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Vecchiato M, Quinto G, Neunhaeuserer D, Battista F, Bettini S, Gasperetti A, Vettor R, Busetto L, Ermolao A. The incidence of cardiac arrhythmias during exercise stress testing: a focus on patients with severe obesity undergoing sleeve gastrectomy. Int J Obes (Lond) 2023; 47:175-180. [PMID: 36593390 DOI: 10.1038/s41366-022-01252-7] [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] [Received: 08/25/2022] [Revised: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Obesity is associated with a higher risk of cardiac arrhythmias. Sleeve gastrectomy (SG) is a common bariatric surgery with beneficial effects on weight loss and comorbidities. The study aimed to investigate the prevalence of arrhythmias during maximal exercise testing in patients with moderate-severe obesity and to evaluate the impact of SG on these arrhythmic events. METHODS All patients with moderate or severe obesity who were considered suitable candidates for SG between June 2015 and September 2020 were recruited. Each patient underwent three incremental, maximal, ECG-monitored cardiopulmonary exercise test 1 month before and 6 and 12 months after SG; the frequency and complexity of ventricular premature beats (VPBs) and atrial premature beats (APBs) have been evaluated during rest, exercise and recovery phases. RESULTS Fifty patients with severe obesity (BMI 46.39 ± 7.89 kg/m2) were included in the study. After SG, patients presented a decreased BMI (34.15 ± 6.25 kg/m2 at 6 months post-SG and 31.87 ± 5.99 kg/m2 at 12 months post-SG). At 6 months post-SG, an increase in VPBs, mainly during the recovery phase, was observed. At 12 months post-SG, a reduction in VPBs compared with the 6 months evaluation was showed. CONCLUSION Although in the early post-surgical phase the risk of exercise-induced arrhythmias may be higher, SG does not seem to increase the occurrence of arrhythmias in the long-term. No life-threating arrhythmias were found during post-SG evaluations.
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Affiliation(s)
- Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Giulia Quinto
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy.
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy.
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Silvia Bettini
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Andrea Gasperetti
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
| | - Roberto Vettor
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Luca Busetto
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy
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Ibisoglu E, Tekin DDN, Kızılırmak F, Güneş ST, Boyraz B, Özdenkaya Y, Çakal S, Çakal B, Savur Ü, Erdoğan A, Olgun FE, Güneş HM. Evaluation of Changes in Ventricular Repolarization Parameters in Morbidly Obese Patients Undergoing Bariatric Surgery. Obes Surg 2021; 31:3138-3143. [PMID: 33856635 DOI: 10.1007/s11695-021-05385-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Weight loss after bariatric surgery has been associated with reduced cardiovascular mortality and overall mortality in obese patients. In this study, we aimed to analyze the changes between pre-operation and post-operation ventricular arrhythmia predictors in patients who underwent bariatric surgery. MATERIALS AND METHODS The study included 58 patients who underwent bariatric surgery. We measured QT max, QT min, QRS, JT, and Tp-e intervals, and we estimated Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc rates, QTc max, QTc min, cQTd, and JTc intervals both pre-op and 6 months post-op. RESULTS Heart rate, PR, QT max, QTc max, QTc min, cQTd, JTc, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, and Tp-e/JTc values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months post-op. CONCLUSION The results of our study showed that bariatric surgery had positive effects on the regression of ventricular repolarization parameters and the possible development of ventricular arrhythmia.
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Affiliation(s)
- Ersin Ibisoglu
- Cardiology Department, Başakşehir Çam and Sakura City Hospital, Başakşehir Mahallesi G-434 Caddesi No: 2L, 34480 Başakşehir, İstanbul, Turkey.
| | - Deniz Dilan Naki Tekin
- Cardiology Department, Başakşehir Çam and Sakura City Hospital, Başakşehir Mahallesi G-434 Caddesi No: 2L, 34480 Başakşehir, İstanbul, Turkey
| | - Filiz Kızılırmak
- Cardiology Department, İstanbul Medipol University, İstanbul, Turkey
| | - Saime Turgut Güneş
- Radiology Department, İstanbul Training and Research Hospital, İstanbul, Turkey
| | | | - Yaşar Özdenkaya
- General Surgery Department, İstanbul Medipol University, İstanbul, Turkey
| | - Sinem Çakal
- İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Beytullah Çakal
- Cardiology Department, İstanbul Medipol University, İstanbul, Turkey
| | - Ümeyir Savur
- İstanbul Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey
| | - Aslan Erdoğan
- Cardiology Department, Başakşehir Çam and Sakura City Hospital, Başakşehir Mahallesi G-434 Caddesi No: 2L, 34480 Başakşehir, İstanbul, Turkey
| | - Fatih Erkam Olgun
- Cardiology Department, İstanbul Medipol University, İstanbul, Turkey
| | - H Murat Güneş
- Cardiology Department, İstanbul Medipol University, İstanbul, Turkey
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Sanches EE, Topal B, de Jongh FW, Cagiltay E, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Mahawar K, Buise MP, Dekker LR, Ramnarain D, Pouwels S. Effects of Bariatric Surgery on Heart Rhythm Disorders: a Systematic Review and Meta-Analysis. Obes Surg 2021; 31:2278-2290. [PMID: 33712936 DOI: 10.1007/s11695-021-05314-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/14/2021] [Accepted: 02/23/2021] [Indexed: 12/17/2022]
Abstract
The aim of this systematic review is to provide an overview of the literature on the effects of bariatric surgery on obesity-associated electrocardiogram (ECG) abnormalities and cardiac arrhythmias. Fourteen studies were included with a methodological quality ranging from poor to good. Majority of the studies showed a significant decrease of QT interval and related measures after bariatric surgery. Seven studies were included in the meta-analysis on effects of bariatric surgery on QTc interval and a significant decrease in QTc interval of - 33.6 ms, 95%CI [- 49.8 to - 17.4] was seen. Bariatric surgery results in significant decrease in QTc interval and P-wave dispersion, i.e., a normalization of initial pathology. The effects on atrial fibrillation are conflicting and not yet fully understood.
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Affiliation(s)
- Elijah E Sanches
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Frank W de Jongh
- Department of Plastic Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Eylem Cagiltay
- Department of Endocrinology and Metabolic Diseases, University of Health Sciences Turkey, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Alper Celik
- Metabolic Surgery Clinic, Sisli, Istanbul, Turkey
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Rui Ribeiro
- Centro Multidisciplinar da Doença Metabólica, Clínica de Santo António, Reboleira, Lisbon, Portugal
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, United Kingdom
| | - Surendra Ugale
- Bariatric & Metabolic Surgery Clinic, Virinchi Hospitals, Hyderabad, India
| | - Kamal Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, United Kingdom
| | - Marc P Buise
- Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Lukas R Dekker
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Dharmanand Ramnarain
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, P.O. Box 9051, 5000 LC, Tilburg, The Netherlands
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, P.O. Box 9051, 5000 LC, Tilburg, The Netherlands.
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Matsumoto T, Ohnishi H, Sato T, Miki T, Akasaka H, Hanawa N, Koyama M, Saitoh S, Miura T. Insulin Resistance is Associated with Longitudinal Changes of Cardiac Repolarization Heterogeneity in Apparently Healthy Subjects. Cardiol Ther 2019; 8:239-251. [PMID: 31273651 PMCID: PMC6828911 DOI: 10.1007/s40119-019-0140-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Increased heterogeneity in ventricular repolarization is a risk factor of sudden cardiac death, but its natural history is unclear. Here we examined whether insulin resistance is associated with longitudinal change in ventricular repolarization heterogeneity in apparently healthy subjects. METHODS The study subjects were participants in health checkups in cohort 1 and cohort 2, which were followed up for 6 years and 5 years, respectively. Subjects with diabetes, cardiovascular disease, or renal disease at baseline were excluded from the analyses. As indices of insulin resistance, the homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride to HDL-cholesterol ratio (TG/HDL-C) were used in cohort 1 and cohort 2, respectively. Heterogeneity in ventricular repolarization was assessed by heart rate-corrected Tpeak-Tend interval in V5 (cTpTe), QT interval, and QT dispersion. In regression analyses, parameters with a skewed distribution were normalized by logarithmic transformation or by Box-Cox transformation. RESULTS In longitudinal analyses, Box-Cox-transformed cTpTe at the end of follow-up was weakly correlated with log HOMA-IR at baseline in cohort 1 (n = 153, r = - 0.207, 95% CI - 0.354 to - 0.050, p = 0.010) and with log TG/HDL-C at baseline in cohort 2 (n = 738, r = - 0.098, 95% CI - 0.169 to - 0.026, p = 0.008). Multiple regression analysis showed that indices of insulin resistance, but not glycosylated hemoglobin (HbA1c) or plasma glucose, at baseline were significant explanatory variables for cTpTe at the end of follow-up. Neither QT interval nor QT dispersion was correlated with metabolic parameters. CONCLUSION Insulin resistance may be involved in the longitudinal increase of ventricular repolarization heterogeneity in apparently healthy subjects.
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Affiliation(s)
- Tamaki Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroshi Akasaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | - Masayuki Koyama
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shigeyuki Saitoh
- Division of Medical and Behavioral Subjects, Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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De Lorenzo A. Prolongation of the QT Interval and Myocardial Ischemia Are More Pieces of the "Metabolically Unhealthy Obesity" Puzzle. Am J Cardiol 2017; 120:891. [PMID: 28693743 DOI: 10.1016/j.amjcard.2017.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 05/03/2017] [Accepted: 06/01/2017] [Indexed: 11/16/2022]
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6
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Blüher S, Käpplinger J, Herget S, Reichardt S, Böttcher Y, Grimm A, Kratzsch J, Petroff D. Cardiometabolic risk markers, adipocyte fatty acid binding protein (aFABP) and the impact of high-intensity interval training (HIIT) in obese adolescents. Metabolism 2017; 68:77-87. [PMID: 28183455 DOI: 10.1016/j.metabol.2016.11.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/14/2016] [Accepted: 11/26/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The impact of high-intensity interval training (HIIT) as well as the association between the adipocyte fatty binding protein (aFABP) and cardiometabolic risk factors in overweight adolescents was investigated. METHODS Twenty-eight adolescents (13-18years; BMI≥90th percentile according to German reference values) were offered HIIT twice weekly for 6months. At baseline and after program completion, anthropometric, clinical and metabolic characteristics were assessed and a fasting blood sample was obtained. Leptin, adiponectin, visfatin and aFABP were measured using commercially available kits. DNA methylation at RALBP1 was assessed using pyrosequencing. Descriptive statistics, Pearson's correlation and linear models were calculated. RESULTS Mean age at start of the program was 15.5±1.4years (53.5% females) and 20/28 (71%) provided follow-up data. At baseline, aFABP was correlated with BMI-SDS (0.48 [0.13,0.72]; p=0.0095), waist-to-height-ratio (0.63 [0.33,0.81], p=0.00036) and body fat content (0.55 [0.21, 0.77]; p=0.0031). Certain markers of metabolic risk were significantly correlated with aFABP (HOMA-IR 0.52 [0.19, 0.75], p=0.0044; γGT 0.48 [0.13, 0.73], p=0.0091; uric acid 0.46 [0.11, 0.71] p=0.013; HDL-C -0.39 [-0.66, -0.01] p=0.043; triglycerides 0.38 [0.01, 0.66], p=0.047). With the exception of triglycerides, these associations vanished after adjusting for BMI-SDS. aFABP did not depend on sex, age or pubertal stage in obese adolescents. After the HIIT program, small but significant reductions were observed in waist-to-height-ratio, (0.013 [0.0025, 0.024]; p=0.023), skin-fold based body fat content (2.0% [0.6, 3.5]; p=0.011), and standard deviation score of systolic blood pressure (0.69 [0.26 to 1.1]; p=0.0036). No changes were observed in adipokines or epigenetic markers following the program. CONCLUSION HIIT may have beneficial effects on body composition and cardiometabolic health in overweight adolescents. Like in adults, aFABP seems to be associated with markers of metabolic risk in obese adolescents.
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Affiliation(s)
- Susann Blüher
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany; Department of Pediatrics, University Hospital of Halle-Wittenberg, Halle, Germany.
| | - Jakob Käpplinger
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany
| | - Sabine Herget
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany
| | - Sandra Reichardt
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany
| | - Yvonne Böttcher
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany; University of Oslo, Institute of Clinical Medicine, Section for Clinical Molecular Biology, Akershus University Hospital, Oslo, Norway
| | - Andrea Grimm
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - David Petroff
- Integrated Research and Treatment Center (IFB) for AdiposityDiseases, University of Leipzig, Germany; Clinical Trial Centre, University of Leipzig, Leipzig, Germany
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Sosner P, Bosquet L, Herpin D, Guilbeault V, Latour E, Paquette-Tannir L, Juneau M, Nigam A, Gayda M. Net Blood Pressure Reduction Following 9 Months of Lifestyle and High-Intensity Interval Training Intervention in Individuals With Abdominal Obesity. J Clin Hypertens (Greenwich) 2016; 18:1128-1134. [PMID: 27126546 DOI: 10.1111/jch.12829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/23/2016] [Accepted: 03/02/2016] [Indexed: 11/29/2022]
Abstract
The authors aimed to study the impact of a combined 9-month lifestyle program (Mediterranean diet nutritional counselling, and high-intensity interval training twice a week) on blood pressure (BP) in individuals with abdominal obesity, taking into account the regression-to-the-mean phenomena. A total of 115 participants (53±9 years; 84 women; waist circumference [WC]: 111±13 cm; systolic/diastolic BP [SBP/DBP]: 133±13/82±8 mm Hg; 13% diabetics; 12% smokers; and 30% taking antihypertensive therapy) were retrospectively analyzed before and after the program. After 9 months, we observed an improvement in weight (-5.2±5.6 kg) and WC (-6.3±6.0 cm), and an average SBP/DBP net decrease of -5.1±13.7/-2.8±8.7 mm Hg. These changes were not uniform: 67 participants (58%) decreased their SBP by 2 mm Hg or more. The characteristics of responders included a higher baseline BP than nonresponders (SBP/DBP: 137.2±13.7/83.1±7.3 mm Hg vs 127.0±10.3/80.0±7.3 mm Hg, P<.05) and a higher proportion of participants with a baseline BP ≥130/85 mm Hg (81% vs 52%, P=.001) or with the metabolic syndrome (75% vs 54%, P=.02).
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Affiliation(s)
- Philippe Sosner
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France. .,Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada. .,Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada. .,Department of Medicine, University of Montreal, Montreal, Canada. .,Cardiology Department, University Hospital of Poitiers, Poitiers, France. .,Sports Medicine Centre "Mon Stade", Paris, France.
| | - Laurent Bosquet
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France.,Department of Kinesiology, University of Montreal, Montreal, Canada
| | - Daniel Herpin
- Cardiology Department, University Hospital of Poitiers, Poitiers, France
| | - Valérie Guilbeault
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada
| | - Elise Latour
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada
| | - Laurie Paquette-Tannir
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada.,Department of Medicine, University of Montreal, Montreal, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada.,Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada.,Department of Medicine, University of Montreal, Montreal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada.,Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada.,Department of Medicine, University of Montreal, Montreal, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, Montreal, Canada.,Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada.,Department of Medicine, University of Montreal, Montreal, Canada
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8
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High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease. Cardiol Rev 2016; 24:273-281. [DOI: 10.1097/crd.0000000000000124] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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9
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Omran J, Firwana B, Koerber S, Bostick B, Alpert MA. Effect of obesity and weight loss on ventricular repolarization: a systematic review and meta-analysis. Obes Rev 2016; 17:520-30. [PMID: 26956255 DOI: 10.1111/obr.12390] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 11/30/2022]
Abstract
We performed a systematic review and meta-analysis of the effects of obesity ± overweight and weight loss on the corrected QT interval (QTc) and QT or QTc dispersion (indices of ventricular repolarization). Mean difference for both QTc and QT or QTc dispersion with 95% confidence intervals (CIs) was calculated comparing obese ± overweight subjects and normal weight controls and QTc and QT or QTc dispersion before and after weight loss from diet ± exercise or bariatric surgery. A total of 22 studies fulfilled the selection criteria. Compared with normal weight controls, there was a significantly longer QTc in obese ± overweight subjects (mean difference of 21.74 msec, 95% CI: 18.76 to 22.32) and significantly longer QT or QTc dispersion (mean difference of 15.17 msec, 95% CI: 13.59 to 16.74). Weight loss was associated with a significant decrease in QTc (mean difference -25.77 msec, 95% CI: -28.33-23.21) and QT or QTc dispersion (mean difference of -13.46 msec, 95% CI: -15.60 to -11.32 in obese ± overweight subjects. Thus, obesity ± overweight is associated with significant prolongation of QTc and QT or QTC dispersion. Weight loss in obese ± overweight subjects produces significant decreases in these variables. © 2016 World Obesity.
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Affiliation(s)
- J Omran
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - B Firwana
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - S Koerber
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - B Bostick
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
| | - M A Alpert
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA
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10
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Boidin M, Lapierre G, Paquette Tanir L, Nigam A, Juneau M, Guilbeault V, Latour E, Gayda M. Effect of aquatic interval training with Mediterranean diet counseling in obese patients: results of a preliminary study. Ann Phys Rehabil Med 2015; 58:269-75. [PMID: 26233941 DOI: 10.1016/j.rehab.2015.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/29/2015] [Accepted: 07/01/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND No previous studies have investigated a high-intensity interval training program (HIIT) with an immersed ergocycle and Mediterranean diet counseling (Med) in obese patients. We aimed to compare the effects of an intensive lifestyle intervention, Med and HIIT with a water-immersed versus dryland ergocycle, on cardiometabolic and exercise parameters in obese patients. METHODS We retrospectively identified 95 obese patients at their entry into a 9-month Med and HIIT program: 21 were trained on a water-immersed ergocycle and 74 on a standard dryland ergocycle. Body composition, cardiometabolic and exercise parameters were measured before and after the program. RESULTS For obese patients performing water- and dryland-exercise (mean age 58±9 years versus 55±7 years), BMI was higher for the water- than dryland-exercise group (39.4±8.3kg/m(2) versus 34.7±5.1kg/m(2), P<0.05), and total fat mass, fasting glycemia and triglycerides level were higher (P<0.05). Both groups showed similarly improved body composition variables (body mass, waist circumference, fat mass, P<0.001), fasting glycemia and triglycerides level (P<0.05). Initial maximal aerobic capacity (metabolic equivalents [METs]) and maximal heart rate (HRmax) were lower for the water- than dryland-exercise group (P<0.05). For both groups, METs, resting HR, resting blood pressure, abdominal and leg muscle endurance were similarly improved (P<0.05). CONCLUSIONS A long-term Mediterranean diet and HIIT program with water-cycling is as effective as a dryland program in improving body composition, fasting glucose, triglycerides level, blood pressure and fitness in obese patients. A Mediterranean diet combined with water-cycling HIIT may be efficient for severely obese patients at high risk of musculoskeletal conditions.
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Affiliation(s)
- Maxime Boidin
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada
| | - Gabriel Lapierre
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada; Department of Kinesiology, University of Montreal, Montreal, QC, Canada
| | - Laurie Paquette Tanir
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada; Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Anil Nigam
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada; Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Martin Juneau
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada; Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Valérie Guilbeault
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada
| | - Elise Latour
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular and Prevention and Rehabilitation Center (ÉPIC), Montreal Heart Institute, University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada; Department of Medicine, University of Montreal, Montreal, QC, Canada.
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Garnier S, Joffroy S, Gaubert I, Sanguignol F, Auneau G, Guiraud T, Mauriège P. Is practice rate rather than exercise intensity more important in health benefits of moderately obese postmenopausal women? Ann Phys Rehabil Med 2015; 58:119-25. [DOI: 10.1016/j.rehab.2015.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/14/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
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Casillas JM. Improving scientific production in cardiovascular rehabilitation: A reasonable challenge for the Annals? Ann Phys Rehabil Med 2015; 58:117-8. [DOI: 10.1016/j.rehab.2015.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/17/2015] [Indexed: 11/29/2022]
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Marquis-Gravel G, Hayami D, Juneau M, Nigam A, Guilbeault V, Latour É, Gayda M. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients. Prev Med Rep 2015; 2:314-8. [PMID: 26844086 PMCID: PMC4721397 DOI: 10.1016/j.pmedr.2015.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objectives To analyze the effects of a long-term intensive lifestyle intervention including high-intensity interval training (HIIT) and Mediterranean diet (MedD) counseling on glycemic control parameters, insulin resistance and β-cell function in obese subjects. Methods The glycemic control parameters (fasting plasma glucose, glycated hemoglobin), insulin resistance, and β-cell function of 72 obese subjects (54 women; mean age = 53 ± 9 years) were assessed at baseline and upon completion of a 9-month intensive lifestyle intervention program conducted at the cardiovascular prevention and rehabilitation center of the Montreal Heart Institute, from 2009 to 2012. The program included 2–3 weekly supervised exercise training sessions (HIIT and resistance exercise), combined to MedD counseling. Results Fasting plasma glucose (FPG) (mmol/L) (before: 5.5 ± 0.9; after: 5.2 ± 0.6; P < 0.0001), fasting insulin (pmol/L) (before: 98 ± 57; after: 82 ± 43; P = 0.003), and insulin resistance, as assessed by the HOMA-IR score (before: 3.6 ± 2.5; after: 2.8 ± 1.6; P = 0.0008) significantly improved, but not HbA1c (%) (before: 5.72 ± 0.55; after: 5.69 ± 0.39; P = 0.448), nor β-cell function (HOMA-β, %) (before: 149 ± 78; after: 144 ± 75; P = 0.58). Conclusion Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects. High-intensity interval training and Mediterranean diet improves glycemic parameters in obese subjects. Patients with insulin resistance benefit the most from this program. This is the first study to confirm these long-term benefits with such a program.
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Affiliation(s)
- Guillaume Marquis-Gravel
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Douglas Hayami
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Valérie Guilbeault
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada
| | - Élise Latour
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
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Abe D, Yoshida T, Ueoka H, Sugiyama K, Fukuoka Y. Relationship between perceived exertion and blood lactate concentrations during incremental running test in young females. BMC Sports Sci Med Rehabil 2015; 7:5. [PMID: 25973209 PMCID: PMC4429818 DOI: 10.1186/2052-1847-7-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 01/12/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND To investigate more practical handling of Borg's ratings of perceived exertion (RPE) and category-ratio scale of RPE (CR-10), we evaluated interrelationships between RPE, CR-10, and blood lactate concentrations (bLa) during incremental treadmill running tests for young females with different aerobic fitness levels. METHODS Oxygen consumption, heart rate, bLa, RPE, and CR-10 were measured from distance runners (DR; n = 15), race walkers (RW; n = 6), and untrained females (UT; n = 11). These variables corresponding to the lactate threshold (LT) and onset of blood lactate accumulation (OBLA) were compared among these groups. RESULTS The UT had significantly lower RPE at LT than DR and RW, although the CR-10 at LT was not significantly different among these groups. The CR-10 at OBLA was significantly lower for the UT than DR. The relationship between bLa and CR-10 was approximated well by two linear regression lines in all groups. The bLa at the intersection only for the RW was significantly lower than that at LT, however, such intersections were observed at CR-10 = 3.1 to 3.2 without significant group differences. The CR-10 scores at LT and intersections were not significantly different in each group. CONCLUSION These results suggested that an intersection between CR-10 and bLa was observed at the CR-10 score around three points of first half regardless of the aerobic fitness levels in young females, and such CR-10 scores would be associated with LT.
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Affiliation(s)
- Daijiro Abe
- Biodynamics Laboratory, Center for Health and Sports Science, Kyushu Sangyo University, 2-3-1 Matsukadai, 813-8503 Higashi-ku, Fukuoka Japan
| | - Takayoshi Yoshida
- Department of Health and Sports Sciences, Graduate School of Medicine, Osaka University, 1-17 Machikaneyama, 560-0043 Toyonaka, Osaka Japan
| | - Hatsumi Ueoka
- Department of Environmental and Applied Physiology, Faculty of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto, 3-1 Tsukide, 862-8502 Higashi-ku, Kumamoto Japan
| | - Koji Sugiyama
- Department of Health and Physical Education, Faculty of Education, Shizuoka University, 836 Ohya, 422-8529 Suruga-ku, Shizuoka Japan
| | - Yoshiyuki Fukuoka
- Department of Environmental and Applied Physiology, Faculty of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto, 3-1 Tsukide, 862-8502 Higashi-ku, Kumamoto Japan ; Faculty of Health and Sports Science, Doshisha University, 1-3 Miyakodani, 610-0394 Kyotanabe, Japan
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Provocative issues in heart disease prevention. Can J Cardiol 2014; 30:S401-9. [PMID: 25444498 DOI: 10.1016/j.cjca.2014.09.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 12/25/2022] Open
Abstract
In this article, new areas of cardiovascular (CV) prevention and rehabilitation research are discussed: high-intensity interval training (HIIT) and new concepts in nutrition. HIIT consists of brief periods of high-intensity exercise interspersed by periods of low-intensity exercise or rest. The optimal mode according our work (15-second exercise intervals at peak power with passive recovery intervals of the same duration) is associated with longer total exercise time, similar time spent near peak oxygen uptake (VO2 peak) VO2 peak, and lesser perceived exertion relative to other protocols that use longer intervals and active recovery periods. Evidence also suggests that compared with moderate-intensity continuous exercise training, HIIT has superior effects on cardiorespiratory function and on the attenuation of multiple cardiac and peripheral abnormalities. With respect to nutrition, a growing body of evidence suggests that the gut microbiota is influenced by lifestyle choices and might play a pivotal role in modulating CV disease development. For example, recent evidence linking processed (but not unprocessed) meats to increased CV risk pointed to the gut microbial metabolite trimethylamine N-oxide as a potential culprit. In addition, altered gut microbiota could also mediate the proinflammatory and cardiometabolic abnormalities associated with excess added free sugar consumption, and in particular high-fructose corn syrup. Substantially more research is required, however, to fully understand how and which alterations in gut flora can prevent or lead to CV disease and other chronic illnesses. We conclude with thoughts about the appropriate role for HIIT in CV training and future research in the role of gut flora-directed interventions in CV prevention.
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Adamson SB, Lorimer R, Cobley JN, Babraj JA. Extremely short-duration high-intensity training substantially improves the physical function and self-reported health status of elderly adults. J Am Geriatr Soc 2014; 62:1380-1. [PMID: 25039507 DOI: 10.1111/jgs.12916] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Simon B Adamson
- Division of Sport and Exercise Sciences, Abertay University, Dundee, UK
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Matsuo T, Saotome K, Seino S, Eto M, Shimojo N, Matsushita A, Iemitsu M, Ohshima H, Tanaka K, Mukai C. Low-volume, high-intensity, aerobic interval exercise for sedentary adults: VO₂max, cardiac mass, and heart rate recovery. Eur J Appl Physiol 2014; 114:1963-72. [PMID: 24917354 DOI: 10.1007/s00421-014-2917-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/15/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to compare the effects of low-volume, high-intensity aerobic interval training (HAIT) on maximal oxygen consumption (VO₂max), left ventricular (LV) mass, and heart rate recovery (HRR) with high-volume, moderate-intensity continuous aerobic training (CAT) in sedentary adults. METHODS Twenty-four healthy but sedentary male adults (aged 29.2 ± 7.2 years) participated in an 8-week, 3-day a week, supervised exercise intervention. They were randomly assigned to either HAIT (18 min, 180 kcal per exercise session) or CAT (45 min, 360 kcal). VO₂max, LV mass (3T-MRI), and HRR at 1 min (HRR-1) and 2 min (HRR-2) after maximal exercise were measured pre- and post-intervention. RESULTS Changes in VO₂max during the 8-week intervention were significant (P < 0.01) in both groups (HAIT, 8.7 ± 3.2 ml kg(-1) min(-1), 22.4 ± 8.9%; CAT, 5.5 ± 2.8 ml kg(-1) min(-1), 14.7 ± 9.5%), while the VO₂max improvement in HAIT was greater (P = 0.02) than in CAT. LV mass in HAIT increased (5.1 ± 8.4 g, 5.7 ± 9.1%, P = 0.05), but not in CAT (0.9 ± 7.8 g, 1.1 ± 8.4%, P = 0.71). While changes in HRR-1 were not significant in either group, change in HRR-2 for HAIT (9.5 ± 6.4 bpm, 19.0 ± 16.0%, P < 0.01) was greater (P = 0.03) than for CAT (1.6 ± 10.9 bpm, 3.9 ± 16.2%, P = 0.42). CONCLUSIONS This study suggests that HAIT has potential as a time-efficient training mode to improve cardiorespiratory capacity and autonomic nervous system function in sedentary adults.
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Affiliation(s)
- Tomoaki Matsuo
- Hazard Evaluation and Epidemiology Research Group, National Institute of Occupational Safety and Health, Japan, 6-21-1 Nagao, Tama-ku, Kawasaki, 214-8585, Japan,
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Abstract
Despite 50 years of pharmacological and psychosocial interventions, schizophrenia remains one of the leading causes of disability. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. The end result is a considerably reduced lifespan that is marred by reduced levels of independence, with few novel treatment options available. Disability is a multidimensional construct that results from different, and often interacting, factors associated with specific types and levels of impairment. In schizophrenia, the most poignant and well characterized determinants of disability are symptoms, cognitive and related skills deficits, but there is limited understanding of other relevant factors that contribute to disability. Here we conceptualize how reduced physical performance interacts with aging, neurobiological, treatment-emergent, and cognitive and skills deficits to exacerbate ADL disability and worsen physical health. We argue that clearly defined physical performance components represent underappreciated variables that, as in mentally healthy people, offer accessible targets for exercise interventions to improve ADLs in schizophrenia, alone or in combination with improvements in cognition and health. And, finally, due to the accelerated aging pattern inherent in this disease – lifespans are reduced by 25 years on average – we present a training model based on proven training interventions successfully used in older persons. This model is designed to target the physical and psychological declines associated with decreased independence, coupled with the cardiovascular risk factors and components of the metabolic syndrome seen in schizophrenia due to their excess prevalence of obesity and low fitness levels.
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Dalzill C, Nigam A, Juneau M, Guilbeault V, Latour E, Mauriège P, Gayda M. Intensive Lifestyle Intervention Improves Cardiometabolic and Exercise Parameters in Metabolically Healthy Obese and Metabolically Unhealthy Obese Individuals. Can J Cardiol 2014; 30:434-40. [DOI: 10.1016/j.cjca.2013.11.033] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 12/01/2022] Open
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Gayda M, Nigam A, Juneau M. Body composition and insulin sensitivity after high-intensity interval training in overweight/obese patients. Obesity (Silver Spring) 2014; 22:624. [PMID: 24339428 DOI: 10.1002/oby.20681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/10/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada; Department of Medicine, University of Montreal, Montreal, Quebec, Canada
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Guiraud T, Nigam A, Gremeaux V, Meyer P, Juneau M, Bosquet L. High-intensity interval training in cardiac rehabilitation. Sports Med 2012; 42:587-605. [PMID: 22694349 DOI: 10.2165/11631910-000000000-00000] [Citation(s) in RCA: 179] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
High-intensity interval training (HIIT) is frequently used in sports training. The effects on cardiorespiratory and muscle systems have led scientists to consider its application in the field of cardiovascular diseases. The objective of this review is to report the effects and interest of HIIT in patients with coronary artery disease (CAD) and heart failure (HF), as well as in persons with high cardiovascular risk. A non-systematic review of the literature in the MEDLINE database using keywords 'exercise', 'high-intensity interval training', 'interval training', 'coronary artery disease', 'coronary heart disease', 'chronic heart failure' and 'metabolic syndrome' was performed. We selected articles concerning basic science research, physiological research, and randomized or non-randomized interventional clinical trials published in English. To summarize, HIIT appears safe and better tolerated by patients than moderate-intensity continuous exercise (MICE). HIIT gives rise to many short- and long-term central and peripheral adaptations in these populations. In stable and selected patients, it induces substantial clinical improvements, superior to those achieved by MICE, including beneficial effects on several important prognostic factors (peak oxygen uptake, ventricular function, endothelial function), as well as improving quality of life. HIIT appears to be a safe and effective alternative for the rehabilitation of patients with CAD and HF. It may also assist in improving adherence to exercise training. Larger randomized interventional studies are now necessary to improve the indications for this therapy in different populations.
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Affiliation(s)
- Thibaut Guiraud
- Montreal Heart Institute, Cardiovascular Prevention Centre-Centre PIC, Universit de Montral, Montral, Qubec, Canada.
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