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Souza WMMD, Vieira MC, Nascimento PMC, Serra SM, Reis MS. Strength training improves functional capacity of individuals with chronic heart failure: Randomized clinical trial. J Bodyw Mov Ther 2024; 39:583-589. [PMID: 38876690 DOI: 10.1016/j.jbmt.2024.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Chronic heart failure (CHF) is characterized by dyspnea, exercise intolerance and impaired quality of life. Physical exercise is a key point in the treatment of these outcomes. OBJECTIVE To evaluate the effect of 24 weeks of two different training strategies on functional capacity, muscle strength and quality of life in individuals with CHF. METHODS The following tests and evaluations were performed before and after 24 weeks of training: exercise test, one-repetition maximum test (1- RM) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Subjects were randomized according to the modality they would perform first: aerobic training group (ATG - n=6) or strength training group (STG - n=7). RESULTS The sample consisted of 13 individuals (10 men), aged 55 ± 12 years and a left ventricular ejection fraction (LVEF) of 38.8 ± 5.3%. There was a significant increase in V'O 2peak only in STG (STG: 26.92 ± 9.81 vs 30.52 ± 8.39 mL.kg -1 .min -1 - p=0.025; ATG: 19.60 ± 7,00 vs 22.42 ± 8.54 mL.kg -1 .min -1 - p=0.119). Both groups showed significant improvements in muscle strength (STG: 45 ± 17 vs 51 ± 20 kg - p=0.001; ATG: 38 ± 19 vs 42 ± 20 kg - p=0.012). There was no significant difference in quality of life (STG: 30 ± 18 vs 24 ± 20 - p=0.109; ATG: 36 ± 16 vs 26 ± 15 - p=0.143). CONCLUSION The early implementation of strength training improves functional capacity and muscle strength of individuals with CHF.
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Affiliation(s)
- Wallace Machado Magalhães de Souza
- Research Group in Cardiorespiratory Evaluation and Rehabilitation, Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, RJ, Brazil; School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Marcelo Carvalho Vieira
- Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, RJ, Brazil
| | | | - Salvador Manoel Serra
- Center for Cardiology and Exercise, Aloysio de Castro State Institute of Cardiology, Rio de Janeiro, RJ, Brazil
| | - Michel Silva Reis
- Research Group in Cardiorespiratory Evaluation and Rehabilitation, Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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2
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Morris BA, Sinaei R, Smart NA. Resistance is not futile: a systematic review of the benefits, mechanisms and safety of resistance training in people with heart failure. Heart Fail Rev 2024; 29:827-839. [PMID: 38619757 PMCID: PMC11189316 DOI: 10.1007/s10741-024-10402-0] [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] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
Exercise offers many physical and health benefits to people with heart failure (CHF), but aerobic training (AT) predominates published literature. Resistance training (RT) provides additional and complementary health benefits to AT in people with CHF; we aimed to elucidate specific health benefits accrued, the mechanism of effect and safety of RT. We conducted a systematic search for RT randomised, controlled trials in people with CHF, up until August 30, 2023. RT offers several benefits including improved physical function (peak VO2 and 6MWD), quality of life, cardiac systolic and diastolic function, endothelial blood vessel function, muscle strength, anti-inflammatory muscle markers, appetite and serious event rates. RT is beneficial and improves peak VO2 and 6MWD, partly restores normal muscle fibre profile and decreases inflammation. In turn this leads to a reduced risk or impact of sarcopenia/cachexia via effect on appetite. The positive impact on quality of life and performance of activities of daily living is related to improved function, which in turn improves prognosis. RT appears to be safe with only one serious event reported and no deaths. Nevertheless, few events reported to date limit robust analysis. RT appears to be safe and offers health benefits to people with CHF. RT modifies the adverse muscle phenotype profile present in people with CHF and it appears safe. Starting slowly with RT and increasing load to 80% of 1 repetition maximum (RM) appears to offer optimal benefit.
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Affiliation(s)
| | - Ronak Sinaei
- University of New England, Armidale, NSW, 2350, Australia
| | - Neil A Smart
- University of New England, Armidale, NSW, 2350, Australia.
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3
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Thomas HJ, Marsh CE, Maslen BA, Lester L, Naylor LH, Green DJ. Endurance versus resistance training in treatment of cardiovascular risk factors: A randomized cross-over trial. PLoS One 2022; 17:e0274082. [PMID: 36067151 PMCID: PMC9447867 DOI: 10.1371/journal.pone.0274082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Individual variability in traditional cardiovascular risk factor responses to different exercise modalities has not been directly addressed in humans using a randomized cross-over design.
Methods
Body weight and body mass index, resting blood pressure, blood glucose, insulin and lipids were assessed in 68 healthy untrained adults (26±6 years) who underwent three-months of exercise training targeted at improving cardiopulmonary fitness (endurance) and skeletal muscle function (resistance), separated by three-months washout.
Results
There were significant increases in weight and body mass index following resistance (+0.8 kg, P<0.01; and +0.26 kg/m2, P<0.01, respectively), but not endurance (+0.1 kg, P = 0.75; and +0.03 kg/m2, P = 0.70, respectively). Although no significant group changes resulted from training in other cardiovascular risk factors, the positive response rate for all variables ranged from 27–49% for resistance and 42–58% for endurance. Between 39–59% of individuals who did not respond to resistance nonetheless responded to endurance, and 28–54% who did not respond to endurance responded to resistance.
Conclusion
Whilst, on average, 12 weeks of resistance or endurance did not change most cardiovascular risk factors, many subjects showed robust positive responses. Exercise modality had an impact on the proportion of subjects who responded to training, and non-response to one mode of training did not imply non-response to the alternate mode. Although the effect of exercise on a single risk factor may be modest, the effect on overall cardiovascular risk profile can be dramatic.
Study registration
The study was registered at the Australian New Zealand Clinical Trials Registry, which was published prior to recruitment and randomization (ACTRN12616001095459).
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Affiliation(s)
- Hannah J. Thomas
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Channa E. Marsh
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Barbara A. Maslen
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Leanne Lester
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Louise H. Naylor
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel J. Green
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
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4
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Fitness tracking reveals task-specific associations between memory, mental health, and physical activity. Sci Rep 2022; 12:13822. [PMID: 35970908 PMCID: PMC9378644 DOI: 10.1038/s41598-022-17781-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/31/2022] [Indexed: 11/15/2022] Open
Abstract
Physical activity can benefit both physical and mental well-being. Different forms of exercise (e.g., aerobic versus anaerobic; running versus walking, swimming, or yoga; high-intensity interval training versus endurance workouts; etc.) impact physical fitness in different ways. For example, running may substantially impact leg and heart strength but only moderately impact arm strength. We hypothesized that the mental benefits of physical activity might be similarly differentiated. We focused specifically on how different intensities of physical activity might relate to different aspects of memory and mental health. To test our hypothesis, we collected (in aggregate) roughly a century’s worth of fitness data. We then asked participants to fill out surveys asking them to self-report on different aspects of their mental health. We also asked participants to engage in a battery of memory tasks that tested their short and long term episodic, semantic, and spatial memory performance. We found that participants with similar physical activity habits and fitness profiles tended to also exhibit similar mental health and task performance profiles. These effects were task-specific in that different physical activity patterns or fitness characteristics varied with different aspects of memory, on different tasks. Taken together, these findings provide foundational work for designing physical activity interventions that target specific components of cognitive performance and mental health by leveraging low-cost fitness tracking devices.
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5
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Locatelli L, Castiglioni S, Maier JAM. From Cultured Vascular Cells to Vessels: The Cellular and Molecular Basis of Vascular Dysfunction in Space. Front Bioeng Biotechnol 2022; 10:862059. [PMID: 35480977 PMCID: PMC9036997 DOI: 10.3389/fbioe.2022.862059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Life evolved on this planet under the pull of gravity, shielded from radiation by the magnetosphere and shaped by circadian rhythms due to Earth’s rotation on its axis. Once living beings leave such a protective environment, adaptive responses are activated to grant survival. In view of long manned mission out of Earth’s orbit, it is relevant to understand how humans adapt to space and if the responses activated might reveal detrimental in the long run. Here we review present knowledge about the effects on the vessels of various extraterrestrial factors on humans as well as in vivo and in vitro experimental models. It emerges that the vasculature activates complex adaptive responses finalized to supply oxygen and nutrients to all the tissues and to remove metabolic waste and carbon dioxide. Most studies point to oxidative stress and mitochondrial dysfunction as mediators of vascular alterations in space. Unraveling the cellular and molecular mechanisms involved in these adaptive processes might offer hints to design proper and personalized countermeasures to predict a safe future in space.
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Affiliation(s)
- Laura Locatelli
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milano, Italy
| | - Sara Castiglioni
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milano, Italy
| | - Jeanette A M Maier
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milano, Italy.,Interdisciplinary Centre for Nanostructured Materials and Interfaces (CIMaINa), Università di Milano, Milan, Italy
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Pedra-Rezende Y, Barbosa JMC, Bombaça ACS, Dantas-Pereira L, Gibaldi D, Vilar-Pereira G, Dos Santos HAM, Ramos IP, Silva-Gomes NL, Moreira OC, Lannes-Vieira J, Menna-Barreto RFS. Physical Exercise Promotes a Reduction in Cardiac Fibrosis in the Chronic Indeterminate Form of Experimental Chagas Disease. Front Immunol 2021; 12:712034. [PMID: 34804007 PMCID: PMC8599157 DOI: 10.3389/fimmu.2021.712034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/15/2021] [Indexed: 01/14/2023] Open
Abstract
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is a neglected tropical disease and a health problem in Latin America. Etiological treatment has limited effectiveness in chronic CD; thus, new therapeutic strategies are required. The practice of physical exercises has been widely advocated to improve the quality of life of CD patients. The most frequent clinical CD manifestation is the chronic indeterminate form (CIF), and the effect of physical exercises on disease progression remains unknown. Here, in a CIF model, we aimed to evaluate the effect of physical exercises on cardiac histological, parasitological, mitochondrial, and oxidative metabolism, electro and echocardiographic profiles, and immunological features. To establish a CIF model, BALB/c and C57BL/6 mice were infected with 100 and 500 trypomastigotes of the Y T. cruzi strain. At 120 days postinfection (dpi), all mouse groups showed normal PR and corrected QT intervals and QRS complexes. Compared to BALB/c mice, C57BL/6 mice showed a lower parasitemia peak, mortality rate, and less intense myocarditis. Thus, C57BL/6 mice infected with 500 parasites were used for subsequent analyses. At 120 dpi, a decrease in cardiac mitochondrial oxygen consumption and an increase in reactive oxygen species (ROS) were detected. When we increased the number of analyzed mice, a reduced heart rate and slightly prolonged corrected QT intervals were detected, at 120 and 150 dpi, which were then normalized at 180 dpi, thus characterizing the CIF. Y-infected mice were subjected to an exercise program on a treadmill for 4 weeks (from 150 to 180 dpi), five times per week in a 30–60-min daily training session. At 180 dpi, no alterations were detected in cardiac mitochondrial and oxidative metabolism, which were not affected by physical exercises, although ROS production increased. At 120 and 180 dpi, comparing infected and non-infected mice, no differences were observed in the levels of plasma cytokines, indicating that a crucial biomarker of the systemic inflammatory profile was absent and not affected by exercise. Compared with sedentary mice, trained Y-infected mice showed similar parasite loads and inflammatory cells but reduced cardiac fibrosis. Therefore, our data show that physical exercises promote beneficial changes that may prevent CD progression.
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Affiliation(s)
- Yasmin Pedra-Rezende
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Biologia das Interações, Instituto Oswaldo Cruz Oswaldo Cruz, Fundação, Rio de Janeiro, Brazil
| | - Juliana M C Barbosa
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana Cristina S Bombaça
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luiza Dantas-Pereira
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Biologia das Interações, Instituto Oswaldo Cruz Oswaldo Cruz, Fundação, Rio de Janeiro, Brazil
| | - Daniel Gibaldi
- Laboratório de Biologia das Interações, Instituto Oswaldo Cruz Oswaldo Cruz, Fundação, Rio de Janeiro, Brazil
| | - Glaucia Vilar-Pereira
- Laboratório de Biologia das Interações, Instituto Oswaldo Cruz Oswaldo Cruz, Fundação, Rio de Janeiro, Brazil.,Instituto Brasileiro de Medicina de Reabilitação, Rio de Janeiro, Brazil
| | - Hílton Antônio Mata Dos Santos
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Análise e Desenvolvimento de Inibidores Enzimáticos e Laboratório Multiusuário de Análises por RMN, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isalira Peroba Ramos
- Centro Nacional de Biologia Estrutural e Bioimagem, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natália Lins Silva-Gomes
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Biologia Molecular de Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Otacilio C Moreira
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Biologia Molecular de Doenças Endêmicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Joseli Lannes-Vieira
- Laboratório de Biologia das Interações, Instituto Oswaldo Cruz Oswaldo Cruz, Fundação, Rio de Janeiro, Brazil
| | - Rubem F S Menna-Barreto
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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7
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Righi GDA, Schuch FB, Tolves T, De Nardi AT, Righi NC, Signori LU, da Silva AMV. Combined aerobic and strength training for fitness outcomes in heart failure: meta-analysis and meta-regression. Disabil Rehabil 2021; 44:4149-4160. [PMID: 33789068 DOI: 10.1080/09638288.2021.1900411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the effects of combined training (CT) versus aerobic training (AT) or versus control on VO2 peak and quadriceps muscle strength in patients with heart failure (HF). MATERIALS AND METHODS Major electronic databases were searched, from inception to November 2020, for randomized clinical trials comparing the effects of CT against AT or control on VO2 peak and/or quadriceps muscle strength in patients with HF. Random effects meta-analyses were conducted, calculating the standardized mean difference (SMD). RESULTS Twenty-eight articles were included. An increase on VO2 peak (SMD = 0.77, 95%CI 0.39-1.14, I2=80.1%) and quadriceps muscle strength (SMD = 0.67, 95%CI 0.18-1.16, I2=0%) was found in CT compared to control. CT increased quadriceps muscle strength, versus AT (SMD = 0.44, 95%CI 0.15-0.74, I2=0%). There were no differences between CT and AT on VO2 peak (SMD=-0.01, 95%CI -0.36 to 0.34, I2=65%). Time of session and training duration moderate the effects of CT over control on VO2 peak. CONCLUSIONS CT promotes increases on quadriceps muscle strength and aerobic capacity over control and provides additional gains on quadriceps muscle strength, having the same effects on VO2 peak compared to AT. A longer time of session is associated with greater benefits to aerobic capacity.Implications for rehabilitationCombining aerobic and strength training increases the functional capacity and quadriceps muscle strength in heart failure patients.Using longer sessions of training has a greater impact on aerobic capacity.
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Affiliation(s)
| | - Felipe Barreto Schuch
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Tainara Tolves
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Luis Ulisses Signori
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.,Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Antônio Marcos Vargas da Silva
- Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.,Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
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8
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Chasland LC, Yeap BB, Maiorana AJ, Chan YX, Maslen BA, Cooke BR, Dembo L, Naylor LH, Green DJ. Testosterone and exercise: effects on fitness, body composition, and strength in middle-to-older aged men with low-normal serum testosterone levels. Am J Physiol Heart Circ Physiol 2021; 320:H1985-H1998. [PMID: 33739155 DOI: 10.1152/ajpheart.00010.2021] [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: 11/22/2022]
Abstract
As men age, serum testosterone (T) concentrations decrease, as do fitness, strength, and lean mass. Whether testosterone treatment confers additive benefit to reverse these changes when combined with exercise training in middle-to-older aged men remains unclear. We assessed the effects of T treatment and exercise, alone and in combination, on aerobic capacity (V̇o2peak), body composition, and muscular strength in men 50-70 yr, waist circumference ≥95 cm and low-normal serum T (6-14 nmol·L-1). Participants (n = 80) were randomized to AndroForte5 (testosterone 5.0% wt/vol, 100 mg/2 mL) cream (T), or matching placebo (P), applied transdermally daily, and supervised center-based exercise (Ex) or no additional exercise (NEx), for 12-wk. Exercise increased V̇o2peak and strength versus nonexercise (V̇o2peak: T + Ex: +2.5 mL·kg-1·min-1, P + Ex: +3.2 mL·kg-1·min-1, P < 0.001; leg press: T + Ex: +31 kg, P + Ex: +24 kg, P = 0.006). T treatment did not affect V̇o2peak or strength. Exercise decreased total (T + Ex: -1.7, P + Ex: -2.3 kg, P < 0.001) and visceral fat (T + Ex: -0.1 kg, P + Ex: -0.3 kg, P = 0.003), and increased total (T + Ex: +1.4 kg, P + Ex: +0.7 kg, P = 0.008) and arm lean mass (T + Ex: +0.5 kg, P + Ex: +0.3 kg, P = 0.024). T treatment did not affect total or visceral fat, but increased total (T + Ex: +1.4 kg, T + NEx: +0.7 kg, P = 0.015), leg (T + Ex: +0.3 kg, T + NEx: +0.2 kg, P = 0.024), and arm lean mass (T + Ex: +0.5 kg, T + NEx: +0.2 kg, P = 0.046). T + Ex increased arm lean mass (T + Ex: +0.5 kg vs. P + NEx: -0.0 kg, P = 0.001) and leg strength (T + Ex: +31 kg vs. P + NEx: +12 kg, P = 0.032) compared with P + NEx, with no other additive effects. Exercise training was more effective than T treatment in increasing aerobic capacity and decreasing total and visceral fat mass. T treatment at therapeutic doses increased lean mass but conferred limited additional benefit when combined with exercise. Exercise should be evaluated as an antiaging intervention in preference to testosterone treatment in men.NEW & NOTEWORTHY We illustrate that exercise training generates superior outcomes to testosterone treatment for improving aerobic fitness, muscular strength, and total and visceral fat mass in men 50-70 yr with low-normal serum testosterone concentrations. Adding testosterone treatment to exercise did not provide any additive benefit for these variables. Testosterone treatment alone and exercise alone had similar impacts on lean mass. Therefore, men unable to exercise may obtain benefit from testosterone treatment alone to improve lean mass.
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Affiliation(s)
- Lauren C Chasland
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia.,Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Andrew J Maiorana
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Yi X Chan
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Barbara A Maslen
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Brian R Cooke
- PathWest Laboratory Medicine, Department of Clinical Biochemistry, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Lawrence Dembo
- Advanced Heart Failure and Cardiac Transplantation Unit, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Louise H Naylor
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia.,Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
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Carbone S, Billingsley HE, Rodriguez-Miguelez P, Kirkman DL, Garten R, Franco RL, Lee DC, Lavie CJ. Lean Mass Abnormalities in Heart Failure: The Role of Sarcopenia, Sarcopenic Obesity, and Cachexia. Curr Probl Cardiol 2020; 45:100417. [PMID: 31036371 PMCID: PMC11146283 DOI: 10.1016/j.cpcardiol.2019.03.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 03/24/2019] [Indexed: 02/07/2023]
Abstract
The role of body composition in patients with heart failure (HF) has been receiving much attention in the last few years. Particularly, reduced lean mass (LM), the best surrogate for skeletal muscle mass, is independently associated with abnormal cardiorespiratory fitness (CRF) and muscle strength, ultimately leading to reduced quality of life and worse prognosis. While in the past, reduced CRF in patients with HF was thought to result exclusively from cardiac dysfunction leading to reduced cardiac output at peak exercise, current evidence supports the concept that abnormalities in LM may also play a critical role. Abnormalities in the LM body composition compartment are associated with the development of sarcopenia, sarcopenic obesity, and cachexia. Such conditions have been implicated in the pathophysiology and progression of HF. However, identification of such conditions remains challenging, as universal definitions for sarcopenia, sarcopenic obesity, and cachexia are lacking. In this review article, we describe the most common body composition abnormalities related to the LM compartment, including skeletal and respiratory muscle mass abnormalities, and the consequences of such anomalies on CRF and muscle strength in patients with HF. Finally, we discuss the potential nonpharmacologic therapeutic strategies such as exercise training (ie, aerobic exercise and resistance exercise) and dietary interventions (ie, dietary supplementation and dietary patterns) that have been implemented to target body composition, with a focus on HF.
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10
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Navasiolava N, Yuan M, Murphy R, Robin A, Coupé M, Wang L, Alameddine A, Gauquelin-Koch G, Gharib C, Li Y, Custaud MA. Vascular and Microvascular Dysfunction Induced by Microgravity and Its Analogs in Humans: Mechanisms and Countermeasures. Front Physiol 2020; 11:952. [PMID: 32973543 PMCID: PMC7468431 DOI: 10.3389/fphys.2020.00952] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022] Open
Abstract
Weightlessness and physical inactivity have deleterious cardiovascular effects. The space environment and its ground-based models offer conditions to study the cardiovascular effects of physical inactivity in the absence of other vascular risk factors, particularly at the macro- and microcirculatory levels. However, the mechanisms involved in vascular dysfunction and remodeling are not sufficiently studied in the context of weightlessness and its analogs including models of physical inactivity. Here, we summarize vascular and microvascular changes induced by space flight and observed in models of microgravity and physical inactivity and review the effects of prophylactic strategies (i.e., countermeasures) on vascular and microvascular function. We discuss physical (e.g., exercise, vibration, lower body negative pressure, and artificial gravity) and nutritional/pharmacological (e.g., caloric restriction, resveratrol, and other vegetal extracts) countermeasures. Currently, exercise countermeasure appears to be the most effective to protect vascular function. Although pharmacological countermeasures are not currently considered to fight vascular changes due to microgravity, nutritional countermeasures are very promising. Dietary supplements/natural health products, especially plant extracts, should be extensively studied. The best prophylactic strategy is likely a combination of countermeasures that are effective not only at the cardiovascular level but also for the organism as a whole, but this strategy remains to be determined.
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Affiliation(s)
| | - Ming Yuan
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Ronan Murphy
- School of Health and Human Performance, Faculty of Science & Health, Dublin City University, Dublin, Ireland
| | - Adrien Robin
- Clinical Research Center, CHU d'Angers, Angers, France.,Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | - Mickael Coupé
- Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | - Linjie Wang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Asmaa Alameddine
- Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
| | | | - Claude Gharib
- Institut NeuroMyoGène, Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France
| | - Yinghui Li
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center (ACC), Beijing, China
| | - Marc-Antoine Custaud
- Clinical Research Center, CHU d'Angers, Angers, France.,Mitovasc, UMR INSERM 1083-CNRS 6015, Université d'Angers, Angers, France
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11
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Green DJ, Marsh CE, Thomas HJ, Naylor LH, Scurrah KJ. Exercise: One size does not fit all: authors' response. J Physiol 2020; 598:4131-4132. [PMID: 32725899 DOI: 10.1113/jp280579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Daniel J Green
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, WA, Australia
| | - Channa E Marsh
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, WA, Australia
| | - Hannah J Thomas
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, WA, Australia
| | - Louise H Naylor
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, WA, Australia
| | - Katrina J Scurrah
- Twins Research Australia, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
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12
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Smith KJ, Moreno-Suarez I, Scheer A, Dembo L, Naylor LH, Maiorana AJ, Green DJ. Cerebral blood flow responses to exercise are enhanced in left ventricular assist device patients after an exercise rehabilitation program. J Appl Physiol (1985) 2019; 128:108-116. [PMID: 31774355 DOI: 10.1152/japplphysiol.00604.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cerebral blood flow during exercise is impaired in patients with heart failure implanted with left ventricular assist devices (LVADs). Our aim was to determine whether a 3-mo exercise training program could mitigate cerebrovascular dysfunction. Internal carotid artery (ICA) blood flow and intracranial middle (MCAv) and posterior cerebral (PCAv) artery velocities were measured continuously using Doppler ultrasound, alongside cardiorespiratory measures at rest and in response to an incremental cycle ergometer exercise protocol in 12 LVAD participants (5 female, 53.6 ± 11.8 yr; 84.2 ± 15.7 kg; 1.73 ± 0.08) pre- (PreTR) and post- (PostTR) completion of a 3-mo supervised exercise rehabilitation program. At rest, only PCAv was different PostTR (38.1 ± 10.4 cm/s) compared with PreTR (43.0 ± 10.8 cm/s; P < 0.05). PreTR, the reduction in PCAv observed from rest to exercise (5.2 ± 1.8%) was mitigated PostTR (P < 0.001). Similarly, exercise training enhanced ICA flow during submaximal exercise (~8.6 ± 13.7%), resulting in increased ICA flow PostTR compared with a reduced flow PreTR (P < 0.001). Although both end-tidal partial pressure of carbon dioxide and mean arterial pressure responses during incremental exercise were greater PostTR than PreTR, only the improved PETCO2 was related to the improved ICA flow (R2 = 0.14; P < 0.05). Our findings suggest that short-term exercise training improves cerebrovascular function during exercise in patients with LVADs. This finding should encourage future studies investigating long-term exercise training and cerebral and peripheral vascular adaptation.NEW & NOTEWORTHY Left ventricular assist devices, now used as destination therapy in end-stage heart failure, enable patients to undertake rehabilitative exercise training. We show, for the first time in humans, that training improves cerebrovascular function during exercise in patients with left ventricular assist devices. This finding may have implications for cerebrovascular health in patients with heart failure.
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Affiliation(s)
- Kurt J Smith
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia.,School of Kinesiology, Lakehead University, Thunder Bay, Canada
| | | | - Anna Scheer
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Lawrence Dembo
- Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Australia
| | - Louise H Naylor
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia.,Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Australia
| | - Andrew J Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia.,Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Australia
| | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
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13
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Abstract
The aim of this study was to develop international standards for evaluating strength endurance with the use of the 3‐Minute Burpee Test. The results of 3862 women (Poland – 2502, Great Britain – 500, Hungary – 412, Serbia – 448) and 5971 men (Poland – 4517, Great Britain – 500, Hungary – 451, Serbia – 503) aged 18‐25 (mean age of 20.36 ± 0.94 and 20.05 ± 1.25 y, respectively) were collated between 2004 and 2018. The students’ strength endurance was evaluated in the 3‐Minute Burpee Test. The results were expressed on a uniform scale with the 3‐sigma rule which was used to develop the T‐score scale for the 3‐Minute Burpee Test. Men completed 56.69 cycles/3 min and women – 48.84/3 min on average. The best male participant completed 82 burpees, and the best female participant – 73 burpees. The majority of male and female participants (66.71% and 68.18%, respectively) were characterized by average strength endurance in the 3‐Minute Burpee Test (range of scores: 47‐66 and 37‐60 cycles/3 min, respectively). Very good strength endurance (76‐85 and 72‐83 cycles/3 min, respectively) was noted in the smallest percentage of male and female participants (0.52% and 0.26%, respectively). Similar studies should be carried out in other countries and in different age groups to develop objective international classification standards for variously‐aged individuals.
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14
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Williams RE, Barreria TV, Tseh W. Fitness-related benefits: land-based versus aqua-base. J Sports Med Phys Fitness 2019; 60:26-31. [PMID: 31565910 DOI: 10.23736/s0022-4707.19.09675-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND It is well documented that individuals participating in land-based aerobic activities receive several fitness-related benefits. Given its virtual weightlessness, thermoregulatory comfort, and ease of movements, aqua-based aerobic activities are commonly perceived as a simpler form of exercise, therefore, lacking the fitness-related benefits equivalent to that of land-based aerobic activities. The purpose of this study was to compare fitness-related benefits between land-based (LAND) versus aqua-based (AQUA) aerobic activity classes within a 15-week period. METHODS One hundred and fifty-four volunteers participating in LAND (N.=76) and AQUA (N.=78) exercise groups were required to exercise 2 days per week, 50 minutes per day, for 15 weeks. Pre- and post-fitness assessments obtained were body composition, muscular endurance, muscular strength, cardiorespiratory endurance, and flexibility. RESULTS Mixed ANOVA showed a main effect and interaction for body composition in which, overall, participants decreased more body fat percentage in the land group. A main effect for both muscular strength and muscular endurance was revealed, but no interactions. There were no significant main effects or interactions for neither cardiorespiratory endurance nor flexibility. CONCLUSIONS Individuals participating in land-based aerobic activities displayed greater decreases in percent body fat when compared to aqua-based aerobic activities, whereas both land- and aqua-based displayed improvements in muscular strength and muscular endurance. There were no changes in cardiorespiratory endurance and flexibility within both groups.
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Affiliation(s)
- Rachel E Williams
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA -
| | | | - Wayland Tseh
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA
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15
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Tucker WJ, Haykowsky MJ, Seo Y, Stehling E, Forman DE. Impaired Exercise Tolerance in Heart Failure: Role of Skeletal Muscle Morphology and Function. Curr Heart Fail Rep 2019; 15:323-331. [PMID: 30178183 DOI: 10.1007/s11897-018-0408-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW To discuss the impact of deleterious changes in skeletal muscle morphology and function on exercise intolerance in patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), as well as the utility of exercise training and the potential of novel treatment strategies to preserve or improve skeletal muscle morphology and function. RECENT FINDINGS Both HFrEF and HFpEF patients exhibit a reduction in percent of type I (oxidative) muscle fibers and oxidative enzymes coupled with abnormal mitochondrial respiration. These skeletal muscle abnormalities contribute to impaired oxidative metabolism with an earlier shift towards glycolytic metabolism during exercise that is strongly associated with exercise intolerance. In both HFrEF and HFpEF patients, peripheral "non-cardiac" factors are important determinants of the improvement in exercise tolerance following aerobic exercise training. Adjunctive strategies that include nutritional supplementation with amino acids and/or anabolic drugs to stimulate anabolic molecular pathways in skeletal muscle show great promise for improving exercise tolerance and treating heart failure-associated sarcopenia, but these efforts remain early in their evolution, with no immediate clinical applications. There is consistent evidence that heart failure is associated with multiple skeletal muscle abnormalities which impair oxygen uptake and utilization and contribute greatly to exercise intolerance. Exercise training induces favorable adaptations in skeletal muscle morphology and function that contribute to improvements in exercise tolerance in patients with HFrEF. The contribution of skeletal muscle adaptations to improved exercise tolerance following exercise training in HFpEF remains unknown and warrants further investigation.
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Affiliation(s)
| | | | - Yaewon Seo
- The University of Texas at Arlington, Arlington, TX, USA
| | - Elisa Stehling
- The University of Texas at Arlington, Arlington, TX, USA
| | - Daniel E Forman
- Department of Medicine, Section of Geriatric Cardiology, Veterans Affairs Geriatric Research Education, and Clinical Center, University of Pittsburgh, 3471 Fifth Avenue, Suite 500, Pittsburgh, PA, 15213, USA.
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16
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Pinckard K, Baskin KK, Stanford KI. Effects of Exercise to Improve Cardiovascular Health. Front Cardiovasc Med 2019; 6:69. [PMID: 31214598 PMCID: PMC6557987 DOI: 10.3389/fcvm.2019.00069] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/07/2019] [Indexed: 12/18/2022] Open
Abstract
Obesity is a complex disease that affects whole body metabolism and is associated with an increased risk of cardiovascular disease (CVD) and Type 2 diabetes (T2D). Physical exercise results in numerous health benefits and is an important tool to combat obesity and its co-morbidities, including cardiovascular disease. Exercise prevents both the onset and development of cardiovascular disease and is an important therapeutic tool to improve outcomes for patients with cardiovascular disease. Some benefits of exercise include enhanced mitochondrial function, restoration and improvement of vasculature, and the release of myokines from skeletal muscle that preserve or augment cardiovascular function. In this review we will discuss the mechanisms through which exercise promotes cardiovascular health.
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Affiliation(s)
| | | | - Kristin I. Stanford
- Department of Physiology and Cell Biology, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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17
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SMITH KURTJ, SUAREZ IGNACIOM, SCHEER ANNA, CHASLAND LAURENC, THOMAS HANNAHJ, CORREIA MARILIAA, DEMBO LAWRENCEG, NAYLOR LOUISEH, MAIORANA ANDREWJ, GREEN DANIELJ. Cerebral Blood Flow during Exercise in Heart Failure: Effect of Ventricular Assist Devices. Med Sci Sports Exerc 2019; 51:1372-1379. [DOI: 10.1249/mss.0000000000001904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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18
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Santos FV, Chiappa GR, Ramalho SHR, de Lima ACGB, de Souza FSJ, Cahalin LP, Durigan JLQ, de Castro I, Cipriano G. Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis. Heart Fail Rev 2019; 23:73-89. [PMID: 29199385 DOI: 10.1007/s10741-017-9658-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recent literature suggests that resistance training (RT) improves peak oxygen uptake ([Formula: see text] peak), similarly to aerobic exercise (AE) in patients with heart failure (HF), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on [Formula: see text] peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases search were extracted study characteristics, exercise type, and ventricular outcomes. The main outcomes were [Formula: see text] peak (ml kg-1 min-1), LVEF (%) and LVEDV (mL). Fifty-nine RCTs were included. RT produced a greater increase in [Formula: see text] peak (3.57 ml kg-1 min-1, P < 0.00001, I 2 = 0%) compared to AE (2.63 ml kg-1 min-1, P < 0.00001, I 2 = 58%) while combined RT and AE produced a 2.48 ml kg-1 min-1 increase in [Formula: see text]; I 2 = 69%) compared to control group. Comparison among the three forms of exercise revealed similar effects on [Formula: see text] peak (P = 0.84 and 1.00, respectively; I 2 = 0%). AE was associated with a greater gain in LVEF (3.15%; P < 0.00001, I 2 = 17%) compared to RT alone or combined exercise which produced similar gains compared to control groups. Subgroup analysis revealed that AE reduced LVEDV (- 10.21 ml; P = 0.007, I 2 = 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants. RT results in a greater gain in [Formula: see text] peak, and induces no deleterious effects on cardiac function in HF patients.
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Affiliation(s)
- Francisco V Santos
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
- Cancer Institute of Sao Paulo, Sao Paulo, Brazil
| | - Gaspar R Chiappa
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
| | - Sergio Henrique Rodolpho Ramalho
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
- Sarah Network of Rehabilitation Hospitals, Brasilia, Brazil
| | - Alexandra Correa Gervazoni Balbuena de Lima
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
| | - Fausto Stauffer Junqueira de Souza
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - João Luiz Quagliotti Durigan
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil
| | - Isac de Castro
- Department of Medicine, Division of Molecular Medicine, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Gerson Cipriano
- Health Sciences and Technology and Rehabilitation Sciencies Program, University of Brasilia, Centro Metropolitano, Conjunto A - Lote 01 - Ceilândia, Brasília, DF, 72220-900, Brazil.
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19
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Zhang Z, Wang B, Fei A. BDNF contributes to the skeletal muscle anti-atrophic effect of exercise training through AMPK-PGC1α signaling in heart failure mice. Arch Med Sci 2019; 15:214-222. [PMID: 30697273 PMCID: PMC6348347 DOI: 10.5114/aoms.2018.81037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/04/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Exercise training is a coadjuvant therapy in preventive cardiology, and it delays cardiac dysfunction and exercise intolerance in heart failure (HF). However, the mechanisms underlying muscle function improvement and cardioprotection are poorly understood. In this study, we tested whether exercise training would counteract skeletal muscle atrophy via activation of the BDNF pathway in myocardial infarction (MI)-induced HF mice. MATERIAL AND METHODS A cohort of male Sham-operated and MI mice were assigned into 8-week moderate exercise training, and untrained counterparters were used as control. Exercise capacity, plasma norepinephrine (NE) level, heart rate (HR), fractional shortening (FS) and ejection fraction (EF) were measured. The protein expression of BDNF, p-TrkB, p-AMPK and PGC1α were analyzed by Western blot. RESULTS Compared with the Sham-operated mice, MI mice displayed reduced total distance run and elevated plasma NE level (both p < 0.05). Exercise training significantly improved distance run and plasma NE levels in HF mice (both p < 0.05). Significantly increased HR, decreased FS and EF were observed in the MI group as compared to the Sham-operated group, and exercise training prevent the hemodynamic status and systolic dysfunction in MI mice (all p < 0.05). The expression of BDNF, p-TrkB, p-AMPK and PGC1α were significantly decreased in the skeletal muscle from MI compared to Sham-operated mice, which were significantly increased by exercise training (all p < 0.05). In addition, BDNF siRNA markedly decreased the protein level of p-AMPK and PGC1α in C2C12 myoblasts. CONCLUSIONS Taken together, our data provide evidence for exercise training may counteract HF-induced muscle atrophy through induced activation of BDNF pathway.
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Affiliation(s)
- Zheng Zhang
- Department of Emergency, Xin Hua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Beili Wang
- Department of Oncology, Xin Hua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Aihua Fei
- Department of Emergency, Xin Hua Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
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20
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Iliopoulos F, Mazis N. Exercise training in heart failure patients: effects on skeletal muscle abnormalities and sympathetic nervous activity—a literature review. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-018-0442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Dor-Haim H, Barak S, Horowitz M, Yaakobi E, Katzburg S, Swissa M, Lotan C. Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial. PLoS One 2018; 13:e0188551. [PMID: 29377893 PMCID: PMC5788332 DOI: 10.1371/journal.pone.0188551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Exercise is considered a valuable nonpharmacological intervention modality in cardiac rehabilitation (CR) programs in patients with ischemic heart disease. The effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac patients' with reduced left ventricular function, post-myocardial infarction (MI) has not been thoroughly investigated. Aim of study to improve cardiac function with a novel method of combined aerobic-resistance circuit training in a randomized control trial by way of comparing the effectiveness of continuous aerobic training (CAT) to SCT on mechanical cardiac function. Secondary to compare their effect on aerobic fitness, manual strength, and quality of life in men post MI. Finally, to evaluate the safety and feasibility of SCT. Methods 29 men post-MI participants were randomly assigned to either 12-weeks of CAT (n = 15) or SCT (n = 14). Both groups, CAT and SCT exercised at 60%-70% and 75–85% of their heart rate reserve, respectively. The SCT group also engaged in intermittently combined resistance training. Primary outcome measure was echocardiography. Secondary outcome measures were aerobic fitness, strength, and quality of life (QoL). The effectiveness of the two training programs was examined via paired t-tests and Cohen's d effect size (ES). Results Post-training, only the SCT group presented significant changes in echocardiography (a reduction in E/e' and an increase in ejection fraction, P<0.05). Similarly, only the SCT group presented significant changes in aerobic fitness (an increase in maximal metabolic equivalent, P<0.05). In addition, SCT improvement in the physical component of QoL was greater than this observed in the CAT group. In both training programs, no adverse events were observed. Conclusion Men post-MI stand to benefit from both CAT and SCT. However, in comparison to CAT, as assessed by echocardiography, SCT may yield greater benefits to the left ventricle mechanical function as well as to the patient's aerobic fitness and physical QoL. Moreover, the SCT program was found to be feasible as well as safe.
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Affiliation(s)
- Horesh Dor-Haim
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
- * E-mail:
| | - Sharon Barak
- The Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Ramat Gan, Israel
- Kaye Academic College of Education, Beer-Sheba, Israel
| | - Michal Horowitz
- Department of Physiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eldad Yaakobi
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Sara Katzburg
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Moshe Swissa
- Cardiac Research Center, Kaplan Medical Center, Rehovot, Israel
| | - Chaim Lotan
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
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22
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Amiya E, Taya M. Is Exercise Training Appropriate for Patients With Advanced Heart Failure Receiving Continuous Inotropic Infusion? A Review. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2018; 12:1179546817751438. [PMID: 29326534 PMCID: PMC5757424 DOI: 10.1177/1179546817751438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 12/07/2017] [Indexed: 12/18/2022]
Abstract
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure. By contrast, exercise training has various effects not only in improving exercise capacity but also on vascular function, skeletal muscle, and autonomic balance. In this review, we summarize the effectiveness and discuss methods of exercise training in patients with advanced heart failure receiving continuous inotropic agents such as dobutamine.
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Affiliation(s)
- Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masanobu Taya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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23
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Gielen S. Exercise training in heart failure: which training modality works best? J Appl Physiol (1985) 2017; 123:442-443. [PMID: 28596272 DOI: 10.1152/japplphysiol.00444.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/17/2017] [Indexed: 01/14/2023] Open
Affiliation(s)
- Stephan Gielen
- Klinikum Lippe, Klinik für Innere Medizin/Kardiologie, Angiologie und Internistische Intensivmedizin, Detmold, Germany; and Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Halle/Saale, Germany
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24
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Abstract
Both the aging process and heart failure (HF) syndrome are characterized by a dramatic reduction of aerobic capacity. Significant decreases in muscle mass and strength are also common. Few HF training studies have included meaningful numbers of older individuals, especially those greater than 80 years of age and older women with HF with reduced ejection fraction. The modest data available suggest similar benefits in older patients and excellent safety. Resistance training may provide additional benefit. Whether exercise training can reduce mortality, hospitalizations, and overall health care costs in older adults with HF awaits the outcome of adequately powered multicenter trials.
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Affiliation(s)
- Jerome L Fleg
- Division of Cardiovascular Diseases, National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 8154, Bethesda, MD 20892-7936, USA.
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25
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Morisawa T, Ueno K, Fukuda Y, Kanazawa N, Kawaguchi H, Zaiki R, Fuzisaki H, Yoshioka H, Sasaki M, Iwata K, Koyama T, Kitai T, Furukawa Y, Takahashi T. Significance of sequential cardiac rehabilitation program through inter-hospital cooperation between acute care and rehabilitation hospitals in elderly patients after cardiac surgery in Japan. Heart Vessels 2017; 32:1220-1226. [DOI: 10.1007/s00380-017-0983-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 04/21/2017] [Indexed: 11/27/2022]
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26
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Abshire DA, Moser DK, Clasey JL, Chung ML, Pressler SJ, Dunbar SB, Heo S, Lennie TA. Body Composition and Bone Mineral Density in Patients With Heart Failure. West J Nurs Res 2017; 39:582-599. [PMID: 27401014 PMCID: PMC5225244 DOI: 10.1177/0193945916658885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to examine associations among bone mineral density, osteopenia/osteoporosis, body mass index (BMI), and body composition in patients with heart failure (HF). A total of 119 patients (age = 61 ± 12 years, 65% male) underwent dual-energy X-ray absorptiometry scans to determine bone mineral density and body composition. In multivariable linear regressions, BMI, relative skeletal muscle index (RSMI), and mineral-free lean mass were positively associated with total body bone mineral density. Mineral-free lean mass was most strongly associated with bone mineral density (β = .398). In multivariable logistic regressions, higher BMI, RSMI, and mineral-free lean mass were associated with lower odds for osteopenia/osteoporosis. Fat mass was not associated with total body bone mineral density or osteopenia/osteoporosis. These results suggest that muscle mass may be the important component of body mass associated with bone mineral density in patients with HF.
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Affiliation(s)
| | - Debra K Moser
- 2 University of Kentucky College of Nursing, Lexington, KY, USA
| | - Jody L Clasey
- 3 University of Kentucky Department of Kinesiology and Health Promotion, Lexington, KY, USA
| | - Misook L Chung
- 2 University of Kentucky College of Nursing, Lexington, KY, USA
| | | | - Sandra B Dunbar
- 5 Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Seongkum Heo
- 6 University of Arkansas for Medical Sciences College of Nursing, Little Rock, AR, USA
| | - Terry A Lennie
- 2 University of Kentucky College of Nursing, Lexington, KY, USA
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CHASLAND LAURENC, GREEN DANIELJ, MAIORANA ANDREWJ, NOSAKA KAZUNORI, HAYNES ANDREW, DEMBO LAWRENCEG, NAYLOR LOUISEH. Eccentric Cycling. Med Sci Sports Exerc 2017; 49:646-651. [DOI: 10.1249/mss.0000000000001151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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28
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Green DJ, Hopman MTE, Padilla J, Laughlin MH, Thijssen DHJ. Vascular Adaptation to Exercise in Humans: Role of Hemodynamic Stimuli. Physiol Rev 2017; 97:495-528. [PMID: 28151424 DOI: 10.1152/physrev.00014.2016] [Citation(s) in RCA: 427] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
On the 400th anniversary of Harvey's Lumleian lectures, this review focuses on "hemodynamic" forces associated with the movement of blood through arteries in humans and the functional and structural adaptations that result from repeated episodic exposure to such stimuli. The late 20th century discovery that endothelial cells modify arterial tone via paracrine transduction provoked studies exploring the direct mechanical effects of blood flow and pressure on vascular function and adaptation in vivo. In this review, we address the impact of distinct hemodynamic signals that occur in response to exercise, the interrelationships between these signals, the nature of the adaptive responses that manifest under different physiological conditions, and the implications for human health. Exercise modifies blood flow, luminal shear stress, arterial pressure, and tangential wall stress, all of which can transduce changes in arterial function, diameter, and wall thickness. There are important clinical implications of the adaptation that occurs as a consequence of repeated hemodynamic stimulation associated with exercise training in humans, including impacts on atherosclerotic risk in conduit arteries, the control of blood pressure in resistance vessels, oxygen delivery and diffusion, and microvascular health. Exercise training studies have demonstrated that direct hemodynamic impacts on the health of the artery wall contribute to the well-established decrease in cardiovascular risk attributed to physical activity.
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Affiliation(s)
- Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Maria T E Hopman
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Jaume Padilla
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - M Harold Laughlin
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - Dick H J Thijssen
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Department of Child Health, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; and Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
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Bozkurt B, Aguilar D, Deswal A, Dunbar SB, Francis GS, Horwich T, Jessup M, Kosiborod M, Pritchett AM, Ramasubbu K, Rosendorff C, Yancy C. Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e535-e578. [DOI: 10.1161/cir.0000000000000450] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sedentary behavior & health-related quality of life among congestive heart failure patients. Int J Cardiol 2016; 220:520-3. [DOI: 10.1016/j.ijcard.2016.06.256] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/24/2016] [Accepted: 06/27/2016] [Indexed: 12/21/2022]
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Panizzolo FA, Maiorana AJ, Naylor LH, Dembo LG, Lloyd DG, Green DJ, Rubenson J. Muscle size explains low passive skeletal muscle force in heart failure patients. PeerJ 2016; 4:e2447. [PMID: 27672504 PMCID: PMC5028761 DOI: 10.7717/peerj.2447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/14/2016] [Indexed: 01/23/2023] Open
Abstract
Background Alterations in skeletal muscle function and architecture have been linked to the compromised exercise capacity characterizing chronic heart failure (CHF). However, how passive skeletal muscle force is affected in CHF is not clear. Understanding passive force characteristics in CHF can help further elucidate the extent to which altered contractile properties and/or architecture might affect muscle and locomotor function. Therefore, the aim of this study was to investigate passive force in a single muscle for which non-invasive measures of muscle size and estimates of fiber force are possible, the soleus (SOL), both in CHF patients and age- and physical activity-matched control participants. Methods Passive SOL muscle force and size were obtained by means of a novel approach combining experimental data (dynamometry, electromyography, ultrasound imaging) with a musculoskeletal model. Results We found reduced passive SOL forces (∼30%) (at the same relative levels of muscle stretch) in CHF vs. healthy individuals. This difference was eliminated when force was normalized by physiological cross sectional area, indicating that reduced force output may be most strongly associated with muscle size. Nevertheless, passive force was significantly higher in CHF at a given absolute muscle length (non length-normalized) and likely explained by the shorter muscle slack lengths and optimal muscle lengths measured in CHF compared to the control participants. This later factor may lead to altered performance of the SOL in functional tasks such gait. Discussion These findings suggest introducing exercise rehabilitation targeting muscle hypertrophy and, specifically for the calf muscles, exercise that promotes muscle lengthening.
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Affiliation(s)
- Fausto Antonio Panizzolo
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, United States; The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, Australia
| | - Andrew J Maiorana
- Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, WA, Australia; School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Louise H Naylor
- The School of Sport Science, Exercise and Health, The University of Western Australia , Crawley , WA , Australia
| | | | - David G Lloyd
- Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University , Gold Coast , QLD , Australia
| | - Daniel J Green
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, Australia; Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jonas Rubenson
- The School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, WA, Australia; Biomechanics Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
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Moalla W, Maingourd Y, Gauthier R, Cahalin LP, Tabka Z, Ahmaidi S. Effect of exercise training on respiratory muscle oxygenation in children with congenital heart disease. ACTA ACUST UNITED AC 2016; 13:604-11. [PMID: 16874152 DOI: 10.1097/01.hjr.0000201515.59085.69] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Diminished aerobic capacity and weakness of both respiratory and peripheral muscles have been observed in cardiac patients and may contribute to exercise limitation. The aim of this study was to evaluate the effects of a home-based training programme on aerobic fitness and oxygenation of the respiratory muscles in children with congenital heart disease (CHD). METHODS AND RESULTS Eighteen patients with CHD aged 12-15 years participated in this study. Ten patients (training group, TG) underwent a training programme for 12 weeks and eight patients served as a non-training control group (CG). All subjects performed a cardiopulmonary exercise test before and after the study period. Oxygenation of the respiratory muscles was assessed using near-infrared spectroscopy. No significant differences were observed, at baseline and after the completion of the study, between the CG and TG in peak exercise workload, oxygen uptake (VO2), carbon dioxide output (VCO2), pulmonary ventilation (VE), and heart rate (HR). However, a significant improvement in exercise performance was found in the TG versus the CG when results were compared at the ventilatory threshold (Vth): workload (45.2+/-8.0 versus 58.5+/-7.4%; P<0.05), VO2 (62.3+/-7.5 versus 69.8+/-5.1%; P<0.05), VCO2 (49.8+/-5.7 versus 60.0+/-5.8%; P<0.05), VE (42.8+/-9.9 versus 50.1+/-9.5%; P<0.05), and HR (69.5+/-6.1 versus 76.0+/-3.5%; P<0.05). After training, an improvement in oxygenation of the respiratory muscles was found in the TG from 60% of VO2max until the end of exercise. At the Vth, the TG showed greater oxygenation after training (55.1+/-6.6 versus 43.0+/-6.9%, P<0.01, respectively). Furthermore, we showed a significant correlation of the change in respiratory muscle oxygenation and VO2 in the TG (r=0.90, P<0.01). CONCLUSION It is concluded that general physical training at submaximal intensity induces better aerobic fitness and improves respiratory muscle oxygenation in children with CHD.
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Affiliation(s)
- Wassim Moalla
- EA-3300: APS et Conduites Motrices: Adapations et Réadaptations, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, France.
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Bjarnason-Wehrens B, Mayer-Berger W, Meister ER, Baum K, Hambrecht R, Gielen S. Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. ACTA ACUST UNITED AC 2016; 11:352-61. [PMID: 15292771 DOI: 10.1097/01.hjr.0000137692.36013.27] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aerobic endurance training has been an integral component of the international recommendations for cardiac rehabilitation for more than 30 years. Notwithstanding, only in recent years have recommendations for a dynamic resistance-training program been cautiously put forward. The perceived increased risk of cardiovascular complications related to blood pressure elevations are the primary concern with resistance training in cardiac patients; recent studies however have demonstrated that this need not be a contraindication in all cardiac patients. While blood pressure certainly may rise excessively during resistance training, the actual rise depends on a variety of controllable factors including magnitude of the isometric component, the load intensity, the amount of muscle mass involved as well as the number of repetitions and/or the load duration. Intra-arterial blood pressure measurements in cardiac patients have demonstrated that that during low-intensity resistance training [40-60% maximum voluntary contraction (MVC)] with 15-20 repetitions, only modest elevations in blood pressure are revealed, similar to those seen during moderate endurance training. When properly implemented by an experienced exercise therapist, in specific patient groups an individually tailored, medically supervised dynamic resistance training program carries no inherent higher risk for the patient than aerobic endurance training. As an adjunct to endurance training, in selected patients, resistance training can increase muscle strength and endurance, as well as positively influence cardiovascular risk factors, metabolism, cardiovascular function, psychosocial well-being and quality of life. According to present data, resistance training is however not recommended for all patient groups. The appropriate training method and correct performance are highly dependent on each patient's clinical status, cardiac stress tolerance and possible comorbidities. Most studies have used middle-aged men of average normal aerobic performance capacity and with good left-ventricular (LV) function. Data are lacking for high-risk groups, women and older patients. With the current knowledge it is reasonable to include resistance training without any restraints as part of cardiac rehabilitation programs for coronary artery disease (CAD) patients with good cardiac performance capacity (i.e., revascularised and with good myocardial function). As patients with myocardial ischaemia and/or poor left ventricular function may develop wall motion disturbances and/or severe ventricular arrhythmias during resistance exercise, the following criteria are suggested for resistance training: moderate-to-good LV function, good cardiac performance capacity [>5-6 metabolic equivalents of oxygen consumption (METS)=1.4 watt/kg body weight], no symptoms of angina pectoris or ST segment depression under continued maintenance of the medical therapy. Based on available data, this article presents recommendations for risk stratification in cardiac rehabilitation programs with respect to the implementation of dynamic resistance training. Additional recommendations for specific patient groups and detailed directions showing how to structure and implement such therapy programs are presented as well.
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Affiliation(s)
- B Bjarnason-Wehrens
- Institute for Cardiology and Sports Medicine, German Sport University, Cologne; Klinik Roderbirken, Leichlingen, Germany.
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Theodorou AA, Panayiotou G, Volaklis KA, Douda HT, Paschalis V, Nikolaidis MG, Smilios I, Toubekis A, Kyprianou D, Papadopoulos I, Tokmakidis SP. Aerobic, resistance and combined training and detraining on body composition, muscle strength, lipid profile and inflammation in coronary artery disease patients. Res Sports Med 2016; 24:171-84. [DOI: 10.1080/15438627.2016.1191488] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - George Panayiotou
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | | | - Helen T. Douda
- School of Physical Education and Sport Science, University of Thrace, Komotini, Greece
| | - Vassilis Paschalis
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
- School of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Michalis G. Nikolaidis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Ilias Smilios
- School of Physical Education and Sport Science, University of Thrace, Komotini, Greece
| | - Argyris Toubekis
- School of Physical Education and Sport Science, University of Thrace, Komotini, Greece
| | - Dimitris Kyprianou
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | | | - Savvas P. Tokmakidis
- School of Physical Education and Sport Science, University of Thrace, Komotini, Greece
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Baghaiee B, Botelho Teixeira A, Tartibian B. Moderate aerobic exercise increases SOD-2 gene expression and decreases leptin and malondialdehyde in middle-aged men. Sci Sports 2016. [DOI: 10.1016/j.scispo.2015.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Finocchiaro G, Sharma S. The Safety of Exercise in Individuals With Cardiomyopathy. Can J Cardiol 2016; 32:467-74. [DOI: 10.1016/j.cjca.2015.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/30/2015] [Accepted: 12/07/2015] [Indexed: 01/02/2023] Open
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Green DJ, Panizzolo FA, Lloyd DG, Rubenson J, Maiorana AJ. Soleus Muscle as a Surrogate for Health Status in Human Heart Failure. Exerc Sport Sci Rev 2016; 44:45-50. [DOI: 10.1249/jes.0000000000000069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Acute Effect on Arterial Stiffness after Performing Resistance Exercise by Using the Valsalva Manoeuvre during Exertion. BIOMED RESEARCH INTERNATIONAL 2015; 2015:343916. [PMID: 26539481 PMCID: PMC4619793 DOI: 10.1155/2015/343916] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
Background. Performing resistance exercise could lead to an increase in arterial stiffness. Objective. We investigate the acute effect on arterial stiffness by performing Valsalva manoeuvre during resistance exercise. Materials and Methods. Eighteen healthy young men were assigned to perform bicep curls by using two breathing techniques (exhalation and Valsalva manoeuvre during muscle contraction) on two separate study days. Carotid pulsed wave velocity (cPWV) was measured as an indicator to reflect the body central arterial stiffness using a high-resolution ultrasound system, and its value was monitored repeatedly at three predefined time intervals: before resistance exercise, immediately after exercise, and 15 minutes after exercise. Results. At the 0th minute after resistance exercise was performed using the Valsalva manoeuvre during exertion, a significant increase in cPWV (4.91 m/s ± 0.52) compared with the baseline value (4.67 m/s ± 0.32, P = 0.008) was observed, and then it nearly returned to its baseline value at the 15th minute after exercise (4.66 m/s ± 0.44, P = 0.010). These findings persisted after adjusting for age, body mass index, and systolic blood pressure. Conclusion. Our result suggests short duration of resistance exercise may provoke a transient increase in central arterial stiffness in healthy young men.
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Al Saif A, Alsenany S. Aerobic and anaerobic exercise training in obese adults. J Phys Ther Sci 2015; 27:1697-700. [PMID: 26180300 PMCID: PMC4499963 DOI: 10.1589/jpts.27.1697] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/14/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Obesity is a global health problem and is associated with a multitude of complications. This study was designed to determine changes in cardiopulmonary functions after aerobic and anaerobic exercise training in obese subjects. [Subjects and Methods] Forty obese subjects, whose ages ranged between 18 and 25 years, were divided into 2 equal groups: group A received aerobic exercise training in addition to dietary measures, and group B received anaerobic exercise training for 3 months in addition to dietary measures. Measurements of systolic blood pressure, diastolic blood pressure, heart rate, maximum voluntary ventilation, maximal oxygen consumption, and body mass index were obtained for both groups before and after the exercise program. [Results] The mean body mass index, systolic blood pressure, diastolic blood pressure, heart rate, and maximal oxygen consumption decreased significantly, whereas the mean maximum voluntary ventilation increased significantly after treatment in group A. The mean maximum voluntary ventilation also increased significantly after treatment in group B. There were significant differences between the mean levels of the investigated parameters in groups A and B after treatment. [Conclusion] Aerobic exercise reduces weight and improves cardiopulmonary fitness in obese subjects better than anaerobic exercise.
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Affiliation(s)
- Amer Al Saif
- Department of Physical Therapy, Faculty of Applied Medical
Sciences, King Abdulaziz University, Saudi Arabia
| | - Samira Alsenany
- Department of Public Health, Faculty of Nursing, King
Abdulaziz University, Saudi Arabia
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Skrypnik D, Bogdański P, Mądry E, Karolkiewicz J, Ratajczak M, Kryściak J, Pupek-Musialik D, Walkowiak J. Effects of Endurance and Endurance Strength Training on Body Composition and Physical Capacity in Women with Abdominal Obesity. Obes Facts 2015; 8:175-87. [PMID: 25968470 PMCID: PMC5652894 DOI: 10.1159/000431002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 01/08/2015] [Indexed: 01/02/2023] Open
Abstract
AIMS To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. METHODS 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. RESULTS Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. CONCLUSION Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity.
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Affiliation(s)
- Damian Skrypnik
- Department of Internal Medicine, Metabolic Disorders and Hypertension, University of Medical Sciences, Poznań, Poland
| | - Paweł Bogdański
- Department of Education and Obesity Treatment and Metabolic Disorders, University of Medical Sciences, Poznań, Poland
| | - Edyta Mądry
- Department of Physiology, University of Medical Sciences, Poznań, Poland
| | - Joanna Karolkiewicz
- Department of Physiology, Biochemistry and Hygiene, University School of Physical Education, Poznań, Poland
| | - Marzena Ratajczak
- Department of Physiology, Biochemistry and Hygiene, University School of Physical Education, Poznań, Poland
| | - Jakub Kryściak
- Department of Physiology, Biochemistry and Hygiene, University School of Physical Education, Poznań, Poland
| | - Danuta Pupek-Musialik
- Department of Internal Medicine, Metabolic Disorders and Hypertension, University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, University of Medical Sciences, Poznań, Poland
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Benda NMM, Seeger JPH, van Lier DPT, Bellersen L, van Dijk APJ, Hopman MTE, Thijssen DHJ. Heart failure patients demonstrate impaired changes in brachial artery blood flow and shear rate pattern during moderate-intensity cycle exercise. Exp Physiol 2015; 100:463-74. [PMID: 25655515 DOI: 10.1113/ep085040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/30/2015] [Indexed: 12/12/2022]
Abstract
NEW FINDINGS What is the central question of this study? We explored whether heart failure (HF) patients demonstrate different exercise-induced brachial artery shear rate patterns compared with control subjects. What is the main finding and its importance? Moderate-intensity cycle exercise in HF patients is associated with an attenuated increase in brachial artery anterograde and mean shear rate and skin temperature. Differences between HF patients and control subjects cannot be explained fully by differences in workload. HF patients demonstrate a less favourable shear rate pattern during cycle exercise compared with control subjects. Repeated elevations in shear rate (SR) in conduit arteries, which occur during exercise, represent a key stimulus to improve vascular function. We explored whether heart failure (HF) patients demonstrate distinct changes in SR in response to moderate-intensity cycle exercise compared with healthy control subjects. We examined brachial artery SR during 40 min of cycle exercise at a work rate equivalent to 65% peak oxygen uptake in 14 HF patients (65 ± 7 years old, 13 men and one woman) and 14 control subjects (61 ± 5 years old, 12 men and two women). Brachial artery diameter, SR and oscillatory shear index (OSI) were assessed using ultrasound at baseline and during exercise. The HF patients demonstrated an attenuated increase in mean and anterograde brachial artery SR during exercise compared with control subjects (time × group interaction, P = 0.003 and P < 0.001, respectively). Retrograde SR increased at the onset of exercise and remained increased throughout the exercise period in both groups (time × group interaction, P = 0.11). In control subjects, the immediate increase in OSI during exercise (time, P < 0.001) was normalized after 35 min of cycling. In contrast, the increase in OSI after the onset of exercise did not normalize in HF patients (time × group interaction, P = 0.029). Subgroup analysis of five HF patients and five control subjects with comparable workload (97 ± 13 versus 90 ± 22 W, P = 0.59) confirmed the presence of distinct changes in mean SR during exercise (time × group interaction, P = 0.030). Between-group differences in anterograde/retrograde SR or OSI did not reach statistical significance (time × group interactions, P > 0.05). In conclusion, HF patients demonstrate a less favourable SR pattern during cycle exercise than control subjects, characterized by an attenuated mean and anterograde SR and by increased OSI.
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Affiliation(s)
- Nathalie M M Benda
- Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Changes in body composition in heart failure patients after a resistance exercise program and branched chain amino acid supplementation. Clin Nutr 2015; 35:41-47. [PMID: 25726428 DOI: 10.1016/j.clnu.2015.02.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/23/2015] [Accepted: 02/08/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS Heart Failure (HF) is a complex syndrome, which can include the physiological, neural hormonal and metabolic complications known as "Cardiac Cachexia" (CC). In the development of CC there is a release of catabolic cytokines (Tumor Necrosis Factor-α, interleukins 1 and 6) that cause a decrease of fat free mass and fat mass. These changes in body composition might be reversed with a therapeutic combination of resistance exercise and branched chain amino acid supplementation (BCAA). AIM Evaluate changes in body composition after a resistance exercise program and BCAA supplementation in patients with HF. METHODS In a randomized clinical trial with 3 month of follow-up anthropometric body composition analysis and stress tests were evaluated at the beginning and in the end of the study. Patients were divided into two groups; the experimental group performed the resistance exercise program and received 10 g/day BCAA supplementation, and the control group only performed the resistance exercise program. Both groups were provided with individualized diets and conventional medical treatment. RESULTS Changes were found in hip circumference between the groups (p = 0.02), and muscle strength was increased in the experimental group (8%) and the control group (11.4%) with no difference between them. METS and VO2Max also increased in experimental and control groups (16.6% and 50.1% respectively). Regarding changes in symptoms, improvements in fatigue (45.4%), decubitus intolerance (21.8%) and dyspnea (25.4%) were observed in the overall sample. CONCLUSION Improvements in physical and functional capacities are attributed to resistance exercise program but not to the BCAA supplementation. CLINICAL TRIALS IDENTIFIER NCT02240511.
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Georgantas A, Dimopoulos S, Tasoulis A, Karatzanos E, Pantsios C, Agapitou V, Ntalianis A, Roditis P, Terrovitis J, Nanas S. Beneficial effects of combined exercise training on early recovery cardiopulmonary exercise testing indices in patients with chronic heart failure. J Cardiopulm Rehabil Prev 2014; 34:378-85. [PMID: 24983706 DOI: 10.1097/hcr.0000000000000068] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Exercise training induces several beneficial effects in patients with chronic heart failure (CHF). This study investigated the effects of high-intensity aerobic interval training (AIT) compared with combined AIT and strength training (COM) on early ventilatory and metabolic recovery pattern after symptom-limited cardiopulmonary exercise testing (CPET) in CHF patients. METHODS Stable CHF patients (N = 42; 54 ± 10 years [mean ± SD], 35 males) participated in an exercise training program for 12 weeks, 3 times per week. Participants were randomly assigned to either AIT (n = 20) or COM group (n = 22). Cardiopulmonary exercise testing was performed before and after completion of the program. Primary measurements included absolute and percentage difference of oxygen uptake, carbon dioxide output, minute ventilation ((Equation is included in full-text article.)E), tidal volume (VT), respiratory rate, and the first-degree slope of oxygen uptake ((Equation is included in full-text article.)O2/t slope) and carbon dioxide output ((Equation is included in full-text article.)CO2/t slope) during the first minute of recovery after maximal exercise. RESULTS The COM group had a greater improvement in the absolute and the percentage difference of (Equation is included in full-text article.)E (P = .03 and P = .04, respectively) and respiratory rate (P = .02 and P = .01, respectively) during the first minute of recovery period after exercise compared with the AIT group alone. No significant changes were noted for VT measurements. A significant increase in (Equation is included in full-text article.)CO2/t slope was observed in COM compared with the AIT group (P = .01). There was a trend for a greater increase in (Equation is included in full-text article.)O2/t slope in the COM group (P = .07). CONCLUSIONS The addition of strength training to AIT induces significant beneficial effects in terms of ventilatory and metabolic recovery kinetics than AIT alone in CHF patients, possibly indicating greater ventilatory efficiency and metabolic improvement.
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Affiliation(s)
- Andreas Georgantas
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory (Drs Georgantas, Dimopoulos, Tasoulis, Karatzanos, Agapitou, Roditis, and Nanas) and 3rd Department of Cardiology, National and Kapodistrian University of Athens (Drs Pantsios, Ntalianis, and Terrovitis), Athens, Greece
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Derman W, Schwellnus M, Hope F, Jordaan E, Padayachee T. Description and implementation of U-Turn Medical, a comprehensive lifestyle intervention programme for chronic disease in the sport and exercise medicine setting: pre-post observations in 210 consecutive patients. Br J Sports Med 2014; 48:1316-21. [PMID: 24982502 DOI: 10.1136/bjsports-2014-093814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Non-communicable disease (NCD) is increasing, but management remains mostly curative, disease-centred and focused on single interventions. We describe the development and implementation of a patient-centred, comprehensive, multidisciplinary lifestyle intervention programme (LIP) for patients with NCD in the sport and exercise medicine (SEM) setting (part 1) and present preliminary observational data (part 2). METHODS Part 1 is a description of the programme development and implementation. In part 2, 210 participants with NCD underwent a 12-week LIP (U-Turn Medical). Physiological, functional and metabolic outcomes were assessed at baseline and at completion. RESULTS 84% of patients had two or more comorbidities, requiring additional considerations for exercise rehabilitation. On completion, there were decreases in % body fat (29.8±6.7% vs 28.5±6.6%), waist (100.2±16.2 vs 97.3±14.8 cm) and hip circumference (105.4±13 vs 104±12 cm), resting heart rate (74.2±13.4 vs 71.4±11.9 bpm), resting systolic blood pressure (125.7±16.1 vs 120.1±13 mm Hg) and cholesterol (4.7±1.2 vs 4.3±0.9 mmol/L), low-density lipoprotein (3±0.9 vs 2.7±0.8 mmol/L) and triglyceride (1.4±0.7 vs 1.3±0.6 mmol/L), and increases in flexibility (12.1±11.6 vs 16.1±10.8 cm) and 6 min walk distance (559.4±156.6 vs 652.3±193.6 m; all p<0.05). CONCLUSIONS A 12-week comprehensive, patient-centred LIP can be implemented successfully in the SEM setting in patients with NCDs with multiple comorbidities. Observed results show improvements in the majority of outcome variables.
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Affiliation(s)
- Wayne Derman
- Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
| | - Martin Schwellnus
- Clinical Sport and Exercise Medicine Research Group, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
| | - Fallon Hope
- International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, Medical Research Council, Parow, South Africa Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
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De Souza MR, Pimenta L, Pithon-Curi TC, Bucci M, Fontinele RG, De Souza RR. Effects of aerobic training, resistance training, or combined resistance-aerobic training on the left ventricular myocardium in a rat model. Microsc Res Tech 2014; 77:727-34. [PMID: 24954110 DOI: 10.1002/jemt.22394] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 05/29/2014] [Accepted: 06/08/2014] [Indexed: 11/08/2022]
Abstract
This study follows the left ventricular (LV) hypertrophy in rats undergoing aerobic training alone (A), resistance training alone (R), or combined resistance and aerobic training (RA) (usually referred as concurrent training) program. A sedentary control group (C) was included. LV remodeling was evaluated using electron and light microscopy. The LV weight to body weight (LVW: BW) increased 11.4% in A group, 35% in the R group, and 18% in the RA group compared to the C group. The LV thickness increased 6% in the A group, 17% in the R group, and 10% in the RA group. The LV internal diameter increased 19% in the A group, 3% in the R group, and 8% in the RA group compared with the C group. The cross-sectional area of cardiomyocyte increased by 1% with the A group, 27% with R group, and 12% with RA training. The capillary density increased by 5.4% with A training, 11.0% with R training, and 7.7% with RA training compared with the C group. The volume fraction of interstitial collagen increased by 0.4% with training A, increased by 2.8% with R training, and 0.9% with RA training. In conclusion, except for the LV internal diameter, which increased more in the A group, the cardiac parameters increased more in the R group than in the other groups and in RA group than in A group. Collagen density increased from 5.4 ± 0.8% in the C group to 5.8 ± 0.6% in the A group (n. s.) (P > 0.05), to 8.2 ± 0.7% in the R group (P < 0.05), and to 6.3 ± 0.4% in the RA group (P < 0.05). These results demonstrate a significant increase for collagen content in the LV with R and RA exercise, but the increase was higher with R training alone than with RA training.
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Khan RS, Lin Y, Hu Y, Son NH, Bharadwaj KG, Palacios C, Chokshi A, Ji R, Yu S, Homma S, Schulze PC, Tian R, Goldberg IJ. Rescue of heart lipoprotein lipase-knockout mice confirms a role for triglyceride in optimal heart metabolism and function. Am J Physiol Endocrinol Metab 2013; 305:E1339-47. [PMID: 24085031 PMCID: PMC3882371 DOI: 10.1152/ajpendo.00349.2013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hearts utilize fatty acids as a primary source of energy. The sources of those lipids include free fatty acids and lipoprotein triglycerides. Deletion of the primary triglyceride-hydrolyzing enzyme lipoprotein lipase (LPL) leads to cardiac dysfunction. Whether heart LPL-knockout (hLPL0) mice are compromised due a deficiency in energetic substrates is unknown. To test whether alternative sources of energy will prevent cardiac dysfunction in hLPL0 mice, two different models were used to supply nonlipid energy. 1) hLPL0 mice were crossed with mice transgenically expressing GLUT1 in cardiomyocytes to increase glucose uptake into the heart; this cross-corrected cardiac dysfunction, reduced cardiac hypertrophy, and increased myocardial ATP. 2) Mice were randomly assigned to a sedentary or training group (swimming) at 3 mo of age, which leads to increased skeletal muscle production of lactate. hLPL0 mice had greater expression of the lactate transporter monocarboxylate transporter-1 (MCT-1) and increased cardiac lactate uptake. Compared with hearts from sedentary hLPL0 mice, hearts from trained hLPL0 mice had adaptive hypertrophy and improved cardiac function. We conclude that defective energy intake and not the reduced uptake of fat-soluble vitamins or cholesterol is responsible for cardiac dysfunction in hLPL0 mice. In addition, our studies suggest that adaptations in cardiac metabolism contribute to the beneficial effects of exercise on the myocardium of patients with heart failure.
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Abstract
Despite remarkable progress in the therapeutic approach of patients with chronic heart failure (CHF), exercise intolerance remains one of the hallmarks of the disease. During the past two decades, evidence has accumulated to underscore the key role of both endothelial dysfunction and skeletal muscle wasting in the process that gradually leads to physical incapacity. Whereas reverse ventricular remodeling has been attributed to aerobic exercise training, the vast majority of studies conducted in this specific patient population emphasize the reversal of peripheral abnormalities. In this review, we provide a general overview on underlying pathophysiological mechanisms. In addition, emphasis is put on recently identified pathways, which contribute to a deeper understanding of the main causes of exercise tolerance and the potential for reversal through exercise training. Recently, deficient bone marrow-related endothelial repair mechanisms have received considerable attention. Both acute exercise bouts, as well as exercise training, affect the mobilization of endothelial progenitor cells and their function. The observed changes following exercise training are believed to significantly contribute to improvement of peripheral endothelial function, as well as exercise capacity. With regard to skeletal muscle dysfunction and energy deprivation, adiponectin has been suggested to play a significant role. The demonstration of local skeletal muscle adiponectin resistance may provide an interesting and new link between the insulin resistant state and skeletal muscle wasting in CHF patients.
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Mandic S, Myers J, Selig SE, Levinger I. Resistance versus aerobic exercise training in chronic heart failure. Curr Heart Fail Rep 2013; 9:57-64. [PMID: 22131070 DOI: 10.1007/s11897-011-0078-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It is now accepted that exercise training is a safe and effective therapeutic intervention to improve clinical status, functional capacity, and quality of life in people with chronic heart failure (CHF). Nevertheless, this therapeutic modality remains underprescribed and underutilized. Both aerobic and resistance training improve exercise capacity and may partially reverse some of the cardiac, vascular, and skeletal muscle abnormalities in individuals with CHF. Aerobic training has more beneficial effects on aerobic power (peak oxygen consumption) and cardiac structure and function than resistance exercise training, while the latter is more effective for increasing muscle strength and endurance and promoting favorable arterial remodeling. Combined aerobic and resistance training is the preferred exercise intervention to reverse or attenuate the loss of muscle mass and improve exercise and functional capacity, muscle strength, and quality of life in individuals with CHF. The challenge now is to translate these research findings into clinical practice.
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Affiliation(s)
- Sandra Mandic
- School of Physical Education, University of Otago, Dunedin, New Zealand.
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Stebbings GK, Morse CI, McMahon GE, Onambele GL. Resting arterial diameter and blood flow changes with resistance training and detraining in healthy young individuals. J Athl Train 2013; 48:209-19. [PMID: 23672385 DOI: 10.4085/1062-6050-48.1.17] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Disruptions to habitual training routines are commonly due to injury or illness and can often lead to detraining adaptations. The implications of such adaptations to the human vasculature in a trained, asymptomatic population are not fully understood. OBJECTIVE To determine the extent of local and systemic changes in arterial diameter and blood flow to resistance training and subsequent detraining in young adults. DESIGN Randomized controlled clinical trial. SETTING University physiology laboratory and fitness suite. PATIENTS OR OTHER PARTICIPANTS Twenty-one healthy volunteers (aged 20.0 ± 2.8 years, 11 men and 10 women). INTERVENTION(S) Eight-week lower limb resistance training period and subsequent 4-week detraining period. MAIN OUTCOME MEASURE(S) Quadriceps and hamstrings concentric torque (strength), resting heart rate, arterial diameter, and blood flow velocity in the superficial femoral and carotid arteries were measured at 0, 8, 10, and 12 weeks. RESULTS Resistance training increased quadriceps and hamstring strength (32% and 35%, respectively, P < .001), whereas strength decreased during detraining (24% and 27%, respectively, P < .05). Resting heart rate decreased after resistance training (16%, P < .01) and increased during detraining (19%, P < .001). Additionally, resistance training significantly increased superficial femoral and carotid resting arterial diameters (27% and 13%, respectively, P < .001) and mean blood flow (53% and 55%, respectively, P < .001). Detraining resulted in a significant decrease in superficial femoral and carotid resting diameter (46% and 10%, respectively, P < .001) and mean blood flow (61% and 38%, respectively, P < .05). CONCLUSIONS Resistance training initiated both local and systemic changes to arterial diameter and blood flow; these changes appeared to reverse after detraining. The local changes in response to detraining showed a worsening (beyond pretraining values) of the vascular dimensional and blood flow characteristics.
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Affiliation(s)
- Georgina K Stebbings
- Department of Exercise and Sport Science, Manchester Metropolitan University, UK
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Effect of 808 nm low-level laser therapy in exercise-induced skeletal muscle fatigue in elderly women. Lasers Med Sci 2013; 28:1375-82. [PMID: 23296713 DOI: 10.1007/s10103-012-1246-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022]
Abstract
Aging process involves several structural changes in muscle tissue which lead to decrease in musculoskeletal function. One of the most common physiological modifications is the increase in fatigability in elderly people, which leads to inability to maintain strength and motor control. In this context, low-level laser therapy (LLLT) has demonstrated positive results in reducing fatigue during physical exercise. Thus, this study aimed to investigate the effects of LLLT on skeletal muscle fatigue in elderly women. Twenty-four subjects divided in two groups entered a crossover randomized triple-blinded placebo-controlled trial. Active LLLT (808 nm wavelength, 100 mW, energy 7 J) or an identical placebo LLLT was delivered on the rectus femoris muscle immediately before a fatigue protocol. Subjects performed a fatigue protocol which consisted of voluntary isotonic contractions of knee flexion-extension performed with a load corresponding to 75 % of 1-MR (Maximum Repetition) during 60 s. Surface electromyography (SEMG) signals were recorded from rectus femoris muscle of dominant lower limb to evaluate peripheral fatigability using median frequency analysis of SEMG signal. The number of repetitions of flexion-extension during fatigue protocol was also compared between groups. The values of median frequency were used to calculate the slope coefficient. The results showed no difference in the slope comparing placebo LLLT and active LLLT groups (p = 0.293). However, a significant difference was observed in the number of repetitions between groups, after active LLLT, subjects demonstrated significantly higher number of repetitions (p = 0.047). In this study, LLLT was efficient in increasing the mean number of repetitions during knee flexion-extension exercise, although results have not shown delay electromyographic fatigue.
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