1
|
Angarten V, Melo X, Pinto R, Santos V, Marôco JL, Fernhall B, Santa-Clara H. Acute effects of exercise on cardiac autonomic function and arterial stiffness in patients with stable coronary artery disease. SCAND CARDIOVASC J 2021; 55:371-378. [PMID: 34704517 DOI: 10.1080/14017431.2021.1995037] [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] [Indexed: 10/20/2022]
Abstract
Objectives. To examine the acute effect of a maximal aerobic exercise effort on aortic, peripheral arterial stiffness and cardiovagal modulation of trained and untrained patients with coronary artery disease (CAD). Design. Cross-sectional study. Methods. Eighteen untrained patients with CAD, 18 trained patients with CAD, and 18 apparently healthy trained subjects were sampled and matched for age and body mass index. Aortic and peripheral stiffness were measured by applanation tonometry estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-dorsalis pedis pulse wave velocity (cdPWV), respectively. Cardiovagal modulation was assessed by heart-rate variability (HRV) indices including the standard deviation of normal-to-normal RR intervals (SDNN), root-mean-square of successive differences (RMSSD), and the high-frequency power band (HF). cfPWV, crPWV, cdPWV, and HRV indices were measured at rest, 10 and 30 min following a maximal cardiopulmonary exercise test on a cycle ergometer. Results. No differences were observed between groups at rest nor over time in indices of HRV, cfPWV and cdPWV. Still, main effects of time were observed in cfPWV (p < .001; ɳ2 = 0.313) and cdPWV (p = .003, ɳ2 = 0.111), RMSSD (p < .001, ɳ2 = 0.352), HF (p < .001, ɳ2 = 0.265) and LF/HF (p = .001, ɳ2 = 0.239), as cdPWV, RMSSD, and HF were reduced 10 min following exercise, whereas cfPWV and LF/HF were increased. Changes in cPP were associated with changes in HRV from rest to min 10 (HF, r = 0.302), and to min 30 (HF, r = 0.377; SDNN, r = 0.357; RMSSD, r = 0.429). Conclusion. Training level and CAD do not seem to influence arterial stiffness and cardiac autonomic responses to maximal exercise.
Collapse
Affiliation(s)
- Vitor Angarten
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal
| | - Xavier Melo
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal.,Departamento de Investigação e Desenvolvimento, GCP Lab, Ginásio Clube Português, Lisboa, Portugal
| | - Rita Pinto
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Exercise and Cardiovascular Rehabilitation Laboratory, Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisboa, Portugal
| | - Vanessa Santos
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal
| | - João Luís Marôco
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal.,Departamento de Investigação e Desenvolvimento, GCP Lab, Ginásio Clube Português, Lisboa, Portugal
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Helena Santa-Clara
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana, Universidade de Lisboa, CIPER, Lisboa, Portugal
| |
Collapse
|
2
|
Zhao L, Zhao L, Pu L, Hua B, Wang Y, Li S, Li Q, Guo T. Left Univentricular Pacing by Rate-Adaptive Atrioventricular Delay in Treatment of Chronic Heart Failure. Med Sci Monit 2017; 23:3971-3980. [PMID: 28814710 PMCID: PMC5572785 DOI: 10.12659/msm.904348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Cardiac resynchronization therapy (CRT) is efficacious in the treatment of chronic heart failure (CHF); however, because it is non-physiological, some patients are unresponsive. The present study used rate-adaptive atrioventricular delay (RAAVD) to track the physiological atrioventricular delay and investigated the effects of left univentricular pacing on CRT. Material/Methods Patients with CHF fulfilling the indication of CRT Class I were categorized into a left univentricular pacing by RAAVD group and a standard biventricular pacing group. Preoperative and postoperative electrocardiography QRS duration, echocardiographic indicators, quality of life, cardiac function, and annual treatment cost were estimated. The standard deviation (RS/R-SD5) of the S/R ratio in lead V1 at 5 heart rate segments in the left univentricular pacing by RAAVD was calculated, and the accuracy of RAAVD in tracking the physiological AV delay was evaluated. Results The comparison between the left univentricular pacing by RAAVD group and the standard biventricular pacing group after operation showed a significantly reduced QRS duration (137±11 vs. 144±11 ms, P<0.05), increased AVVTI (21.84±2.25 vs. 20.45±2.12 cm, P<0.05), reduced IVMD (64.27±12.29 vs. 71.39±13.64 ms, P<0.05), decreased MRA (3.09±1.12 vs. 3.73±1.19 cm2, P<0.05), and reduced average annual treatment cost (1.30±0.1 vs. 2.20±0.2 million Yuan, P<0.05). The RS/R-SD5 in the left univentricular pacing by RAAVD group was negatively correlated with improvements in cardiac function (r=−0.394, P=0.031). Conclusions Left univentricular pacing by RAAVD has treatment effects similar to those of standard biventricular pacing, and is an economically and physiologically effective method for biventricular systolic resynchronization in the treatment of CHF.
Collapse
Affiliation(s)
- Lulu Zhao
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Ling Zhao
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Lijin Pu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Baotong Hua
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Yu Wang
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Shumin Li
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Qing Li
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Tao Guo
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China (mainland)
| |
Collapse
|
3
|
|
4
|
Gu M, Hua W, Fan XH, Ding LG, Wang J, Niu HX, Xu C, Jin H, Zhang S. Short-Term Availability of Viable Left Ventricular Pacing Sites with Quartet™ Quadripolar Leads. Med Sci Monit 2017; 23:767-773. [PMID: 28188984 PMCID: PMC5317280 DOI: 10.12659/msm.902743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Whether quadripolar leads can provide sufficient viable left ventricular pacing sites (LVPSs) for device optimization and multipoint pacing remains unclear. This study aimed to evaluate the acute and 3-month availability of viable LVPSs provided by a quadripolar LV pacing lead. MATERIAL AND METHODS A single-center cohort study evaluated consecutive patients who underwent a CRT implant with the QuartetTM LV lead under local guidelines. The availability of viable LVPSs was assessed at the pre-discharge and 3-month follow-up visit. Bipolar lead configurations, which served as the control group, were modeled by eliminating the 2 proximal electrodes on the Quartet™ LV lead. RESULTS A total of 24 patients were enrolled and finished 3-month follow-up. The mean follow-up period was 93±3 days. At pre-discharge, the Quartet™ LV lead provided more viable LVPSs compared with the bipolar equivalents (median 3 [IQR 2-4] vs. median 2 [IQR 1-2], P<0.001). The percentage of patients with at least 1, 2, 3, and 4 viable LVPSs were 100% (24/24), 91.7% (22/24), 58.3% (14/24), and 33.3% (8/24) for Quartet™ leads and 91.7% (22/24), 70.8% (17/24), 0% (0/24), and 0% (0/24) for bipolar lead configurations, respectively. The median and IQR values of viable LVPSs provided by the Quartet™ LV lead remained the same (3 [IQR 2-4]) between pre-discharge and 3-month follow-up (P=0.45). CONCLUSIONS Compared with the bipolar equivalent, QuartetTM LV lead provides more viable LVPSs and opportunities for CRT optimization and multipoint LV pacing. The number of LVPSs provided by Quartet™ leads remained unchanged between pre-discharge and 3-month follow-up.
Collapse
Affiliation(s)
- Min Gu
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Wei Hua
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Xiao-Han Fan
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Li-Gang Ding
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Jing Wang
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Hong-Xia Niu
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Cong Xu
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Han Jin
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| | - Shu Zhang
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (mainland)
| |
Collapse
|