Cardiovascular Workload Research Articles

An Overview of the Effect of Weight Loss on Cardiovascular Autonomic Function

The prevalence of obesity is rising to epidemic proportions in many countries worldwide. Obesity seriously increases an individual's risk of developing many health problems including diabetes. Diabetes, like obesity, is also in epidemic proportions with 300 million adults predicted to have the disease by 2025. Investigating strategies for the prevention and treatment of obesity and diabetes is vitally important. Autonomic dysfunction is evident in both obesity and diabetes. In persons with diabetes, impaired cardiovascular autonomic activity is characterized by a reduction in parasympathetic tone with a relative increase in sympathetic activity and is specifically associated with a number of clinically significant manifestations including exercise intolerance, intraoperative cardiovascular lability, orthostatic hypotension, silent myocardial ischemia, and increased risk of mortality. In obesity, parasympathetic function is decreased while regional heterogeneity of increased sympathetic activity may occur. Autonomic dysfunction increases cardiovascular workload, hemodynamic stress, serious dysrhythmias, and significant cardiac pathology. Thus, cardiac autonomic imbalance may also be an important link between obesity and increased morbidity and mortality. Beyond the obese and diabetic state, multiple variables associated with these conditions such as insulin, glucose, leptin, adiponectin and free fatty acids have an affect on the autonomic nervous system. Autonomic disturbances, however, appear to be reversible with weight reduction. Since autonomic imbalance is a marker of adverse risk, improvement obtained from weight loss should be beneficial for the health of individuals with obesity and diabetes. This overview will examine the relationship of the autonomic nervous system in obesity and diabetes and explore the effect of weight loss on autonomic function.

The effect of music listening on older adults undergoing cardiovascular surgery

The purpose of this study was to determine the effect of music listening on postoperative anxiety and intubation time in patients undergoing cardiovascular surgery. Coronary artery disease and valvular heart disease affect approximately 15 million Americans and 5 million persons in the U.K. annually, with the majority of these patients being older adults. The anxiety experienced before, during and after surgery increases cardiovascular workload, thereby prolonging recovery time. Music listening as a nursing intervention has shown an ability to reduce anxiety. The study used a randomized control trial design. Sixty adults older than 65 years were randomly assigned to the control and the experimental groups. The experimental group listened to music during and after surgery, while the control group received standard postoperative care. The Spielberger State Trait Anxiety Inventory was administered to both groups before surgery and 3 days postoperatively. The mean of the differences between scores was compared using analysis of variance. Differences in mean intubation time were measured in both groups. Older adults who listened to music had lower scores on the state anxiety test (F = 5.57, p = .022) and had significantly fewer minutes of postoperative intubation (F = 5.45, p = .031) after cardiovascular surgery. Older adults undergoing cardiovascular surgery who listen to music had less anxiety and reduced intubation time than those who did not.

Gerard W. Ostheimer “What’s New in Obstetric Anesthesia” Lecture

Gerard W. Ostheimer “What’s New in Obstetric Anesthesia” Lecture

Respostas hemodinâmicas, cardiorrespiratórias e ocorrência de lesão muscular no meio aquático e terrestre em mulher não ativa: estudo de caso

The purpose of this study was to compare the effects of a graded dynamic exercise in water and on land on cardiorespiratory responses and muscle damage. The exercise was performed by a woman who had not been involved in any regular, structured exercise program for at least 6 months before participating in the study. The two graded dynamic exercises were performed on cycle ergometer in water and on land, separated by 1 week, reaching the maximal effort. Oxygen consumption was measured using a Gas Analyser (KB1-C, AEROSPORT), systolic and diastolic blood pressures were measured using a sphygmomanometer (Baumanometer) and heart rate was measured with a Sport tester Polar S610. Plasma creatine kinase activity was determined using a commercially available kit (CK-NAC, Bioliquid). Maximal oxygen uptake value on land was 1,56 l.min-1 and in water was 1,64 l.min-1. Maximal heart rate and blood pressure demonstrated a lower response in water. Creatine kinase levels were not alterated in all measures for both environments. Our data suggest that the maximal exercise on a cycle ergometer performed in water reduce cardiovascular workload without risks of muscle damage.

Postoperative care of the vascular surgery patient

The patient undergoing peripheral vascular surgery is at increased operative risk owing to overt or occult manifestations of coexisting atherosclerotic disease mainly affecting cardiac and renal function. Common problems in the postoperative period are related to hyper-/hypotension, hypothermia, tachycardia, hypoxaemic episodes, hypercapnia, myocardial ischaemia/infarction and renal functional disturbances. Relevant strategies for prevention of postoperative morbidity and mortality should include monitoring of cardiac performance, central and peripheral haemodynamics (including graft function), systemic oxygenation and renal function. Increased cardiac workload and oxygen requirements are commonly caused by increased stress owing to hypothermia, pain or nausea. Therefore, therapeutic measures for adequate sedation and pain alleviation are essential in the postoperative period for reducing stress-associated increases in cardiovascular work load and oxygen requirements.

Diagnostic and prognostic value of exercise testing.

Measuring blood pressure during exercise under a standard protocol could be a useful diagnostic method in high-risk patients and in borderline hypertensive subjects. It may also serve as an adapted test for hypertensive subjects undergoing physical activity at work or at leisure time with a particular cardiovascular work load. It can be used as a method of assessment to confirm the efficacy of an antihypertensive drug, and for prognostic evaluation of cardiovascular risk in terms of morbidity and mortality. An exercise blood pressure profile does not provide information about blood pressure during activities of daily living. For this purpose, ambulatory blood pressure measurement appears to be more relevant.