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Merchant RA, Loke B, Chan YH. Ability of Heart Rate Recovery and Gait Kinetics in a Single Wearable to Predict Frailty: Quasiexperimental Pilot Study. JMIR Form Res 2024; 8:e58110. [PMID: 39361400 DOI: 10.2196/58110] [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: 03/06/2024] [Revised: 08/09/2024] [Accepted: 09/05/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND Aging is a risk factor for falls, frailty, and disability. The utility of wearables to screen for physical performance and frailty at the population level is an emerging research area. To date, there is a limited number of devices that can measure frailty and physical performance simultaneously. OBJECTIVE The aim of this study is to evaluate the accuracy and validity of a continuous digital monitoring wearable device incorporating gait mechanics and heart rate recovery measurements for detecting frailty, poor physical performance, and falls risk in older adults at risk of falls. METHODS This is a substudy of 156 community-dwelling older adults ≥60 years old with falls or near falls in the past 12 months who were recruited for a fall prevention intervention study. Of the original participants, 22 participants agreed to wear wearables on their ankles. An interview questionnaire involving demographics, cognition, frailty (FRAIL), and physical function questions as well as the Falls Risk for Older People in the Community (FROP-Com) was administered. Physical performance comprised gait speed, timed up and go (TUG), and the Short Physical Performance Battery (SPPB) test. A gait analyzer was used to measure gait mechanics and steps (FRAIL-functional: fatigue, resistance, and aerobic), and a heart rate analyzer was used to measure heart rate recovery (FRAIL-nonfunctional: weight loss and chronic illness). RESULTS The participants' mean age was 74.6 years. Of the 22 participants, 9 (41%) were robust, 10 (46%) were prefrail, and 3 (14%) were frail. In addition, 8 of 22 (36%) had at least one fall in the past year. Participants had a mean gait speed of 0.8 m/s, a mean SPPB score of 8.9, and mean TUG time of 13.8 seconds. The sensitivity, specificity, and area under the curve (AUC) for the gait analyzer against the functional domains were 1.00, 0.84, and 0.92, respectively, for SPPB (balance and gait); 0.38, 0.89, and 0.64, respectively, for FRAIL-functional; 0.45, 0.91, and 0.68, respectively, for FROP-Com; 0.60, 1.00, and 0.80, respectively, for gait speed; and 1.00, 0.94, and 0.97, respectively, for TUG. The heart rate analyzer demonstrated superior validity for the nonfunctional components of frailty, with a sensitivity of 1.00, specificity of 0.73, and AUC of 0.83. CONCLUSIONS Agreement between the gait and heart rate analyzers and the functional components of the FRAIL scale, gait speed, and FROP-Com was significant. In addition, there was significant agreement between the heart rate analyzer and the nonfunctional components of the FRAIL scale. The gait and heart rate analyzers could be used in a screening test for frailty and falls in community-dwelling older adults but require further improvement and validation at the population level.
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Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | | | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Jamieson A, Jones S, Chaturvedi N, Hughes AD, Orini M. Accuracy of smartwatches for the remote assessment of exercise capacity. Sci Rep 2024; 14:22994. [PMID: 39362983 PMCID: PMC11452199 DOI: 10.1038/s41598-024-74140-x] [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: 05/04/2024] [Accepted: 09/24/2024] [Indexed: 10/05/2024] Open
Abstract
Exercise capacity is a strong independent predictor of cardiovascular and all-cause mortality. The utilization of well-established submaximal tests of exercise capacity such as the 6-min walk test (6MWT), 3-min step test (3MST) and 10-chair rise test (10CRT) in the community would improve patient care but requires remote monitoring technology. Consumer grade smartwatches provide such an opportunity, however, their accuracy in measuring physiological responses to these tests is unclear. The aim of this study was to determine the accuracy of consumer grade smartwatches in assessing exercise capacity to develop a framework for remote, unsupervised testing. 16 healthy adults (7 male (44%), age median 27 [interquartile range (IQR) 26,29] years) performed 6MWTs using two protocols: (1) standard-straight 30 m laps (6MWT-standard) and 2) continuous lap-circular 240 m laps around a park (6MWT-continuous lap), 3MSTs and 10CRTs. Each one of these four tests was performed three times across two clinic visits. Each participant was fitted with a Garmin Vivoactive4 and Fitbit Sense smartwatch to measure three parameters: distance, step counts and heart rate (HR) response. Reference measures were a meter-wheel, hand tally counter and ECG, respectively. Mean HR was measured at rest, peak exercise and recovery. Agreement was measured using Bland-Altman analysis for repeated measures and summarized as median absolute percentage errors (MAPE). Distance during 6MWT-continuous lap had better agreement than during 6MWT-standard for both Garmin (MAPE: 6.4% [3.0, 10.4%] versus 20.1% [13.9, 28.4%], p < 0.001) and Fitbit (8.0% [2.9, 10.1% versus 18.8% [15.2, 28.1%], p < 0.001). Garmin measured step count more accurately than Fitbit (MAPE: 1.8% [0.9, 2.9%] versus 8.0% [2.6, 12.3%], p < 0.001). Irrespective of test, both devices showed excellent accuracy in measuring HR at rest and recovery (≤ 3%), while accuracy decreased during peak exercise (Fitbit: ~ 12% and Garmin: ~ 7%). In young adults without mobility difficulties, exercise capacity can be measured remotely using standardized tests and consumer grade smartwatches.
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Affiliation(s)
- Alexandra Jamieson
- MRC Unit for Lifelong Health and Ageing, UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Siana Jones
- MRC Unit for Lifelong Health and Ageing, UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing, UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing, UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Michele Orini
- MRC Unit for Lifelong Health and Ageing, UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
- Department of Biomedical Engineering, King's College London, London, UK
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Hutson MJ, O'Donnell E, McConnell K, Chauntry AJ, Blagrove RC. Energy availability modulates regional blood flow via estrogen-independent pathways in regularly menstruating young women. Eur J Appl Physiol 2024; 124:3045-3055. [PMID: 38809480 PMCID: PMC11466997 DOI: 10.1007/s00421-024-05497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE This study aimed to investigate the impact of short-term low energy availability (LEA) on vascular function in young, regularly menstruating women. METHODS Participants were 19 women, aged 22.9 ± 4.2 years, with body mass index 18-30 kg·m2. They were divided into two groups and completed two conditions in a crossover design: a 3-day control condition (CON) with an energy availability of 45 kcals·kgFFM-1·day-1 and a 3-day LEA condition of 15 kcals·kgFFM-1 day-1. Assessments were conducted during the early follicular phase of the menstrual cycle. Outcome measures included forearm blood flow (FBF), heart rate, blood pressure, arterial stiffness, resting energy expenditure (REE), metabolic blood markers and body composition. RESULTS Significant time-by-condition interactions were found for resting FBF (p = .004), REE (p = .042), triiodothyronine (p = .006), β-hydroxybutyrate (p = .002) and body mass (p < .001). Resting FBF was 1.43 ± 1.01 and 1.31 ± 0.61 (arbitrary units) at pre and post, respectively, in LEA and 1.52 ± 0.7 and 1.76 ± 0.57 at pre and post in CON. The LEA condition led to a decrease in triiodothyronine (pre: 1.54 ± 0.28, post: 1.29 ± 0.27 ng ml-1), REE (pre: 1588 ± 165, post: 1487 ± 160 kcals day-1) and body mass (pre: 61.4 ± 7.5, post: 59.6 ± 7.3 kg). Changes in resting FBF were significantly correlated with changes in REE in the LEA condition (r = 0.53; p = 0.02). CONCLUSION Short-term LEA modifies regional blood flow and this might contribute to the observed decreased in REE. Findings emphasize the need for careful management of energy availability in populations at risk of LEA.
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Affiliation(s)
- Mark J Hutson
- Faculty of Life and Health Sciences, School of Sport, Ulster University, Coleraine, BT52 1SA, UK.
| | - Emma O'Donnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Kyle McConnell
- Faculty of Life and Health Sciences, School of Sport, Ulster University, Coleraine, BT52 1SA, UK
| | - Aiden J Chauntry
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Richard C Blagrove
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
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Armstrong R, Murphy G, Wheen P, Brandon L, Kenny RA, Maree AO. Speed of Heart Rate Recovery After Orthostatic Stress as a Modifiable Risk Factor During Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2024; 44:E64-E65. [PMID: 39240678 DOI: 10.1097/hcr.0000000000000882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Affiliation(s)
- Richard Armstrong
- Author Affiliations: Department of Cardiology, St James's Hospital, Dublin, Ireland (Drs Armstrong, Murphy, and Brandon, Mr Maree, and Dr Wheen); and Mercers Institute for Successful Aging, St James's Hospital and Trinity College, Dublin, Ireland (Ms Kenny)
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Hernández B, Dyer AH, McCrory C, Newman L, Finucane C, Kenny RA. Which Components of the Haemodynamic Response to Active Stand Predict Cardiovascular Disease and Mortality? Data From The Irish Longitudinal Study on Ageing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.30.24311251. [PMID: 39211878 PMCID: PMC11361238 DOI: 10.1101/2024.07.30.24311251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background An integrated haemodynamic response during standing may serve as an integrative marker of neuro-cardiovascular function. Individual components of both heart rate (HR) and blood pressure (BP) responses to active stand (AS) have been linked with cardiovascular disease (CVD) and mortality. We assessed longitudinal associations between entire HR/BP response curves during AS, incident CVD and mortality over 12 years. Methods Beat-to-beat measurements of dynamic HR/BP responses to AS were conducted in 4,336 individuals (61.5±8.2 years; 53.7% female). Functional Principal Components Analysis was applied to HR/BP response curves and their association with CVD and mortality assessed. We hypothesised that integrating BP/HR information from the entire haemodynamic response curve may uncover novel associations with both CVD and mortality. Results Higher systolic BP (SBP) before AS and blunted recovery of SBP during AS was associated with all-cause mortality over 12-years (Hazard Ratio [HR]: 1.14; 1.04, 1.26; p=0.007). Higher baseline/peak HR and lower HR from 30 seconds post stand onwards were associated with lower mortality due to circulatory causes (HR: 0.78; 0.64, 0.95; p = 0.013). Higher HR throughout AS was associated with mortality from other causes (HR: 1.48; 1.22, 1.80; p<0.001). Findings persisted on robust covariate adjustment. Conclusions We observed distinct relationships between HR/BP responses to AS and 12-year incident CVD and mortality. Integrating the entire haemodynamic response may reveal more nuanced relationships between HR/BP responses to AS, CVD and mortality - serving as an integrative marker of neuro-cardiovascular health in midlife and beyond.
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Choi SY, Kim CY, Joo MC. Comparison of autonomic nervous system dysfunction, arterial stiffness, and heart rate recovery according to spinal cord injury level. J Int Med Res 2024; 52:3000605241266591. [PMID: 39180298 PMCID: PMC11344901 DOI: 10.1177/03000605241266591] [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: 02/14/2024] [Accepted: 06/10/2024] [Indexed: 08/26/2024] Open
Abstract
OBJECTIVE To investigate the differences in autonomic nervous system (ANS) dysfunction, arterial stiffness, and the degree of delay in post-exercise heart rate recovery (HRR) according to the level of spinal cord injury (SCI), and propose preventive measures against cardiovascular diseases after SCI. METHODS This retrospective study included 51 patients with SCI. Based on the neurological level of injury (NLI), patients were divided into two groups: Group A (NLI at and above T6) and Group B (NLI below T6). To assess ANS dysfunction, the head-up tilt test and 24-hour ambulatory blood pressure monitoring were conducted. Arterial stiffness was measured using the pulse wave velocity test. The exercise tolerance test was conducted to measure post-exercise HRR. RESULTS Group A had significantly higher values in the head-up tilt test and 24-hour ambulatory blood pressure monitoring. In the pulse wave velocity test, both sides (left and right) had significantly higher values in Group B. One minute after the exercise tolerance test, Group A had significantly slower HRR (18.8 ± 11.1 beats/minute) than Group B. CONCLUSION Understanding the impact of ANS dysfunction and arterial stiffness on HRR in SCI according to NLI may provide insights for clinical management and preventative strategies for cardiovascular diseases.
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Affiliation(s)
- Seok-Yeon Choi
- Rehabilitation Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
- Korean Air Force Aerospace Medical Center, Cheongju, Republic of Korea
| | - Chan Yong Kim
- Rehabilitation Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Min Cheol Joo
- Rehabilitation Medicine, Wonkwang University Hospital, Iksan, Republic of Korea
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Ghidoni C, van der Stouwe JG, Würzburger L, Wiech P, Vontobel J, Bohm P, Moser G, Petrasch G, Rossi VA, Schmied CM, Caselli S, Niederseer D. Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase. Eur J Clin Invest 2024:e14285. [PMID: 38994816 DOI: 10.1111/eci.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/28/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE. METHODS 800 patients aged 17-90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre-existent hypertension. RESULTS Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9-11.1]) and diastolic (2.4 [0.4-4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2-9.4]) and diastolic BP (4.5 [1.9-7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1-7.5]) and fully adjusted (5.5 [1.1-10.0]) models. There was no difference in maximum diastolic BP between groups. CONCLUSION In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.
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Affiliation(s)
- Céline Ghidoni
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Gerrit van der Stouwe
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Laura Würzburger
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick Wiech
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Vontobel
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Philipp Bohm
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Georg Moser
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gloria Petrasch
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
| | - Valentina A Rossi
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian M Schmied
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - Stefano Caselli
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Herzgefaesszentrum Im Park, Hirslanden Klinik Im Park, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Cozgarea A, Cozma D, Teodoru M, Lazăr-Höcher AI, Cirin L, Faur-Grigori AA, Lazăr MA, Crișan S, Gaiță D, Luca CT, Văcărescu C. Heart Rate Recovery: Up to Date in Heart Failure-A Literature Review. J Clin Med 2024; 13:3328. [PMID: 38893039 PMCID: PMC11173322 DOI: 10.3390/jcm13113328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/15/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
The rising prevalence of cardiovascular disease underscores the growing significance of heart failure (HF). Pathophysiological insights into HF highlight the dysregulation of the autonomic nervous system (ANS), characterized by sympathetic overactivity and diminished vagal tone, impacting cardiovascular function. Heart rate recovery (HRR), a metric measuring the heart's ability to return to its baseline rate post-exertion, plays a crucial role in assessing cardiovascular health. Widely applied across various cardiovascular conditions including HF, coronary artery disease (CAD), and arterial hypertension (HTN), HRR quantifies the difference between peak and recovery heart rates. Given its association with elevated sympathetic tone and exercise, HRR provides valuable insights into the perspective of HF, beyond effort tolerance, reaching toward prognostic and mortality indicators. Incorporating HRR into cardiovascular evaluations enhances our understanding of autonomic regulation in HF, offering potential implications for prognostication and patient management. This review addresses the significance of HRR in HF assessment, analyzing recently conducted studies, and providing a foundation for further research and clinical application.
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Affiliation(s)
- Andreea Cozgarea
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Dragoș Cozma
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Minodora Teodoru
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania
| | - Alexandra-Iulia Lazăr-Höcher
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Liviu Cirin
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Adelina-Andreea Faur-Grigori
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
| | - Mihai-Andrei Lazăr
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Simina Crișan
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Dan Gaiță
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Constantin-Tudor Luca
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
| | - Cristina Văcărescu
- Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania; (A.C.); (A.-I.L.-H.); (A.-A.F.-G.); (M.-A.L.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania
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Connolly E, Knight SP, Duggan E, Scarlett S, Newman L, Cahill M, Kenny RA, Doyle SL, Romero-Ortuno R. Cardiovascular Autonomic Function and Progression of Age-Related Macular Degeneration in The Irish Longitudinal Study of Ageing (TILDA). Invest Ophthalmol Vis Sci 2024; 65:24. [PMID: 38874963 PMCID: PMC11182369 DOI: 10.1167/iovs.65.6.24] [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: 11/15/2023] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Purpose To examine if changes in hemodynamic measures during an orthostatic challenge were associated with progression of age-related macular degeneration (AMD) over a 4-year period in The Irish Longitudinal Study on Ageing. Methods Participants with AMD who underwent an active stand (AS) test at wave 1 (2009/2010) and retinal photographs at both wave 1 and wave 3 (2014/2015) were included (N = 159: 121 with no AMD progression and 38 with progression). Beat-to-beat hemodynamic data were non-invasively collected using a Finometer MIDI device during the AS at wave 1, recording systolic blood pressure (sBP), diastolic blood pressure (dBP), mean arterial pressure (MAP), and heart rate. Cardiac output, stroke volume, and total peripheral resistance (TPR) were derived from these measures. Baseline characteristics were compared between groups with and without AMD progression. Mixed-effects linear regression models were used to assess the association between changes in hemodynamic parameters during the AS and AMD progression, controlling for known AMD-associated risk factors. Results At baseline, increasing age and lower dBP were significantly associated with AMD progression. Mixed-effects models for the period between standing and 10 seconds post-stand revealed significant associations with AMD progression with a steeper drop in dBP and a slower drop in TPR. Between 10 and 20 seconds post-stand, AMD progression was significantly associated with less pronounced reduction in heart rate. Conclusions These observational data suggest that impaired hemodynamic responses within the first 20 seconds of orthostasis may be associated with the progression of AMD.
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Affiliation(s)
- Emma Connolly
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Silvin P. Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Eoin Duggan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mark Cahill
- Progressive Vision Research, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sarah L. Doyle
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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10
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Baytugan NZ, Kandemir HÇ. The effect of anabolic androgenic steroids on heart rate recovery index and electrocardiographic parameters in male bodybuilders. J Electrocardiol 2024; 84:95-99. [PMID: 38579637 DOI: 10.1016/j.jelectrocard.2024.03.015] [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: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The control of the cardiovascular system depends on the autonomic nerve system. Chronic anabolic andorogenic steroids (AAS) use causes sympathovagal imbalance and increases sympathetic nerve activity. OBJECTIVE The reduction in heart rate from the peak exercise rate following the end of the exercise stress test is known as the heart rate recovery index (HRRI). Several methods have been utilized to assess myocardial repolarization, such as QT interval (QT), corrected QT interval (QTc), and T-wave peak-to-end interval (Tp-e interval). Based on a growing number of data a higher Tp-e/QT ratio is linked to malignant ventricular arrhythmias, and an increased Tp-e interval may correlate with the transmural dispersion of repolarization. Our hypothesis is that the use of chronic AAS was decrease HRRI during maximal exercise and increased risk of cardiac arrhythmias and sudden cardiac death. METHODS This study included 44 male bodybuilders, with an average age of 29.7 ± 8.14 years, divided into AAS abuse [AAS users (n = 21) and AAS nonuser (n = 23)]. RESULTS The first (p = 0.001) and second minute (p = 0.001) HRRI of the subjects with AAS users were significantly lower than those of the control group. Additionally, HRRI after the third (p = 0.004) and fifth minutes (p = 0.007) of the recovery period were significantly lower in AAS group compared with the control group. Who used AAS had significantly higher QT, QTc, Tp-e, Tp-e/QT, and Tp-e/QTc values than non-users (all p = 0.001). CONCLUSIONS Chronic AAS use has been shown to cause sympathetic dominance, which may be a pro arrhythmic state.
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da Fonseca RX, Gomes da Cruz CJ, Soares EDMKVK, Garcia GL, Porto LGG, Molina GE. Post-exercise heart rate recovery and its speed are associated with resting-reactivity cardiovagal modulation in healthy women. Sci Rep 2024; 14:5526. [PMID: 38448470 PMCID: PMC10917800 DOI: 10.1038/s41598-024-51842-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
The present study sought to expand upon prior investigations of the relationship between post-exercise heart rate recovery (HRR) and cardiovagal resting-reactivity modulation. HRR from 1st to 5th min after maximal exercise test was correlated with a cardiovagal index of heart rate variability (SD1) at resting (supine and orthostatic positions) and its reactivity after the orthostatic stress test in 34 healthy women. Statistical analysis employed non-parametric tests with a p-value set at 5%. HRR, ∆%HRR, and coefficient of HRR (CHRR) at the 3rd and 5th min correlated with SD1 and SD1n (normalized units) in the supine position (rs = 0.36 to 0.47; p = < 0.01). From the 1st to 5th min, HRR, ∆%HRR, and CHRR correlated with SD1 and SD1n in the orthostatic position (rs = 0.29 to 0.47; p = ≤ 0.01 to 0.05), except for HRR at 5th min with SD1n (p = 0.06). Following the orthostatic stress test, HRR at 3rd and HRR, %∆HRR at 5th min correlated with ∆absSD1 (rs = 0.28 to 0.35; p = 0.02 to 0.05). All HRR measurements at 1st min correlated with ∆absSD1n (rs = 0.32 to 0.38; p = 0.01 to 0.03), and the CHRR at 1st min correlated with ∆%SD1(rs = 0.37; p = 0.01). After the sample was divided into high and low cardiovagal modulation subgroups, the subgroup with high modulation at rest (supine and orthostatic) and higher cardiovagal reactivity (reduction) showed faster HRR (p = ≤ 0.01 to 0.05; ES:0.37 to 0.50). HRR throughout the 1st to 5th min positively correlates with cardiovagal modulation in the orthostatic position, and the 3rd and 5th min positively correlate with cardiovagal modulation in both postures at rest. Faster HRR following the maximal exercise test is associated with high resting-reactivity cardiovagal modulation in healthy women.
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Affiliation(s)
- Richard Xavier da Fonseca
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil
| | - Carlos Janssen Gomes da Cruz
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil
- University Center Euro Americano, Brasília, DF, Brazil
| | - Edgard de Melo Keene Von Koening Soares
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil
- Skidemore College, Saratoga Springs, NY, USA
| | - Giliard Lago Garcia
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil
- University Center Institute of Higher Education of Brasília - IESB, Brasília, DF, Brazil
| | - Luiz Guilherme Grossi Porto
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil
| | - Guilherme Eckhardt Molina
- Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-graduação em Educação Física, Laboratório de Fisiologia do Exercício, Brasília, DF, 70910-900, Brazil.
- Grupo de Estudo em Fisiologia e Epidemiologia do Exercício e da Atividade Física (GEAFS), Universidade de Brasília, Brasília, DF, Brazil.
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Sidar SS, Skuthan A. Occupational Therapy Practitioners' Perceptions of Providing Services for the Acute Postpartum Population. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241234846. [PMID: 38436257 DOI: 10.1177/15394492241234846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Occupational therapy practitioners' (OTP's) perceptions of their role in working on the acute postpartum hospital unit are unknown. The objective of this research was to determine the perspectives of OTP's enrolled in a continuing education course to gain competency in providing services to acute postpartum patients. Investigators engaged in a phenomenology consisting of semi-structured interviews with six OTP's working in acute care hospitals preparing to work on the postpartum unit. Three themes emerged from transcripts: (a) Its' Not THAT Different; (b) Willing To Try; and (c) Shifting Focus To Mom. OTPs working in hospitals identified existing skills applicable to working with acute postpartum patients, a need for additional learning to enhance competence, and a desire to focus support for the birthing person to improve maternal outcomes. Hospital onboarding and/or entry-level OTP programs should consider including education on the postpartum population. Future research should focus on program implementation on acute postpartum hospital units.
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13
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Park S, Kim HL, Park KT, Joh HS, Lim WH, Seo JB, Kim SH, Kim MA. Association between arterial stiffness and autonomic dysfunction in participants underwent treadmill exercise testing: a cross-sectional analysis. Sci Rep 2024; 14:3588. [PMID: 38351168 PMCID: PMC10864279 DOI: 10.1038/s41598-024-53681-1] [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: 06/18/2023] [Accepted: 02/03/2024] [Indexed: 02/16/2024] Open
Abstract
Data on the impact of arterial stiffness on autonomic function are limited. We sought to investigate whether heart rate recovery (HRR), a predictor of autonomic function, is impaired in patients with increased arterial stiffness. A total of 475 participants (mean age 55.8 ± 11.1 years, 34.3% women) who underwent a treadmill exercise test (TET) for the evaluation of chest pain were retrospectively analyzed. All patients underwent brachial-ankle pulse wave velocity (baPWV) measurement on the same day. HRR was defined as the difference in heart rate from maximal exercise to 1 min of recovery. Participants with the lowest HRR tertile were older and had more cardiovascular risk factors than those with the highest HRR tertile. Simple correlation analysis showed that baPWV was negatively correlated with HRR (r = - 0.327, P < 0.001). In multiple linear regression analysis, there was a significant association between baPWV and HRR, even after adjusting for potential confounders (β = - 0.181, P < 0.001). In participants who underwent TET, baPWV was negatively correlated with HRR. The results of our study indicate a potential relationship between arterial stiffness and the autonomic nervous system.
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Affiliation(s)
- Sungjoon Park
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Kyung-Taek Park
- Department of Cardiology, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Hyun Sung Joh
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Republic of Korea.
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14
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Sampaio T, Morais JE, Bragada JA. StepTest4all: Improving the Prediction of Cardiovascular Capacity Assessment in Young Adults. J Funct Morphol Kinesiol 2024; 9:30. [PMID: 38390930 PMCID: PMC10885065 DOI: 10.3390/jfmk9010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Cardiovascular capacity, expressed as maximal oxygen uptake (VO2max), is a strong predictor of health and fitness and is considered a key measure of physiological function in the healthy adult population. The aim of this study was to investigate the influence of the physical activity levels (PAlevel) of participants in the StepTest4all (validated protocol for the estimation of VO2max in adults). The sample consisted of 69 participants, including 27 women (age 21.7 ± 3.6 years; body mass = 63.5 ± 14.8 kg; height = 1.64 ± 0.06 m; body mass index = 23.7 ± 5.3 kg/m2) and 42 men (aged 21.7 ± 3.4 years; body mass = 72.0 ± 7.3 kg; height = 1.77 ± 0.07 m; body mass index = 23.1 ± 2.1 kg/m2). The participants were assigned to one of the two groups: (i) the VO2max prediction group and (ii) the prediction model validation group. In the multiple linear regression, the following predictors of VO2max remained significant: sex (p < 0.001), physical activity level (p = 0.014), and HRR60 (p = 0.020). The prediction equation (R2 = 74.0%, SEE = 4.78) showed a close and strong relationship between the measurements and can be expressed as follows: VO2max = 17.105 + 0.260·(HRR60) + 8.563·(sex) + 4.097·(PAlevel), in which HRR60 is the magnitude of the HR decrease (bpm) in one minute immediately after stopping the step, and sex: men = 1, women = 0, and PAlevel is level 1 (low), level 2 (moderate), and level 3 (high). The StepTest4all was shown to be a suitable method for estimating cardiovascular capacity, expressed as VO2max, in young adults. Retaining PAlevel as a significant predictor allows us to better individualize the participants' VO2max.
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Affiliation(s)
- Tatiana Sampaio
- Department of Sports Sciences, Instituto Politécnico de Bragança, 5301-856 Bragança, Portugal
- Research Center in Sports, Health and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Jorge E Morais
- Department of Sports Sciences, Instituto Politécnico de Bragança, 5301-856 Bragança, Portugal
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, 5301-856 Bragança, Portugal
| | - José A Bragada
- Department of Sports Sciences, Instituto Politécnico de Bragança, 5301-856 Bragança, Portugal
- Research Centre for Active Living and Wellbeing (LiveWell), Instituto Politécnico de Bragança, 5301-856 Bragança, Portugal
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15
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Syversen A, Dosis A, Jayne D, Zhang Z. Wearable Sensors as a Preoperative Assessment Tool: A Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:482. [PMID: 38257579 PMCID: PMC10820534 DOI: 10.3390/s24020482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Surgery is a common first-line treatment for many types of disease, including cancer. Mortality rates after general elective surgery have seen significant decreases whilst postoperative complications remain a frequent occurrence. Preoperative assessment tools are used to support patient risk stratification but do not always provide a precise and accessible assessment. Wearable sensors (WS) provide an accessible alternative that offers continuous monitoring in a non-clinical setting. They have shown consistent uptake across the perioperative period but there has been no review of WS as a preoperative assessment tool. This paper reviews the developments in WS research that have application to the preoperative period. Accelerometers were consistently employed as sensors in research and were frequently combined with photoplethysmography or electrocardiography sensors. Pre-processing methods were discussed and missing data was a common theme; this was dealt with in several ways, commonly by employing an extraction threshold or using imputation techniques. Research rarely processed raw data; commercial devices that employ internal proprietary algorithms with pre-calculated heart rate and step count were most commonly employed limiting further feature extraction. A range of machine learning models were used to predict outcomes including support vector machines, random forests and regression models. No individual model clearly outperformed others. Deep learning proved successful for predicting exercise testing outcomes but only within large sample-size studies. This review outlines the challenges of WS and provides recommendations for future research to develop WS as a viable preoperative assessment tool.
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Affiliation(s)
- Aron Syversen
- School of Computing, University of Leeds, Leeds LS2 9JT, UK
| | - Alexios Dosis
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.D.); (D.J.)
| | - David Jayne
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.D.); (D.J.)
| | - Zhiqiang Zhang
- School of Electrical Engineering, University of Leeds, Leeds LS2 9JT, UK;
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16
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Miao J, Yang H, Shi R, Wang C. The effect of cardiac rehabilitation on cardiopulmonary function after coronary artery bypass grafting: A systematic review and meta-analysis. iScience 2023; 26:107861. [PMID: 38058302 PMCID: PMC10696125 DOI: 10.1016/j.isci.2023.107861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/15/2023] [Accepted: 09/06/2023] [Indexed: 12/08/2023] Open
Abstract
We carried out a meta-analysis on the effect of cardiac rehabilitation (CR) on cardiopulmonary function after coronary artery bypass grafting (CABG). Four databases were searched for studies comparing CR with control. A random-effects model was used to pool mean difference (MD). The meta-analysis showed an increase in peak oxygen consumption (peak VO2) (MD = 1.93 mL/kg/min, p = 0.0006), and 6-min walk distance (6MWD) (MD = 59.21 m, p < 0.00001), and a decrease in resting heart rate (resting HR) (MD = 5.68 bpm, p < 0.0001) in the CR group. The subgroup analysis revealed aerobic exercise could further improve resting HR and peak HR, and physical/combination with aerobic exercise could further increase 6MWD. The improvement of peak VO2, workload, resting HR, peak HR, and 6MWD regarding CR performed within one week after CABG is greater than that one week after CABG. CR after CABG can improve the cardiopulmonary function, which is reflected by the improvement of peak VO2, 6MWD, and resting HR.
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Affiliation(s)
- Jiapeng Miao
- Department of Cardiovascular Medicine, Zhuzhou Central Hospital, Xiangya hospital Zhuzhou, Central South University, 116 Changjiang South Road, Zhuzhou 412000, China
| | - Huayun Yang
- Department of Cardiovascular Medicine, Guilin People’s Hospital, 12 Wenming Road, Guilin 541002, China
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
| | - Chengming Wang
- Department of Cardiovascular Medicine, Zhuzhou Central Hospital, Xiangya hospital Zhuzhou, Central South University, 116 Changjiang South Road, Zhuzhou 412000, China
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Boyes NG, Mannozzi J, Rapin N, Alvarez A, Al-Hassan MH, Lessanework B, Lahti DS, Olver TD, O'Leary DS, Tomczak CR. Augmented sympathoexcitation slows postexercise heart rate recovery. J Appl Physiol (1985) 2023; 135:1300-1311. [PMID: 37883101 DOI: 10.1152/japplphysiol.00549.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/13/2023] [Accepted: 10/23/2023] [Indexed: 10/27/2023] Open
Abstract
Slow heart rate recovery following exercise may be influenced by persistent sympathoexcitation. This study examined 1) the effect of muscle metaboreflex activation (MMA) on heart rate recovery following dynamic exercise; and 2) whether the effect of MMA on heart rate recovery is reversible by reducing sympathoexcitation [baroreflex activation via phenylephrine (PE)] in canines. Twenty-two young adults completed control and MMA protocols during cycle ergometry at 110% ventilatory threshold with 5 min recovery. Heart rate recovery kinetics [tau (τ), amplitude, end-exercise, and end-recovery heart rate] and root mean square of successive differences (RMSSD) were measured. Five chronically instrumented canines completed control, MMA (50%-60% imposed reduction in hindlimb blood flow), and MMA with end-exercise PE infusion (MMA + PE) protocols during moderate exercise (6.4 km·h-1) and 3 min recovery. Heart rate recovery kinetics and MAP were measured. MAP increased during MMA versus control in canines (P < 0.001). Heart rate recovery τ was slower during MMA versus control in humans (17% slower; P = 0.011) and canines (150% slower; P = 0.002). Heart rate recovery τ was faster during MMA + PE versus MMA (40% faster; P = 0.034) and was similar to control in canines (P = 0.426). Amplitude, end-exercise, and end-recovery heart rate were similar between conditions in humans (all P ≥ 0.122) and in canines (all P ≥ 0.084). MMA decreased RMSSD in early recovery (P = 0.004). MMA-induced sympathoexcitation slows heart rate recovery and this effect is markedly attenuated with PE. Therefore, elevated sympathoexcitation via MMA impairs heart rate recovery and inhibition of this stimulus normalizes, in part, heart rate recovery.NEW & NOTEWORTHY Augmented sympathoexcitation, via muscle metaboreflex activation, functionally slows heart rate recovery in both young healthy adults and chronically instrumented canines. Furthermore, elevated sympathoexcitation corresponded with lower parasympathetic activity, as assessed by heart rate variability, during the first 3 min of recovery. Finally, sympathoinhibition, via phenylephrine infusion, normalizes heart rate recovery during muscle metaboreflex activation.
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Affiliation(s)
- Natasha G Boyes
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joseph Mannozzi
- Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Nicole Rapin
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Alberto Alvarez
- Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Mohamed-Hussein Al-Hassan
- Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Beruk Lessanework
- Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Dana S Lahti
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - T Dylan Olver
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donal S O'Leary
- Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, United States
| | - Corey R Tomczak
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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18
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Mekoulou Ndongo J, Bika Lele EC, Guessogo WR, Mbang Mbian W, Ayina Ayina CN, Guyot J, Ngongang Ouankou C, Temfemo A, Kojom Foko LP, Tchoudjin E, Gassina LG, Bongue B, Roche F, Mandengue SH, Assomo-Ndemba PB. Post-exercise heart rate variability recovery after 800-m endurance run load among Cameroonian adolescent's males. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:283-289. [PMID: 38314045 PMCID: PMC10831379 DOI: 10.1016/j.smhs.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 02/06/2024] Open
Abstract
The 800-m (m) run is part of Physical Education classes in Cameroon, after which arrhythmias may occur during recovery. Hence, this study aimed at determining relationship between 800-m run loads on cardiac autonomic recovery among school adolescents. Forty-two male adolescents (aged [17 ± 1] years) performed 800-m. Post-exercise heart rate variability (HRV) was recorded during 5-min (min) (HRV5-min) and 15-min (HRV15-min) in time: Standard deviation of normal to normal (SDNN); Root mean square of successive differences (RMSSD) and frequency domain (LH: Low frequency, HF: High frequency, TP: Total power). Rating of Perceived Exertion (RPE) and blood lactate concentration (BLa) were measured after exercise. In HRV5-min, RPE was associated with SDNN (r = -0.44, p < 0.01) and RMSSD (r = -0.38, p < 0.05). BLa was correlated with SDNN (r = -0.38, p < 0.05) and RMSSD (r = -0.56, p < 0.001) in the time-domain, LF (r = -0.64, p < 0.001), HF (r = -0.58, p < 0.001) and TP (r = -0.61, p < 0.001) in frequency-domain. Moreover, RPE was correlated with LF (r = -0.44, p < 0.01), TP (r = -0.49, p < 0.01) while exercise duration with HF (r = -0.38, p < 0.05). In HRV15-min, BLa was correlated with RMSSD (r = -0.53, p < 0.001) and SDNN (r = -0.68, p < 0.001). RPE was negatively correlated SDNN (r = -0.53, p < 0.01) and RMSSD (r = -0.44, p < 0.01). BLa was associated with HF (r = -0.55, p < 0.001), TP (r = -0.50, p < 0.01) and RPE with LF (r = -0.51, p < 0.01), HF (r = -0.50, p < 0.01), TP (r = -0.49, p < 0.01). In addition, exercise duration was negatively linked to HF (r = -0.36, p < 0.05). This study outlined that in untrained adolescents an increase of 800-m loads is associated with a slow vagal indexes of HRV during the recovery.
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Affiliation(s)
- Jerson Mekoulou Ndongo
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Elysée Claude Bika Lele
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Wiliam Richard Guessogo
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- National Institute of Youth and Sports Yaounde, University of Yaounde I, Cameroon
| | - Wiliam Mbang Mbian
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- National Institute of Youth and Sports Yaounde, University of Yaounde I, Cameroon
| | - Clarisse Noel Ayina Ayina
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Jessica Guyot
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, 42023, Université Jean Monnet, Saint-Étienne, France
| | - Christian Ngongang Ouankou
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
| | - Abdou Temfemo
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
| | - Ernest Tchoudjin
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Louis-Georges Gassina
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Bienvenu Bongue
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, 42023, Université Jean Monnet, Saint-Étienne, France
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon
| | - Frederic Roche
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, 42023, Université Jean Monnet, Saint-Étienne, France
| | - Samuel Honoré Mandengue
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Sciences, University of Douala, Cameroon
| | - Peguy Brice Assomo-Ndemba
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Cameroon
- Faculty of Medicine and Biomedical Science, University of Yaounde I, Cameroon
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19
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Lee H, Kim H, Oh S, Park JK, Jang JY, Chun KH, Yoon SJ. Delayed blood pressure recovery after exercise stress test is associated with autonomic dysfunction and pulse pressure in a middle-aged healthy group. PLoS One 2023; 18:e0285961. [PMID: 37788242 PMCID: PMC10547162 DOI: 10.1371/journal.pone.0285961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Delayed heart rate (HR) and blood pressure recovery after exercise test is known as the reliable indexes of autonomic dysfunction. Here we tried to evaluate the serial changes in various indicators during exercise test and correlations with recovery of HR and blood pressure in a normotensive healthy middle-aged group. METHODS A total of 122 patients without hypertension or diabetes was enrolled (mean age, 55.6 ± 11.0; male, 56.6%; mean blood pressure, 124.8 ± 16.6 / 81.5 ± 9.6 mmHg). Treadmill test was performed for evaluation of chest pain. Patients with coronary artery disease, positive treadmill test result, left ventricular dysfunction or renal failure were excluded. Heart rate recovery was calculated by subtracting the HR in the first or second minute of recovery period from the HR of peak exercise (HRR1 or HRR2). Systolic blood pressure in the 4th minute of recovery stage (SBPR4) was used to show delayed blood pressure recovery. RESULTS Metabolic equivalents (METs) and HR in stage 2 to 4 were significantly correlated with both HRR1 and HRR2. Multiple regression analysis of HRR revealed significant correlation of METs and SBPR4. SBPR4 was significantly correlated with both HRR1 and HRR2 (HRR1, r = -0.376, p<0.001; HRR2, r = -0.244, p = 0.008) as well as SBP in the baseline to stage 3 and pulse pressure (r = 0.406, p<0.001). CONCLUSIONS Delayed BP recovery after peak exercise test revealed significant association with autonomic dysfunction and increased pulse pressure in normotensive middle-aged healthy group. It can be a simple and useful marker of autonomic dysfunction and arterial stiffness.
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Affiliation(s)
- Hancheol Lee
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Hyeongsoo Kim
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Seungjin Oh
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jong-Kwan Park
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Ji-Yong Jang
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Kyeong-Hyeon Chun
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Se-Jung Yoon
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
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20
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Guo G, Hu Y, Kong F, Zheng H, Liu G. Evaluation of Heart Rate Recovery in Obese Children and Adolescents With Prehypertension. Clin Pediatr (Phila) 2023; 62:1040-1047. [PMID: 36852784 DOI: 10.1177/00099228231151399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P < .05), waist-to-hip ratio (WHR) (OR = 1.258; P < .05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P < .01), diastolic blood pressure (DBP) (OR = 1.304; P < .01), and HRR values (OR = 0.892; P < .05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism.
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Affiliation(s)
- Gang Guo
- Department of Emergency, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yao Hu
- Department of Gastroenterology, Hepatology and Nutrition, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fanjun Kong
- Department of Surgery, Jiangsu Cancer Hospital, Nanjing, China
| | - Huan Zheng
- Department of Cardiology, Worldpath Clinic International, Shanghai, China
| | - Guanghui Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Barreto J, Campos-Staffico AM, Nadruz W, Quinaglia T, Sposito AC. The role of SGLT2i in attenuating residual cardiovascular risk through blood pressure-lowering: mechanistic insights and perspectives. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1243530. [PMID: 37822556 PMCID: PMC10562622 DOI: 10.3389/fcdhc.2023.1243530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023]
Abstract
Sodium glucose cotransporter 2 inhibitors (SGLT2) have been increasingly pursued as a promising target for addressing residual cardiovascular risk. Prior trials demonstrated that SGLT2i not only promotes glucose-lowering, but also improves endothelial dysfunction, adiposity, fluid overload, and insulin sensitivity thus contributing to hemodynamic changes implicated in its cardiorenal benefits. The mechanisms in the effect of SGLT2i on blood pressure and their potential role in preventing cardiovascular events are hereby revised.
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Affiliation(s)
- Joaquim Barreto
- Laboratory of Atherosclerosis and Vascular Biology, University of Campinas (Unicamp), Campinas, Sao Paulo, Brazil
| | | | - Wilson Nadruz
- Cardiology Division, Clinics Hospital, Unicamp, Campinas, Sao Paulo, Brazil
| | - Thiago Quinaglia
- Massachussets General Hospital, Harvard University, Boston, MA, United States
| | - Andrei C. Sposito
- Laboratory of Atherosclerosis and Vascular Biology, University of Campinas (Unicamp), Campinas, Sao Paulo, Brazil
- Cardiology Division, Clinics Hospital, Unicamp, Campinas, Sao Paulo, Brazil
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22
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Papadakis Z, Grandjean PW, Forsse JS. Effects of Acute Exercise on Cardiac Autonomic Response and Recovery in Non-Dialysis Chronic Kidney Disease Patients. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:812-825. [PMID: 35522981 DOI: 10.1080/02701367.2022.2057401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
Purpose: Heart rate variability (HRV) has gained acceptance as a key marker of cardiovascular health. We compared HRV responses after continuous moderate-intensity exercise (CMIE) and high-intensity interval exercise (HIIE) matched for intensity and duration in individuals with midspectrum chronic kidney disease (CKD). Methods: Twenty men and women (age 62.0 ± 10 yrs.) diagnosed with CKD stages G3a and G3b participated in a 2 (condition) x 4 (time point) repeated cross-over measures design study. HRV time-domain indices were based on the standard deviation of all NN intervals (SDNN) and the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and frequency domain. High-frequency (HF), low-frequency (LF), total power (TP) were examined. CMIE consisted of treadmill walking for 30 minutes at a 2% incline and speed corresponding to 60%-65% of reserve volume of oxygen (VO2R). HIIE included five intervals of 3 minutes at 90% of VO2R and 2 minutes at 20% VO2R intervals. Conditions were designed to be of the same average intensity (60% to 65% of VO2R) and caloric expenditure (~144 kcal). Results: Immediately following exercise SDNN, RMSSD, HF, LF, and TP were significantly lower compared to before exercise (p <.05). HRV responses were not different between conditions and conditions X time (p >.05). Conclusions: Thirty minutes of either CMIE or HIIE decreased HRV indices, pointing to an autonomic imbalance favoring vagal mediation. HRV's responses regarding HIIE were no different from CMIE, therefore, from an autonomic function point of view this similarity may be useful for CKD exercise prescription and programming.
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COULIBALY I, BOKA B, YAO H, EKOU A, TRO G, TOURE C, KOUASSI D. [Heart rate recovery and presence of coronary lesions in case of ischemic heart disease at the Abidjan Cardiology Institute in Côte d'Ivoire]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i2.2023.200. [PMID: 37525677 PMCID: PMC10387318 DOI: 10.48327/mtsi.v3i2.2023.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/27/2023] [Indexed: 08/02/2023]
Abstract
Introduction Heart rate recovery (HRR) measured during stress tests, assesses the vago-sympathetic balance. It is a known prognostic and predictive parameter of cardiovascular mortality that is believed to be correlated with the presence and severity of coronary artery disease. The aim of this work was to assess the predictive value of heart rate recovery in the diagnostic and severity of coronary lesions in a major metropolis of sub-Saharan Africa where access to specialist care is unevenly distributed. Patients and method We conducted a retrospective observational study from January 2010 to February 2020 at the Abidjan Cardiology Institute, including patients who performed a diagnostic coronary angiography after a positive exercise test. Clinical, angiographic and exercise parameters were analyzed and compared in patients with abnormal heart rate recovery (HRR) and those with normal one. Results The main study limitation is small sampling due to the cost of the angiographic procedure which limits its realization. We recorded 41 subjects whose mean age was 53.4 ± 9.6 years with a male predominance (sex ratio of 3.6). The predominant age group was between 50 and 60 years. Males were older than females with no significant difference. The predominant cardiovascular risk factors were overweight/obesity (68.29%) and hypertension (61%). Eight patients (19.5%) presenting an abnormal HRR (≤12 bpm) had more significant coronary disease (p=0.02) and more severe ones (p=0.003). Patients with abnormal HRR tended to be older without statistical significance (p=0.081), and had lower chronotropic reserve and maximum heart rate (p=0.008 and p=0.042, respectively). The positive predictive value of HHR was 87.5% and its negative predictive value was 60.6%. Conclusion Abnormal HRR can predict the presence of coronary artery disease and its severity. Evaluating HRR during stress tests could help in the detection, evaluation, and monitoring of ischemic heart disease in our resource-limited countries.
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Affiliation(s)
- Iklo COULIBALY
- Service Médecine, Institut de cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - Bénédicte BOKA
- Service Médecine, Institut de cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
| | - Hermann YAO
- Service d'hémodynamique, Institut de cardiologie d'Abidjan, Côte d'Ivoire
| | - Arnaud EKOU
- Service d'hémodynamique, Institut de cardiologie d'Abidjan, Côte d'Ivoire
| | - Gabin TRO
- Institut de cardiologie de Bouaké, Côte d'Ivoire
| | - Camille TOURE
- Service d'hémodynamique, Institut de cardiologie d'Abidjan, Côte d'Ivoire
| | - Désirée KOUASSI
- Service Médecine, Institut de cardiologie d'Abidjan, 01 BP V 206 Abidjan, Côte d'Ivoire
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Giga V, Boskovic N, Djordjevic-Dikic A, Beleslin B, Nedeljkovic I, Stankovic G, Tesic M, Jovanovic I, Paunovic I, Aleksandric S. Heart Rate Recovery as a Predictor of Long-Term Adverse Events after Negative Exercise Testing in Patients with Chest Pain and Pre-Test Probability of Coronary Artery Disease from 15% to 65. Diagnostics (Basel) 2023; 13:2229. [PMID: 37443623 DOI: 10.3390/diagnostics13132229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The prognosis of patients with chest pain after a negative exercise test is good, but some adverse events occur in this low-risk group. The aim of our study was to identify predictors of long-term adverse events after a negative exercise test in patients with chest pain and a lower intermediate (15-65%) pre-test probability of coronary artery disease (CAD) and to assess the prognostic value of exercise electrocardiography and exercise stress echocardiography in this group of patients. METHODS We identified from our stress test laboratory database 862 patients with chest pain without previously known CAD and with a pre-test probability of CAD ranging from 15 to 65% (mean 41 ± 14%) who underwent exercise testing. Patients were followed for the occurrence of death, non-fatal myocardial infarction (MI) and clinically guided revascularization. RESULTS During the median follow-up of 94 months, 87 patients (10.1%) had an adverse event (AE). A total of 30 patients died (3.5%), 23 patients suffered non-fatal MI (2.7%) and 34 patients (3.9%) had clinically guided revascularization (20 patients percutaneous and 14 patients surgical revascularizations). Male gender, age, the presence of diabetes and a slow heart rate recovery (HRR) in the first minute after exercise were independently related to the occurrence of AEs. Adverse events occurred in 10.3% of patients who were tested by exercise stress echocardiography and in 10.0% of those who underwent stress electrocardiography (p = 0.888). CONCLUSION The risk of AEs after negative exercise testing in patients with a pre-test probability of CAD of 15-65% is low. Male patients with a history of diabetes and slow HRR in the first minute after exercise have an increased risk of an adverse outcome.
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Affiliation(s)
- Vojislav Giga
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nikola Boskovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Branko Beleslin
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Ivana Nedeljkovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Goran Stankovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milorad Tesic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivana Jovanovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivana Paunovic
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Srdjan Aleksandric
- Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Laurino MJL, da Silva AKF, Santos LA, Vanderlei LCM. Water drinking during aerobic exercise improves the recovery of non-linear heart rate dynamics in coronary artery disease: crossover clinical trial. Front Neurosci 2023; 17:1147299. [PMID: 37424997 PMCID: PMC10323825 DOI: 10.3389/fnins.2023.1147299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The post-exercise recovery is a period of vulnerability of the cardiovascular system in which autonomic nervous system plays a key role in cardiovascular deceleration. It is already known that individuals with coronary artery disease (CAD) are at greater risk due to delayed vagal reactivation in this period. Water ingestion has been studied as a strategy to improve autonomic recovery and mitigate the risks during recovery. However, the results are preliminary and need further confirmation. Therefore, our aim was to investigate the influence of individualized water drinking on the non-linear dynamics of heart rate during and after aerobic exercise in CAD subjects. Methods 30 males with CAD were submitted to a control protocol composed of initial rest, warming up, treadmill exercise, and passive recovery (60 min). After 48 hours they performed the hydration protocol, composed of the same activities, however, with individualized water drinking proportional to the body mass lost in the control protocol. The non-linear dynamics of heart rate were assessed by indices of heart rate variability extracted from the recurrence plot, detrended fluctuation analysis, and symbolic analysis. Results and discussion During exercise, the responses were physiological and similar in both protocols, indicating high sympathetic activity and reduced complexity. During recovery, the responses were also physiological, indicating the rise of parasympathetic activity and the return to a more complex state. However, during hydration protocol, the return to a more complex physiologic state occurred sooner and non-linear HRV indices returned to resting values between the 5th and 20th minutes of recovery. In contrast, during the control protocol, only a few indices returned to resting values within 60 minutes. Despite that, differences between protocols were not found. We conclude that the water drinking strategy accelerated the recovery of non-linear dynamics of heart rate in CAD subjects but did not influence responses during exercise. This is the first study to characterize the non-linear responses during and after exercise in CAD subjects.
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Shiwani MA, Chico TJA, Ciravegna F, Mihaylova L. Continuous Monitoring of Health and Mobility Indicators in Patients with Cardiovascular Disease: A Review of Recent Technologies. SENSORS (BASEL, SWITZERLAND) 2023; 23:5752. [PMID: 37420916 PMCID: PMC10300851 DOI: 10.3390/s23125752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 07/09/2023]
Abstract
Cardiovascular diseases kill 18 million people each year. Currently, a patient's health is assessed only during clinical visits, which are often infrequent and provide little information on the person's health during daily life. Advances in mobile health technologies have allowed for the continuous monitoring of indicators of health and mobility during daily life by wearable and other devices. The ability to obtain such longitudinal, clinically relevant measurements could enhance the prevention, detection and treatment of cardiovascular diseases. This review discusses the advantages and disadvantages of various methods for monitoring patients with cardiovascular disease during daily life using wearable devices. We specifically discuss three distinct monitoring domains: physical activity monitoring, indoor home monitoring and physiological parameter monitoring.
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Affiliation(s)
- Muhammad Ali Shiwani
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
| | - Timothy J. A. Chico
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
| | - Fabio Ciravegna
- Dipartimento di Informatica, Università di Torino, 10124 Turin, Italy
| | - Lyudmila Mihaylova
- Department of Automatic Control and Systems Engineering, The University of Sheffield, Sheffield S1 3JD, UK
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27
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Gois CO, Conceição LSR, de Andrade Guimarães AL, Carvalho VO. Comment on: "exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis". Egypt Heart J 2023; 75:19. [PMID: 36928450 PMCID: PMC10020400 DOI: 10.1186/s43044-023-00344-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Low cardiorespiratory fitness is associated with poor prognosis in individuals with coronary artery disease and after coronary artery bypass grafting surgery. Thus, we comment about a meta-analysis that adds important information about the effect of exercise training on cardiac autonomic function in individuals following coronary artery bypass grafting surgery. MAIN BODY The study by Kushwaha et al. showed positive effects for heart rate variability and heart rate recovery in subjects after coronary artery bypass grafting surgery in response to acute physical training. These data are relevant, since heart rate variability is an independent predictor of for all-cause and cardiovascular mortality for individuals with cardiovascular disorders. Additionally, attenuated heart rate recovery is associated with increased risk for the same outcomes. Moreover, we summarize the quantitative data from studies that compared the effect of physical training in comparison with control group in cardiorespiratory fitness in adults following coronary artery bypass grafting. CONCLUSIONS Our findings suggest that improvements in peak oxygen consumption result in an additional benefit in adults following coronary artery bypass grafting. Considered that, the increased cardiorespiratory fitness is an independent predictor of longer survival in coronary artery disease.
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Affiliation(s)
- Caroline Oliveira Gois
- Postgraduate Program in Health Science, Department of Physical Therapy, Federal University of Sergipe (Universidade Federal de Sergipe - UFS), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil. .,The GrEAt Group (Grupo de Estudos Em Atividade Físicasica), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil.
| | - Lino Sergio Rocha Conceição
- The GrEAt Group (Grupo de Estudos Em Atividade Físicasica), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
| | - Alana Lalucha de Andrade Guimarães
- Postgraduate Program in Health Science, Department of Physical Therapy, Federal University of Sergipe (Universidade Federal de Sergipe - UFS), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil.,The GrEAt Group (Grupo de Estudos Em Atividade Físicasica), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
| | - Vitor Oliveira Carvalho
- Postgraduate Program in Health Science, Department of Physical Therapy, Federal University of Sergipe (Universidade Federal de Sergipe - UFS), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil.,The GrEAt Group (Grupo de Estudos Em Atividade Físicasica), Av. Marechal Rondon, s/n -Jardim Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
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Nelson BW, Pollak OH, Clayton MG, Telzer EH, Prinstein MJ. An RDoC-based approach to adolescent self-injurious thoughts and behaviors: The interactive role of social affiliation and cardiac arousal. Dev Psychopathol 2023:1-11. [PMID: 36882930 DOI: 10.1017/s0954579423000251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Recent theoretical models have posited that increases in self-injurious thoughts and behaviors (SITBs) during adolescence may be linked to failures in biological stress regulation in contexts of social stress. However, there is a lack of data examining this hypothesis during the transition to adolescence, a sensitive period of development characterized by changes across socioaffective and psychophysiological domains. Building on principles from developmental psychopathology and the RDoC framework, the present study used a longitudinal design in a sample of 147 adolescents to test whether interactions among experiences of social (i.e., parent and peer) conflict and cardiac arousal (i.e., resting heart rate) predicted adolescents' engagement in SITBs (i.e., nonsuicidal self-injury, NSSI; and suicidal ideation; SI) across 1-year follow-up. Prospective analyses revealed that adolescents experiencing a combination of greater peer, but not family, conflict and higher cardiac arousal at baseline showed significant longitudinal increases in NSSI. In contrast, social conflict did not interact with cardiac arousal to predict future SI. Findings indicate that greater peer-related interpersonal stress in adolescents may increase risk for future NSSI among youth with physiological vulnerabilities (i.e., higher resting heart rate) that may be markers of maladaptive stress responses. Future research should examine these processes at finer timescales to elucidate whether these factors are proximal predictors of within-day SITBs.
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Affiliation(s)
- Benjamin W Nelson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Olivia H Pollak
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew G Clayton
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eva H Telzer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Aktas H, Gul M, Inci S, Yildirim O, Turgut M. The effect of insulin resistance on the heart rate recovery in healthy individuals with a low-to-moderate cardiovascular disease risk profile. J Investig Med 2023; 71:482-488. [PMID: 36825620 DOI: 10.1177/10815589231158040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The association between insulin resistance (IR) and heart rate recovery index (HRRI) has been reported previously, but the cardiovascular disease (CVD) risk profile of the subjects was unclear in these studies. Therefore, we evaluated the association between IR and HRRI in apparently healthy individuals without metabolic syndrome who had a low-to-moderate CVD risk profile. A total of 182 eligible subjects were retrospectively included in the study. The subjects were divided into two groups according to the homeostasis model assessment of IR (HOMA-IR) value. HOMA-IR ≥2.5 was defined as IR (+) group (92 subjects), and <2.5 as IR (-) group (88 subjects). HRRI-2 was found by subtracting the heart rate at the second minute in the post-exercise recovery period from the maximum heart rate. Abnormal HRRI was defined as HRRI-2 that is ≤42 beats. The mean age of the patients was 41.91 ± 8.64 and 49.4% of them were female. Abnormal HRRI rates were significantly higher in the IR (+) group (37.2% vs 18.2%; p = 0.004). A negative correlation was detected between HRRI-2 and HOMA-IR (r = -0.416; p < 0.001). HOMA-IR (Odds Ratio (OR) = 1.57; confidence interval (CI) = 1.10-2.23; p = 0.013) and maximum heart rate during exercise (OR = 0.95; CI = 0.91-0.99; p = 0.013) as independent variables of abnormal HRRI. The HOMA-IR value of 2.82 was identified as an effective cutoff point for the prediction of abnormal HRRI (area under the curve: 0.658; CI: 0.570-0.746; p = 0.001). In this study, it was shown that IR without metabolic syndrome reduces HRRI in healthy individuals with a low-to-moderate CVD risk profile.
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Affiliation(s)
- Halil Aktas
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Murat Gul
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Sinan Inci
- Department of Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Oguz Yildirim
- Department of Cardiology, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Mustafa Turgut
- Department of Internal Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Torres-Castro R, Núñez-Cortés R, Larrateguy S, Alsina-Restoy X, Barberà JA, Gimeno-Santos E, García AR, Sibila O, Blanco I. Assessment of Exercise Capacity in Post-COVID-19 Patients: How Is the Appropriate Test Chosen? Life (Basel) 2023; 13:621. [PMID: 36983777 PMCID: PMC10054514 DOI: 10.3390/life13030621] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
There is a wide range of sequelae affecting COVID-19 survivors, including impaired physical capacity. These sequelae can affect the quality of life and return to work of the active population. Therefore, one of the pillars of following-up is the evaluation of physical capacity, which can be assessed with field tests (such as the six-minute walk test, the one-minute standing test, the Chester step test, and the shuttle walking test) or laboratory tests (such as the cardiopulmonary exercise test). These tests can be performed in different contexts and have amply demonstrated their usefulness in the assessment of physical capacity both in post-COVID-19 patients and in other chronic respiratory, metabolic, cardiologic, or neurologic diseases. However, when traditional tests cannot be performed, physical function can be a good substitute, especially for assessing the effects of an intervention. For example, the Short Physical Performance Battery assessment and the Timed Up and Go assessment are widely accepted in older adults. Thus, the test should be chosen according to the characteristics of each subject.
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Affiliation(s)
- Rodrigo Torres-Castro
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8380453, Chile
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46003 Valencia, Spain
| | - Santiago Larrateguy
- Servicio de Kinesiología y Fisioterapia, Hospital de la Baxada “Dra. Teresa Ratto”, Paraná 3100, Argentina
- Facultad de Ciencias de la Salud, Universidad Adventista del Plata, Libertador San Martin 3103, Argentina
| | - Xavier Alsina-Restoy
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Joan Albert Barberà
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
| | - Elena Gimeno-Santos
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Agustin Roberto García
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
| | - Oriol Sibila
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Isabel Blanco
- Department of Pulmonary Medicine, Hospital Clínic—Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 30627 Madrid, Spain
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Jaafar Z, Lim YZ. A comparison of low and high dose of moderate intensity aerobic exercise on heart rate recovery of the sedentary adults: a pragmatic randomized controlled trial. J Sports Med Phys Fitness 2023; 63:310-318. [PMID: 35620954 DOI: 10.23736/s0022-4707.22.13958-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heart rate recovery (HRR) has been used as a prognostication marker of health. A slower drop in HRR is linked to a higher risk of cardiovascular diseases and all-cause mortality. Since aerobic exercise has been shown to have favorable effects on HRR, we aimed to compare the effects of two different aerobic exercise doses on HRR among a sedentary adult population. METHODS A pragmatic randomised controlled trial was conducted on 29 healthy sedentary adults (seven males and 22 females) in a 12-week exercise program. They were randomly assigned to group A (75 min/week, N.=15) or group B (150 min/week, N.=14) of moderate intensity aerobic exercise groups. HRR at 1-minute (HRR1), HRR at 2-minute (HRR2), and peak oxygen uptake (VO<inf>2peak</inf>) were measured pre- and post-intervention. RESULTS The improvements of HRR1 and HRR2 were seen in both groups but was only significant (P<0.05) for group A with HRR1, -4.07 bpm (post 24.47±6.42 - pre 20.40±5.51, P=0.018) and HHR2, -3.93 bpm (post 43.40±13.61 - pre 39.47±10.68, P=0.046). Group B showed increment of HRR1, -1.14 bpm (post 21.14±5.35 - pre 20.00±6.30, P=0.286) and HRR2, -2.5 bpm, (post 39.36±8.01 - pre 36.86±9.57, P=0.221). Improvement of the VO<inf>2peak</inf> was only significant in group B with an increment of 1.52±2.61 (P=0.049). CONCLUSIONS In conclusion, our study suggests that improvements in heart rate recovery (HRR1 and HRR2) among sedentary healthy adults can be achieved by engaging in moderate intensity exercise at a dose lower than the current recommended guidelines. The lower dose seems to be more attainable and may encourage exercise compliance. Future studies should further explore the effects of different exercise volumes on HRR in a larger sample size and also by controlling for BMI or gender.
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Affiliation(s)
- Zulkarnain Jaafar
- Sports Medicine Unit, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia - .,Sports and Exercise Medicine Research and Education Group, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia -
| | - Yi Z Lim
- Sports Medicine Unit, Faculty of Medicine, Malaya University, Kuala Lumpur, Malaysia
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Garcia GL, Porto LGG, da Cruz CJG, Molina GE. Can resting heart rate explain the heart rate and parasympathetic responses during rest, exercise, and recovery? PLoS One 2022; 17:e0277848. [PMID: 36477005 PMCID: PMC9728889 DOI: 10.1371/journal.pone.0277848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022] Open
Abstract
The effect of resting heart rate (RHR) on the heart rate (HR) dynamics and parasympathetic modulation at rest, exercise, and recovery remain to be clarified. This study compares HR and parasympathetic responses at rest, during submaximal exercise testing and recovery in young, physically active men with different RHR average values. HR and parasympathetic responses were compared between two groups: bradycardia group-RHR < 60 bpm (BG, n = 20) and normocardia group-RHR ≥ 60 ≤ 100 bpm (NG, n = 20). A Polar RS800® was used to record the RR-interval series and HR at rest in the supine position, following the postural change (from supine to orthostatic position) and in the orthostatic position for 5 minutes, as well as during and after a submaximal exercise testing. Statistical analysis employed the MANOVA, Mann-Whitney, and Simple Linear regression test with a two-tailed p-value set at ≤ 0.05. BG at rest showed lower HR in the orthostatic position, higher parasympathetic activity in the supine and orthostatic positions, and higher parasympathetic reactivity than NG (p ≤ 0.01) after the postural change. BG before exercise showed lower HR and higher values of the chronotropic reserve and parasympathetic withdrawal than NG (p ≤ 0.01) throughout the exercise. Following the exercise, BG showed higher values of HR recovery (HRR) and parasympathetic reactivation in the 3rd and 5th minutes of recovery than NG (p ≤ 0.01). Lastly, the RHR can explain the variance of the HR at rest, during exercise testing, and recovery from 11 to 48%. We concluded that BG (RHR < 60 bpm) showed higher chronotropic and parasympathetic modulation at rest, higher chronotropic reserve, parasympathetic withdrawal during the submaximal exercise test, and faster HRR and parasympathetic reactivation after effort in young physically active men.
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Affiliation(s)
- Giliard Lago Garcia
- Exercise Physiology Laboratory of Faculty of Physical Education, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Research Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS)—University of Brasilia, Brasilia, Brazil
- * E-mail:
| | - Luiz Guilherme Grossi Porto
- Exercise Physiology Laboratory of Faculty of Physical Education, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Research Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS)—University of Brasilia, Brasilia, Brazil
| | - Carlos Janssen Gomes da Cruz
- Exercise Physiology Laboratory of Faculty of Physical Education, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Research Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS)—University of Brasilia, Brasilia, Brazil
| | - Guilherme Eckhardt Molina
- Exercise Physiology Laboratory of Faculty of Physical Education, University of Brasilia, Brasilia, Distrito Federal, Brazil
- Research Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS)—University of Brasilia, Brasilia, Brazil
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Antikainen E, Njoum H, Kudelka J, Branco D, Rehman RZU, Macrae V, Davies K, Hildesheim H, Emmert K, Reilmann R, Janneke van der Woude C, Maetzler W, Ng WF, O’Donnell P, Van Gassen G, Baribaud F, Pandis I, Manyakov NV, van Gils M, Ahmaniemi T, Chatterjee M. Assessing fatigue and sleep in chronic diseases using physiological signals from wearables: A pilot study. Front Physiol 2022; 13:968185. [PMID: 36452041 PMCID: PMC9702812 DOI: 10.3389/fphys.2022.968185] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/31/2022] [Indexed: 08/07/2023] Open
Abstract
Problems with fatigue and sleep are highly prevalent in patients with chronic diseases and often rated among the most disabling symptoms, impairing their activities of daily living and the health-related quality of life (HRQoL). Currently, they are evaluated primarily via Patient Reported Outcomes (PROs), which can suffer from recall biases and have limited sensitivity to temporal variations. Objective measurements from wearable sensors allow to reliably quantify disease state, changes in the HRQoL, and evaluate therapeutic outcomes. This work investigates the feasibility of capturing continuous physiological signals from an electrocardiography-based wearable device for remote monitoring of fatigue and sleep and quantifies the relationship of objective digital measures to self-reported fatigue and sleep disturbances. 136 individuals were followed for a total of 1,297 recording days in a longitudinal multi-site study conducted in free-living settings and registered with the German Clinical Trial Registry (DRKS00021693). Participants comprised healthy individuals (N = 39) and patients with neurodegenerative disorders (NDD, N = 31) and immune mediated inflammatory diseases (IMID, N = 66). Objective physiological measures correlated with fatigue and sleep PROs, while demonstrating reasonable signal quality. Furthermore, analysis of heart rate recovery estimated during activities of daily living showed significant differences between healthy and patient groups. This work underscores the promise and sensitivity of novel digital measures from multimodal sensor time-series to differentiate chronic patients from healthy individuals and monitor their HRQoL. The presented work provides clinicians with realistic insights of continuous at home patient monitoring and its practical value in quantitative assessment of fatigue and sleep, an area of unmet need.
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Affiliation(s)
- Emmi Antikainen
- VTT Technical Research Centre of Finland Ltd., Tampere, Finland
| | | | - Jennifer Kudelka
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Diogo Branco
- LASIGE, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Rana Zia Ur Rehman
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Victoria Macrae
- NIHR Newcastle Biomedical Research Centre and NIHR Newcastle Clinical Research Facility, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Kristen Davies
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Hanna Hildesheim
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Kirsten Emmert
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Ralf Reilmann
- George-Huntington-Institute, University of Münster, Münster, Germany
- Department of Clinical Radiology, University of Münster, Münster, Germany
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Wan-Fai Ng
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre and NIHR Newcastle Clinical Research Facility, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Patricio O’Donnell
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, United States
| | | | | | | | | | - Mark van Gils
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Teemu Ahmaniemi
- VTT Technical Research Centre of Finland Ltd., Tampere, Finland
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Cabral DF, Bigliassi M, Cattaneo G, Rundek T, Pascual-Leone A, Cahalin LP, Gomes-Osman J. Exploring the interplay between mechanisms of neuroplasticity and cardiovascular health in aging adults: A multiple linear regression analysis study. Auton Neurosci 2022; 242:103023. [PMID: 36087362 PMCID: PMC11012134 DOI: 10.1016/j.autneu.2022.103023] [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: 02/09/2022] [Revised: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neuroplasticity and cardiovascular health behavior are critically important factors for optimal brain health. OBJECTIVE To assess the association between the efficacy of the mechanisms of neuroplasticity and metrics of cardiovascular heath in sedentary aging adults. METHODS We included thirty sedentary individuals (age = 60.6 ± 3.8 y; 63 % female). All underwent assessments of neuroplasticity, measured by the change in amplitude of motor evoked potentials elicited by single-pulse Transcranial Magnetic Stimulation (TMS) at baseline and following intermittent Theta-Burst (iTBS) at regular intervals. Cardiovascular health measures were derived from the Incremental Shuttle Walking Test and included Heart Rate Recovery (HRR) at 1-min/2-min after test cessation. We also collected plasma levels of brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and c-reactive protein. RESULTS We revealed moderate but significant relationships between TMS-iTBS neuroplasticity, and the predictors of cardiovascular health (|r| = 0.38 to 0.53, p < .05). HRR1 was the best predictor of neuroplasticity (β = 0.019, p = .002). The best fit model (Likelihood ratio = 5.83, p = .016) of the association between neuroplasticity and HRR1 (β = 0.043, p = .002) was selected when controlling for demographics and health status. VEGF and BDNF plasma levels augmented the association between neuroplasticity and HRR1. CONCLUSIONS Our findings build on existing data demonstrating that TMS may provide insight into neuroplasticity and the role cardiovascular health have on its mechanisms. These implications serve as theoretical framework for future longitudinal and interventional studies aiming to improve cardiovascular and brain health. HRR1 is a potential prognostic measure of cardiovascular health and a surrogate marker of brain health in aging adults.
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Affiliation(s)
- Danylo F Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA.
| | - Marcelo Bigliassi
- Department of Teaching and Learning, Florida International University, Miami, FL, USA
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Badalona, Spain; Department of Medicine, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Evelyn F. McKnight Brain Institute, University of Miami, Miami, FL, USA
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Badalona, Spain; Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA
| | - Joyce Gomes-Osman
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
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Hinchman CA, Cabral DF, Ciesla M, Flothmann M, Nunez C, Rice J, Loewenstein DA, Kitaigorodsky M, Cahalin LP, Rundek T, Pascual-Leone A, Cattaneo G, Gomes-Osman J. Exercise engagement drives changes in cognition and cardiorespiratory fitness after 8 weeks of aerobic training in sedentary aging adults at risk of cognitive decline. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:923141. [PMID: 36189006 PMCID: PMC9397848 DOI: 10.3389/fresc.2022.923141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/11/2022] [Indexed: 12/23/2022]
Abstract
Background With our aging population, many individuals are at risk of developing age-related cognitive decline. Physical exercise has been demonstrated to enhance cognitive performance in aging adults. This study examined the effects of 8 weeks of aerobic exercise on cognitive performance and cardiorespiratory fitness in sedentary aging adults at risk for cognitive decline. Methods Fifty-two participants (age 62.9 ± 6.8, 76.9% female) engaged in eight weeks of moderate-to high-intensity exercise (19 in-person, 33 remotely). Global cognition was measured by the Repeatable Battery for the Assessment of Neuropsychological Status, the Delis-Kaplan Executive Function System, and the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS) Fourth Edition. Cardiorespiratory fitness was measured via heart rate recovery at minute 1 (HRR1) and 2 (HRR2), and exercise engagement (defined as percent of total exercise time spent in the prescribed heart rate zone). We measured pre and post changes using paired t-tests and mixed effects models, and investigated the association between cardiorespiratory and cognitive performance using multiple regression models. Cohen's d were calculated to estimate effect sizes. Results Overall, 63.4 % of participants demonstrated high engagement (≥ 70% total exercise time spent in the prescribed heart rate zone). There were significant pre-post improvements in verbal fluency and verbal memory, and a significant decrement in working memory, but these were associated with small effect sizes (Cohen's d <0.5). Concerning cardiorespiratory fitness, there was a pre-to-post significant improvement in HRR1 (p = 0.01, d = 0.30) and HRR2 (p < 0.001, d = 0.50). Multiple regressions revealed significant associations between cardiorespiratory and cognitive performance, but all were associated with small effect sizes (Cohen's d < 0.5). Interestingly, there were significant between-group differences in exercise engagement (all p < 0.001), with remote participants demonstrating greater exercise engagement than in-person participants. Conclusion Improvements in cognition and cardiorespiratory fitness were observed after 8 weeks of moderate to high-intensity exercise in aging adults. These results suggest that committing to a regular exercise regimen, even for a brief two-month period, can promote improvements in both cardiorespiratory fitness and cognitive performance, and that improvements are driven by exercise engagement.
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Affiliation(s)
- Carrie A Hinchman
- School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Danylo F Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States
| | | | - Marti Flothmann
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.,Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Christina Nunez
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States
| | - Jordyn Rice
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States
| | - David A Loewenstein
- Center for Cognitive Neuroscience and Aging, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Marcela Kitaigorodsky
- Center for Cognitive Neuroscience and Aging, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.,Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Alvaro Pascual-Leone
- Linus Health, Waltham, MA, United States.,Department of Neurology, Harvard Medical School, Boston, MA, United States.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Rosindale, MA, United States.,Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Rosindale, MA, United States.,Guttmann Brain Health Institute, Barcelona, Spain
| | - Gabriele Cattaneo
- Guttmann Brain Health Institute, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Joyce Gomes-Osman
- Linus Health, Waltham, MA, United States.,Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.,Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
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Iqbal M, Putra ICS, Kamarullah W, Pranata R, Achmad C, Karwiky G, Pramudyo M, Goenawan H, Akbar MR, Kartasasmita AS, Kim YH. Revisiting exercise-induced premature ventricular complexes as a prognostic factor for mortality in asymptomatic patients: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:949694. [PMID: 36247448 PMCID: PMC9556273 DOI: 10.3389/fcvm.2022.949694] [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: 05/21/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundRecent investigations suggest that premature ventricular complexes (PVCs) during an exercise test are associated with an elevated risk of mortality in asymptomatic individuals. However, given the small number of studies included, the association between these two entities in the asymptomatic population remains obscure. Our aim was to evaluate this matter.MethodsA comprehensive literature search was conducted utilizing several online databases up to April 2022. The study comprised cohort studies examining the relationship between exercise-induced premature ventricular complexes (EI-PVCs) and all-cause mortality (ACM) as well as cardiovascular mortality (CVM) in asymptomatic populations. To provide diagnostic values across the statistically significant parameters, we additionally calculated sensitivity, specificity, and area under the curve (AUC).ResultsA total of 13 studies consisting of 82,161 patients with a mean age of 49.3 years were included. EI-PVCs were linked to an increased risk of ACM (risk ratio (RR) = 1.30 (95% confidence interval (CI) = 1.18–1.42); p < 0.001; I2 = 59.6%, p-heterogeneity < 0.001) and CVM (RR = 1.67 (95% CI = 1.40–1.99); p < 0.001; I2 = 7.5%, p-heterogeneity = 0.373). Subgroup analysis based on the frequency of PVCs revealed that frequent PVCs were similarly related to a higher risk of ACM and CVM, but not infrequent PVCs. Moreover, diagnostic test accuracy meta-analysis showed that recovery phase EI-PVCs have a higher overall specificity than exercise phase EI-PVCs regarding our outcomes of interest.ConclusionEI-PVCs are correlated with a higher risk of ACM and CVM. When compared to the exercise phase, the specificity of PVCs generated during the recovery period in predicting interest outcomes is higher. As a result, we propose that the exercise ECG be utilized on a regular basis in middle-aged asymptomatic individuals to measure the frequency of PVCs and stratify the risk of mortality.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=328852], identifier [CRD42022328852].
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Affiliation(s)
- Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, South Korea
- *Correspondence: Mohammad Iqbal,
| | - Iwan Cahyo Santosa Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - William Kamarullah
- R. Syamsudin, SH Regional Public Hospital, Sukabumi, West Java, Indonesia
| | - Raymond Pranata
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - Chaerul Achmad
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - Giky Karwiky
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - Miftah Pramudyo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - Hanna Goenawan
- Division of Physiology, Department of Biomedical Sciences, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia
| | | | - Young Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, South Korea
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Kushwaha P, Moiz JA, Mujaddadi A. Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis. Egypt Heart J 2022; 74:67. [PMID: 36138168 PMCID: PMC9500144 DOI: 10.1186/s43044-022-00306-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exercise training improves cardiac autonomic function is still debatable in patients with coronary artery bypass grafting (CABG). The aim of the present review is to assess the effect of exercise on CABG patient's heart rate variability (HRV) and heart rate recovery (HRR) parameters. MAIN BODY Databases (PubMed, Web of Science and PEDro) were accessed for systematic search from inception till May 2022. Eleven potential studies were qualitatively analyzed by using PEDro and eight studies were included in the quantitative synthesis. Meta-analysis was conducted by using a random-effect model, inverse-variance approach through which standardized mean differences (SMDs) were estimated. The analysis of pooled data showed that exercise training improved HRV indices of standard deviation of the R-R intervals (SDNN) [SMD 0.44, 95% CI 0.17, 0.71, p = 0.002], square root of the mean squared differences between adjacent R-R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08, p = 0.0008], high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98, p = 0.005] and low frequency-to-high frequency (LF/HF) ratio [SMD - 0.34, 95% CI - 0.65, - 0.02, p = 0.03]. CONCLUSIONS Exercise training enhances cardiac autonomic function in CABG patients. Owing to the methodological inconsistencies in assessing HRV, the precise effect on autonomic function still remains conflicted. Future high-quality trials are needed focusing on precise methodological approach and incorporation of various types of exercise training interventions will give clarity regarding autonomic adaptations post-exercise training in CABG. Trial registration CRD42021230270 , February 19, 2021.
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Affiliation(s)
- Purnima Kushwaha
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025 India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025 India
| | - Aqsa Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025 India
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Bragada JA, Bartolomeu RF, Rodrigues PM, Magalhães PM, Bragada JP, Morais JE. Validation of StepTest4all for Assessing Cardiovascular Capacity in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11274. [PMID: 36141547 PMCID: PMC9517667 DOI: 10.3390/ijerph191811274] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cardiovascular capacity, expressed as maximal oxygen uptake (VO2max), is a strong predictor of health and fitness and is considered a key measure of physiological function in the healthy adult population. The purpose of this study was to validate a specific step test (StepTest4all) as an adequate procedure to estimate cardiovascular capacity in young adults. METHODS The sample was composed of 56 participants, including 19 women (aged 21.05 ± 2.39 years, body mass = 57.50 ± 6.64 kg, height = 1.62 ± 0.05 m, body mass index = 22.00 ± 2.92 kg/m2) and 37 men (aged 22.05 ± 3.14 years, body mass = 72.50 ± 7.73 kg, height = 1.76 ± 0.07 m, body mass index = 23.34 ± 2.17 kg/m2). Participants were included in one of the following groups: (i) the group used to predict the VO2max, and (ii) the group used to validate the prediction model. All participants performed the StepTest4all protocol. The step height and the intensity of the effort was determined individually. Heart rate and oxygen uptake were measured continuously during rest, effort, and recovery phases. The validation process included the following three stages: (i) mean data comparison, (ii) simple linear regression, and (iii) Bland-Altman analysis. RESULTS The linear regression retained, as significant predictors of the VO2max, sex (p < 0.001) and heart rate recovery for one minute (p = 0.003). The prediction equation revealed a high relationship between measurements (R2 = 63.0%, SEE = 5.58). The validation procedure revealed non-significant differences (p > 0.05) between the measured and estimated maximal oxygen uptake, high relationship (R2 = 63.3%), and high agreement with Bland-Altman plots. Thus, VO2max can be estimated with the formula: VO2max = 22 + 0.3 · (HRR1min) + 12 · (sex), where HRR1min is the magnitude of the HR decrease (bpm) in one minute immediately after the step was stopped, and sex: men = 1, women = 0. CONCLUSIONS The StepTest4all is an adequate procedure to estimate cardiovascular capacity, expressed as VO2max, in young adults. In addition, it is possible to determine the qualitative level of cardiovascular capacity from the heart rate recovery for one minute, more specifically, poor: <20, moderate: 20 to 34, good: 35 to 49, and excellent: ≥50. This procedure has the benefit of being simple to apply and can be used by everyone, even at home, without specialist supervision.
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Affiliation(s)
- José A. Bragada
- Department of Sport Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Centre in Sports, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Raul F. Bartolomeu
- Department of Sport Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Centre in Sports, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sport Sciences, Instituto Politécnico da Guarda, 6300-559 Guarda, Portugal
| | - Pedro M. Rodrigues
- Department of Sport Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
| | - Pedro M. Magalhães
- Department of Sport Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
| | - João P. Bragada
- North East Local Health Unit—Health Care Unit of Santa Maria, 5301-852 Bragança, Portugal
| | - Jorge E. Morais
- Department of Sport Sciences, Instituto Politécnico de Bragança, 5300-253 Bragança, Portugal
- Research Centre in Sports, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
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Fortier S, Kelly LP, Basset FA. Practical guidance for firefighter applicants preparing for cardiorespiratory fitness testing: a secondary analysis of self-reported physical activity levels. PeerJ 2022; 10:e13832. [PMID: 36093334 PMCID: PMC9455017 DOI: 10.7717/peerj.13832] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 01/18/2023] Open
Abstract
Adequate cardiorespiratory fitness is critical for firefighters since an insufficient level of fitness threatens the integrity of their operations and could be dangerous for their lives. In fact, the leading cause of mortality for on-duty firefighters is not injury but sudden cardiac death. Therefore, to mitigate these risks, potential firefighter recruits are often required to perform a graded exercise test to determine their cardiorespiratory fitness as part of the recruitment process. However, there are currently limited data available to prospective firefighters on the amounts and types of exercises needed to be successful in the graded exercise test, commonly known as a V̇O2max test. Physiological parameters for the current secondary analysis were collected on firefighter applicants who performed the graded exercise test where 72% were successful and 28% were unsuccessful to meet the minimum standard set at 42.5 ml kg-1 min-1. Prior to their test, applicants were asked to describe their exercise training routine by indicating the number of minutes per week spent exercising. Activities were then divided into one of two categories: endurance exercise or strength and power exercise training. The total exercise training describes the sum of all activities performed each week. The sum of endurance exercise activities and the sum of strength and power exercise activities were compared between the successful and the unsuccessful groups and results showed that successful applicants had a higher training volume and performed more endurance exercise training as compared to unsuccessful applicants. Therefore, practical recommendations related to exercise training regime are presented for firefighter applicants to embrace as guidance to prepare for their graded exercise test as part of their recruitment process.
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Affiliation(s)
- Sylvie Fortier
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Liam P. Kelly
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
| | - Fabien A. Basset
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
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Wang J, Zhu Q, Zhang S, Wen L, Wang L. Observation of Clinical Efficacy of Anisodamine and Chlorpromazine in the Treatment of Intractable Hiccup after Stroke. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6563193. [PMID: 35915796 PMCID: PMC9338746 DOI: 10.1155/2022/6563193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022]
Abstract
Objective This study is aimed at investigating the clinical efficacy of anisodamine combined with chlorpromazine on intractable hiccups after stroke. Methods 150 patients admitted to Affiliated Hospital of the Hebei University of Engineering from 2017 to 2021 were selected as the research objects, all of which received the computed tomography (CT) examination. During CT examination, intelligent algorithms were used to segment the images. An unsupervised multilayer image threshold segmentation algorithm was proposed by using Kullback-Leibler (K-L) divergence and the modified particle swarm optimization (MPSO) algorithm. All patients were divided into three groups, with each group of 50 patients. Patients in the control group (group A) took the calcium tablets, vitamin C tablets, and vitamin B1 tablets orally. Patients in the control group (group B) received the acupoint injection of anisodamine, and those in the observation group (group C) received the acupoint injection of anisodamine combined with chlorpromazine. The therapeutic effect and patient satisfaction of the three groups were compared. Results The two-dimensional (2D) K-L divergence was applied for the multilayer segmentation of images, which was helpful to obtain accurate images. The MPSO algorithm was adopted to reduce the computational complexity. The total efficiency of group C was 98%, that of group B was 56%, and that of group A was 22%. The total efficiency and satisfaction rate of group C were signally better than those of group A and group B (P < 0.05). Conclusion The combination of 2D K-L divergence and MPSO algorithm could improve the accuracy of multilayer image segmentation and CT imaging. Acupoint injection of anisodamine combined with chlorpromazine had better efficacy than the injection of anisodamine alone for the treatment of intractable hiccups after stroke, with high safety and clinical promotion value.
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Affiliation(s)
- Jing Wang
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002 Hebei, China
| | - Qinghua Zhu
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002 Hebei, China
| | - Shuyan Zhang
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002 Hebei, China
| | - Lisha Wen
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002 Hebei, China
| | - Li Wang
- Department of Neurology, Affiliated Hospital of Hebei University of Engineering, Handan, 056002 Hebei, China
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Qiu S, Cai X, Yuan Y, Xie B, Sun Z, Wu T. Is imaging-based muscle quantity associated with risk of diabetes? A meta-analysis of cohort studies. Diabetes Res Clin Pract 2022; 189:109939. [PMID: 35662615 DOI: 10.1016/j.diabres.2022.109939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 11/03/2022]
Abstract
AIMS Greater muscle quantity (muscle mass and area) is associated with better glycemic control in adults, but its longitudinal association with risk of diabetes remains debatable. We therefore conducted this meta-analysis to address this issue. METHODS We performed a literature search and included cohort studies that measured muscle quantity objectively by imaging-based approaches and reported their association with risk of diabetes. Study-specific data were pooled using a random-effects model. RESULTS Thirty-three unique datasets, with 10 on total muscle quantity, and 23 on regional (8 on appendicular, 4 on leg, 6 on thigh, and 5 on abdominal) muscle quantity, were included. Muscle quantity was all measured by dual energy x-ray absorptiometry or computed tomography. Most datasets revealed nonsignificant outcomes. Meta-analysis showed collectively that the risk of diabetes was not related to total or regional muscle quantity in either normalized or unnormalized form, with the hazard ratios ranged from 0.92 to 1.09 per every 1 standard deviation higher of corresponding muscle quantity in general (all P > 0.10). Neither sex nor weight status affected the relationship. CONCLUSIONS Our study did not provide adequate evidence to support the concept that large muscle quantity was associated with low risk of diabetes in population-based cohort studies.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China; The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China(1)
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yang Yuan
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Bo Xie
- Department of General Practice, Zhongda Hospital, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China.
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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Deutsch L, Debevec T, Millet GP, Osredkar D, Opara S, Šket R, Murovec B, Mramor M, Plavec J, Stres B. Urine and Fecal 1H-NMR Metabolomes Differ Significantly between Pre-Term and Full-Term Born Physically Fit Healthy Adult Males. Metabolites 2022; 12:metabo12060536. [PMID: 35736470 PMCID: PMC9228004 DOI: 10.3390/metabo12060536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 12/04/2022] Open
Abstract
Preterm birth (before 37 weeks gestation) accounts for ~10% of births worldwide and remains one of the leading causes of death in children under 5 years of age. Preterm born adults have been consistently shown to be at an increased risk for chronic disorders including cardiovascular, endocrine/metabolic, respiratory, renal, neurologic, and psychiatric disorders that result in increased death risk. Oxidative stress was shown to be an important risk factor for hypertension, metabolic syndrome and lung disease (reduced pulmonary function, long-term obstructive pulmonary disease, respiratory infections, and sleep disturbances). The aim of this study was to explore the differences between preterm and full-term male participants' levels of urine and fecal proton nuclear magnetic resonance (1H-NMR) metabolomes, during rest and exercise in normoxia and hypoxia and to assess general differences in human gut-microbiomes through metagenomics at the level of taxonomy, diversity, functional genes, enzymatic reactions, metabolic pathways and predicted gut metabolites. Significant differences existed between the two groups based on the analysis of 1H-NMR urine and fecal metabolomes and their respective metabolic pathways, enabling the elucidation of a complex set of microbiome related metabolic biomarkers, supporting the idea of distinct host-microbiome interactions between the two groups and enabling the efficient classification of samples; however, this could not be directed to specific taxonomic characteristics.
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Affiliation(s)
- Leon Deutsch
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia; (L.D.); (S.O.)
| | - Tadej Debevec
- Faculty of Sports, University of Ljubljana, SI-1000 Ljubljana, Slovenia;
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, SI-1000 Ljubljana, Slovenia
| | - Gregoire P. Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015 Lausanne, Switzerland;
| | - Damjan Osredkar
- Department of Pediatric Neurology, University Children’s Hospital, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Simona Opara
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia; (L.D.); (S.O.)
| | - Robert Šket
- Institute for Special Laboratory Diagnostics, University Children’s Hospital, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia;
| | - Boštjan Murovec
- Faculty of Electrical Engineering, University of Ljubljana, Jamova 2, SI-1000 Ljubljana, Slovenia;
| | - Minca Mramor
- Department of Infectious Diseases, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia;
| | - Janez Plavec
- National Institute of Chemistry, NMR Center, SI-1000 Ljubljana, Slovenia;
| | - Blaz Stres
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia; (L.D.); (S.O.)
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, SI-1000 Ljubljana, Slovenia
- Institute of Sanitary Engineering, Faculty of Civil and Geodetic Engineering, University of Ljubljana, SI-1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-4156-7633
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Thomas JM, Black WS, Kern PA, Pendergast JS, Clasey JL. Heart rate recovery as an assessment of cardiorespiratory fitness in young adults. JOURNAL OF CLINICAL EXERCISE PHYSIOLOGY 2022; 11:44-53. [PMID: 36466304 PMCID: PMC9718361 DOI: 10.31189/2165-6193-11.2.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background Cardiorespiratory fitness, typically measured as peak oxygen uptake (VO2peak) during maximal graded exercise testing (GXTmax), is a predictor of morbidity, mortality, and cardiovascular disease. However, measuring VO2peak is costly and inconvenient and thus not widely used in clinical settings. Alternatively, postexercise heart rate recovery (HRRec), which is an index of vagal reactivation, is a valuable assessment of VO2peak in older adults and athletes. However, the validity of HRRec as a clinical indicator of cardiorespiratory fitness in young, sedentary adults, who are a rapidly growing population at risk for developing obesity and cardiovascular disease, has not been fully elucidated. Methods We investigated the association between cardiorespiratory fitness, measured by VO2peak (mL·kg-1·min-1), and HRRec measures after a GXTmax in 61 young (25.2 ± 6.1 years), sedentary adults (40 females) using 3 methods. We examined the relationship between VO2peak and absolute (b·min-1) and relative (%) HRRec measures at 1, 2, and 3 min post GXTmax, as well as a measure of the slow component HRRec (HRRec 1 min minus HRR 2 min), using Pearson's correlation analysis. Results VO2peak (36.5 ± 7.9 mL·kg-1·min-1) was not significantly correlated with absolute HRRec at 1 min (r = 0.18), 2 min (r = 0.04) or 3 min (r = 0.01). We also found no significant correlations between VO2peak and relative HRRec at 1 min (r = 0.09), 2 min (r = -0.06) or 3 min (r = -0.10). Lastly, we found no correlation between the measure of the slow component HRRec and VO2peak (r = -0.14). Conclusions Our results indicate that HRRec measures are not a valid indicator of cardiorespiratory fitness in young, sedentary adults.
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Affiliation(s)
- J. Matthew Thomas
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, USA
| | - W. Scott Black
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
- Department of Clinical Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Philip A. Kern
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, USA
- The Department of Internal Medicine, Division of Endocrinology, University of Kentucky, Lexington, Kentucky, USA
- Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, Kentucky, USA
| | - Julie S. Pendergast
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, USA
- Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, Kentucky, USA
- Saha Cardiovascular Center, University of Kentucky, Lexington, Kentucky, USA
- Department of Biology, University of Kentucky, Lexington, Kentucky, USA
| | - Jody L. Clasey
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
- Center for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, USA
- Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, Kentucky, USA
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Abstract
Purpose of Review Wearable technology is rapidly evolving and the data that it can provide regarding an individual’s health is becoming increasingly important for clinicians to consider. The purpose of this review is to help inform health care providers of the benefits of smartwatch interrogation, with a focus on reviewing the various parameters and how to apply the data in a meaningful way. Recent Findings This review details interpretation of various parameters found commonly in newer smartwatches such as heart rate, step count, ECG, heart rate recovery (HRR), and heart rate variability (HRV), while also discussing potential pitfalls that a clinician should be aware of. Summary Smartwatch interrogation is becoming increasingly relevant as the continuous data it provides helps health care providers make more informed decisions regarding diagnosis and treatment. For this reason, we recommend health care providers familiarize themselves with the technology and integrate it into clinical practice.
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Zampogna E, Ambrosino N, Oliva FM, Sotgiu G, Saderi L, Cremonese G, Bellelli G, Spanevello A, Angeli F, Visca D. Heart rate recovery in adult individuals with asthma. Monaldi Arch Chest Dis 2022; 93. [PMID: 35546720 DOI: 10.4081/monaldi.2022.2265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 01/21/2023] Open
Abstract
Slow heart rate recovery (HRR) after exercise is a predictor of overall mortality in individuals with and without cardiovascular or respiratory disorders. No data on adults with asthma are available. The purpose of the study is to evaluate the prevalence of slow HRR in these individuals as compared with those with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of baseline characteristics and physiological response to the six-minute walking distance test of stable individuals with asthma or COPD. Slow HRR was defined as HRpeak - HR at 1 minute after end exercise <12 bpm. Individuals with asthma walked significantly longer (median (IQR): 455 (385-512) vs 427 (345-485) meters; p=0.005) with a lower prevalence of slow HRR (30.3% vs 49.0%, respectively: p<0.001) than those with COPD. Individuals with asthma and slow HRR were older and walked less than those with normal HRR, without any difference in airway obstruction or in disease severity. Multivariate analysis showed that only the difference HRpeak - baseline HR (∆HR), was a predictor of slow HRR in both groups. More than 30% of adult individuals with asthma may show slow HRR. Only exercise ∆HR but no baseline characteristic seems to predict the occurrence of slow HRR.
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Affiliation(s)
- Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate.
| | - Nicolino Ambrosino
- Division of Pulmonary Rehabilitation, ICS Maugeri IRCCS, Institute of Montescano.
| | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari.
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Medicine, University of Sassari.
| | - Gioele Cremonese
- Division of Cardiac Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate.
| | - Giorgio Bellelli
- Division of Pulmonary Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate.
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate; Department of Medicine and Surgery, University of Insubria, Varese.
| | - Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, Varese; Division of Cardiac Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate.
| | - Dina Visca
- Division of Pulmonary Rehabilitation, ICS Maugeri IRCCS, Institute of Tradate; Department of Medicine and Surgery, University of Insubria, Varese.
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Tabachnikov V, Saliba W, Aker A, Zafrir B. Heart Rate Response to Exercise and Recovery: INDEPENDENT PROGNOSTIC MEASURES IN PATIENTS WITHOUT KNOWN MAJOR CARDIOVASCULAR DISEASE. J Cardiopulm Rehabil Prev 2022; 42:E34-E41. [PMID: 35383665 DOI: 10.1097/hcr.0000000000000679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Heart rate response during exercise testing (ET) provides valuable prognostic information. Limited data are available regarding the prognostic interplay of heart rate (HR) measured at rest, exercise and recovery phases of ET, and its ability to predict risk beyond exercise capacity. METHODS Retrospective analysis of treadmill ETs was performed by the Bruce protocol in patients aged 35-75 yr without known cardiovascular disease (CVD; n = 13 887; 47% women). Heart rate recovery at 2 min (HRR2; defined abnormal <42 beats) and chronotropic index (CI; defined abnormal <80%, determined as age-predicted HR reserve) were analyzed in association with the risk of developing myocardial infarction, stroke, or death (major adverse cardiovascular event [MACE]) during median follow-up of 6.5 yr. RESULTS The HRR2 <42 beats and CI <80% were each associated with increased risk of MACE: adjusted hazard ratios with 95% confidence interval 1.47: 1.27-1.72 and 1.66: 1.42-1.93, P < .001, respectively, evident also when analyzed as continuous variables. Strength of association of HRR2 and CI with outcome was attenuated but remained significant with further adjustment for exercise duration and metabolic equivalents. Having both HRR2 and CI abnormal compared with only one measure abnormal was associated with hazard ratios with 95% confidence interval of 1.66: 1.38-2.00 and 1.48: 1.22-1.79 for MACE, before and after adjustment for cardiorespiratory fitness (CRF). The degree of CRF (low vs mid/high) did not modify the prognostic effect of HRR2 and CI (P-for-interaction nonsignificant). CONCLUSIONS Both HRR2 and CI provide independent prognostic information beyond CRF in patients without CVD referred for ET. The predictive ability is more pronounced when both abnormal HR measures coexist.
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Affiliation(s)
- Vsevolod Tabachnikov
- Departments of Cardiology (Drs Tabachnikov, Aker, and Zafrir) and Community Medicine and Epidemiology (Dr Saliba), Lady Davis Carmel Medical Center, Haifa, Israel; and Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel (Drs Saliba and Zafrir)
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Eyyupkoca F, Kocak A, Yildirim O, Altintas MS, Ercan K, Sabanoglu C, Okutucu S. Is there a relationship between heart rate recovery and blood pressure in white coat hypertension? KARDIOLOGIIA 2022; 62:55-63. [PMID: 35569164 DOI: 10.18087/cardio.2022.4.n1897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/14/2021] [Accepted: 11/26/2021] [Indexed: 06/15/2023]
Abstract
Aim Increasing evidence suggests that autonomic dysfunction may be involved in the etiology of white coat hypertension (WCH). The aim of this study was to evaluate cardiac autonomic function by using heart rate recovery (HRR) indices in patients with WCH classified according to their circadian rhythm type of blood pressure (BP).Material and methods This cross-sectional study included 120 participants over the age of 18 yrs, including 50 patients diagnosed with WCH and 70 healthy controls with normal in- and out-of-office BP and without any known disease. Circadian rhythm types, i.e., dippers and non-dippers, were identified using ambulatory BP monitoring. The HRR indices were calculated by subtracting the 1st-minute (HRR1), 2nd-minute (HRR2), and 3rd-minute (HRR3) heart rates from the maximal heart rate recorded during stress testing.Results The lesser decline in nighttime BP (6.4±2.14 and 13.3±2.2 mmHg, respectively; p<0.001) and the smaller mean HRR1 (25.5±3.0 and 30.3±3.1 beats / min, respectively; p<0.001) were evident in WCH non-dippers compared to WCH dippers. Linear regression analysis showed that HRR1 (β±SE=0.43±0.11; p<0.001) and diastolic BP at maximum exercise (β±SE=0.14±0.07; p=0.040) are independent risk factors for the blunted decline in nighttime BP.Conclusion Delayed recovery of heart rate after an exercise stress test is associated with non-dipper type of circadian rhythm of BP. This was more pronounced in WCH patients, and these patients are at risk of autonomic dysfunction.
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Charlton PH, Kyriacou PA, Mant J, Marozas V, Chowienczyk P, Alastruey J. Wearable Photoplethysmography for Cardiovascular Monitoring. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2022; 110:355-381. [PMID: 35356509 PMCID: PMC7612541 DOI: 10.1109/jproc.2022.3149785] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/06/2022] [Accepted: 01/27/2022] [Indexed: 05/29/2023]
Abstract
Smart wearables provide an opportunity to monitor health in daily life and are emerging as potential tools for detecting cardiovascular disease (CVD). Wearables such as fitness bands and smartwatches routinely monitor the photoplethysmogram signal, an optical measure of the arterial pulse wave that is strongly influenced by the heart and blood vessels. In this survey, we summarize the fundamentals of wearable photoplethysmography and its analysis, identify its potential clinical applications, and outline pressing directions for future research in order to realize its full potential for tackling CVD.
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Affiliation(s)
- Peter H. Charlton
- Department of Biomedical EngineeringSchool of Biomedical Engineering and Imaging SciencesKing’s College London, King’s Health PartnersLondonSE1 7EUU.K.
- Research Centre for Biomedical Engineering, CityUniversity of LondonLondonEC1V 0HBU.K.
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeCB1 8RNU.K.
| | - Panicos A. Kyriacou
- Research Centre for Biomedical Engineering, CityUniversity of LondonLondonEC1V 0HBU.K.
| | - Jonathan Mant
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeCB1 8RNU.K.
| | - Vaidotas Marozas
- Department of Electronics Engineering and the Biomedical Engineering Institute, Kaunas University of Technology44249KaunasLithuania
| | - Phil Chowienczyk
- Department of Clinical PharmacologyKing’s College LondonLondonSE1 7EHU.K.
| | - Jordi Alastruey
- Department of Biomedical EngineeringSchool of Biomedical Engineering and Imaging SciencesKing’s College London, King’s Health PartnersLondonSE1 7EUU.K.
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Del Rosso S, Baraquet L, Bergero G, Muñoz F, Mazzocco YL, Aoki MP, Perovic NR. Associations between objectively measured physical activity, sedentary time, and cardiorespiratory fitness with inflammatory and oxidative stress markers and heart rate variability. J Public Health Res 2022; 11:22799036221106580. [PMID: 38606291 PMCID: PMC11008712 DOI: 10.1177/22799036221106580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 04/13/2024] Open
Abstract
Background To assess the associations between physical activity (PA) and sedentary time (SEDT) with inflammatory and oxidative stress markers, heart rate variability (HRV) and post-exercise recovery (HRR) controlling for cardiorespiratory fitness (CRF) and potential confounders. Design and methods The following data was collected from 44 participants during 2019 (age = 49.5 ± 6.4 years, 66% women): Plasma levels of C-reactive protein (CRP) and cytokines (IL-1β, INF-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-18, IL-23); catalase (CAT) and glutathione peroxidase (GPX) activities; resting heart (HR) rate for HRV analysis, anthropometric measures, a submaximal cycling test to evaluate CRF with active recovery to assess and HRR (absolute and ΔHR), and 7-day accelerometry. Results Women spent significantly more SEDT (p = 0.035), had higher inflammatory markers (IL-6 and TNF) and lower HRV indices [SDNN, LF/HF, SD2 (p > 0.05)]. Significant associations were found between SEDT and markers of inflammation [CRP, B = 0.006, p = 0.001; MCP-1, B = 0.003, p = 0.038]. HRV indices were significantly associated with inflammatory/oxidative stress markers [IL-10 (p = 0.04), GPX (p = 0.014), ln-IL 23 (p = 0.036), CAT (p = 0.026)] while HRR was positively associated with light PA [Δ3 (B = 0.051, p = 0.043), Δ4 (B = 0.062, p = 0.021)] and inversely related to catalase [Δ3 (B = -54.7, p = 0.042), Δ4 (B = -54.1, p = 0.021] and CRP [Δ5 (B = -19.8, p = 0.033)]. Higher CRF showed lower values for TNF-α (p = 0.02) and IL-10 (p = 0.003) and better HRV/HRR indices [RMSSD, PNS, SampEn, SD1 (p < 0.05)]. Conclusions SEDT had a higher impact on inflammation and autonomic balance, independently of PA levels with differences by sex and CRF. PA appears to be more important for a better HRR. Lower HRV and HRR could be indicative of inflammatory status.
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Affiliation(s)
- Sebastian Del Rosso
- Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Lucía Baraquet
- Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Gastón Bergero
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Fabian Muñoz
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Yanina Luciana Mazzocco
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Maria Pilar Aoki
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
- Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Nilda Raquel Perovic
- Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Nelson BW, Flannery JE, Flournoy J, Duell N, Prinstein MJ, Telzer E. Concurrent and prospective associations between fitbit wearable-derived RDoC arousal and regulatory constructs and adolescent internalizing symptoms. J Child Psychol Psychiatry 2022; 63:282-295. [PMID: 34184767 DOI: 10.1111/jcpp.13471] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Adolescence is characterized by alterations in biobehavioral functioning, during which individuals are at heightened risk for onset of psychopathology, particularly internalizing disorders. Researchers have proposed using digital technologies to index daily biobehavioral functioning, yet there is a dearth of research examining how wearable metrics are associated with mental health. METHODS We preregistered analyses using the Adolescent Brain Cognitive Development Study dataset using wearable data collection in 5,686 adolescents (123,862 person-days or 2,972,688 person-hours) to determine whether wearable indices of resting heart rate (RHR), step count, and sleep duration and variability in these measures were cross-sectionally associated with internalizing symptomatology. All models were also run controlling for age, sex, body mass index, socioeconomic status, and race. We then performed prospective analyses on a subset of this sample (n = 143) across 25 months that had Fitbit data available at baseline and follow-up in order to explore directionality of effects. RESULTS Cross-sectional analyses revealed a small, yet significant, effect size (R2 = .053) that higher RHR, lower step count and step count variability, and greater variability in sleep duration were associated with greater internalizing symptoms. Cross-lagged panel model analysis revealed that there were no prospective associations between wearable variables and internalizing symptoms (partial R2 = .026), but greater internalizing symptoms and higher RHR predicted lower step count 25 months later (partial R2 = .010), while higher RHR also predicted lower step count variability 25 months later (partial R2 = .008). CONCLUSIONS Findings indicate that wearable indices concurrently associate with internalizing symptoms during early adolescence, while a larger sample size is likely required to accurately assess prospective or directional effects between wearable indices and mental health. Future research should capitalize on the temporal resolution provided by wearable devices to determine the intensive longitudinal relations between biobehavioral risk factors and acute changes in mental health.
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Affiliation(s)
- Benjamin W Nelson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica E Flannery
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John Flournoy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Natasha Duell
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eva Telzer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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