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Huang J, Yu Z, Wu Y, He X, Zhao J, He J, Staessen JA, Dong Y, Liu C, Wei FF. Prognostic Significance of Blood Pressure at Rest and After Performing the Six-Minute Walk Test in Patients With Acute Heart Failure. Am J Hypertens 2024; 37:199-206. [PMID: 38041568 DOI: 10.1093/ajh/hpad115] [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: 07/31/2023] [Revised: 09/14/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND It remains unclear whether systolic (SBP) and diastolic (DBP) pressure and BP response after six-minute walk test (6MWT) are associated with adverse outcomes in patients with acute heart failure (AHF). METHODS We investigated these associations in 98 AHF patients (24.5% women; mean age, 70.5 years) enrolled in the ROSE trial (The Low-dose Dopamine or Low-dose Nesiritide in Acute Heart Failure with Renal Dysfunction). The primary endpoint consisted of any death or rehospitalization within 6 months after randomization. We computed hazard ratios (HRs) of the risks associated with 1-SD increase in post-exercise BP levels and BP ratios, calculated as BP immediately after 6MWT divided by BP before 6MWT. RESULTS The BP before and after 6MWT averaged 110.6/117.5 mm Hg for SBP and 61.9/64.7 mm Hg for DBP. In multivariable-adjusted analyses including clinic BP measured at the same day of 6MWT, higher DBP after 6MWT was associated with lower risk of the primary endpoint (HR, 0.49; 95% confidence interval [CI], 0.26-0.95; P = 0.034). Both higher SBP and DBP immediately after 6MWT were associated with lower risk of 6-month mortality (HRs, 0.39/0.16; 95% CI, 0.17-0.90/0.065-0.40; P ≤ 0.026). The post-exercise SBP ratio was associated with the risk of 6-month mortality in multivariable-adjusted analyses (HR, 0.44; P = 0.023). CONCLUSIONS Higher BP levels and BP ratios immediately after 6MWT conferred lower risk of adverse health outcomes. Our observations highlight that 6MWT-related BP level and response may refine risk estimates in patients hospitalized AHF and may help further investigation for the development of HF preventive strategies.
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Affiliation(s)
- Jiale Huang
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhongping Yu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yuzhong Wu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xin He
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jingjing Zhao
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jiangui He
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jan A Staessen
- Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium
- Biomedical Research Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Yugang Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
- National Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Disease, Guangzhou, China
| | - Chen Liu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
- National Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Disease, Guangzhou, China
| | - Fang-Fei Wei
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Lei D. CARDIOPULMONARY CAPACITY UNDER ENDURANCE RUNNING TRAINING. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
ABSTRACT Introduction Inversely to increasingly rich material life, the physical quality of Chinese people is in a steady decline. The most convenient sport that greatly impacts the cardiopulmonary system is endurance running. It has become a form of mass activity promoting physical fitness. Objective Explore the relationship between the efficiency of endurance running training and the function of cardiopulmonary capacity. Methods 320 male and female volunteers were trained in endurance running. The load degree was adjusted according to the endurance running experience by the ergometric treadmill’s gradient. The experimental and control group subjects exercised for 30 minutes, and parameters such as resting heart rate, maximum heart rate, and maximum lung capacity were recorded before and after the intervention. Results Extending the duration of resistance running and its load improves cardiopulmonary capacity. Conclusion There is a positive correlation between the efficiency of resistance running training and the promotion of cardiopulmonary capacity. Therefore, the appropriate increase of load and duration time of resistance running is beneficial to promote the cardiopulmonary capacity of individuals and improve the overall fitness index of the population. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
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Affiliation(s)
- Dongtao Lei
- Beijing Institute of Technology Zhuhai, China
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Hao Y. EFFECT OF SPORTS TRAINING ON THE REHABILITATION OF HYPERTENSIVE PATIENTS. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228032021_0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: Hypertension is one of the most common cardiovascular and cerebrovascular diseases and a major public health problem. Although, through the rational use of drugs, the blood pressure of hypertensive patients can be better controlled, a series of side effects of drugs and expensive medical expenses limit the ability of patients to comply with the demands of hypertension. Objective: To explore the effect of long-term exercise training on the rehabilitation of hypertensive patients. Methods: The patients were divided into a control group and an exercise group, and we used multiple measurements of blood pressure, a questionnaire, and registered the situation of each patient, after what results were compared and analyzed. Results: After 12 weeks of training, the subject's blood pressure has dropped significantly. The systolic blood pressure dropped by an average of 15.5mmHg compared to before the exercise prescription was implemented, diastolic blood pressure dropped by an average of 10.6mmHg. Conclusions: Continuous physical exercise in hypertensive patients has medium- and long-term effect on blood pressure control. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Yanlong Hao
- University of Sanya Instituer of Physical, China
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Narita K, Hoshide S, Kario K. Changes in Blood Pressure Reactivity Against Physical Activity Evaluated by Multisensor-ABPM in Heart Failure Patients. JACC: ASIA 2022; 2:387-389. [PMID: 36338418 PMCID: PMC9627843 DOI: 10.1016/j.jacasi.2022.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan
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Nakanishi M, Miura H, Irie Y, Nakao K, Fujino M, Otsuka F, Aoki T, Yanase M, Goto Y, Noguchi T. Association of adherence to a 3 month cardiac rehabilitation with long-term clinical outcomes in heart failure patients. ESC Heart Fail 2022; 9:1424-1435. [PMID: 35142087 PMCID: PMC8934955 DOI: 10.1002/ehf2.13838] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 11/09/2022] Open
Abstract
Aims Although comprehensive cardiac rehabilitation (CCR) is recommended for patients with heart failure (HF), participants often show low adherence. The aim of this study was to evaluate the association of CCR completion and response with long‐term clinical outcomes. Methods and results We screened 824 HF patients who participated in a 3 month CCR programme and underwent baseline assessment, including cardiopulmonary exercise testing (CPX). After excluding 52 participants who experienced all‐cause death or HF hospitalization within 180 days, long‐term outcomes were compared between those who attended 3 month follow‐up assessment including CPX (completers) and those who did not (non‐completers). We also compared the prognostic value of the changes in peak oxygen uptake (VO2) vs. quadriceps muscle strength (QMS) during the 3 month CCR programme. Among the 772 study patients, there were no significant differences in baseline characteristics, including left ventricular ejection fraction, B‐type natriuretic peptide levels, and peak VO2, between the completers (n = 561) and non‐completers (n = 211), except for a higher age (63.2 ± 14.2 vs. 59.4 ± 16.2 years; P = 0.0015) and proportion of females (27% vs. 17%; P = 0.0030) among the completers. During a median follow‐up of 55.4 months, the completers had lower rates of the composite of all‐cause death or HF hospitalization (34.4% vs. 44.6%; P = 0.0015) and all‐cause death (16.9% vs. 24.6%; P = 0.0037) than the non‐completers. After adjustment for prognostic baseline characteristics, including age and sex, CCR completion was associated with 34% and 44% reductions in the composite outcome and all‐cause death, respectively. Among the completers, peak VO2 and QMS increased significantly (8.9 ± 15.8% and 10.5 ± 17.9%, respectively) over 3 months. Patients who had an increase in peak VO2 ≥ 6.3% (median value) during the CCR programme had significantly lower rates of the composite outcome (27.0% vs. 33.8%; P = 0.048) and all‐cause mortality (10.0% vs. 17.4%; P = 0.0069) than those who did not. No statistically significant difference was observed in the composite outcome (30.5% vs. 30.4%; P = 0.76) or all‐cause mortality (13.0% vs. 14.4%; P = 0.39) between those with and without an increase in QMS ≥8.3% (median value). Conclusions In HF patients who participated in a 3 month CCR programme, its completion was associated with lower risks of subsequent HF hospitalization and death. Within the group of patients who completed the programme, the improvement in exercise capacity, but not in skeletal muscle strength, over the 3‐month period was associated with better outcomes. These findings highlight the importance of the post‐CCR follow‐up assessment, including CPX, to identify a patient's adherence and response to the CCR programme.
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Affiliation(s)
- Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuki Irie
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | | | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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