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Valenzuela PL, Castillo-García A, Saco-Ledo G, Santos-Lozano A, Lucia A. Physical exercise: a polypill against chronic kidney disease. Nephrol Dial Transplant 2024; 39:1384-1391. [PMID: 38460948 DOI: 10.1093/ndt/gfae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Indexed: 03/11/2024] Open
Abstract
We are currently facing a pandemic of physical inactivity that might contribute to the growing prevalence of chronic kidney disease (CKD). Here, we summarize currently available evidence on the association between physical activity and CKD, and also review the effects of exercise intervention in affected patients. Physical activity/exercise might act as a polypill against CKD, preventing its development or even exerting beneficial effects once it is established (i.e. improvements in patients' physical fitness and cardiovascular risk, as well as in kidney function). Exercise benefits are also found at advanced CKD stages or in patients under hemodialysis. The biological mechanisms behind the clinical evidence are also discussed. An active lifestyle appears as a cornerstone in CKD prevention and management.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
| | | | - Gonzalo Saco-Ledo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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2
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Yuschen X, Choi JH, Seo J, Sun Y, Lee E, Kim SW, Park HY. Effects of Acute Beetroot Juice Supplementation and Exercise on Cardiovascular Function in Healthy Men in Preliminary Study: A Randomized, Double-Blinded, Placebo-Controlled, and Crossover Trial. Healthcare (Basel) 2024; 12:1240. [PMID: 38998775 PMCID: PMC11241253 DOI: 10.3390/healthcare12131240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Nitrate-rich beetroot juice (NRBRJ) can potentially enhance exercise performance and improve cardiovascular function, leading to an increased use of NRBRJ over the years. However, the combined effects of NRBRJ supplementation and exercise on cardiovascular function remain unclear. Therefore, this study compared cardiovascular function responses to submaximal exercise with either placebo (PLA) or NRBRJ supplementation in healthy men. Twelve healthy men (aged 25.2 ± 2.3 years) completed the 30-min submaximal cycle ergometer exercise trials corresponding to 70% maximal heart rate (HRmax) with either PLA or NRBRJ supplementation in a random order. The mean exercise load, heart rate (HR), stroke volume (SV), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and total peripheral resistance (TPR) were measured during exercise. The brachial-ankle pulse wave velocity (baPWV) and flow-mediated dilation (FMD) were measured before and after exercise. NRBRJ supplementation was more effective than PLA in increasing the mean exercise load and decreasing DBP and MAP during submaximal exercise. Furthermore, baPWV decreased in the NRBRJ trial and was considerably lower after exercise in the NRBRJ-supplemented group than in the PLA-supplemented group. FMD significantly increased in the PLA and NRBRJ trials; however, NRBRJ supplementation demonstrated a significantly higher FMD before and after exercise than PLA supplementation. In conclusion, acute NRBRJ supplementation and exercise were more effective than PLA supplementation and exercise in improving aerobic exercise capacity and cardiovascular function in healthy men.
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Affiliation(s)
- Xie Yuschen
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Jae-Ho Choi
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Jisoo Seo
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Yerin Sun
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Eunjoo Lee
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Sung-Woo Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
- Physical Activity and Performance Institute, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
| | - Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
- Physical Activity and Performance Institute, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea
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3
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Mitra S, Mitra M, Nandi P, Pandey M, Chakrabarty M, Saha M, Nandi DK. Efficacy of Yoga for COVID-19 Stress Prophylaxis. J Phys Act Health 2023; 20:1034-1042. [PMID: 37625797 DOI: 10.1123/jpah.2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The global COVID-19 lockdown restricted daily routines due to the psychological fear of infection, which imposed an unknown universal threat on female college students, affecting physiological health and well-being. However, scant information concerning the efficacy of yogic practice on female college students during the stressful COVID-19 pandemic situation is available. METHODS In a randomized controlled trial (n = 74, age = 21.65 [4.05] y), a study was conducted with a well-conceptualized yogic module for 5 days/week for 3 months (40 min daily in the morning) among yogic volunteers. Pre-post analysis of anthropometric, physiological, and biochemical indices in pandemic-stressed female college students was done for the control and yoga groups. RESULTS After 3 months of yogic practice, significant reduction (P < .05) in heart rate (d = 0.64, meandiff = 5.43), systolic blood pressure (d = 0.59, meandiff = 5.32), cortisol (d = 0.59, meandiff = 6.354), and triglycerides (P < .01, d = 0.45, meandiff = 13.95) was observed. After yogic follow-up significant improvement (P < .01) in high-frequency (d = 0.56, meandiff = -7.3), total power (d = 0.46, meandiff = -1150) and time domain parameters of heart rate variability led to ameliorate the stress index. Superoxide dismutase (P < .01, d = 0.78, meandiff = 0.69), catalase (P < .05, d = 0.48, meandiff = -7.37), glutathione (P < .001, d = 0.83, meandiff = -4.15), high-density lipoprotein (P < .05, d = 0.48, meandiff = -11.07), and dopamine (P < .001, d = 0.97, meandiff = -135.4) values along with inflammatory markers (P < .001) significantly improved among yogic volunteers after regular practice. CONCLUSIONS Our findings suggest that a 3-month well-conceptualized yogic intervention during COVID-19 may be considered as a prophylactic tool to improve female college students' universal psychophysiological health by ameliorating autonomic functions, cardiometabolic risk factors, and immune metabolisms in an economical and environment-friendly manner.
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Affiliation(s)
- Sudeep Mitra
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
| | - Mousumi Mitra
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
| | - Purna Nandi
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
| | - Madhumita Pandey
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
| | - Mousumi Chakrabarty
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
| | - Mantu Saha
- Work Physiology & Yoga Laboratory, Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organisation (DRDO), Delhi,India
| | - Dilip Kumar Nandi
- Laboratory of Human Performance, PG Department of Human Physiology & BMLT, Raja Narendra Lal Khan Women's College (Autonomous), Midnapore,India
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Barragán R, González-Mohíno F, Veiga S, Juárez Santos-García D. Effects of 8-week of training on heart rate variability, overtraining state and performance in international young swimmers. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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La Gerche A, Howden EJ, Haykowsky MJ, Lewis GD, Levine BD, Kovacic JC. Heart Failure With Preserved Ejection Fraction as an Exercise Deficiency Syndrome: JACC Focus Seminar 2/4. J Am Coll Cardiol 2022; 80:1177-1191. [PMID: 36075837 DOI: 10.1016/j.jacc.2022.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 10/14/2022]
Abstract
Across differing spectrums of cardiac function and cardiac pathologies, there are strong associations between measures of cardiorespiratory fitness and burden of symptoms, quality of life, and prognosis. In this part 2 of a 4-part series, we contend that there is a strong association among physical activity, cardiorespiratory fitness, and cardiac function. We argue that a chronic lack of exercise is a major risk factor for heart failure with preserved ejection fraction in some patients. In support of this hypothesis, increasing physical activity is associated with greater cardiac mass, greater stroke volumes, greater cardiac output and peak oxygen consumption, and fewer clinical events. Conversely, physical inactivity results in cardiac atrophy, reduced output, reduced chamber size, and decreased ability to augment cardiac performance with exercise. Moreover, physical inactivity is a strong predictor of heart failure risk and death. In sum, exercise deficiency should be considered part of the broad heart failure with preserved ejection fraction phenotype.
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Affiliation(s)
- Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; National Centre for Sports Cardiology, Fitzroy, Victoria, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
| | - Erin J Howden
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Mark J Haykowsky
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jason C Kovacic
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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6
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Fabiani M, Asnakew BA, Bowie DC, Chism SM, Clements GM, Gardner JC, Islam SS, Rubenstein SL, Gratton G. A healthy mind in a healthy body: Effects of arteriosclerosis and other risk factors on cognitive aging and dementia. THE PSYCHOLOGY OF LEARNING AND MOTIVATION 2022; 77:69-123. [PMID: 37139101 PMCID: PMC10153623 DOI: 10.1016/bs.plm.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this review we start from the assumption that, to fully understand cognitive aging, it is important to embrace a holistic view, integrating changes in bodily, brain, and cognitive functions. This broad view can help explain individual differences in aging trajectories and could ultimately enable prevention and remediation strategies. As the title of this review suggests, we claim that there are not only indirect but also direct effects of various organ systems on the brain, creating cascades of phenomena that strongly contribute to age-related cognitive decline. Here we focus primarily on the cerebrovascular system, because of its direct effects on brain health and close connections with the development and progression of Alzheimer's Disease and other types of dementia. We start by reviewing the main cognitive changes that are often observed in normally aging older adults, as well as the brain systems that support them. Second, we provide a brief overview of the cerebrovascular system and its known effects on brain anatomy and function, with a focus on aging. Third, we review genetic and lifestyle risk factors that may affect the cerebrovascular system and ultimately contribute to cognitive decline. Lastly, we discuss this evidence, review limitations, and point out avenues for additional research and clinical intervention.
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Affiliation(s)
- Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Bethlehem A. Asnakew
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Daniel C. Bowie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sydney M. Chism
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Grace M. Clements
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jennie C. Gardner
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samia S. Islam
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samantha L. Rubenstein
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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7
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Mariano IM, Amaral AL, V. Carrijo VH, Costa JG, Rodrigues MDL, Cunha TM, Puga GM. Different cardiovascular responses to exercise training in hypertensive women receiving β-blockers or angiotensin receptor blockers: A pilot study. Clin Exp Hypertens 2022; 44:442-450. [DOI: 10.1080/10641963.2022.2065290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Igor M. Mariano
- Physical Education Department, Federal University of Uberlândia, Uberlândia, Brazil
| | - Ana Luiza Amaral
- Physical Education Department, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Juliene G. Costa
- Physical Education Department, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Thulio M. Cunha
- Medicine Department, Federal University of Uberlândia, Uberlândia, Brazil
| | - Guilherme M. Puga
- Physical Education Department, Federal University of Uberlândia, Uberlândia, Brazil
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Effects of High-Intensity Interval Training on the Vascular and Autonomic Components of the Baroreflex at Rest in Adolescents. Pediatr Exerc Sci 2022; 34:13-19. [PMID: 34311441 DOI: 10.1123/pes.2020-0220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE In a sample of healthy adolescents, the authors aimed to investigate the effects of high-intensity interval exercise (HIIE) training and detraining on baroreflex sensitivity (BRS) and it's vascular and autonomic components at rest. METHODS Nineteen volunteers were randomly allocated to (1) 4 weeks HIIE training performed 3 times per week or (2) a control condition with no intervention for the same duration as HIIE training. PRE, POST, and following 2 weeks of detraining resting supine heart rate and blood pressure were measured, and a cross-spectral method (integrated gain [gain in low frequency]) was used to determine BRS gain. Arterial compliance (AC) was assessed as the BRS vascular component. LFgain divided by AC (LFgain/AC) was used as the autonomic determinant of BRS. RESULTS The HIIE training was completed with 100% compliance. HIIE did not change resting gain in low frequency (LFgain) (P = .66; effect size = 0.21), AC (P = .44; effect size = 0.36), or LFgain/AC (P = .68; effect size = 0.19) compared to control. CONCLUSION Four weeks of HIIE training does not change BRS and its autonomic and vascular determinant in a sample of healthy adolescents at rest.
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9
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Nyerges-Bohák Z, Nagy K, Rózsa L, Póti P, Kovács L. Heart rate variability before and after 14 weeks of training in Thoroughbred horses and Standardbred trotters with different training experience. PLoS One 2021; 16:e0259933. [PMID: 34882704 PMCID: PMC8659354 DOI: 10.1371/journal.pone.0259933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
Changes in heart rate and heart rate variabilty (HRV) were investigated in untrained (UT; starting their first racing season) and detrained (DT; with 1–3 years of race experience) racehorses before and after 14-week conventional training. HRV was measured at rest over 1 h between 9:00 and 10:00 AM on the usual rest day of the horses. The smallest worthwhile change (SWC) rate was calculated for all HRV parameters. UT horses had significantly higher heart rate compared to DT (P<0.001). There were no gender- or training-related differences in heart rate. The root-mean-square of successive differences (rMSSD) in the consecutive inter-beat-intervals obtained after the 14-week training period was lower compared to pre-training rMSSD (P<0.001). The rMSSD was not influenced by breed, age or gender. In DT horses, there was a significant decrease in the high frequency (HF) component of HRV (P≤0.05) as the result of the 14-week training. These results may reflect saturation of high-frequency oscillations of inter-beat intervals rather than the reduction in parasympathetic influence on the heart. The HF did not differ significantly between the two measurements in UT horses; however, 16.6% of the animals showed a decrease in HF below SWC (P≤0.05). This supports the likelihood of parasympathetic saturation. Although no significant decrease in heart rate was found for the post-training, 30.0% of DT and 58.3% of UT horses still showed a decrease in heart rate below the SWC. Also by individual examination, it was also visible that despite significant post-training decrease in rMSSD, 1 (4.6%) DT and 2 (6.7%) UT horses reached SWC increase in rMMSD. In the case of these horses, the possibility of maladaptation should be considered. The present results indicate that similar to as found in human athletes, cardiac ANS status of racehorses also changes during the physiological adaptation to training. To explore more precise links between HRV and training effectiveness in horses, a more frequent recording would be necessary. Detailed analysis of HRV parameters based on SWC will be able to highlight the importance of fitness evaluation at individual level.
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Affiliation(s)
- Zsófia Nyerges-Bohák
- Institute of Animal Sciences, Hungarian University of Agriculture and Life Sciences, Kaposvár, Hungary
| | - Krisztina Nagy
- Institute of Animal Sciences, Hungarian University of Agriculture and Life Sciences, Kaposvár, Hungary
| | - László Rózsa
- Institute of Animal Sciences, Hungarian University of Agriculture and Life Sciences, Kaposvár, Hungary
| | - Péter Póti
- Institute of Animal Sciences, Hungarian University of Agriculture and Life Sciences, Kaposvár, Hungary
| | - Levente Kovács
- Institute of Animal Sciences, Hungarian University of Agriculture and Life Sciences, Kaposvár, Hungary
- * E-mail:
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10
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Carrick-Ranson G, Howden EJ, Levine BD. Exercise in Octogenarians: How Much Is Too Little? Annu Rev Med 2021; 73:377-391. [PMID: 34794323 DOI: 10.1146/annurev-med-070119-115343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The global population is rapidly aging, with predictions of many more people living beyond 85 years. Age-related physiological adaptations predispose to decrements in physical function and functional capacity, the rate of which can be accelerated by chronic disease and prolonged physical inactivity. Decrements in physical function exacerbate the risk of chronic disease, disability, dependency, and frailty with advancing age. Regular exercise positively influences health status, physical function, and disease risk in adults of all ages. Herein, we review the role of structured exercise training in the oldest old on cardiorespiratory fitness and muscular strength and power, attributes critical for physical function, mobility, and independent living. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Graeme Carrick-Ranson
- Surgical and Translational Research (STaR) Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Erin J Howden
- Baker Heart and Diabetes Institute, Melbourne, Victoria 3004 Australia
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, and the University of Texas Southwestern Medical Center, Dallas, Texas 75213, USA;
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11
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Lester GR, Abiusi FS, Bodner ME, Mittermaier PM, Cote AT. The Impact of Fitness Status on Vascular and Baroreceptor Function in Healthy Women and Men. J Vasc Res 2021; 59:16-23. [PMID: 34571505 DOI: 10.1159/000518985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic endurance exercise training elicits desirable physiological adaptations in the cardiovascular system. The volume of exercise training required to generate healthy adaptations is unclear. This study assessed the effects of differing exercise training levels on arterial stiffness, compliance, and autonomic function. METHODS Eighty healthy adults (38.5 ± 9.7 years; 44% female) defined as endurance-trained (ET, n = 29), normally active (NA, n = 27), or inactive (IN, n = 24) participated. Cardiovascular markers, including hemodynamics, large arterial compliance and small arterial compliance (LAC and SAC), carotid-femoral pulse wave velocity (PWV), and spontaneous baroreceptor sensitivity (BRS) were assessed. RESULTS ET showed significantly greater LAC values (21.4 ± 6.5) than NA (16.9 ± 2.5; p = 0.002) and IN (14.7 ± 3.2 mL × mm Hg × 10; p = 0.028). Values for SAC and BRS were significantly higher in ET than IN (p < 0.001 and p = 0.028, respectively), but not NA. Compared to IN, PWV values for ET and NA were significantly lower (p < 0.003). After adjusting for covariates (age, sex, and SBP), significant associations with cardiovascular fitness status were noted for all markers but BRS. CONCLUSION Endurance exercise increases LAC likely due to high-volume training; however, lower volumes of physical activity may be sufficient to positively benefit vascular health overall.
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Affiliation(s)
- Garth R Lester
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Francesca S Abiusi
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Michael E Bodner
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
| | - Peter M Mittermaier
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Anita T Cote
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Sanchis-Gomar F, Lavie CJ, Marín J, Perez-Quilis C, Eijsvogels TMH, O'Keefe JH, Perez MV, Blair SN. Exercise Effects On Cardiovascular Disease: From Basic Aspects To Clinical Evidence. Cardiovasc Res 2021; 118:2253-2266. [PMID: 34478520 DOI: 10.1093/cvr/cvab272] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.,Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Jorge Marín
- Growth, Exercise, Nutrition and Development Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Carme Perez-Quilis
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Science, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - James H O'Keefe
- St. Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Marco V Perez
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Steven N Blair
- Department of Exercise Sciences, University of South Carolina, Columbia, USA
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Koller A, Laughlin MH, Cenko E, de Wit C, Tóth K, Bugiardini R, Trifunovits D, Vavlukis M, Manfrini O, Lelbach A, Dornyei G, Padro T, Badimon L, Tousoulis D, Gielen S, Duncker DJ. Functional and structural adaptations of the coronary macro- and micro-vasculature to regular aerobic exercise by activation of physiological, cellular and molecular mechanisms: Esc Working Group on Coronary Pathophysiology & Microcirculation Position Paper. Cardiovasc Res 2021; 118:357-371. [PMID: 34358290 DOI: 10.1093/cvr/cvab246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/01/2021] [Accepted: 08/04/2021] [Indexed: 11/14/2022] Open
Abstract
Regular aerobic exercise (RAEX) elicits several positive adaptations in all organs and tissues of the body, culminating in improved health and well-being. Indeed, in over half a century, many studies have shown the benefit of RAEX on cardiovascular outcome in terms of morbidity and mortality. RAEX elicits a wide range of functional and structural adaptations in the heart and its coronary circulation, all of which are to maintain optimal myocardial oxygen and nutritional supply during increased demand. Although there is no evidence suggesting that oxidative metabolism is limited by coronary blood flow (CBF) rate in the normal heart even during maximal exercise, increased CBF and capillary exchange capacities have been reported. Adaptations of coronary macro- and microvessels include outward remodeling of epicardial coronary arteries, increased coronary arteriolar size and density, and increased capillary surface area. In addition, there are adjustments in the neural and endothelial regulation of coronary macrovascular tone. Similarly, there are several adaptations at the level of microcirculation, including enhanced smooth muscle dependent pressure-induced myogenic constriction and upregulated endothelium-dependent flow-/shear-stress-induced dilation, increasing the range of diameter change. Alterations in the signaling interaction between coronary vessels and cardiac metabolism have also been described. At the molecular and cellular level, ion channels are key players in the local coronary vascular adaptations to RAEX, with enhanced activation of influx of Ca2+ contributing to the increased myogenic tone (via voltage gated Ca2+ channels) as well as the enhanced endothelium-dependent dilation (via TRPV4 channels). Finally, RAEX elicits a number of beneficial effects on several hemorheological variables that may further improve CBF and myocardial oxygen delivery and nutrient exchange in the microcirculation by stabilizing and extending the range and further optimizing the regulation of myocardial blood flow during exercise. These adaptations also act to prevent and/or delay the development of coronary and cardiac diseases.
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Affiliation(s)
- Akos Koller
- Department of Translational Medicine, Semmelweis University, Budapest, Hungary; Research Center for Sports Physiology, University of Physical Education, Budapest, Hungary; Department of Physiology, New York Medical College, Valhalla, NY, 10595, USA
| | - M Harold Laughlin
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Edina Cenko
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Cor de Wit
- Institut für Physiologie, Universitat zu Lu ¨beck, Lu beck, Germany and15DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lu ¨beck, Lubeck, Germany
| | - Kálmán Tóth
- Division of Cardiology, 1st Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Raffaele Bugiardini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Danijela Trifunovits
- Cardiology Department, Clinical Centre of Serbia and Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Marija Vavlukis
- University Clinic for Cardiology, Medical Faculty, Ss' Cyril andMethodius University, Skopje, Republic of Macedonia
| | - Olivia Manfrini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Adam Lelbach
- Departmental Group of Geriatrics, Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Dr. Rose Private Hospital, Budapest, Hungary
| | - Gabriella Dornyei
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Teresa Padro
- Cardiovascular Program-ICCC, Research Institute Hospital Santa Creu i Sant Pau; IIB-Sant Pau; CiberCV-Institute Carlos III; Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program-ICCC, Research Institute Hospital Santa Creu i Sant Pau; IIB-Sant Pau; CiberCV-Institute Carlos III; Barcelona, Spain
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Stephan Gielen
- Department of Cardiology, Angiology, and Intensive Care Medicine, Klinikum Lippe, Detmold, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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14
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Grässler B, Thielmann B, Böckelmann I, Hökelmann A. Effects of Different Exercise Interventions on Cardiac Autonomic Control and Secondary Health Factors in Middle-Aged Adults: A Systematic Review. J Cardiovasc Dev Dis 2021; 8:jcdd8080094. [PMID: 34436236 PMCID: PMC8396995 DOI: 10.3390/jcdd8080094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023] Open
Abstract
This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic control. Secondary factors were related to factors that contribute to cardiovascular health. Studies examining the effects of endurance, resistance, multimodal, or coordinative training interventions in healthy participants aged between 45 and 60 years old on average were considered. The methodological quality of the studies was examined using two assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. The literature review retrieved eight studies fulfilling all inclusion criteria. Cardiac autonomic control and cardiovascular health improved after endurance and multimodal interventions. Resistance training had no significant impact on HRV or any secondary health factor. Coordinative exercise interventions showed inconclusive results regarding HRV but showed significant improvements in secondary health factors. The quality assessment tools revealed some methodological and reporting deficits. Despite the small number of studies, we suggest endurance and multimodal interventions including aerobic exercises for the enhancement of cardiac autonomic control and the reduction of cardiovascular risk in middle-aged adults. Further studies need to be conducted to examine the long-term effects of exercise in the midlife period.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
- Correspondence: ; Tel.: +49-391-6756682
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
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15
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Schwarck S, Busse N, Ziegler G, Glanz W, Becke A, Düzel E. Heart Rate Variability During Physical Exercise Is Associated With Improved Cognitive Performance in Alzheimer's Dementia Patients-A Longitudinal Feasibility Study. Front Sports Act Living 2021; 3:684089. [PMID: 34337405 PMCID: PMC8319237 DOI: 10.3389/fspor.2021.684089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Heart rate variability (HRV) rapidly gains attention as an important marker of cardiovascular autonomic modulation. Moreover, there is evidence for a link between the autonomic deficit measurable by reduced HRV and the hypoactivity of the cholinergic system, which is prominently affected in Alzheimer's disease (AD). Despite the positive influence of physical exercise on cognition and its promising association with HRV, previous studies did not explore the effect of long-term physical exercise in older adults with AD. Taking advantage of a longitudinal study we analyzed the effect of a 20-week dual task training regime (3 × 15-min per week) on the vagal mediated HRV index RMSSD (root mean square of successive RR interval differences) during physical exercise and the short-term memory performance in a AD cohort (N = 14). Each training contained physical exercise on a bicycle ergometer while memorizing 30 successively presented pictures as well as the associated post-exercise picture recognition memory test. Linear-mixed modeling revealed that HRV-RMSSD significantly increased over the intervention time. Moreover, the reaction time in the picture recognition task decreased while the accuracy remained stable. Furthermore, a significantly negative relationship between increased fitness measured by HRV-RMSSD and decreased reaction time was observed. This feasibility study points to the positive effects of a dual task regime on physical and cognitive fitness in a sample with impaired cognitive performance. Beyond this, the results show that the responsiveness of parasympathetic system as measured with HRV can be improved in patients with dementia.
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Affiliation(s)
- Svenja Schwarck
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Nancy Busse
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Gabriel Ziegler
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Wenzel Glanz
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Andreas Becke
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Düzel
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.,German Center of Neurodegenerative Diseases (DZNE), Magdeburg, Germany
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16
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Matus LN, Flessland OD, Mueller PJ. Sex-dependent development of enhanced sympathoexcitation in sedentary versus physically active rats. J Physiol 2021; 599:4101-4116. [PMID: 34258769 DOI: 10.1113/jp281757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/07/2021] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS The rostral ventrolateral medulla (RVLM) may contribute to sex-based differences in cardiovascular disease (CVD) based on overactivation of the sympathetic nervous system observed in sedentary male rats; however, the added influence of the reproductive cycle in females is currently unknown. To our knowledge this is the first study to demonstrate greater increases in sympathetic nerve activity in response to direct activation of the RVLM in female versus male rats prior to the onset of the reproductive cycle, which persisted after the onset of the reproductive cycle. Lower resting blood pressures in females also suggest peripheral adaptations contribute to sex-based differences in CVD. Sedentary versus physically active conditions appear to promote higher resting sympathetic outflow independent of age and sex. Our results demonstrate the importance of examining sedentary conditions in the context of sex differences and the reproductive cycle in contributing to sympathetic overactivity associated with cardiovascular disease. ABSTRACT Female reproductive hormones are considered cardioprotective based on higher risks of cardiovascular disease (CVD) in post- versus pre-menopausal women. Similarly, based on epidemiological studies, a sedentary lifestyle is also a major risk factor for CVD. The mechanisms by which sedentary conditions contribute to CVD, and their influences in the presence and absence of female reproductive hormones are unknown. We hypothesized that sexually immature male and female rats would have similar centrally mediated regulation of blood pressure, but upon sexual maturation, female rats would have lower resting blood pressure and centrally-mediated sympathoexcitation compared to age-matched males. We also predicted resting sympathetic activity would increase upon exposure to sedentary versus active conditions (voluntary wheel running) in males but not in females. We recorded splanchnic sympathetic nerve activity (SSNA) and blood pressure in 4-, 8- and 16-week-old male and female rats under Inactin anaesthesia before and during microinjections of glutamate (1-100 mM) into the rostral ventrolateral medulla (RVLM). Four-week-old female rats had lower resting blood pressure and greater sympathoexcitation following activation of the RVLM, as did 8- and 16-week-old female rats, independent of age or activity condition. Sedentary animals had higher baseline SSNA compared to active animals, independent of sex or age. Our results reveal a complex influence of the interactions between the female reproductive cycle and sedentary conditions. They also demonstrate the importance of examining sedentary conditions in the context of sex- and female reproductive cycle-dependent incidences of cardiovascular disease.
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Affiliation(s)
- Lyndsey N Matus
- Department of Physiology, Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI, 48201, USA
| | - Olivia D Flessland
- Department of Physiology, Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI, 48201, USA
| | - Patrick J Mueller
- Department of Physiology, Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI, 48201, USA
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17
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Perrone MA, Volterrani M, Manzi V, Barchiesi F, Iellamo F. Heart rate variability modifications in response to different types of exercise training in athletes. J Sports Med Phys Fitness 2021; 61:1411-1415. [PMID: 34137572 DOI: 10.23736/s0022-4707.21.12480-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE Spectral analysis of heart rate variability (HRV) is a long-standing technique to indirectly assess neural cardiac regulation. This article specifically addressed how spectral analysis of HRV could help to understand neural cardiovascular adaptations to long-term exercise training and inform us on training status in athletes. METHODS We reviewed literature searching for articles investigating resting cardiovascular adaptations to long-tem exercise training through spectral analysis of HRV in athletes, from amateur to world class categories, practicing different sport disciplines, focusing, in particular, on a series of work performed over time in our laboratory, which may highlight how different types of exercise training differently affect neural cardiac regulation. RESULTS Spectral analysis of HRV has been shown its capability of detecting different adaptational changes in cardiac autonomic nervous system (ANS) regulation attending physical training in athletes of different sport disciplines. Studies showed that spectral analysis of HRV provide results that are sport-dependent and differ at individual level. ANS adaptations to exercise training are presented and discussed. CONCLUSIONS Reported studies indicate that spectral analysis of HRV is an effective tool to monitor and optimize the training process and also to predict athletic achievements in competitions. Cardiac ANS adaptations are strongly dependant on the type of training being performed. The individual nature of cardiac ANS adaptations should be considered to properly interpret the observed findings.
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Affiliation(s)
- Marco A Perrone
- Department of Cardiology and Sports Medicine, University of Rome Tor Vergata, Rome, Italy -
| | - Maurizio Volterrani
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Rome, Italy
| | - Vincenzo Manzi
- Department of Cardiology and Sports Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Barchiesi
- Institute of Sports Medicine and Science, Sport e Salute, Rome, Italy
| | - Ferdinando Iellamo
- Department of Cardiology and Sports Medicine, University of Rome Tor Vergata, Rome, Italy.,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana, Rome, Italy
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18
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Grässler B, Thielmann B, Böckelmann I, Hökelmann A. Effects of Different Training Interventions on Heart Rate Variability and Cardiovascular Health and Risk Factors in Young and Middle-Aged Adults: A Systematic Review. Front Physiol 2021; 12:657274. [PMID: 33981251 PMCID: PMC8107721 DOI: 10.3389/fphys.2021.657274] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/30/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: Heart rate variability (HRV), the beat-to-beat variation of adjacent heartbeats, is an indicator of the function of the autonomic nervous system (ANS). Increased HRV reflects well-functioning of autonomic control mechanism and cardiovascular health. The aim of this systematic review is to provide a systematic overview of the effects of different physical training modalities on resting HRV and cardiovascular health and risk factors (i.e., baroreflex sensitivity, body fat, body mass, body mass index, blood pressure, heart rate recovery, VO2 max, and VO2 peak) in young and middle-aged (mean age of the studies samples up to 44 years), healthy adults. Methods: A systematic review in accordance with the PRISMA guidelines was performed. Studies investigating the effects of different physical interventions (endurance, resistance, high-intensity, coordinative, or multimodal training) on HRV were included. Trials were considered eligible if the intervention lasted for at least 4 weeks and participants were regarded as general healthy. Five electronic databases were searched from 2005 to September 8th, 2020. The methodological quality of eligible studies was assessed by two study quality and reporting assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. Results: Of 3,991 retrieved records, 26 were considered eligible and analyzed. Twelve studies used an endurance training (of which three included high-intensity sessions), six studies resistance training, four studies coordinative training, two studies high-intensity training, and two studies used a multimodal intervention. Overall, the results showed for all types of intervention an improvement in linear and non-linear HRV parameters and cardiovascular health and risk factors. However, quality assessment revealed some methodological and reporting deficits. Conclusion: This systematic review highlights the benefits of different types of physical training interventions on autonomic function and health parameters in young and middle-aged, healthy adults. In conclusion, higher training intensities and frequencies are more likely to improve HRV. For future studies, we recommend adhering to the criteria of methodological standards of exercise interventions and HRV measurements and encourage the use of non-linear HRV parameters.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
| | - Beatrice Thielmann
- Department of Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Irina Böckelmann
- Department of Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
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19
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Nikolaidis PT, Clemente-Suárez VJ, Chlíbková D, Knechtle B. Training, Anthropometric, and Physiological Characteristics in Men Recreational Marathon Runners: The Role of Sport Experience. Front Physiol 2021; 12:666201. [PMID: 33912075 PMCID: PMC8075001 DOI: 10.3389/fphys.2021.666201] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/15/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to examine the physiological and training characteristics in marathon runners with different sport experiences (defined as the number of finishes in marathon races). The anthropometry and physiological characteristics of men recreational endurance runners with three or less finishes in marathon races (novice group, NOV; n = 69, age 43.5 ± 8.0 years) and four or more finishes (experienced group, EXP; n = 66, 45.2 ± 9.4 years) were compared. EXP had faster personal best marathon time (3:44 ± 0:36 vs. 4:20 ± 0:44 h:min, p < 0.001, respectively); lower flexibility (15.9 ± 9.3 vs. 19.3 ± 15.9 cm, p = 0.022), abdominal (20.6 ± 7.9 vs. 23.8 ± 9.0 mm, p = 0.030) and iliac crest skinfold thickness (16.7 ± 6.7 vs. 19.9 ± 7.9 mm, p = 0.013), and body fat assessed by bioimpedance analysis (13.0 ± 4.4 vs. 14.6 ± 4.7%, p = 0.047); more weekly training days (4.6 ± 1.4 vs. 4.1 ± 1.0 days, p = 0.038); and longer weekly running distance (58.8 ± 24.0 vs. 47.2 ± 16.1 km, p = 0.001) than NOV. The findings indicated that long-term marathon training might induce adaptations in endurance performance, body composition, and flexibility.
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Affiliation(s)
- Pantelis T Nikolaidis
- Exercise Physiology Laboratory, Nikaia, Greece.,School of Health and Caring Sciences, University of West Attica, Athens, Greece
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain.,Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla, Colombia
| | - Daniela Chlíbková
- Centre of Sports Activities, Brno University of Technology, Brno, Czechia
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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20
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Tarumi T, Yamabe T, Fukuie M, Kimura R, Zhu DC, Ohyama-Byun K, Maeda S, Sugawara J. Proximal Aortic Compliance in Young Male Endurance Athletes: An MRI Study. Med Sci Sports Exerc 2021; 53:543-550. [PMID: 32881770 DOI: 10.1249/mss.0000000000002508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION High-intensity endurance training can elicit profound cardiac adaptations; however, the current evidence as to its impact on the proximal aorta is limited. The purpose of this study was to investigate the morphological and functional characteristics of the proximal aorta in endurance athletes. METHODS Fifteen young male middle- and long-distance runners were compared with 19 age- and sex-matched sedentary control participants. CINE phase-contrast magnetic resonance imaging was used to measure blood flow velocities and cross-sectional areas of the ascending and proximal descending aorta. Aortic blood pressure was measured simultaneously during the phase-contrast magnetic resonance imaging scan using a generalized transfer function. Maximal oxygen uptake (V˙O2max) was measured in the athletes. Left ventricular morphology was assessed in a subgroup of participants (n = 16) with cardiac magnetic resonance imaging. RESULTS The athlete group exhibited an average V˙O2max of 69.5 ± 3.1 mL·kg-1⋅min-1, which is above the 90th percentile of men with similar age according to the American College of Sports Medicine guideline. The athletes had significantly higher stroke volume and slower heart rate at rest and greater left ventricular end-diastolic volume and mass than the sedentary participants. Significantly larger cross-sectional areas and higher compliance of the ascending and proximal descending aorta were also found in the athletes, independently of body surface area. Moreover, higher compliance of the ascending aorta was associated with greater stroke volume (r = 0.382, P = 0.026) and slower heart rate (r = -0.442, P = 0.009) across all participants. CONCLUSIONS The proximal aorta of young male endurance athletes undergoes morphological and functional adaptations that may be resulting from the significant hemodynamic alterations associated with their cardiac function.
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Affiliation(s)
- Takashi Tarumi
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, JAPAN
| | | | | | - Ryota Kimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, JAPAN
| | - David C Zhu
- Department of Radiology and Cognitive Imaging Research Center, Michigan State University, East Lansing, MI
| | - Keigo Ohyama-Byun
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, JAPAN
| | - Seiji Maeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, JAPAN
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21
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Sailer C, Edelmann H, Buchanan C, Giro P, Babcock M, Swanson C, Spotts M, Schulte M, Pratt-Cordova A, Coe G, Beindorff M, Page RL, Ambardekar AV, Pal JD, Kohrt W, Wolfel E, Lawley JS, Tarumi T, Cornwell WK. Impairments in Blood Pressure Regulation and Cardiac Baroreceptor Sensitivity Among Patients With Heart Failure Supported With Continuous-Flow Left Ventricular Assist Devices. Circ Heart Fail 2021; 14:e007448. [PMID: 33464953 DOI: 10.1161/circheartfailure.120.007448] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Continuous-flow (CF) left ventricular assist devices (LVADs) improve outcomes for patients with advanced heart failure (HF). However, the lack of a physiological pulse predisposes to side-effects including uncontrolled blood pressure (BP), and there are little data regarding the impact of CF-LVADs on BP regulation. METHODS Twelve patients (10 males, 60±11 years) with advanced heart failure completed hemodynamic assessment 2.7±4.1 months before, and 4.3±1.3 months following CF-LVAD implantation. Heart rate and systolic BP via arterial catheterization were monitored during Valsalva maneuver, spontaneous breathing, and a 0.05 Hz repetitive squat-stand maneuver to characterize cardiac baroreceptor sensitivity. Plasma norepinephrine levels were assessed during head-up tilt at supine, 30o and 60o. Heart rate and BP were monitored during cardiopulmonary exercise testing. RESULTS Cardiac baroreceptor sensitivity, determined by Valsalva as well as Fourier transformation and transfer function gain of Heart rate and systolic BP during spontaneous breathing and squat-stand maneuver, was impaired before and following LVAD implantation. Norepinephrine levels were markedly elevated pre-LVAD and improved-but remained elevated post-LVAD (supine norepinephrine pre-LVAD versus post-LVAD: 654±437 versus 323±164 pg/mL). BP increased during cardiopulmonary exercise testing post-LVAD, but the magnitude of change was modest and comparable to the changes observed during the pre-LVAD cardiopulmonary exercise testing. CONCLUSIONS Among patients with advanced heart failure with reduced ejection fraction, CF-LVAD implantation is associated with modest improvements in autonomic tone, but persistent reductions in cardiac baroreceptor sensitivity. Exercise-induced increases in BP are blunted. These findings shed new light on mechanisms for adverse events such as stroke, and persistent reductions in functional capacity, among patients supported by CF-LVADs. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03078972.
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Affiliation(s)
- Christine Sailer
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | | | - Cullen Buchanan
- Department of Medicine (C.B., P.G.), University of Colorado Anschutz Medical Campus, Aurora
| | - Pedro Giro
- Department of Medicine (C.B., P.G.), University of Colorado Anschutz Medical Campus, Aurora
| | - Matthew Babcock
- Division of Geriatric Medicine, Department of Medicine (M.B., W.K.), University of Colorado Anschutz Medical Campus, Aurora
| | - Christine Swanson
- Department of Medicine-Endocrinology, Metabolism and Diabetes (C.S.), University of Colorado Anschutz Medical Campus, Aurora
| | - Melanie Spotts
- Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Margaret Schulte
- Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Ashley Pratt-Cordova
- Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Greg Coe
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Mark Beindorff
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Robert L Page
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Services, Aurora (R.L.P.)
| | - Amrut V Ambardekar
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Jay D Pal
- Department of Cardiothoracic Surgery (J.D.P.), University of Colorado Anschutz Medical Campus, Aurora
| | - Wendy Kohrt
- Division of Geriatric Medicine, Department of Medicine (M.B., W.K.), University of Colorado Anschutz Medical Campus, Aurora.,Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Eugene Wolfel
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
| | - Justin S Lawley
- Department of Sport Science, University of Innsbruck, Austria (J.S.L.)
| | - Takashi Tarumi
- Human Informatics Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki prefecture, Japan (T.T.)
| | - William K Cornwell
- Department of Medicine-Cardiology (C.S., G.C., M.B., A.V.A., E.W., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora.,Clinical and Translational Research Center (M. Spotts, M. Schulte, A.P.-C., W.K., W.K.C.), University of Colorado Anschutz Medical Campus, Aurora
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22
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Matias LAS, Mariano IM, Batista JP, de Souza TCF, Amaral AL, Dechichi JGC, de Lima Rodrigues M, Carrijo VHV, Cunha TM, Puga GM. Acute and chronic effects of combined exercise on ambulatory blood pressure and its variability in hypertensive postmenopausal women. CHINESE J PHYSIOL 2020; 63:227-234. [PMID: 33109789 DOI: 10.4103/cjp.cjp_61_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The aim of this study was to investigate the acute and chronic effects, and their correlation, after combined aerobic and resistance exercises in blood pressure (BP) and its variability (BPV) in hypertensive postmenopausal women. Fourteen hypertensive postmenopausal women monitored BP at rest and during 24 h by ambulatory BP monitoring in a control day without exercise performance a pretraining (baseline), after an acute exercise session (acute), and after a chronic exercise training for 10 weeks (chronic). After exercise training, systolic BP (SBP, Δ = -150 mmHg.24 h), diastolic BP (DBP, Δ = -96 mmHg.24 h), and mean BP (MBP, Δ = -95 mmHg.24 h) area under the curve were smaller than baseline measurements (P < 0.05) with no difference between acute and baseline measurements. The SBP (ΔSD24 = -2, ΔSDdn = -1.7, and ΔARV24 = -1.9 mmHg), DBP (ΔSD24 = -0.9, ΔSDdn = -0.8, and ΔARV24 = -0.9 mmHg), and MBP (ΔSD24 = -1.5, ΔSDdn = -1.3, and ΔARV24 = -1.2 mmHg) variability reduced in acute session in relation to baseline, with no chronic effects. There are moderate correlations between acute and chronic responses in wake SBP, sleep DBP, and SD24. In conclusion, combined exercise reduces ambulatory BP chronically but not acutely. In contrast, BPV decreases after an acute session but not chronically. Awake SBP, sleep DBP, and SD24indices are promising candidates to predict individual cardiovascular responses to exercise.
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Affiliation(s)
- Larissa Aparecida Santos Matias
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Igor Moraes Mariano
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Jaqueline Pontes Batista
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Tállita Cristina Ferreira de Souza
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Ana Luiza Amaral
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Juliene Gonçalves Costa Dechichi
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Mateus de Lima Rodrigues
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Victor Hugo Vilarinho Carrijo
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Thulio Marquez Cunha
- Department of Pneumology, School of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Guilherme Morais Puga
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education Department, Federal University of Uberlândia, Uberlândia, MG, Brazil
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23
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Hoffmann F, Rabineau J, Mehrkens D, Gerlach DA, Moestl S, Johannes BW, Caiani EG, Migeotte PF, Jordan J, Tank J. Cardiac adaptations to 60 day head-down-tilt bed rest deconditioning. Findings from the AGBRESA study. ESC Heart Fail 2020; 8:729-744. [PMID: 33191629 PMCID: PMC7835618 DOI: 10.1002/ehf2.13103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
Aims Reduced physical activity increases the risk of heart failure; however, non‐invasive methodologies detecting subclinical changes in myocardial function are not available. We hypothesized that myocardial, left ventricular, systolic strain measurements could capture subtle abnormalities in myocardial function secondary to physical inactivity. Methods and results In the AGBRESA study, which assessed artificial gravity through centrifugation as potential countermeasure for space travel, 24 healthy persons (eight women) were submitted to 60 day strict −6° head‐down‐tilt bed rest. Participants were assigned to three groups of eight subjects: a control group, continuous artificial gravity training on a short‐arm centrifuge (30 min/day), or intermittent centrifugation (6 × 5 min/day). We assessed cardiac morphology, function, strain, and haemodynamics by cardiac magnetic resonance imaging (MRI) and echocardiography. We observed no differences between groups and, therefore, conducted a pooled analysis. Consistent with deconditioning, resting heart rate (∆8.3 ± 6.3 b.p.m., P < 0.0001), orthostatic heart rate responses (∆22.8 ± 19.7 b.p.m., P < 0.0001), and diastolic blood pressure (∆8.8 ± 6.6 mmHg, P < 0.0001) increased, whereas cardiac output (∆−0.56 ± 0.94 L/min, P = 0.0096) decreased during bed rest. Left ventricular mass index obtained by MRI did not change. Echocardiographic left ventricular, systolic, global longitudinal strain (∆1.8 ± 1.83%, P < 0.0001) decreased, whereas left ventricular, systolic, global MRI circumferential strain increased not significantly (∆−0.68 ± 1.85%, P = 0.0843). MRI values rapidly returned to baseline during recovery. Conclusion Prolonged head‐down‐tilt bed rest provokes changes in cardiac function, particularly strain measurements, that appear functional rather than mediated through cardiac remodelling. Thus, strain measurements are of limited utility in assessing influences of physical deconditioning or exercise interventions on cardiac function.
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Affiliation(s)
- Fabian Hoffmann
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany.,Department of Internal Medicine III, University of Cologne, Cologne, Germany
| | | | - Dennis Mehrkens
- Department of Internal Medicine III, University of Cologne, Cologne, Germany
| | - Darius A Gerlach
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Stefan Moestl
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Bernd W Johannes
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Enrico G Caiani
- Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy.,Consiglio Nazionale delle Ricerche, Institute of Electronics and Information and Telecommunication Engineering, Milan, Italy
| | | | - Jens Jordan
- Head of the Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
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24
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Dechichi JGC, Mariano IM, Giolo JS, Batista JP, Amaral AL, Ribeiro PAB, de Oliveira EP, Puga GM. Isoflavone Supplementation Does Not Potentiate the Effect of Combined Exercise Training on Resting and Ambulatory Blood Pressure in Non-Obese Postmenopausal Women: A Randomized Double-Blind Controlled Trial-A Pilot Study. Nutrients 2020; 12:nu12113495. [PMID: 33203003 PMCID: PMC7697944 DOI: 10.3390/nu12113495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
Physical exercise and isoflavone supplementation are potential strategies to prevent and treat cardiovascular diseases in postmenopausal women. The aim of this study was to investigate whether there are additive effects of isoflavone supplementation when associated with combined aerobic and resistance exercise on resting and ambulatory blood pressure monitoring (ABPM) and in blood pressure variability (BPV). Thirty-one non-obese postmenopausal women were randomly allocated into two groups: placebo and exercise (Placebo n = 19); and isoflavone supplementation (100 mg/day) and exercise (isoflavone n = 19). ABPM and BPV were evaluated before and after 10 weeks of moderate combined (aerobic and resistance) exercise training. Generalized Estimating Equation (GEE) with Bonferroni correction and intention-to-treat analysis was used to compare the effects of interventions on resting BP, ABPM and BPV. Combined exercise training decreased resting systolic (SBP) and diastolic blood pressure (DBP) and reduced 24 h and awake ambulatory SBP, DBP and mean blood pressure over time, with no additional effects of isoflavone supplementation. No changes were observed in sleep period, or in BPV indexes (Standard Deviation of 24 h (SD), daytime and nighttime interval (SDdn) and average real variability (ARV) in both groups. We conclude that isoflavone supplementation does not potentiate the effects of combined training on resting and ambulatorial systolic and diastolic blood pressure in non-obese postmenopausal women.
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Affiliation(s)
- Juliene G. C. Dechichi
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
| | - Igor M. Mariano
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
| | - Jéssica S. Giolo
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
| | - Jaqueline P. Batista
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
| | - Ana Luiza Amaral
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
| | - Paula A. B. Ribeiro
- Research Center of University of Montreal Hospital Centre, Montreal, QC H2X 0A9, Canada;
| | - Erick P. de Oliveira
- Laboratory of Nutrition, Exercise and Health (LaNES), School of Medicine, Federal University of Uberlandia (UFU), 38402-022 Uberlândia, MG, Brazil;
| | - Guilherme M. Puga
- Laboratory of Cardiorespiratory and Metabolic Physiology, Physical Education and Physical Therapy Department, Federal University of Uberlândia, 38400-678 Uberlândia, MG, Brazil; (J.G.C.D.); (I.M.M.); (J.S.G.); (J.P.B.); (A.L.A.)
- Correspondence: ; Tel.: +55-343218-2965
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25
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Tarumi T, Rossetti H, Thomas BP, Harris T, Tseng BY, Turner M, Wang C, German Z, Martin-Cook K, Stowe AM, Womack KB, Mathews D, Kerwin DR, Hynan L, Diaz-Arrastia R, Lu H, Cullum CM, Zhang R. Exercise Training in Amnestic Mild Cognitive Impairment: A One-Year Randomized Controlled Trial. J Alzheimers Dis 2020; 71:421-433. [PMID: 31403944 DOI: 10.3233/jad-181175] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The current evidence is inconclusive to support the benefits of aerobic exercise training (AET) for preventing neurocognitive decline in patients with amnestic mild cognitive impairment (aMCI). OBJECTIVE To examine the effect of a progressive, moderate-to-high intensity AET program on memory and executive function, brain volume, and cortical amyloid-β (Aβ) plaque deposition in aMCI patients. METHODS This is a proof-of-concept trial that randomized 70 aMCI patients to 12 months of AET or stretching and toning (SAT, active control) interventions. Primary neuropsychological outcomes were assessed by using the California Verbal Learning Test-second edition (CVLT-II) and the Delis-Kaplan Executive Function System (D-KEFS). Secondary outcomes were the global and hippocampal brain volumes and the mean cortical and precuneus Aβ deposition. RESULTS Baseline cognitive scores were similar between the groups. Memory and executive function performance improved over time but did not differ between the AET and SAT groups. Brain volume decreased and precuneus Aβ plaque deposition increased over time but did not differ between the groups. Cardiorespiratory fitness was significantly improved in the AET compared with SAT group. In amyloid positive patients, AET was associated with reduced hippocampal atrophy when compared with the SAT group. CONCLUSION The AET and SAT groups both showed evidence of slightly improved neuropsychological scores in previously sedentary aMCI patients. However, these interventions did not prevent brain atrophy or increases in cortical Aβ deposition over 12 months. In amyloid positive patients, AET reduced hippocampal atrophy when compared with the SAT group.
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Affiliation(s)
- Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Heidi Rossetti
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Binu P Thomas
- Departments of Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Harris
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin Y Tseng
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX, USA
| | - Marcel Turner
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Ciwen Wang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Zohre German
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristin Martin-Cook
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ann M Stowe
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kyle B Womack
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dana Mathews
- Departments of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Diana R Kerwin
- Institute for Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Linda Hynan
- Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ramon Diaz-Arrastia
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- Departments of Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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26
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Moreira JBN, Wohlwend M, Wisløff U. Exercise and cardiac health: physiological and molecular insights. Nat Metab 2020; 2:829-839. [PMID: 32807982 DOI: 10.1038/s42255-020-0262-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
The cardiac benefits of exercise have been recognized for centuries. Studies have undisputedly shown that regular exercise is beneficial for the cardiovascular system in young, old, healthy and diseased populations. For these reasons, physical activity has been recommended worldwide for cardiovascular disease prevention and treatment. Although the benefits of exercise are clear, understanding of the molecular triggers that orchestrate these effects remains incomplete and has been a topic of intense research in recent years. Here, we provide a comprehensive review of the cardiac effects of physical activity, beginning with a brief history of exercise in cardiovascular medicine and then discussing seminal work on the physiological effects of exercise in healthy, diseased and aged hearts. Later, we revisit pioneering work on the molecular mechanisms underlying the cardiac benefits of exercise, and we conclude with our view on the translational potential of this knowledge as a powerful platform for cardiovascular disease drug discovery.
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Affiliation(s)
- Jose B N Moreira
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Martin Wohlwend
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
- School of Human Movement & Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.
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27
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Iellamo F, Lucini D, Volterrani M, Casasco M, Salvati A, Gianfelici A, Di Gianfrancesco A, Urso A, Manzi V. Autonomic nervous system responses to strength training in top-level weight lifters. Physiol Rep 2020; 7:e14233. [PMID: 31642195 PMCID: PMC6805848 DOI: 10.14814/phy2.14233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/10/2019] [Accepted: 07/24/2019] [Indexed: 11/24/2022] Open
Abstract
In athletes, spectral analysis of HR variability (HRV) has been shown capable to detect the adaptational changes in sympatho‐vagal control attending physical training. So far, studies investigated autonomic nervous system (ANS) changes occurring with endurance training, whereas adaptations to markedly different exercise modes, for example, strength training, have never been investigated. We assessed the changes in cardiac ANS parameters during long‐term training in weight lifters of the Italian team preparing for the European Championship, where athletes competed for obtaining the pass for Olympic Games. We investigated nine athletes. Subject trained 3 sessions/day, 6 days a week. The intensity of strength exercises varied from 70% to 95% 1 RM. Training load (TL) was calculated as: volume (min) × intensity (%1RM).All ANS parameters were significantly and highly correlated on an individual basis to the dose of exercise with a second‐order regression model (r2 ranged from 0.96 to 0.99; P < 0.001). The low‐frequency (LF) component of HRV and LF/HF ratio showed an initial increase with the progression of TL and then a decrease, resembling a bell‐shaped curve with a minimum at the highest TL. The high‐frequency (HF) component of HRV and R‐R interval showed a reciprocal pattern, with an initial decrease with progression of TL followed by an increase, resembling an U‐shaped curve with a maximum at the highest TL. These adaptations were at the opposite to those previously reported in endurance athletes. These results suggest that in Olympic weight lifters, ANS adaptations to training are dose‐related on individual basis and that ANS adaptations are mainly sport‐specific.
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Affiliation(s)
- Ferdinando Iellamo
- Department of Clinical Science and Translational Medicine and School of Sports Medicine, University Tor Vergata, Rome, Italy.,Scientific Institute of Research and Scientific Institute of Research and Care Care, San Raffaele Pisana, Rome, Italy
| | - Daniela Lucini
- BIOMETRA, Exercise Medicine Unit, University of Milan, Humanitas, Milan, Italy
| | - Maurizio Volterrani
- Scientific Institute of Research and Scientific Institute of Research and Care Care, San Raffaele Pisana, Rome, Italy
| | | | | | - Antonio Gianfelici
- Italian Federation of Sport Medicine, Rome, Italy.,Italian Federation of weight lifting, Rome, Italy
| | | | - Antonio Urso
- Italian Federation of weight lifting, Rome, Italy
| | - Vincenzo Manzi
- Scientific Institute of Research and Scientific Institute of Research and Care Care, San Raffaele Pisana, Rome, Italy
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28
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Ambulatory blood pressure variability and combined exercise training: comparison between hypertensive and normotensive postmenopausal women. Blood Press Monit 2020; 25:338-345. [PMID: 32815922 DOI: 10.1097/mbp.0000000000000480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of the study was to verify the effects of moderate combined aerobic and resistance exercises training in ambulatory blood pressure (ABPM) and its variability in hypertensive and normotensive postmenopausal women. METHODS Twenty-six participants were divided into two groups: hypertensive (HT = 13) and normotensive (NT = 13). They performed 30 sessions of combined exercises (aerobic and resistance exercises at same session) over 10 weeks. We evaluated: resting BP and 24-h ABPM with systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR). To evaluate blood pressure variability (BPV), the following were considered: 24-h SD (SD24), the mean diurnal and nocturnal deviations (SDdn), average real variability (ARV24). RESULTS The two-way analysis of variance showed no difference in ABPM nor BPV responses after training between groups. Both HT and NT groups had similar BP reductions in 24-h DBP (P < 0.01; ΔNT = -3.1 ± 1.1, ΔHT = -1.8 ± 1.2 mmHg), 24-h area under the curve of DBP (P = 0.01; ΔNT = -73±105, ΔHT = -44 ± 115 mmHg), and wake DBP (P < 0.01; ΔNT = -3.4 ± 1.2, ΔHT = -1.8 ± 1.3 mmHg), without differences in BPV responses. Moreover, HT women had higher overall SBP SDdn (P = 0.01), SBP ARV (P = 0.02), and MBP ARV (P < 0.01) than NT women. CONCLUSION Ten-week combined exercise training resulted in similar BP reductions in hypertensive and normotensive postmenopausal women, but not in BPV responses.
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29
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Benchimol-Barbosa PR, Nasario Junior O, Nadal J. Assessing Dynamic Atrioventricular Conduction Time to RR-interval Coupling in Athletes and Sedentary Subjects. Arq Bras Cardiol 2020; 115:71-77. [PMID: 32401843 PMCID: PMC8384324 DOI: 10.36660/abc.20190281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/01/2019] [Indexed: 11/18/2022] Open
Abstract
Background Atrioventricular conduction time ( AVCT ) is influenced by autonomic input and subject to physiological remodeling. Objective To evaluate beat-by-beat AVCT and RR-interval variability in athletes and healthy sedentary subjects. Methods Twenty adults, including 10 healthy sedentary (Controls) and 10 elite long-distance runners (Athletes), age, weight and height-adjusted, underwent maximal metabolic equivalent (MET) assessment, and 15-min supine resting ECG recording seven days later. The interval between P-wave and R-wave peaks defined the AVCT . Mean (M) and standard deviation (SD) of consecutive RR-intervals (RR) and coupled AVCT were calculated, as well as regression lines of RR vs. AVCT (RR-AVCT) . Concordant AV conduction was defined as positive RR-AVCT slope and discordant otherwise. A multivariate linear regression model was developed to explain MET based on AVCT and RR-interval variability parameters. Significance-level: 5 %. Results In Athletes, M-RR and SD-RR values were higher than in Controls, whereas M-AVCT and SD-AVCT were not. RR-AVCT slopes were, respectively, 0.038 ± 0.022 and 0.0034 ± 0.017 (p < 0.05). Using a cut-off value of 0.0044 (AUC 0.92 ± 0.07; p < 0.001), RR-AVCT slope showed 100% specificity and 80% sensitivity. In a multivariate model, SD-RR and RR-AVCT slope were independent explanatory variables of MET (F-ratio: 17.2; p < 0.001), showing 100% specificity and 90% sensitivity (AUC 0.99 ± 0.02; p < 0.001). Conclusion In elite runners, AVCT to RR -interval dynamic coupling shows spontaneous discordant AV conduction, characterized by negative AVCT vs. RR -interval regression line slope. RR -intervals standard deviation and AVCT vs. RR -interval regression line slope are independent explanatory variables of MET (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
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Affiliation(s)
| | - Olivassé Nasario Junior
- Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Jurandir Nadal
- Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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30
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Maffetone P, Laursen PB. Maximum Aerobic Function: Clinical Relevance, Physiological Underpinnings, and Practical Application. Front Physiol 2020; 11:296. [PMID: 32300310 PMCID: PMC7142223 DOI: 10.3389/fphys.2020.00296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/16/2020] [Indexed: 11/13/2022] Open
Abstract
The earliest humans relied on large quantities of metabolic energy from the oxidation of fatty acids to develop larger brains and bodies, prevent and reduce disease risk, extend longevity, in addition to other benefits. This was enabled through the consumption of a high fat and low-carbohydrate diet (LCD). Increased fat oxidation also supported daily bouts of prolonged, low-intensity, aerobic-based physical activity. Over the past 40-plus years, a clinical program has been developed to help people manage their lifestyles to promote increased fat oxidation as a means to improve various aspects of health and fitness that include reducing excess body fat, preventing disease, and optimizing human performance. This program is referred to as maximum aerobic function, and includes the practical application of a personalized exercise heart rate (HR) formula of low-to-moderate intensity associated with maximal fat oxidation (MFO), and without the need for laboratory evaluations. The relationship between exercise training at this HR and associated laboratory measures of MFO, health outcomes and athletic performance must be verified scientifically.
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Affiliation(s)
- Philip Maffetone
- Independent Researcher, Ormond Beach, FL, United States.,Auckland University of Technology, Auckland, New Zealand
| | - Paul B Laursen
- Auckland University of Technology, Auckland, New Zealand
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31
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Kramer A. An Overview of the Beneficial Effects of Exercise on Health and Performance. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:3-22. [PMID: 32342447 DOI: 10.1007/978-981-15-1792-1_1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Life expectancy is steadily increasing in modern societies, and so are noncommunicable diseases such as cardiovascular diseases, diabetes, obesity, and cancer, accounting for more than 70% of all deaths globally. The costs associated with these diseases are enormous, but it has been estimated that the majority of these noncommunicable diseases are preventable. In addition to an unhealthy diet, tobacco use, and harmful use of alcohol, physical inactivity is a key risk factor. Consequently, physical activity is a logical remedy, and in this chapter an overview of the numerous beneficial effects of physical activity on health and performance is given.The chapter is divided into three parts: First, the basics of physical activity and exercise are discussed, for instance exercise classification, exercise intensity operationalization, energy supply, and the acute effects of exercise such as blood flow redistribution and increased cardiac output. In the second part, the effects of exercise on physical performance are summarized. Specifically, it is discussed how endurance, strength, power, and balance can be improved. This discussion includes recommendations regarding the type, intensity, and duration of the exercise leading to improvements in one of these aspects of physical performance, as well as the mechanisms causing these adaptations. In the third part, the beneficial effects of physical activity on physical and mental health are outlined, with particular attention to cardiovascular diseases, the metabolic syndrome, musculoskeletal diseases, mood, anxiety, depression, and dementia.It can be concluded that with adequate programming, regular physical activity is an effective way to improve physical performance, improve physical and mental health, and reduce the risk factors for many noncommunicable diseases such as cardiovascular diseases, metabolic syndrome, sarcopenia, osteoporosis, and depression. In contrast to medication, physical exercise has no negative side effects, costs very little, and targets many health issues at once. If the multitude of beneficial effects of regular exercise were to be combined in a single low-cost drug, it would be prescribed for almost all types of physical and mental health issues.
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Affiliation(s)
- Andreas Kramer
- Sensorimotor Performance Lab, Department of Sport Science, University of Konstanz, Konstanz, Germany.
- FG Sports Science, University of Konstanz, Konstanz, Germany.
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Thomas BP, Tarumi T, Sheng M, Tseng B, Womack KB, Cullum CM, Rypma B, Zhang R, Lu H. Brain Perfusion Change in Patients with Mild Cognitive Impairment After 12 Months of Aerobic Exercise Training. J Alzheimers Dis 2020; 75:617-631. [PMID: 32310162 PMCID: PMC8062932 DOI: 10.3233/jad-190977] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aerobic exercise (AE) has recently received increasing attention in the prevention of Alzheimer's disease (AD). There is some evidence that it can improve neurocognitive function in elderly individuals. However, the mechanism of these improvements is not completely understood. In this prospective clinical trial, thirty amnestic mild cognitive impairment participants were enrolled into two groups and underwent 12 months of intervention. One group (n = 15) performed AE training (8M/7F, age = 66.4 years), whereas the other (n = 15) performed stretch training (8M/7F, age = 66.1 years) as a control intervention. Both groups performed 25-30 minutes training, 3 times per week. Frequency and duration were gradually increased over time. Twelve-month AE training improved cardiorespiratory fitness (p = 0.04) and memory function (p = 0.004). Cerebral blood flow (CBF) was measured at pre- and post-training using pseudo-continuous-arterial-spin-labeling MRI. Relative to the stretch group, the AE group displayed a training-related increase in CBF in the anterior cingulate cortex (p = 0.016). Furthermore, across individuals, the extent of memory improvement was associated with CBF increases in anterior cingulate cortex and adjacent prefrontal cortex (voxel-wise p < 0.05). In contrast, AE resulted in a decrease in CBF of the posterior cingulate cortex, when compared to the stretch group (p = 0.01). These results suggest that salutary effects of AE in AD may be mediated by redistribution of blood flow and neural activity in AD-sensitive regions of brain.
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Affiliation(s)
- Binu P. Thomas
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Min Sheng
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Benjamin Tseng
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Kyle B. Womack
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C. Munro Cullum
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bart Rypma
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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McNamara DA, Aiad N, Howden E, Hieda M, Link MS, Palmer D, Samels M, Everding B, Ng J, Adams-Huet B, Opondo M, Sarma S, Levine BD. Left Atrial Electromechanical Remodeling Following 2 Years of High-Intensity Exercise Training in Sedentary Middle-Aged Adults. Circulation 2019; 139:1507-1516. [PMID: 30586729 DOI: 10.1161/circulationaha.118.037615] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Moderate intensity exercise is associated with a decreased incidence of atrial fibrillation. However, extensive training in competitive athletes is associated with an increased atrial fibrillation risk. We evaluated the effects of 24 months of high intensity exercise training on left atrial (LA) mechanical and electric remodeling in sedentary, healthy middle-aged adults. METHODS Sixty-one participants (53±5 years) were randomized to 10 months of exercise training followed by 14 months of maintenance exercise or stretching/balance control. Fourteen Masters athletes were added for comparison. Left ventricular (LV) and LA volumes underwent 3D echocardiographic assessment, and signal-averaged electrocardiographs for filtered P-wave duration and atrial late potentials were completed at 0, 10, and 24 months. Extended ambulatory monitoring was performed at 0 and 24 months. Within and between group differences from baseline were compared using mixed-effects model repeated-measures analysis. RESULTS Fifty-three participants completed the study (25 control, 28 exercise) with 88±11% adherence to assigned exercise sessions. In the exercise group, both LA and LV end diastolic volumes increased proportionately (19% and 17%, respectively) after 10 months of training (peak training load). However, only LA volumes continued to increase with an additional 14 months of exercise training (LA volumes 55%; LV end diastolic volumes 15% at 24 months versus baseline; P<0.0001 for all). The LA:LV end diastolic volumes ratio did not change from baseline to 10 months, but increased 31% from baseline in the Ex group ( P<0.0001) at 24 months, without a change in controls. There were no between group differences in the LA ejection fraction, filtered P-wave duration, atrial late potentials, and premature atrial contraction burden at 24 months and no atrial fibrillation was detected. Compared with Masters athletes, the exercise group demonstrated lower absolute LA and LV volumes, but had a similar LA:LV ratio after 24 months of training. CONCLUSIONS Twenty-four months of high intensity exercise training resulted in LA greater than LV mechanical remodeling with no observed electric remodeling. Together, these data suggest different thresholds for electrophysiological and mechanical changes may exist in response to exercise training, and provide evidence supporting a potential mechanism by which high intensity exercise training leads to atrial fibrillation. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov . Unique identifier: NCT02039154.
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Affiliation(s)
- David A McNamara
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.A.M., N.A., M.S.L., S.S., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Norman Aiad
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.A.M., N.A., M.S.L., S.S., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Erin Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Michinari Hieda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Mark S Link
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.A.M., N.A., M.S.L., S.S., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Dean Palmer
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Jason Ng
- University of Illinois at Chicago School of Medicine (J.N.)
| | - Beverley Adams-Huet
- Division of Biostatistics, Department of Clinical Sciences and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (B.A.-H.)
| | - Mildred Opondo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.).,Stanford University School of Medicine, CA (M.O.)
| | - Satyam Sarma
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.A.M., N.A., M.S.L., S.S., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
| | - Benjamin D Levine
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.A.M., N.A., M.S.L., S.S., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (D.A.M., N.A., E.H., M.H., M.S.L., D.P., M.S., B.E., M.O., S.S., B.D.L.)
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The blood pressure variability and baroreflex sensitivity in healthy participants are not determined by sex or cardiorespiratory fitness. Blood Press Monit 2019; 23:260-270. [PMID: 29994926 DOI: 10.1097/mbp.0000000000000338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Heart rate (HR) and blood pressure (BP) autonomic modulation and baroreflex sensitivity (BRS) are important indexes of cardiovascular homeostasis. However, methodological errors are often observed, such as joint analysis of men and women. Another important aspect is that we still do not know whether cardiorespiratory fitness influences these autonomic parameters in healthy individuals. OBJECTIVES This study aimed to investigate whether sex can affect BRS, autonomic modulation of HR and BP variabilities (HRV and BPV, respectively), as well as the influence of cardiorespiratory fitness on these autonomic parameters. METHODS Healthy men and women (N=120) were assigned to groups according to the peak oxygen consumption (VO2 peak) obtained in the cardiorespiratory test: low cardiorespiratory fitness (VO2 peak: 22-38 ml/kg/min), moderate cardiorespiratory fitness (VO2 peak: 38-48 ml/kg/min), and high cardiorespiratory fitness (VO2 peak>48 ml/kg/min). HRV and BPV evaluations were performed for all groups in the frequency domain by spectral analysis. Spontaneous BRS was assessed using the sequence method. RESULTS Women presented lower BP values compared with men. HR did not differ between sexes, but showed an inverse relationship with cardiorespiratory performance. The HRV analysis showed greater sympathetic modulation for men and greater vagal modulation for women. Men and women presented similar results for systolic BPV and BRS, and cardiorespiratory performance did not influence any of the autonomic parameters evaluated. CONCLUSION Cardiorespiratory fitness does not interfere with HRV and BPV autonomic modulation or BRS. However, the cardiac modulatory balance differs between sexes, with a greater influence of the autonomic vagal component in women and the sympathetic component in men.
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Subramanian SK, Sharma VK, Arunachalam V, Rajendran R, Gaur A. Comparison of Baroreflex Sensitivity and Cardiac Autonomic Function Between Adolescent Athlete and Non-athlete Boys - A Cross-Sectional Study. Front Physiol 2019; 10:1043. [PMID: 31507430 PMCID: PMC6713997 DOI: 10.3389/fphys.2019.01043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/30/2019] [Indexed: 01/24/2023] Open
Abstract
Introduction: It is well known that regular physical activity improves cardiovascular health, and higher baroreflex sensitivity and heart rate variability are associated with cardiovascular health. Adolescence is the age when an individual's behavior is easily modified; early intervention at this stage in terms of physical conditioning or training prevents future cardiovascular risk. Hence, we conceived the present study to assess and compare the baroreflex sensitivity and autonomic function between adolescent athletes and non-athletes. Methods: We recruited school going athletes (n = 30) and non-athlete boys (n = 30) in the 10-19 age group after obtaining their assent and consent from their parents. We assessed height, weight, heart rate, blood pressure, baroreflex sensitivity, and cardiac autonomic function. Comparison between groups was made using the unpaired t-test for height, weight, body mass index, heart rate, blood pressure, and baroreflex sensitivity and using Mann-Whitney U test for cardiac autonomic function parameters. Results: There was a trend for higher baroreflex sensitivity in athletes. Heart rate variability (total power and SDNN) was higher in athletes. The parasympathetic tone was higher in terms of higher RMSSD, and higher HF power. Parasympathetic reactivity was higher in athletes in terms of higher 30:15 ratio and EI ratio. Conclusion: Athletic level physical conditioning has a positive influence on baroreflex function and autonomic function that may prove beneficial to the adolescents' cardiovascular health.
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Affiliation(s)
- Senthil Kumar Subramanian
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Vijayawada, India
| | - Vivek Kumar Sharma
- Department of Physiology, Government Institute of Medical Sciences, Greater Noida, India
| | | | - Rajathi Rajendran
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Archana Gaur
- Department of Physiology, Chengalpattu Medical College, Chengalpattu, India
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Opondo MA, Aiad N, Cain MA, Sarma S, Howden E, Stoller DA, Ng J, van Rijckevorsel P, Hieda M, Tarumi T, Palmer MD, Levine BD. Does High-Intensity Endurance Training Increase the Risk of Atrial Fibrillation? A Longitudinal Study of Left Atrial Structure and Function. Circ Arrhythm Electrophysiol 2019; 11:e005598. [PMID: 29748195 DOI: 10.1161/circep.117.005598] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 03/12/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exercise mitigates many cardiovascular risk factors associated with atrial fibrillation. Endurance training has been associated with atrial structural changes which can increase the risk for atrial fibrillation. The dose of exercise training required for these changes is uncertain. We sought to evaluate the impact of exercise on left atrial (LA) mechanical and electrical function in healthy, sedentary, middle-aged adults. METHODS Sixty-one adults (52±5 years) were randomized to either 10 months of high-intensity exercise training or yoga. At baseline and post-training, all participants underwent maximal exercise stress testing to assess cardiorespiratory fitness, P-wave signal-averaged electrocardiography for filtered P-wave duration and atrial late potentials (root mean square voltage of the last 20 ms), and echocardiography for LA volume, left ventricular end-diastolic volume, and mitral inflow for assessment of LA active emptying. Post-training data were compared with 14 healthy age-matched Masters athletes. RESULTS LA volume, Vo2 max, and left ventricular end-diastolic volume increased in the exercise group (15%, 17%, and 16%, respectively) with no change in control (P<0.0001). LA active emptying decreased post-exercise versus controls (5%; P=0.03). No significant changes in filtered P-wave duration or root mean square voltage of the last 20 ms occurred after exercise training. LA and left ventricular volumes remained below Masters athletes. The athletes had longer filtered P-wave duration but no difference in the frequency of atrial arrhythmia. CONCLUSIONS Changes in LA structure, LA mechanical function, and left ventricular remodeling occurred after 10 months of exercise but without significant change in atrial electrical activity. A longer duration of training may be required to induce electrical changes thought to cause atrial fibrillation in middle-aged endurance athletes. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique Identifier: NCT02039154.
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Affiliation(s)
- Mildred A Opondo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.).,Department of Cardiovascular Medicine, Stanford University School of Medicine, CA (M.A.O.)
| | - Norman Aiad
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Matthew A Cain
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Satyam Sarma
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Erin Howden
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Douglas A Stoller
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Jason Ng
- Department of Medicine, University of Illinois at Chicago (J.N.)
| | - Pieter van Rijckevorsel
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Michinari Hieda
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Takashi Tarumi
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.).,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - M Dean Palmer
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
| | - Benjamin D Levine
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas (N.A., M.A.C., S.S., E.H., D.A.S., M.H., T.T., B.D.L.). .,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (M.A.O., N.A., M.A.C., S.S., E.H., D.A.S., P.v.R., M.H., T.T., M.D.P., B.D.L.)
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Kiuchi MG, Chen S, Carnagarin R, Schlaich MP. New insights about post-exercise albuminuria in hypertensive patients. J Clin Hypertens (Greenwich) 2019; 21:1180-1182. [PMID: 31282605 DOI: 10.1111/jch.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Márcio Galindo Kiuchi
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Western Australia, Australia
| | - Shaojie Chen
- Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
| | - Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Western Australia, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Western Australia, Australia.,Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia.,Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Ferreira Junior A, Schamne JC, Altimari LR, Okano AH, Okuno NM. Effect of walk training combined with blood flow restriction on resting heart rate variability and resting blood pressure in middle-aged men. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900020005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Zaffalon Júnior JR, Viana AO, de Melo GEL, De Angelis K. The impact of sedentarism on heart rate variability (HRV) at rest and in response to mental stress in young women. Physiol Rep 2018; 6:e13873. [PMID: 30238692 PMCID: PMC6148327 DOI: 10.14814/phy2.13873] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/28/2018] [Indexed: 12/04/2022] Open
Abstract
Sedentarism is one of the main risk factors for the onset of cardiometabolic diseases. Some biomarkers, such as heart rate variability (HRV), have been largely studied and found to be involved in the genesis of the dysfunctions associated with sedentary behavior. However, comparatively few studies have focused on the female sex. The objective of this study was to analyze the hemodynamic, autonomic and quality of life parameters at rest and in response to mental stress of sedentary and physically active young women. A total of 96 women, 18-30 years of age, were divided into sedentary (SW = 48) and active (AW = 48) groups. Anthropometric, hemodynamic and quality of life parameters were evaluated and the R-R interval was recorded to quantify the cardiac autonomic modulation at rest and in response to the Stroop Color Test. The groups were similar in age, weight, height, body mass index, fat percentage, systolic and diastolic blood pressure values and glycemia. The physical health domain of quality of life was compromised in the SW group. The SW group presented higher heart rate, lower variance of RR interval and RMSSD and higher cardiac sympathovagal balance (LF/HF) both at rest and in response to the mental stress test. We concluded that sedentary lifestyle in women induces impairment in autonomic cardiac modulation at rest and in response to physiological stress, compromising the quality of life, even before altering any cardiovascular or metabolic clinical parameters, reinforcing the potential role of HRV as early marker of cardiovascular risk in this population.
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Affiliation(s)
| | | | | | - Kátia De Angelis
- Nove de Julho University (UNINOVE)São PauloSão PauloBrazil
- Federal University of São Paulo (UNIFESP)São PauloSão PauloBrazil
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Fu Q, Levine BD. Exercise and non-pharmacological treatment of POTS. Auton Neurosci 2018; 215:20-27. [PMID: 30001836 DOI: 10.1016/j.autneu.2018.07.001] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/29/2018] [Accepted: 07/01/2018] [Indexed: 12/11/2022]
Abstract
Recent research has demonstrated that cardiovascular deconditioning (i.e., cardiac atrophy and hypovolemia) contributes significantly to the Postural Orthostatic Tachycardia Syndrome (POTS) and its functional disability. Therefore, physical reconditioning with exercise training and volume expansion via increased salt and fluid intake should be initiated early in the course of treatment for patients with POTS if possible. The use of horizontal exercise (e.g., rowing, swimming, recumbent bike, etc.) at the beginning is a critical strategy, allowing patients to exercise while avoiding the upright posture that elicits their POTS symptoms. As patients become increasingly fit, the duration and intensity of exercise should be progressively increased, and upright exercise can be gradually added as tolerated. Supervised training is preferable to maximize functional capacity. Other non-pharmacological interventions, which include: 1) chronic volume expansion via sleeping in the head-up position; 2) reduction in venous pooling during orthostasis by lower body compression garments extending at least to the xiphoid or with an abdominal binder; and 3) physical countermeasure maneuvers, such as squeezing a rubber ball, leg crossing, muscle pumping, squatting, negative-pressure breathing, etc., may also be effective in preventing orthostatic intolerance and managing acute clinical symptoms in POTS patients. However, randomized clinical trials are needed to evaluate the efficacies of these non-pharmacological treatments of POTS.
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Affiliation(s)
- Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Herzig D, Asatryan B, Brugger N, Eser P, Wilhelm M. The Association Between Endurance Training and Heart Rate Variability: The Confounding Role of Heart Rate. Front Physiol 2018; 9:756. [PMID: 29971016 PMCID: PMC6018465 DOI: 10.3389/fphys.2018.00756] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 05/29/2018] [Indexed: 12/19/2022] Open
Abstract
Heart rate variability (HRV) is a widely used marker of cardiac autonomic nervous activity (CANA). Changes in HRV with exercise training have often been interpreted as increases in vagal activity. HRV is strongly associated with heart rate, which in turn, is associated with heart size. There is strong evidence from basic studies that lower heart rate in response to exercise training is caused by morphological and electrical remodeling of the heart. In a cross-sectional study in participants of a 10 mile race, we investigated the influence of endurance exercise on HRV parameters independently of heart size and heart rate. One-hundred-and-seventy-two runners (52 females and 120 males) ranging from novice runners with a first participation to an endurance event to highly trained runners, with up to 15 h of training per week, were included in the analysis. R-R intervals were recorded by electrocardiography over 24 h. Left ventricular end diastolic volume indexed to body surface area (LVEDVI) was assessed by transthoracic echocardiography and peak oxygen consumption (VO2peak) by cardiopulmonary exercise testing. Exercise was quantified by VO2peak, training volume, and race performance. HRV was determined during deep sleep. HRV markers of vagal activity were moderately associated with exercise variables (standardized β = 0.28-0.40, all p < 0.01). These associations disappeared when controlling for heart rate and LVEDVI. Due to the intrinsic association between heart rate and HRV, conclusions based on HRV parameters do not necessarily reflect differences in CANA. Based on current evidence, we discourage the use of HRV as a marker of CANA when measuring the effect of chronic exercise.
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Affiliation(s)
- David Herzig
- University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Lemos MDP, Mota GRD, Marocolo M, Sordi CCD, Chriguer RS, Barbosa Neto O. Exercise Training Attenuates Sympathetic Activity and Improves Morphometry of Splenic Arterioles in Spontaneously Hipertensive Rats. Arq Bras Cardiol 2018; 110:263-269. [PMID: 29694556 PMCID: PMC5898777 DOI: 10.5935/abc.20180053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/06/2017] [Indexed: 11/20/2022] Open
Abstract
Background Alterations in the structure of resistance vessels contribute to elevated
systemic vascular resistance in hypertension and are linked to sympathetic
hyperactivity and related lesions in target organs. Objective To assess the effects of exercise training on hemodynamic and autonomic
parameters, as well as splenic arteriolar damages in male Wistar Kyoto (WKY)
and Spontaneously Hypertensive Rats (SHR). Methods Normotensive sedentary (WKYS) and trained (WKYT) rats,
and hypertensive sedentary (SHRS) and trained (SHRT)
rats were included in this study. After 9 weeks of experimental protocol
(swimming training or sedentary control), arterial pressure (AP) and heart
rate (HR) were recorded in freely moving rats. We assessed the autonomic
control of the heart by sympathetic and vagal autonomic blockade.
Morphometric analyses of arterioles were performed in spleen tissues. The
statistical significance level was set at p < 0.05. Results Resting bradycardia was observed in both trained groups (WKYT:
328.0 ± 7.3 bpm; SHRT: 337.0 ± 5.2 bpm) compared
with their respective sedentary groups (WKYS: 353.2 ± 8.5
bpm; SHRS: 412.1 ± 10.4 bpm; p < 0.001). Exercise
training attenuated mean AP only in SHRT (125.9 ± 6.2
mmHg) vs. SHRS (182.5 ± 4.2 mmHg, p < 0.001). The
WKYT showed a higher vagal effect (∆HR: 79.0 ± 2.3
bpm) compared with WKYS (∆HR: 67.4 ± 1.7 bpm; p <
0.05). Chronic exercise decreased sympathetic effects on SHRT
(∆HR: -62.8 ± 2.8 bpm) in comparison with SHRS (∆HR: -99.8
± 9.2 bpm; p = 0.005). The wall thickness of splenic arterioles in
SHR was reduced by training (332.1 ± 16.0 µm2 in
SHRT vs. 502.7 ± 36.3 µm2 in
SHRS; p < 0.05). Conclusions Exercise training attenuates sympathetic activity and AP in SHR, which may be
contributing to the morphological improvement of the splenic arterioles.
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Affiliation(s)
| | | | - Moacir Marocolo
- Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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43
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DeLucia CM, De Asis RM, Bailey EF. Daily inspiratory muscle training lowers blood pressure and vascular resistance in healthy men and women. Exp Physiol 2018; 103:201-211. [PMID: 29178489 DOI: 10.1113/ep086641] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/21/2017] [Indexed: 01/14/2023]
Abstract
NEW FINDINGS What is the central question of this study? What impact does inspiratory muscle training have on systemic vascular resistance, cardiac output and baroreflex sensitivity in adult men and women? What is the main finding and its importance? Inspiratory muscle training exerts favorable effects on blood pressure, vascular resistance and perception of stress. This exercise format is well-tolerated and equally effective whether implemented in men or women. ABSTRACT Previous work has shown that inspiratory muscle training (IMT) lowers blood pressure after a mere 6 weeks, identifying IMT as a potential therapeutic intervention to prevent or treat hypertension. Here, we explore the effects of IMT on respiratory muscle strength and select cardiovascular parameters in recreationally active men and women. Subjects were randomly assigned to IMT (n = 12, 75% maximal inspiratory pressure) or sham training (n = 13, 15% maximal inspiratory pressure) groups and underwent a 6-week intervention comprising 30 breaths day-1 , 5 days week-1 . Pre- and post-training measures included maximal inspiratory pressure and resting measures of blood pressure, cardiac output, heart rate, spontaneous cardiac baroreflex sensitivity and systemic vascular resistance. We evaluated psychological and sleep status via administration of the Cohen-Hoberman inventory of physical symptoms and the Epworth sleepiness scale. Male and female subjects in the IMT group showed declines in systolic/diastolic blood pressures (-4.3/-3.9 mmHg, P < 0.025) and systemic vascular resistance (-3.5 mmHg min l-1 , P = 0.008) at week 6. There was no effect of IMT on cardiac output (P = 0.722), heart rate (P = 0.795) or spontaneous cardiac baroreflex sensitivity (P = 0.776). The IMT subjects also reported fewer stress-related symptoms (pre- versus post-training, 12.5 ± 8.5 versus 7.2 ± 9.7, P = 0.025). Based on these results, we suggest that a short course of IMT confers significant respiratory and cardiovascular improvements and parallel (modest) psychological benefits in healthy men and women.
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Affiliation(s)
- Claire M DeLucia
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Roxanne M De Asis
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - E Fiona Bailey
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, USA
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Bhati P, Bansal V, Moiz JA. Comparison of different volumes of high intensity interval training on cardiac autonomic function in sedentary young women. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2017-0073/ijamh-2017-0073.xml. [PMID: 28837421 DOI: 10.1515/ijamh-2017-0073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
Purpose The present study was conducted to compare the effects of low volume of high intensity interval training (LVHIIT) and high volume of high intensity interval training (HVHIIT) on heart rate variability (HRV) as a primary outcome measure, and on maximum oxygen consumption (VO2max), body composition, and lower limb muscle strength as secondary outcome measures, in sedentary young women. Methods Thirty-six participants were recruited in this study. The LVHIIT group (n = 17) performed one 4-min bout of treadmill running at 85%-95% maximum heart rate (HRmax), followed by 3 min of recovery by running at 70% HRmax, three times per week for 6 weeks. The HVHIIT group (n = 15) performed four times 4-min bouts of treadmill running at 85%-95% HRmax, interspersed with 3-min of recovery by running at 70% HRmax, 3 times per week for 6 weeks. All criterion measures were measured before and after training in both the groups. Results Due to attrition of four cases, data of 32 participants was used for analysis. A significant increase in high frequency (HF) power (p < 0.001) and decrease in the ratio of low frequency to high frequency power (LF/HF) ratio (p < 0.001) in HRV parameters, was observed post-HVHIIT, whereas, these variables did not change significantly (HF: p = 0.92, LF/HF ratio: p = 0.52) in LVHIIT group. Nevertheless, both the interventions proved equally effective in improving aerobic capacity (VO2max), body composition, and muscle strength. Conclusion The study results suggest that both LVHIIT and HVHIIT are equally effective in improving VO2max, body composition, and muscle strength, in sedentary young women. However, HVHIIT induces parasympathetic dominance as well, as measured by HRV.
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Affiliation(s)
- Pooja Bhati
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India
| | - Vishal Bansal
- Department of Physiology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi-110007,India, Phone: +91-11-27402406
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, India
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Ramos JS, Dalleck LC, Borrani F, Beetham KS, Mielke GI, Dias KA, Wallen MP, Keating SE, Fassett RG, Coombes JS. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: A randomised trial. Int J Cardiol 2017; 245:245-252. [PMID: 28747269 DOI: 10.1016/j.ijcard.2017.07.063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/24/2017] [Accepted: 07/18/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. METHODS Individuals with MetS (n=56) were randomised into the following 16-week training interventions: i) MICT (n=16, 30min at 60-70%HRpeak, 5×/week); ii) 4HIIT (n=19, 4×4min bouts at 85-95%HRpeak, interspersed with 3min of active recovery at 50-70%HRpeak, 3×/week); or iii) 1HIIT (n=21, 1×4min bout at 85-95%HRpeak, 3×/week). R-R interval recorded for 5min in a supine position at pre- and post-intervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, Alpha1, Alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group×time interaction effects were examined (ANCOVA) and Eta squared (η2) interaction effect sizes calculated. RESULTS While there were no significant between-group differences in CAF indices, there were small-to-medium group×time interaction effects on SDNN [F(2,52)=0.70, p=0.50, η2=0.02], RMSSD [F(2,52)=1.35, p=0.27, η2=0.03], HF power [F(2,52)=1.27, p=0.29, η2=0.03], SD1 [F(2,52)=0.47, p=0.63, η2=0.01], and SD2 [F(2,52)=0.41, p=0.67, η2=0.01]. The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN, +30%, +17%, 9%; RMSSD, +30%, +22%, -2%; HF power, +69%, +18%, +7%; SD1, +30%, +22%,-2%; SD2, +22%, +14%, 4%). CONCLUSIONS There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS.
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Affiliation(s)
- Joyce S Ramos
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia; Health and Exercise Science, Flinders University, South Australia, Australia
| | - Lance C Dalleck
- Recreation, Exercise, and Sport Science Department, Western State Colorado University, Gunnison, CO, United States
| | - Fabio Borrani
- Institut des Sciences du Sport de l'Universite de Lausanne (ISSUL), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kassia S Beetham
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Gregore Iven Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Katrin A Dias
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Matthew P Wallen
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Robert G Fassett
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
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46
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Kiuchi MG, Chen S. The effect of the physical activity on polymorphic premature ventricular complexes in chronic kidney disease. Kidney Res Clin Pract 2017; 36:167-174. [PMID: 28680824 PMCID: PMC5491163 DOI: 10.23876/j.krcp.2017.36.2.167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Polymorphic premature ventricular complexes (PVCs) are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Endurance exercise training clearly lowers sympathetic activity in sympatho-excitatory disease states and may be tolerated by patients with chronic kidney disease (CKD). METHODS We assessed 40 CKD patients with hypertension with polymorphic PVCs. Patients underwent a complete medical history and physical examination. We evaluated the effectiveness of β blocker only or β blocker + exercise during 12 months of follow-up regarding the changes of the numbers of PVCs and mean heart rate (HR) by 24-hour-Holter. RESULTS We observed in the β blocker group a significant decrease in the number of polymorphic PVCs from baseline 36,515 ± 3,518 to 3, 6, 9 and 12 months of follow-up, 28,314 ± 2,938, 23,709 ± 1,846, 22,564 ± 1,673, and 22,725 ± 1,415, respectively (P < 0.001). In the β blocker + exercise group a significant decrease in the number of polymorphic PVCs also occurred from baseline 36,091 ± 3,327 to 3, 6, 9 and 12 months of follow-up, 29,252 ± 3,211, 20,948 ± 2,386, 14,238 ± 3,338, and 6,225 ± 2,319, respectively (P < 0.001). Comparisons between the two groups at the same time point showed differences from the sixth month onwards: the 6th (Δ = -2,761, P = 0.045), 9th (Δ = -8,325, P < 0.001) and 12th (Δ = -16,500, P < 0.001) months. There was an improvement during the 12 months of follow-up vs. baseline, after the β blocker or β blocker + exercise in mean 24-hour HR Holter monitoring, creatinine values, eGFR, and ACR. CONCLUSION Polymorphic PVCs may be modifiable by physical activity in CKD patients with hypertension without structural heart disease.
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Affiliation(s)
- Márcio G Kiuchi
- Division of Cardiac Surgery and Artificial Cardiac Stimulation, Department of Medicine, Hospital e Clínica São Gonçalo, São Gonçalo, RJ, Brazil.,Division of Electrophysiology, Department of Cardiology, Hospital e Clínica São Gonçalo, São Gonçalo, RJ, Brazil
| | - Shaojie Chen
- Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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47
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Stebbings GK, Williams AG, Herbert AJ, Lockey SJ, Heffernan SM, Erskine RM, Morse CI, Day SH. TTN
genotype is associated with fascicle length and marathon running performance. Scand J Med Sci Sports 2017; 28:400-406. [DOI: 10.1111/sms.12927] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 01/10/2023]
Affiliation(s)
- G. K. Stebbings
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
| | - A. G. Williams
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
- Institute of Sport, Exercise and Health; University College London; London UK
| | - A. J. Herbert
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
| | - S. J. Lockey
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
- School of Medical Education; Newcastle University; Newcastle upon Tyne UK
| | - S. M. Heffernan
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
| | - R. M. Erskine
- Institute of Sport, Exercise and Health; University College London; London UK
- School of Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - C. I. Morse
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
| | - S. H. Day
- MMU Sports Genomics Laboratory; Department of Exercise and Sport Science; Manchester Metropolitan University; Crewe UK
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48
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Cohen-Holzer M, Sorek G, Schweizer M, Katz-Leurer M. The influence of a constraint and bimanual training program using a variety of modalities on endurance and on the cardiac autonomic regulation system of children with unilateral cerebral palsy: A self-control clinical trial. NeuroRehabilitation 2017; 41:119-126. [PMID: 28505992 DOI: 10.3233/nre-171463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An intensive hybrid program, combining constraint with bimanual training, improves upper extremity function as well as walking endurance of children with unilateral cerebral palsy (UCP). Endurance improvement may be associated with the cardiac autonomic regulation system (CARS) adaptation, known to be impaired among these children. OBJECTIVE To examine the influence of an intensive hybrid program on CARS, walking endurance and the correlation with upper extremity function of children with UCP. METHODS Twenty-four children aged 6-10 years with UCP participated in a hybrid program, 10 days, 6 hours per day. Data were collected pre-, post- and 3-months post-intervention. Main outcome measures included the Polar RS800CX for heart rate (HR) and heart rate variability (HRV) data, the 6-Minute Walk Test (6MWT) for endurance, and the Assisting Hand Assessment (AHA) and Jebsen-Taylor Test of Hand Function (JTTHF) for bimanual and unimanual function. RESULTS A significant reduction in HR and an increase in HRV at post- and 3-month post-intervention was noted (χ22= 8.3, p = 0.016) along with a significant increase in 6MWT with a median increase of 81 meters (χ22= 11.0, p = 0.004) at the same interval. A significant improvement was noted in unimanual and bimanual performance following the intervention. CONCLUSIONS An intensive hybrid program effectively improved CARS function as well as walking endurance and upper extremity function in children with UCP (213).
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Affiliation(s)
- Marilyn Cohen-Holzer
- Department of Occupational Therapy, Alyn Children's Hospital and Rehabilitation Center, Jerusalem, Israel
| | - Gilad Sorek
- Department of Physical Therapy, Alyn Children's Hospital and Rehabilitation Center, Jerusalem, Israel
| | - Maayan Schweizer
- Department of Physical Therapy, Alyn Children's Hospital and Rehabilitation Center, Jerusalem, Israel
| | - Michal Katz-Leurer
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hu MX, Lamers F, de Geus EJC, Penninx BWJH. Influences of lifestyle factors on cardiac autonomic nervous system activity over time. Prev Med 2017; 94:12-19. [PMID: 27836526 DOI: 10.1016/j.ypmed.2016.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/08/2016] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in lifestyle factors relate to 2-year changes in cardiac activity. Baseline (n=2618) and 2-year follow-up (n=2010) data of the Netherlands Study of Depression and Anxiety was combined. Baseline data was collected in the Netherlands from 2004-2007. Lifestyle factors were habitual physical activity, frequency of sport activities, alcohol use, and smoking. Indicators of cardiac activity were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) (100min of registration). The results showed that high physical activity (-1.8beats/min compared to low activity), high frequency of sport activities ('couple of times/week': -2.5beats/min compared to 'almost never') and mild/moderate alcohol use (-1.2beats/min compared to non-drinking) were related to low HR. Heavy smoking was related to high HR (>30cigarettes/day: +5.1beats/min compared to non-smoking). High frequency of sport activities was associated with high RSA ('couple of times/week':+1.7ms compared to 'almost never') and moderate smoking with longer PEP (11-20cigarettes/day: +2.8ms compared to non-smoking). Associations were consistent across waves. Furthermore, 2-year change in frequency of sport activities and number of smoked cigarettes/day was accompanied by 2-year change in HR (β=-0.076 and β=0.101, respectively) and RSA (β=0.046 and β=-0.040, respectively). Our findings support consistent effects of lifestyle on HR and parasympathetic activity in the expected direction. Cardiac autonomic dysregulation may be partly mediating the relationship between lifestyle and subsequent cardiovascular health.
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Affiliation(s)
- Mandy Xian Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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50
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Howden EJ, Lawley JS, Esler M, Levine BD. Potential role of endurance training in altering renal sympathetic nerve activity in CKD? Auton Neurosci 2016; 204:74-80. [PMID: 27908698 DOI: 10.1016/j.autneu.2016.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/16/2016] [Accepted: 11/23/2016] [Indexed: 12/20/2022]
Abstract
Chronic kidney disease (CKD), is characterized by a progressive loss of renal function and increase in cardiovascular risk. In this review paper, we discuss the pathophysiology of increased sympathetic nerve activity in CKD patients and raise the possibility of endurance exercise being an effective countermeasure to address this problem. We specifically focus on the potential role of endurance training in altering renal sympathetic nerve activity as increased renal sympathetic nerve activity negatively impacts kidney function as well indirectly effects multiple other systems and organs. Recent technological advances in device based therapy have highlighted the detrimental effect of elevated renal sympathetic nerve activity in CKD patients, with kidney function and blood pressure being improved post renal artery nerve denervation in selected patients. These developments provide optimism for the development of alternative and/or complementary strategies to lower renal sympathetic nerve activity. However, appropriately designed studies are required to confirm preliminary observations, as the widespread use of the renal denervation approach to lower sympathetic activity presently has limited feasibility. Endurance training may be one alternative strategy to reduce renal sympathetic nerve activity. Here we review the role of endurance training as a potential alternative or adjunctive to current therapy in CKD patients. We also provide recommendations for future research to assist in establishing an evidence base for the use of endurance training to lower renal sympathetic activity in CKD patients.
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Affiliation(s)
- Erin J Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX 75231, United States; University of Texas Southwestern Medical Center, Dallas, TX 75231, United States; Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
| | - Justin S Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX 75231, United States; University of Texas Southwestern Medical Center, Dallas, TX 75231, United States
| | - Murray Esler
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX 75231, United States; University of Texas Southwestern Medical Center, Dallas, TX 75231, United States
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