1
|
Post EM, Kraemer WJ. Physiological Mechanisms That Impact Exercise Adaptations for Individuals With Down Syndrome. J Strength Cond Res 2023; 37:e646-e655. [PMID: 38015740 DOI: 10.1519/jsc.0000000000004658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
ABSTRACT Post, EM, and Kraemer, WJ. Physiological mechanisms that impact exercise adaptations for individuals with Down syndrome. J Strength Cond Res 37(12): e646-e655, 2023-Down syndrome (DS) is the most common chromosomal disorder diagnosed in the United States since 2014. There is a wide range of intellectual severities, with the average IQ of individuals with DS at approximately 50 and adults without intellectual delay at approximately 70-130. Individuals with DS vary from mild to severe cognitive impairment, depending on the phenotypic penetration on the 21st chromosome, with the average cognitive capacity equivalent to a cognitive functioning of an 8- to 9-year-old child. To have successful health, all aspects of health must be considered (i.e., overall health, fitness, and social). Both aerobic training and resistance training (RT) are favored for a healthy lifestyle. Resistance training specifically can help improve motor function and overall activities of daily living. Although many motivational and environmental barriers for individuals with DS can make exercising difficult, there are many ways to overcome those barriers (both intrinsically and extrinsically). Individuals with DS should strive for 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise a week or a combination of both. The individual should also strive for 2 or more days a week of strengthening activities, such as RT, involving all muscle groups. These activities will help improve many aspects of life, leading to a better quality of life. Regular group exercise activity can help increase self-confidence and success socially in life. This review will focus on the underlying biological mechanisms related to DS, their influence on exercise, and the roles exercise plays in mediating positive health, physical fitness, and social lifestyle outcomes.
Collapse
Affiliation(s)
- Emily M Post
- Department of Health and Sports Science, Otterbein University, Westerville, Ohio
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut; and
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia
| |
Collapse
|
2
|
Haligheri G, Johnson T, Kathol M, Kuzava L, Goth N, Staggs VS, Donnelly JE, Ptomey LT, Forsha D. Early cardiac dysfunction in obese adolescents with Down syndrome or autism. Cardiol Young 2023; 33:1678-1685. [PMID: 36184834 DOI: 10.1017/s1047951122003158] [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: 11/06/2022]
Abstract
BACKGROUND Obesity in adolescents with intellectual and developmental disabilities) occurs at twice the frequency as their typically developing peers. Typically developing adolescents with obesity have abnormal cardiac function (as measured by strain echocardiography) and cardiac mass, but the effects of obesity on cardiac health in adolescents with Down syndrome or autism spectrum disorder are unknown. The purpose of this study was to evaluate the impact of body mass index on cardiac function in adolescents with Down syndrome or autism. METHODS Adolescents (age 12-21 years) with Down syndrome (n = 28), autism (n = 33), and age-/sex-matched typically developing controls (n = 15) received an echocardiogram optimised for strain analysis at a single timepoint. Measures of ventricular function, mass, and size were collected. Regression modelling evaluated the impact of body mass index and intellectual and developmental disabilities diagnosis on these cardiac measures. RESULTS In regression modelling, an elevated body mass index z-score was associated with diminished systolic biventricular function by global strain (left ventricular longitudinal strain β 0.87, P < 0.001; left ventricular circumferential strain β 0.57, p 0.003; right ventricular longitudinal strain β 0.63, P < 0.001). Diminished left ventricular diastolic function by early diastolic strain rate was also associated with elevated body mass index (global longitudinal end-diastolic strain rate β -0.7, P < 0.001). No association was found between traditional (non-strain) measures of systolic and diastolic ventricular function and body mass index z-score. CONCLUSIONS Obesity in adolescents with Down syndrome or autism negatively impacts cardiac function as measured by echocardiographic strain analysis that was not detected by traditional parameters.
Collapse
Affiliation(s)
- Geetha Haligheri
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
- University of Missouri - Kansas City, Department of Pediatrics, Kansas City, MO, USA
| | - Tyler Johnson
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Melanie Kathol
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Laura Kuzava
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Natalie Goth
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Vincent S Staggs
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | | | | | - Dan Forsha
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
- University of Missouri - Kansas City, Department of Pediatrics, Kansas City, MO, USA
| |
Collapse
|
3
|
Abdelrahman EG, Kamal NM, Alharthi S, Albalawi M, Assar E. Down syndrome patients with normal hearts: are they really normal? Medicine (Baltimore) 2023; 102:e32886. [PMID: 36820596 PMCID: PMC9907910 DOI: 10.1097/md.0000000000032886] [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: 02/12/2023] Open
Abstract
Even though congenital heart disease is a common finding in down syndrome (DS) patients, some of them have anatomically normal hearts. However, the term "normal" might not be suitable, as these patients usually suffer from functional cardiac dysfunction. Several research highlighted that despite the absence of anatomical heart defects, subtle cardiac function derangements are present in DS patients. We aim to assess cardiac functions by Two-dimensional echocardiography and tissue Doppler imaging (TDI) in pediatric DS patients who have anatomically normal hearts. One hundred seventy-two patients with karyotyping confirmed DS with anatomically normal hearts and 165 healthy normal control children were enrolled in the current study. Their cardiac functions were assessed using both 2-dimensional echocardiography and TDI. Both patients and controls had structurally and anatomically normal hearts. In DS patients, the right side of the heart showed a significant reduction in both systolic and diastolic functions. Systolic dysfunction was evident by significantly decreased levels of Tricuspid annular plane systolic excursion and systolic wave by TDI. Diastolic dysfunction of the right ventricle was evident by prolonged deceleration time by conventional echocardiography and a significant decrease in annular tissue doppler velocity during early diastole/late diastole ratio by TDI. The E/De ratio was significantly increased. Even with anatomically normal hearts, DS patients should undergo cardiac function assessment by echocardiography & TDI. TDI is superior to conventional echocardiography in detecting subtle cardiac dysfunction especially left ventricular diastolic dysfunction in DS patients. TDI showed a significant decrease in the early/atrial ratio of mitral valve annulus and prolongation of left ventricle isometric relaxation time in DS children. Also, the left ventricle E/De ratio was prolonged denoting elevated filling pressures and diastolic dysfunction. This indicates that the TDI has higher sensitivity to detect diastolic dysfunction than conventional Echocardiography. Biventricular TDI-derived myocardial performance index was found to be significantly increased in DS children.
Collapse
Affiliation(s)
- Eman G Abdelrahman
- Pediatric department, Faculty of Medicine, Benha University, Benha, Egypt
| | - Naglaa M Kamal
- Pediatric department, Faculty of Medicine, Cairo University, Cairo, Egypt
- * Correspondence: Naglaa M Kamal, Pediatric department, Faculty of Medicine, Cairo University, Cairo, Egypt (e-mail: )
| | - Sultan Alharthi
- Pediatric department, Alhada Armed Forces Hospital, Taif, KSA
| | - Muflih Albalawi
- Cardiology service department, King Salman Armed Forces Hospital, Tabuk, KSA
| | - Effat Assar
- Pediatric department, Faculty of Medicine, Benha University, Benha, Egypt
| |
Collapse
|
4
|
Beck VDY, Wee SO, Lefferts EC, Hibner BA, Burton LC, Baynard T, Fernhall B, Hilgenkamp TIM. Comprehensive cardiopulmonary profile of individuals with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:978-987. [PMID: 35734935 DOI: 10.1111/jir.12954] [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: 10/28/2021] [Revised: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) have low levels of cardiorespiratory fitness and previous studies have shown that these low levels of fitness have a physiological cause. During exercise, the cardiovascular, ventilatory and muscular systems are simultaneously active. While individual parameters of these systems have been investigated in DS before, the interaction between these parameters and systems have not been discussed in detail. Doing so may provide important insight regarding the aetiology of low cardiorespiratory fitness and which parameters of the cardiovascular, pulmonary and muscular systems are altered in individuals with DS compared with their peers without DS. METHODS Cardiopulmonary exercise tests were performed in healthy adults with and without DS. Parameters related to the cardiovascular, ventilatory and muscular systems were collected until VO2peak . In total, 51 participants were included in analysis, of which 21 had DS. RESULTS Individuals with DS showed lower peak values for all collected outcomes (P ≤ 0.001) compared with those without DS, except for ventilatory threshold as a percentage of maximal oxygen uptake and VE /VCO2 slope, which were similar. CONCLUSIONS Our results show that individuals with DS present impairments across the cardiovascular, ventilatory and muscular aspects of the cardiopulmonary system.
Collapse
Affiliation(s)
- V D Y Beck
- Department of Physical Therapy, University of Nevada - Las Vegas, Las Vegas, NV, USA
| | - S O Wee
- Department of Kinesiology, California State University San Bernardino, San Bernardino, CA, USA
| | - E C Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - B A Hibner
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - L C Burton
- Department of Health and Kinesiology, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - T Baynard
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - B Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - T I M Hilgenkamp
- Department of Physical Therapy, University of Nevada - Las Vegas, Las Vegas, NV, USA
| |
Collapse
|
5
|
Azar FM, Beck VDY, Matthews AM, Forsha DE, Hilgenkamp TIM. Cardiac Structure and Function in Adults with Down Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12310. [PMID: 36231610 PMCID: PMC9566526 DOI: 10.3390/ijerph191912310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this population. Previous research suggested lower systolic and diastolic function, but inconsistent methodologies and younger samples warrant research in adults with Ds. Our aim is to compare the cardiac structure and function of adults with Ds to age- and sex-matched adults without Ds. Echocardiography was used to assess systolic function, diastolic function, and cardiac structure in n = 19 adults (Ds n = 9, control n = 10). Regarding cardiac structure, adults with Ds had increased left ventricular posterior wall thickness at end-systole compared to adults without Ds (p = 0.007). Regarding systolic and diastolic function, adults with Ds were found to have lower septal peak systolic annular velocity (S') (p = 0.026), lower lateral and septal mitral annular early diastolic velocity (E') (p = 0.007 and p = 0.025, respectively), lower lateral peak mitral annular late diastolic velocity (A') (p = 0.027), and higher lateral and septal mitral annular early systolic velocity to diastolic velocity ratios (E/e') (p = 0.001 and p = 0.001, respectively). Differences in both cardiac structure and function were found when comparing adults with Ds to matched adults without Ds. Most of the differences were indicative of worse diastolic function.
Collapse
Affiliation(s)
- Fadi M. Azar
- Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas (UNLV), Las Vegas, NV 89154, USA
| | - Victor D. Y. Beck
- Department of Physical Therapy, University of Nevada, Las Vegas (UNLV), Las Vegas, NV 89154, USA
| | - Alice M. Matthews
- Department of Physical Therapy, University of Nevada, Las Vegas (UNLV), Las Vegas, NV 89154, USA
| | - Daniel E. Forsha
- Division of Cardiology, Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Thessa I. M. Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas (UNLV), Las Vegas, NV 89154, USA
| |
Collapse
|
6
|
Oviedo GR, Carbó-Carreté M, Guerra-Balic M, Tamulevicius N, Esquius L, Guàrdia-Olmos J, Javierre C. Hemodynamic and cardiorespiratory responses to submaximal and maximal exercise in adults with Down syndrome. Front Physiol 2022; 13:905795. [PMID: 36060693 PMCID: PMC9437284 DOI: 10.3389/fphys.2022.905795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: The genetic disorder causing Down syndrome (DS) affects the cardiorespiratory and hemodynamic parameters. When exercising, sufficient blood flow is necessary for active muscles. Cardiac output (Q) must be proportional to the peripheral requirements. In case the stroke volume (SV) is lower, the heart rate (HR) will increase further in order to maintain an adequate blood flow in the active territories (HR compensatory response). People with DS have a lower HR response to maximal exercise. Nevertheless, the response of the hemodynamic and cardiorespiratory parameters during the submaximal phases of maximal exercise was not well studied.Objective: to evaluate cardiorespiratory and hemodynamic parameters 1) during submaximal and 2) maximal metabolic treadmill test in individuals with and without DS.Methods: fifteen adults with DS (age = 27.33 ± 4.98 years old; n = 12 males/3 females) and 15 adults without disabilities, matched by age and sex, participated in this cross-sectional study. Peak and submaximal cardiorespiratory and hemodynamic parameters were measured during a treadmill test. Linear mixed-effects models were used to analyse interactions between the variables. Post-hoc analyses were employed to assess within and between-group differences.Results: The DS group showed lower peak values for ventilation (VE), respiratory exchange ratio (RER), tidal volume (VT), ventilatory equivalent for O2 (VEqO2), end-tidal partial pressure for O2 (PETO2), O2 uptake (VO2) and CO2 production (all p < 0 .050), Q, SV, systolic and diastolic blood pressure (SBP, DBP), and HR (all p < 0 .050). There were group-by-time interactions (all p < 0 .050) for all ventilatory submaximal values. Significant group and time differences were observed for VE; RER; respiratory rate (RR); VEqO2; PETO2; VO2, and VT (all p < 0 .050). There were also group-by-time interactions (all p < 0 .050) and group and time differences for SBP, mean arterial blood pressure (MAP) and HR (all p < 0.010).Conclusion: During submaximal exercise, we verified a compensatory response of HR, and greater VE and VO2 in the individuals with DS. In addition, we were able to observe that the DS group had a reduced SBP and MAP response to submaximal exercise. On the other hand, we found that adults with DS have lower peak hemodynamic and cardiorespiratory values, and a lower cardiac reserve. Further research is warranted to investigate the effects of these results on the general health of adults with DS and the impact of long-term exercise programs on these parameters.
Collapse
Affiliation(s)
- Guillermo R. Oviedo
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
- School of Health Science Blanquerna, University Ramon Llull, Barcelona, Spain
- *Correspondence: Guillermo R. Oviedo,
| | - María Carbó-Carreté
- Serra Hunter Fellow, Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Myriam Guerra-Balic
- Faculty of Psychology, Education and Sport Science Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Nauris Tamulevicius
- Department of Health Sciences and Human Performance, College of Natural and Health Sciences, The University of Tampa, Tampa, FL, United States
| | - Laura Esquius
- Foodlab Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Universitat de Barcelona Institute of Complex Systems, Barcelona, Spain
| | - Casimiro Javierre
- Department of Physiological Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Post EM, Kraemer WJ, Kackley ML, Caldwell LK, Volek JS, Sanchez BN, Focht BC, Newton RU, Häkkinen K, Maresh CM. The Effects of Resistance Training on Physical Fitness and Neuromotor-Cognitive Functions in Adults With Down Syndrome. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:927629. [PMID: 36189007 PMCID: PMC9397808 DOI: 10.3389/fresc.2022.927629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
Adults with Down syndrome are an underserved population at high risk for a host of different pathologies from aging and lack of activity.
Collapse
Affiliation(s)
- Emily M. Post
- Department of Exercise Science, Ohio Dominican University, Columbus, OH, United States
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - William J. Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- Exercise Medicine Research Institute, and School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- *Correspondence: William J. Kraemer
| | - Madison L. Kackley
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Lydia K. Caldwell
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX, United States
| | - Jeff S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Barbara N. Sanchez
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Brian C. Focht
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Robert U. Newton
- Exercise Medicine Research Institute, and School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Carl M. Maresh
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| |
Collapse
|
8
|
Hilgenkamp TIM, Lefferts EC, White DW, Baynard T, Fernhall B. Blunted autonomic response to standing up and head-up tilt in individuals with intellectual disabilities. J Appl Physiol (1985) 2021; 130:1778-1785. [PMID: 33914659 DOI: 10.1152/japplphysiol.00328.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Previous research suggests individuals with intellectual disabilities (ID) may experience autonomic dysfunction, however, this has not been thoroughly investigated. The aim of this study was to compare the autonomic response to standing up (active orthostasis) and head-up tilt (passive orthostasis) in individuals with ID to a control group without ID. Eighteen individuals with and 18 individuals without ID were instrumented with an ECG-lead and finger-photoplethysmography for continuous heart rate and blood pressure recordings. The active and passive orthostasis protocol consisted of 10-min supine rest, 10-min standing, 10-min supine recovery, 5-min head-up tilt at 70°, followed by 10-min supine recovery. The last 5 min of each position was used to calculate hemodynamic and autonomic function (time- and frequency-domain heart rate and blood pressure variability measures and baroreflex sensitivity). Individuals with ID had higher heart rate during baseline and recovery (P < 0.05), and an attenuated hemodynamic (stroke volume, heart rate) and heart rate variability response to active and passive orthostasis (interaction effect P < 0.05) compared with individuals without ID. Mean arterial pressure (MAP) was higher in individuals with ID at all timepoints. Individuals with ID demonstrated altered hemodynamic and autonomic regulation compared with a sex- and age-matched control group, evidenced by a higher mean arterial pressure and a reduced response in parasympathetic modulation to active and passive orthostasis.NEW & NOTEWORTHY Individuals with ID demonstrated altered hemodynamic and autonomic regulation to the clinical autonomic function tasks standing up and head-up tilt (active and passive orthostasis). Higher resting heart rate and higher MAP throughout the protocol suggest a higher arousal level, and individuals with ID showed a blunted response in parasympathetic modulation. Further research should investigate the relationship of these findings with clinical outcomes.
Collapse
Affiliation(s)
- Thessa I M Hilgenkamp
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois.,Chair of Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Daniel W White
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Tracy Baynard
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Bo Fernhall
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
9
|
BOONMAN ANNEJN, SCHROEDER ELIZABETHC, HOPMAN MARIATE, FERNHALL BO, Hilgenkamp THESSAIM. Cardiopulmonary Profile of Individuals with Intellectual Disability. Med Sci Sports Exerc 2019; 51:1802-1808. [DOI: 10.1249/mss.0000000000001995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
10
|
Hilgenkamp TIM, Baynard T. Do individuals with intellectual disability have a lower peak heart rate and maximal oxygen uptake? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:785-791. [DOI: 10.1111/jar.12430] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Thessa Irena Maria Hilgenkamp
- Intellectual Disability Medicine; Department of General Practice; Erasmus MC University Medical Center; Rotterdam the Netherlands
- Integrative Physiology Lab; University of Illinois at Chicago; Chicago IL USA
| | - Tracy Baynard
- Department of Kinesiology and Nutrition; University of Illinois at Chicago; Chicago IL USA
- Integrative Physiology Lab; University of Illinois at Chicago; Chicago IL USA
| |
Collapse
|
11
|
Bouma BJ, Mulder BJ. Changing Landscape of Congenital Heart Disease. Circ Res 2017; 120:908-922. [DOI: 10.1161/circresaha.116.309302] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/13/2017] [Accepted: 01/13/2017] [Indexed: 01/23/2023]
Abstract
Congenital heart disease is the most frequently occurring congenital disorder affecting ≈0.8% of live births. Thanks to great efforts and technical improvements, including the development of cardiopulmonary bypass in the 1950s, large-scale repair in these patients became possible, with subsequent dramatic reduction in morbidity and mortality. The ongoing search for progress and the growing understanding of the cardiovascular system and its pathophysiology refined all aspects of care for these patients. As a consequence, survival further increased over the past decades, and a new group of patients, those who survived congenital heart disease into adulthood, emerged. However, a large range of complications raised at the horizon as arrhythmias, endocarditis, pulmonary hypertension, and heart failure, and the need for additional treatment became clear. Technical solutions were sought in perfection and creation of new surgical techniques by developing catheter-based interventions, with elimination of open heart surgery and new electronic devices enabling, for example, multisite pacing and implantation of internal cardiac defibrillators to prevent sudden death. Over time, many pharmaceutical studies were conducted, changing clinical treatment slowly toward evidence-based care, although results were often limited by low numbers and clinical heterogeneity. More attention has been given to secondary issues like sports participation, pregnancy, work, and social-related difficulties. The relevance of these issues was already recognized in the 1970s when the need for specialized centers with multidisciplinary teams was proclaimed. Finally, research has become incorporated in care. Results of intervention studies and registries increased the knowledge on epidemiology of adults with congenital heart disease and their complications during life, and at the end, several guidelines became easily accessible, guiding physicians to deliver care appropriately. Over the past decades, the landscape of adult congenital heart disease has changed dramatically, which has to be continued in the future.
Collapse
Affiliation(s)
- Berto J. Bouma
- From the Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Barbara J.M. Mulder
- From the Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
12
|
Balli S, Yucel IK, Kibar AE, Ece I, Dalkiran ES, Candan S. Assessment of cardiac function in absence of congenital and acquired heart disease in patients with Down syndrome. World J Pediatr 2016; 12:463-469. [PMID: 27059745 DOI: 10.1007/s12519-016-0012-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/12/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Extra genetic material in patients with Down syndrome (DS) may affect the function of any organ system. We evaluated cardiac functions using conventional tissue Doppler and two-dimensional speckle tracking echocardiography in patients with DS in the absence of congenital and acquired heart disease in patients. METHODS A total of 115 patients with DS between 6 and 13 years of age with clinically and anatomically normal heart and 55 healthy children were included in this cross-sectional study. DS was diagnosed by a karyotype test. Patients with mosaic type were not included in this study. Systolic and diastolic functions were evaluated by echocardiography. RESULTS Pulsed waved Doppler transmitral early/late inflow velocity (E/A), tissue Doppler mitral annular early/late diastolic peak velocity (Ea/Aa), transtricuspid E/A and tricuspid valve annulus Ea/Aa, pulmonary venous Doppler systolic/diastolic (S/D) wave ratio were lower in patients with Down syndrome than in the control group (P=0.04, P=0.001, P<0.05, P<0.001, P<0.001, respectively). Mitral and tricuspid annular Ea were lower in patients with DS (P<0.001). The right and left ventricular myocardial performance indexes were higher in patients with DS than in the controls (P<0.01). They had significantly higher left ventricular mass, ejection fraction, the mitral annular plane systolic excursion values. However, the Down syndrome group compared with the controls had a lower strain values examined by two-dimensional longitudinal speckle-tracking strain echocardiography. CONCLUSION These findings suggest conventional tissue Doppler and two-dimensional longitudinal speckletracking strain echocardiography were useful methods of investigating ventricular function and identifying a higher incidence of biventricular dysfunction in patients with Down syndrome compared with the healthy controls.
Collapse
Affiliation(s)
- Sevket Balli
- Department of Pediatric Cardiology, Balikesir Ataturk Hospital, Balikesir, Turkey.
| | - Ilker Kemal Yucel
- Department of Pediatric Cardilogy, Siyami Ersek Education and Research Hospital, Istanbul, Turkey
| | - Ayse Esin Kibar
- Department of Pediatric Cardiology, Children's Hospital, Mersin, Turkey
| | - Ibrahim Ece
- Department of Pediatric Cardiology, Yuzuncu Yil University of Medicine, Van, Turkey
| | | | - Sukru Candan
- Department of Medical Genetics, Balikesir Ataturk Hospital, Balikesir, Turkey
| |
Collapse
|
13
|
Oppewal A, Hilgenkamp TIM, van Wijck R, Evenhuis HM. Cardiorespiratory fitness in individuals with intellectual disabilities--a review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3301-3316. [PMID: 23892875 DOI: 10.1016/j.ridd.2013.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/02/2013] [Indexed: 06/02/2023]
Abstract
Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of this review were to update previous reviews about (a) the cardiorespiratory fitness levels and their determinants in individuals with ID, and (b) the validity and reliability of cardiorespiratory fitness testing in individuals with ID. We searched the databases of Pubmed and Embase for relevant studies, resulting in 31 included articles. These studies mainly included younger participants with mild to moderate ID. Results confirmed previous findings of low cardiorespiratory fitness levels in individuals with ID. Cardiorespiratory fitness levels of children and adolescents with ID are already low, with further decline with increasing age. Furthermore, females have lower cardiorespiratory fitness levels than males. Physical inactivity and chronotropic incompetence are most likely to contribute to low cardiorespiratory fitness levels. Peak cardiorespiratory fitness levels of individuals with ID can be assessed with maximal treadmill protocols, after allowing for familiarization sessions. Although, predicting maximal oxygen uptake from field tests is problematic, field tests have been found valid and reliable as indicators of cardiorespiratory fitness.
Collapse
Affiliation(s)
- Alyt Oppewal
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | | | | | | |
Collapse
|
14
|
van der Wall EE. Crown years for noninvasive cardiovascular imaging (part I): 60 years of echocardiography. Neth Heart J 2013; 21:161-2. [PMID: 23423599 PMCID: PMC3673607 DOI: 10.1007/s12471-013-0381-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- E E van der Wall
- Interuniversity Cardiology Institute of the Netherlands (ICIN) - Netherlands Heart Institute (NHI), Catherijnesingel 52, 3501, DG, Utrecht, the Netherlands,
| |
Collapse
|
15
|
van der Wall EE, van Gilst WH. Neurocardiology: close interaction between heart and brain. Neth Heart J 2013; 21:51-2. [PMID: 23239452 PMCID: PMC3547430 DOI: 10.1007/s12471-012-0369-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- E E van der Wall
- Interuniversity Cardiology Institute of the Netherlands (ICIN) - Netherlands Heart Institute (NHI), Catharijnesingel 52, 3511 GC, Utrecht, the Netherlands,
| | | |
Collapse
|