Search

Purpose: To investigate the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous exercise training (MICE) on hemodynamic and functional variables in individuals with Parkinson's disease. Methods: Twenty participants (13 men) were randomly assigned to a thrice-weekly HIIT (n = 12) or MICE (n = 8) for 12 weeks. Hemodynamic (resting heart rate and blood pressure, carotid femoral pulse wave velocity, endothelial reactivity, and heart rate variability) and functional variables (5-time sit-to-stand, timed up and go, and 6-min walking tests) assessed before and after training. Results: Demographic, hemodynamic and functional variables were similar between groups at baseline. Endothelial reactivity tended to increase after HIIT, but not after MICE, resulting in improved level (∼8%, P <.01) of this variable in HIIT versus MICE during follow-up. Six-minute walking test improved after HIIT (10.4 ± 3.8%, P <.05), but did not change after MICE. Sit to stand improved similarly after HIIT (27.2 ± 6.1%, P <.05) and MICE (21.5 ± 5.4%, P <.05). No significant changes were found after HIIT or MICE in any other variable assessed. Conclusion: These results suggest that exercise intensity may influence training-induced adaptation on endothelial reactivity and aerobic capacity in individuals with Parkinson's disease. [ABSTRACT FROM AUTHOR]

We sought to assess the residual effects (post 72-h training cessation) on fasting plasma glucose (FPG) and fasting insulin (FI) after 12-weeks of high-intensity interval training (HIIT), resistance training (RT), or concurrent training (CT) in women with insulin resistance (IR). We also aimed to determine the training-induced, post-training residual impact of CT. A total of adult 45 women (age 38.5±9.2years) were included in the final analysis and were assigned to a control (CG; n =13, BMI 28.3±3.6kg/m2), HIIT [ n =14, BMI 28.6±3.6kg/m2, three sessions/wk., 80–100% of the maximum heart rate (HRmax)], RT [ n =8, BMI 29.4±5.5kg/m2, two sessions/wk., 8–10 points of the modified Borg, corresponding to 20 to 50% range of one maximum repetition test (1RM)], or CT group (n =10, BMI 29.1±3.0kg/m2, three sessions/wk., 80–100% of HRmax, and 8–10 Borg, or 20 to 50% range of 1RM, to each HIIT and RT compounds), with the latter including both HIIT and RT regimens. Training interventions lasted 12-weeks. The main outcomes were FPG and FI measured at pre- and 24-h and 72-h post-training (FPG24h, FI24h, and FPG72h, FI72h, respectively). Secondary endpoints were body composition/anthropometry and the adiposity markers waist circumference (WC) and tricípital skinfold (TSF). The residual effects 72-h post-training [delta (∆)] were significantly poorer (all p <0.01) in the CT group (∆FPG72h+6.6mg/dl, η 2: 0.76) than in the HIIT (∆FPG72h+1.2mg/dl, η 2: 0.07) and RT (∆FPG72h+1.0mg/dl, η 2: 0.05) groups. These findings reveal that HIIT reduces FPG and RT reduces FI 24-h post-training; both exercise interventions alone have remarkably better residual effects on FPG and FI (post-72h) than CT in women with insulin resistance. [ABSTRACT FROM AUTHOR]

Background Heart failure (HF) and atrial fibrillation (AF) are often concomitant and act in a vicious cycle. Atrial fibrillation is associated with greater functional limitations and increased morbidity and mortality in patients with HF. Moreover, AF associated with HF increases patients' physical inactivity, worsening their clinical condition, and prognosis. Exercise training is safe and has clear benefits in HF. However, these benefits have not been demonstrated when AF is associated with HF. Case summary We present the case of a 57-year-old man with permanent AF and HF with reduced ejection fraction, who underwent 12 weeks of exercise training that included cardiopulmonary exercise testing, neuromuscular sympathetic activity (NMSA), and muscle blood flow (MBF) before and after training. Discussion Exercise training was shown to have a potential benefit in reducing the activity of the sympathetic nerve and increasing muscle blood flow, as well as increasing VO2peak and decreasing the VE/VCO2 slope in a patient with AF associated with HF with reduced ejection fraction. These results may indicate favourable clinical implications in this group of patients. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Blood pressure (BP) and hemodynamic response to heated water-based (HEx) vs. land-based exercise (LEx) were assessed in 15 (6 men) older hypertensives (age 66.4±4.9 yr) under pharmacological treatment. Participants were randomly assigned to perform 30 min of moderate-intensity HEx (walking inside the pool), LEx (walking on a treadmill) and non-exercise control (CON) intervention. Resting BP, arterial stiffness, endothelial reactivity and heart rate variability (HRV) were measured before, immediately after, and 45 min after interventions. 24-h ambulatory BP monitoring was performed after interventions. Resting systolic (but not diastolic) BP reduced 9.9±3.1 mmHg (P <0.01) 45 min after HEx only. 24-h systolic and diastolic, daytime diastolic and nightime systolic BP were lower (P <0.05) after HEx than both LEx and CON. Daytime systolic BP was also lower (P <0.05) after HEx than CON. Nighttime diastolic was not different between interventions. HEx-induced ambulatory BP reduction ranged 4.5±1.3 mmHg (24-h diastolic BP) to 9.5±3.0 mmHg (nighttime systolic BP), and persisted for 18/11 h in systolic/diastolic BP, when compared with CON. No significant changes in arterial stiffness, endothelial reactivity and HRV were found during any intervention. These results suggest that HEx may have important implications for managing BP in older hypertensive under pharmacological treatment. [ABSTRACT FROM AUTHOR]

Background Idiopathic dilated cardiomyopathy prognosis is influenced by endothelial dysfunction in adults with heart failure but this information is lacking in children. Objective Evaluate endothelial function in children with IDCM and HF. Method The idiopathic dilated cardiomyopathy group (IDCM) was composed of 15 children with left ventricular ejection fraction <40%. The heart failure group (HF) was composed of 16 children with left ventricular ejection fraction (LVEF) >50% who had previously been diagnosed with idiopathic dilated cardiomyopathy. The control group (CON) was composed of 11 healthy children. The endothelial function in all children was assessed via reactive hyperemia index (RHI) – peripheral artery tonometry testing and cardiopulmonary exercise test. Results IDCM were significantly shorter than CON (1.2 × 1.4 in m, respectively) and they received higher carvedilol, captopril, and furosemide dosage. CON presented RHI = 1.53 ± 0.26. HF presented RHI = 1.14 ± 0.31. IDCM presented RHI = 1.04 ± 0.24. CON showed a RHI 31% higher than HF and 25% higher than IDCM, significantly. LVEF was moderately correlated to the RHI (r = 0.46). For each unit of RHI, there was an addition of 10.57 in maximal oxygen consumption (VO 2 max). Lower RHI values correlated with lower VO 2 max values. Conclusion Children with IDCM and HF had endothelial dysfunction. The endothelium remained dysfunctional even after improvement in cardiac function. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Cardiovascular Surgery is the property of Sociedade Brasileira de Cirurgia Cardiovascular and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

SUMMARY Background: The origin of dyspnea in chronic heart failure (HF) is multifactorial, and excessive ventilation is thought to play a role in inducing this symptom. Chemosensivity is augmented in HF, correlates with increased pulmonary ventilation (VE), and is an adverse prognostic marker. Despite increased blood levels of natriuretic peptides in clinical conditions associated with dyspnea, their effect on pulmonary VE and chemoreceptor activity remains unexplored. Methods: We tested in a prospective, placebo-controlled, three-way cross-over, double-blind randomized study the effects of the recombinant form of the natural human B-type natriuretic peptide (R-BNP) in comparison with placebo and levosimendan on chemoreflex sensitivity at rest, as well as their effects on pulmonary VE, systemic blood pressure, heart rate and sympathetic serum activity both at rest and during exercise. Results: Eleven stable chronic HF patients were randomized to sessions of 6-min treadmill-walking tests during placebo, or levosimendan or R-BNP intravenous infusion in the following conditions: room air, hypoxia, and hypercapnia. R-BNP administration determined higher pulmonary ventilatory response at rest and during exercise ( P < 0.001) consequent to a boost of respiratory rate ( P < 0.001) under room air and hypoxia conditions. Norepinephrine blood levels increased from rest to exercise in all conditions without differences among placebo, levosimendan, and R-BNP effects. BNP blood levels remained unchanged. Conclusions: The novelty of the present findings is that R-BNP infusion in HF patients can boost pulmonary ventilatory response at rest and during exercise. [ABSTRACT FROM AUTHOR]

Aims To evaluate the feasibility, safety, and potential beneficial effects of left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) patients. Methods and results In this prospective, randomized pilot study, inclusion criteria were New York Heart Association (NYHA) functional class II or III, left ventricular ejection fraction (LVEF) ≤40%, sinus rhythm, and resting heart rate >65 b.p.m., despite optimal medical therapy (MT). Fifteen patients were randomly assigned either to MT alone or MT plus LCSD. The primary endpoint was safety, measured by mortality in the first month of follow-up and morbidity according to pre-specified criteria. Secondary endpoints were exercise capacity, quality of life, LVEF, muscle sympathetic nerve activity (MSNA), brain natriuretic peptide (BNP) levels and 24 h Holter mean heart rate before and after 6 months. We studied clinical effects in long-term follow-up. Ten patients underwent LCSD. There were no adverse events attributable to surgery. In the LCSD group, LVEF improved from 25 ± 6.6 to 33 ± 5.2 (P = 0.03); 6 min walking distance improved from 167 ± 35 to 198 ± 47 m (P = 0.02). Minnesota Living with Heart Failure Questionnaire (MLWHFQ) score physical dimension changed from 21 ± 5 to 15 ± 7 (P = 0.06). The remaining analysed variables were unchanged. During 848 ± 549 days of follow-up, in the MT group, three patients either died or underwent cardiac transplantation (CT), while in the LCSD group six were alive without CT. Conclusions LCSD was feasible and seemed to be safe in systolic HF patients. Its beneficial effects warrant the development of a larger randomized trial. [ABSTRACT FROM PUBLISHER]

Background: Conventional cardiac rehabilitation program consist of 15 min of warm-up, 30 min of aerobic exercise and followed by 15 min calisthenics exercise. The Pilates method has been increasingly applied for its therapeutic benefits, however little scientific evidence supports or rebukes its use as a treatment in patients with heart failure (HF). Purpose: Investigate the effects of Pilates on exercise capacity variables in HF. Methods: Sixteen pts with HF, left ventricular ejection fraction 27 ± 14%, NYHA class I-II were randomly assigned to conventional cardiac rehabilitation program (n = 8) or mat Pilates training (n = 8) for 16 weeks of 30 min of aerobic exercise followed by 20 min of the specific program. Results: At 16 weeks, pts in the mat Pilates group and conventional group showed significantly increase on exercise time 11.9 ± 2.5 to 17.8 ± 4 and 11.7 ± 3.9 to 14.2 ± 4 min, respectively. However, only the Pilates group increased significantly the ventilation (from 56 ± 20 to 69 ± 17 L/min, P= 0.02), peak VO2 (from 20.9 ± 6 to 24.8 ± 6 mL/kg/min, P= 0.01), and O2 pulse (from 11.9 ± 2 to 13.8 ± 3 mL/bpm, P= 0.003). The Pilates group showed significantly increase in peak VO2 when compared with conventional group (24.8 ± 6 vs. 18.3 ± 4, P= 0.02). Conclusions: The result suggests that the Pilates method may be a beneficial adjunctive treatment that enhances functional capacity in patients with HF who are already receiving standard medical therapy. [ABSTRACT FROM AUTHOR]

SUMMARY Background: Heart transplantation is a gold-standard treatment for selected patients in the terminal stages of heart failure and it can improve patients' quality of life, exercise capacity, and survival. Despite of the exercise performance in heart transplant recipients increases with respect to pre-transplantation, it still remains subnormal when compared with healthy subjects. Exercise training is an important nonpharmacological tool in heart transplant recipients to improve the exercise capacity, muscle strength, quality of life, and the chronotropic response. Despite this there is no consensus about what methods of aerobic exercise prescription are more adequate. Aim: The purpose of this review is to provide an up-to-date summary of the direct and indirect methods of prescription of aerobic exercise training in heart transplant recipients. Conclusion: The indirect methods of aerobic exercise prescription seem to be very frail and they do not seem to be reliable in heart transplant recipients. [ABSTRACT FROM AUTHOR]

In recent years, beta-blocker therapy has become a primary pharmacologic intervention in patients with heart failure by blocking the sympathetic activity. To compare the exercise training's sympathetic blockade in healthy subjects (athletes) and the carvedilol's sympathetic blockade in sedentary heart failure patients by the evaluation of the heart rate dynamic during an exercise test. A total of 26 optimized and 49 nonoptimized heart failure patients in a stable condition (for, at least, 3 months), 15 healthy athletes and 17 sedentary healthy subjects were recruited to perform a cardiopulmonary exercise test. The heart rate dynamic (rest, reserve, peak and the peak heart rate in relation to the maximum predicted for age) was analyzed and compared between the four groups. The heart rate reserve was the same between optimized (48 ± 15) and nonoptimized (49 ± 18) heart failure patients ( P < 0.0001). The athletes (188 ± 9) showed a larger heart rate reserve compared to sedentary healthy subjects (92 ± 10, P < 0.0001). Athletes and healthy sedentary reached the maximum age-predicted heart ratefor their age, but none of the heart failure patients did. The carvedilol's sympathetic blockade occurred during the rest and during the peak effort in the same proportion, but the exercise training's sympathetic blockade in healthy subjects occurred mainly in the rest. [ABSTRACT FROM AUTHOR]

Abstract: Background: Peak oxygen consumption and resting left ventricular ejection fraction (LVEF) are independent predictors of survival in adult heart failure (HF) patients. Aim: To evaluate these factors in children. Methods: We prospectively studied 31 children with NYHA class I to III HF (mean LVEF 26±10%; mean age 8.6±1.9 years). All had dilated cardiomyopathy and were awaiting heart transplantation. A cardiopulmonary treadmill exercise test was performed and LVEF determined by radionuclide ventriculography. Results: During a median follow-up of 1282 days, 20 children reached at least one end-point (death or heart transplantation). Clinical data from the 11 children without events and the 20 children with events are as follows: NYHA class 1±0 vs. 2±0.9 (p <0.01); SBP 118±17 vs. 102±16 (p =0.01); DBP 70±10 vs. 61±10 (p =0.02); heart rate 165±22 vs. 148±22 (NS); double-product 19±4 vs. 15±4 (p =0.01); end-tidal carbon dioxide tension (PetCO2) 35±5 vs. 30±6 (NS); oxygen consumption (VO2) 22±5.4 vs. 18.3±5.7 (NS); exercise time 19±4 vs. 13±6 (p <0.003), and LVEF 31±8 vs. 22±10 (p =0.02). These variables all correlated with prognosis on univariate analysis. In multivariate analysis, only decreasing exercise time and LVEF were predictive of events during follow-up (p <0.001 and 0.04). Conclusion: These findings suggest that reduction in LVEF and exercise tolerance in children with heart failure is predictive of functional status. [Copyright &y& Elsevier]

Study objective: To determine and compare the cardiopulmonary responses of healthy children and children with heart failure due to idiopathic dilated cardiomyopathy (IC) to progressive treadmill exercise testing. Setting: University teaching hospital specializing in cardiology. Patients or participants: Twenty-six children with stable, chronic heart failure (left ventricular ejection fraction < 45%) caused by IC (IC group) and 12 healthy children (control group). Interventions: After 12-lead resting ECG, all children underwent progressive treadmill exercise testing using a modified Naughton protocol. Tests were performed in a controlled-temperature exercise facility, at least 2 h after a light meal. Measurements and results: Cardiopulmonary parameters were assessed at rest, at anaerobic threshold (AT), and at peak exercise. At rest, the tidal volume (V[sub T]) and O[sub 2] consumption (VO[sub 2]) for heart rate (O[sub 2] pulse) were lower, while the heart rate, respiratory rate, and ventilatory equivalent for O[sub 2] (minute ventilation [VE]/VO[sub 2]) were higher in the lC group compared with the control group. At AT, the systolic BP, O[sub 2] pulse, V[sub T], exercise duration, VO[sub 2], CO[sub 2] production (VCO[sub 2]), and VE were lower, while the VE/VO[sub 2] and ventilatory equivalent for CO[sub 2] (VE/VCO[sub 2]) were higher in the IC group (p < 0.05). At peak exercise, the IC group had a significantly lower systolic BP, O[sub 2] pulse, exercise duration, VO[sub 2], and VCO[sub 2], but higher VE/VO[sub 2] and VE/VCO[sub 2] than the control group (p < 0.05). The VE/VCO[sub 2] slope was significantly higher for the IC group. No correlation existed between variables evaluated at rest vs during exercise. Conclusions: Gas exchange analysis performed during exercise successfully differentiated children with heart failure from healthy children. [ABSTRACT FROM AUTHOR]

A letter to the editor in response to an article about the 6-min walking test as a sub-maximal exercise test in heart failure patients, published in a previous issue is presented.