Cardiovascular Responses Research Articles

Sex-Related Glycemic and Cardiovascular Responses After Continuous and Interval Aerobic Sessions in Patients With Type 1 Diabetes: A Randomized Crossover Study

We aimed to investigate sex-related glycemic and cardiovascular responses after intensity- (moderate) and duration- (30 minutes) matched interval aerobic exercise (IAE) and continuous (CAE) aerobic exercise sessions in patients with type 1 diabetes mellitus (T1DM). A total of 19 volunteers (10 women) participated in 2 randomized and crossover sessions (1:1). Heart rate, systolic and diastolic blood pressure, double product, and blood glucose (BG) levels were measured before (PRE), immediately after (POST-0), and 20 minutes after (POST-20) each session. The rates of perceived exertion (RPE) and enjoyment levels (ELs) were assessed after each session. Generalized estimating equations were used to analyze the data (condition × time × sex). Regarding sex-related changes, men showed BG reductions at POST-0 and POST-20 after CAE (∆: -3.7 and -3.7 mmol/L, respectively) and only at POST-0 after IAE (∆: -1.6 mmol/L), with 1 episode of hypoglycemia occurring in the latter group. In contrast, women showed reduced BG values only after CAE at both time points (∆: -1.4 and -1.7 mmol/L) compared with PRE values. The decrease in BG levels at both time points was higher for men after CAE than IAE. Cardiovascular responses, RPEs, and ELs were similar between exercise sessions, except for blood pressure, which showed higher values in men. In conclusion, lower BG levels were observed after CAE, with greater reductions in men. Similar cardiovascular, RPE, and EL responses were found across sexes and sessions. Consideration of sex-specific recommendations may be warranted when prescribing aerobic exercise, particularly, for men with irregular physical activity levels.

More efficient adaptation of cardiovascular response to repeated restraint in spontaneously hypertensive rats: the role of autonomic nervous system

We hypothesized that sympathetic hyperactivity and parasympathetic insuficiency in spontaneously hypertensive rats (SHR) underlie their exaggerated cardiovascular response to acute stress and impaired adaptation to repeated restraint stress exposure compared to Wistar-Kyoto rats (WKY). Cardiovascular responses to single (120 min) or repeated (daily 120 min for 1 week) restraint were measured by radiotelemetry and autonomic balance was evaluated by power spectral analysis of systolic blood pressure variability (SBPV) and heart rate variability (HRV). Baroreflex sensitivity (BRS) was measured by the pharmacological Oxford technique. Stress-induced pressor response and vascular sympathetic activity (low-frequency component of SBPV) were enhanced in SHR subjected to single restraint compared to WKY, whereas stress-induced tachycardia was similar in both strains. SHR exhibited attenuated cardiac parasympathetic activity (high-frequency component of HRV) and blunted BRS compared to WKY. Repeated restraint did not affect the stress-induced increase in blood pressure. However, cardiovascular response during the post-stress recovery period of the 7th restraint was reduced in both strains. The repeatedly restrained SHR showed lower basal heart rate during the dark (active) phase and slightly decreased basal blood pressure during the light phase compared to stress-naive SHR. SHR subjected to repeated restraint also exhibited attenuated stress-induced tachycardia, augmented cardiac parasympathetic activity, attenuated vascular sympathetic activity and improved BRS during the last seventh restraint compared to single-stressed SHR. Thus, SHR exhibited enhanced cardiovascular and sympathetic responsiveness to novel stressor exposure (single restraint) compared to WKY. Unexpectedly, the adaptation of cardiovascular and autonomic responses to repeated restraint was more effective in SHR.

Cardiovascular Responses to Occupational Physical Activity are Exaggerated by Work-Related Stress and Low Fitness.

Paradoxical associations between high occupational physical activity (OPA) and cardiovascular disease may be explained by exaggerated cardiovascular responses from high work-related stress or low worker fitness. OPA, blood pressure (BP), heart rate (HR), and rate-pressure product (HR x BP, RPP) were measured objectively for 24-hours in nineteen male workers. Work-related stress was measured using the Stress-in-General Scale. Fitness was estimated using a submaximal treadmill test. Effect modification by work-related stress and fitness on associations between OPA and cardiovascular responses was examined using mixed models with interactions. Associations between OPA and RPP, HR, and BP were stronger with high stress (p < 0.05). Associations of work-time MVPA and RPP were attenuated with higher fitness (p < 0.05). OPA performed under high work-related stress or by workers with low fitness may exaggerate cardiovascular responses to OPA.

The Experimental Pain Experienced in a Cold Pressor Task Is Influenced by Hemoglobin Levels in Young Adult Females.

The intensity of pain perceived for the same noxious stimulus is different in different persons, depending on the biological, psychological, and social factors related to the individual. In clinical practice, it is important to know the factors influencing pain perception. The presence of anemia may affect pain perception. This study was conducted on 73 female subjects of whom 25 were non-anemic, 24 had mild, and 24 had moderate anemia. Experimental pain was produced by cold pressor task (CPT). Pain response was evaluated in terms of cardiovascular reactivity (CVR - changes in blood pressure and heart rate), and pain sensitivity (PS - pain threshold, pain tolerance, and pain rating). Anemic subjects showed higher CVR to stress. The average increase in systolic blood pressure was 5.28 mm of Hg in non-anemic, compared to 3.25 in mildly anemic and 9.00 mm of Hg in moderately anemic subjects. The average increase in diastolic blood pressure was 2.24 mm of Hg in non-anemic, 2.5 in mildly anemic, and 4.83 mm of Hg in moderately anemic subjects. The average increase in heart rate was 2.88 beats per minute (bpm) in non-anemic, 4.83 in mildly anemic, and 7 bpm in moderately anemic subjects. Pain rating was higher in anemic subjects (average 7.21) compared to the non-anemic subjects (average 6.44). CPT-induced pain causes greater cardiovascular reactivity in anemic patients. The average pain rating is higher in anemic subjects.

A descending pathway from the lateral/ventrolateral PAG to the rostroventral medulla mediating the vasomotor response evoked by social defeat stress in rats.

The stress-induced cardiovascular response is based on the defensive reaction in mammals. It has been shown that the sympathetic vasomotor pathway of acute psychological stress is indirectly mediated via neurons in the rostroventral medulla (RVM) from the hypothalamic stress center. In this study, direct projections to the RVM and distribution of neuroexcitatory marker c-Fos-expressed neurons were investigated during social defeat stress (SDS) in conscious rats. The experimental rat that was injected with a neural tracer, FluoroGold (FG) into the unilateral RVM, was exposed to the SDS. Double-positive neurons of both c-Fos and FG were locally distributed in the lateral/ventrolateral periaqueductal gray matter (l/vl PAG) in the midbrain. These results suggest that the neurons in the l/vl PAG contribute to the defensive reaction evoked by acute psychological stress, such as the SDS. During the SDS period, arterial pressure (AP) and heart rate (HR) showed sustained increases in the rat. Therefore, we performed chemical stimulation by excitatory amino acid microinjection within the l/vl PAG and measured cardiovascular response and sympathetic nerve activity in some anesthetized rats. The chemical stimulation of neurons in the l/vl PAG caused significant increases in arterial pressure and renal sympathetic nerve activity. Taken together, our results suggest that neurons in the l/vl PAG are a possible candidate for the cardiovascular descending pathway that modulates sympathetic vascular resistance evoked by acute psychological stress, like the SDS.NEW & NOTEWORTHY The sympathetic vasomotor pathway of an acute psychological stress-induced cardiovascular response is mediated via neurons in the RVM indirectly from the hypothalamus. In this study, we showed the relaying area of the efferent sympathetic vasomotor pathway from the hypothalamus to the RVM. The results suggested that the pressor response during psychological stress is mediated via neurons in the lateral/ventrolateral PAG to the RVM.

Blunted brachial blood flow velocity response to acute mental stress in PTSD females.

Post-traumatic stress disorder (PTSD) is associated with increased cardiovascular disease (CVD) risk. Compared with males, females are twice as likely to develop PTSD after trauma exposure, and cardiovascular reactivity to stress is a known risk factor for CVD. We aimed to examine hemodynamic responses to acute mental stress in trauma-exposed females with and without a clinical diagnosis of PTSD. We hypothesized that females with PTSD would have higher heart rate (HR), blood pressure (BP), and lower blood flow velocity (BFV) responsiveness compared with controls. We enrolled 21 females with PTSD and 21 trauma-exposed controls. We continuously measured HR using a three-lead electrocardiogram, BP using finger plethysmography, and brachial BFV using Doppler ultrasound. All variables were recorded during 10 min of supine rest, 5 min of mental arithmetic, and 5 min of recovery. Females with PTSD were older, and had higher BMI and higher resting diastolic BP. Accordingly, age, BMI, and diastolic BP were covariates for all repeated measures analyses. Females with PTSD had a blunted brachial BFV response to mental stress (time × group, p = 0.005) compared with controls, suggesting greater vasoconstriction. HR and BP responses were comparable. In conclusion, our results suggest early impairment of vascular function in premenopausal females with PTSD.

The Use of Virtual Reality in Stable Sitting Trunk Rehabilitation for Stroke Patients: A Pilot Study

INTRODUCTION: Virtual reality (VR) holds promise for stroke rehabilitation. However, many existing VR systems requires users to stand while playing, posing a potential falling risk for stroke patients. This study investigated the effects of a custom-developed VR system that focus on trunk rehabilitation in stable sitting position on muscle activities, postural control, and physiological cost compared to conventional trunk exercises in stroke patients. MATERIALS AND METHODS: A cross-sectional observational pilot study was conducted involving 12 paretic stroke subjects performing four exercises: two Conventional Trunk Exercises (CTE) and two VR-based Trunk Exercises (VRTE) using customized Tilt-The-Maze (self-paced) or Catch-The-Mole (game-paced) games. Muscle activity was measured using electromyography (EMG). Postural control data in the Anterior-Posterior (AP) and Medio-Lateral (ML) axes was recorded using a force plate, while the physiological cost was measured via a heart rate sensor during the exercises. RESULTS: The results indicated low muscle activity and light-intensity cardiovascular responses in all CTE and VRTE exercises. Game-paced VRTE recorded slightly higher Center of Pressure (CoP) velocity in the AP and ML axes versus CTE (AP:4.40±1.80 vs. 4.02±1.20 cm/s; ML:6.40±2.54 vs. 5.42±2.21 cm/s). In contrast, the self-paced VRTE showed an insignificant impact on postural control than both CTE and game-paced VRTE. CONCLUSION: The game-paced VRTE induced comparable effects on muscular activation, postural control, and physiological cost to that of CTE in stroke patients. The findings suggest the stable-sitting VR system as a supplementary approach to the existing trunk rehabilitation protocols for stroke patients.

Effects of Resistance Exercise with and without Blood Flow Restriction on Acute Hemodynamic Responses: A Systematic Review and Meta-Analysis.

Low-load intensity resistance exercise with blood flow restriction (BFR) is an alternative method for enhancing strength and muscle mass. However, acute cardiovascular responses to a complete training session remain uncertain compared to high-load intensity resistance exercise (HI). Therefore, the objective of this study to examine acute and post-exercise hemodynamic responses to low-load BFR and HI protocols. This systematic review and meta-analysis (RD42022308697) followed PRISMA guidelines to investigate whether the responses of heart rate (HR), blood systolic (SBP), blood diastolic pressure (DBP), and rate pressure product (RPP) immediately after and up to 60 min post-exercise from BFR were consistent with those reported after resistance exercises performed at HI in healthy individuals. Searches using PICO descriptors were conducted in databases from January 2011 to December 2023, and effect sizes were determined by Hedge's g. The selected studies involved 160 participants in nine articles, for which the responses immediately after BFR and HI exercises showed no differences in HR (p = 0.23) or SBP (p = 0.57), but significantly higher DBP (p < 0.01) and lower RPP (p < 0.01) responses were found when comparing BFR to HI. Furthermore, the BFR and HI protocols showed no differences regarding SBP (p = 0.21) or DBP (p = 0.68) responses during a 15 to 60 min post-exercise period. Thus, these results indicated that hemodynamic responses are similar between BFR and HI, with a similar hypotensive effect up to 60 min following exercise.

Retrospective case-control non-inferiority analysis of ultrasound-guided erector spinae plane block in dogs undergoing mini-hemilaminectomy for intervertebral disc disease.

Veterinary medicine has seen significant advancements in locoregional anaesthesia and pain management, including the emergence of the erector spinae plane (ESP) block. However, limited clinical evidence exists on its efficacy and safety. This study compares ultrasound-guided ESP block (ESP group) with an intraoperative intravenous ketamine infusion analgesic protocol (CRI group) in dogs undergoing thoracolumbar mini-hemilaminectomy, focusing on intraoperative opioid consumption, cardiovascular response to surgical stimulation (CR), postoperative pain scores (PS), and postoperative opioid consumption. Retrospective, case-control, non-inferiority study conducted in a single centre. Data collected included demographics, bupivacaine dose, ESP block operator, intraoperative recorded variables (haemodynamic variables, CR, complications, rescue analgesia), pre- and postoperative analgesia, 24-hour PS and opioid administration, first food intake post-extubation and postoperative complications. Univariate and multiple regression analyses were applied. One-hundred dogs were included, 75 in the ESP group and 25 in the CRI group. Univariate analysis revealed no significant differences between treatment groups in terms of CR, PS, postoperative rescue analgesia, intraoperative and postoperative opioid consumption, or time to first meal intake. However, the multivariate regression analysis indicated that dogs receiving ketamine infusion had higher CR suspected to be nociception-related (p = 0.036), and higher postoperative opioid consumption (p = 0.013). Our study suggests that ultrasound-guided ESP block is as effective as intraoperative ketamine infusion providing perioperative analgesia in dogs undergoing thoracolumbar mini-hemilaminectomy for intervertebral disc disease. ESP group showed significantly lower CR suspected to be nociception-related intraoperatively and lower postoperative opioid consumption within the initial 24 hours.

The roles of exercise stress echocardiography for the evaluation of heart failure with preserved ejection fraction in the heart failure pandemic era.

Heart failure with preserved ejection fraction (HFpEF) accounts for nearly 70% of all HF and has become the dominant form of HF. The increased prevalence of HFpEF has contributed to a rise in the number of HF patients, known as the "heart failure pandemic". In addition to the fact that HF is a progressive disease and a delayed diagnosis may worsen clinical outcomes, the emergence of disease-modifying treatments such as sodium-glucose transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists has made appropriate and timely identification of HFpEF even more important. However, diagnosis of HFpEF remains challenging in patients with a lower degree of congestion. In addition to normal EF, this is related to the fact that left ventricular (LV) filling pressures are often normal at rest but become abnormal during exercise. Exercise stress echocardiography can identify such exercise-induced elevations in LV filling pressures and facilitate the diagnosis of HFpEF. Exercise stress echocardiography may also be useful for risk stratification and assessment of exercise tolerance as well as cardiovascular responses to exercise. Recent attention has focused on dedicated dyspnea clinics to identify early HFpEF among patients with unexplained dyspnea and to investigate the causes of dyspnea. This review discusses the role of exercise stress echocardiography in the diagnosis and evaluation of HFpEF.

Social participation is associated with a habituated blood pressure response to recurrent stress

Lower cardiovascular reactivity is a proposed marker of motivational dysregulation and is related to a range of adverse behavioural and health outcomes. Social participation is a form of motivated behaviour and represents the frequency in which an individual engages in social activities. Low social participation has recently been linked to lower cardiovascular responses to acute psychological stress. With recent work emphasizing the importance of assessing adaptation of the cardiovascular response to recurrent stress, the aim of the current study is to build on previous work by examining the relationship between social participation and cardiovascular stress response adaptation. This study utilised data from the Pittsburgh Cold Study 3 (PCS 3). Two hundred and thirteen participants (M = 30.13; SD = 10.85) completed a social participation measure and had their systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored across two separate standardized stress testing sessions. The testing sessions consisted of a 20-minute baseline and a 15-minute stress task. Results indicated that higher levels of social participation were associated with greater blood pressure habituation to recurrent stress, extending previous work identifying that social participation was associated with higher cardiovascular responses to stress. The present study identifies that those reporting greater levels of social participation may show enhanced stress tolerance when exposed to recurrent stress.

Decreased Extracellular Vesicle Vasorin in Severe Preeclampsia Plasma Mediates Endothelial Dysfunction.

Preeclampsia (PE) is a serious pregnancy complication affecting 5-8% of pregnancies globally. It is a leading cause of maternal and neonatal morbidity and mortality. Despite its prevalence, the underlying mechanisms of PE remain unclear. This study aimed to determine the potential role of vasorin (VASN) in PE pathogenesis by investigating its levels in extracellular vesicles (EV) and its effects on vascular function. We conducted unbiased proteomics on urine-derived EV from severe PE (sPE) and normotensive pregnant women (NTP), identifying differential protein abundances. Out of one hundred and twenty proteins with ≥ ±1.5-fold regulation at P<0.05 between sPE and NTP, we focused on Vasorin (VASN), which is downregulated in sPE in urinary EV, in plasma EV and in the placenta and is a known regulator of vascular function. We generated EV with high VASN content from both human and murine placenta explants (Plex EV), which recapitulated disease-state-dependent effects on vascular function observed when treating murine aorta rings (MAR) or human aortic endothelial cells (HAEC) with murine or human plasma-derived EV. In normal murine pregnancy, VASN increases with gestational age (GA), and VASN is decreased in plasma EV, in placenta tissue and in Plex EV after intravenous administration of adenovirus encoding short FMS-like tyrosine kinase 1 (sFLT-1), a murine model of PE (murine-PE). VASN is decreased in plasma EV, in placenta tissue and in EV isolated from conditioned media collected from placenta explants (Plex EV) in patients with sPE as compared to NTP. Human sPE and murine-PE plasma EV and Plex EV impair migration, tube formation, and induces apoptosis in human aortic endothelial cells (HAEC) and inhibit acetylcholine-induced vasorelaxation in murine vascular rings (MAR). VASN over-expression counteracts the effects of sPE EV treatment in HAEC and MAR. RNA sequencing revealed that over-expression or knock down of VASN in HAEC results in contrasting effects on transcript levels of hundreds of genes associated with vasculogenesis, endothelial cell proliferation, migration and apoptosis. The data suggest that VASN, delivered to the endothelium via EV, regulates vascular function and that the loss of EV VASN may be one of the mechanistic drivers of PE. What is NewVASN in circulating plasma EV in sPE is reduced compared with VASN content in plasma EV of gestational age-matched pregnant women.VASN is encapsulated and transported in EV and plays a pro-angiogenic role during pregnancy.VASN should be explored both for its pro-angiogenic mechanistic role and as a novel biomarker and potential predictive diagnostic marker for the onset and severity of PE.What Are the Clinical Implications?VASN plays a role in maintaining vascular health and the normal adaptive cardiovascular response in pregnancy. A decrease of VASN is observed in sPE patients contributing to cardiovascular maladaptation.Strategies to boost diminished VASN levels and/or to pharmacologically manipulate mechanisms downstream of VASN may be explored for potential therapeutic benefit in PE.The decrease in EV-associated VASN could potentially be used as a (predictive) biomarker for PE.

BNT12, a novel hybrid peptide of opioid and neurotensin pharmacophores, produces potent central antinociception with limited side effects

The development of multitarget opioid drugs has emerged as an attractive approach for innovative pain management with reduced side effects. In the present study, a novel hybrid peptide BNT12 containing the opioid and neurotensin (NT)-like fragments was synthesized and pharmacologically characterized. In acute radiant heat paw withdrawal test, intracerebroventricular (i.c.v.) administration of BNT12 produced potent antinociception in mice. The central antinociceptive activity of BNT12 was mainly mediated by μ-, δ-opioid receptor, neurotensin receptor type 1 (NTSR1) and 2 (NTSR2), supporting a multifunctional agonism of BNT12 in the functional assays. BNT12 also exhibited significant antinociceptive effects in spared nerve injury (SNI)-neuropathic pain, complete Freund's adjuvant (CFA)-induced inflammatory pain, acetic acid-induced visceral and formalin-induced pain after i.c.v. administration. Furthermore, BNT12 exhibited substantial reduction of acute antinociceptive tolerance, shifted the dose-response curve to the right by only 1.3-fold. It is noteworthy that BNT12 showed insignificant chronic antinociceptive tolerance at the supraspinal level. In addition, BNT12 exhibited reduced or no opioid-like side effects on conditioned place preference (CPP) response, naloxone-precipitated withdrawal response, acute hyperlocomotion, motor coordination, gastrointestinal transit, and cardiovascular responses. The present investigation demonstrated that the novel hybrid peptide BNT12 might serve as a promising analgesic candidate with limited opioid-like side effects.

Effect of Virtual Reality Glasses and Melody on Cortisol and Adrenocorticotropic Hormone Levels in Patients With Knee Replacement Surgery Under Combined Spinal Epidural Anaesthesia.

With advanced virtual reality (VR) technology, its usage in health care is creating an impact on patient outcomes. Patients undergoing knee replacement surgery are already anxious due to the surgery, anaesthesia, and unfamiliar environment of the operation theatre. In addition to that, the unpleasant noise of tools makes it worse. Peri-operative anxiety correlates with increased anaesthesia requirements and prolonged recovery. It causes the release of stress hormones such as cortisol, adrenaline, and norepinephrine, which can lead to difficult intravascular access due to vasoconstriction and heightened cardiovascular responses. Studies on music therapy have shown a reduction in cortisol levels, contributing to anxiety alleviation. VR glasses create immersive environments to distract patients from various stress factors. Investigating the use of VR/music on serum cortisol and adrenocorticotropic hormone (ACTH) levels in knee replacement surgery can improve peri-operative care, improving patient outcomes. The study was done to investigate the impact of virtual reality glasses and music therapy on serum cortisol and ACTHlevels in patients undergoing knee replacement surgery under combined spinal epidural anaesthesia. In this prospective randomised control, single-centric study, patients of either sex, aged between 18 and 65 years, undergoing knee replacement surgery under combined spinal and epidural (CSE) anaesthesia, were included. The primary objective was to compare serum cortisol and ACTH levels, while the secondary objective was to compare the State-Trait Anxiety Inventory for State Anxiety (STAI-SA) score and Patient Satisfaction Score (PSS) in the peri-operative period. A total of 100 patients were assessed for eligibility, and 66 patients met the inclusion and exclusion criteria and were finally randomised and equally assigned to group M-VR (music-virtual reality) and group C (control). Three blood samples were collected for serum cortisol and serum ACTH levels one hour before surgery (T1), one hour after skin incision (T2), and two hours after the completion of surgery (T3). STAI-SA was measured one hour before surgery (T1) and two hours after the completion of surgery (T2), while PSS was recorded two hours after the completion of surgery. Hemodynamic parameters were noted during the entire peri-operative period. The demographic and anthropometric parameters were comparable in both groups. Hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP]) were found to be comparable in the pre-operative period, while significant differences (p > 0.05) were noted after 30 minutes of surgery and continued till the end of surgery. Serum cortisol and serum ACTH levels were comparable in the pre-operative period but showed significantly lower variations in group M-VR in comparison to group C in the intra-operative period. PSS was significantly higher in group M-VR in comparison to group C. This study substantiates the role of virtual reality and music therapy (VR/music) on anxiety reduction, improved satisfaction scores, and lesser ACTH/cortisol level variations in knee replacement surgery. It further emphasises larger randomised controlled studies in various other surgical populations, along with long-term follow-up and outcome assessment.

EGFR-TKIs - induced cardiotoxicity in NSCLC: incidence, evaluation, and monitoring.

The advent of targeted drug therapy has greatly changed the treatment landscape of advanced non-small cell lung cancer(NSCLC), but the cardioxic side effects of targeted drug anti-cancer therapy seriously affect the prognosis of NSCLC, and it has become the second leading cause of death in cancer patients. Therefore, early identification of the cardiotoxic side effects of targeted drugs is crucial for the prevention and treatment of cardiovascular diseases. The cardiotoxic side effects that may be caused by novel targeted drugs epidermal growth factor receptor inhibitors, including thromboembolic events, heart failure, cardiomyopathy, arrhythmia and hypertension, are discussed, and the mechanisms of their respective adverse cardiovascular reactions are summarized, to provide useful recommendations for cardiac management of patients with advanced lung cancer to maximize treatment outcomes for lung cancer survivors. Clinicians need to balance the risk-benefit ratio between targeted therapy for malignant tumors and drug-induced cardiotoxicity, and evaluate and monitor TKIs-induced cardiotoxicity through electrocardiogram, cardiac imaging, biomarkers, etc., so as to remove the susceptibility risk factors as soon as possible and provide a reference for the clinical use of such drugs in the treatment of malignant tumors.

Depressive symptoms, task choice, and effort: The moderating effect of personal control on cardiac response.

Dysphoric individuals perceive mental tasks as more demanding and show increased cardiovascular responses during the performance of easy cognitive tasks. Recent research on action shielding indicates that providing individuals with personal control over their tasks can mitigate the effects of manipulated affective states on cardiovascular responses reflecting effort. We investigated whether the shielding effect of personal choice also applies to the effect of dispositional negative mood on effort. N = 125 university students with high (dysphoric) versus low (nondysphoric) depressive symptoms engaged in an easy cognitive task either by personal choice or external assignment. As expected, dysphoric individuals showed significantly stronger cardiac PEP reactivity during task performance when the task was externally assigned. Most importantly, this dysphoria effect disappeared when participants could ostensibly personally choose their task. Our findings show that the previously observed shielding effect of personal action choice against incidental affective stimulation also applies to dispositional negative affect.

Effects of Acute Beetroot Juice Supplementation and Exercise on Cardiovascular Function in Healthy Men in Preliminary Study: A Randomized, Double-Blinded, Placebo-Controlled, and Crossover Trial.

Nitrate-rich beetroot juice (NRBRJ) can potentially enhance exercise performance and improve cardiovascular function, leading to an increased use of NRBRJ over the years. However, the combined effects of NRBRJ supplementation and exercise on cardiovascular function remain unclear. Therefore, this study compared cardiovascular function responses to submaximal exercise with either placebo (PLA) or NRBRJ supplementation in healthy men. Twelve healthy men (aged 25.2 ± 2.3 years) completed the 30-min submaximal cycle ergometer exercise trials corresponding to 70% maximal heart rate (HRmax) with either PLA or NRBRJ supplementation in a random order. The mean exercise load, heart rate (HR), stroke volume (SV), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and total peripheral resistance (TPR) were measured during exercise. The brachial-ankle pulse wave velocity (baPWV) and flow-mediated dilation (FMD) were measured before and after exercise. NRBRJ supplementation was more effective than PLA in increasing the mean exercise load and decreasing DBP and MAP during submaximal exercise. Furthermore, baPWV decreased in the NRBRJ trial and was considerably lower after exercise in the NRBRJ-supplemented group than in the PLA-supplemented group. FMD significantly increased in the PLA and NRBRJ trials; however, NRBRJ supplementation demonstrated a significantly higher FMD before and after exercise than PLA supplementation. In conclusion, acute NRBRJ supplementation and exercise were more effective than PLA supplementation and exercise in improving aerobic exercise capacity and cardiovascular function in healthy men.

Effects of Daily Physical Activity on Exercise Capacity in Chronic Obstructive Pulmonary Disease.

Background and Objectives: In adults, 150 to 300 min a week of moderate-intensity physical activity is the recommended daily level to maintain or improve fitness. In subjects with chronic obstructive pulmonary disease (COPD), reductions in daily physical activity (DPA) amounts are related to clinically significant outcomes. In this study, we ascertain whether or not COPD patients, when clustered into active (DPA ≥ 30 min a day, 5 days a week) and inactive (DPA < 30 min a day, 5 days a week), may differ in exercise capacity, as assessed by a cardiopulmonary exercise test (CPET). Materials and Methods: A large sample of clinically stable COPD patients was retrospectively recruited and then underwent spirometry and an incremental ramp protocol 5-15 watts/min CPET. DPA was assessed by a questionnaire. Results: A total of 83 (female 25%, age range 41-85 y) active and 131 (female 31%, age range 49-83 y) inactive participants were enrolled. They were similar in age, sex distribution, body mass index (BMI) and in spirometry. The two groups were significantly different in dyspnea on exertion, as assessed by the modified Medical Research Council (mMRC), and in cardio-metabolic parameters, but not in ventilatory ones, as confirmed by the CPET. Conclusions: COPD patients experiencing physical activity of at least 30 min a day, 5 days a week, showed a greater exercise capacity and an improved cardiovascular response to exercise, when compared to inactive ones. Active and inactive participants did not differ in terms of airflow obstruction severity as well as in dynamic hyperinflation and ventilatory inefficiency during exercise. This study further suggests the benefits of regular physical activity in COPD.

The PAD-adapted 30-20-10 during Nordic walking: A new exercise training session in patients with symptomatic peripheral artery disease.

This study aimed to investigate the feasibility of a peripheral artery disease (PAD)-adapted 30-20-10 Nordic walking session in patients with symptomatic PAD and to compare the cardiovascular response of this new training session to a traditional walking (TW) and 4 × 4 minutes Nordic walking session. This is a prospective observational study. Patients with Fontaine stage II PAD were included. Patients participated in Nordic walking sessions, which were randomly assigned as TW, 4 × 4 minute intervals, and peripheral artery disease adapted 30-20-10 exercise session (PAD-adapted 30-20-10 sessions). PAD-adapted 30-20-10 and 4 × 4 minutes sessions consisted of 4 repetitions of 4 minutes of effort followed by 3 minutes of passive recovery. PAD-adapted 30-20-10 session was characterized by 4 continuous 1-min repetitions at 3 different walking speeds [high (30 seconds), moderate (20 seconds) and low (10 seconds)]. During the 4 × 4 minutes session, patients were asked to cover the maximal distance at a constant speed. During TW session, patients were asked to walk at a speed inducing moderate-to-severe claudication pain. Heart rate, rating of perceived exertion (RPE) and claudication pain intensity using a visual analog scale were assessed. The perceived enjoyment of each session was assessed using a visual analog scale ranging from 0 (not enjoyable) to 10 (very enjoyable). Eleven patients with chronic symptomatic PAD were included (62 ± 13 years; 54% women). The mean heart rate during the time of effort was significantly higher in PAD-adapted 30-20-10 group than in 4 × 4 minutes and TW groups (127 ± 12, 122 ± 12, 114 ± 11 bpm, respectively; P ≤ .001). The mean rating of perceived exertion (16 ± 1, 15 ± 1, 13 ± 1; P ≤ .001) and claudication pain intensity (8 ± 1, 7 ± 1; 7 ± 1 mm; P ≤ .019) were significantly higher during PAD-adapted 30-20-10 sessions than during 4 × 4 minutes and TW sessions. The perceived enjoyment was similar among sessions (8.7 ± 1.6 for TW, 8.6 ± 1.7 for 4 × 4 minutes, and 8.8 ± 1.8 mm for PAD-adapted 30-20-10 sessions; P = .935). The PAD-adapted 30-20-10 session is feasible and induces higher cardiovascular stimulation and claudication pain than 4 × 4 minutes and TW procedures in patients with symptomatic PAD. Despite these different responses, a similar perceived enjoyment among the sessions has been shown. Future investigations are needed to examine the effects of this new training session in these patients.

An intelligent aortic valve model for complete cardiac cycle.

The aortic valve (AV) is crucial for cardiovascular (CV) hemodynamic, impacting cardiac output (CO) and left ventricular volumetric flow rate (LVQ). Its nonlinear behavior challenges standard LVQ prediction methods as well as CO one. This study presents a novel approach for modeling the AV in the CV system, offering an improved method for estimating crucial parameters like LVQ across various AV conditions, including aortic stenosis (AS). The model, based on AV channel length during the entire cardiac phase, introduces a time-varying AV resistance (TV-AVR) parameterized by the pressure ratio across the AV and LVQ, enabling the simulation of both healthy and AS-related conditions. To validate this model, in vitro measurements are compared using a hybrid mock circulatory loop device. An unconventional use of a convolutional neural network (CNN) corrects the model's estimates, eliminating the need for labeled datasets. This approach, incorporating real-time learning and transforming 1-D CV signals into 2-D tensors, significantly improves the accuracy of LVQ measurements, achieving an error rate of less than 3.41 ± 4.84% for CO in healthy conditions and 2.83 ± 1.35% in AS cases-a 33.13% enhancement over linear diode models. These results underscore the potential of this approach for enhancing the diagnosis, prediction, and treatment of AV diseases. The key contributions of the proposed method encompass nonlinear TV-AVR estimation, investigation of transient CV responses, prediction of instantaneous CO, development of a flexible framework for noninvasive measurements integration, and the introduction of an adjustable resistance model using an extended Kalman filter (EKF) and CNN combination, all without requiring labeled data.