Obese Patients Decrease Work Rate in Order to Keep a Constant Target Heart Rate

Predicting Heart Rate Slow Component Dynamics: A Model Across Exercise Intensities, Age, and Sex

The heart rate slow component (scHR) is an intensity-dependent HR increment that emerges during constant exercises, partially dissociated from metabolism (V˙O2). The scHR has been observed during constant-workload exercise in young and older adults. Unless this scHR is accounted for, exercise prescription using HR targets lead to an undesired reduction in metabolic intensity over time.

PURPOSE

The purpose of this study is to characterize scHR across intensities, sex, and age to develop and validate a predictive equation able to maintain the desired metabolic stimulus over time in a constant aerobic exercise session.

METHODS

In our study, 66 individuals (35 females; 35 ± 13 yrs) performed the following: (i) a ramp-test for respiratory exercise threshold (GET and RCP) and maximal oxygen uptake (V˙O2max) detection, and (ii) 6 × 9-minute constant exercises at different intensities. The scHR was calculated by linear fitting from the fifth minute of exercise (bpm⋅min-1). A multiple-linear equation was developed to predict the scHR based on individual and exercise variables. The validity of the equation was tested on an independent sample by a Pearson correlation and Bland-Altman analysis between the measured and estimated HR during constant exercises.

RESULTS

The scHR increases with intensity and is larger in males (p < 0.05). A multiple-linear equation predicts the scHR based on the relative exercise intensity to RCP, age, and sex (r2 = 0.54, SEE = 0.61 bpm⋅min-1). scHR (bpm⋅min-1) = -0.0514 + (0.0240 × relative exercise intensity to RCP) - (0.0172 × age) - (0.347 × Sex (males = 0 and females score = 1)). In the independent sample, we found an excellent correlation between the measured and estimated HR (r2 = 0.98, p < 0.001) with no bias (-0.01 b·min-1, z-score= -0.04) and a fair precision (±4.09 b·min-1).

CONCLUSIONS

The dynamic of the scHR can be predicted in a heterogeneous sample accounting for the combined effects of relative intensity, sex, and age. The above equation provides the means to dynamically adapt HR targets over time, avoiding an undesired reduction in the absolute and relative training load. This strategy would allow the maintenance of the desired metabolic stimulus (V˙O2) throughout an exercise session in a heterogeneous population.

An overview of emerging smart capsules using other-than-light technologies for colonic disease detection

Wireless capsule endoscopy (CE) has revolutionized gastrointestinal diagnostics, offering a non-invasive means to visualize and monitor the GI tract. This review traces the evolution of CE technology. Addressing the limitations of traditional white light (WL) CE, the paper explores non-WL technologies, integrating diverse sensing modalities and novel biomarkers to enhance diagnostic capabilities. Concluding with an assessment of Technology Readiness Levels, the paper emphasizes the transformative impact of non-WL colon CE devices on GI diagnostics, promising more precise, patient-centric, and accessible healthcare for GI disorders.

Application and performance of heart-rate-based methods to estimate oxygen consumption at different exercise intensities in postmenopausal women

PURPOSE

Heart rate (HR) is a widespread method to estimate oxygen consumption ( V ˙ O2), exercise intensity, volume, and energy expenditure. Still, accuracy depends on lab tests or using indexes like HRnet and HRindex. This study addresses HR indexes' applicability in postmenopausal women (PMW), who constitute over 50% of the aging population and may have unique characteristics (e.g., heart size) affecting HR use.

METHODS

Fourteen PMW underwent a cycling ramp incremental test to establish the relationships between V ˙ O2 (in MET) and absolute HR, HRnet, and HRindex. In a second group of ten PMW, population-specific and general equations were tested to predict MET and energy expenditure during six constant work exercises at various intensities. Pulmonary gas exchange and HR were continuously measured using a metabolic cart. Correlations, Bland-Altman analysis, and two-way RM-ANOVA were used to compare estimated and measured values.

RESULTS

Strong linear relationships between the three HR indexes and MET were found in Group 1. In Group 2, population-specific equations showed medium-to-high correlations, precision, and no significant biases when estimating MET and energy expenditure. HRnet and HRindex outperformed absolute HR in accuracy. General HR equations had similar correlations but exhibited larger biases and imprecision. Statistical differences between measured and estimated values were observed at all intensities with general equations.

CONCLUSION

This investigation confirms the suitability of HR for estimating aerobic metabolism in one of the most significant aging populations. However, it emphasizes the importance of considering individual variability and developing population-specific models when utilizing HR to infer metabolism.

In Cardiac Patients β-Blockers Attenuate the Decrease in Work Rate during Exercise at a Constant Submaximal Heart Rate

PURPOSE

Exercise prescription based on fixed heart rate (HR) values is not associated with a specific work rate (WR) during prolonged exercise. This phenomenon has never been evaluated in cardiac patients and might be associated with a slow component of HR kinetics and β-adrenergic activity. The aims were to quantify, in cardiac patients, the WR decrease at a fixed HR and to test if it would be attenuated by β-blockers.

METHODS

Seventeen patients with coronary artery disease in stable conditions (69 ± 9 yr) were divided into two groups according to the presence (BB) or absence (no-BB) of a therapy with β-blockers, and performed on a cycle ergometer: an incremental exercise (INCR) and a 15-min "HR CLAMPED " exercise, in which WR was continuously adjusted to maintain a constant HR, corresponding to the gas exchange threshold +15%. HR was determined by the ECG signal, and pulmonary gas exchange was assessed breath-by-breath.

RESULTS

During INCR, HR peak was lower in BB versus no-BB ( P < 0.05), whereas no differences were observed for other variables. During HR CLAMPED , the decrease in WR needed to maintain HR constant was less pronounced in BB versus no-BB (-16% ± 10% vs -27 ± 10, P = 0.04) and was accompanied by a decreased V̇O 2 only in no-BB (-13% ± 6%, P < 0.001).

CONCLUSIONS

The decrease in WR during a 15-min exercise at a fixed HR (slightly higher than that at gas exchange threshold) was attenuated in BB, suggesting a potential role by β-adrenergic stimulation. The phenomenon may represent, also in this population, a sign of impaired exercise tolerance and interferes with aerobic exercise prescription.

Decrease in work rate in order to keep a constant heart rate: biomarker of exercise intolerance following a 10-day bed rest

Aerobic exercise prescription is often set at specific heart rate (HR) values. Previous studies demonstrated that during exercise carried out at a HR slightly above that corresponding to the gas exchange threshold (GET), work rate (WR) has to decrease in order to maintain HR constant. We hypothesized a greater WR decrease at a fixed HR following simulated microgravity/inactivity (bed rest, BR). Ten male volunteers (23±5 yr) were tested before (PRE) and after (POST) a 10-day horizontal BR, and performed on a cycle ergometer: a) incremental exercise; b) 15-min HR_CLAMPED exercise, in which WR was continuously adjusted to maintain a constant HR, corresponding to that at 120% of GET determined in PRE; c) two moderate-intensity constant WR (MOD) exercises. Breath-by-breath VO₂^, HR and other variables were determined. After BR, VO_2peak and GET significantly decreased, by about 10%. During HR_CLAMPED (145±11 b∙min^-1), the decrease in WR needed to maintain a constant HR was greater in POST vs. PRE (-39±10 vs. -29±14%, p<0.01). In 6 subjects the decreased WR switched from the heavy- to the moderate-intensity domain. The decrease in WR during HR_CLAMPED, in PRE vs. POST, was significantly correlated with the VO_2peak decrease (R²=0.52; p=0.02). A greater amplitude of the slow component of the HR kinetics was observed during MOD following BR. Exercise at a fixed HR is not associated with a specific WR or WR domain; the problem, affecting exercise evaluation and prescription, is greater following BR. The WR decrease during HR_CLAMPED is a biomarker of exercise intolerance following BR.

An Intensity-dependent Slow Component of HR Interferes with Accurate Exercise Implementation in Postmenopausal Women

Heart rate (HR) targets are commonly used to administer exercise intensity in sport and clinical practice. However, as exercise protracts, a time-dependent dissociation between HR and metabolism can lead to a misprescription of the intensity ingredient of the exercise dose.