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Heart rate drifts upward over time during interval exercise and during exercise in hot conditions. As such, work rate must be lowered to maintain target heart rate. The purpose was to characterize acute work rate adjustments during high-intensity interval training based on target heart rate. Seven humans (three females) completed five study visits: a graded exercise test on a cycle ergometer to measure maximal heart rate (HRmax) in ∼22 °C and four trials performed in ∼22 °C (TEMP) or ∼35 °C (HOT), consisting of an 8 min warm-up at 70% HRmax followed by one (15TEMP and 15HOT) or five (43TEMP and 43HOT) rounds of high-intensity interval training (one round = 4 min work at 90% HRmax and 3 min recovery at 70% HRmax) totaling 15 min or 43 min of exercise, respectively. Work rate was lowered 33 ± 20 W (p = 0.005) in 43TEMP and 56 ± 30 W (p = 0.003) in 43HOT between the first and fifth work intervals. Thermal strain (0.2 °C higher rectal temperature, p = 0.01) and cardiovascular strain (6 beats·min–1 larger increase in heart rate from first to fifth recovery interval, p = 0.01) were greater in 43HOT versus 43TEMP. Using target heart rate during high-intensity interval training may reduce the training stimulus, especially in hot environments, but it may also limit thermal strain and enable participants to complete the prescribed workout despite the heat. [ABSTRACT FROM AUTHOR]

This study aimed to verify the effects of prescribed personalized forest walking by considering individuals' characteristics. To prescribe individualized exercise programs, we developed an algorithm to calculate exercise intensity based on each participant's age, regular exercise, fatigue level, and chronic disease type, if any. To investigate the effects of forest walking on physical and mental health based on exercise prescription, we recruited 59 participants (average age: 39.1 ± 19.0 years old) aged 18 years or older. Physiological and psychological responses were compared before and after walking in the forest. Systolic blood pressure, diastolic blood pressure, percent body fat, negative affect, and emotional exhaustion significantly decreased, while the pulse rate significantly increased following the forest walking. Additionally, we investigated the effects of exercise relative to successfully maintaining one's target heart rate and found that these effects were even greater when success score of maintaining the target heart rate while walking improved. Comparison of the groups relative to successfully achieving the target heart rate indicated that the high-achievement group had significant reductions in systolic and diastolic blood pressure, body fat mass, percent body fat, negative affect, and emotional exhaustion, and a significant increase in pulse rate. However, the low-achievement group only showed a significant reduction in emotional exhaustion. This study showed that prescribed forest walking has a positive impact on human health and is expected to have a positive effect on the motivation to start and continue exercising. [ABSTRACT FROM AUTHOR]

Echocardiographic stress tests are often used to evaluate patients who complain of chest pain. However, some patients fail to reach the target heart rate required for the test to be conclusive (usually defined as 85% of the predicted maximal heart rate based on the patient's age) and are often sent for additional imaging tests, such as myocardial perfusion imaging (MPI) or cardiac computed tomography angiography (CTA). Few studies have evaluated the effectiveness of these additional tests in patients who present with chest pain but did not meet the heart rate requirements for a stress test. The primary objective of the study was to evaluate the efficacy of additional imaging tests for patients who experience chest pain during daily activities but are unable to reach the target heart rate currently required for an echocardiographic stress test. The study group included 415 consecutive patients who underwent a stress echocardiogram, did not achieve their target heart rate, and did not demonstrate abnormal changes during the test. The control group consisted of 415 consecutive patients who did reach their target heart rate and demonstrated no signs of ischemia. Demographic and clinical data, medication use, imaging test results (MPI, CTA, and/or coronary catheterization) and documented cardiac events that occurred during 1 year of follow-up were obtained from the electronic medical records. Of the 415 patients in the study group, 73 (17.6%) were referred to another imaging test within 12 months. Of these 73 patients, 59 underwent MPI and 14 underwent cardiac CTA. In 12 of these patients (16.4%) the test was considered to be abnormal, but only 7 patients (1.7%) subsequently underwent a percutaneous intervention (PCI). In the control group, 28 (6.7%) patients were referred for another imaging test. Of these 28 patients, 14 underwent MPI and 14 underwent cardiac CTA. None of these tests were found to be abnormal, but two patients (0.5%) underwent a PCI (p = 0.2 between groups). There were no deaths during the study period and no patients underwent bypass surgery. The majority of the patients who underwent PCI had additional clinical risk factors (diabetes, hypertension, and/or known coronary artery disease), had taken a beta blocker within 24 h prior to the test, and/or did not reach a heart rate above 78% of their target heart rate. Our study suggests that in most patients with chest pain who do not show ischemic changes on a stress echocardiogram, additional imaging studies can be safely deferred, even if the required target heart rate was not reached. However, in patients with diabetes and/or known coronary disease, those who took a beta blocker 24 h prior to the test, or those who did not achieve a heart rate above 78% of the current target heart rate, additional imaging studies should be considered. [ABSTRACT FROM AUTHOR]

Background: Aerobic exercise reduces pain sensitivity, a phenomenon known as exercise-induced hypoalgesia (EIH); however, little is known about EIH when the upper limbs are aerobically exercised. This study aimed to test the acute effect of a single aerobic upper-limb exercise on pain threshold and pain intensity in healthy participants, with two different protocols for controlling intensity. Methods: 31 participants performed two 20 min exercise sessions a week apart. In each session, the intensity was controlled by a target heart rate (THR) of 60% of heart rate reserve or by a rate of perceived exertion (RPE) of 7/10 on the Borg scale. Pain threshold for pressure (PPT) heat (HPT) and pain intensity in response to Tonic Heat Pain (THP) were measured pre- and post-exercise. To examine the effect of exercise in each protocol on pain sensitivity, rmANOVA was conducted. Results: Pain sensitivity remained unchanged following arm exercise in both protocols (PPT, p = 0.67; HPT, p = 0.56; and THP p = 0.39). Higher HR in the THR protocol was demonstrated with a significant protocol X time, interaction effect (F(3) = 11.194 p < 0.004). Conclusions: Moderate–high-intensity upper-limb aerobic exercise did not affect pain sensitivity in healthy individuals. Exercise intensity when controlled by THR showed a higher mean heart rate compared to exercise intensity based on RPE. [ABSTRACT FROM AUTHOR]

The rates of atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) continue to grow with many patients suffering from their combined impact on quality of life and prognosis.A lower heart rate (HR) in HFrEF is associated with reduced morbidity and mortality due to beta-blocker and ivabradine therapy. Postulated mechanisms include reduced neurohumoral activation, increased diastolic filling time and myocardial energy conservation. In contrast, the landmark randomised controlled non-inferiority RACE II trial demonstrated that a lenient rate control strategy (target HR

The aim of this study was to evaluate constants of the Karvonen (k) and heart rate reserve (HRR) (a) formulas that correspond to the anaerobic threshold (AT) to conveniently estimate the intensity of exercise therapy in nonbetablocked patients undergoing hemodialysis. Twenty-three patients undergoing hemodialysis performed cardiopulmonary exercise testing (CPX) and their HR at AT was measured. The predictor coefficients for a target HR corresponding to AT were calculated for each patient based on CPX. Interclass correlation coefficients (ICC) and Bland-Altman analysis were used to evaluate the reliability of the formulas. Mean values of coefficient k of the Karvonen formula and a of the HRR formula were 0.24 ± 0.11 and 17.4 ± 8, respectively. The target HR calculated with k = 0.24 and a = 17 had significant ICC between HR at AT (0.74 and 0.77, respectively; P < 0.05). Using the Karvonen and HRR formulas to determine a target HR corresponding to AT is a simple and easy method that can be used to develop exercise programs for hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background: Aerobic exercise reduces pain sensitivity, a phenomenon known as exercise-induced hypoalgesia (EIH); however, little is known about EIH when the upper limbs are aerobically exercised. This study aimed to test the acute effect of a single aerobic upper-limb exercise on pain threshold and pain intensity in healthy participants, with two different protocols for controlling intensity. Methods: 31 participants performed two 20 min exercise sessions a week apart. In each session, the intensity was controlled by a target heart rate (THR) of 60% of heart rate reserve or by a rate of perceived exertion (RPE) of 7/10 on the Borg scale. Pain threshold for pressure (PPT) heat (HPT) and pain intensity in response to Tonic Heat Pain (THP) were measured pre- and post-exercise. To examine the effect of exercise in each protocol on pain sensitivity, rmANOVA was conducted. Results: Pain sensitivity remained unchanged following arm exercise in both protocols (PPT, p = 0.67; HPT, p = 0.56; and THP p = 0.39). Higher HR in the THR protocol was demonstrated with a significant protocol X time, interaction effect (F(3) = 11.194 p < 0.004). Conclusions: Moderate–high-intensity upper-limb aerobic exercise did not affect pain sensitivity in healthy individuals. Exercise intensity when controlled by THR showed a higher mean heart rate compared to exercise intensity based on RPE.

Aim: To explore the effect of CYP2D6*10 (100C > T) and ADRB1 1165 G > C polymorphisms on heart rate of post-PCI (percutaneous coronary intervention) patients treated with metoprolol succinate sustained-release tablets. Methods: A total of 756 inpatients with metoprolol succinate sustained-release tablets were selected and the genotypes of CYP2D6*10 and ADRB1 1165G > C were detected in 319 patients using gene chip detection. The target heart rate was defined as a resting heart rate < 70 beats/min. Clinical data were collected. Results: A total of 319 inpatients were enrolled in the study. The mutant allele frequencies of CYP2D6 and ADRB1 were 57.21 and 69.44%, respectively. Whatever the dose of metoprolol, the heart rates were lower in patients with homozygous mutation of CYP2D6 than those with heterozygous mutation and wild-type (p < 0.05). Nevertheless, this effect was not seen between different genotypes of ADRB1 . Logistic regression analysis showed that the dose of metoprolol and the genotypes of CYP2D6 were predictors of heart rate <70 beats/min in these patients. Further multivariate analysis indicated that patients with homozygous mutation had better control of heart rates compared with those with wild-type and heterozygous mutation of CYP2D6*10 genotypes (all: p < 0.001). Conclusion: CYP2D6*10 polymorphisms were associated with the heart rate of post-PCI patients treated with metoprolol succinate sustained-release tablets.

Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether the amount of time participants exercised in the target heart rate zone (THRZ) influenced change in blood pressure (BP) one year following a cardiac event. Lifestyle exercise (habitual, small exercise opportunities) and intensity were objectively measured using portable heart rate monitors. Linear mixed models were used to analyze change in BP among 331 participants. Mean BP at baseline was 118/70 mmHg, and both systolic and diastolic BP increased from baseline to one year—4.79 mmHg (p <.001) and 2.09 mmHg (p =.002), respectively. Overall, participants had a decrease in levels of lifestyle exercise. After controlling for time, age, gender, and study group, SBP change was inversely associated with amount of time in THRZ. Given suboptimal engagement in recommended exercise, the underlying mechanisms of lifestyle exercise effects on the time spent in THRZ to reduce BP warrants further study in this population. [ABSTRACT FROM AUTHOR]

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Exercise prescription based on exercise test results is complicated by the need to downregulate the absolute training intensity to account for cardiovascular drift in order to achieve a desired internal training load. We tested a recently developed generalized model to perform this downregulation using metabolic equivalents (METs) during exercise testing and training. A total of 20 healthy volunteers performed an exercise test to define the METs at 60, 70, and 80% of the heart rate (HR) reserve and then performed randomly ordered 30 min training bouts at absolute intensities predicted by the model to achieve these levels of training intensity. The training HR at 60 and 70% HR reserve, but not 80%, was significantly less than predicted from the exercise test, although the differences were small. None of the ratings of perceived exertion (RPE) values during training were significantly different than predicted. There was a strong overall correlation between predicted and observed HR (r = 0.88) and RPE (r = 0.52), with 92% of HR values within ±10 bpm and 74% of RPE values within ±1 au. We conclude that the generalized functional translation model is generally adequate to allow the generation of early absolute training loads that lead to desired internal training loads.

The study aims to provide a morphological profile of Indian cricketers and find physiological demands and positional differences of the batsmen in T20 matches according to their batting order. Eighty-three male cricketers (age: 17.93 ± 2.23 years) participated in this study and categorized into upper-order ( n = 36), middle-order ( n = 35) and lower-order ( n = 12) batsmen. Height, weight, body fat%, and somatotype were measured. Movement analysis and heart rate (HR) responses were recorded during batting in T20 matches using PolarV800 smart-watch and H7 HR sensor. Descriptive statistics, one-way ANOVA followed by post-hoc analysis examined group differences. Results indicated that upper-order batsmen were balanced mesomorph, middle-order batsmen were mesomorphic-endomorph, and lower-order batsmen were mesomorphic-ectomorph. Cricket-specific movement patterns showed that standing made-up the majority of time spent (54.1 - 60.9%), while maximum distance was covered by walking (68.5 - 73.3%) during batting. Lower-order batsmen spent significantly lesser time ( p < 0.01; d = 1.02) in the crease and covered lesser total distance ( p < 0.05; d = 0.85) compared to upper and middle-order batsmen, respectively. Upper-order batsmen maintained a significantly lower average HR throughout batting compared to middle ( p < 0.01; d = 1.07) and lower-order ( p < 0.01; d = 2.04) batsmen. Moreover, upper-order batsmen spent significantly more time in the low-intensity target HR (THR) zone (~9.9%) compared to the middle (~3.2%; p < 0.01; d = 0.72) and lower-order (~2.3%; p < 0.05; d = 0.69). Additionally, upper-order batsmen spent significantly less time (20.8%; p < 0.01) in the high-intensity THR compared to the middle (55.3%) and lower-order (52.2%) batsmen. Therefore, the findings highlight distinct movement and physiological demands associated with batting at different orders during T20 matches, which conditioning coaches and cricketers can utilize to optimize training programs and enhance individual performance.

Although there is evidence supporting the benefit of regular exercise, and recommendations about exercise and physical activity, the process of individually prescribing exercise following exercise testing is more difficult. Guidelines like % heart rate (HR) reserve (HRR) require an anchoring maximal test and do not always provide a homogenous training experience. When prescribing HR on the basis of % HRR, rating of perceived exertion or Talk Test, cardiovascular/perceptual drift during sustained exercise makes prescription of the actual workload difficult. To overcome this issue, we have demonstrated a strategy for “translating” exercise test responses to steady state exercise training on the basis of % HRR or the Talk Test that appeared adequate for individuals ranging from cardiac patients to athletes. However, these methods depended on the nature of the exercise test details. In this viewpoint, we combine these data with workload expressed as Metabolic Equivalent Task (METs). We demonstrate that there is a regular stepdown between the METs during training to achieve the same degree of homeostatic disturbance during testing. The relationship was linear, was highly-correlated (r = 0.89), and averaged 71.8% (Training METs/Test METs). We conclude that it appears possible to generate a generalized approach to correctly translate exercise test responses to exercise training.

Walking is one of the most common exercise in the world. Controlling this activity according to scientific methods and health standards can be considered as a major step in the promotion of global health. Nowadays, since mobile devices are ubiquitous and smart, they can be utilized to ensure that walking activities are compatible with scientific methods. To achieve this aim, a novel pervasive computing method is presented which can be easily implanted on mobile devices as a smart application. In this method, by analyzing environmental and physiological data along with data related to level of user's fitness, target heart rate range for the user will be determined. Since our method computes this target heart rate range based on user's goal for walking which can be fat burning or staying healthy, maintaining the range of user's heart rate during walking leads to the achievement of highest efficiency for the user. In this regard, a set of environmental sensors and a heart rate sensor are needed on the mobile device. Finally, we leverage the speed of walking and its relation to user's heart rate to keep the heart rate in the computed target range by delivering controlling messages towards the user during the walk to adjust his or her walking speed. The results of utilizing this method prove its ability in raising the efficiency of walking activity. [ABSTRACT FROM AUTHOR]

Introduction The Movicorde system was designed in order to help cardiologists and physiotherapists atexercise training sessions,where constant supervision of relevant parameters is required.Objectives To evaluate the use of Movicorde in high-risk cardiac patients, including the presence of arrhythmias, ST segmentabnormalities and target heart rate.Methods A descriptive, cross-sectional study of 80 high-risk patients who attended the gymnasium of the Institute of Cardiology,from July 2009 through April 2011, in a Cardiac Rehabilitation (CR) program.The measurements taken by Movicordewere compared to those taken by the cardiologists and a data base was created for statistical analyses.Results Sixty two (62) patients had premature ventricular complexes (PVC). The high specificity (99.87 %), sensibility (80,33%)and the 83,42% positive predictive value (VPP) of the system to detect PVC, was described. There was total concordancebetween the equipment and the physicians in 57 patients (71,25%) with respect to ST segment depression.This had a very superior observed value to that expected and showed that the results were representative (p

Background Exercise electrocardiography in asymptomatic adults has been criticized because of relatively poor accuracy predicting future heart disease risk, but studies may have been too short. We investigated if integrated analysis of graded exercise tolerance tests (GXT) predicted long-term coronary heart disease (CHD) and all-cause mortalities among community-dwelling older adults. Methods and results From 1972 to 1974, 1789 adult residents of a predominantly Caucasian, middle- to upper-middle-class southern California community participated in a clinical evaluation that included a GXT; 52.4% (N = 939) of those who had baseline GXT were followed up to 2010-up to 36 years-for vital status, CHD and all-cause mortality. Multiply adjusted hazard ratios of an abnormal graded GXT were 1.65 (95% CI 0.78-3.49) and 1.56 (95% CI 1.15-2.11) for CHD and all-cause mortality, respectively. An integrated analysis hazard ratio was calculated based on the following GXT findings: significant ST change, inability to achieve target heart rate [THR], abnormal heart rate recovery [HRR], and chronotropic incompetency [ChI]. Compared to those with 0 or 1 abnormality, participants with 2 or more positive findings had significantly higher CHD (HR 2.18) and all-cause (HR 1.92) mortalities. Participants with 3 or more positive findings showed even higher hazard ratios-CHD (HR 6.16) and all-cause (HR 2.49) mortalities. When adjusted for any of 3 Framingham risk models, the integrated electrocardiographic model correlated well with CHD and all-cause mortalities. Conclusions An integrated analysis of electrocardiographic and non-electrocardiographic measures of GXT is useful in predicting long-term CHD and all-cause mortalities in an asymptomatic middle-aged population. [ABSTRACT FROM AUTHOR]

The rates of atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) continue to grow with many patients suffering from their combined impact on quality of life and prognosis. A lower heart rate (HR) in HFrEF is associated with reduced morbidity and mortality due to beta-blocker and ivabradine therapy. Postulated mechanisms include reduced neurohumoral activation, increased diastolic filling time and myocardial energy conservation. In contrast, the landmark randomised controlled non-inferiority RACE II trial demonstrated that a lenient rate control strategy (target HR <110 beats per minute [bpm]) was more attainable and safer than a strict rate control strategy (resting HR <80 bpm) in permanent AF. Physiologically, a higher HR is needed to compensate for the lost 'atrial kick' that contributes to the cardiac output by coordinated atrial contractions in normal sinus rhythm. This leaves the not insignificant number of patients with HFrEF and AF in a conundrum over optimal HR control. Retrospective analyses of AF and HR control in landmark HFrEF trials (e.g. CHARM, PARADIGM and ATMOSPHERE) point towards better outcomes with a less stringent target HR. However, this association disappears after adjustment for known prognostic markers in HFrEF, including left ventricular ejection fraction, New York Heart Association class and NT-proBNP levels. There is a clear need for dedicated randomised controlled trials, investigating rate control strategies in this increasingly large subgroup of patients. Regardless of rate control strategy, effective anti-coagulation and guideline-directed medical therapy must not be forgotten in the treatment of patients with HFrEF and AF., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author.)

Background: Higher resting heart rate (HR) in patients with heart failure (HF) and sinus rhythm (SR) is associated with increased mortality. In patients hospitalized for HF, the aim herein, was to assess the use and dosage of guideline-recommended HR lowering medications, HR control at discharge and predictors of HR control., Methods: In the present study, were Polish participants of the European Society of Cardiology HF Long-Term (ESC-HF-LT) Registry. Those selected were hospitalized for HF, with reduced ejection fraction (HFrEF) and SR at discharge (n = 236). The patients were divided in two groups ( < 70 and ≥ 70 bpm). Logistic regression was used to identify the predictors of HR ≥ 70 bpm., Results: Of patients with HFrEF and SR, 59% had HR ≥ 70 bpm at hospital discharge. At discharge, 96% and only 0.5% of the patients with HFrEF and SR received beta-blocker and ivabradine, respectively. In the HF groups < 70 and ≥ 70 bpm, only 11% and 4% of patients received beta-blocker target doses, respectively. There was no difference in the use of other guideline-recommended medications. Age, New York Heart Association class, HR on admission and lack of HR lowering medications were predictors of discharge HR ≥ 70 bpm., Conclusions: Heart rate control after hospitalization for HFrEF is unsatisfactory, which may be attributed to suboptimal doses of beta-blockers, and negligence in use other HR lowering drugs (including ivabradine).