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Objectives: To conduct a systematic review to determine the acute and chronic effects of inspiratory muscle training (IMT) in type 2 diabetes mellitus (T2DM) patients on cardiac autonomic function, glucose variability, inspiratory muscle strength and endurance, hemodynamic variables, and exercise capacity., Methods: A search was carried out according to a specific search strategy, following the PRISMA statement, and three independent reviewers have undertaken the article selection process. Searches were carried out in June 2023, on the following electronic databases: EMBASE, MEDLINE (PubMed), SCOPUS (Elsevier), and Web of Science. The methodological quality of the studies was assessed using the PEDro scale. The search was limited to English-language, randomized controlled trials (RCTs), involving T2DM patients (>18 years old, with or without autonomic neuropathy, and/or inspiratory muscle weakness) following an acute or chronic intervention protocol based on IMT. Exclusion criteria were reviews, clinical trials, case studies, theses, dissertations, scientific conference abstracts, subjects with other chronic respiratory/neurological/cardiovascular diseases, and studies addressing other breathing exercises., Results: The search strategy identified 1,352 studies, of which eight (two involving acute and six involving chronic IMT effects) were included. A total of 214 adults aged 52-63 years (51/49 male/female ratio), with BMI ranging from 27 to 36.8 kg/m², were included. The results demonstrated that after IMT, acute effects were reported, such as reduced glucose levels and an increase in the parasympathetic pathway, but also chronic effects including improved inspiratory muscle strength, endurance, and exercise capacity., Conclusion: Although some methodological differences among the studies were found, IMT may have beneficial effects on cardiac autonomic function, glucose level control, inspiratory muscle strength/endurance as well as exercise capacity. However, further studies are necessary to confirm these benefits., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Breuil-Marsal, Godek, Lotti, Feiereisen, Marçal, Rehder-Santos, Milan-Mattos and Abreu.)

Background: The influence of aerobic exercise training on cardiovascular adaptations in healthy males vs females is unclear. This systematic review and meta-analysis summarized sex-based differences in cardiac adaptations following aerobic exercise training interventions in healthy adults., Methods: Five electronic databases were searched from inception to June 2024. Cardiac adaptation data included peak oxygen uptake, heart rate, arteriovenous oxygen difference, systolic and diastolic blood pressure, stroke volume, cardiac output, left ventricular (LV) mass, LV end diastolic volume (LVEDV), LV end systolic volume (LVESV), and LV ejection fraction (LVEF). Meta-analyses were conducted in RevMan 5.4., Results: Meta-analyses were conducted on 4 outcomes: LV mass, LVEDV, LVESV, and LVEF. The meta-analysis revealed no sex differences in LV mass (standardized mean difference = -0.01, 95% confidence interval [CI]: -0.29, 0.27, P = 0.97), LVESV (mean difference [MD] = 1.85, 95% CI: -3.45, 7.10, P = 0.5), or LVEF (MD = -0.9, 95% CI: -3.26, 1.46, P = 0.45) following aerobic exercise interventions. Meta-analyses revealed a sex difference in LVEDV: males show a greater improvement in LVEDV (MD = 7.67, 95% CI: 2.75, 12.59, P = 0.002) than females after aerobic exercise training. No other sex differences were observed in any of the other outcomes. The overall risk of bias was low, and the quality of evidence was moderate., Conclusions: Aerobic exercise interventions were associated with a larger increase in LVEDV in men relative to women, yet no sex differences were found in cardiac morphology (LV mass) or functional indices (LVEF)., (Copyright © 2024 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Nearly 20 years have elapsed since the first clinical trial investigated the impact of interval training on patients with cardiovascular disease (CVD). This clinical corner discusses the health outcomes of systematic reviews and meta-analyses and appropriately powered randomized clinical trials which have tested these interval training programs across various CVDs (i.e., coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, and cardiac implantable electronic devices). The publications included in this clinical corner have shown that interval training leads to similar or superior improvements in peak oxygen uptake (V̇O 2 peak), functional capacity, pain free walking, quality of life, anxiety, depression, and endothelial function, but the magnitude of improvements across varying protocols (e.g., length and number of work periods, intensities of work periods, duration of exercise sessions, frequency of exercise sessions, and duration of program) and optimal dosage for males and females are unclear across CVD conditions. The heterogeneity in protocols, physical and mental health outcome measures, and lack of sex- and gender-based analyses calls for more high-quality research in this area., Competing Interests: The authors declare there are no competing interests.

Competing Interests: Conflict of interest: none declared.

Purpose: Improving cardiorespiratory fitness (CRF) through exercise training is associated with lower morbidity and mortality in patients with atrial fibrillation (AF). Smaller CRF improvements have been suggested in females than males with cardiovascular disease following exercise training. This systematic review compared changes in CRF (primary) and additional physical and mental health outcomes following exercise training between females and males with AF., Review Methods: Five bibliographic databases were searched to identify prospective studies implementing exercise training in patients with AF. The mean difference (MD) in the change following exercise training was compared between sexes using random-effects meta-analyses., Summary: Sex-specific data were obtained from 19 of 63 eligible studies, with 886 participants enrolled in exercise training (n = 259 [29%] females; female: 68 ± 7 years, male: 66 ± 8 years). Exercise training was 6 weeks to 1 year in duration and mostly combined moderate- to vigorous-intensity aerobic and resistance training, 2 to 6 d/wk. Changes in CRF did not differ between sexes (MD = 0.15: 95% CI, -1.08 to 1.38 mL O2/kg/min; P = .81; I2 = 27%). Severity of AF (MD = 1.00: 95% CI, 0.13-1.87 points; I2 = 0%), general health perceptions (MD = -3.71: 95% CI, -6.88 to -0.55 points; I2 = 22%), and systolic blood pressure (MD = 3.11: 95% CI, 0.14-6.09 mmHg; I2 = 42%) improved less in females than in males. Females may benefit from more targeted exercise training programs given their smaller improvement in several health outcomes than males. However, our findings are largely hypothesis-generating, considering the limited sample size and underrepresentation of females (29% females in our review vs 47% females with AF globally)., Competing Interests: All authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To evaluate the effectiveness of gamified versus nongamified health promotion interventions on cardiometabolic health and fitness parameters in healthcare worker women., Design: Randomized parallel group trial., Setting: A public outpatient health center in Brazil., Subjects: Women employees (included: n = 29; lost to follow-up: n = 1; analyzed: n = 28)., Interventions: 8 weeks of gamified (n = 15) or nongamified (n = 13) interventions, consisting of health lectures, nutritional counseling, and supervised exercise training. The gamified group was divided into teams that received points based on completion of health goals/tasks., Measures: Anthropometric, cardiometabolic and physical fitness parameters., Analysis: Two-way ANOVA with repeated measures (group vs. time), and Bonferroni post hoc tests., Results: Body mass (-1.5 ± 1.5 kg), waist circumference (-1.6 ± 3.0 cm), HbA1C (-.2 ± .3%), triglycerides (-21.5 ± 48.2 mg/dl), systolic (-11.1 ± 7.9 mmHg) and diastolic (-7.1 ± 5.8 mmHg) blood pressure, as well as sit and reach (3.9 ± 3.0 cm) and six-minute walking (56 ± 37 m) performance improved ( P < .05) only after the gamified intervention. Sit-to-stand performance improved after both the gamified (-1.18 ± 1.24 s) and nongamified (-1.49 ± 1.87 s) interventions., Conclusion: The gamified intervention was more effective than the nongamified intervention for improving cardiometabolic and physical fitness parameters, suggesting that gamification may be an effective tool for promoting health in healthcare worker women., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: While research demonstrates low levels of physical activity (PA) among adults living with atrial fibrillation (AF), there is limited evidence investigating sex differences in moderate to vigorous intensity physical activity (MVPA) and sedentary time in this population. The primary aim was to examine sex differences in MVPA levels and sitting time between women and men with AF. Secondary aims explored sex differences in sociodemographic factors, outcome expectations, and task self-efficacy toward PA levels., Methods: This was a subanalysis of the CHAMPLAIN-AF cohort study. Women and men with AF completed a survey, including the Short-Form International Physical Activity Questionnaire., Results: A total of 210 women (median = 66.0 yr: 95% CI, 63.5-68.0) and 409 men (median = 66.0 yr: 95% CI, 64.0-67.0) were included. No sex differences were observed in median weekly MVPA (60 min/wk: 95% CI, 0-120 in women vs 120 min/wk: 95% CI, 85-150 in men) and daily sitting time (5.5 hr/d: 95% CI, 5.0-6.0 in women vs 6.0 hr/d: 95% CI, 5.0-6.0 in men). Women engaged in significantly less vigorous-intensity PA than men ( P = .03) and demonstrated significantly lower task self-efficacy ( P < .01). Significant positive correlations in PA levels with outcome expectations (mostly weak) and task self-efficacy (mostly strong) were observed in both sexes., Conclusion: Most women and men with AF did not meet the global MVPA guidelines but met the sitting time recommendation. Women presented with lower vigorous-intensity physical activity levels and confidence than men. Strategies to increase physical activity behavior, considering sociodemographic factors and task self-efficacy, are needed and may differ between sexes., Competing Interests: All authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To perform a systematic review of studies assessing the effects of regular exercise on heart rate variability (HRV) in individuals with lower extremity arterial disease (LEAD) and symptoms of claudication., Methods: A systematic search in the electronic databases MEDLINE, Embase, and Scielo, was conducted and updated on January 21, 2023. Randomized clinical trials investigating patients with LEAD and IC, assessing ≥ 4 wk of exercise interventions, and reporting at least one HRV measure (e.g., time or frequency domains) at baseline and follow-up were included. Two reviewers independently screened studies for inclusion, performed data extraction, and quality assessment of included studies., Results: Data from 7 trials were included (i.e., 5 walking, 1 resistance, and 1 isometric handgrip training), totaling 327 patients (66% males; range: 61 - 68 yr; ankle brachial index: 0.4 - 0.7). Following exercise training, three studies investigating walking training reported an increase in parasympathetic modulation indices and/or a decrease in sympathetic modulation indices (n = 2) as well as an increase in non-linear indices (n = 1)., Conclusion: The current evidence is weak, and larger randomized controlled trials are needed to confirm the efficacy of exercise training in improving HRV. Additionally, the high divergence in the methodology of studies indicated the need for standard tools to improve the quality of HRV measurements in exercise trials. It is recommended to use standard procedures in future trials investigating HRV., Competing Interests: Declaration of Competing Interest No potential conflict of interest is reported by the author(s)., (Copyright © 2023. Published by Elsevier Inc.)

Background: Atrial fibrillation (AF) is a serious medical condition and a burgeoning patient population. Chronic exercise training, including high-intensity interval training (HIIT), has been shown to improve symptoms and quality of life in patients with AF. Yet, the acute responses to HIIT in this population remain understudied, leaving clinicians and patients hesitant about prescribing and engaging in high-intensity exercise, respectively., Case Summary: This case series describes acute exercise responses [i.e. power output, heart rate (HR), blood pressure (BP), ratings of perceived exertion (RPE), symptoms] to 10 weeks (3 days/week) of HIIT. Participants were four white males (58-80 years old) with permanent AF, co-morbidities (diabetes, coronary artery disease, Parkinson's disease), and physical limitations. The increases in HR and BP during HIIT were modest across all participants, regardless of age and medication use. Differences in RPE were observed; the oldest participant perceived the sessions as more challenging despite a lower HR response. All patients complied with the HIIT prescription of 80-100% of peak power output by week 4. No adverse events were reported., Discussion: Patients' concerns regarding high-intensity exercise may discourage them from participating in HIIT, our results demonstrated no abnormal HR or BP (e.g. hypotension) responses during HIIT or cool-down. These findings align with the typical exercise responses noted in other cardiovascular populations. Notwithstanding the high metabolic demands of HIIT, male patients with permanent AF tolerated HIIT without problem. Further investigation of HIIT as an approach to enable those with AF to recover physical capacity and minimize symptomatology is warranted., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Background: The aim of this study was to assess hemodynamic and cardiac autonomic response to high-intensity interval exercise (HIIE) versus moderate-intensity continuous exercise (MICE) in individuals with Parkinson's disease (PD)., Methods: Twelve individuals (six men) with PD were randomly assigned to perform HIIE (4 min of warm-up followed by 21 min alternating 1 min at levels 15-17 with 2 min at levels 9-11 of rating of perceived exertion [RPE] in a cycle ergometer), MICE (4 min of warm-up followed by 26 min at levels 11-14 of RPE in a cycle ergometer) and control (CON; 30 min of sitting rest) interventions in separate days. Heart rate (HR), blood pressure (BP), endothelial reactivity and heart rate variability (HRV) were assessed before, immediately after and 45 min after each intervention. HR and exercise workload were measured during each intervention., Results: Despite the within (high- vs. low-intensity intervals of HIIE) and between (HIIE vs. MICE) differences in workload during exercise sessions, HR was not different between high- (average HR=98±18 bpm) and low-intensity (average HR 97±19 bpm) intervals of HIIE, as well as between HIIE (average HR=97±18 bpm) and MICE (average HR=93±19 bpm) throughout the exercise. There were significant, but small, increases (P<0.01) in HR and systolic BP at post HIIE and MICE, which returned to levels similar to preintervention during recovery. There were no within- and between-intervention differences in diastolic BP, endothelial reactivity and HRV., Conclusions: The present results suggest that hemodynamic response to exercise is impaired in individuals with PD.

Our aim was to evaluate the effect of community-based exercise program (CBEP) intensity and modality on anthropometric, hemodynamic, and functional capacity parameters in low-income older women. Forty insufficiently active older women (68.2 ± 7.9 years) were randomly assigned to perform 12 weeks of twice-weekly high-intensity interval training combined with resistance training (HIIT+RT/n = 12), moderate-intensity continuous training combined with resistance training (MICT+RT/n = 13), or resistance training alone (RT/n = 15). Anthropometric (body mass index and waist circumference), hemodynamic (blood pressure and heart rate), and functional capacity variables (flexibility, upper and lower limb muscle strength, and mobility) were assessed before and after training programs. Waist circumference reduced similarly after all CBEP (~3 to ~4 cm; P < 0.05). Tendency toward reduction in diastolic blood pressure (~4 mm Hg; P = 0.073), and improvements in flexibility (14.5%, P = 0.011) and handgrip strength (15.8%; P = 0.02) were found only in HIIT+RT. Indeed, only RT was effective to improve five-time sit to stand (14.1%; P = 0.013). No significant difference between groups was found during follow-up in any variable. The results of present study suggest that low-income older women may improve anthropometric, hemodynamic and functional capacity variables by participating in twice-weekly short-term (i.e.: 12 weeks) CBEP. However, the CBEP-effects on hemodynamic and functional capacity appears to be affected by exercise intensity (only HIIT+RT tended toward improving diastolic BP) and modality (only RT improved significantly five-time sit to stand), respectively., (Copyright © 2021 Elsevier Inc. All rights reserved.)

We aimed to analyze the usefulness of the 6-20 rating of perceived exertion (RPE) scale for prescribing and self-regulating high-intensity interval (HIIE) and moderate-intensity continuous (MICE) aerobic exercise performed in a heated swimming pool (32 °C). Fifteen older individuals (65 ± 3 years) treated for hypertension underwent a symptom-limited maximal graded exercise test to determine their heart rate at anaerobic threshold, and respiratory compensation point. On different days, participants were randomized to HIIE (walking/jogging between 11 and 17 of RPE; 25 min) and MICE (walking at 11-13 of RPE; 30 min). Heart rate during the low-intensity intervals of HIIE and MICE remained below the graded exercise test's heart rate at anaerobic threshold (-7 ± 18 bpm/-16 ± 15 bpm) and respiratory compensation point (-18 ± 18 bpm/-30 ± 16 bpm), respectively, and maintained in the aerobic training zone during the high-intensity intervals of HIIE (+8 ± 18 bpm/-4 ± 19 bpm). The RPE scale at 15-17 is a useful tool for prescribing and self-regulating heated water-based HIIE and may have important implications for water-based exercise in older individuals with hypertension.

Background: Post-exercise hypotension (PEH) is an important tool in the daily management of patients with hypertension. Varying the exercise parameters is likely to change the blood pressure (BP) response following a bout of exercise. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. Yet, to date, it is not known whether a single session of HIIE maximizes PEH more than a bout of moderate-intensity continuous exercise (MICE). Objective: To compare the effect of HIIE vs. MICE on PEH by means of a systematic review and meta-analysis. Methods: A systematic search in the electronic databases MEDLINE, Embase, and SPORTDiscus was conducted from the earliest date available until February 24, 2020. Randomized clinical trials comparing the transient effect of a single bout of HIIE to MICE on office and/or ambulatory BP in humans (≥18 years) were included. Data were pooled using random effects models with summary data reported as weighted means and 95% confidence interval (CIs). Results: Data from 14 trials were included, involving 18 comparisons between HIIE and MICE and 276 (193 males) participants. The immediate effects, measured as office BP at 30- and 60-min post-exercise, was similar for a bout of HIIE and MICE ( p > 0.05 for systolic and diastolic BP). However, HIIE elicited a more pronounced BP reduction than MICE [(-5.3 mmHg (-7.3 to -3.3)/ -1.63 mmHg (-3.00 to -0.26)] during the subsequent hours of ambulatory daytime monitoring. No differences were observed for ambulatory nighttime BP ( p > 0.05). Conclusion: HIIE promoted a larger PEH than MICE on ambulatory daytime BP. However, the number of studies was low, patients were mostly young to middle-aged individuals, and only a few studies included patients with hypertension. Therefore, there is a need for studies that involve older individuals with hypertension and use ambulatory BP monitoring to confirm HIIE's superiority as a safe BP lowering intervention in today's clinical practice. Systematic Review Registration: PROSPERO (registration number: CRD42020171640)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Marçal, Goessler, Buys, Casonatto, Ciolac and Cornelissen.)

The aim of this study was to evaluate blood pressure (BP), heart rate, arterial stiffness and endothelial reactivity responses to heated water immersion in older individuals with hypertension. Thirty-five sedentary individuals (67 ± 5 years) under treatment for hypertension were randomly assigned to water-based [n = 20; 30 min of seated resting in a heated swimming pool (30-32 °C)] or land-based group [n = 15; 30 min of seated resting in a quiet room with controlled temperature (21-23 °C)]. BP, heart rate, arterial stiffness and endothelial reactivity were measured before, immediately after (post) and 45 min after (recovery) each session. Heart rate reduced (P < 0.05) during the land-based session, and the reduction was maintained at post (~7 bpm) and recovery (~9 bpm), but no heart rate changes occurred during and after the water-based session. Systolic/diastolic BP increased (P = <0.001) at post (~29/10 mmHg) and recovery (~10/7 mmHg) in the water-based group, but not in the land-based group. No significant changes in pulse wave velocity and endothelial reactivity occurred in both groups. These results suggest that the hemodynamic response to heated water immersion should be taken into account when assessing the effect of heated water-based exercise on postexercise hypotension in older individuals with hypertension., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: We tested the hypothesis that the 6 to 20 rating of perceived exertion (RPE) is a cost-effective tool similar to heart rate (HR) response to cardiopulmonary exercise test for prescribing and self-regulating high-intensity interval exercise (HIIE). In this context, we analyzed if health-related responses to exercise are similar between HIIE prescribed and self-regulated by RPE (HIIERPE) and HIIE prescribed and regulated by HR response to cardiopulmonary exercise test (HIIEHR)., Methods: Twelve young (21±2 years) sedentary or insufficiently active individuals (weekly levels ˂150 minutes or 75 minutes of moderate- or vigorous-intensity physical activity, respectively) were randomly assigned to perform HIIERPE (25 minutes), HIIEHR (25 minutes) and control session (25 minutes of seated resting). Blood pressure, HR, and arterial stiffness (pulse wave velocity) were measured before, immediately after, and 30 minutes after each intervention. HR, speed, and distance were measured during exercise sessions. 24-hours ambulatory blood pressure was measured after each intervention., Results: Exercise HR, speed, and distance, as well as blood pressure response to exercise were not different between HIIERPE and HIIEHR. Pulse wave velocity reduced (P<0.05) at postintervention in both HIIERPE (0.28±0.17 m/s) and HIIEHR (0.27±0.11 m/s). However, pulse wave velocity at recovery was lower than pre-intervention only during HIIERPE (0.30±0.10 m/s)., Conclusions: These results suggest that RPE is a cost-effective tool for prescribing self-regulating HIIE and improving health-related variables in young individuals.

Diabetes is the second most prevalent non-communicable chronic diseases (NCDs) in patients with coronavirus disease 2019 (COVID-19) and is highly associated with increased incidence of disease severity and mortality. Individuals with diabetes and poor glycemic control have an even worse prognosis. Despite of the need/effectiveness of social distancing measures (i.e.: home confinement, quarantine and/or lockdown) during COVID-19 outbreak, preliminary findings showed an increase in negative behaviors during COVID-19 home confinement (i.e.: ~33.5% reduction in physical activity, ~28.6% (~3.10h) increase in sedentary behavior (i.e.: daily sitting, reclining and lying down time), and more unhealthy food consumption and meal pattern), which may have important clinical implications. For example, we estimated that this reduction in physical activity can increase the cases of type 2 diabetes (from ~7.2% to ~9.6%; ~11.1 million cases per year) and all-cause mortality (from ~9.4% to ~12.5%; ~1.7 million deaths per year) worldwide. Few weeks of reduction in physical activity levels result in deleterious effects on several cardiometabolic (i.e.: glycemic control, body composition, inflammatory cytokines, blood pressure, vascular function…) and functional parameters (i.e.: cardiorespiratory/muscle fitness, balance, agility…). In contrast, physical activity and exercise are important tools for preventing and treating diabetes and others NCDs. Home-based exercise programs are useful, safe and effective for the management of diabetes, and could be widely used during COVID-19 outbreak. In this context, there is an urgent need for recommending physical activity/exercise, during and beyond COVID-19 outbreak, for improving the management of diabetes, as well as to prevent the increase in global burden of COVID-19, diabetes and others NCDs., (Copyright © 2020 Marçal, Fernandes, Viana and Ciolac.)

Purpose: The purpose of this study was to investigate the hemodynamic and cardiorespiratory adaptations to exercise in individuals with heart transplantation with evidence of cardiac reinnervation (cardiac reinnervation group) versus without evidence of cardiac reinnervation (no cardiac reinnervation group)., Methods: Sedentary individuals with heart transplantation (age = 45.5 ± 2.2 years; time elapsed since surgery = 6.7 ± 0.7 years) were divided into the cardiac reinnervation ( n  = 16) and no cardiac reinnervation ( n  = 17) groups according to their heart rate response to cardiopulmonary exercise testing. The 24-hour ambulatory blood pressure, carotid-femoral pulse wave velocity, and cardiorespiratory fitness were assessed before and after 12 weeks of a thrice-weekly exercise program (five minutes of warm-up, 30 min of endurance exercise, one set of 10-15 reps in five resistance exercises, and five minutes of cool-down)., Results: The cardiac reinnervation group had reduced ( p  < 0.01) 24-hour systolic/diastolic blood pressure (7/9 mm Hg), daytime systolic/diastolic blood pressure (9/10 mm Hg) and nighttime diastolic blood pressure (6 mm Hg) after training. The no cardiac reinnervation group reduced ( p  < 0.05) only 24-hour (5 mm Hg), daytime (5 mm Hg) and nighttime (6 mm Hg) diastolic blood pressure after training. Hourly analysis showed that the cardiac reinnervation group reduced systolic/diastolic blood pressure for 10/21 h, while the no cardiac reinnervation group reduced systolic/diastolic blood pressure for only 3/11 h. The cardiac reinnervation group also improved both maximal oxygen consumption (10.8%) and exercise tolerance (13.4%) after training, but the no cardiac reinnervation group improved only exercise tolerance (9.9%). Pulse wave velocity did not change in both groups., Conclusion: There were greater improvements in ambulatory blood pressure and maximal oxygen consumption in the cardiac reinnervation than the no cardiac reinnervation group. These results suggest that cardiac reinnervation associates with hemodynamic and cardiorespiratory adaptations to exercise training in individuals with heart transplantation.