Saint Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Brain Research Unit, Department of Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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2
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Hanna P, Ardell JL. Cardiac Neuroanatomy and Fundamentals of Neurocardiology. Card Electrophysiol Clin 2024; 16:229-237. [PMID: 39084716 DOI: 10.1016/j.ccep.2024.01.002] [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: 08/02/2024]
Abstract
Cardiac control is mediated via nested-feedback reflex control networks involving the intrinsic cardiac ganglia, intra-thoracic extra-cardiac ganglia, spinal cord, brainstem, and higher centers. This control system is optimized to respond to normal physiologic stressors; however, it can be catastrophically disrupted by pathologic events such as myocardial ischemia. In fact, it is now recognized that cardiac disease progression reflects the dynamic interplay between adverse remodeling of the cardiac substrate coupled with autonomic dysregulation. With advances in understanding of this network dynamic in normal and pathologic states, neuroscience-based neuromodulation therapies can be devised for the management of acute and chronic cardiac pathologies.
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Affiliation(s)
- Peter Hanna
- University of California Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA; UCLA Neurocardiology Research Program of Excellence, UCLA, Los Angeles, CA 90095, USA
| | - Jeffrey L Ardell
- University of California Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA; UCLA Neurocardiology Research Program of Excellence, UCLA, Los Angeles, CA 90095, USA.
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3
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Fitts RH, Wang X, Kwok WM, Camara AKS. Cardiomyocyte Adaptation to Exercise: K+ Channels, Contractility and Ischemic Injury. Int J Sports Med 2024. [PMID: 38648799 DOI: 10.1055/a-2296-7604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Cardiovascular disease is a leading cause of morbidity and mortality, and exercise-training (TRN) is known to reduce risk factors and protect the heart from ischemia and reperfusion injury. Though the cardioprotective effects of exercise are well-documented, underlying mechanisms are not well understood. This review highlights recent findings and focuses on cardiac factors with emphasis on K+ channel control of the action potential duration (APD), β-adrenergic and adenosine regulation of cardiomyocyte function, and mitochondrial Ca2+ regulation. TRN-induced prolongation and shortening of the APD at low and high activation rates, respectively, is discussed in the context of a reduced response of the sarcolemma delayed rectifier potassium channel (IK) and increased content and activation of the sarcolemma KATP channel. A proposed mechanism underlying the latter is presented, including the phosphatidylinositol-3kinase/protein kinase B pathway. TRN induced increases in cardiomyocyte contractility and the response to adrenergic agonists are discussed. The TRN-induced protection from reperfusion injury is highlighted by the increased content and activation of the sarcolemma KATP channel and the increased phosphorylated glycogen synthase kinase-3β, which aid in preventing mitochondrial Ca2+ overload and mitochondria-triggered apoptosis. Finally, a brief section is presented on the increased incidences of atrial fibrillation associated with age and in life-long exercisers.
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Affiliation(s)
- Robert H Fitts
- Biological Sciences, Marquette University, Milwaukee, United States
| | - Xinrui Wang
- Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
| | - Wai-Meng Kwok
- Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
- Anesthesiology, Medical College of Wisconsin, Milwaukee, United States
- Cancer Center, Medical College of Wisconsin, Milwaukee, United States
| | - Amadou K S Camara
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, United States
- Anesthesiology, Medical College of Wisconsin, Milwaukee, United States
- Cancer Center, Medical College of Wisconsin, Milwaukee, United States
- Physiology, Medical College of Wisconsin, Milwaukee, United States
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4
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Liu K, Bai Y, Wu D, Zhang Z, Liao X, Wu H, Deng Q. Healthy lifestyle and essential metals attenuated association of polycyclic aromatic hydrocarbons with heart rate variability in coke oven workers. Int J Hyg Environ Health 2024; 256:114323. [PMID: 38237548 DOI: 10.1016/j.ijheh.2024.114323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
Whether adopting healthy lifestyles and maintaining moderate levels of essential metals could attenuate the reduction of heart rate variability (HRV) related to polycyclic aromatic hydrocarbons (PAHs) exposure are largely unknown. In this study, we measured urinary metals and PAHs as well as HRV, and constructed a healthy lifestyle score in 1267 coke oven workers. Linear regression models were used to explore the association of healthy lifestyle score and essential metals with HRV, and interaction analysis was performed to investigate the potential interaction between healthy lifestyle score, essential metals, and PAHs on HRV. Mean age of the participants was 41.9 years (84.5% male). Per one point higher healthy lifestyle score was associated with a 2.5% (95% CI, 1.0%-3.9%) higher standard deviation of all normal to normal intervals (SDNN), 2.1% (95% CI, 0.5%-3.6%) higher root mean square of successive differences in adjacent NN intervals (r-MSSD), 4.3% (95% CI, 0.4%-8.2%) higher low frequency, 4.4% (95% CI, 0.2%-8.5%) higher high frequency, and 4.4% (95% CI, 1.2%-7.6%) higher total power, respectively. Urinary level of chromium was positively associated with HRV indices, with the corresponding β (95% CI) (%) was 5.17 (2.84, 7.50) for SDNN, 4.29 (1.74, 6.84) for r-MSSD, 12.26 (6.08, 18.45) for low frequency, 12.61 (5.87, 19.36) for high frequency, and 11.31 (6.19, 16.43) for total power. Additionally, a significant interaction was found between healthy lifestyle score and urinary total hydroxynaphthalene on SDNN (Pinteraction = 0.04), and higher level of urinary chromium could attenuate the adverse effect of total hydroxynaphthalene level on HRV (all Pinteraction <0.05). Findings of our study suggest adopting healthy lifestyle and maintaining a relatively high level of chromium might attenuate the reduction of HRV related to total hydroxynaphthalene exposure.
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Affiliation(s)
- Kang Liu
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Yansen Bai
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Degang Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Zhaorui Zhang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China
| | - Xiaojing Liao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Haimei Wu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Qifei Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, Guangdong, China.
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5
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Abreu RMD, Cairo B, Rehder-Santos P, da Silva CD, Signini ÉDF, Milan-Mattos JC, Sakaguchi CA, Catai AM, Porta A. Cardiorespiratory coupling is associated with exercise capacity in athletes: A cross-sectional study. Respir Physiol Neurobiol 2024; 320:104198. [PMID: 37956746 DOI: 10.1016/j.resp.2023.104198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/24/2023] [Accepted: 11/09/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To determine the association between exercise capacity based on peak oxygen uptake (VO2peak) and resting cardiorespiratory coupling (CRC) levels in athletes and non-athletes' subjects. METHODS A cross-sectional study was carried out in 42 apparently healthy male subjects, aged between 20 and 40 years old. The participants were allocated into athletes (n = 21) and non-athletes (n = 21) groups. Resting electrocardiogram and respiratory movement (RESP) were simultaneously acquired during 15 min in supine position and quiet breathing. The beat-to-beat heart period (HP) and RESP series were determined from the recorded signals. Traditional analysis of HP based on frequency domain indexes was performed considering the high-frequency (0.15 - 0.45 Hz) components. To compute the CRC, the linear association between HP and RESP series was determined via squared coherence function and directionality of interaction was investigated through the causal extension of this approach. The exercise capacity was assessed through incremental cardiopulmonary exercise testing in order to determine the VO2peak. RESULTS Traditional analysis of HP based on high-frequency index was not correlated with exercise capacity in the athletes (r = -0.1, p = 0.5) and non-athletes (r = -0.1, p = 0.3) cohorts. However, resting CRC values was associated with exercise capacity in athletes (r = 0.4, p = 0.03), but not in the non-athletes group (r = -0.2, p = 0.3). CONCLUSION These results suggest that improved resting values of CRC is associated with higher exercise capacity (VO2peak) in endurance athletes. Moreover, frequency domain of HP was not sensitive to identifying this relationship, probably because effects of training on parasympathetic modulation might be affected by respiratory dynamics, and this influence has a directionality (i.e., from RESP to HP).
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Affiliation(s)
- Raphael Martins de Abreu
- LUNEX University, International University of Health, Exercise & Sports S.A. 50, Department of Physiotherapy, Differdange, Luxembourg; LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg; Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil.
| | - Beatrice Cairo
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy
| | - Patricia Rehder-Santos
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | | | - Étore De Favari Signini
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | | | - Camila Akemi Sakaguchi
- Appalachian State University, Department of Health, Leisure, and Exercise Science, NC, United States
| | - Aparecida Maria Catai
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, São Paulo, Brazil
| | - Alberto Porta
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy; IRCCS Policlinico San Donato, Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, San Donato Milanese, Milan, Italy
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6
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Iellamo F. Acute responses and chronic adaptations to exercise in humans: a look from the autonomic nervous system window. J Sports Med Phys Fitness 2024; 64:137-150. [PMID: 37791830 DOI: 10.23736/s0022-4707.23.15353-9] [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: 10/05/2023]
Abstract
The objective of this review was to give an overview on the current knowledge on the neural mechanisms of cardiovascular regulation during acute exercise and the autonomic adaptations brought about by chronic exercise, that is, exercise training. Evidence derived mainly from human studies, which supports the contribution of the different control mechanisms, namely the centralcommand, the reflex drive from active muscles and the arterial baroreflex, with the attendant modifications in autonomic nervous system activity, in determining the acute cardiovascular responses to exercise are discussed, along with some controversial issues and evolving concepts in exercise physiology. In particular, data that show how the various neural mechanisms involved in cardiovascular regulation during exercise are differently modulated by factors related to the muscular activity being performed, such as the type and intensity of exercise and the size of the active muscle masses are presented, stressing the plasticity of the neural network. Thereafter, the clinical implications pertaining neural cardiovascular adaptations to exercise training are presented and discussed, in the context of cardiac diseases. In particular, I will summarize a series of investigations performed in our laboratory that utilized a new training methodology and different exercise formats to quantify the training load in cardiac patients. The way by which individualized exercise training doses affects the autonomic nervous system and the cardiorespiratory adaptations is highlighted.
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Affiliation(s)
- Ferdinando Iellamo
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy -
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7
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Csathó Á, Van der Linden D, Matuz A. Change in heart rate variability with increasing time-on-task as a marker for mental fatigue: A systematic review. Biol Psychol 2024; 185:108727. [PMID: 38056707 DOI: 10.1016/j.biopsycho.2023.108727] [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: 07/08/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Fatigue-specific changes in the autonomic nervous system are often assumed to underlie the development of mental fatigue caused by prolonged cognitive tasks (i.e. Time-on-Task). Therefore, several previous studies have chosen to investigate the Time-on-Task related changes in heart rate variability (HRV). However, previous studies have used many different HRV indices, and their results often show inconsistencies. The present study, therefore, systematically reviewed previous empirical HRV studies with healthy individuals and in which mental fatigue is induced by prolonged cognitive tasks. Articles relevant to the objectives were systematically searched and selected by applying the PRISMA guidelines. We screened 360 records found on 4 databases and found that 19 studies were eligible for full review in accordance with the inclusion criteria. In general, all studies reviewed (with the exception of two studies) found significant changes in HRV with increasing Time-on-Task, suggesting that HRV is a reliable autonomic marker for Time-on-Task induced fatigue. The most conclusive HRV indices that showed a consistent Time-on-Task effect were the low frequency component of HRV and the time domain indices, particularly the root mean square of successive differences. Time-on-Task typically induced an increasing trend in both type of measures.
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Affiliation(s)
- Árpád Csathó
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary; Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
| | - Dimitri Van der Linden
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - András Matuz
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary; Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
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8
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Rymuza H, Mączyńska J, Krauze N, Kowalik I, Smolis-Bąk E, Ciszewski A, Szwed H, Dąbrowski R. Effects of exercise training after acute coronary syndromes in octogenarians - prospective 12-month evaluation. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:145-152. [PMID: 38642349 DOI: 10.36740/merkur202402102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Aim: To demonstrate the impact of individual exercise training on the course of the disease, exercise tolerance and quality of life (QoL) in patients over 75 years after acute coronary syndrome (ACS). PATIENTS AND METHODS Materials and methods: Study included octogenarians after ACS randomly assigned into two groups: a training group (ExT) subjected to individualized physical training and a control group (CG) with standard recommendations for activity. Patients underwent exercise tolerance test (ETT), 6-minute walk test (6-MWT), NHP and QoL questionnaires evaluation, lab tests, ECG, echocardiographic examination at the beginning and after 2, 6 and 12 months. RESULTS Results: Study included 51 patients, mean age 80 years, 50% men, all patients completed the study. Initial physical capacity was comparable in both groups. After 2-month training the average ETT exercise time increased by 12.5% (p=0.0004), the load increased by 13% (p=0.0005) and the 6-MWT results improved by 8.3% (p=0.0114). Among CG these changes were not significant. But 6 and 12 months after training cessation 6-MWT results returned to the initial values (p=0.069, p=0.062 respecitvely). Average ETT exercise time and average load decreased significantly after 12 months (p=0.0009, p=0.0006). Level of pain was significantly lower at the end of the training in ExT group (p=0.007), but it returned to initial 12 months later (p=0.48). QoL deteriorated significantly in the ExT group 12 months after training cessation (p=0.04). CONCLUSION Conclusions: Cardiac rehabilitation in octogenarians after ACS was safe and improved physical performance in a short period of time. Cessation of training resulted in a loss of achieved effects and deterioration of the QoL.
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Affiliation(s)
- Hanna Rymuza
- CARDIOLOGY CLINIC, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Justyna Mączyńska
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Natasza Krauze
- DEPARTMENT OF CARDIOLOGY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND
| | - Ilona Kowalik
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Edyta Smolis-Bąk
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Andrzej Ciszewski
- DEPARTMENT OF INTERVENTIONAL CARDIOLOGY AND ANGIOLOGY, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Hanna Szwed
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Rafał Dąbrowski
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
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9
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Schunke KJ, Rodriguez J, Dyavanapalli J, Schloen J, Wang X, Escobar J, Kowalik G, Cheung EC, Ribeiro C, Russo R, Alber BR, Dergacheva O, Chen SW, Murillo-Berlioz AE, Lee KB, Trachiotis G, Entcheva E, Brantner CA, Mendelowitz D, Kay MW. Outcomes of hypothalamic oxytocin neuron-driven cardioprotection after acute myocardial infarction. Basic Res Cardiol 2023; 118:43. [PMID: 37801130 PMCID: PMC10558415 DOI: 10.1007/s00395-023-01013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
Altered autonomic balance is a hallmark of numerous cardiovascular diseases, including myocardial infarction (MI). Although device-based vagal stimulation is cardioprotective during chronic disease, a non-invasive approach to selectively stimulate the cardiac parasympathetic system immediately after an infarction does not exist and is desperately needed. Cardiac vagal neurons (CVNs) in the brainstem receive powerful excitation from a population of neurons in the paraventricular nucleus (PVN) of the hypothalamus that co-release oxytocin (OXT) and glutamate to excite CVNs. We tested if chemogenetic activation of PVN-OXT neurons following MI would be cardioprotective. The PVN of neonatal rats was transfected with vectors to selectively express DREADDs within OXT neurons. At 6 weeks of age, an MI was induced and DREADDs were activated with clozapine-N-oxide. Seven days following MI, patch-clamp electrophysiology confirmed the augmented excitatory neurotransmission from PVN-OXT neurons to downstream nuclei critical for parasympathetic activity with treatment (43.7 ± 10 vs 86.9 ± 9 pA; MI vs. treatment), resulting in stark improvements in survival (85% vs. 95%; MI vs. treatment), inflammation, fibrosis assessed by trichrome blue staining, mitochondrial function assessed by Seahorse assays, and reduced incidence of arrhythmias (50% vs. 10% cumulative incidence of ventricular fibrillation; MI vs. treatment). Myocardial transcriptomic analysis provided molecular insight into potential cardioprotective mechanisms, which revealed the preservation of beneficial signaling pathways, including muscarinic receptor activation, in treated animals. These comprehensive results demonstrate that the PVN-OXT network could be a promising therapeutic target to quickly activate beneficial parasympathetic-mediated cellular pathways within the heart during the early stages of infarction.
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Affiliation(s)
- Kathryn J Schunke
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA.
- Department of Anatomy, Biochemistry and Physiology, University of Hawaii, 651 Ilalo St, Honolulu, HI, BSB 211 96813, USA.
| | - Jeannette Rodriguez
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Jhansi Dyavanapalli
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA
| | - John Schloen
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Xin Wang
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA
| | - Joan Escobar
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA
| | - Grant Kowalik
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Emily C Cheung
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Caitlin Ribeiro
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA
| | - Rebekah Russo
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Bridget R Alber
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Olga Dergacheva
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA
| | - Sheena W Chen
- Division of Cardiothoracic Surgery and Cardiothoracic Research, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA
| | - Alejandro E Murillo-Berlioz
- Division of Cardiothoracic Surgery and Cardiothoracic Research, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA
| | - Kyongjune B Lee
- Division of Cardiothoracic Surgery and Cardiothoracic Research, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA
| | - Gregory Trachiotis
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
- Division of Cardiothoracic Surgery and Cardiothoracic Research, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA
| | - Emilia Entcheva
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA
| | - Christine A Brantner
- The GWU Nanofabrication and Imaging Center, 800 22nd Street NW, Washington, DC, 20052, USA
| | - David Mendelowitz
- Department of Pharmacology and Physiology, George Washington University, Suite 640 Ross Hall, 2300 Eye St. NW, Washington, DC, 20052, USA.
| | - Matthew W Kay
- Department of Biomedical Engineering, George Washington University, Suite 5000 Science and Engineering Hall, 800 22nd Street NW, Washington, DC, 20052, USA.
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10
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Polyák A, Topal L, Zombori-Tóth N, Tóth N, Prorok J, Kohajda Z, Déri S, Demeter-Haludka V, Hegyi P, Venglovecz V, Ágoston G, Husti Z, Gazdag P, Szlovák J, Árpádffy-Lovas T, Naveed M, Sarusi A, Jost N, Virág L, Nagy N, Baczkó I, Farkas AS, Varró A. Cardiac electrophysiological remodeling associated with enhanced arrhythmia susceptibility in a canine model of elite exercise. eLife 2023; 12:80710. [PMID: 36815557 PMCID: PMC10014074 DOI: 10.7554/elife.80710] [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: 05/31/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
The health benefits of regular physical exercise are well known. Even so, there is increasing evidence that the exercise regimes of elite athletes can evoke cardiac arrhythmias including ventricular fibrillation and even sudden cardiac death (SCD). The mechanism of exercise-induced arrhythmia and SCD is poorly understood. Here, we show that chronic training in a canine model (12 sedentary and 12 trained dogs) that mimics the regime of elite athletes induces electrophysiological remodeling (measured by ECG, patch-clamp, and immunocytochemical techniques) resulting in increases of both the trigger and the substrate for ventricular arrhythmias. Thus, 4 months sustained training lengthened ventricular repolarization (QTc: 237.1±3.4 ms vs. 213.6±2.8 ms, n=12; APD90: 472.8±29.6 ms vs. 370.1±32.7 ms, n=29 vs. 25), decreased transient outward potassium current (6.4±0.5 pA/pF vs. 8.8±0.9 pA/pF at 50 mV, n=54 vs. 42), and increased the short-term variability of repolarization (29.5±3.8 ms vs. 17.5±4.0 ms, n=27 vs. 18). Left ventricular fibrosis and HCN4 protein expression were also enhanced. These changes were associated with enhanced ectopic activity (number of escape beats from 0/hr to 29.7±20.3/hr) in vivo and arrhythmia susceptibility (elicited ventricular fibrillation: 3 of 10 sedentary dogs vs. 6 of 10 trained dogs). Our findings provide in vivo, cellular electrophysiological and molecular biological evidence for the enhanced susceptibility to ventricular arrhythmia in an experimental large animal model of endurance training.
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Affiliation(s)
- Alexandra Polyák
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Leila Topal
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Noémi Zombori-Tóth
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Noémi Tóth
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - János Prorok
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research NetworkSzegedHungary
| | - Zsófia Kohajda
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research NetworkSzegedHungary
| | - Szilvia Déri
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | | | - Péter Hegyi
- Centre for Translational Medicine and Institute of Pancreatic Diseases, Semmelweis UniversityBudapestHungary
- Institute for Translational Medicine, Medical School, University of PécsPécsHungary
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation, University of SzegedSzegedHungary
| | - Viktória Venglovecz
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Gergely Ágoston
- Institute of Family Medicine, University of SzegedSzegedHungary
| | - Zoltán Husti
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Péter Gazdag
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Jozefina Szlovák
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Tamás Árpádffy-Lovas
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Muhammad Naveed
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Annamária Sarusi
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
| | - Norbert Jost
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research NetworkSzegedHungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of SzegedSzegedHungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of SzegedSzegedHungary
| | - Norbert Nagy
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research NetworkSzegedHungary
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of SzegedSzegedHungary
| | - Attila S Farkas
- Department of Internal Medicine, Cardiology ward, University of SzegedSzegedHungary
| | - András Varró
- Department of Pharmacology and Pharmacotherapy, University of SzegedSzegedHungary
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research NetworkSzegedHungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of SzegedSzegedHungary
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11
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Viti A, Panconi G, Guarducci S, Garfagnini S, Mondonico M, Bravi R, Minciacchi D. Modulation of Heart Rate Variability following PAP Ion Magnetic Induction Intervention in Subjects with Chronic Musculoskeletal Pain: A Pilot Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3934. [PMID: 36900946 PMCID: PMC10001461 DOI: 10.3390/ijerph20053934] [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: 01/12/2023] [Revised: 02/18/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Heart rate variability (HRV) analysis has emerged as a simple and non-invasive technique to indirectly evaluate the autonomic nervous system (ANS), and it is considered a sensible and advanced index of health status. Pulsed electromagnetic fields (PEMFs) are widely used in clinical settings for improving the health status of individuals with chronic musculoskeletal pain. The aim of the present single-blind, randomized, placebo-controlled parallel pilot study was to investigate the acute effect of a single session of PEMFs stimulation by a PAP ion magnetic induction (PAPIMI) device on ANS activity, as measured by HRV, in patients with chronic musculoskeletal pain, and compare such effect with that induced by a sham (control) PAPIMI inductor. Thirty-two patients were randomized into two groups: PAPIMI intervention (PAP) (n = 17) and sham PAPIMI intervention (SHAM-PAP) (n = 15). HRV was assessed before and following the interventions. The PAP group showed a significant increase in all values of the time-domain parameters (SDNN, RMSSD, NN50, and pNN50) and the HF component of HRV, suggesting a parasympathetic effect. In contrast, the SHAM-PAP group showed no significant differences in all HRV indices following the intervention. Preliminary findings suggested that PAPIMI inductor could influence ANS activity and provided initial evidence of the potential physiological response induced by the PAPIMI device.
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Affiliation(s)
- Antonio Viti
- Centro Fisioterapico Apuano, Via delle Contrade 242, 55047 Lucca, Italy
| | - Giulia Panconi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Sara Guarducci
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | | | - Mosè Mondonico
- Centro Fisioterapico Apuano, Via delle Contrade 242, 55047 Lucca, Italy
| | - Riccardo Bravi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Diego Minciacchi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
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12
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Valenzuela PL, Baggish A, Castillo-García A, Santos-Lozano A, Boraita A, Lucia A. Strenuous Endurance Exercise and the Heart: Physiological versus Pathological Adaptations. Compr Physiol 2022; 12:4067-4085. [PMID: 35950659 DOI: 10.1002/cphy.c210045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Although the benefits of regular physical activity on cardiovascular health are well established, the effects of strenuous endurance exercise (SEE) have been a matter of debate since ancient times. In this article, we aim to provide a balanced overview of what is known about SEE and the heart-from epidemiological evidence to recent cardiac imaging findings. Lifelong SEE is overall cardioprotective, with endurance master athletes showing in fact a youthful heart. Yet, some lines of research remain open, such as the need to elucidate the time-course and potential relevance of transient declines in heart function (or increases in biomarkers of cardiac injury) with SEE. The underlying mechanisms and clinical relevance of SEE-associated atrial fibrillation, myocardial fibrosis, or high coronary artery calcium scores also remain to be elucidated. © 2022 American Physiological Society. Compr Physiol 12:1-19, 2022.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Adrián Castillo-García
- Fissac - Physiology, Health and Physical Activity, Madrid, Spain.,Biology Systems Department, University of Alcalá, Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.,i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain
| | - Araceli Boraita
- Department of Cardiology, Sports Medicine Center, Spanish Agency for Health Protection in Sports, Madrid, Spain
| | - Alejandro Lucia
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.,Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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13
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Ketelhut S, Wehlan E, Bayer G, Ketelhut RG. Influence of Initial Severity of Depression on the Effectiveness of a Multimodal Therapy on Depressive Score, Heart Rate Variability, and Hemodynamic Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9836. [PMID: 36011470 PMCID: PMC9407770 DOI: 10.3390/ijerph19169836] [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: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Depression is a major cause of disability among populations worldwide. Apart from primary symptoms, depressed patients often have a higher cardiovascular risk profile. Multimodal therapy concepts, including exercise, have emerged as promising approaches that not only improve depressive symptoms but also have a positive impact on cardiovascular risk profile. However, controversies have arisen concerning the influence of baseline severity on the effects of therapy concepts for this demographic. This study assessed whether pretreatment severity moderates psychological and physiological treatment outcomes of a multimodal therapy. A total of 16 patients diagnosed with mild depression (MD) and 14 patients diagnosed with severe depression (SD) took part in a 3-month outpatient multimodal treatment therapy. Before and after the treatment, depression score (Beck Depression Inventory (BDI)), peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), heart rate (HR), and parasympathetic parameters of heart rate variability (RMSSD) were assessed. Significant time effects were detected for BDI (−20.0 ± 11.6, p > 0.001, η2 = 0.871), pSBP (−4.7 ± 6.8 mmHg, p < 0.001, η2 = 0.322), pDBP (−3.5 ± 6.9 mmHg, p = 0.01, η2 = 0.209), cSBP (−4.8 ± 6.5 mmHg, p < 0.001, η2 = 0.355), cDBP (−3.6 ± 6.8 mmHg, p = 0.008, η2 = 0.226), PWV (−0.13 ± 0.23 m/s, p = 0.008, η2 = 0.229), HR (4.3 ± 8.8 min−1, p = 0.015, η2 = 0.193), RMSSD (−12.2 ± 23.9 ms, p = 0.017, η2 = 0.251), and and SDNN (10.5 ± 17.8 ms, p = 0.005, η2 = 0.330). Significant time × group interaction could be revealed for BDI (p < 0.001, η2 = 0.543), with patients suffering from SD showing stronger reductions. Pretreatment severity of depression has an impact on the effectiveness of a multimodal therapy regarding psychological but not physiological outcomes.
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Affiliation(s)
- Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
| | - Emanuel Wehlan
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
| | - Gerhart Bayer
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
| | - Reinhard G. Ketelhut
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
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14
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Oliveira CM, Novelli FI, Alves-Santos ÉT, Queiroz MG, Ghezzi AC, Cambri LT. Physical activity influences heart rate variability in young adults, regardless of dextrose ingestion. Blood Press Monit 2022; 27:220-226. [PMID: 35258021 DOI: 10.1097/mbp.0000000000000593] [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: 11/25/2022]
Abstract
INTRODUCTION Cardiac autonomic modulation can be altered by carbohydrate ingestion. On the other hand, some of the protective effects of physical activity may be due to its impact on the autonomic nervous system. PURPOSE This cross-sectional study was conducted to evaluate whether physical activity level influences heart rate variability (HRV) under fasting and mainly, after dextrose ingestion. METHODS Healthy adults aged 18-40 years ( n = 92; 54.35 % women) were separated into nonactive ( n = 47) and active groups ( n = 45), based on the physical activity level determined by International Physical Activity Questionnaire (IPAQ) and then compared. RESULTS There were no significant differences ( P > 0.05) for age, body mass, BMI, abdominal circumference, blood pressure, fasting glucose and blood glucose at 60 min after dextrose ingestion between groups. Body fat (%) was lower in the active group ( P = 0.02). The time-domain indices (RMSSD, SDNN and pNN50) were higher in the physically active group compared to the nonactive group (main effect of group, P < 0.01). The SDNN index was higher at 60 min after dextrose ingestion compared to fasting (main effect of time, P ≤ 0.01). However, no HRV indices showed significantly interaction effect (group x time; P > 0.05). CONCLUSION The magnitude of HRV responses to glucose was not influenced by physical activity status. Young adults who met at least the minimum physical activity recommendations showed a higher cardiac autonomic modulation, regardless of dextrose ingestion.
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Affiliation(s)
| | - Fabiula Isoton Novelli
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
- Medicine Department, Graduate Program in Sciences, University of São Paulo, São Paulo
| | | | - Marilene Gonçalves Queiroz
- Physical Education Department, Graduate Program in Health Sciences, Federal University of Mato Grosso, Cuiabá
| | | | - Lucieli Teresa Cambri
- Nutrition Department, Graduate Program in Nutrition, Foods and Metabolism
- Physical Education Department, Graduate Program in Physical Education, Federal University of Mato Grosso, Cuiabá
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15
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Effects of Vibration Training on Weight Loss and Heart Rate Variability in the Obese Female College Students. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1041688. [PMID: 35872875 PMCID: PMC9300325 DOI: 10.1155/2022/1041688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 12/05/2022]
Abstract
Objective The present study examined the effects of a 12-week whole-body vibration training (WBVT) regimen on heart rate variability (HRV) and body composition in the obese female college students. Methods Participants were assigned to either the WBVT (n = 17) or obese control group (n = 19). The students in the WBVT group conducted a 12-week (5 times per week and 30 min per time) exercise protocols (30 to 40 Hz of frequency and 4 mm of amplitude), and the obese control group did not perform regular physical training during 12 weeks of study. Then, body composition (body weight, BMI, body fat, body fat percentage; trunk fat mass, muscle mass, MM) and HRV (time domain and frequency domain index) were measured in all subjects before and after WBVT intervention. Results (1) After 12-week WBVT intervention, body fat mass, trunk fat mass, and body fat percentage significantly decreased and muscle mass increased in the WBVT group (P < 0.01, respectively); there was no significant change in body weight and BMI (P > 0.05, respectively). (2) After 12-week WBVT intervention, LFn, LF/HF, and HR significantly decreased (P < 0.05, P < 0.01), R-R interval and RMSSD significantly increased (P < 0.01, respectively), and there was no significant difference in HFn (P > 0.05). Nevertheless, there was no significant change before and after the test in body composition and HRV in the obese control group (P > 0.05, respectively). (3) After 12-week WBVT intervention, compared with the obese control group, body fat mass, body fat percentage, trunk fat mass, and LF/HF significantly decreased (P < 0.05, P < 0.01), muscle mass, and RMSSD increased (P < 0.05) in the WBVT group; but there were no significant difference in other indicators (P > 0.05) between the obese control group and WBVT group. (4) The reduction of body fat percentage before and after the WBVT intervention are positively correlated with the reduction in the LFn and LF/HF (r = 0.542, r = 0.504; P < 0.05, respectively) and negatively correlated with the increase in the RMSSD (r = −0.514, P < 0.05), and the reduction of trunk fat mass are positively correlated with the reduction in the LF/HF (r = 0.540, P < 0.05). Conclusion The results indicate that WBVT improves HRV and body composition in obese female college students, and the reduction in body fat percentage and trunk fat mass are associated with a shift in cardiac autonomic regulation towards vagal dominance and improve sympathetic-vagus balance after WBVT intervention. In conclusion, WBVT may be a feasible treatment to improve cardiac autonomic function and body composition.
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16
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Complementary Role of Combined Indirect and Direct Cardiac Sympathetic (Hyper)Activity Assessment in Patients with Heart Failure by Spectral Analysis of Heart Rate Variability and Nuclear Imaging: Possible Application in the Evaluation of Exercise Training Effects. J Cardiovasc Dev Dis 2022; 9:jcdd9060181. [PMID: 35735810 PMCID: PMC9225187 DOI: 10.3390/jcdd9060181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 12/10/2022] Open
Abstract
In chronic heart failure (CHF), abnormalities in cardiac autonomic control, characterized by sympathetic overactivity, contribute to the progression of the disease and are associated with an unfavorable prognosis. Assessing cardiac autonomic status is clinically important in the management of patients with CHF. To this aim, heart rate variability (HRV) analysis has been extensively used as a non-invasive tool for assessing cardiac autonomic regulation, and has been shown to predict the clinical outcome in patients with CHF. Adrenergic nerve activity has also been estimated using iodine-123 (I-123) metaiodobenzylguanidine (MIBG), a noradrenaline analogue. MIBG is an analogue of norepinephrine sharing the same cellular mechanism of uptake, storage, and release in presynaptic sympathetic neurons. As an innervation tracer, 123I-MIBG allows for the evaluation of cardiac sympathetic neuronal function. Cardiac MIBG imaging has also been reported to predict a poor clinical outcome in CHF. MIBG provides direct information on the function of the presynaptic sympathetic nerve endings, whereas HRV, which depends on postsynaptic signal transduction, reflects the end-organ response of the sinus node. The aim of this brief review is to provide the reader with some basic concepts regarding the spectral analysis of HRV and MIBG, highlighting what is known about their respective roles in detecting cardiac sympathetic hyperactivity in CHF and, in perspective, their possible combined use in assessing non-pharmacological treatments in patients with CHF and reduced ejection fraction, with a particular focus on the effects of exercise training.
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17
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Lemos LK, Filho CATT, Santana dos Santos F, Biral TM, Cavina APDS, Junior EP, de Oliveira Damasceno S, Vendrame JW, Pastre CM, Vanderlei FM. Autonomic and cardiovascular responses on post-eccentric exercise recovery with blood flow restriction at different loads: randomized controlled trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Thome J, Densmore M, Terpou BA, Théberge J, McKinnon MC, Lanius RA. Contrasting Associations Between Heart Rate Variability and Brainstem-Limbic Connectivity in Posttraumatic Stress Disorder and Its Dissociative Subtype: A Pilot Study. Front Behav Neurosci 2022; 16:862192. [PMID: 35706833 PMCID: PMC9190757 DOI: 10.3389/fnbeh.2022.862192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Increasing evidence points toward the need to extend the neurobiological conceptualization of posttraumatic stress disorder (PTSD) to include evolutionarily conserved neurocircuitries centered on the brainstem and the midbrain. The reticular activating system (RAS) helps to shape the arousal state of the brain, acting as a bridge between brain and body. To modulate arousal, the RAS is closely tied to the autonomic nervous system (ANS). Individuals with PTSD often reveal altered arousal patterns, ranging from hyper- to blunted arousal states, as well as altered functional connectivity profiles of key arousal-related brain structures that receive direct projections from the RAS. Accordingly, the present study aims to explore resting state functional connectivity of the RAS and its interaction with the ANS in participants with PTSD and its dissociative subtype. Methods Individuals with PTSD (n = 57), its dissociative subtype (PTSD + DS, n = 32) and healthy controls (n = 40) underwent a 6-min resting functional magnetic resonance imaging and pulse data recording. Resting state functional connectivity (rsFC) of a central node of the RAS – the pedunculopontine nuclei (PPN) – was investigated along with its relation to ANS functioning as indexed by heart rate variability (HRV). HRV is a prominent marker indexing the flexibility of an organism to react adaptively to environmental needs, with higher HRV representing greater effective adaptation. Results Both PTSD and PTSD + DS demonstrated reduced HRV as compared to controls. HRV measures were then correlated with rsFC of the PPN. Critically, participants with PTSD and participants with PTSD + DS displayed inverse correlations between HRV and rsFC between the PPN and key limbic structures, including the amygdala. Whereas participants with PTSD displayed a positive relationship between HRV and PPN rsFC with the amygdala, participants with PTSD + DS demonstrated a negative relationship between HRV and PPN rsFC with the amygdala. Conclusion The present exploratory investigation reveals contrasting patterns of arousal-related circuitry among participants with PTSD and PTSD + DS, providing a neurobiological lens to interpret hyper- and more blunted arousal states in PTSD and PTSD + DS, respectively.
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Affiliation(s)
- Janine Thome
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maria Densmore
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Braeden A. Terpou
- Homewood Research Institute, Guelph, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jean Théberge
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Programs, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Ruth A. Lanius
- Department of Psychiatry, Western University, London, ON, Canada
- Imaging Division, Lawson Health Research Institute, London, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- Department of Neuroscience, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
- *Correspondence: Ruth A. Lanius,
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19
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Dor-Haim H, Horowitz M, Yaakobi E, Katzburg S, Barak S. Intermittent aerobic-resistance interval training versus continues aerobic training: Improvement in cardiac electrophysiologic and anthropometric measures in male patients post myocadiac infarction, a randomized control trial. PLoS One 2022; 17:e0267888. [PMID: 35503787 PMCID: PMC9064084 DOI: 10.1371/journal.pone.0267888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Exercise is a valuable intervention modality for patients post-myocardial infarction (MI). Aerobic and resistance training are both commonly used separately in cardiac rehabilitation. However, the effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac electrophysiologic and anthropometric measures had not been thoroughly investigated. Aim The primary objective of this study was to compare the effectiveness of moderate-intensity continuous-aerobic training (CAT) vs. SCT on cardiac electrical measures (resting electrocardiographic, ECG; a nd heart rate variability, HRV) in patients’ post-MI presenting reduced left ventricular function. Second, to examine its effect on anthropometric measures. Material and methods Twenty-nine men post-MI with reduced left ventricular function were assigned randomly to either 12 weeks of CAT (n = 15) or SCT (n = 14). CAT group performed moderate-intensity activity. SCT group performed high-intensity exercise, alternating between resistance and aerobic training. Differences between CAT and SCT groups were done using independent t-tests, paired t-tests and effect size (ES). Results Participants in both groups improved their HRV measures (increase in HFnu; p < 0.05; ES > 0.51) and ECG (reduction in QT-dispersion; p < 0.05; ES > 0.51). Only the SCT group had significant improvements in waist circumference (p < 0.05). Conclusion Exercise improves cardiac electrical measures post-MI. However, in comparison to CAT, SCT may yield greater anthropometric changes. In order to have improvements in cardiac electrical stability, clinicians working with post-MI patients may use both CAT and SCT. However, SCT might result in greater improvements.
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Affiliation(s)
- Horesh Dor-Haim
- O2 Health Promotion and Sports Medicine Department, Givat Ram, Jerusalem, Israel
| | - Michal Horowitz
- The laboratory of Environmental Physiology Department of Physiology, Faculty of Dentistry Hebrew University of Jerusalem, Hadassah Ein Kerem Campus Jerusalem, Jerusalem, Israel
| | - Eldad Yaakobi
- The Sagol Center for Hyperbaric Medicine and Research, Yitzhak Shamir Medical Center, Be’er Ya’akov, Israel
| | - Sara Katzburg
- O2 Health Promotion and Sports Medicine Department, Givat Ram, Jerusalem, Israel
- Department of Developmental Biology and Cancer Research, Israel-Canada Medical Research Institute, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Barak
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel
- Kaye Academic College of Education, Beer-Sheba, Israel
- * E-mail:
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20
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Kui P, Polyák A, Morvay N, Tiszlavicz L, Nagy N, Ördög B, Takács H, Leprán I, Farkas A, Papp JG, Jost N, Varró A, Baczkó I, Farkas AS. Long-Term Endurance Exercise Training Alters Repolarization in a New Rabbit Athlete’s Heart Model. Front Physiol 2022; 12:741317. [PMID: 35237176 PMCID: PMC8882986 DOI: 10.3389/fphys.2021.741317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
In the present study, the effect of long-term exercise training was investigated on myocardial morphological and functional remodeling and on proarrhythmic sensitivity in a rabbit athlete’s heart model. New-Zealand white rabbits were trained during a 12-week long treadmill running protocol and compared with their sedentary controls. At the end of the training protocol, echocardiography, in vivo and in vitro ECG recordings, proarrhythmic sensitivity with dofetilide (nM) were performed in isolated hearts, and action potential duration (APD) measurements at different potassium concentrations (4.5 and 2 mM) were made in the isolated papillary muscles. Expression levels of the slow component of delayed rectifier potassium current and fibrosis synthesis and degradation biomarkers were quantified. Echocardiography showed a significantly dilated left ventricle in the running rabbits. ECG PQ and RR intervals were significantly longer in the exercised group (79 ± 2 vs. 69 ± 2 ms and 325 ± 11 vs. 265 ± 6 ms, p < 0.05, respectively). The in vivo heart rate variability (HRV) (SD of root mean square: 5.2 ± 1.4 ms vs. 1.4 ± 0.2 ms, p < 0.05) and Tpeak-Tend variability were higher in the running rabbits. Bradycardia disappeared in the exercised group in vitro. Dofetilide tended to increase the QTc interval in a greater extent, and significantly increased the number of arrhythmic beats in the trained animals in vitro. APD was longer in the exercised group at a low potassium level. Real-time quantitative PCR (RT-qPCR) showed significantly greater messenger RNA expression of fibrotic biomarkers in the exercised group. Increased repolarization variability and higher arrhythmia incidences, lengthened APD at a low potassium level, increased fibrotic biomarker gene expressions may indicate higher sensitivity of the rabbit “athlete’s heart” to life-threatening arrhythmias.
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Affiliation(s)
- Péter Kui
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Alexandra Polyák
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- ELKH-SZTE Working Group of Cardiovascular Pharmacology, Szeged, Hungary
| | - Nikolett Morvay
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - László Tiszlavicz
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Norbert Nagy
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- ELKH-SZTE Working Group of Cardiovascular Pharmacology, Szeged, Hungary
| | - Balázs Ördög
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Hedvig Takács
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - István Leprán
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - András Farkas
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Julius Gy. Papp
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- ELKH-SZTE Working Group of Cardiovascular Pharmacology, Szeged, Hungary
| | - Norbert Jost
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- ELKH-SZTE Working Group of Cardiovascular Pharmacology, Szeged, Hungary
| | - András Varró
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- ELKH-SZTE Working Group of Cardiovascular Pharmacology, Szeged, Hungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- *Correspondence: András Varró,
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Attila S. Farkas
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
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Abstract
Much of biology is rhythmical and comprises oscillators that can couple. These have optimized energy efficiency and have been preserved during evolution. The respiratory and cardiovascular systems contain numerous oscillators, and importantly, they couple. This coupling is dynamic but essential for an efficient transmission of neural information critical for the precise linking of breathing and oxygen delivery while permitting adaptive responses to changes in state. The respiratory pattern generator and the neural network responsible for sympathetic and cardiovagal (parasympathetic) tone generation interact at many levels ensuring that cardiac output and regional blood flow match oxygen delivery to the lungs and tissues efficiently. The most classic manifestations of these interactions are respiratory sinus arrhythmia and the respiratory modulation of sympathetic nerve activity. These interactions derive from shared somatic and cardiopulmonary afferent inputs, reciprocal interactions between brainstem networks and inputs from supra-pontine regions. Disrupted respiratory-cardiovascular coupling can result in disease, where it may further the pathophysiological sequelae and be a harbinger of poor outcomes. This has been well documented by diminished respiratory sinus arrhythmia and altered respiratory sympathetic coupling in animal models and/or patients with myocardial infarction, heart failure, diabetes mellitus, and neurological disorders as stroke, brain trauma, Parkinson disease, or epilepsy. Future research needs to assess the therapeutic potential for ameliorating respiratory-cardiovascular coupling in disease.
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Affiliation(s)
- James P Fisher
- Manaaki Manawa-The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tymoteusz Zera
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Julian F R Paton
- Manaaki Manawa-The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.
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22
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Hadaya J, Buckley U, Gurel NZ, Chan CA, Swid MA, Bhadra N, Vrabec TL, Hoang JD, Smith C, Shivkumar K, Ardell JL. Scalable and reversible axonal neuromodulation of the sympathetic chain for cardiac control. Am J Physiol Heart Circ Physiol 2022; 322:H105-H115. [PMID: 34860595 PMCID: PMC8714250 DOI: 10.1152/ajpheart.00568.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Maladaptation of the sympathetic nervous system contributes to the progression of cardiovascular disease and risk for sudden cardiac death, the leading cause of mortality worldwide. Axonal modulation therapy (AMT) directed at the paravertebral chain blocks sympathetic efferent outflow to the heart and maybe a promising strategy to mitigate excess disease-associated sympathoexcitation. The present work evaluates AMT, directed at the sympathetic chain, in blocking sympathoexcitation using a porcine model. In anesthetized porcine (n = 14), we applied AMT to the right T1-T2 paravertebral chain and performed electrical stimulation of the distal portion of the right sympathetic chain (RSS). RSS-evoked changes in heart rate, contractility, ventricular activation recovery interval (ARI), and norepinephrine release were examined with and without kilohertz frequency alternating current block (KHFAC). To evaluate efficacy of AMT in the setting of sympathectomy, evaluations were performed in the intact state and repeated after left and bilateral sympathectomy. We found strong correlations between AMT intensity and block of sympathetic stimulation-evoked changes in cardiac electrical and mechanical indices (r = 0.83-0.96, effect size d = 1.9-5.7), as well as evidence of sustainability and memory. AMT significantly reduced RSS-evoked left ventricular interstitial norepinephrine release, as well as coronary sinus norepinephrine levels. Moreover, AMT remained efficacious following removal of the left sympathetic chain, with similar mitigation of evoked cardiac changes and reduction of catecholamine release. With growth of neuromodulation, an on-demand or reactionary system for reversible AMT may have therapeutic potential for cardiovascular disease-associated sympathoexcitation.NEW & NOTEWORTHY Autonomic imbalance and excess sympathetic activity have been implicated in the pathogenesis of cardiovascular disease and are targets for existing medical therapy. Neuromodulation may allow for control of sympathetic projections to the heart in an on-demand and reversible manner. This study provides proof-of-concept evidence that axonal modulation therapy (AMT) blocks sympathoexcitation by defining scalability, sustainability, and memory properties of AMT. Moreover, AMT directly reduces release of myocardial norepinephrine, a mediator of arrhythmias and heart failure.
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Affiliation(s)
- Joseph Hadaya
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California,2UCLA Molecular, Cellular and Integrative Physiology
Program, Los Angeles, California
| | - Una Buckley
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Nil Z. Gurel
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Christopher A. Chan
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Mohammed A. Swid
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Niloy Bhadra
- 3Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, Ohio,4Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Tina L. Vrabec
- 3Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, Ohio,4Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Jonathan D. Hoang
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California,2UCLA Molecular, Cellular and Integrative Physiology
Program, Los Angeles, California
| | - Corey Smith
- 5Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
| | - Kalyanam Shivkumar
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California,2UCLA Molecular, Cellular and Integrative Physiology
Program, Los Angeles, California
| | - Jeffrey L. Ardell
- 1Cardiac Arrhythmia Center and Neurocardiology Research Program of
Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California,2UCLA Molecular, Cellular and Integrative Physiology
Program, Los Angeles, California
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23
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Huang C, Kong Z, Nie J, Pan M, Zhang H, Shi Q, George K. Impact of high-intensity interval and moderate-intensity continuous exercise on heart rate variability and cardiac troponin. J Sports Med Phys Fitness 2021; 61:1301-1308. [PMID: 34610731 DOI: 10.23736/s0022-4707.20.11657-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND It remains uncertain whether exercise modality (high-intensity interval [HIE]; moderate-intensity continuous [MCE]) mediates exercise-induced changes in markers of pro-arrhythmogenic state and/or cardiac damage. This study examines heart rate variability (HRV) and cardiac troponin T (cTnT) kinetic responses to HIE and MCE. METHODS Fourteen sedentary, overweight/obese females completed two trials including HIE (2-min running at 90% V̇O<inf>2max</inf> followed by 2-min running at 50% V̇O<inf>2max</inf>, repeated for 60 min) and MCE (70% V̇O<inf>2max</inf> steady-state running for 60 min) in a randomized, counterbalanced fashion. Supine HRV was evaluated as root mean square of successive differences (RMSSD), normalized low-frequency (LF) and high-frequency (HF) spectral power, as well as the LF/HF ratio before (PRE), immediately (0 HR), 3 (3 HR) and 24 (24 HR) hours after exercise. Serum cTnT was assessed using a high-sensitivity assay at the same time-points and the values were corrected for plasma volume changes. RESULTS Exercise temporarily altered all HRV indices (i.e. RMSSD and HF decreased; LF and LF/HF ratio increased at 0 HR, all P<0.05) but a rebound increase of RMSSD was observed at 24 HR, and the kinetic responses of HRV were similar between exercise modalities. The cTnT was significantly elevated (P<0.05) after exercise at 3 HR (by 688%) and 24 HR (by 374%) with no between-modality differences. There was no significant correlation between delta change in cTnT and HRV metrics. CONCLUSIONS Exercise modality (workload-equivalent HIE vs. MCE) did not mediate exercise-induced alteration in autonomic activity and cTnT elevation, and it seems these are largely separate exercise-induced phenomena.
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Affiliation(s)
- Chuanye Huang
- Graduate School, Shandong Sport University, Jinan, China
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China
| | - Jinlei Nie
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, China -
| | - Mingling Pan
- College of Sport and Health, Shandong Sport University, Jinan, China
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Qingde Shi
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, China
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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24
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Sun X, Zhao S, Chen K, Hua W, Su Y, Liu X, Xu W, Wang F, Fan X, Dai Y, Liu Z, Zhang S. Association between cardiac autonomic function and physical activity in patients at high risk of sudden cardiac death: a cohort study. Int J Behav Nutr Phys Act 2021; 18:128. [PMID: 34544427 PMCID: PMC8454096 DOI: 10.1186/s12966-021-01200-0] [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: 03/14/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background High levels of physical activity (PA) and heart rate variability (HRV) are associated with cardiovascular benefits in patients with cardiovascular diseases. HRV, representing cardiac autonomic function, is positively associated with PA. However, the impacts of PA and cardiac autonomic function on cardiovascular outcomes were not analysed in the same study population. This lack of evidence supported our hypothesis that PA might contribute to cardiovascular benefits via enhanced cardiac autonomic function. Methods Patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy defibrillator (CRT-D) implantation were included from the SUMMIT registry. HRV and PA values were assessed during the first 30–60 days post device implantation using a continuous home monitoring system. Causal mediation analysis was conducted to explore the possible mediation function of HRV in the association of PA with long-term cardiac death and all-cause mortality in patients at a high risk of sudden cardiac death. Results Over a mean follow-up period of 47.7 months, 63 cardiac deaths (18.9%) and 85 all-cause death events (25.5%) were observed among 342 patients with ICD/CRT-D implantation. A positive linear association between HRV and PA was demonstrated and the β value of HRV was 0.842 (95% confidence interval [CI]: 0.261–1.425, P = 0.005) in the multiple linear regression analysis. Multivariable Cox proportional hazards analysis revealed that high levels of PA (≥11.0%) and HRV (≥75.9 ms) were independent protective factors against cardiac death (PA: hazard ratio [HR] = 0.273; 95% CI, 0.142–0.526, P < 0.001; HRV: HR = 0.224; 95% CI, 0.103–0.489, P < 0.001) and all-cause mortality (PA: HR = 0.299; 95% CI, 0.177–0.505, P < 0.001; HRV: HR = 0.394; 95% CI, 0.231–0.674, P = 0.001). Causal mediation analysis demonstrated partial mediation effects of PA that were mediated through HRV on cardiac death (mediation proportion = 12.9, 95%CI: 2.2–32.0%, P = 0.006) and all-cause mortality (mediation proportion = 8.2, 95%CI: 1.6–20.0%, P = 0.006). Conclusions HRV might be a modest mediator in the association between high levels of PA and the reduced risks of cardiac death and all-cause mortality in ICD/CRT-D recipients. This finding supports that enhanced cardiac autonomic function might be one of the underlying mechanisms by which regular PA contributes to cardiovascular benefits.
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Affiliation(s)
- Xuerong Sun
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Shuang Zhao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Keping Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Wei Hua
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Yangang Su
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Fang Wang
- Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohan Fan
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Yan Dai
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Zhimin Liu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China.
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25
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da Silva Santos PM, Novelli FI, Araújo JA, Tamanho S, Cambri LT. Aerobic fitness influences cardiac autonomic modulation in police officers regardless of specific duties. Blood Press Monit 2021; 26:200-206. [PMID: 33491996 DOI: 10.1097/mbp.0000000000000518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study assesses whether the specific duties of a police officer or aerobic fitness influences blood pressure (BP) and cardiac autonomic modulation. METHOD Police officers (n = 161) were divided into administrative and operational (34.72 ± 5.98 vs. 33.95 ± 5.61 years old) groups, and subsequently divided into lower and higher aerobic fitness (35.49 ± 4.32 vs. 45.39 ± 13.10 mL·kg-1·min-1). RESULTS Higher SBP (125 ± 10 vs. 121 ± 10 mmHg; P = 0.02) and aerobic fitness (42.10 ± 5.57 vs. 38.51 ± 6.67 mL·kg-1·min-1; P < 0.01) were observed in the operational group. On the other hand, lower obesity indicators and higher heart rate variability (HRV) indices (SD1: 26.67 ± 14.19 vs. 20.98 ± 9.12; SD2: 54.04 ± 19.81 vs. 47.32 ± 18.85; RMSSD: 36.50 ± 18.78 vs. 29.90 ± 12.51; SDNN: 42.80 ± 16.05 vs. 36.85 ± 14.23 ms; pNN50: 17.32 ± 17.54 vs. 10.60 ± 10.77 %) were observed in the higher aerobic fitness group (P ≤ 0.05). CONCLUSION In summary, although the operational occupation had shown a negative influence on SBP, the HRV was not impaired in police officers. Additionally, aerobic fitness was related to differences in obesity indicators and HRV regardless of police duties. Our findings encourage the inclusion of BP and HRV measurements in routine health checks to screen for early hypertension and autonomic dysfunction.
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Affiliation(s)
- Patrícia Marina da Silva Santos
- Physical Education Department, Graduate Program on Physical Education, Federal University of Mato Grosso (UFMT), Cuiabá, Montana, Brazil
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26
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Rogers B, Giles D, Draper N, Mourot L, Gronwald T. Detection of the Anaerobic Threshold in Endurance Sports: Validation of a New Method Using Correlation Properties of Heart Rate Variability. J Funct Morphol Kinesiol 2021; 6:jfmk6020038. [PMID: 33925974 PMCID: PMC8167649 DOI: 10.3390/jfmk6020038] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/12/2022] Open
Abstract
Past attempts to define an anaerobic threshold (AnT) have relied upon gas exchange kinetics, lactate testing and field-based evaluations. DFA a1, an index of heart rate (HR) variability (HRV) fractal correlation properties, has been shown to decrease with exercise intensity. The intent of this study is to investigate whether the AnT derived from gas exchange is associated with the transition from a correlated to uncorrelated random HRV pattern signified by a DFA a1 value of 0.5. HRV and gas exchange data were obtained from 15 participants during an incremental treadmill run. Comparison of the HR reached at the second ventilatory threshold (VT2) was made to the HR reached at a DFA a1 value of 0.5 (HRVT2). Based on Bland-Altman analysis and linear regression, there was strong agreement between VT2 and HRVT2 measured by HR (r = 0.78, p < 0.001). Mean VT2 was reached at a HR of 174 (±12) bpm compared to mean HRVT2 at a HR of 171 (±16) bpm. In summary, the HR associated with a DFA a1 value of 0.5 on an incremental treadmill ramp was closely related to that of the HR at the VT2 derived from gas exchange analysis. A distinct numerical value of DFA a1 representing an uncorrelated, random interbeat pattern appears to be associated with the VT2 and shows potential as a noninvasive marker for training intensity distribution and performance status.
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Affiliation(s)
- Bruce Rogers
- College of Medicine, University of Central Florida, 6850 Lake Nona Boulevard, Orlando, FL 32827-7408, USA
- Correspondence:
| | - David Giles
- Lattice Training Ltd., Chesterfield S41 9AT, UK;
| | - Nick Draper
- School of Health Sciences, College of Education, Health and Human Development, University of Canterbury, 8041 Christchurch, New Zealand;
| | - Laurent Mourot
- EA3920 Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, Exercise Performance Health Innovation (EPHI) Platform, University of Bourgogne Franche-Comté, 25000 Besançon, France;
- Division for Physical Education, National Research Tomsk Polytechnic University, Lenin Ave, 30, 634050 Tomsk Oblast, Russia
| | - Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany;
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27
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The Impact of Aerobic Training on Cardiovascular Reactivity to and Recovery From Psychological and Orthostatic Challenge. Psychosom Med 2021; 83:125-137. [PMID: 33337592 PMCID: PMC7858227 DOI: 10.1097/psy.0000000000000896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Elevated cardiovascular reactivity to, and reduced recovery from, challenging events may increase the risk of cardiovascular disease, and exercise training may reduce this reactivity. However, in a randomized controlled trial of aerobic versus strength training in sedentary, healthy young adults, we found no training group differences in reactivity or recovery. Because strength training also may have a reactivity-reducing effect, we conducted a secondary analysis of data from another trial, this time with a wait-list control condition. METHODS One hundred nineteen healthy, young, sedentary adults were randomized to a 12-week aerobic training program or wait-list control. Before (T1) and after (T2) training and after 4 weeks of sedentary deconditioning (T3), we measured heart rate (HR), heart rate variability, and blood pressure at rest and in response to and recovery from psychological and orthostatic challenge. Data were analyzed using a group (aerobic versus wait-list) by session (T1, T2, and deconditioning) and by period (baseline, psychological challenge, recovery, standing) three-way analysis of variance with prespecified contrasts. RESULTS Aerobic capacity significantly increased at T2 and decreased at T3 only in the aerobic training group. The groups did not differ on HR, heart rate variability, or blood pressure reactivity to or recovery from challenge. Without baseline adjustment, there were no significant treatment differences in response to challenges. With baseline adjustment, there were significant treatment by session effects for HR (Cohen d = 0.54, p = .002), systolic blood pressure (d = 0.44, p = .014), diastolic blood pressure (d = 0.74, p = .002), and root mean squared successive difference (d = 0.48, p = .006) reactivity from T1 to T2 only for orthostatic challenge: at T2, reactivity in the aerobic group was nonsignificantly reduced, compared with T1. In the wait-list group, reactivity significantly increased after T1. CONCLUSIONS This study raises further doubt about attenuation of cardiovascular reactivity or enhancement of recovery as a cardioprotective mechanism of aerobic exercise training.Clinical Trial Registration:ClinicalTrials.gov Unique identifier: NCT01335737.
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Tricot GK, Araújo JA, Novelli FI, Puga GM, Arsa G, Cambri LT. Parasympathetic modulation during sleep time is reduced after maximal exercise, correlated with aerobic fitness in young women. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2021. [DOI: 10.1590/1980-0037.2021v23e83295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
abstract It is known that cardiovascular risk is increased during exercise and recovery. Thus, it is necessary to assess all the risk associated with exercise to minimize the possibility of cardiovascular events. The aim of this study was to verify whether a maximal exercise alters ambulatory cardiac autonomic modulation in untrained women and whether aerobic fitness is correlated to cardiac autonomic modulation. Twelve women (25.35 ± 5.44 years) were outfitted with the Holter monitor on an experimental (after maximum exercise) and a control day to heart rate variability (HRV) evaluation. Maximal exercise increased 24 h heart rate (82 ± 14 vs 77 ± 11 bpm; p = 0.04) and during sleep time (72 ± 14 vs. 65 ± 9 bpm; p = 0.01), reduced parasympathetic modulation (HF – n.u. 49.96 ± 11.56 vs 42.10 ± 14.98; p = 0.04), and increased low-frequency/high-frequency ratio (2.88 ± 3.24 vs 1.31 ± 0.60; p = 0.03) during sleep time compared to the control day. Aerobic fitness was correlated positively with LF, HF, and HF (n.u.) indices (r = 0.61 to 0.73, p < 0.05) and correlated negatively with LF (n.u.) and LF/HF ratio (Rho = - 0.57 to - 0.69; p < 0.05). Maximal exercise alters parasympathetic modulation during sleep time in untrained women. Ambulatory cardiac autonomic modulation after exercise is related to aerobic fitness.
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Effect of an Exergaming-Based Dance Training Paradigm on Autonomic Nervous System Modulation in Healthy Older Adults: A Randomized Controlled Trial. J Aging Phys Act 2020; 29:1-9. [PMID: 32702664 DOI: 10.1123/japa.2019-0452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to determine if an exergaming-based dance training protocol can improve heart rate variability (HRV) in healthy older adults. A total of 20 healthy older adults (≥65 years old) were randomly assigned to two groups. The intervention group received an exergaming-based dance aerobic training for 6 weeks, while the control group received a 1-hr education on conventional physical exercises. Data obtained from HRV analysis pre- (Week 0) and postintervention (Week 7) consisted of high-frequency power, low- and high-frequency ratio, and root mean square of differences and percentage of adjacent RR intervals with a difference of duration greater than 50 ms values. HRV was assessed during rest and during a 6-min walk test. In addition, the YMCA submaximal cycle ergometer test was used to acquire estimated maximal O2 consumption pre- and postintervention. After the training, the intervention group showed significant improvement in HRV high-frequency power, root mean square of differences, and percentage of adjacent RR intervals with a difference of duration greater than 50 ms values in both rest and 6-min walk test conditions compared with the control group. Similarly, the intervention group showed higher maximal O2 consumption compared with the control group after the training. Our results support the effectiveness of an exergaming-based dance aerobic training on improving cardiac autonomic control in aging.
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La Rovere MT, Porta A, Schwartz PJ. Autonomic Control of the Heart and Its Clinical Impact. A Personal Perspective. Front Physiol 2020; 11:582. [PMID: 32670079 PMCID: PMC7328903 DOI: 10.3389/fphys.2020.00582] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/11/2020] [Indexed: 12/21/2022] Open
Abstract
This essay covers several aspects of the autonomic control of the heart, all relevant to cardiovascular pathophysiology with a direct impact on clinical outcomes. Ischemic heart disease, heart failure, channelopathies, and life-threatening arrhythmias are in the picture. Beginning with an overview on some of the events that marked the oscillations in the medical interest for the autonomic nervous system, our text explores specific areas, including experimental and clinical work focused on understanding the different roles of tonic and reflex sympathetic and vagal activity. The role of the baroreceptors, not just for the direct control of circulation but also because of the clinical value of interpreting alterations (spontaneous or induced) in their function, is discussed. The importance of the autonomic nervous system for gaining insights on risk stratification and for providing specific antiarrhythmic protection is also considered. Examples are the interventions to decrease sympathetic activity and/or to increase vagal activity. The non-invasive analysis of the RR and QT intervals provides additional information. The three of us have collaborated in several studies and each of us contributes with very specific and independent areas of expertise. Here, we have focused on those areas to which we have directly contributed and hence speak with personal experience. This is not an attempt to provide a neutral and general overview on the autonomic nervous system; rather, it represents our effort to share and provide the readers with our own personal views matured after many years of research in this field.
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Affiliation(s)
- Maria Teresa La Rovere
- Department of Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Montescano (Pavia), Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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31
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Restan AZ, Camacho AA, Cerqueira JA, Zacché E, Kirnew MD, Loureiro BA, Silva SB, Moranza HG, Ferraz GC. Effect of a lactate-guided conditioning program on heart rate variability obtained using 24-Holter electrocardiography in Beagle dogs. PLoS One 2020; 15:e0233264. [PMID: 32479554 PMCID: PMC7263627 DOI: 10.1371/journal.pone.0233264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/03/2020] [Indexed: 11/18/2022] Open
Abstract
The dogs’ responses to training exercise are seldom monitored using physiological variables, and cardiac autonomic regulation (CAR) is a relevant determinant of endurance-training adaptation. There are studies in the literature establishing that regular exercise could interfere with CAR in dogs, measured by heart rate and vagal-derived indexes of heart-rate-variability (HRV). However, few studies were found using a prescribed training program based on the lactate threshold (LT) to determine HRV by a 24-h Holter analysis. The purpose of this study was to test whether an endurance-training program (ETP) guided individually by LT raises time-domain measures of HRV in healthy Beagle dogs. Twenty dogs were assigned to two groups: control (C) and trained (T). The dogs from group T underwent an incremental exercise test (IET) to determine their LT. Both LT and velocity corresponding to the LT (VLT) was determined by visual inspection. T group performed an eight-week endurance-training program consisting of treadmill runs set to 70–80% of the VLT. Next, dogs from the group T have submitted to IET again. The maximal velocities (Vmax) at which achieved by the trained dogs in both IETs were determined. The group S did not undergo IETs or ETP. HRV was determined by the 24-hour-Holter at rest, before and on the 2°, 4°, 6° and 8° training weeks. To examine the HR impact on HRV, standard HRV variables were normalized to prevailing HR. VLT and Vmax rose in group T, indicating an improvement of dogs’ aerobic and anaerobic capacity. The normalized standard HRV indexes were relatively attenuated since these variables had a reduction in the degree of correlation concerning an average HR. The ETP resulted in decreased resting heart rate and increased time-domain indices, highlighting the log-transformed square root of the mean sum of the squared differences between R–R intervals (Ln rMSSD). The lactate-guided endurance-training program could lead to better parasympathetic cardiac modulation in Beagle dogs.
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Affiliation(s)
- Alejandro Z. Restan
- Department of Animal Morphology and Physiology, Laboratory of Pharmacology and Equine Exercise Physiology (LAFEQ), School of Agricultural and Veterinarian Sciences (FCAV), São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Aparecido A. Camacho
- Department of Veterinary Medicine and Surgery, School of Agricultural and Veterinarian Sciences College of Agriculture and Veterinary Sciences (FCAV), São Paulo State University Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - Juliana A. Cerqueira
- Department of Animal Morphology and Physiology, Laboratory of Pharmacology and Equine Exercise Physiology (LAFEQ), School of Agricultural and Veterinarian Sciences (FCAV), São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Evandro Zacché
- Department of Veterinary Medicine and Surgery, School of Agricultural and Veterinarian Sciences College of Agriculture and Veterinary Sciences (FCAV), São Paulo State University Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - Murillo D. Kirnew
- Department of Veterinary Medicine and Surgery, School of Agricultural and Veterinarian Sciences College of Agriculture and Veterinary Sciences (FCAV), São Paulo State University Universidade Estadual Paulista (UNESP), Jaboticabal, SP, Brazil
| | - Bruna A. Loureiro
- Centro de Ciências Agrárias, Department of Animal Science, Universidade Federal da Paraíba, Centro de Ciências Agrárias, Areia, Paraiba, Brazil
| | - Samara B. Silva
- Department of Animal Morphology and Physiology, Laboratory of Pharmacology and Equine Exercise Physiology (LAFEQ), School of Agricultural and Veterinarian Sciences (FCAV), São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Henriette G. Moranza
- Department of Animal Morphology and Physiology, Laboratory of Pharmacology and Equine Exercise Physiology (LAFEQ), School of Agricultural and Veterinarian Sciences (FCAV), São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Guilherme C. Ferraz
- Department of Animal Morphology and Physiology, Laboratory of Pharmacology and Equine Exercise Physiology (LAFEQ), School of Agricultural and Veterinarian Sciences (FCAV), São Paulo State University (UNESP), Jaboticabal, SP, Brazil
- * E-mail:
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32
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Wang X, Fitts RH. Cardiomyocyte slowly activating delayed rectifier potassium channel: regulation by exercise and β-adrenergic signaling. J Appl Physiol (1985) 2020; 128:1177-1185. [DOI: 10.1152/japplphysiol.00802.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Results demonstrate that exercise training (TRN) downregulates ventricular IKs channel current and the channel’s responsiveness to β-agonist factors mediated by TRN-induced decline in channel subunits KCNQ1 and KCNE1 and the A-kinase anchoring protein yotiao. The reduced IKs current helps explain the TRN-induced prolongation of the action potential in basal conditions and, coupled with previously reported upregulation of the KATP channel, results in a more efficient heart that is better able to respond to beat-by-beat changes in metabolism.
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Affiliation(s)
- Xinrui Wang
- Department of Biological Sciences, Marquette University, Milwaukee, Wisconsin
| | - Robert H. Fitts
- Department of Biological Sciences, Marquette University, Milwaukee, Wisconsin
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Affiliation(s)
- Antonio Crisafulli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Pasquale Pagliaro
- Department of Clinical and Biological Science, University of Torino, Torino, Italy
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An E, Nolty AAT, Amano SS, Rizzo AA, Buckwalter JG, Rensberger J. Heart Rate Variability as an Index of Resilience. Mil Med 2019; 185:363-369. [DOI: 10.1093/milmed/usz325] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Abstract
Introduction
Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility. The present study investigated HRV as a broad index of resilience.
Materials and Methods
Twenty-four male participants from the Army National Guard Special Forces completed psychological measures known to relate to resilience and had HRV measured while undergoing stressful virtual environment scenarios. Pearson product-moment correlations were used to explore the relationships between HRV and resilience factors. All research was conducted with the oversight of the Human Subjects Review Committee of Fuller Theological Seminary.
Results
Trends toward significance were reported in order to provide results that would reasonably be expected in a study of higher power. Trends between resilience factors and HRV were found only during specific stress-inducing simulations (see Tables III).
Conclusion
Greater resilience to stress was associated with HRV during nonstress periods. Higher levels of resilience to traumatic events were associated with HRV during circumstances that were more stressful and emotionally distressing. Post hoc analysis revealed that specific factors including flexibility, emotional control, and spirituality were driving the relationship between general resilience and HRV following emotionally laden stressors. Less stress vulnerability was associated with HRV following intermittent brief stressors. In sum, HRV appears to represent some aspects of an individual’s overall resilience profile. Although resilience remains a complex, multidimensional construct, HRV shows promise as a global psychophysiological index of resilience. This study also offers important perspectives concerning ways to optimize both physical and psychological health.
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Affiliation(s)
- Eric An
- Graduate School of Psychology, Fuller Theological Seminary, 135 N Oakland Ave, Pasadena, CA 91101
| | - Anne A T Nolty
- Graduate School of Psychology, Fuller Theological Seminary, 135 N Oakland Ave, Pasadena, CA 91101
- Headington Institute, 402 S Marengo Ave, Pasadena, CA 91101
| | - Stacy S Amano
- Graduate School of Psychology, Fuller Theological Seminary, 135 N Oakland Ave, Pasadena, CA 91101
| | - Albert A Rizzo
- Institute for Creative Technologies, University of Southern California, 12015 E Waterfront Dr, Los Angeles, CA 90094
| | - J Galen Buckwalter
- Headington Institute, 402 S Marengo Ave, Pasadena, CA 91101
- Institute for Creative Technologies, University of Southern California, 12015 E Waterfront Dr, Los Angeles, CA 90094
| | - Jared Rensberger
- Graduate School of Psychology, Fuller Theological Seminary, 135 N Oakland Ave, Pasadena, CA 91101
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Fiuza-Luces C, Santos-Lozano A, Joyner M, Carrera-Bastos P, Picazo O, Zugaza JL, Izquierdo M, Ruilope LM, Lucia A. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol 2019; 15:731-743. [PMID: 30115967 DOI: 10.1038/s41569-018-0065-1] [Citation(s) in RCA: 426] [Impact Index Per Article: 85.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite strong scientific evidence supporting the benefits of regular exercise for the prevention and management of cardiovascular disease (CVD), physical inactivity is highly prevalent worldwide. In addition to merely changing well-known risk factors for systemic CVD, regular exercise can also improve cardiovascular health through non-traditional mechanisms. Understanding the pathways through which exercise influences different physiological systems is important and might yield new therapeutic strategies to target pathophysiological mechanisms in CVD. This Review includes a critical discussion of how regular exercise can have antiatherogenic effects in the vasculature, improve autonomic balance (thereby reducing the risk of malignant arrhythmias), and induce cardioprotection against ischaemia-reperfusion injury, independent of effects on traditional CVD risk factors. This Review also describes how exercise promotes a healthy anti-inflammatory milieu (largely through the release of muscle-derived myokines), stimulates myocardial regeneration, and ameliorates age-related loss of muscle mass and strength, a frequently overlooked non-traditional CVD risk factor. Finally, we discuss how the benefits of exercise might also occur via promotion of a healthy gut microbiota. We argue, therefore, that a holistic view of all body systems is necessary and useful when analysing the role of exercise in cardiovascular health.
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Affiliation(s)
- Carmen Fiuza-Luces
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain. .,CIBER de Enfermedades Raras (CIBERER), Madrid, Spain.
| | - Alejandro Santos-Lozano
- i+HeALTH Research Group, Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain.,Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Michael Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Pedro Carrera-Bastos
- Centre for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Malmö, Sweden.,NutriScience - Education and Consulting, Lisbon, Portugal
| | - Oscar Picazo
- NutriScience - Education and Consulting, Lisbon, Portugal
| | - José L Zugaza
- Achucarro - Basque Center for Neuroscience, Bilbao, Spain.,Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, Leioa, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER of Frailty and Healthy Aging (CIBERFES), Navarrabiomed, Pamplona, Spain
| | - Luis M Ruilope
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
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36
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Joyner MJ. Hypertrophic cardiomyopathy and exercise: a need for more information. J Physiol 2019; 597:1225-1226. [DOI: 10.1113/jp277538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Michael J. Joyner
- Department of Anesthesiology & Perioperative MedicineMayo Clinic Rochester MN 55905 USA
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37
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Qin R, Murakoshi N, Xu D, Tajiri K, Feng D, Stujanna EN, Yonebayashi S, Nakagawa Y, Shimano H, Nogami A, Koike A, Aonuma K, Ieda M. Exercise training reduces ventricular arrhythmias through restoring calcium handling and sympathetic tone in myocardial infarction mice. Physiol Rep 2019; 7:e13972. [PMID: 30806037 PMCID: PMC6389758 DOI: 10.14814/phy2.13972] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 12/21/2022] Open
Abstract
Exercise can improve morbidity and mortality in heart failure patients; however, the underlying mechanisms remain to be fully investigated. Thus, we investigated the effects of exercise on cardiac function and ventricular arrhythmias in myocardial infarction (MI) induced heart failure mice. Wild-type male mice underwent sham-operation or permanent left coronary artery ligation to induce MI. MI mice were divided into a sedentary (MI-Sed) and two intervention groups: MI-Ex (underwent 6-week treadmill exercise training) and MI-βb (oral bisoprolol treatment (1 mg/kg/d) without exercise). Cardiac function and structure were assessed by echocardiography and histology. Exercise capacity and cardiopulmonary function was accepted as oxygen consumption at peak exercise (peak VO2 ). Autonomic nervous system function and the incidence of spontaneous ventricular arrhythmia were evaluated via telemetry recording. mRNA and protein expressions in the left ventricle (LV) were investigated by real-time PCR and Western blotting. There were no differences in survival rate, MI size, cardiac function and structure, while exercise training improved peak VO2 . Compared with MI-Sed, MI-Ex, and MI-βb showed decreased sympathetic tone and lower incidence of spontaneous ventricular arrhythmia. By Western blot, the hyperphosphorylation of CaMKII and RyR2 were restored by exercise and β-blocker treatment. Furthermore, elevated expression of miR-1 and decreased expression of its target protein PP2A were recovered by exercise and β-blocker treatment. Continuous intensive exercise training can suppress ventricular arrhythmias in subacute to chronic phase of MI through restoring autonomic imbalance and impaired calcium handling, similarly to that for β-blockers.
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Affiliation(s)
- Rujie Qin
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Nobuyuki Murakoshi
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - DongZhu Xu
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Kazuko Tajiri
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Duo Feng
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Endin N. Stujanna
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Saori Yonebayashi
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Yoshimi Nakagawa
- Department of Internal Medicine (Endocrinology and Metabolism)Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Hitoshi Shimano
- Department of Internal Medicine (Endocrinology and Metabolism)Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Akihiko Nogami
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Akira Koike
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
- Medical ScienceFaculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Kazutaka Aonuma
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
| | - Masaki Ieda
- Department of CardiologyFaculty of MedicineGraduate School of Comprehensive Human SciencesUniversity of TsukubaTsukubaJapan
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38
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Chowdhury MA, Sholl HK, Sharrett MS, Haller ST, Cooper CC, Gupta R, Liu LC. Exercise and Cardioprotection: A Natural Defense Against Lethal Myocardial Ischemia-Reperfusion Injury and Potential Guide to Cardiovascular Prophylaxis. J Cardiovasc Pharmacol Ther 2019; 24:18-30. [PMID: 30041547 PMCID: PMC7236859 DOI: 10.1177/1074248418788575] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Similar to ischemic preconditioning, high-intensity exercise has been shown to decrease infarct size following myocardial infarction. In this article, we review the literature on beneficial effects of exercise, exercise requirements for cardioprotection, common methods utilized in laboratories to study this phenomenon, and discuss possible mechanisms for exercise-mediated cardioprotection.
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Affiliation(s)
- Mohammed Andaleeb Chowdhury
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
- * Mohammed Andaleeb Chowdhury, Haden K. Sholl, and Megan S. Sharrett contributed equally to this work
| | - Haden K Sholl
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
- * Mohammed Andaleeb Chowdhury, Haden K. Sholl, and Megan S. Sharrett contributed equally to this work
| | - Megan S Sharrett
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Steven T Haller
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Christopher C Cooper
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Rajesh Gupta
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Lijun C Liu
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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39
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Such-Miquel L, Brines L, Alberola AM, Zarzoso M, Chorro FJ, Guerrero J, Parra G, Gallego N, Soler C, Del Canto I, Guill A, Such L. Effect of chronic exercise on myocardial electrophysiological heterogeneity and stability. Role of intrinsic cholinergic neurons: A study in the isolated rabbit heart. PLoS One 2018; 13:e0209085. [PMID: 30562383 PMCID: PMC6298659 DOI: 10.1371/journal.pone.0209085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/19/2018] [Indexed: 11/19/2022] Open
Abstract
A study has been made of the effect of chronic exercise on myocardial electrophysiological heterogeneity and stability, as well as of the role of cholinergic neurons in these changes. Determinations in hearts from untrained and trained rabbits on a treadmill were performed. The hearts were isolated and perfused. A pacing electrode and a recording multielectrode were located in the left ventricle. The parameters determined during induced VF, before and after atropine (1μM), were: fibrillatory cycle length (VV), ventricular functional refractory period (FRPVF), normalized energy (NE) of the fibrillatory signal and its coefficient of variation (CV), and electrical ventricular activation complexity, as an approach to myocardial heterogeneity and stability. The VV interval was longer in the trained group than in the control group both prior to atropine (78±10 vs. 68±10 ms) and after atropine (76±8 vs. 67±10 ms). Likewise, FRPVF was longer in the trained group than in the control group both prior to and after atropine (53±8 vs. 42±7 ms and 50±6 vs. 40±6 ms, respectively), and atropine did not modify FRPVF. The CV of FRPVF was lower in the trained group than in the control group prior to atropine (12.5±1.5% vs. 15.1±3.8%) and, decreased after atropine (15.1±3.8% vs. 12.2±2.4%) in the control group. The trained group showed higher NE values before (0.40±0.04 vs. 0.36±0.05) and after atropine (0.37±0.04 vs. 0.34±0.06; p = 0.08). Training decreased the CV of NE both before (23.3±2% vs. 25.2±4%; p = 0.08) and after parasympathetic blockade (22.6±1% vs. 26.1±5%). Cholinergic blockade did not modify these parameters within the control and trained groups. Activation complexity was lower in the trained than in the control animals before atropine (34±8 vs. 41±5), and increased after atropine in the control group (41±5 vs. 48±9, respectively). Thus, training decreases the intrinsic heterogeneity of the myocardium, increases electrophysiological stability, and prevents some modifications due to muscarinic block.
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Affiliation(s)
- Luis Such-Miquel
- Department of Physiotherapy, Universitat de València, Valencia, Spain
- Health Research Institute (INCLIVA), Valencia, Spain
| | - Laia Brines
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Antonio M. Alberola
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Physiology, Universitat de València, Valencia, Spain
| | - Manuel Zarzoso
- Department of Physiotherapy, Universitat de València, Valencia, Spain
- Health Research Institute (INCLIVA), Valencia, Spain
| | - Francisco J. Chorro
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Juan Guerrero
- Department of Electronic Engineering, Universitat de València, Valencia, Spain
| | - Germán Parra
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Physiology, Universitat de València, Valencia, Spain
| | | | - Carlos Soler
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Physiology, Universitat de València, Valencia, Spain
| | | | - Antonio Guill
- ITACA, Universitat Politècnica de València, Valencia, Spain
| | - Luis Such
- Health Research Institute (INCLIVA), Valencia, Spain
- Department of Physiology, Universitat de València, Valencia, Spain
- * E-mail:
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40
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Tessier MP, Pennestri MH, Godbout R. Heart rate variability of typically developing and autistic children and adults before, during and after sleep. Int J Psychophysiol 2018; 134:15-21. [DOI: 10.1016/j.ijpsycho.2018.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/15/2022]
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41
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Bennett JM, Reeves G, Billman GE, Sturmberg JP. Inflammation-Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing "the Epidemic" of Chronic Diseases. Front Med (Lausanne) 2018; 5:316. [PMID: 30538987 PMCID: PMC6277637 DOI: 10.3389/fmed.2018.00316] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/23/2018] [Indexed: 01/06/2023] Open
Abstract
Siloed or singular system approach to disease management is common practice, developing out of traditional medical school education. Textbooks of medicine describe a huge number of discrete diseases, usually in a systematic fashion following headings like etiology, pathology, investigations, differential diagnoses, and management. This approach suggests that the body has a multitude of ways to respond to harmful incidences. However, physiology and systems biology provide evidence that there is a simple mechanism behind this phenotypical variability. Regardless if an injury or change was caused by trauma, infection, non-communicable disease, autoimmune disorders, or stress, the typical physiological response is: an increase in blood supply to the area, an increase in white cells into the affected tissue, an increase in phagocytic activity to remove the offending agent, followed by a down-regulation of these mechanisms resulting in healing. The cascade of inflammation is the body's unique mechanism to maintain its integrity in response to macroscopic as well as microscopic injuries. We hypothesize that chronic disease development and progression are linked to uncontrolled or dysfunctional inflammation to injuries regardless of their nature, physical, environmental, or psychological. Thus, we aim to reframe the prevailing approach of management of individual diseases into a more integrated systemic approach of treating the "person as a whole," enhancing the patient experience, ability to a make necessary changes, and maximize overall health and well-being. The first part of the paper reviews the local immune cascades of pro- and anti-inflammatory regulation and the interconnected feedback loops with neural and psychological pathways. The second part emphasizes one of nature's principles at work-system design and efficiency. Continually overwhelming this finely tuned system will result in systemic inflammation allowing chronic diseases to emerge; the pathways of several common conditions are described in detail. The final part of the paper considers the implications of these understandings for clinical care and explore how this lens could shape the physician-patient encounter and health system redesign. We conclude that healthcare professionals must advocate for an anti-inflammatory lifestyle at the patient level as well as at the local and national levels to enhance population health and well-being.
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Affiliation(s)
- Jeanette M. Bennett
- Department of Psychological Science, StressWAVES Biobehavioral Research Lab, The University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Glenn Reeves
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - George E. Billman
- Department of Physiology and Cell Biology, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH, United States
| | - Joachim P. Sturmberg
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
- Foundation President, International Society for Systems and Complexity Sciences for Health, Delaware, United States
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42
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da Silva Rolim P, da Costa Matos RA, Von Koenig Soares EDMK, Molina GE, da Cruz CJG. Caffeine increases parasympathetic reactivation without altering resting and exercise cardiac parasympathetic modulation: A balanced placebo design. Eur J Sport Sci 2018; 19:490-498. [PMID: 30326789 DOI: 10.1080/17461391.2018.1532532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The sympathicotonic effect of caffeine is strongly evidenced in the literature. However, the effects of caffeine or caffeine expectancy on the cardiac parasympathetic modulation remain obscure. Thus, the aim of this study was to investigate the effects of caffeine consumption and expectancy of caffeine consumption on the cardiac parasympathetic modulation under different stress conditions. Twenty-one physically active men (22.3 ± 2.9 years, 25.2 ± 2.7 kg/m2) consumed ∼3 mg/kg of caffeine received as caffeine, caffeine as placebo, placebo as placebo and placebo as caffeine. Parasympathetic modulation was assessed by heart rate variability (HRV-Poincaré SD1 index) at supine and orthostatic positions, during a submaximal exercise (HRV threshold-HRVT) and during each 60 seconds (s) within 300 s of post-exercise active recovery. A factorial ANOVA for repeated measures (p < 0.05) was used to assess the effect of caffeine, expectancy and resting time after caffeine intake on the HRV. No significant effect of caffeine or expectancy was observed on the SD1 value at supine or standing positions (p = 0.47-0.53; p = 0.57-0.31, respectively), despite an increase in this variable after resting periods in both positions (p < 0.001). During exercise, caffeine and expectancy do not alter the HRVT (p = 0.51-0.39). However, higher SD1 values were observed after caffeine administration from 60 to 300 s post-exercise recovery (p = 0.01-0.05) but not for the effects of expectancy (p = 0.19-0.94). We concluded that low doses of caffeine or expectancy do not alter the resting cardiac parasympathetic modulation or HRVT. However, caffeine, but not expectancy, increases parasympathetic reactivation after a submaximal exercise test in young men.
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Affiliation(s)
- Paloma da Silva Rolim
- a Group of Studies and Research in Cardiac Autonomic Function (GEFAC) , Centro Universitário Euro Americano-UNIEURO , Brasilia , Brazil
| | - Raquel Adjafre da Costa Matos
- a Group of Studies and Research in Cardiac Autonomic Function (GEFAC) , Centro Universitário Euro Americano-UNIEURO , Brasilia , Brazil
| | | | - Guilherme Eckhardt Molina
- b Laboratory of Exercise Physiology, Faculty of Physical Education , Universidade de Brasília , Brasilia , Brazil
| | - Carlos Janssen Gomes da Cruz
- a Group of Studies and Research in Cardiac Autonomic Function (GEFAC) , Centro Universitário Euro Americano-UNIEURO , Brasilia , Brazil.,b Laboratory of Exercise Physiology, Faculty of Physical Education , Universidade de Brasília , Brasilia , Brazil
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Wang X, Fitts RH. Effects of regular exercise on ventricular myocyte biomechanics and KATP channel function. Am J Physiol Heart Circ Physiol 2018; 315:H885-H896. [DOI: 10.1152/ajpheart.00130.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Exercise training is known to protect the heart from ischemia and improve function during exercise by reducing cardiomyocyte action potential duration (APD) and increasing contractility. The cellular mechanisms involve β-adrenergic regulation and the ATP-sensitive K+ (KATP) channel, but how each alters function of the left ventricle and sex specificity is unknown. To address this, female and male Sprague-Dawley rats were randomly assigned to wheel-running (TRN) or sedentary (SED) groups. After 6–8 wk of training, myocytes were isolated from the left ventricle and field stimulated at 1, 2, and 5 Hz. TRN significantly increased cardiomyocyte contractility, the kinetics of the Ca2+ transient, and responsiveness to the adrenergic receptor agonist isoproterenol (ISO), as reflected by an increased sarcomere shortening. Importantly, we demonstrated a TRN-induced upregulation of KATP channels, which was reflected by elevated content, current density, and the channel’s contribution to APD shortening at high activation rates and in the presence of the activator pinacidil. TRN induced increase in KATP current occurred throughout the left ventricle, but channel subunit content showed regional specificity with increases in Kir6.2 in the apex and SUR2A in base regions. In summary, TRN elevated cardiomyocyte cross-bridge kinetics, Ca2+ sensitivity, and the responsiveness of contractile function to β-adrenergic receptor stimulation in both sexes. Importantly, upregulation of the KATP channel accelerates repolarization and shortens APD during stress and exercise. These adaptations have clinical importance, as increased contractility and reduced APD would help protect cardiac output and reduce intracellular Ca2+ overload during stresses such as regional ischemia. NEW & NOTEWORTHY Our results demonstrate that regular exercise significantly increased ventricular myocyte shortening and relaxation velocity and the rate of rise in intracellular Ca2+ transient and enhanced the response of biomechanics and Ca2+ reuptake to β-adrenergic stimulation. Importantly, exercise training upregulated the cardiomyocyte sarcolemma ATP-sensitive K+ channel across the left ventricle in both sexes, as reflected by elevated channel subunit content, current density, and the channel’s contribution to reduced action potential duration at high activation rates.
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Affiliation(s)
- Xinrui Wang
- Department of Biological Sciences, Marquette University, Milwaukee, Wisconsin
| | - Robert H. Fitts
- Department of Biological Sciences, Marquette University, Milwaukee, Wisconsin
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Xavier J, Volpato J, Dalmina A, Cancelier C, Costa Á, Pereira E, Serafini L, Saito M, Yonezawa L. Efeito de diferentes intensidades de exercício em esteira sobre os parâmetros eletrocardiográficos de cães hígidos. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se a padronização de testes de exercício de alta e baixa intensidades em esteira, bem como a avaliação do eletrocardiograma de cães submetidos a esses testes. Para tal fim, sete cães da raça Australian Cattle Dog e quatro da raça Border Collie clinicamente saudáveis foram submetidos a dois testes de exercício em esteira, com pelo menos sete dias de intervalo: T1 - teste de exercício de alta intensidade e curta duração, e T2 - teste de exercício de baixa intensidade e longa duração. A amplitude e a duração de ondas e intervalos foram avaliadas no momento antes do exercício (M0) e nos momentos imediatamente após o término dos testes (MPE) e 30 minutos após (M30). A frequência e o ritmo cardíacos foram avaliados antes dos testes e continuamente por 30 minutos após o término do exercício. Verificou-se diferença significativa somente para a duração do intervalo QT em M30 em T1, além de algumas arritmias, como complexos atriais e ventriculares prematuros isolados em três animais após o teste T1, e em quatro após T2. Os testes de exercício foram adequados para promover estimulação simpática nos cães, contudo não causaram alterações significativas no eletrocardiograma, provavelmente em razão do excelente condicionamento físico dos animais.
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Affiliation(s)
- J.S. Xavier
- Universidade do Estado de Santa Catarina, Brazil
| | - J. Volpato
- Universidade do Estado de Santa Catarina, Brazil
| | - A.C. Dalmina
- Universidade do Estado de Santa Catarina, Brazil
| | | | - Á. Costa
- Universidade do Estado de Santa Catarina, Brazil
| | | | - L. Serafini
- Universidade do Estado de Santa Catarina, Brazil
| | - M.E. Saito
- Universidade do Estado de Santa Catarina, Brazil
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Lakin R, Guzman C, Izaddoustdar F, Polidovitch N, Goodman JM, Backx PH. Changes in Heart Rate and Its Regulation by the Autonomic Nervous System Do Not Differ Between Forced and Voluntary Exercise in Mice. Front Physiol 2018; 9:841. [PMID: 30061838 PMCID: PMC6055008 DOI: 10.3389/fphys.2018.00841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022] Open
Abstract
Most exercise studies in mice have relied on forced training which can introduce psychological stress. Consequently, the utility of mouse models for understanding exercise-mediated effects in humans, particularly autonomic nervous system (ANS) remodeling, have been challenged. We compared the effects of voluntary free-wheel running vs. non-voluntary swimming on heart function in mice with a focus on the regulation of heart rate (HR) by the ANS. Under conditions where the total excess O2 consumption associated with exercise was comparable, the two exercise models led to similar improvements in ventricular function as well as comparable reductions in HR and its control by parasympathetic nervous activity (PNA) and sympathetic nervous activity (SNA), compared to sedentary mice. Both exercise models also increased HR variability (HRV) by similar amounts, independent of HR reductions. In all mice, HRV depended primarily on PNA, with SNA weakly affecting HRV at low frequencies. The differences in both HR and HRV between exercised vs. sedentary mice were eliminated by autonomic blockade, consistent with the similar intrinsic beating rates observed in atria isolated from exercised vs. sedentary mice. In conclusion, both forced and voluntary exercise induce comparable ventricular physiological remodeling as well as HR reductions and HR-independent enhancements of HRV which were both primarily dependent on increased PNA. New and noteworthy -No previous mouse studies have compared the effects of forced and voluntary exercise on the heart function and its modulation by the autonomic nervous system (ANS).-Both voluntary free-wheel running and forced swimming induced similar improvements in ventricular contractile function, reductions in heart rate (HR) and enhancements of HR variability (HRV).-HR regulation in exercised mice was linked to increased parasympathetic nerve activity and reduced sympathetic nerve activity.- HRV was independent of HR and depended primarily on PNA in both exercised and sedentary mice.- Complete cardiac autonomic blockade eliminated differences in both HR and HRV between exercised and sedentary mice.
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Affiliation(s)
- Robert Lakin
- Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Camilo Guzman
- Department of Biology, York University, Toronto, ON, Canada
| | - Farzad Izaddoustdar
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Nazari Polidovitch
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada.,Department of Biology, York University, Toronto, ON, Canada
| | - Jack M Goodman
- Department of Exercise Sciences, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada
| | - Peter H Backx
- Division of Cardiology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada.,Department of Biology, York University, Toronto, ON, Canada
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Joyner MJ, Dempsey JA. Physiological Redundancy and the Integrative Responses to Exercise. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a029660. [PMID: 28490539 DOI: 10.1101/cshperspect.a029660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The biological responses to acute and chronic exercise are marked by a high level of physiological redundancy that operates at various levels of integration, including the molecular, cellular, organ-system, and whole-body scale. During acute exercise, this redundancy protects whole-body homeostasis in the face of 10-fold or more increases in whole-body metabolic rate. In some cases, there are "trade-offs" between optimizing the performance of a given organ or system versus whole-body performance. Physiological redundancy also plays a key role in the adaptive responses to exercise training and high levels of habitual physical activity, including the positive effects of regular exercise on health. Appreciation of the general principles of physiological redundancy is critical to (1) gain an overall understanding of short- and long-term responses to exercise, and (2) place physiological responses occurring at various levels of integration in perspective.
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Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota 55905
| | - Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53706
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Autonomic cardiac function, body composition and cardiorespiratory fitness changes in adolescents after a multidisciplinary obesity treatment program: a feasibility study. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-017-0396-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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48
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Botek M, Krejčí J, McKune A. Sex Differences in Autonomic Cardiac Control and Oxygen Saturation Response to Short-Term Normobaric Hypoxia and Following Recovery: Effect of Aerobic Fitness. Front Endocrinol (Lausanne) 2018; 9:697. [PMID: 30532736 PMCID: PMC6265316 DOI: 10.3389/fendo.2018.00697] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/05/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction: The main aims of this study were to investigate autonomic nervous system (ANS) and arterial oxygen saturation (SpO2) responses to simulated altitude in males and females, and to determine the association between maximal oxygen uptake (VO2max) and these responses. Materials and Methods: Heart rate variability (HRV) and SpO2 were monitored in a resting supine position during Preliminary (6 min normoxia), Hypoxia (10 min, fraction of inspired oxygen (FiO2) of 9.6%, simulated altitude ~6,200 m) and Recovery (6 min normoxia) phases in 28 males (age 23.7 ± 1.7 years, normoxic VO2max 59.0 ± 7.8 ml.kg-1.min-1, body mass index (BMI) 24.2 ± 2.1 kg.m-2) and 30 females (age 23.8 ± 1.8 years, VO2max 45.1 ± 8.7 ml.kg-1.min-1, BMI 21.8 ± 3.0 kg.m-2). Spectral analysis of HRV quantified the ANS activity by means of low frequency (LF, 0.05-0.15 Hz) and high frequency (HF, 0.15-0.50 Hz) power, transformed by natural logarithm (Ln). Time domain analysis incorporated the square root of the mean of the squares of the successive differences (rMSSD). Results: There were no significant differences in SpO2 level during hypoxia between the males (71.9 ± 7.5%) and females (70.8 ± 7.1%). Vagally-related HRV variables (Ln HF and Ln rMSSD) exhibited no significant differences between sexes across each phase. However, while the sexes demonstrated similar Ln LF/HF values during the Preliminary phase, the males (0.5 ± 1.3) had a relatively higher (p = 0.001) sympathetic activity compared to females (-0.6 ± 1.4) during the Hypoxia phase. Oxygen desaturation during resting hypoxia was significantly correlated with VO2max in males (r = -0.45, p = 0.017) but not in females (r = 0.01, p = 0.952) and difference between regression lines were significant (p = 0.024). Conclusions: Despite similar oxygen desaturation levels, males exhibited a relatively higher sympathetic responses to hypoxia exposure compared with females. In addition, the SpO2 response to resting hypoxia exposure was related to maximal aerobic capacity in males but not females.
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Affiliation(s)
- Michal Botek
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Jakub Krejčí
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
- *Correspondence: Jakub Krejčí
| | - Andrew McKune
- Discipline of Sport and Exercise Science, School of Rehabilitation and Exercise Sciences, Research Institute for Sport and Exercise Science, University of Canberra, Canberra, ACT, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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49
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Utzinger ML. Enhancing Heart Rate Variability. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Lai X, Zhong L, Fu HX, Dang S, Wang X, Zhang N, Feng GK, Liu ZQ, Wang X, Wang L. Effects of neuregulin-1 on autonomic nervous system remodeling post-myocardial infarction in a rat model. Neural Regen Res 2017; 12:1905-1910. [PMID: 29239338 PMCID: PMC5745846 DOI: 10.4103/1673-5374.219054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Sympathetic nerve and vagus nerve remodeling play an important part in cardiac function post-myocardial infarction (MI). Increasing evidence indicates that neuregulin-1 (NRG-1) improves cardiac function following heart failure. Since its impact on cardiac function and neural remodeling post-MI is poorly understood, we aimed to investigate the role of NRG-1 in autonomic nervous system remodeling post-MI. Forty-five Sprague-Dawley rats were equally randomized into three groups: sham (with the left anterior descending coronary artery exposed but without ligation), MI (left anterior descending coronary artery ligation), and MI plus NRG-1 (left anterior descending coronary artery ligation followed by intraperitoneal injection of NRG-1 (10 μg/kg, once daily for 7 days)). At 4 weeks after MI, echocardiography was used to detect the rat cardiac function by measuring the left ventricular end-systolic inner diameter, left ventricular diastolic diameter, left ventricular end-systolic volume, left ventricular end-diastolic volume, left ventricular ejection fraction, and left ventricular fractional shortening. mRNA and protein expression levels of tyrosine hydroxylase, growth associated protein-43 (neuronal specific protein), nerve growth factor, choline acetyltransferase (vagus nerve marker), and vesicular acetylcholine transporter (cardiac vagal nerve fiber marker) in ischemic myocardia were detected by real-time PCR and western blot assay to assess autonomous nervous remodeling. After MI, the rat cardiac function deteriorated significantly, and it was significantly improved after NRG-1 injection. Compared with the MI group, mRNA and protein levels of tyrosine hydroxylase and growth associated protein-43, as well as choline acetyltransferase mRNA level significantly decreased in the MI plus NRG-1 group, while mRNA and protein levels of nerve growth factor and vesicular acetylcholine transporters, as well as choline acetyltransferase protein level slightly decreased. Our results indicate that NRG-1 can improve cardiac function and regulate sympathetic and vagus nerve remodeling post-MI, thus reaching a new balance of the autonomic nervous system to protect the heart from injury.
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Affiliation(s)
- Xin Lai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Liang Zhong
- Wuhan Medical & Healthcare Center for Women and Children, Wuhan, Hubei Province, China
| | - Hai-Xia Fu
- Department of Cardiology, Henan Province People's Hospital, Zhengzhou, Henan Province, China
| | - Song Dang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Xin Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Ning Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Gao-Ke Feng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Zi-Qiang Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
| | - Long Wang
- Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei Province; Hubei Key Laboratory of Cardiology, Wuhan, Hubei Province, China
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