1
|
Ueno K, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Miki T, Hotta K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Leg strength and incidence of heart failure in patients with acute coronary syndrome. Eur J Prev Cardiol 2024; 31:834-842. [PMID: 38150177 DOI: 10.1093/eurjpc/zwad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
AIMS The risk of developing heart failure (HF) after acute coronary syndrome (ACS) remains high. It is unclear whether skeletal muscle strength, in addition to existing risk factors, is a predictor for developing HF after ACS. We aimed to clarify the relationship between quadriceps isometric strength (QIS), a skeletal muscle strength indicator, and the risk of developing HF in patients with ACS. METHODS AND RESULTS We included 1053 patients with ACS without a prior HF or complications of HF during hospitalization. The median (interquartile range) age was 67 (57-74) years. The patients were classified into two groups-high and low QIS-using the sex-specific median QIS. The endpoint was HF admissions. During a mean follow-up period of 4.4 ± 3.7 years, 75 (7.1%) HF admissions were observed. After multivariate adjustment, a high QIS was associated with a lower risk of HF [hazard ratio: 0.52, 95% confidence interval (CI): 0.32-0.87]. Hazard ratio (95% CI) per 5% body weight increment increase of QIS for HF incidents was 0.87 (0.80-0.95). Even when competing risks of death were taken into account, the results did not change. The inclusion of QIS was associated with increases in net reclassification improvement (0.26; 95% CI: 0.002-0.52) and an integrated discrimination index (0.01; 95% CI: 0.004-0.02) for HF. CONCLUSION The present study showed that a higher level of QIS was strongly associated with a lower risk of developing HF after ACS. These findings suggest that skeletal muscle strength could be one of the factors contributing to the risk of developing HF after ACS.
Collapse
Affiliation(s)
- Kensuke Ueno
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Division of Research, ARCE Inc., Sagamihara, Japan
| | - Shota Uchida
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takumi Noda
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Takashi Miki
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Kazuki Hotta
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, School of Medicine, Kitasato University, Sagamihara, Japan
| |
Collapse
|
2
|
Hansen D, Beckers P, Neunhäuserer D, Bjarnason-Wehrens B, Piepoli MF, Rauch B, Völler H, Corrà U, Garcia-Porrero E, Schmid JP, Lamotte M, Doherty P, Reibis R, Niebauer J, Dendale P, Davos CH, Kouidi E, Spruit MA, Vanhees L, Cornelissen V, Edelmann F, Barna O, Stettler C, Tonoli C, Greco E, Pedretti R, Abreu A, Ambrosetti M, Braga SS, Bussotti M, Faggiano P, Takken T, Vigorito C, Schwaab B, Coninx K. Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure: A Consensus Statement from the EXPERT Working Group. Sports Med 2023; 53:2013-2037. [PMID: 37648876 DOI: 10.1007/s40279-023-01909-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
Whereas exercise training, as part of multidisciplinary rehabilitation, is a key component in the management of patients with chronic coronary syndrome (CCS) and/or congestive heart failure (CHF), physicians and exercise professionals disagree among themselves on the type and characteristics of the exercise to be prescribed to these patients, and the exercise prescriptions are not consistent with the international guidelines. This impacts the efficacy and quality of the intervention of rehabilitation. To overcome these barriers, a digital training and decision support system [i.e. EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool], i.e. a stepwise aid to exercise prescription in patients with CCS and/or CHF, affected by concomitant risk factors and comorbidities, in the setting of multidisciplinary rehabilitation, was developed. The EXPERT working group members reviewed the literature and formulated exercise recommendations (exercise training intensity, frequency, volume, type, session and programme duration) and safety precautions for CCS and/or CHF (including heart transplantation). Also, highly prevalent comorbidities (e.g. peripheral arterial disease) or cardiac devices (e.g. pacemaker, implanted cardioverter defibrillator, left-ventricular assist device) were considered, as well as indications for the in-hospital phase (e.g. after coronary revascularisation or hospitalisation for CHF). The contributions of physical fitness, medications and adverse events during exercise testing were also considered. The EXPERT tool was developed on the basis of this evidence. In this paper, the exercise prescriptions for patients with CCS and/or CHF formulated for the EXPERT tool are presented. Finally, to demonstrate how the EXPERT tool proposes exercise prescriptions in patients with CCS and/or CHF with different combinations of CVD risk factors, three patient cases with solutions are presented.
Collapse
Affiliation(s)
- Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
- UHasselt, BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre) (REVAL/BIOMED), Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium.
| | - Paul Beckers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Translational Pathophysiological Research, Antwerp University, Antwerp, Belgium
| | - Daniel Neunhäuserer
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Birna Bjarnason-Wehrens
- Department of Preventive and Rehabilitative Sport and Exercise Medicine, Institute for Cardiology and Sports Medicine, German Sports University, Cologne, Germany
| | - Massimo F Piepoli
- Clinical Cardiology, IRCCS Policlinico San Donato, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Bernhard Rauch
- Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen am Rhein/Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen am Rhein/Zentrum für Ambulante Rehabilitation, ZAR Trier, Trier, Germany
| | - Heinz Völler
- Department of Cardiology, Klinik am See, Rüdersdorf, Germany
- Center of Rehabilitation Research, University of Potsdam, Potsdam, Germany
| | - Ugo Corrà
- Cardiologic Rehabilitation Department, Istituti Clinici Scientifici Salvatore Maugeri, SPA, SB, Scientific Institute of di Veruno, IRCCS, Veruno, NO, Italy
| | | | - Jean-Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Barmelweid, Switzerland
| | | | | | - Rona Reibis
- Cardiological Outpatient Clinics at the Park Sanssouci, Potsdam, Germany
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Rehab-Center Salzburg, Ludwig Boltzmann Institute for Digital Health and Prevention, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre) (REVAL/BIOMED), Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium
| | - Constantinos H Davos
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Martijn A Spruit
- UHasselt, BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre) (REVAL/BIOMED), Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium
- Department of Research & Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn/Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Luc Vanhees
- Research Group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department Rehabilitation Sciences, University Leuven, Leuven, Belgium
| | - Véronique Cornelissen
- Research Group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department Rehabilitation Sciences, University Leuven, Leuven, Belgium
| | - Frank Edelmann
- Department of Cardiology, Angiology and Intensive Care, Deutsches Herzzentrum der Charité (DHZC), Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Olga Barna
- Family Medicine Department, National O.O. Bogomolets Medical University, Kiev, Ukraine
| | - Christoph Stettler
- Division of Endocrinology, Diabetes and Clinical Nutrion, University Hospital/Inselspital, Bern, Switzerland
| | - Cajsa Tonoli
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | | | | | - Ana Abreu
- Centre of Cardiovascular RehabilitationCardiology Department, Centro Universitário Hospitalar Lisboa Norte & Faculdade de Medicina da Universidade Lisboa/Instituto Saúde Ambiental & Instituto Medicina Preventiva, Faculdade Medicina da Universidade Lisboa/CCUL/CAML, Lisbon, Portugal
| | - Marco Ambrosetti
- Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, Italy
| | | | - Maurizio Bussotti
- Unit of Cardiorespiratory Rehabilitation, Instituti Clinici Maugeri, IRCCS, Institute of Milan, Milan, Italy
| | | | - Tim Takken
- Division of Pediatrics, Child Development & Exercise Center, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Internal Medicine and Cardiac Rehabilitation, University of Naples Federico II, Naples, Italy
| | - Bernhard Schwaab
- Curschmann Clinic, Rehabilitation Center for Cardiology, Vascular Diseases and Diabetes, Timmendorfer Strand/Medical Faculty, University of Lübeck, Lübeck, Germany
| | - Karin Coninx
- UHasselt, Faculty of Sciences, Human-Computer Interaction and eHealth, Hasselt University, Hasselt, Belgium
| |
Collapse
|
3
|
Kristiansen J, Grove EL, Pedersen OB, Kristensen SD, Hvas AM. Effect of regular exercise training on platelet function in patients with cardiovascular disease and healthy individuals: A systematic review. Thromb Res 2023; 231:223-235. [PMID: 36609119 DOI: 10.1016/j.thromres.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Regular exercise training is essential in prevention and treatment of cardiovascular disease (CVD), yet the beneficial effects of exercise remain only partly explained. Platelets play a key role in CVD and may be affected by regular exercise training. We aimed to systematically summarise studies investigating the effect of regular exercise training on platelet function in patients with CVD and in healthy individuals. METHODS Studies were identified by PubMed, Embase and Web of Science May 16, 2022. We selected studies investigating markers of platelet function in relation to regular exercise training in patients with CVD and in healthy individuals. Regular exercise was defined as exercise training for four weeks or more. RESULTS Of the included studies, 11 investigated patients with CVD and 29 were on healthy individuals. Studies were heterogeneous regarding design, study population and methodology, and the results were ambiguous. In total, 52 different markers of platelet function were investigated with platelet aggregation, soluble P-selectin, and thromboxane B2 (TXB2) as the most frequently examined. When evaluating between-group changes after regular exercise, two studies found a reduced platelet aggregation in the exercise group whilst three studies did not find a difference between groups. With respect to TXB2, three studies reported a reduction and two studies an increase in the exercise group. There were no between-group differences in the seven studies examining soluble P-selectin. CONCLUSION Regular exercise training has no clear impact on platelet function in patients with CVD or healthy individuals. PROSPERO REGISTRATION CRD42022350539.
Collapse
Affiliation(s)
- Jacobina Kristiansen
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands; Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Erik L Grove
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
| | - Oliver Buchhave Pedersen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Steen D Kristensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Anne-Mette Hvas
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
4
|
Hallak AO, Hallak FZ, Hallak YO, Hallak OO, Hayson AW, Tanami SA, Bennett WL, Lavie CJ. Exercise Therapy in the Management of Peripheral Arterial Disease. Mayo Clin Proc Innov Qual Outcomes 2023; 7:476-489. [PMID: 37823000 PMCID: PMC10562863 DOI: 10.1016/j.mayocpiqo.2023.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
The incidence and prevalence of peripheral artery disease (PAD) are increasing globally and have a marked economic burden in the United States. The American Heart Association/American College of Cardiology guidelines recommend exercise therapy as a Class 1A, but its utilization remains suboptimal. This state-of-the-art review aims to provide a comprehensive review of the most updated information available on PAD, along with its risk factors, management options, outcomes, economic burden, and the role of exercise therapy in managing PAD.
Collapse
Affiliation(s)
- Ahmad O. Hallak
- Department of Cardiology, Ochsner Medical Center, New Orleans, LA
| | | | - Yusuf O. Hallak
- School of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | | | - Aaron W. Hayson
- Department of Vascular Surgery, Ochsner Medical Center, New Orleans, LA
| | - Sadia A. Tanami
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo
| | | | - Carl J. Lavie
- Department of Cardiology, Ochsner Medical Center, New Orleans, LA
| |
Collapse
|
5
|
Sordi AF, Lemos MM, de Souza Marques DC, Ryal JJ, Priscila de Paula Silva Lalucci M, Marques MG, Amaro Camilo ML, De Paula Ramos S, Franzói De Moraes SM, Valdés-Badilla P, Mota J, Magnani Branco BH. Effects of a multi-professional intervention on body composition, physical fitness and biochemical markers in overweight COVID-19 survivors: a clinical trial. Front Physiol 2023; 14:1219252. [PMID: 37700761 PMCID: PMC10494426 DOI: 10.3389/fphys.2023.1219252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/10/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction: The sequelae post-COVID can affect different systems. In this sense, considering the multi-factorial etiology of COVID-19, multi-professional interventions could be a relevant strategy for recovery health indicators. Objective: This study aimed to investigate the effects of multi-professional intervention on body composition, physical fitness, and biomarkers in overweight COVID-19 survivors with different symptomatology. Methodology: A non-randomized parallel group intervention included 69 volunteers (BMI ≥25 kg/m2), divided into three groups according to SARS CoV-2 symptomatology, but only 35 finished the longitudinal protocol [control group (n = 11); moderate group (n = 17) and severe group (n = 7)]. The groups were submitted to a multi-professional program (nutritional intervention, psychoeducation, and physical exercise intervention) for 8 weeks, and the volunteers underwent body composition assessments (primary outcome) and physical and biochemical tests (secondary outcome) in pre- and post-intervention. This study was registered on the Clinical Trials Registration Platform number: RBR-4mxg57b and with the local research ethics committee protocol under number: 4,546,726/2021. Results: After the 8-week multi-professional intervention, the following results were observed for the moderate COVID-19 group: improved dynamic strength of lower- and (p = 0.003), upper-limbs (p = 0.008), maximal isometric lumbar-traction strength (p = 0.04), flexibility (p = 0.0006), and albumin (p = 0.0005), as well as a reduction in the C reactive protein (CRP) (p = 0.003) and fasting glucose (p = 0.001); for the severe COVID-19 group: an improvement in dynamic lower-body strength (p = 0.001), higher values of albumin (p = 0.005) and HDL-c (p = 0.002), and lower values of CRP (p = 0.05), and for the control group: an improvement in sit-up repetitions (p = 0.008), and a reduction of CRP (p = 0.01), fasting glucose (p = 0.001) and total cholesterol (p = 0.04) were identified. All experimental groups reduced triglycerides after intervention (p < 0.05). Conclusion: Finally, 8 weeks of multiprofessional intervention can be an efficient tool for reversing the inflammatory process and promoting improvements in daily activities and quality of life, although it is believed that the severe COVID-19 group needs longer interventions to improve different health indicators. Clinical Trial Registration: https://ensaiosclinicos.gov.br/, identifier: RBR-4mxg57b.
Collapse
Affiliation(s)
- Ana Flávia Sordi
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
| | - Maurício Medeiros Lemos
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
| | - Déborah Cristina de Souza Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
| | - Joed Jacinto Ryal
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
| | - Marielle Priscila de Paula Silva Lalucci
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
| | - Marilene Guiraldi Marques
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
| | - Maria Luiza Amaro Camilo
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
| | | | | | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, Chile
| | - Jorge Mota
- Laboratory for Integrative and Translational Research in Population Health (ITR), Research Centre of Physical Activity, Health, and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| | - Braulio Henrique Magnani Branco
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Technology and Innovation, Maringá, Brazil
- Graduate Program in Health Promotion, Cesumar University, Maringá, Brazil
- Laboratory for Integrative and Translational Research in Population Health (ITR), Research Centre of Physical Activity, Health, and Leisure, Faculty of Sports, University of Porto, Porto, Portugal
| |
Collapse
|
6
|
Kambic T, Božič Mijovski M, Jug B, Hadžić V, Lainscak M. Insulin resistance, lipids and body composition in patients with coronary artery disease after combined aerobic training and resistance training: a randomised, controlled trial. Diabetol Metab Syndr 2023; 15:47. [PMID: 36918949 PMCID: PMC10014406 DOI: 10.1186/s13098-023-01017-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/04/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The effect of resistance training (RT) in cardiac rehabilitation (CR) on insulin resistance remains elusive. We examined whether the addition of high-load (HL) or low loads (LL) RT has any effect on the levels of insulin resistance and lipids versus aerobic training (AT) alone in patients with coronary artery disease (CAD). METHODS Seventy-nine CAD patients were randomised to HL-RT [70-80% of one repetition maximum (1-RM)] and AT, LL-RT (35-40% of 1-RM) and AT or AT (50-80% of maximal power output), and 59 patients [75% males, 15% diabetics, age: 61 (8) years, left ventricular ejection fraction: 53 (9) %] completed the study. Plasma levels of glucose, insulin, blood lipids [total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL)] cholesterol and body composition were measured at baseline and post-training (36 training sessions). RESULTS Training intervention had only time effect on lean mass (p = 0.002), total and LDL cholesterol levels (both p < 0.001), and no effects on levels of glucose and insulin resistance (homeostatic assessment 2-insulin resistance). Total and LDL cholesterols levels decreased following AT [mean difference (95% confidence interval); total cholesterol: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.013; LDL: - 0.4 mmol/l (- 0.7 mmol/l, - 0.1 mmol/l), p = 0.006] and HL-RT [total cholesterol: - 0.5 mmol/l (- 0.8 mmol/l, - 0.2 mmol/l), p = 0.002; LDL: - 0.5 mol/l (- 0.7 mmol/l, - 0.2 mmol/l), p = 0.002]. No associations were observed between post-training change in body composition and post-training change in blood biomarkers. CONCLUSIONS RT when combined with AT had no additional effect beyond AT alone on fasting glucose metabolism, blood lipids and body composition in patients with CAD. Trial registration number NCT04638764.
Collapse
Affiliation(s)
- Tim Kambic
- Cardiac Rehabilitation Unit, General Hospital Murska Sobota, 9000, Murska Sobota, Slovenia
- Faculty of Sport, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Mojca Božič Mijovski
- Laboratory for Haemostasis and Atherothrombosis, Department of Vascular Diseases, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Borut Jug
- Department of Vascular Diseases, University Clinical Centre Ljubljana, 1000, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Mitja Lainscak
- Faculty of Medicine, University of Ljubljana, 1000, Ljubljana, Slovenia.
- Division of Cardiology, Department of Internal Medicine, General Hospital Murska Sobota, Rakican, Ulica dr. Vrbnjaka 6, 9000, Murska Sobota, Slovenia.
| |
Collapse
|
7
|
Gao Y, Yue L, Miao Z, Wang F, Wang S, Luan B, Hao W. The Effect and Possible Mechanism of Cardiac Rehabilitation in Partial Revascularization Performed on Multiple Coronary Artery Lesions. Clin Interv Aging 2023; 18:235-248. [PMID: 36843631 PMCID: PMC9948643 DOI: 10.2147/cia.s398732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/10/2023] [Indexed: 02/20/2023] Open
Abstract
Purpose To observe the effect of cardiac rehabilitation (CR) in patients with partial revascularization performed on multiple coronary artery lesions and explore its possible mechanism. Patients and Methods A total of 400 patients with multiple coronary artery lesions were enrolled and randomly divided into a complete revascularization group and a CR group, with 200 cases in each group. Target lesion revascularization was performed radically in the complete revascularization group, while it was partially completed in the CR group, and postoperative CR was performed. All the patients were put under conventional treatment. Left ventricular end diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6-MWD), quality-of-life scores, safety and levels of serum nitric oxide (NO), nitric oxide synthase (NOS), superoxide dismutase (SOD), and vascular endothelial growth factor (VEGF) were evaluated and compared between two groups before and after training. Results There was no significant difference in LVEDD, LVEF, 6-MWD, quality-of-life scores, levels of serum NO, NOS, SOD, and VEGF between two groups before training (p>0.05). 1 year later, compared with the complete revascularization group, the occurrence of major adverse events in the CR group declined (p>0.05); the measurements of LVEDD decreased and LVEF increased (p>0.05), 6-MWD increased significantly (p<0.05), quality-of-life scores were higher (p<0.05), the levels of serum NO, NOS, and SOD increased noticeably, and the levels of serum VEGF decreased significantly in the CR group (p<0.05). There were significant differences within the same group, before and after training (p<0.05). Conclusion Cardiac rehabilitation training, not increase in the incidence of adverse events, is effective and safe after partial revascularization in patients with multiple coronary artery lesions, which has notable clinical advantages in promoting patients' exercise endurance and quality-of-life by improving the nitric oxide synthase system and antioxidant system and reducing the level of VEGF.
Collapse
Affiliation(s)
- Yang Gao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Ling Yue
- Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Zhilin Miao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Fengrong Wang
- Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China
| | - Shuai Wang
- Department of Cardiology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, People’s Republic of China
| | - Bo Luan
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China
| | - Wenjun Hao
- Department of Cardiology, The People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, People’s Republic of China,Correspondence: Wenjun Hao, Department of Cardiology, The People’s Hospital of Liaoning Province, NO. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email
| |
Collapse
|
8
|
Tao X, Chen Y, Zhen K, Ren S, Lv Y, Yu L. Effect of continuous aerobic exercise on endothelial function: A systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1043108. [PMID: 36846339 PMCID: PMC9950521 DOI: 10.3389/fphys.2023.1043108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background: Current research suggests that continuous aerobic exercise can be effective in improving vascular endothelial function, while the effect between different intensities and durations of exercise is unclear. The aim of this study was to explore the effect of different durations and intensities of aerobic exercise on vascular endothelial function in different populations. Methods: Searches were performed in PubMed, Web of Science, and EBSCO databases. We included studies that satisfied the following criteria: 1) randomized controlled trials (RCTs); 2) including both an intervention and control group; 3) using flow-mediated dilation (FMD) as the outcome measure; and 4) testing FMD on the brachial artery. Results: From 3,368 search records initially identified, 41 studies were eligible for meta-analysis. There was a significant effect of continuous aerobic exercise on improving flow-mediated dilation (FMD) [weighted mean difference (WMD), 2.55, (95% CI, 1.93-3.16), p < 0.001]. Specifically, moderate-intensity [2.92 (2.02-3.825), p < 0.001] and vigorous-intensity exercise [2.58 (1.64-3.53), p < 0.001] significantly increased FMD. In addition, a longer duration [<12 weeks, 2.25 (1.54-2.95), p < 0.001; ≥12 weeks, 2.74 (1.95-3.54), p < 0.001], an older age [age <45, 2.09 (0.78-3.40), p = 0.002; 45 ≤ age <60, 2.25 (1.49-3.01), p < 0.001; age ≥60, 2.62 (1.31-3.94), p < 0.001], a larger basal body mass index (BMI) [20 < BMI < 25, 1.43 (0.98-1.88), p < 0.001; 25 ≤ BMI < 30, 2.49 (1.07-3.90), p < 0.001; BMI ≥ 30, 3.05 (1.69-4.42), p < 0.001], and a worse basal FMD [FMD < 4, 2.71 (0.92-4.49), p = 0.003; 4 ≤ FMD < 7, 2.63 (2.03-3.23), p < 0.001] were associated with larger improvements in FMD. Conclusion: Continuous aerobic exercise, especially moderate-intensity and vigorous-intensity aerobic exercise, contributed to improving FMD. The effect of continuous aerobic exercise on improving FMD was associated with duration and participant's characteristics. Specifically, a longer duration, an older age, a larger basal BMI, and a worse basal FMD contributed to more significant improvements in FMD. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341442], identifier [CRD42022341442].
Collapse
Affiliation(s)
- Xifeng Tao
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yiyan Chen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Kai Zhen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiqi Ren
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,China Institute of Sport and Health Science, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
| |
Collapse
|
9
|
Hu M, Wang X, Yang Y. Causal relationship between moderate to vigorous physical activity and venous thromboembolism. J Thromb Thrombolysis 2023; 55:576-583. [PMID: 36595107 DOI: 10.1007/s11239-022-02754-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 01/04/2023]
Abstract
Previous studies have shown conflicting results about the impact of moderate to vigorous physical activity on the risk of venous thromboembolism (VTE). Using Mendelian randomization, we assessed whether moderate to vigorous physical activity causally affects VTE from genetic level. Genetic instruments associated with moderate to vigorous physical activity at the genome-wide significance level (P < 5×10- 8) were selected from the UK Biobank. Summary-level data for VTE were obtained from the FinnGen consortium. Univariable and multivariable Mendelian randomization analyses were conducted. Genetically predicted moderate to vigorous physical activity had no effect on VTE [odds ratio (OR) = 1.08; 95% confidence interval (CI) 0.66-1.78; P = 0.75] under a multiplicative random-effects inverse-variance weighted model. MR-Egger (OR = 0.20; 95% CI 0.01-4.70; P = 0.33), weighted median (OR = 1.08; 95% CI 0.52-2.25; P = 0.84), simple mode (OR = 2.53; 95% CI 0.59-10.92; P = 0.23), weighted mode (OR = 2.21; 95% CI 0.50-9.74; P = 0.31), and multivariable Mendelian randomization (OR = 0.74; 95% CI 0.46-1.19; P = 0.22) also yielded no significant association. The overall estimate was not influenced by individual single nucleotide polymorphism. No evidence of heterogeneity or horizontal pleiotropy was observed. Therefore, moderate to vigorous physical activity had no causal association with VTE in the general population.
Collapse
Affiliation(s)
- Mengjin Hu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China
| | - Xiaoning Wang
- School of Medicine, Shandong University, Jinan, 250012, China
| | - Yuejin Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, China.
| |
Collapse
|
10
|
Makita S, Yasu T, Akashi YJ, Adachi H, Izawa H, Ishihara S, Iso Y, Ohuchi H, Omiya K, Ohya Y, Okita K, Kimura Y, Koike A, Kohzuki M, Koba S, Sata M, Shimada K, Shimokawa T, Shiraishi H, Sumitomo N, Takahashi T, Takura T, Tsutsui H, Nagayama M, Hasegawa E, Fukumoto Y, Furukawa Y, Miura SI, Yasuda S, Yamada S, Yamada Y, Yumino D, Yoshida T, Adachi T, Ikegame T, Izawa KP, Ishida T, Ozasa N, Osada N, Obata H, Kakutani N, Kasahara Y, Kato M, Kamiya K, Kinugawa S, Kono Y, Kobayashi Y, Koyama T, Sase K, Sato S, Shibata T, Suzuki N, Tamaki D, Yamaoka-Tojo M, Nakanishi M, Nakane E, Nishizaki M, Higo T, Fujimi K, Honda T, Matsumoto Y, Matsumoto N, Miyawaki I, Murata M, Yagi S, Yanase M, Yamada M, Yokoyama M, Watanabe N, Ito H, Kimura T, Kyo S, Goto Y, Nohara R, Hirata KI. JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease. Circ J 2022; 87:155-235. [PMID: 36503954 DOI: 10.1253/circj.cj-22-0234] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Shigeru Makita
- Department of Cardiac Rehabilitation, Saitama Medical University International Medical Center
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Hitoshi Adachi
- Department of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University of Medicine
| | - Shunichi Ishihara
- Department of Psychology, Bunkyo University Faculty of Human Sciences
| | - Yoshitaka Iso
- Division of Cardiology, Showa University Fujigaoka Hospital
| | - Hideo Ohuchi
- Department of Pediatrics, National Cerebral and Cardiovascular Center
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus
| | - Koichi Okita
- Graduate School of Lifelong Sport, Hokusho University
| | - Yutaka Kimura
- Department of Health Sciences, Kansai Medical University Hospital
| | - Akira Koike
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kazunori Shimada
- Department of Cardiology, Juntendo University School of Medicine
| | | | - Hirokazu Shiraishi
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University
| | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | - Emiko Hasegawa
- Faculty of Psychology and Social Welfare, Seigakuin University
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Sumio Yamada
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine
| | - Yuichiro Yamada
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital
| | | | | | - Takuji Adachi
- Department of Physical Therapy, Nagoya University Graduate School of Medicine
| | | | | | | | - Neiko Ozasa
- Cardiovascular Medicine, Kyoto University Hospital
| | - Naohiko Osada
- Department of Physical Checking, St. Marianna University Toyoko Hospital
| | - Hiroaki Obata
- Division of Internal Medicine, Niigata Minami Hospital.,Division of Rehabilitation, Niigata Minami Hospital
| | | | - Yusuke Kasahara
- Department of Rehabilitation, St. Marianna University Yokohama Seibu Hospital
| | - Masaaki Kato
- Department of Cardiovascular Surgery, Morinomiya Hospital
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Hospital
| | - Yasuyuki Kobayashi
- Department of Medical Technology, Gunma Prefectural Cardiovascular Center
| | | | - Kazuhiro Sase
- Clinical Pharmacology and Regulatory Science, Graduate School of Medicine, Juntendo University
| | - Shinji Sato
- Department of Physical Therapy, Teikyo Heisei University
| | - Tatsuhiro Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Daisuke Tamaki
- Department of Nutrition, Showa University Fujigaoka Hospital
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Mari Nishizaki
- Department of Rehabilitation, National Hospital Organization Okayama Medical Center
| | - Taiki Higo
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kanta Fujimi
- Department of Rehabilitation, Fukuoka University Hospital
| | - Tasuku Honda
- Department of Cardiovascular Surgery, Hyogo Brain and Heart Center
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Shioya Hospital, International University of Health and Welfare
| | | | - Ikuko Miyawaki
- Department of Nursing, Kobe University Graduate School of Health Sciences
| | - Makoto Murata
- Department of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Masanobu Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center
| | | | - Miho Yokoyama
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine
| | | | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Syunei Kyo
- Tokyo Metropolitan Geriatric Medical Center
| | | | | | - Ken-Ichi Hirata
- Department of Internal Medicine, Kobe University Graduate School of Medicine
| | | |
Collapse
|
11
|
Zhou H, Wang S, Zhao C, He H. Effect of exercise on vascular function in hypertension patients: A meta-analysis of randomized controlled trials. Front Cardiovasc Med 2022; 9:1013490. [PMID: 36620631 PMCID: PMC9812646 DOI: 10.3389/fcvm.2022.1013490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The purpose of this study was to systematically evaluate the effect of exercise on vascular function in patients with pre- and hypertension. Methods A systematic review of articles retrieved via the PubMed, Embase, EBSCO, and Web of Science databases was conducted. All the randomized controlled trials published between the establishment of the databases and October 2022 were included. Studies that evaluated the effects of exercise intervention on vascular function in patients with pre- and hypertension were selected. Results A total of 717 subjects were included in 12 randomized controlled trials. The meta-analysis showed that in patients with pre- and hypertension, exercise can significantly reduce systolic blood pressure (SBP) (MD = -4.89; 95% CI, -7.05 to -2.73; P < 0.00001) and diastolic blood pressure (DBP) (MD = -3.74; 95% CI, -5.18 to -2.29; P < 0.00001) and can improve endothelium-dependent flow-mediated dilatation (MD = 2.14; 95% CI, 1.71-2.61; P < 0.00001), and exercise did not reduce pulse wave velocity (PWV) (MD = 0.03, 95% CI, -0.45-0.50; P = 0.92). Regression analysis showed that changes in exercise-related vascular function were independent of subject medication status, baseline SBP, age and duration of intervention. Conclusion Aerobic, resistance, and high-intensity intermittent exercise all significantly improved SBP, DBP, and FMD in pre- and hypertensive patients, however, they were not effective in reducing PWV, and this effect was independent of the subject's medication status, baseline SBP, age and duration of intervention. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022302646.
Collapse
Affiliation(s)
- Huayi Zhou
- College of Sport and Human Science, Beijing Sport University, Beijing, China
| | - Shengya Wang
- College of Sport and Human Science, Beijing Sport University, Beijing, China
| | - Changtao Zhao
- Department of Physical Health and Arts Education, Ministry of Education, Beijing, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China,*Correspondence: Hui He,
| |
Collapse
|
12
|
Wang B, Gan L, Deng Y, Zhu S, Li G, Nasser MI, Liu N, Zhu P. Cardiovascular Disease and Exercise: From Molecular Mechanisms to Clinical Applications. J Clin Med 2022; 11:jcm11247511. [PMID: 36556132 PMCID: PMC9785879 DOI: 10.3390/jcm11247511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022] Open
Abstract
Inactivity is a significant risk factor for cardiovascular disease. Exercise may greatly enhance the metabolism and function of the cardiovascular system, lower several risk factors, and prevent the development and treatment of cardiovascular disease while delivering easy, physical, and emotional enjoyment. Exercise regulates the cardiovascular system by reducing oxidative stress and chronic inflammation, regulating cardiovascular insulin sensitivity and the body's metabolism, promoting stem cell mobilization, strengthening autophagy and myocardial mitochondrial function, and enhancing cardiovascular damage resistance, among other effects. Appropriate exercise intervention has become an essential adjuvant therapy in clinical practice for treating and rehabilitating various cardiovascular diseases. However, the prescription of exercise for preventing and treating cardiovascular diseases, particularly the precise selection of individual exercise techniques and their volume, remains controversial. Using multiomics to explain further the molecular process underlying the positive effects of exercise on cardiovascular health will not only improve our understanding of the effects of exercise on health but also establish a scientific basis and supply new ideas for preventing and treating cardiovascular diseases by activating the endogenous protective mechanisms of the body and suggesting more specific exercise prescriptions for cardiovascular rehabilitation.
Collapse
Affiliation(s)
- Bo Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
| | - Lin Gan
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
| | - Yuzhi Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
| | - Shuoji Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
| | - Ge Li
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
| | - Moussa Ide Nasser
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
- Correspondence: (M.I.N.); (N.L.); (P.Z.)
| | - Nanbo Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
- Correspondence: (M.I.N.); (N.L.); (P.Z.)
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China; (B.W.); (L.G.); (Y.D.); (S.Z.); (G.L.)
- Guangdong Provincial Key Laboratory of Pathogenesis, Targeted Prevention and Treatment of Heart Disease, Guangzhou 510640, China
- Correspondence: (M.I.N.); (N.L.); (P.Z.)
| |
Collapse
|
13
|
Effect of aerobic exercise on cardiotoxic outcomes in women with breast cancer undergoing anthracycline or trastuzumab treatment: a systematic review and meta-analysis. Support Care Cancer 2022; 30:10323-10334. [DOI: 10.1007/s00520-022-07368-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/18/2022] [Indexed: 11/05/2022]
|
14
|
Tsukakoshi D, Yamamoto S, Takeda S, Furuhashi K, Sato M. Clinical Perspectives on Cardiac Rehabilitation After Heart Failure in Elderly Patients with Frailty: A Narrative Review. Ther Clin Risk Manag 2022; 18:1009-1028. [PMID: 36324527 PMCID: PMC9620837 DOI: 10.2147/tcrm.s350748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/11/2022] [Indexed: 01/25/2023] Open
Abstract
The purpose of this narrative review is to examine rehabilitation modalities for patients with heart failure and Frailty who require comprehensive intervention. Ischemic heart disease is the leading cause of death worldwide, accounting for 16% of global mortality. Due to population growing and aging, the total number of heart failure patients continues to rise, a condition known as the heart failure pandemic. Furthermore, frailty has been associated with an increased risk for heart failure and increased morbidity and mortality. The 2021 update of the 2017 ACC expert consensus decision pathway for optimization of HF treatment has become more concerning, citing frailty as one of the 10 most important issues associated with heart failure with reduced ejection fraction (HFrEF). Frailty and heart failure share common pathological mechanisms and are associated with poor clinical outcomes. Most studies of frailty in patients with heart failure primarily focus on physical frailty, and associations between psycho-psychological and social factors such as cognitive dysfunction and social isolation have also been reported. These results suggest that a more comprehensive assessment of frailty is important to determine the risk in patients with heart failure. Therefore, mechanisms of the three domains, including not only physical frailty but also cognitive, psychological, spiritual, and social aspects, should be understood. In addition to interventions in these three domains, nutritional and pharmacological interventions are also important and require tailor-made interventions for the widely varied conditions associated with heart failure and frailty. Although several studies have shown a relationship between frailty and prognosis in patients with heart failure, interventions to improve the prognosis have not yet been established. Further information is needed on frailty intervention by a multidisciplinary team to improve the prognosis.
Collapse
Affiliation(s)
- Daichi Tsukakoshi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan,Correspondence: Shuhei Yamamoto, Department of Rehabilitation, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan, Tel +81-263-37-2836, Fax +81-263-37-2835, Email
| | - Shuhei Takeda
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Keisuke Furuhashi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Masaaki Sato
- Division of Occupational Therapy, School of Health Sciences, Shinshu University, Matsumoto, Nagano, Japan
| |
Collapse
|
15
|
Wu C, Bu R, Wang Y, Xu C, Chen Y, Che L, Wang S. Rehabilitation effects of circuit resistance training in coronary heart disease patients: A systematic review and meta-analysis. Clin Cardiol 2022; 45:821-830. [PMID: 35758277 PMCID: PMC9346966 DOI: 10.1002/clc.23855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 12/01/2022] Open
Abstract
Background and Hypothesis The rehabilitation effect of circuit resistance training in coronary heart disease (CHD) patients remains unclear. We perform this review to examine the rehabilitation effect of circuit resistance training in CHD patients and to provide a basis for the formulation of reasonable individual exercise prescriptions for CHD patients. Methods Randomized controlled trials (RCTs) were searched on PubMed, Web of Science, The Cochrane Library, Embase, Clinical Trials, and CNKI. About 1232 studies were identified. Nine RCTs were finally used for the present meta‐analysis to determine the rehabilitation effect of circuit resistance training in CHD patients, compared to aerobic training. Individuals enrolled for the studies were at a mean age of 60.5 years old and were all CHD patients. Following the PRISMA guidelines, we extracted basic information about the study and patient characteristics, as well as measurements (e.g., the peak oxygen uptake, the body mass index [BMI], the body fat percentage, the systolic blood pressure, the total cholesterol, and triglycerides). Subsequently, this meta‐analysis determined the overall effect by using standardized mean difference (SMD) and 95% confidence interval (CI). Results Compared with aerobic training, circuit resistance training significantly decrease the BMI and the body fat percentage. Conclusions As suggested from the present meta‐analysis of RCTs, circuit resistance training is effective in improving the BMI and the body fat percentage in CHD patients and may help delay the progression of CHD. CRT has the advantage of lower load in most cases with a similar effect.
Collapse
Affiliation(s)
- Chunchun Wu
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Rongsheng Bu
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Yaoguo Wang
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Chaoxiang Xu
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Youfang Chen
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, Fujian, China
| | - Lishuang Che
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shengnan Wang
- Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| |
Collapse
|
16
|
Manresa-Rocamora A, Ribeiro F, Casanova-Lizón A, Flatt AA, Sarabia JM, Moya-Ramón M. Cardiac Rehabilitation Improves Endothelial Function in Coronary Artery Disease Patients. Int J Sports Med 2022; 43:905-920. [PMID: 35468652 DOI: 10.1055/a-1717-1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Exercise-based cardiac rehabilitation may be an effective non-pharmacological intervention for improving endothelial function in coronary artery disease patients. Therefore, this systematic review with meta-analysis aimed to (a) estimate the training-induced effect on endothelial and vascular smooth muscle function, assessed by flow-mediated dilation and nitroglycerin-mediated dilation, respectively, in coronary artery disease patients; and to (b) study the influence of potential trial-level variables (i. e. study and intervention characteristics) on the training-induced effect on endothelial and vascular smooth muscle function. Electronic searches were performed in Pubmed, Scopus, and Embase up to February 2021. Random-effects models of standardised mean change were estimated. Heterogeneity analyses were performed by using the Chi 2 test and I 2 index. Our results showed that exercise-based cardiac rehabilitation significantly enhanced flow-mediated dilation (1.04 [95% confidence interval=0.76 to 1.31]) but did not significantly change nitroglycerin-mediated dilation (0.05 [95% confidence interval=-0.03 to 0.13]). Heterogeneity testing reached statistical significance (p<.001) with high inconsistency for flow-mediated dilation (I 2 =92%). Nevertheless, none of the analysed variables influenced the training-induced effect on flow-mediated dilation. Exercise-based cardiac rehabilitation seems to be an effective therapeutic strategy for improving endothelial-dependent dilation in coronary artery disease patients, which may aid in the prevention of cardiovascular events.
Collapse
Affiliation(s)
- Agustín Manresa-Rocamora
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine- iBiMED, Universidade de Aveiro, Aveiro, Portugal
| | - Antonio Casanova-Lizón
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Andrew A Flatt
- Health Sciences and Kinesiology, Georgia Southern University - Armstrong Campus, Savannah, United States
| | - José Manuel Sarabia
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| | - Manuel Moya-Ramón
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.,Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain
| |
Collapse
|
17
|
Exercise Training and Interventions for Coronary Artery Disease. J Cardiovasc Dev Dis 2022; 9:jcdd9050131. [PMID: 35621842 PMCID: PMC9146277 DOI: 10.3390/jcdd9050131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 12/22/2022] Open
Abstract
Coronary artery disease (CAD) may be considered a main cause of mortality and the prevalence of CAD is increasing nowadays, leading to high health costs in many countries. Despite the fact of the regression of the atherosclerotic plaque, the decrease in blood viscosity and the growth of collateral vessels have been proposed as improvements that CAD patients may obtain under exercise performance. Thus, the present narrative review aimed to carry out a brief specific analysis of the results achieved when performing endurance, strength or inspiratory muscle training. Exercise attenuates certain pathophysiological processes of this disease, such as endothelial dysfunction or the vulnerability of atherosclerotic plaques, and produces improvements in functional capacity and muscle strength, among others. Within the different exercise modalities, the most important parameter to be considered seems to be the total caloric expenditure, and not so much the modality itself. As such, in cardiac rehabilitation, when prescribing exercise, we should possibly focus on the modality that obtains more adherence in patients. To conclude, it must be highlighted that total caloric expenditure is not being taken into account when comparing interventions and this relevant information should be considered in future studies.
Collapse
|
18
|
Abstract
Lean mass abnormalities are highly prevalent in patients referred for cardiac rehabilitation (CR). As such, current guidelines recommend incorporating resistance exercise (RE) into the exercise prescription of Phase II-IV CR. The effects of RE on health-related outcomes in patients with cardiovascular (CV) disease (CVD) have not been extensively investigated in comparison to aerobic exercise, the traditional modality of exercise implemented in CR. The purpose of this review is to highlight the growing prevalence of lean mass abnormalities such as dynapenia and sarcopenia in CVD and briefly outline the contributing pathophysiology of these impairments as potential targets for RE training. An update on the current evidence pertaining to the effects of RE on exercise capacity, skeletal muscle strength, body composition, CV health, and quality of life in CR patient populations is provided. The current recommendations for RE training in CR are discussed. Future directions for research and clinical practice in this field are highlighted, and included the need to identify the most efficacious principles of resistance training for different health related outcomes in CVD, as well as the suggested drive towards a 'personalized medicine' approach to exercise prescription in CR.
Collapse
|
19
|
Fan Y, Yu M, Li J, Zhang H, Liu Q, Zhao L, Wang T, Xu H. Efficacy and Safety of Resistance Training for Coronary Heart Disease Rehabilitation: A Systematic Review of Randomized Controlled Trials. Front Cardiovasc Med 2021; 8:754794. [PMID: 34805309 PMCID: PMC8602574 DOI: 10.3389/fcvm.2021.754794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Resistance training (RT), as part of exercise prescriptions during cardiac rehabilitation for patients with cardiovascular disease (CVD), is often used as a supplement to aerobic training (AT). The effectiveness and safety of RT has not been sufficiently confirmed for coronary heart disease (CHD). Objective: To provide updated evidence from randomized clinical trials (RCTs) on efficacy and safety of RT for the rehabilitation of CHD. Method: Three English and four Chinese electronic literature databases were searched comprehensively from establishment of each individual database to Dec, 2020. RCTs which compared RT with AT, no treatment, health education, physical therapy, conventional medical treatment (or called usually care, UC) in CHD were included. Methodological quality of RCTs extracted according to the risk of bias tool described in the Cochrane handbook. The primary outcomes were the index of cardiopulmonary exercise testing and the quality of life (QOL). The secondary outcomes included the skeletal muscle strength, aerobic capacity, left ventricular function and structure. Results: Thirty-right RCTs with a total of 2,465 participants were included in the review. The pooling results suggest the RT+AT is more effective in the cardiopulmonary exercise function (peak oxygen uptake, peak VO2) [MD, 1.36; 95% CI, 0.40–2.31, P = 0.005; I2 = 81%, P < 0.00001], the physical score of QOL [SMD, 0.71; 95% CI, 0.33–1.08, P = 0.0003; I2 = 74%, P < 0.0001] and global score of QOL [SMD, 0.78; 95% CI, 0.43–1.14, P < 0.0001; I2 = 60%, P = 0.03], also in the skeletal muscle strength, the aerobic capacity and the left ventricular ejection fraction (LVEF) than AT group. However, there is insufficient evidence confirmed that RT+AT can improve the emotional score of QOL [SMD, 0.27; 95% CI, −0.08 to 0.61, P = 0.13; I2 = 70%, P = 0.0004] and decrease left ventricular end-diastolic dimension (LVEDD). No significant difference between RT and AT on increasing peak VO2 [MD, 2.07; 95% CI, −1.96 to 6.09, P = 0.31; I2 = 97%, P < 0.00001], the physical [SMD, 0.18; 95% CI, −0.08 to 0.43, P = 0.18; I2 = 0%, P = 0.51] and emotional [SMD, 0.22; 95% CI, −0.15 to 0.59, P = 0.24; I2 = 26%, P = 0.25] score of QOL. Moreover, the pooled data of results suggest that RT is more beneficial in increasing peak VO2 [MD, 3.10; 95% CI, 2.52–3.68, P < 0.00001], physical component [SMD, 0.85; 95% CI, 0.57–1.14, P < 0.00001; I2 = 0%, P = 0.64] and the emotional conditions [SMD, 0.74; 95% CI, 0.31–1.18, P = 0.0009; I2 = 58%, P = 0.12] of QOL and LVEF, and decreasing LVEDD than UC. Low quality evidence provided that RT had effect in decreasing rehospitalization events than UC [RR, 0.33, 95% CI 0.17 to 0.62, P = 0.0006; I2 = 0%, P = 0.64]. There is no significant difference in the safety of RT compared to AT. Conclusions: RT combined with AT is more beneficial than AT alone for CHD. RT can effectively improve the capacity of exercise and the QOL compared with UC. But the difference between RT and AT is still unknown. More high-quality and large-sample studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Yixuan Fan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Meili Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Jingen Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - He Zhang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiyu Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Lin Zhao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Tong Wang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Hao Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
20
|
Kozakova M, Palombo C. Vascular Ageing and Aerobic Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10666. [PMID: 34682413 PMCID: PMC8535583 DOI: 10.3390/ijerph182010666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/15/2022]
Abstract
Impairment of vascular function, in particular endothelial dysfunction and large elastic artery stiffening, represents a major link between ageing and cardiovascular risk. Clinical and experimental studies identified numerous mechanisms responsible for age-related decline of endothelial function and arterial compliance. Since most of these mechanisms are related to oxidative stress or low-grade inflammation, strategies that suppress oxidative stress and inflammation could be effective for preventing age-related changes in arterial function. Indeed, aerobic physical activity, which has been shown to improve intracellular redox balance and mitochondrial health and reduce levels of systemic inflammatory markers, also improves endothelial function and arterial distensibility and reduces risk of cardiovascular diseases. The present paper provides a brief overview of processes underlying age-related changes in arterial function, as well as the mechanisms through which aerobic exercise might prevent or interrupt these processes, and thus attenuate vascular ageing.
Collapse
Affiliation(s)
- Michaela Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, Italy;
| | - Carlo Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy
| |
Collapse
|
21
|
Gao J, Pan X, Li G, Chatterjee E, Xiao J. Physical Exercise Protects Against Endothelial Dysfunction in Cardiovascular and Metabolic Diseases. J Cardiovasc Transl Res 2021; 15:604-620. [PMID: 34533746 PMCID: PMC8447895 DOI: 10.1007/s12265-021-10171-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022]
Abstract
Increasing evidence shows that endothelial cells play critical roles in maintaining vascular homeostasis, regulating vascular tone, inhibiting inflammatory response, suppressing lipid leakage, and preventing thrombosis. The damage or injury of endothelial cells induced by physical, chemical, and biological risk factors is a leading contributor to the development of mortal cardiovascular and cerebrovascular diseases. However, the underlying mechanism of endothelial injury remains to be elucidated. Notably, no drugs effectively targeting and mending injured vascular endothelial cells have been approved for clinical practice. There is an urgent need to understand pathways important for repairing injured vasculature that can be targeted with novel therapies. Exercise training-induced protection to endothelial injury has been well documented in clinical trials, and the underlying mechanism has been explored in animal models. This review mainly summarizes the protective effects of exercise on vascular endothelium and the recently identified potential therapeutic targets for endothelial dysfunction.
Collapse
Affiliation(s)
- Juan Gao
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong, 226011, China.,Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, 333 Nan Chen Road, Shanghai, 200444, China
| | - Xue Pan
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong, 226011, China.,Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, 333 Nan Chen Road, Shanghai, 200444, China
| | - Guoping Li
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Emeli Chatterjee
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Junjie Xiao
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong, 226011, China. .,Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, 333 Nan Chen Road, Shanghai, 200444, China.
| |
Collapse
|
22
|
Effects of resistance training on endothelial function: A systematic review and meta-analysis. Atherosclerosis 2021; 333:91-99. [PMID: 34399984 DOI: 10.1016/j.atherosclerosis.2021.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/06/2021] [Accepted: 07/29/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS The effects of resistance training on flow-mediated dilation (FMD), which has been the gold standard non-invasive assessment of endothelial function and is associated with the risk of cardiovascular events, are not well known. We conducted a systematic review to analyze the effects of resistance training on FMD. METHODS We searched Pubmed, Embase, CINAHL, SPORTDiscuss, Scopus, Web of Science and PEDro databases for studies that met the following criteria: (a) randomized controlled trials of resistance exercise with a comparative non-exercise group or contralateral untrained limb in adults and/or elderly; (b) studies that measured post-occlusion brachial artery FMD by ultrasonography, before and after intervention. Mean differences (MDs) with 95 % confidence interval (95 % CI) were calculated using an inverse variance method with a random effects model. RESULTS Twenty-three studies were included in the meta-analysis (n = 785 participants; 53 % females). Resistance training on FMD responses showed a favorable result for the resistance training group (n = 366) compared to the control group (n = 358) (MD 2.39, 95%CI 1.65, 3.14; p<0.00001). Subgroup analysis indicated favorable results for the dynamic resistance training (n = 545; MD 2.12, 95 % CI 1.26, 2.98; p<0.00001) and isometric handgrip training (n = 179; MD 3.32, 95 % CI 1.68, 4.96; p<0.0001) compared to the control group. The effect of resistance training on FMD responses was also favorable regardless of the condition of the participants (Healthy [n = 261]: MD 2.11, 95 % CI 1.04, 3.18; p<0.0001; Cardiovascular disease [n = 310]: MD 2.89, 95 % CI 0.88, 4.90; p = 0.005; metabolic disease [n = 153]: MD 2.40, 95 % CI 1.59, 3.21; p<0.00001). CONCLUSIONS Resistance training improves FMD in healthy individuals and patients with cardiovascular and metabolic diseases.
Collapse
|
23
|
Craighead DH, Heinbockel TC, Freeberg KA, Rossman MJ, Jackman RA, Jankowski LR, Hamilton MN, Ziemba BP, Reisz JA, D’Alessandro A, Brewster LM, DeSouza CA, You Z, Chonchol M, Bailey EF, Seals DR. Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure. J Am Heart Assoc 2021; 10:e020980. [PMID: 34184544 PMCID: PMC8403283 DOI: 10.1161/jaha.121.020980] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
Background High-resistance inspiratory muscle strength training (IMST) is a novel, time-efficient physical training modality. Methods and Results We performed a double-blind, randomized, sham-controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50-79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long-lasting effects. Thirty-six participants completed high-resistance IMST (75% maximal inspiratory pressure, n=18) or low-resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg (P<0.01) with IMST, which was ≈75% sustained 6 weeks after IMST (P<0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P=0.03); blood pressure was unaffected by sham training (all P>0.05). Twenty-four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow-mediated dilation improved ≈45% with IMST (P<0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P<0.05). IMST decreased C-reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P>0.05). Conclusions High-resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above-normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03266510.
Collapse
Affiliation(s)
| | | | | | - Matthew J. Rossman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Rachel A. Jackman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | | | - Brian P. Ziemba
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Julie A. Reisz
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - L. Madden Brewster
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | - Zhiying You
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Michel Chonchol
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - E. Fiona Bailey
- Department of PhysiologyUniversity of Arizona College of MedicineTucsonAZ
| | - Douglas R. Seals
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| |
Collapse
|
24
|
Zhang Y, Zhang YJ, Zhang HW, Ye WB, Korivi M. Low-to-Moderate-Intensity Resistance Exercise Is More Effective than High-Intensity at Improving Endothelial Function in Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136723. [PMID: 34206463 PMCID: PMC8297299 DOI: 10.3390/ijerph18136723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/29/2022]
Abstract
Aerobic exercise has been confirmed to improve endothelial function (EF). However, the effect of resistance exercise (RE) on EF remains controversial. We conducted this systematic review and meta-analysis on randomized controlled trials (RCTs) to determine the effect of RE and its intensities on EF. We searched Web of Science, PubMed/MEDLINE, Scopus, and Wiley Online Library, and included 15 articles (17 trials) for the synthesis. Overall, RE intervention significantly improved flow-mediated dilatation (FMD) in brachial artery (SMD = 0.76; 95% CI: 0.47, 1.05; p < 0.00001), which represents improved EF. Meta-regression showed that the RE intensity was correlated with changes in FMD (Coef. = −0.274, T = −2.18, p = 0.045). We found both intensities of RE improved FMD, but the effect size for the low- to moderate-intensity (30–70%1RM) was bigger (SMD = 1.02; 95% CI: 0.60, 1.43; p < 0.0001) than for the high-intensity (≥70%1RM; SMD = 0.48; 95% CI: 0.21, 0.74; p = 0.005). We further noticed that RE had a beneficial effect (SMD = 0.61; 95% CI: 0.13, 1.09; p = 0.01) on the brachial artery baseline diameter at rest (BADrest), and the age variable was correlated with the changes in BADrest after RE (Coef. = −0.032, T = −2.33, p = 0.038). Young individuals (<40 years) presented with a bigger effect size for BADrest (SMD = 1.23; 95% CI: 0.30, 2.15; p = 0.009), while middle-aged to elderly (≥40 years) were not responsive to RE (SMD = 0.07; 95% CI: −0.28, 0.42; p = 0.70). Based on our findings, we conclude that RE intervention can improve the EF, and low- to moderate-intensity is more effective than high-intensity.
Collapse
Affiliation(s)
- Yong Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
| | - Ya-Jun Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
- Correspondence: (Y.-J.Z.); (H.-W.Z.)
| | - Hong-Wei Zhang
- Department of Rehabilitation Medicine, Shaoxing University, Shaoxing 312000, China;
- Correspondence: (Y.-J.Z.); (H.-W.Z.)
| | - Wei-Bing Ye
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China; (W.-B.Y.); (M.K.)
| | - Mallikarjuna Korivi
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua 321004, China; (W.-B.Y.); (M.K.)
| |
Collapse
|
25
|
Thompson G, Wilson IM, Davison GW, Crawford J, Hughes CM. "Why would you not listen? It is like being given the winning lottery numbers and deciding not to take them": semi-structured interviews with post-acute myocardial infarction patients and their significant others exploring factors that influence participation in cardiac rehabilitation and long-term exercise training. Disabil Rehabil 2021; 44:4750-4760. [PMID: 33961501 DOI: 10.1080/09638288.2021.1919213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Despite the clinical benefits, coronary artery disease patient participation rates in cardiac rehabilitation (CR) and long-term exercise are poor. This study explored the factors related to participation in these interventions from the perspectives of post-acute myocardial infarction (AMI) patients and their significant others. METHODS Semi-structured interviews were performed with post-AMI patients (number (n) = 10) and their significant others (n = 10) following phase-III and phase-IV CR. Reflexive thematic analysis with an inductive orientation was utilised to identify themes within the dataset (ClinicalTrials.gov identifier: NCT03907293). RESULTS The overarching theme of the data was a perceived need to improve health, with the participants viewing health benefits as the principal motive for participating in CR and long-term exercise training. Three further themes were identified: motivation, extrinsic influences, and CR experience. These themes captured the underlying elements of the participants' decision to take part in CR and long-term exercise training for the purpose of health improvements. CONCLUSION An AMI collectively impacts the attitudes and beliefs of patients and their significant others in relation to CR participation, long-term exercise, and health. The factors identified in this study may inform strategies to promote patient enrollment in CR and adherence to long-term exercise.IMPLICATIONS FOR REHABILITATIONPost-AMI patients and their significant others reported that health benefits were the primary motive for participating in CR and long-term exercise, with aspects related to motivation, extrinsic influences, and CR experience underpinning the decision.Healthcare professionals should supply information about health benefits during the CR referral process, with insights into the experiences of CR graduates potentially improving the strength of recommendation.CR facilitators may promote long-term exercise adherence by assisting patients with the identification of an enjoyable exercise modality.Healthcare professionals should include significant others in the CR referral process, which may enable these individuals to support the patients' decisions.
Collapse
Affiliation(s)
- Gareth Thompson
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Iseult M Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gareth W Davison
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, UK
| | - Jacqui Crawford
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Ciara M Hughes
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| |
Collapse
|
26
|
Pasman WJ, Memelink RG, de Vogel-Van den Bosch J, Begieneman MPV, van den Brink WJ, Weijs PJM, Wopereis S. Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study. Nutrients 2020; 12:E2979. [PMID: 33003389 PMCID: PMC7601009 DOI: 10.3390/nu12102979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
Collapse
Affiliation(s)
- Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
| | | | - Mark P. V. Begieneman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Willem J. van den Brink
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
- Department of Nutrition and Dietetics, Amsterdam University Medical Centres, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| |
Collapse
|
27
|
Are the Current Cardiac Rehabilitation Programs Optimized to Improve Cardiorespiratory Fitness in Patients? A Meta-Analysis. J Aging Phys Act 2020; 29:327-342. [PMID: 32796140 DOI: 10.1123/japa.2019-0363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 11/18/2022]
Abstract
Previous meta-analyses have shown that high-intensity interval training (HIIT) is more suitable than moderate continuous training (MCT) for improving peak oxygen uptake (VO2peak) in patients with coronary artery disease. However, none of these meta-analyses have tried to explain the heterogeneity of the empirical studies in optimizing cardiac rehabilitation programs. Therefore, our aims were (a) to estimate the effect of MCT and HIIT on VO2peak, and (b) to find the potential moderator variables. A search was conducted in PubMed, Scopus, and ScienceDirect. Out of the 3,110 references retrieved, 29 studies fulfilled the selection criteria to be included in our meta-analysis. The mean difference was used as the effect size index. Our results showed significant enhancements in VO2peak after cardiac rehabilitation based on MCT and HIIT (mean difference = 3.23; 95% confidence interval [2.81, 3.65] ml·kg-1·min-1 and mean difference = 4.61; 95% confidence interval [4.02, 5.19] ml·kg-1·min-1, respectively), with greater increases after HIIT (p < .001). Heterogeneity analyses reached statistical significance with moderate heterogeneity for MCT (p < .001; I2 = 67.0%), whereas no heterogeneity was found for the effect of HIIT (p = .220; I2 = 22.0%). Subgroup analyses showed significant between-group heterogeneity of the MCT-induced effect based on the training mode (p < .001; I2 = 90.4%), the risk of a new event (p = .010; I2 = 77.4%), the type of cardiovascular event (p = .009; I2 = 84.8%), the wait time to start cardiac rehabilitation (p = .010; I2 = 76.6%), and participant allocation (p = .002; I2 = 89.9%). Meta-regressions revealed that the percentages of patients undergoing a revascularization procedure (B = -0.022; p = .041) and cardiorespiratory fitness at baseline (B = -0.103; p = .025) were inversely related to the MCT-induced effect on the VO2peak.
Collapse
|
28
|
Hwang CL, Elokda A, Ozemek C, Arena R, Phillips SA. More than a matter of the heart: the concept of intravascular multimorbidity in cardiac rehabilitation. Expert Rev Cardiovasc Ther 2020; 18:557-562. [PMID: 32700592 DOI: 10.1080/14779072.2020.1798761] [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: 10/23/2022]
Abstract
INTRODUCTION Coronary artery disease (CAD) is the major cause of death of cardiovascular disease. It is initiated by atherosclerosis, which narrows the coronary arteries and limits blood flow and oxygen to the heart. Multiple pathophysiological conditions within the arteries, such as arterial wall thickening, endothelial dysfunction, and arterial stiffening, are associated with the development of atherosclerosis. AREAS COVERED We introduce a new concept of 'intravascular multimorbidity,' the presence and integration of multiple pathophysiological conditions within the arteries. We also introduce some measurements of intravascular multimorbidity and discuss how these measurements can be utilized in cardiac rehabilitation (CR). EXPERT OPINION We propose that the measures of intravascular multimorbidity in different arteries may provide information on disease severity and serve as unique prognostic 'barometers' to disease progression in patients with CAD. By measuring the underlying disease mechanisms within the arteries and understanding individual variability of disease progression/regression, these measures may also provide a unique prognostic window in CR. The window into intravascular multimorbidity can help guide clinical strategies, for example, assessing progress and appropriate titration of exercise. Intravascular multimorbidity may represent an important opportunity for more researchers and clinical professions to evaluate patients in CR.
Collapse
Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Golf Coast University , Fort Myers, FL, USA
| | - Cemal Ozemek
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Shane A Phillips
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| |
Collapse
|
29
|
Thompson G, Davison GW, Crawford J, Hughes CM. Exercise and inflammation in coronary artery disease: A systematic review and meta-analysis of randomised trials. J Sports Sci 2020; 38:814-826. [DOI: 10.1080/02640414.2020.1735684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Gareth Thompson
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| | - Gareth W. Davison
- Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey, County Antrim
| | - Jacqui Crawford
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| | - Ciara M. Hughes
- Institute of Nursing and Health Research, Ulster University, Jordanstown Campus, Newtownabbey, County Antrim
| |
Collapse
|
30
|
Lin TC, Cai ZY. The effects of whole body vibration training combined with blood flow restriction on von Willebrand factor response. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-192147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
31
|
Mangiacapra F, Del Buono MG, Abbate A, Gori T, Barbato E, Montone RA, Crea F, Niccoli G. Role of endothelial dysfunction in determining angina after percutaneous coronary intervention: Learning from pathophysiology to optimize treatment. Prog Cardiovasc Dis 2020; 63:233-242. [PMID: 32061633 DOI: 10.1016/j.pcad.2020.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 02/01/2023]
Abstract
Endothelial dysfunction (EnD) is a hallmark feature of coronary artery disease (CAD), representing the key early step of atherosclerotic plaque development and progression. Percutaneous coronary intervention (PCI) is performed daily worldwide to treat symptomatic CAD, however a consistent proportion of patients remain symptomatic for angina despite otherwise successful revascularization. EnD plays a central role in the mechanisms of post-PCI angina, as it is strictly associated with both structural and functional abnormalities in the coronary arteries that may persist, or even accentuate, following PCI. The assessment of endothelial function in patients undergoing PCI might help to identify those patients at higher risk of future cardiovascular events and recurrent/persistent angina who might therefore benefit more from an intensive treatment. In this review, we address the role of EnD in determining angina after PCI, discussing its pathophysiological mechanisms, diagnostic approaches and therapeutic perspectives.
Collapse
Affiliation(s)
- Fabio Mangiacapra
- Unit of Cardiovascular Science, Campus Bio-Medico University, Rome, Italy.
| | - Marco Giuseppe Del Buono
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Tommaso Gori
- Kardiologie I, Zentrum für Kardiologie, University Medical Center Mainz and DZHK Standort Rhein-Main, Mainz, Germany
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Rocco Antonio Montone
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| | - Giampaolo Niccoli
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
32
|
Molecular Mechanisms of Cardiac Remodeling and Regeneration in Physical Exercise. Cells 2019; 8:cells8101128. [PMID: 31547508 PMCID: PMC6829258 DOI: 10.3390/cells8101128] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 02/08/2023] Open
Abstract
Regular physical activity with aerobic and muscle-strengthening training protects against the occurrence and progression of cardiovascular disease and can improve cardiac function in heart failure patients. In the past decade significant advances have been made in identifying mechanisms of cardiomyocyte re-programming and renewal including an enhanced exercise-induced proliferational capacity of cardiomyocytes and its progenitor cells. Various intracellular mechanisms mediating these positive effects on cardiac function have been found in animal models of exercise and will be highlighted in this review. 1) activation of extracellular and intracellular signaling pathways including phosphatidylinositol 3 phosphate kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), EGFR/JNK/SP-1, nitric oxide (NO)-signaling, and extracellular vesicles; 2) gene expression modulation via microRNAs (miR), in particular via miR-17-3p and miR-222; and 3) modulation of cardiac cellular metabolism and mitochondrial adaption. Understanding the cellular mechanisms, which generate an exercise-induced cardioprotective cellular phenotype with physiological hypertrophy and enhanced proliferational capacity may give rise to novel therapeutic targets. These may open up innovative strategies to preserve cardiac function after myocardial injury as well as in aged cardiac tissue.
Collapse
|
33
|
What Is the Optimal Exercise Prescription for Patients With Dilated Cardiomyopathy in Cardiac Rehabilitation? A SYSTEMATIC REVIEW. J Cardiopulm Rehabil Prev 2019; 39:235-240. [DOI: 10.1097/hcr.0000000000000382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
34
|
Kambič T, Novaković M, Tomažin K, Strojnik V, Jug B. Blood Flow Restriction Resistance Exercise Improves Muscle Strength and Hemodynamics, but Not Vascular Function in Coronary Artery Disease Patients: A Pilot Randomized Controlled Trial. Front Physiol 2019; 10:656. [PMID: 31244668 PMCID: PMC6581774 DOI: 10.3389/fphys.2019.00656] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/09/2019] [Indexed: 01/22/2023] Open
Abstract
Resistance training may be associated with unfavorable cardiovascular responses (such as hemodynamic alterations, anginal symptoms or ventricular arrhythmias). In healthy adults, blood flow-restricted (BFR) resistance training improves muscle strength and hypertrophy improvements at lower loads with minimal systemic cardiovascular adverse responses. The aim of this study was to assess the safety and efficacy of BFR resistance training in patients with coronary artery disease (CAD) compared to usual care. Patients with stable CAD were randomized to either 8 weeks of supervised biweekly BFR resistance training (30-40% 1RM unilateral knee extension) or usual exercise routine. At baseline and after 8 weeks, patients underwent 1-RM knee extension tests, ultrasonographic appraisal of vastus lateralis (VL) muscle diameter and of systemic (brachial artery) flow-mediated dilation, and determination of markers of inflammation (CD40 ligand and tumor necrosis factor alfa), and fasting glucose and insulin levels for homeostatic model assessment (HOMA). A total of 24 patients [12 per group, mean age 60 ± 2 years, 6 (25%) women] were included. No training-related adverse events were recorded. At baseline groups significantly differ in age (mean difference: 8.7 years, p < 0.001), systolic blood pressure (mean difference: 12.17 mmHg, p = 0.024) and in metabolic control [insulin (p = 0.014) and HOMA IR (p = 0.014)]. BFR-resistance training significantly increased muscle strength (1-RM, +8.96 kg, p < 0.001), and decreased systolic blood pressure (-6.77 mmHg; p = 0.030), whereas VL diameter (+0.09 cm, p = 0.096), brachial artery flow-mediated vasodilation (+1.55%; p = 0.079) and insulin sensitivity (HOMA IR change of 1.15, p = 0.079) did not improve significantly. Blood flow restricted resistance training is safe and associated with significant improvements in muscle strength, and may be therefore provided as an additional exercise option to aerobic exercise to improve skeletal muscle functioning in patients with CAD. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03087292.
Collapse
Affiliation(s)
- Tim Kambič
- Laboratory of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Novaković
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Tomažin
- Laboratory of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Vojko Strojnik
- Laboratory of Kinesiology, Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Borut Jug
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
35
|
Grafe K, Bendick P, Burr M, Boura J, Franklin BA. Effects of Resistance Training on Vascular and Hemodynamic Responses in Patients With Coronary Artery Disease. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2018; 89:457-464. [PMID: 30300089 DOI: 10.1080/02701367.2018.1519385] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to determine the impact of adjunctive resistance training (RT) in aerobically trained patients with coronary artery disease on systolic blood pressure (SBP), heart rate (HR), rating of perceived exertion (RPE; using the traditional 6-to-20 scale), and rate-pressure product (RPP) responses to lifting fixed submaximal workloads. Additionally, pretest and posttest RT measures of brachial artery reactivity were obtained. METHOD Fifteen patients with coronary artery disease (Mage = 66.1 ± 5.1 years) who were already performing regular aerobic exercise completed an adjunctive 12-week progressive RT program. Prior to and immediately after the training period, hemodynamic responses and RPE were obtained while participants performed one set of exercises including the bicep curl (BC), shoulder press (SP), and leg press (LP) at individually determined fixed submaximal loads, using ~ 60% to 80% of estimated maximal voluntary contraction. Vascular function was assessed by flow-mediated vasodilation (FMD) testing before and after training. RESULTS Attenuated hemodynamic and RPE responses for all variables were observed. Meaningful changes were attained for RPP ([HR × SBP] / 100) during BC (106 ± 27 mmHg × beats/min × 10-2 to 91 ± 22 mmHg × beats/min × 10-2, d = 0.6, p < .05) and SP (102 ± 24 mmHg × beats/min × 10-2 to 86 ± 17 mmHg × beats/min × 10-2, d = 0.8, p < .05). Rating of perceived exertion decreased significantly during all exercises (d ranging from 1.8 to 3.1, p < .05): BC (14.3 ± 2.6 to 9.7 ± 1.6), SP (13.9 ± 1.6 to 9.2 ± 1.5), and LP (14.3 ± 1.4 to 10.3 ± 1.6). Peak group FMD responses were 12.8% and 10.3% dilation at pretraining and posttraining, respectively (p > .05). Five of the 15 participants showed modest improvements in their posttraining time to achieve maximum dilation from a mean of 117 s to 81 s, although this change was not statistically significant (p > .05). CONCLUSION Among aerobically trained cardiac patients, a supplemental RT program resulted in decreased hemodynamic and RPE responses to lifting fixed submaximal workloads.
Collapse
|
36
|
Hieda M, Howden EJ, Sarma S, Cornwell W, Lawley JS, Tarumi T, Palmer D, Samels M, Everding B, Livingston S, Fu Q, Zhang R, Levine BD. The impact of 2 years of high-intensity exercise training on a model of integrated cardiovascular regulation. J Physiol 2018; 597:419-429. [PMID: 30387144 DOI: 10.1113/jp276676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/31/2018] [Indexed: 12/19/2022] Open
Abstract
KEY POINTS Heart rate variability, a common and easily measured index of cardiovascular dynamics, is the output variable of complicated cardiovascular and respiratory control systems. Both neural and non-neural control mechanisms may contribute to changes in heart rate variability. We previously developed an innovative method using transfer function analysis to assess the effect of prolonged exercise training on integrated cardiovascular regulation. In the present study, we modified and applied this to investigate the effect of 2 years of high-intensity training on circulatory components to tease out the primary effects of training. Our method incorporated the dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function. The dynamic Starling mechanism gain and arterial-cardiac baroreflex gain were significantly increased in the exercise group. These parameters remained unchanged in the controls. Conversely, neither group experienced a change in dynamic arterial elastance. The integrated cardiovascular regulation gain in the exercise group was 1.34-fold larger than that in the control group after the intervention. In these previously sedentary, otherwise healthy, middle-aged adults, 2 years of high-intensity exercise training improved integrated cardiovascular regulation by enhancing the dynamic Starling mechanism and arterial-cardiac baroreflex sensitivity. ABSTRACT Assessing the effects of exercise training on cardiovascular variability is challenging because of the complexity of multiple mechanisms. In a prospective, parallel-group, randomized controlled study, we examined the effect of 2 years of high-intensity exercise training on integrated cardiovascular function, which incorporates the dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function. Sixty-one healthy participants (48% male, aged 53 years, range 52-54 years) were randomized to either 2 years of exercise training (exercise group: n = 34) or control/yoga group (controls: n = 27). Before and after 2 years, subjects underwent a 6 min recording of beat-by-beat pulmonary artery diastolic pressure (PAD), stroke volume index (SV index), systolic blood pressure (sBP) and RR interval measurements with controlled respiration at 0.2 Hz. The dynamic Starling mechanism, dynamic arterial elastance and arterial-cardiac baroreflex function were calculated by transfer function gain between PAD and SV index; SV index and sBP; and sBP and RR interval, respectively. Fifty-three participants (controls: n = 25; exercise group: n = 28) completed the intervention. After 2 years, the dynamic Starling mechanism gain (Group × Time interaction: P = 0.008) and the arterial-cardiac baroreflex gain (P = 0.005) were significantly increased in the exercise group but remained unchanged in the controls. There was no change in dynamic arterial elastance in either of the two groups. The integrated cardiovascular function gain in the exercise group increased 1.34-fold, whereas there was no change in the controls (P = 0.02). In these previously sedentary, otherwise healthy middle-aged adults, a 2 year programme of high-intensity exercise training improved integrated cardiovascular regulation by enhancing the dynamic Starling mechanism and arterial-cardiac baroreflex sensitivity, without changing dynamic arterial elastance.
Collapse
Affiliation(s)
- Michinari Hieda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Erin J Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - William Cornwell
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,University of Colorado, School of Medicine, CO, USA
| | - Justin S Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,University of Innsbruck, Department of Sport Science, Innsbruck, Austria
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Dean Palmer
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Mitchel Samels
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Braden Everding
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Sheryl Livingston
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Centre, TX, USA
| |
Collapse
|
37
|
Hypotensive Effect of Heated Water-Based Exercise Persists After 12-Week Cessation of Training in Patients With Resistant Hypertension. Can J Cardiol 2018; 34:1641-1647. [PMID: 30527153 DOI: 10.1016/j.cjca.2018.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Heated water-based exercise (HEx) promotes a marked reduction of blood pressure (BP), but it is not entirely clear whether its effects on BP persist after cessation of HEx. METHODS We analyzed the effects of cessation of HEx on 24-hour ambulatory BP monitoring (ABPM) in patients with resistant hypertension (RH). Thirty-two patients (aged 53 ± 6 years) with RH (4 to 6 antihypertensive drugs) were randomly assigned to HEx (n = 16) or control (n = 16) groups. Antihypertensive therapy remained unchanged during the protocol. The HEx group participated in 36 sessions (60 minutes) in a heated pool (32oC [89.6°F]) for 12 weeks (training), followed by 12 weeks of cessation of training. The control group was evaluated during the same period and instructed to maintain their habitual activities. RESULTS HEx and control groups had similar BP levels at baseline. HEx training reduced the 24-hour systolic (-19.5 ± 4.6 vs 3.0 ± 0.7 mm Hg, P = 0.001) and diastolic BP (-11.1 ± 2.4 vs 2.06 ± 0.9 mm Hg, P = 0.001) at week 12, compared with the control group. After 12 weeks of training cessation (week 24), 24-hour BP remained significantly lower in the HEx group than in the control group (-9.6 ± 3.8 vs 6.3 ± 3.5 mm Hg, P = 0.01 and -7.5±2.2 vs 2.2 ± 1.0 mm Hg, P = 0.009, for systolic and diastolic BP, respectively), although these differences were attenuated. CONCLUSIONS BP remained lower after cessation of 12-week training among patients with RH who underwent HEx compared with the controls. The carryover effects of HEx on BP may help to overcome the challenging problem of exercise compliance in long-term follow-up.
Collapse
|
38
|
Ho MY, Wen MS, Yeh JK, Hsieh IC, Chen CC, Hsieh MJ, Tsai ML, Yang CH, Wu VCC, Hung KC, Wang CC, Wang CY. Excessive irisin increases oxidative stress and apoptosis in murine heart. Biochem Biophys Res Commun 2018; 503:2493-2498. [PMID: 30208516 DOI: 10.1016/j.bbrc.2018.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/02/2018] [Indexed: 01/12/2023]
Abstract
Irisin is an exercise-related myokine. The abundance of irisin is associated with many diseases, such as myocardial infarction, chronic kidney disease, metabolic syndrome, obesity, and diabetes mellitus. In cardiomyocytes, irisin modulates the mitochondrial thermogenesis, regulates ischemic responses, and affects calcium signaling. Previous studies suggested that irisin increases cardiomyoblast mitochondrial functions and protects ischemic and reperfusion injury in ex vivo murine heart. In human, clinical studies have shown that acute myocardial infarction patients with more elevated serum irisin abundances are associated with increased major adverse cardiovascular events. However, the mechanisms responsible for this discrepancy between in myocardial infarction patients and ex vivo murine heart is unclear. Based on the clinical observations, we hypothesized that excessive irisin might lead to mitochondrial dysfunctions and cardiomyocyte damages. Our data showed that overexpression of irisin in mice with the adenovirus resulted in enhanced mitochondrial respiration with a higher oxygen consumption rate. Enhanced irisin expression in heart and irisin treatment in cardiomyocytes increased reactive oxygen species production. Furthermore, irisin treatment in cardiomyocytes enhanced the apoptosis and the cleaved caspase 9 levels in hypoxic condition. Pathway analysis in the murine heart with the overexpression of irisin showed that angiopoietin-Tie2, IL-8, IL-13, TGF-β, and thrombopoietin signaling were affected by irisin. Collectively, these results supported that excessive irisin causes mitochondrial overdrive with a higher reactive oxygen species production, which results in increased apoptosis of cardiomyocytes in a hypoxic environment.
Collapse
Affiliation(s)
- Ming-Yun Ho
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Ming-Shien Wen
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan.
| | - Jih-Kai Yeh
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - I-Chang Hsieh
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Chun-Chi Chen
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Ming-Jer Hsieh
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Ming-Lung Tsai
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Chia-Hung Yang
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Victor Chien-Chia Wu
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Kuo-Chun Hung
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Chun-Chieh Wang
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Chao-Yung Wang
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan.
| |
Collapse
|
39
|
Winter SDCN, Macedo RMD, Francisco JC, Santos PC, Lopes APS, Meira LFD, Carvalho KATD, Faria Neto JR, Macedo ACBD, Guarita-Souza LC. Impact of a High-Intensity Training on Ventricular Function in Rats After Acute Myocardial Infarction. Arq Bras Cardiol 2018. [PMID: 29538503 PMCID: PMC5941962 DOI: 10.5935/abc.20180036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Physical exercise should be part of the treatment of post-acute myocardial
infarction (AMI) patients. Objective To evaluate the effects of two training prescription models (continuous x
interval) and its impact on ventricular function in rats after AMI with
normal ventricular function. Methods Forty Wistar rats were evaluated by echocardiography 21 days after the AMI.
Those with LVEF = 50% (n = 29) were included in the study and randomized to
control group (CG n = 10), continuous training group (CTG n = 9) or interval
training group (ITG, n = 10). Then, a swimming test with control of lactate
production was performed. Based on its result, the lactate threshold (LT)
was established to define the training intensities. After six weeks, the
animals were reassessed by echocardiography and lactate production. Outcome
measures were end-diastolic diameter (EDD), end-systolic diameter (ESD),
left ventricular ejection fraction (LVEF, %) lactate at rest, lactate
without overload, and lactate with 12g and 13.5g of additional load. Group
comparisons of quantitative variables of the study were performed by
one-factor analysis of variance (ANOVA). The Newman-Keuls test was used for
multiple comparisons of the groups. Within-group comparisons of dependent
variables between the two training protocols were performed by Student's
t-test. Normality of the variables was tested by the Shapiro-Wilks test.
Values of p < 0.05 indicated statistical significance. Results EDD, ESD, and LVEF before and after the training period were similar in
within-group comparisons. However, EDD was significantly different (p=0.008)
in the CG. Significant differences were found for L12g (p=0.002) and L13.5g
(p = 0.032) in the ITG, and for L12g (p = 0.014) in the CG. No differences
were found in the echocardiographic parameters between the groups.
Significant differences were found in lactate without overload (p = 0.016)
and L12 (p = 0.031) in the second assessment compared with the first, and
between the groups - ITG vs. CG (p = 0.019) and CTG vs. CG (p = 0.035). Conclusion Both methods produced a training effect without altering ventricular
function.
Collapse
Affiliation(s)
| | - Rafael Michel de Macedo
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | - Júlio Cesar Francisco
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | - Paula Costa Santos
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | - Ana Paula Sarraff Lopes
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | - Leanderson Franco de Meira
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | | | - José Rocha Faria Neto
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| | | | - Luiz César Guarita-Souza
- Centro de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
| |
Collapse
|
40
|
Abstract
PURPOSE Flow-mediated dilation, a barometer of cardiovascular (CV) health, is reported to increase with exercise training (ET); however, the potential moderating factors of ET are not clear to date. The purpose of this study was to determine the effect of ET assessed by brachial artery flow-mediated dilation (BAFMD). METHODS Authors searched PubMed between January 1999 and December 2013, bibliographies, and reviews to identify studies examining ET and BAFMD. Two independent reviewers extracted quality, descriptive, exercise, and outcome data of eligible studies. Data were presented as weighted effect sizes (ESs) and 95% confidence limits. RESULTS Analysis included 66 studies reporting BAFMD data (1865 ET and 635 control subjects). Overall, ET had significant improvements in BAFMD compared with controls (P < .0001). Exercise training at higher ET intensities resulted in a greater increase in BAFMD (9.29; 95% CI, 5.09-13.47) than lower ET intensities (3.63; 95% CI, -0.56 to 7.83) or control (-0.42; 95% CI, -2.06 to 1.21). Subjects whose ET duration was ≥150 min/wk (11.33; 95% CI, 7.15-15.51) had a significant improvement in BAFMD compared with those with <150 min/wk (4.79; 95% CI, 3.08-6.51) or control (-0.30; 95% CI, -1.99 to 1.39). Age (P = .11) and baseline artery diameter (P = .31) did not modify the BAFMD response to ET. CONCLUSION Exercise training contributes to a significant increase in BAFMD. These results provide indirect evidence that ET alters a well-known factor associated with the primary and secondary prevention of CV diseases. Exercise training interventions, including greater intensity and duration, may optimize the increase in BAFMD.
Collapse
|
41
|
Maessen MFH, Eijsvogels TMH, Hijmans-Kersten BTP, Grotens A, Schreuder THA, Hopman MTE, Thijssen DHJ. Vascular Function and Structure in Veteran Athletes after Myocardial Infarction. Med Sci Sports Exerc 2017; 49:21-28. [PMID: 27992395 DOI: 10.1249/mss.0000000000001075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE Although athletes demonstrate lower cardiovascular risk and superior vascular function compared with sedentary peers, they are not exempted from cardiac events (i.e., myocardial infarction [MI]). The presence of an MI is associated with increased cardiovascular risk and impaired vascular function. We tested the hypothesis that lifelong exercise training in post-MI athletes, similar as in healthy controls, is associated with a superior peripheral vascular function and structure compared with a sedentary lifestyle in post-MI individuals. METHODS We included 18 veteran athletes (ATH) (>20 yr) and 18 sedentary controls (SED). To understand the effect of lifelong exercise training after MI, we included 20 veteran post-MI athletes (ATH + MI) and 19 sedentary post-MI controls (SED + MI). Participants underwent comprehensive assessment using vascular ultrasound (vascular stiffness, intima-media thickness, and endothelium (in)dependent mediated dilatation). Lifetime risk score was calculated for a 30-yr risk prediction of cardiovascular disease mortality of the participants. RESULTS ATH demonstrated a lower vascular stiffness and smaller femoral intima-media thickness compared with SED. Vascular function and structure did not differ between ATH + MI and SED + MI. ATH (4.0% ± 5.1%) and ATH + MI (6.1% ± 3.7%) had a significantly better lifetime risk score compared with their sedentary peers (SED: 6.9% ± 3.7% and SED + MI: 9.3% ± 4.8%). ATH + MI had no secondary events versus two recurrent MI and six elective percutaneous coronary interventions within SED + MI (P < 0.05). CONCLUSION Although veteran post-MI athletes did not have a superior peripheral vascular function and structure compared with their sedentary post-MI peers, benefits of lifelong exercise training in veteran post-MI athletes relate to a better cardiovascular risk profile and lower occurrence of secondary events.
Collapse
Affiliation(s)
- Martijn F H Maessen
- 1Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS; 2Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM; and 3Radboud Institute for Health Sciences, Department of Neurology, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
| | | | | | | | | | | | | |
Collapse
|
42
|
Gram AS, Bladbjerg EM, Quist JS, Petersen MB, Rosenkilde M, Stallknecht B. Anti-inflammatory effects of active commuting and leisure time exercise in overweight and obese women and men: A randomized controlled trial. Atherosclerosis 2017; 265:318-324. [DOI: 10.1016/j.atherosclerosis.2017.06.923] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
|
43
|
Raichlen DA, Alexander GE. Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health. Trends Neurosci 2017; 40:408-421. [PMID: 28610948 PMCID: PMC5926798 DOI: 10.1016/j.tins.2017.05.001] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/18/2017] [Accepted: 05/01/2017] [Indexed: 11/23/2022]
Abstract
The field of cognitive neuroscience was transformed by the discovery that exercise induces neurogenesis in the adult brain, with the potential to improve brain health and stave off the effects of neurodegenerative disease. However, the basic mechanisms underlying exercise-brain connections are not well understood. We use an evolutionary neuroscience approach to develop the adaptive capacity model (ACM), detailing how and why physical activity improves brain function based on an energy-minimizing strategy. Building on studies showing a combined benefit of exercise and cognitive challenge to enhance neuroplasticity, our ACM addresses two fundamental questions: (i) what are the proximate and ultimate mechanisms underlying age-related brain atrophy, and (ii) how do lifestyle changes influence the trajectory of healthy and pathological aging?
Collapse
Affiliation(s)
- David A Raichlen
- School of Anthropology, University of Arizona, 1009 East South Campus Drive, Tucson AZ 85721, USA.
| | - Gene E Alexander
- Departments of Psychology and Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA; Arizona Alzheimer's Consortium, Phoenix, AZ 85006, USA
| |
Collapse
|
44
|
Hollings M, Mavros Y, Freeston J, Fiatarone Singh M. The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials. Eur J Prev Cardiol 2017; 24:1242-1259. [DOI: 10.1177/2047487317713329] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Matthew Hollings
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Australia
| | - Yorgi Mavros
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Australia
| | - Jonathan Freeston
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Australia
| | - Maria Fiatarone Singh
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Australia
- Sydney Medical School, The University of Sydney, Australia
- Hebrew SeniorLife, Harvard Medical School, USA
- Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, USA
| |
Collapse
|
45
|
Aerobic Training Intensity for Improved Endothelial Function in Heart Failure Patients: A Systematic Review and Meta-Analysis. Cardiol Res Pract 2017; 2017:2450202. [PMID: 28348916 PMCID: PMC5350392 DOI: 10.1155/2017/2450202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/07/2017] [Indexed: 12/17/2022] Open
Abstract
Objective. Flow-mediated dilation (FMD) is widely utilised to assess endothelial function and aerobic exercise improves FMD in heart failure patients. The aim of this meta-analysis is to quantify the effect of aerobic training intensity on FMD in patients with heart failure. Background. A large number of studies now exist that examine endothelial function in patients with heart failure. We sought to add to the current literature by quantifying the effect of the aerobic training intensity on endothelial function. Methods. We conducted database searches (PubMed, Embase, ProQuest, and Cochrane Trials Register to June 30, 2016) for exercise based rehabilitation trials in heart failure, using search terms exercise training, endothelial function, and flow-mediated dilation (FMD). Results. The 13 included studies provided a total of 458 participants, 264 in intervention groups, and 194 in nonexercising control groups. Both vigorous and moderate intensity aerobic training significantly improved FMD. Conclusion. Overall both vigorous and moderate aerobic exercise training improved FMD in patients with heart failure.
Collapse
|
46
|
Rodrigues B, Feriani DJ, Gambassi BB, Irigoyen MC, Angelis KD, Hélio José Júnior C. Exercise training on cardiovascular diseases: Role of animal models in the elucidation of the mechanisms. MOTRIZ: REVISTA DE EDUCACAO FISICA 2017. [DOI: 10.1590/s1980-6574201700si0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
47
|
Pearson MJ, Smart NA. Effect of exercise training on endothelial function in heart failure patients: A systematic review meta-analysis. Int J Cardiol 2016; 231:234-243. [PMID: 28089145 DOI: 10.1016/j.ijcard.2016.12.145] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/23/2016] [Accepted: 12/20/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Endothelial dysfunction contributes to the development and progression of cardiovascular disease and heart failure (HF) and is associated with an increased risk of mortality. Flow-mediated dilation (FMD) is widely utilised to assess endothelial function and is improved with exercise training in heart failure patients. The aim of this meta-analysis is to quantify the effect of exercise training in patients with heart failure. BACKGROUND A large number of studies now exist that have examined endothelial function in patients with heart failure. We sought to add to the current literature by quantifying the effect of exercise training on endothelial function. METHODS We conducted database searches (PubMed, EMBASE, PROQUEST and Cochrane Trials Register to June 2016) for exercise based rehabilitation trials in heart failure, using search terms exercise training, endothelial function, flow-mediated dilation (FMD) and endothelial progenitor cells (EPCs). RESULTS The 16 included studies provided a total of 529 participants, 293 in an intervention and 236 in controls groups. FMD was improved with exercise training in exercise vs. control, SMD of 1.08 (95%CI 0.70 to 1.46, p<0.00001). CONCLUSION Overall exercise training improved endothelial function, assessed via FMD, and endothelial progenitor cells in heart failure patients.
Collapse
Affiliation(s)
- M J Pearson
- School of Science and Technology, University of New England, Armidale, NSW 2351, Australia
| | - N A Smart
- School of Science and Technology, University of New England, Armidale, NSW 2351, Australia.
| |
Collapse
|
48
|
Xanthos PD, Gordon BA, Kingsley MIC. Implementing resistance training in the rehabilitation of coronary heart disease: A systematic review and meta-analysis. Int J Cardiol 2016; 230:493-508. [PMID: 28040292 DOI: 10.1016/j.ijcard.2016.12.076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy. METHODS Six electronic databases were searched to identify studies investigating RT, coronary heart disease and physical function. The overall quality of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible and qualitative analysis was performed for the remaining data. RESULTS Improvements in peak oxygen uptake (WMD: 0.61, 95% CI: 0.20-1.10), peak work capacity (SMD: 0.38, 95% CI: 0.11-0.64) and muscular strength (SMD: 0.65, 95% CI: 0.43-0.87) significantly favoured CT over AT with moderate quality evidence. There was no evidence of a difference in effect when comparing RT and AT. Shorter duration CT was superior to shorter duration AT for improving peak oxygen uptake and muscular strength (low quality evidence) while longer duration CT was only superior to longer duration AT in improving muscular strength (moderate quality evidence). CONCLUSIONS CT is more beneficial than AT alone for improving physical function. Although preliminary findings are promising, more high-quality evidence is required to determine the efficacy of high intensity resistance training. Shorter duration interventions that include resistance training might allow patients to return to their normal activities of daily living earlier.
Collapse
Affiliation(s)
- Paul D Xanthos
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Brett A Gordon
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Michael I C Kingsley
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| |
Collapse
|
49
|
Affiliation(s)
- Scott Kinlay
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.)
| | - Thomas Michel
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.)
| | - Jane A Leopold
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.).
| |
Collapse
|
50
|
Francois ME, Durrer C, Pistawka KJ, Halperin FA, Little JP. Resistance-based interval exercise acutely improves endothelial function in type 2 diabetes. Am J Physiol Heart Circ Physiol 2016; 311:H1258-H1267. [PMID: 27638878 PMCID: PMC5130498 DOI: 10.1152/ajpheart.00398.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 09/09/2016] [Indexed: 01/22/2023]
Abstract
Different modes of exercise, disease, and training status can modify endothelial shear stress and result in distinct effects on endothelial function. To date, no study has examined the influence of type 2 diabetes (T2D) and training status on the acute endothelial response to different modes of interval exercise (INT). We examined the effect of a single session of resistance- and cardio-based INT compared with a time-matched control on endothelial function in 12 age-matched T2D participants, 12 untrained, and 11 trained adults (aged 56 ± 7 yr). Flow-mediated dilation (%FMD) of the brachial artery was assessed at baseline and immediately, 1, and 2 h after an acute bout of cardio interval (C-INT), resistance interval (R-INT), and seated control (CTL); these interventions were randomized and separated by >2 days. C-INT involved seven 1-min cycling intervals at 85% of peak power with 1-min recovery between. R-INT involved the same pattern of seven 1-min intervals using leg resistance exercises. Endothelial function (%FMD) was improved after R-INT in all groups (Condition × Time interaction, P < 0.01), an effect that was most robust in T2D where %FMD was higher immediately (+4.0 ± 2.8%), 1 h (+2.5 ± 2.5%), and 2 h (+1.9 ± 1.9%) after R-INT compared with CTL (P < 0.01 for all). C-INT improved %FMD in T2D at 1-h postexercise (+1.6 ± 2.2%, P = 0.03) compared with CTL. In conclusion, R-INT acutely improves endothelial function throughout the 2-h postexercise period in T2D patients. The long-term impact of resistance exercise performed in an interval pattern is warranted.
Collapse
Affiliation(s)
- Monique E Francois
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada; and
| | - Cody Durrer
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada; and
| | - Kevin J Pistawka
- Kelowna General Hospital, Kelowna Cardiology Associates, Kelowna, British Columbia
| | - Frank A Halperin
- Kelowna General Hospital, Kelowna Cardiology Associates, Kelowna, British Columbia
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada; and
| |
Collapse
|