Cardiorespiratory Exercise Research Articles

Importance of cardiac rehabilitation on cardiorrespiratory fitness in patients undergoing percutaneous aortic valve replacement

Abstract Background Percutaneous Aortic Valve Replacement (TAVR) significantly improves cardiac function in patients with severe aortic stenosis. However, the vast majority of these patients do not reach an adequate functional class despite the valve change, due to the deterioration of hemodynamic function and the repercussions of afterload over time. Cardiac rehabilitation (CR) program is an interdisciplinary intervention aimed at restoring functionality in Post-TAVR patients and the key to optimizing the recovery and enhancing cardiorrespiratory fitness (CRFit). The Purpose of the study is to provide an analysis of the effects of CR on exercise capacity and CRFit in TAVR patients. Methods Quasi-experimental study in TAVR patients that underwent a 4-6 week CR program, including personalized aerobic and strength training. Outcomes assessed pre- and post-rehabilitation included VO2 max, ventilatory thresholds (VT1 and VT2), and exercise capacity. The study also evaluated METs efficiency by comparing actual to predicted METs values before and after the therapy, alongside expired gas analysis test to examine exercise tolerance and its relation to VO2max gains. Results A total of 28 patients were analyzed, with an average age of 73 years (±8.1), initial weight of 68 kg (±12.32), and final weight of 65 kg (±11.13). The average ejection fraction (EF) from echocardiographic parameters was 62% (±10.1). All patients underwent cardiopulmonary exercise testing (CPET) after post-TAVR with improvements in CRFit. Initial exercise test parameters showed an average METs-load at 8.1 (±1.98), VO2max at 4.75 (±1.86), VT1 at 3.05 (±1.86), VAT at 3.85 (±1.62), VT2 at 4.5 (±2.28), and VE/VCO2 at 38 (±5.32). Final test parameters revealed VO2max at 5.8 (±2.09), VT1 at 3.2 (±1.33), VAT at 4.65 (±1.60), VT2 at 5.15 (±2.3), and VE/VCO2 at 36.4 (±69.95). Pearson's correlation analysis between CPET variables and the percentage improvement of various exercise test parameters found no statistically significant correlation. Except for METs-load and final time in Bruce, which show a significant and inversely proportional correlation (r=-0.67, p< 0.001). Conclusions The study demonstrates the effect of cardiac rehabilitation program in enhancing cardiorespiratory fitness and exercise capacity in post-TAVR patients. Notably, improvements in VO2max and ventilatory thresholds highlight the program's efficacy in promoting cardiovascular health. The inverse correlation between initial time in Bruce and METs improvement underscores the importance of baseline exercise capacity in predicting rehabilitation outcomes. Our results allow us to conclude that training volume is not the only variable to consider for proper CR. This insight could guide personalized rehabilitation strategies, making a significant contribution to the field of cardiac recovery post-TAVR.Measured METsBruce time - METs correlation

Validation of the CRAVE-C scale in Chinese adults: a four-study examination of competing motivations for physical activity versus rest

BackgroundThe study aimed to validate the Cravings for Rest and Volitional Energy Expenditure (CRAVE) scale among Chinese adults with different health conditions (healthy control, chronic illnesses, and psychiatric disorders) and skill levels (athletes vs. non-athletes).MethodsIn Study 1, a confirmatory factor analysis (CFA) using the Maximum Likelihood Method (MLM) was performed on a Chinese sample of emerging adults (N = 481) to evaluate the structural validity of the Cravings for Rest and Volitional Energy Expenditure-Chinese version (CRAVE-C). In Study 2, differences in “Move” and “Rest” desires were examined among patients with psychiatric disorders, patients with chronic illnesses, and healthy controls. In study 3, investigated the relationship between cardiorespiratory fitness and exercise motivation using the CRAVE-C (N = 83). In Study 4, the changes in “Move” desire from baseline to post-training were compared between athletes and non-athletes.ResultsResults from Study 1 indicated that the 10-item CRAVE-C showed good fit indices (Chi2 (34) = 118.769, CFI = 0.95, TLI = 0.934, SRMR = 0.053, RMSEA = 0.072). “Move” positively correlated with various factors of the Affective Exercise Experiences Questionnaire-Chinese and the Physical Effort Scale-Chinese, while “Rest” correlated negatively. In Study 2, Patients with psychiatric disorders had a significantly higher “Move” desire than healthy controls. Patients with chronic illnesses had a significantly higher “Rest” desire than healthy controls. In Study 3, higher cardiorespiratory fitness was associated with a slight increase in “Move” desire (3.26% ± 37.35%) and a decrease in “Rest” desire (18.94% ± 66.99%). Lower fitness was linked to a significant decline in “Move” desire (−54.61% ± 111.33%) and an increase in “Rest” desire (43.62% ± 63.64%). In Study 4, the athlete group demonstrated a significant increase in “Move” desire from baseline to post-training, whereas the non-athlete group reported a significant decrease in “Move” desire from baseline to post-training.ConclusionThe 10-item CRAVE-C has good reliability and validity in the Chinese cultural context and can be used among Chinese adults with different health conditions and skill levels.

Value of preparticipation cardiovascular evaluation of master athletes by self-reported symptoms and cardiovascular risk-score

Purpose The risk of sudden cardiac death (SCD) is increased during endurance competitive sports. Coronary artery disease (CAD) is the most common cause of SCD in master athletes ≥ 35 years old (MAs). To reduce the risk of SCD self-assessment of symptoms by questionnaire, and evaluation of cardiovascular risk-score, are recommended as pre-participation cardiovascular evaluation (PCVE). We aimed to examine whether PCVE predicts CVD in MAs with or without increased risk as measured by validated score instruments. Methods We performed a single-site observational cohort study of healthy MAs based on findings at PCVE. They were allocated in two different groups: those MAs with reported symptoms on the questionnaire and/or with elevated cardiovascular risk score were allocated to a symptom group (SG), while MAs with no symptoms, nor raised risk score were defined as control group (CG). Thereafter, all were examined with extended examinations: resting-ECG, cardiorespiratory exercise testing and echocardiography. Results Total, 81 (18 women) MAs participated in the study. There were no differences at baseline between SG (n = 39) and CG (n = 42); sex (p = 0.11), age (55.0 ± 9.8 vs. 51.9 ± 11.1 years; p = 0.18), maximal oxygen uptake (49.8 ± 7.6 vs. 51.6 ± 7.0 ml/kg/min; p = 0.26), resting heart rate (61.4 ± 12.8 vs. 60.2 ± 11.0/min; p = 0.66), training hours/week (7.0 ± 3.2 vs. 7.1 ± 3.1; p = 0.88). After further examination, sixteen (20%) MAs were found with CVD: 12 in SG, 4 in CG (p = 0.024). The negative predictive value and specificity of the PCVE were 90% and 58%, respectively. Conclusion Negative findings on PCVE by questionnaire and cardiovascular risk-score may be a strategy to exclude subjects from preparticipation screening, thus saving resources.

Post-exercise T Cell Response Influenced By Absolute Intensity In Resistance Exercise But Not Cardiorespiratory Exercise

Post-exercise T Cell Response Influenced By Absolute Intensity In Resistance Exercise But Not Cardiorespiratory Exercise

Impact of age and sex on heart rate variability and cardiometabolic function in healthy adults

Heart rate variability (HRV) is a non-invasive measure of cardiac autonomic function. A clearer understanding as to whether resting autonomic function represented by HRV could be associated with changes in peak exercise cardiac function remains unanswered. This study evaluated the effect of age and sex on HRV, cardiometabolic function, and determined the correlation between HRV and cardiac function in healthy individuals. Sixty-eight participants (age range: 19–78 years old, females, n = 28) were recruited. Participants were stratified according to age (younger (<40 years old, n = 43, females, n = 17) and older age groups (>55 years old, n = 25, females, n = 11). Firstly, HRV was measured using non-invasive impedance cardiography method (TaskForce, CNSystems, Graz, Austria) and recorded at rest (supine position) for 30 min. HRV measures included: low frequency (LF) power, high frequency (HF) power (both normalised (nu) and absolute units (ms2)) and LF/HF ratio. Participants then completed a progressive cardiorespiratory exercise test using a semi-recumbent cycle ergometer (Corival, Lode, Groningen, Netherlands) with simultaneous gas exchange measurements (Metalyzer 3B, Cortex, Leipzig, Germany). Cardiac function was represented by peak exercise cardiac power output index (CPO). After controlling for body mass index and physical activity, males had significantly higher mean vales of RR interval than females (males = 1043 ± 165; females = 952 ± 128 ms, p = 0.02). There was no significant main effect of age, sex or their interaction on any of the other HRV measures. In younger and older females, resting RR interval had a significant relationship with peak exercise CPO (young females: r = 0.54, p < 0.05; old females: r = 0.81, p < 0.01). There was also a significant relationship between resting HF power and peak exercise CPO in younger females (r = 0.70, p < 0.01). HRV was not influenced by age but RR interval was associated with peak exercise CPO in females regardless of age, whilst HF power was significantly associated with CPO in younger females only.

Comparative effectiveness of exercise on cardiorespiratory function or exercise efficiency after stroke: A network meta-analysis of randomized control trials.

The network meta-analysis (NMA) was to compare and rank the effectiveness of different exercises on cardiorespiratory function or exercise efficiency in post-stroke patients. A NMA of randomized controlled trials (RCTs) was conducted. PubMed, Embase, Cochrane Library, and Web of Science were searched. The impact of exercises including individual and combination of aerobic exercise (AE), resistance exercise (RE), task-oriented training (TOT), gait training (GT), breathing exercise (BE), and regular rehabilitation training (RRT) on 6-min walk test (6MWT), peak oxygen consumption (VO2peak), maximum oxygen consumption (VO2max), resting heart rate (HRrest), resting systolic blood pressure (SBPrest), and resting diastolic blood pressure (DBPrest) were assessed. In total, 36 studies were included in the meta-analysis. AEGT (AE + GT) (63.06%) had the highest likelihood of improving 6MWT performance in post-stroke patients. RRTRE (RRT + RE) was the most favourable exercise in terms of 6MWT performance assessing by minimum clinically significant difference (MCID). AERE (AE + RE) had the highest likelihood of improving VO2peak and reducing HRrest in post-stroke patients. Different types of exercise demonstrated the benefits of improving cardiorespiratory function in stroke patients. Further research is needed to determine the best exercise regimen to maximize the benefits of rehabilitation interventions for post-stroke patients.

Two sides of the same runner! The association between biomechanical and physiological markers of endurance performance in distance runners

BackgroundThe number of people who run to achieve competitive performance has increased, encouraging the scientific community to analyze the association of factors that can affect a runner performance. Research QuestionIs there association between running spatiotemporal and angular kinematics with the physiological markers of endurance performance during a cardiorespiratory exercise test? MethodsThis was an observational cross-sectional study with 40 distance runners simultaneously submitted to a running biomechanical analysis and cardiorespiratory exercise test on a treadmill. Mixed models were developed to verify the association between angular kinematic data obtained by the Movement Deviation Profile and the running spatiotemporal data with oxygen consumption and ventilatory thresholds. ResultsSpatiotemporal variables [.e., step frequency Odds Ratio 0.09 [0.06–0.12 95 % Confidence Interval], center of mass vertical displacement Odds Ratio 0.10 [0.07–0.14 95 % Confidence Interval], and step length [Odds Ratio −0.01 [-0.01 to −0.00 95 % Confidence Interval]] were associated with VO2. Also, step frequency Odds Ratio 1.03 [1.01–1.05 95 % Confidence Interval] was associated with the first ventilatory threshold, and angular running kinematics [Movement Deviation Profile analysis] Odds Ratio 1.47 [1.13–1.91 95 % Confidence Interval] was associated with peak of exercise during the cardiorespiratory exercise test. SignificanceOur findings demonstrated that: both higher step frequency and center of mass vertical displacement are associated with the increase of oxygen demand; step frequency is associated with the first ventilatory threshold, due to the entrainment mechanism and angular kinematic parameters are associated with peak aerobic speed. Future studies could also compare the biomechanical and physiological characteristics of different groups of distance runners. This could help identify the factors that contribute to oxygen demands during running and performance across different ages, genders, and levels of competition.

EFFECTS OF CARDIAC REHABILITATION IN PATIENTS WITH VENTRICULAR ASSIST DEVICES: A SCOPING REVIEW

Introduction Ventricular assist devices represent a treatment option for patients with advanced heart failure, offering control over various haemodynamic variables. Similarly, the prescription of exercise within a cardiac rehabilitation programme for heart failure patients is recommended to reduce symptoms, hospitalisations, improve cardiorespiratory fitness, and increase exercise tolerance. Therefore, exercise prescription can impact those with ventricular assist devices. Given the limited evidence on exercise-based cardiac rehabilitation programmes for this population, this review aims to describe the most commonly used strategies and their health benefits when physical exercise is included in a cardiac rehabilitation programme for patients with ventricular assist devices. Materials and Methods An exploratory review was conducted through searches in the databases: PubMed, SCOPUS, PeDro, and ScienceDirect. The search was limited to studies published between 2013 and 2023. Filters were applied independently by title, abstract, and full text. The included articles were analysed based on the description of the types of cardiac rehabilitation strategies used in patients with ventricular assist devices. Results Seven articles were included. Each programme employed a cardiopulmonary exercise test before prescribing physical exercise. The most commonly used strategy was aerobic exercise, predominantly high-intensity interval training (HIIT) with intensities close to 90% of peak VO2, followed by continuous moderate-intensity exercise. Limb strength exercises were included in three programmes. Conclusions The analysed literature suggests that cardiac rehabilitation in patients with ventricular assist devices is safe and can provide benefits in cardiorespiratory fitness and exercise tolerance. High-intensity interval training is identified as an appropriate strategy for achieving results, offering short-term improvements.

ZOom Delivered Intervention Against Cognitive decline (ZODIAC) COVID-19 pandemic adaptations to the Post-Ischaemic Stroke Cardiovascular Exercise Study (PISCES): protocol for a randomised controlled trial of remotely delivered fitness training for brain health

BackgroundStroke increases subsequent dementia risk yet there are no specific post-stroke therapies to protect cognition. Cardiorespiratory exercise is recommended for secondary prevention of stroke and may be neuroprotective. The Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES) aims to reduce post-stroke secondary neurodegeneration and cognitive decline. During the pandemic, we pivoted to a ZOom Delivered Intervention Against Cognitive decline (ZODIAC) protocol, reducing pandemic-amplified barriers to exercise.MethodsWe present pandemic adaptions for a multicentre phase IIb assessor-blinded randomised controlled trial of ischaemic stroke survivors testing the efficacy and feasibility of an 8-week home-based exercise intervention delivered at 2 months post-stroke. We compare cardiorespiratory exercise (intervention arm) versus balance and stretching (active control arm). Participants are assessed with magnetic resonance imaging (MRI), fitness, blood, microbiome, and neuropsychological tests at three study visits: before and after the exercise intervention and at 12 months. Modifications to the original protocol include pre-exercise safety home visits, commercial delivery of exercise equipment to facilitate assessor blinding, and reconsideration of statistical plan to allow pooling of the studies. We have reduced in-person study visits from 27 to 3. Primary outcome remains between-group (intervention versus control) difference in brain volume change; secondary outcome is between-group difference in global cognitive ability to allow remote administration of a validated cognitive scale.DiscussionRemotely delivered exercise interventions reduce participant burden and may reduce barriers to recruitment. A decrease in the number of in-person study visits can be supported by greater information capture via self-reported questionnaires and phone surveys.Trial registrationProspectively ACTRN12616000942459. Registered on July 2016.

Возрастные особенности аэробных возможностей организма у спортсменов с разной направленностью физических нагрузок

The purpose of this study was to identify age-related features of aerobic capacity in athletes working on their endurance or speed-strength qualities. Materials and methods. The research involved 103 male athletes, who were divided into groups according to the type of physical activity (endurance (n = 58) and strength-speed (n = 45)) and age (12–15, 16–18 and 19–26 years). Their aerobic capacity was determined using cardiorespiratory exercise testing. Results. It was shown that the increase in relative peak oxygen consumption (VO2peak) was influenced not so much by age as by the type of physical activity (ANOVA: F = 18.1, p = 0.00004). At the same time, respiratory coefficient (F = 5.6, p = 0.007), heart rate at anaerobic threshold (F = 4.9, p = 0.009), tidal volume (F = 7.5, p = 0.01) and minute ventilation (F = 6.6, p = 0.002) were influenced mainly by age. In athletes aged 12–15 years, factor analysis established a negative correlation of type of physical activity with oxygen pulse, while physical working capacity was positively correlated with breathing parameters. Subjects aged 16–18 years showed no significant correlations between the variables and type of physical activity; at the same time, the number of correlations between ergometry parameters and physical working capacity factor increased with age. In athletes aged 19–26, the variables correlated strongly with the type of physical activity; the contribution of VO2peak to the physical working capacity factor is clearly demonstrated. The development of aerobic capacity is mainly influenced by the type of physical activity. However, in athletes aged 12–15 years, aerobic loads do not lead to a significant increase in VO2peak. The greatest increase in VO2peak is observed in 16–18-year-olds, while after 18 years of age, its growth halts.

Progressive overload in cardiorespiratory exercise training for young and old: Is increasing duration or intensity of exercise more important?

People undertake endurance training to improve their health and cardio-respiratory fitness. Subsequent cardio-respiratory and skeletal muscle aerobic metabolic adaptations are gauged by improvements in maximum or peak oxygen uptake (V̇O2peak) and the blood lactate inflection point or threshold during incremental exercise – (LIP). To further improve physiological capability, subsequent homoeostatic disturbances from exercise should be progressively greater in succeeding exercise sessions. Therefore, exercise duration, frequency or intensity should be progressively increased during a training regimen to ensure adaptation potential is realized. A progressive increase in training workload is termed “progressive overload”. Despite the universal acknowledgment of the importance of progressive overload, it is unclear if systematically progressing altering either exercise intensity or duration (or distance covered) affect cardio-respiratory gains differently in young and older populations. As running faster results in higher heart rates and greater skeletal muscle metabolic stress than running the same distance at a lower speed, in this hypothesis we postulate that progressively increasing exercise run intensity will result in greater mean and higher incidence of V̇O2peak and LIP gains in young adults (<50 years). However, the mechanisms that initiate improvements in cardio-respiratory fitness and skeletal muscle aerobic function may be different in older adults due to the inevitable aging decline in cardio-vascular function and mechanical and morphological properties of muscle–tendon units. In older adults (>60 years) we hypothesize progressively increasing run distance while maintaining the same speed will just be as effective as to progressively increasing speed to improve V̇O2peak and LIP. To test these hypotheses, we propose a study that compares progressively increasing run intensity to a treatment of progressive matched run distance where speed remains constant in young and old adults.

Effect of Right Nostril Breathing on Cardiorespiratory Parameters and Reaction Time in Young, Healthy Humans: An Interventional Study.

Yogic breathing helps in reduction of stress and strain in the body. Right and left nostril breathings (RNB and LNB, respectively) have different effects on cardiorespiratory parameters. The study was performed to examine the effect of RNB exercise on cardiorespiratory parameters and reaction time in young, healthy human volunteers. In this prospective, interventional study, 110 young healthy volunteers underwent systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), respiratory rate (RR), vital capacity (VC), peak expiratory flow rate (PEFR), and reaction time (RT) examination before and after 2 weeks of performing 45 min of RNB exercise daily. There was notable increment in SBP (113.39 ± 17.72 vs. 117.74 ± 10.83 mmHg, P = 0.002) and DBP (67.64 ± 10.32 vs. 71.27 ± 8.68 mmHg, P = 0.002). PR increased nonsignificantly (86.44 ± 12.65/min vs. 87.32 ± 13.43/min, P = 0.476). Significant decrease in RR (14.40 ± 2.48/min vs. 12.31 ± 2.23/min, P < 0.0001) was observed. VC (3.57 ± 0.57 vs. 3.82 ± 0.55 L/min, P < 0.0001) and PEFR (441.36 ± 50.22 vs. 468.91 ± 53.66 L/min, P < 0.0001) also increased significantly. Substantial reduction in auditory reaction time (ART) (165.58 ± 32.18 vs. 147.42 ± 23.39 ms, P < 0.0001) and visual reaction time (VRT) (191.04 ± 37.94 vs. 165.86 ± 28.74 ms, P < 0.0001) was seen. After engaging in cardiorespiratory exercise, the maximal heart rate (MHR) remained unchanged (P = 0.929). RNB results in increase in blood pressure, heart rate, VC, and PEFR and decrease in ART and VRT. Further studies in patients with cardiorespiratory diseases are necessary to understand its clinical utility.

Effects of a Transoceanic Rowing Challenge on Cardiorespiratory Function and Muscle Fitness.

Ultra-endurance sports and exercise events are becoming increasingly popular for older age groups. We aimed to evaluate changes in cardiac function and physical fitness in males aged 50-60 years who completed a 50-day transoceanic rowing challenge. This case account of four self-selected males included electro- and echo-cardiography (ECG, echo), cardiorespiratory and muscular fitness measures recorded nine months prior to and three weeks after a transatlantic team-rowing challenge. No clinically significant changes to myocardial function were found over the course of the study. The training and race created expected functional changes to left ventricular and atrial function; the former associated with training, the latter likely due to dehydration, both resolving towards baseline within three weeks post-event. From race-start to finish all rowers lost 8.4-15.6 kg of body mass. Absolute cardiorespiratory power and muscular strength were lower three weeks post-race compared to pre-race, but cardiorespiratory exercise economy improved in this same period. A structured program of moderate-vigorous aerobic endurance and muscular training for>6 months, followed by 50-days of transoceanic rowing in older males proved not to cause any observable acute or potential long-term risks to cardiovascular health. Pre-event screening, fitness testing, and appropriate training is recommended, especially in older participants where age itself is an increasingly significant risk factor.

High-intensity acute exercise impacts motor learning in healthy older adults

Healthy aging is associated with changes in motor sequence learning, with some studies indicating decline in motor skill learning in older age. Acute cardiorespiratory exercise has emerged as a potential intervention to improve motor learning, however research in healthy older adults is limited. The current study investigated the impact of high-intensity interval exercise (HIIT) on a subsequent sequential motor learning task. Twenty-four older adults (aged 55–75 years) completed either 20-minutes of cycling, or an equivalent period of active rest before practicing a sequential force grip task. Skill learning was assessed during acquisition and at a 6-hour retention test. In contrast to expectation, exercise was associated with reduced accuracy during skill acquisition compared to rest, particularly for the oldest participants. However, improvements in motor skill were retained in the exercise condition, while a reduction in skill was observed following rest. Our findings indicate that high-intensity exercise conducted immediately prior to learning a novel motor skill may have a negative impact on motor performance during learning in older adults. We also demonstrated that exercise may facilitate early offline consolidation of a motor skill within this population, which has implications for motor rehabilitation.

The First Season After the COVID-19 Pandemic Cardiorespiratory and Statistics’ Performance in Czech Ice Hockey Players

The study describes the cardiorespiratory and statistics performance of ice hockey players during the season of 2020 after the COVID-19 lockdown’. Eight elite Czech male players (4 non-COVID-19 and 4 COVID-19 groups) were evaluated before and after the competition season. Players performed a cardiorespiratory exercise test and the maximal oxygen consumption, ventilatory threshold, respiratory compensation point, maximal heart rate and test time were measured. The number of matches, goals and plus/minus statistics were retained. No significant differences between groups before and after the season for all cardiorespiratory responses were found, and the no-COVID-19 group played more games. The conclusion highlights that the cardiorespiratory performance place all players (with and without COVID-19 history) in similar conditions to be prepared for the next season. Due to a wide variation among players’ statistics, based on plus/minus parameters, cannot be established that the 2020 season impaired the players’ statistics.

HIIT vs. MICT to Improve Cardiorespiratory Fitness and Exercise Capacity in Older Adult

HIIT vs. MICT to Improve Cardiorespiratory Fitness and Exercise Capacity in Older Adult

Exercising with a Surgical Mask is Safe but Decreases Performance in Both Athletic and Non-Athletic Individuals

Introduction: Upper respiratory tract infections (URTI) are common medical problems in athletes. Many athletes with URTI continue to train at high-levels and even compete. Using a mask as an additional measure may be beneficial to prevent the spreading of infection among teammates. However, there are many concerns about the effects of mask use on exercise safety and performance. Although some studies have investigated the effects of masks on performance in healthy individuals, studies in athletes are even more limited. Thus, we aimed to evaluate the impact of surgical masks on performance and safety during a cardiorespiratory exercise test (CPET) test applied to both athletes and non-athletes. Patients and Methods: A cross-over, non-randomized study was designed. The study was conducted in two phases. In phase 1, the CPET was performed without using a surgical mask. In phase 2, CPET was performed with a surgical mask in addition to the spiro mask 48 hours after the first test. Thirty participants aged 18-35 were included in the study. They were further divided as athletes (n= 17) and non-athletes (n= 13) subgroups. Results: Significant decreases were observed in some parameters of submaximal exercise [VEan, BFan, VE/ VO2 , VE/VCO2 (p&lt; 0.001)] and in maximal exercise [VEmax, BFmax, TVmax, VE/VO2 , VE/VCO2 (p&lt; 0.001)]. There were also significant decreases in VO2 levels (VO2 an, VO2 max) when compared with and without a surgical mask in both submaximal and maximal exercise (p&lt; 0.001). Additionally, PETO2 decreased, and PETCO2 increased in maximum exercise (p&lt; 0.001), whereas no significant changes were detected at the submaximal level. In subgroup analysis, VEan, VEmax, VO2 an, VO2 max parameters were decreased in athletes compared to non-athletes in surgical masked tests. Conclusion: Surgical masks for athletes and non-athletes decrease performance but have no detrimental effect on cardiorespiratory parameters. Athletes should be aware of this negative effect when high-level performance is demanded.

Comparative study of the effects of left ventricular and biventricular pacing on indices of cardiac function and clinical status of heart failure patients: preliminary results of READAPT study

Abstract Nonresponse to cardiac resynchronization therapy (CRT) has been related with right ventricular dysfunction. Preferential left ventricular pacing (pLVP) can overcome iatrogenic right ventricular dysfunction by achieving left ventricle resynchronization and by allowing for intrinsic activation of the right side, with ramifications extending beyond cardiac output and atrial fibrillation occurrence. Moreover, the AdaptivCRT® algorithm also automatically adjusts interventricular (V-V) delay every minute, optimizing it by means of comparing relative activation delay between right and left ventricles (electrically – driven optimization). In the present study we evaluated the effects of a pLVP algorithm on 50 heart failure patients (all Caucasians, 49% male; 66 +/- 8 years old; 46% ischemic cardiomyopathy; 41% diabetics; NYHA II-III) following randomization to standard biventricular pacing and pLVP, on echocardiographic and cardiopulmonary exercise test indices of functional status, as well as a self-reported quality of life questionnaire. Device programming was based on echocardiography-evaluated maximization of stroke volume and subsequent interventricular and atrioventricular delay adjustments delegated to the device. The follow-up consisted of 6 and 12-months visits; after the 1rst month of optimizing maximum CRT response. Results Significant comparative effects of LVP over optimized CRT were noted regarding RV systolic velocity in TDI even from 6-months from baseline (6% increase, p=0.01); while end-systolic diameter of left ventricle was increased by 4% in 6-months in CRT group (p=0.01), while no significant difference was observed in LVP group. At 12 months endsystolic volume was significantly decreased (16%, p=0.01) and left ventricular systolic longitudinal strain was improved in 12 months in LVP group compared to CRT group (p- for interaction =0.001). Additionally, in cardiorespiratory exercise test LVP group showed improved inotropic reserve compared to CRT group according to maximum SBP achieved (20% increase, p&amp;lt;0.01 for interaction); while all other cardiorespiratory indices shoed borderline significant changes at 12 -months. Minnesota score was significantly reduced in LV-P group by 70% at 6-months; whereas no significant change was observed in CRT group (p for interaction &amp;lt;0.01). Conclusions In the preliminary findings of READAPT study, it seems that LV pacing optimized by a standardized echocardiographic protocol in patients with preserved AV conduction, LBBB, can achieve a higher percentage of synchronized LV pacing associated with improved patient quality of life; right ventricular function and endsystolic volume at 6 and 12-months of follow-up, over echo-optimized CRT pacing.

Effect of arterial hypertension in cardiopulmonary status and right ventricle function after hospitalization for Sars-Cov-2

Abstract Introduction There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN). Purpose The purpose of our study was to investigate whether hospitalization for COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection. Methods All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization. Results Out of total population of 198 patients with COVID19 infection, sixty-two subjects were hypertensives (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) who were evaluated 3 months after the symptoms onset. Of demographic characteristics in hospitalized patients, only age (63±8 vs. 52±11 years, p&amp;lt;0.001) was significantly higher. When analyzing cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p:0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p:0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hypertensives despite the fact that left ventricle ejection fraction was similar between two groups probably due to small sample size. Using linear regression analysis adjusted for age, gender, hospitalization, and LVEF, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients. Conclusion To conclude our study highlighted negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.

Ageing attenuates exercise-enhanced motor cortical plasticity.

Cardiorespiratory exercise is known to modulate motor cortical plasticity in young adults, but the influence of ageing on this relationship is unknown. Here, we compared the effects of a single session of cardiorespiratory exercise on motor cortical plasticity in young and older adults. We acquired measures of cortical excitatory and inhibitory activity of the primary motor cortex using transcranial magnetic stimulation (TMS) from 20 young (mean±SD = 25.30 ± 4.00 years, 14 females) and 20 older (mean±SD = 64.10 ± 6.50 years, 11 females) healthy adults. Single- and paired-pulse TMS measurements were collected before and after a 20min bout of high-intensity interval cycling exercise or an equivalent period of rest, and again after intermittent theta burst stimulation (iTBS). In both young (P = 0.027, Cohen's d = 0.87) and older adults (P = 0.006, Cohen's d = 0.85), there was an increase in glutamatergic excitation and a reduction in GABAergic inhibition from pre- to postexercise. However, in contrast to younger adults, older adults showed an attenuated plasticity response to iTBS following exercise (P = 0.011, Cohen's d = 0.85). These results demonstrate an age-dependent decline in cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults. Our findings align with the hypothesis that the capacity for cortical plasticity is altered in older age. KEY POINTS: Exercise enhances motor cortical plasticity in young adults, but how ageing influences this effect is unknown. Here, we compared primary motor cortical plasticity responses in young and older adults before and after a bout of high-intensity interval exercise and again after a plasticity-inducing protocol, intermittent theta burst stimulation. In both young and older adults, exercise led to an increase in glutamatergic excitation and a reduction in GABAergic inhibition. Our key result was that older adults showed an attenuated plasticity response to theta burst stimulation following exercise, relative to younger adults. Our findings demonstrate an age-dependent decline in exercise-enhanced cortical plasticity and indicate that a preceding bout of high-intensity interval exercise might be less effective for enhancing primary motor cortex plasticity in older adults.