Peak Heart Rate Research Articles

Effects of Exercise Interventions on Estimated Pulse Wave Velocity and Mean Arterial Pressure in Overweight Adults: The Role of Modality.

Estimated pulse wave velocity (ePWV) is mathematically calculated from age and mean arterial pressure (MAP). We examined the effects of high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) on ePWV and MAP in insufficiently active overweight adults. Using the randomized controlled trial design, thirteen males (27.46 3.80 years old; body mass index (BMI) = 29.61 5.52) randomly completed either two-week HIIT (n = 7) or MICT (n = 6). HIIT consisted of 8 sessions of cycling, 20 min/session with an exercise-to-rest ratio of 10/50 s at 90% peak heart rate ( ). MICT consisted of 8 cycling sessions, 40 min/session at 60-75% . Oscillometric brachial MAP was measured pre- and post-intervention, and ePWV was calculated. Two-way repeated measure analysis of variance examined the effects of time, intervention, and their interactions on ePWV and MAP. Significant time effects were observed for ePWV and MAP, where both measures comparably decreased over time in HIIT and MICT groups (p 0.05 for all). However, no significant intervention or interaction effects were detected, indicating no superiority of either exercise modality for ePWV or MAP improvements. This study uniquely revealed that two weeks of HIIT or MICT resulted in significant, comparable, and clinically meaningful decreases in ePWV and MAP among insufficiently active overweight adults. As such, overweight adults who have time as a constraint to engage in traditional exercise (i.e., MICT) can accomplish comparable vascular benefits by performing HIIT.

Hemodynamic and Metabolic Responses to Moderate and Vigorous Cycle Ergometry in Men Who Have Had Transtibial Amputation.

Adults who have had an amputation face barriers to having an active lifestyle which attenuates cardiorespiratory fitness. Prior studies in amputees typically involve treadmill walking or arm ergometry, yet physiological responses to bilateral leg cycling are less understood. This study assessed the hemodynamic and metabolic responses to moderate and vigorous cycle ergometry in men who have had a transtibial amputation (TTA). Five men who had had a unilateral TTA (age = 39 ± 15 yr) and six controls (CONs) without an amputation (age = 31 ± 11 yr) performed two 20 min bouts of cycling differing in intensity. Cardiac output (CO), stroke volume (SV), and oxygen consumption (VO2) were measured during moderate intensity continuous exercise (MICE) and high intensity interval exercise (HIIE) using thoracic impedance and indirect calorimetry. In response to MICE and HIIE, the HR and VO2 levels were similar (p > 0.05) between groups. Stroke volume and CO were higher (p < 0.05) in the CONs, which was attributed to their higher body mass. In men with TTAs, HIIE elicited a peak HR = 88%HRmax and substantial blood lactate accumulation, representing vigorous exercise intensity. No adverse events were exhibited in the men with TTAs. The men with TTAs show similar responses to MICE and HIIE versus the CONs.

The variability of physical enjoyment, physiological responses, and technical-tactical performance according to the bout duration of small-sided games: a comparative study between female and male soccer players

BackgroundThis study aimed to compare various factors, namely perceived enjoyment (PE), percentage of peak heart rate (%HRpeak), blood lactate (La), rating of perceived exertion (RPE), and technical-tactical performance among soccer players across different bout durations (CB: continuous bout, MIB: medium intermittent bouts, and SIB: short intermittent bouts) and between male and female players during four-a-side (4vs4) small-sided games (SSGs) including goalkeepers.Methodssixteen female soccer players (age: 20.1 ± 0.5 years old) and sixteen professional male adults (age: 20.7 ± 0.7 years old) participated in the study. SSGs (4vs4) were performed in a CB: (1 × 12 min), and in an interval format: MIB: (2 × 6 min), and SIB: (3 × 4 min) with 2 min of passive recovery. PE was collected after each SSGs. The players’ heart rate (HR) was continuously measured, whereas ratings of perceived exertion (RPE) and, blood lactate concentration ([La]) were determined at the end of each SSGs. Technical-tactical performance were analyzed during each session of SSGs. Pitch dimensions were (length x width) (25 × 32 m), and relative space per players was 100 m2.ResultsFor female soccer players, medium intermittent bouts (MIB) elicited significantly higher perceived enjoyment (PE) compared to continuous bouts (CB) (p < 0.001) and short intermittent bouts (SIB) (p < 0.01). Conversely, for male soccer players, CB resulted in higher PE compared to MIB (p < 0.001) and SIB (p < 0.001). During CB and MIB, peak heart rate (PeakHR) and percentage of peak heart rate (%HRpeak) were significantly higher in female players compared to SIB (PeakHR: CB: p < 0.001; PeakHR: MIB: p < 0.01; %HRpeak: CB: p < 0.001; %HRpeak: MIB: p < 0.01). Blood lactate (La) and rating of perceived exertion (RPE) were significantly greater in CB compared to MIB (La: p < 0.001; RPE: p < 0.01) and SIB (La: p < 0.001; RPE: p < 0.001) for female players only. For male players, CB resulted in significantly higher PeakHR, %HRpeak, La, and RPE compared to MIB (peak HR: p < 0.01, dunb = 1.35; %HR: p < 0.01; La: p < 0.01; RPE: p < 0.01) and SIB (peak HR: p < 0,01; %HR: p < 0.01; RPE: md = 0.87, p < 0.05). Regarding technical-tactical performance, in female players, the % of successful passes, successful tackles, and successful duels were higher during SIB compared to CB (p < 0.01; p < 0.001; p < 0.001) and MIB compared to CB (p < 0.01; p < 0.001; p < 0.001), while ball loss was lower during SIB compared to CB (p < 0.001) and MIB compared to CB (p < 0.001). In male players, % of successful passes and tackles were higher during CB compared to MIB (p < 0.001 and p < 0.05) and SIB (p < 0.001 and p < 0.05), while CB had a lower % of ball loss compared to MIB (p < 0.01) and SIB (p < 0.001). There was no significant difference in the % of successful duels between the bouts for either gender.ConclusionThis study showed a difference in physical enjoyment between male and female soccer players depending on the bout duration of SSGs. For that, trainers should consider intermittent bouts for female soccer players and continuous bouts for male soccer players when designing SSGs-based training in order to significantly improve PE, training load, and technical-tactical performance.

Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients.

In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake ( O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non-responder (NR) CHD patients. A total of 72 CHD patients completed a 3-month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in O2peak (>the median for R and ≤the median for NR). In the R group, O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (-19% in R and -11% in NR, p < 0.001). Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.

Physiological and metabolic responses of Parabadminton athletes to field simulated effort.

Due to the increase in the number of Parabadminton (PBd) athletes and the lack of scientific knowledge of the sport, it is important to evaluate performance variables in different game stimuli. Thus, this study sought to examine the physiological and metabolic responses in a simulated effort protocol in PBd athletes. Forty-seven volunteers (WH1=7; WH2=9; SL3=8; SL4=9; SU5=6; SH6=8) performed a simulated effort protocol, consisting of 2 blocks of activities (1st change of direction + 1st simulated effort; 2nd change of direction + 2nd simulated effort). Peak and average oxygen consumption (VO<inf>2</inf>peak and VO<inf>2</inf>avg), peak, percentage, and average heart rate (HRmax, %HRmax, and HRavg), percentage of carbohydrates and lipids contributions (%CARB and %FAT), and average and total energy expenditure (EEavg and EEtotal) were evaluated. The data was compared between protocol stages, functional classes (FCs), and court size. It was adopted P<0.05. Differences were found between the stages of the protocol in VO<inf>2</inf>peak (P=0.0008), VO<inf>2</inf>avg (P=0.0004); HRmax (P<0.0001); %HRmax (P=0.0001), HRavg (P=0.0001), %CARB (P=0.0001), %FAT (P=0.0001), EEavg (P=0.0002), and EEtotal (P=0.008). Among FCs, SL4 athletes were superior to WH1 athletes for VO<inf>2</inf>peak (P=0.075), VO<inf>2</inf>avg (P=0.022), EEavg (P=0.011), and EEtotal (P=0.022). Athletes who completed protocol in the full court were greater than half court for VO<inf>2</inf>peak (P<0.001), VO<inf>2</inf>avg (P<0.001), %HRmax (P=0.032), HRavg (P=0.018), %CARB (P=0.022), %FAT (P=0.022), and EEavg (P=0.016). PBd athletes belonging to higher FCs (4, 5, and 6) and who cover greater distances on the court exhibit physiological and metabolic responses under greater influence of the type of disability.

Antihistamine Medication Blunts Localized-Vibration-Induced Increases in Popliteal Blood Flow

Localized vibration (LV) of the lower leg increases arterial blood flow (BF). However, it is unclear how LV causes this increase. Understanding the mechanisms of this response could lead to the optimized future use of LV as a therapy. One possible mechanism of LV-mediated BF is through histamine release by mechanosensitive mast cells. The purpose of this study was to measure the BF response of 21 recreationally active young adults (11 male, 10 female, mean age 22.1 years) after 47 Hz and 10 min LV to the calf, with and without antihistamine medication (180 mg Fexofenadine). Each participant received both control (no antihistamine) and antihistamine (treatment) conditions separated by at least 24 h. BF ultrasound measurements (mean and peak blood velocity, volume flow, popliteal diameter, and heart rate) were taken before LV therapy and periodically for 19 min post LV. Using a cell means mixed model, we found that LV significantly increased the control mean blood velocity immediately post LV but did not significantly increase the antihistamine mean blood velocity immediately post LV. Therefore, we hypothesize that a primary mechanism of LV increase in BF is histamine release from mechano-sensing mast cells, and that this response is force-dependent.

The Swiss Primary Hypersomnolence and Narcolepsy Cohort Study: feasibility of long-term monitoring with Fitbit smartwatches in central disorders of hypersomnolence and extraction of digital biomarkers in narcolepsy.

The Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (SPHYNCS) is a multicenter research initiative to identify new biomarkers in central disorders of hypersomnolence (CDH). Whereas narcolepsy type 1 (NT1) is well characterized, other CDH disorders lack precise biomarkers. In SPHYNCS, we utilized Fitbit smartwatches to monitor physical activity, heart rate, and sleep parameters over 1 year. We examined the feasibility of long-term ambulatory monitoring using the wearable device. We then explored digital biomarkers differentiating patients with NT1 from healthy controls (HC). A total of 115 participants received a Fitbit smartwatch. Using a adherence metric to evaluate the usability of the wearable device, we found an overall adherence rate of 80% over 1 year. We calculated daily physical activity, heart rate, and sleep parameters from 2 weeks of greatest adherence to compare NT1 (n = 20) and HC (n = 9) participants. Compared to controls, NT1 patients demonstrated findings consistent with increased sleep fragmentation, including significantly greater wake-after-sleep onset (p = .007) and awakening index (p = .025), as well as standard deviation of time in bed (p = .044). Moreover, NT1 patients exhibited a significantly shorter REM latency (p = .019), and sleep latency (p = .001), as well as a lower peak heart rate (p = .008), heart rate standard deviation (p = .039) and high-intensity activity (p = .009) compared to HC. This ongoing study demonstrates the feasibility of long-term monitoring with wearable technology in patients with CDH and potentially identifies a digital biomarker profile for NT1. While further validation is needed in larger datasets, these data suggest that long-term wearable technology may play a future role in diagnosing and managing narcolepsy.

Cyclooxygenase products contribute to the exaggerated exercise pressor reflex evoked by static muscle contraction in male UCD-type 2 diabetes mellitus rats.

Cyclooxygenase (COX) products of arachidonic acid metabolism, specifically prostaglandins, play a role in evoking and transmitting the exercise pressor reflex in health and disease. Individuals with type 2 diabetes mellitus (T2DM) have an exaggerated exercise pressor reflex; however, the mechanisms for this exaggerated reflex are not fully understood. We aimed to determine the role played by COX products in the exaggerated exercise pressor reflex in T2DM rats. The exercise pressor reflex was evoked by static muscle contraction in unanesthetized, decerebrate, male, adult University of California Davis (UCD)-T2DM (n = 8) and healthy Sprague-Dawley (n = 8) rats. Changes (Δ) in peak mean arterial pressure (MAP) and heart rate (HR) during muscle contraction were compared before and after intra-arterial injection of indomethacin (1 mg/kg) into the contracting hindlimb. Data are presented as means ± SD. Inhibition of COX activity attenuated the exaggerated peak MAP (Before: Δ32 ± 13 mmHg and After: Δ18 ± 8 mmHg; P = 0.004) and blood pressor index (BPi) (Before: Δ683 ± 324 mmHg·s and After: Δ361 ± 222 mmHg·s; P = 0.006), but not HR (Before: Δ23 ± 8 beats/min and After Δ19 ± 10 beats/min; P = 0.452) responses to muscle contraction in T2DM rats. In healthy rats, COX activity inhibition did not affect MAP, HR, or BPi responses to muscle contraction. Inhibition of COX activity significantly reduced local production of prostaglandin E2 in T2DM and healthy rats. We conclude that peripheral inhibition of COX activity attenuates the pressor response to muscle contraction in T2DM rats, suggesting that COX products partially contribute to the exaggerated exercise pressor reflex in those with T2DM.NEW & NOTEWORTHY We compared the pressor and cardioaccelerator responses to static muscle contraction before and after inhibition of cyclooxygenase (COX) activity within the contracting hindlimb in decerebrate, unanesthetized type 2 diabetic mellitus (T2DM) and healthy rats. The pressor responses to muscle contraction were attenuated after peripheral inhibition of COX activity in T2DM but not in healthy rats. We concluded that COX products partially contribute to the exaggerated pressor reflex in those with T2DM.

Living in Western Australia induces some physiological adaptations of seasonal acclimatisation in the surgical burns team

ABSTRACT Seasonal acclimatization is known to result in adaptations that can improve heat tolerance. Staff who operate on burn injuries are exposed to thermally stressful conditions and seasonal acclimatization may improve their thermoeffector responses during surgery. Therefore, the aim of this study was to assess the physiological and perceptual responses of staff who operate on burn injuries during summer and winter, to determine whether they become acclimatized to the heated operating theater. Eight staff members had physiological and perceptual responses compared during burn surgeries conducted in thermoneutral (CON: 24.1 ± 1.2°C, 45 ± 7% relative humidity [RH]) and heated (HOT: 31.3 ± 1.6°C, 44 ± 7% RH) operating theaters, in summer and winter. Physiological parameters that were assessed included core temperature, heart rate, total sweat loss, sweat rate, and urinary specific gravity. Perceptual responses included ratings of thermal sensation and comfort. In summer, CON compared to winter CON, baseline (85 ± 15 bpm VS 94 ± 18 bpm), mean (84 ± 16 bpm VS 93 ± 18 bpm), and peak HR (94 ± 17 bpm VS 105 ± 19 bpm) were lower (p < 0.05), whereas core temperature was not different between seasons in either condition (p > 0.05). In HOT, ratings of discomfort were higher in summer (15 ± 3) than winter (13 ± 3; p > 0.05), but ratings of thermal sensation and sweat rate were similar between seasons (p > 0.05). The surgical team in burns in Western Australia can obtain some of the physiological adaptations that result from seasonal acclimatization, but not all. That is most likely due to a lower than required amount of outdoor heat exposure in summer, to induce all physiological and perceptual adaptations.

Chronological age-based vs. Bio-banded friendly football tournament: Effects on physical performance and spatial exploration behaviour in 7v7 match play

ABSTRACT Biological age-based competitions have been suggested to mitigate maturation bias among youth football players. This study analysed the physical demands and spatial exploration behaviour when playing football matches against biological or chronological age-based opposition. One-hundred and sixteen U-13 and U-14 male regional-level football players were recruited from five Portuguese football academies. Each player completed eight games, four per condition (chronological and biological-based), on the same day. Games were played in 7 vs. 7 formats, with 20-min duration, and conformed to standard officiating and rule procedures. The following variables were considered from GPS-data in each game: distance covered, high-intensity accelerations and decelerations, body impacts, and average and peak speeds. Furthermore, average, and peak heart rates (HRpeak) and spatial exploration index were collected. Players covered significantly less distance (ES = 1.11), performed fewer decelerations (ES = 0.82), achieved lower average speeds (ES = 1.15), had fewer body impacts (ES = 0.94), and recorded lower HRpeak (ES = 0.56) in the biological age-based competition compared to the chronological-age-based. No significant differences were found between the two formats in spatial exploration. Both game formats offer distinct physical demands at the external and internal levels. Finally, practitioners can manipulate the type of opposition to get distinct physical demands to mitigate the effect of maturation bias during development.

Comparing high-intensity versus moderate-intensity exercise training in coronary artery disease patients: a randomized controlled trial with 6- and 12-month follow-up

Abstract Aim This study aimed to investigate the long-term effects of two exercise-based CR programs on physical activity (PA), sedentary behavior, physical fitness, quality of life (QoL), and mental health in coronary artery disease (CAD) patients. Subject and methods Seventy-two CAD participants were randomized (1:1:1) into HIIT, MICT, and control groups. Both training programs spanned 6 weeks with three supervised treadmill exercise sessions per week. MICT targeted ≈70–75% of peak heart rate (HR), while HIIT aimed for ≈85–95% of peak HR. The control group adhered to standard medical recommendations. Assessments at 6- and 12-months post-intervention included body composition, aerobic capacity, muscle strength, PA, SB, QoL, anxiety, and depression. Results Over the 6- and 12-month follow-up periods, both exercise groups maintained the levels of aerobic capacity (HIIT ≈ 19.6 ml kg−1 min−1, MICT ≈ 17.8 ml kg−1 min−1), QoL, and PA compared to baseline (p &lt; .001). Symptoms of anxiety and depression remained lower than baseline (p &lt; .001). The HIIT group demonstrated a significant decreasing trend in waist circumference (∆m3−m2% −2 cm, p = .033) compared to MICT (p = .016) and control (p = .001) at 6 months of follow-up. It was maintained at 12 months of follow-up with significant differences to MICT (p = .018) and control (p = .001). In contrast, the control group experienced deteriorations in body composition, SB, symptoms of anxiety, and depression, along with a decline in aerobic capacity over time. Conclusion Encouraging CAD patients to maintain elevated PA levels can promote cardiovascular, WC, and mental health. CR exercise programs can reduce cardiovascular risk factors and induce favorable lifestyle changes. Notably, HIIT demonstrated sustained improvements surpassing those of MICT. These findings underscore the importance of structured exercise-based CR programs in optimizing long-term outcomes for CAD patients. Trial Registration https://clinicaltrials.gov/ct2/show/NCT03538119 on May 25, 2018.

The effects of affect-guided interval training on pleasure, enjoyment, and autonomy: A registered report

This registered report tested the effects of a novel exercise protocol, namely affect-guided interval training, on motivationally relevant variables of remembered pleasure, forecasted pleasure, enjoyment, and autonomy. Affect-guided interval training (AIT) consisted of 60-s intervals that alternated between the highest pleasant intensity and lowest pleasant intensity for 20 min; this was intended to minimize the potential displeasure of traditional high-intensity interval training. The novel protocol was compared to self-selected exercise intensity (30 min) and high-intensity interval training (60-s intervals for 20 min). All sessions were, on average, vigorous in intensity (80–89% peak heart rate). Data indicate that the AIT session was experienced as the most pleasant, had the most pleasant slope of affect, was remembered as the most pleasant, resulted in the most positive affective forecasts, and was the most enjoyable. Both the affect-guided interval session and self-selected exercise session resulted in greater autonomy than high-intensity interval training. Several evaluative and motivationally relevant variables, including (a) remembered pleasure, (b) enjoyment, and (c) forecasted pleasure were predicted by (a) experienced pleasure, the (b) pleasure experienced at the end of exercise, and (c) the slope of pleasure experienced throughout the exercise session. Overall, this study suggests that affect-guided interval training is a feasible and positive alternative that can be included as a viable option for exercise programming.

Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study

Purpose Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. Materials and methods This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6–18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27–29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. Results In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027). Conclusions These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.

Effects of High-Intensity Interval Training vs Moderate-Intensity Continuous Training on Body Composition and Blood Biomarkers in Coronary Artery Disease Patients: A Randomized Controlled Trial.

Cardiac rehabilitation (CR) is essential in reducing cardiovascular mortality and morbidity. High-intensity interval training (HIIT) has emerged as a promising exercise intervention for enhancing clinical outcomes in cardiac patients. This study aimed to investigate the effects of two short-term exercise-based programs employing HIIT and moderate-intensity continuous training (MICT) in comparison to a control group concerning blood pressure, body composition, and blood biomarkers in patients diagnosed with coronary artery disease (CAD). Seventy-two CAD patients (14% women) underwent randomization into three groups: HIIT, MICT, and control. The training programs encompassed six weeks of supervised treadmill exercises, conducted thrice weekly. MICT targeted 70-75% of peak heart rate (HRpeak), while HIIT was tailored to 85-95% of HRpeak. The control group received guidance on adopting healthy lifestyles. Outcome measurements included evaluations of blood pressure, body composition, and blood biomarkers. In contrast to MICT, the HIIT exhibited superior improvements in body fat mass ( %HIIT: 4.5%, p 0.001 vs. %MICT: 3.2%, p 0.001), waist circumference ( %HIIT: 4.1%, p = 0.002 vs. %MICT: 2.5%, p = 0.002), hemoglobin A1c (HbA1c) ( %HIIT: 10.4%, p 0.001 vs. %MICT: 32.3%, p 0.001) and thyrotropin (TSH) ( %HIIT: 16.5%, p = 0.007 vs. %MICT: 3.1%, p = 0.201). Both HIIT and MICT induced significant enhancements across all variables compared to the control group. HIIT and MICT emerged as effective modalities for enhancing systolic and diastolic function, body composition, and blood biomarkers in CAD patients, with HIIT demonstrating incremental improvements over MICT. The absence of participation in exercise-based programs following cardiovascular events yielded less favorable outcomes. HIIT holds promise as an adjunct intervention in CR programs for CAD patients. https://clinicaltrials.gov/ct2/show/NCT03538119.

Effects of different rehabilitation modality on cardiopulmonary function in patients with acute coronary syndrome after revascularization.

To investigate the effects of different rehabilitation modalities on cardiopulmonary function in patients with acute coronary syndrome after revascularization. Two randomized controlled trials were conducted. All patients were stable for more than 48 h and less than 1 week after revascularization for acute coronary syndrome and were randomly assigned to Group A (home-based rehabilitation group) or Group B (center guided home-based rehabilitation group). The cardiopulmonary exercise test was mainly performed before and 3 months after cardiac rehabilitation (at the end of intervention). The primary endpoints of the study were peak oxygen uptake (VO2peak), and the secondary endpoints were maximum metabolic equivalents (METs), anaerobic threshold exercise load (Load AT), maximal workload (Load max), and anaerobic threshold oxygen uptake (VO2 AT). A total of 106 patients were included in the study, with 47 patients in Group A (with 6 losses) and 50 patients in Group B (with 3 losses). There were no significant difference between the two groups in terms of age, gender, body mass index (BMI), left ventricular ejection fraction(LVEF), low-density lipoprotein cholesterol(LDL-C),cardiovascular risk factors. In Group A, no significant differences in CPET indices were observed before and after the intervention. In Group B, values of maximum metabolic equivalents (METs), peak heart rate (PHR), anaerobic threshold exercise load (Load AT), maximal workload (Load max), maximum ventilation per minute (VE max), peak oxygen uptake (VO2peak), anaerobic threshold oxygen uptake (VO2 AT) and maximum oxygen pulse (VO2/HRmax) were higher than those before the intervention (P < 0.05). In addition, METs (max), Load AT, Load max, VO2 AT, and VO2peak in Group B were higher than those in group A (P < 0.05). The change rates of VO2peak, METs(max), PHR, Load max, VO2 AT, VE max, VO2/HR(max) in the two groups were significantly different before and after intervention (P < 0.05). Cardiac exercise rehabilitation is helpful for improving patients' cardiopulmonary endurance and quality of life. Moreover, rehabilitation modalities with regular hospital guidance can improve cardiopulmonary function in a shorter period,which seems to be more effective than a complete home-based rehabilitation model. http://www.chictr.org.cn, identifier (ChiCTR2400081034).

The Impact of Type 2 Diabetes on Peripheral and Cerebral Hemodynamic Responses to Active Stand.

Although type 2 diabetes mellitus (T2DM) is an established risk factor for cognitive impairment, the underlying mechanisms remain poorly explored. One potential mechanism may be through effects of T2DM on cerebral perfusion. The current study hypothesized that T2DM is associated with altered peripheral and central hemodynamic responses to orthostasis, which may in turn be associated with cognitive impairment in T2DM. A novel use of function-on-scalar regression, which allows the entire hemodynamic response curve to be modeled, was employed to assess the association between T2DM and hemodynamic responses to orthostasis. Logistic regression was used to assess the relationship between tissue saturation index (TSI), T2DM, and cognitive impairment. All analyses used cross-sectional data from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA). Of 2984 older adults (aged 64.3 ± 8.0; 55% female), 189 (6.3%) had T2DM. T2DM was associated with many features that are indicative of autonomic dysfunction including a blunted peak heart rate and lower diastolic blood pressure. T2DM was associated with reduced TSI and also with greater odds of impaired performance on the Montreal Cognitive Assessment (odds ratio [OR]: 1.62; confidence interval [CI: 1.07, 2.56]; p = .019). Greater TSI was associated with lower odds of impaired performance (OR: 0.90, CI [0.81-0.99]; p = .047). T2DM was associated with impaired peripheral and cerebral hemodynamic responses to active stand. Both T2DM and reduced cerebral perfusion were associated with impaired cognitive performance. Altered cerebral perfusion may represent an important mechanism linking T2DM and adverse brain health outcomes in older adults.

No Effect of Serum Electrolyte Levels on Electroconvulsive Therapy Seizure Quality Parameters.

Seizure quality is considered to be associated with treatment outcomes of electroconvulsive therapy (ECT). A wide range of treatment parameters and patient characteristics are known to influence seizure quality. However, conflicting results exist for the role of serum electrolyte levels and seizure quality. We retrospectively analyzed a total of 454 patients and a total of 2119 individual acute ECT sessions irrespective of diagnosis where a clinical evaluation of serum levels of sodium, potassium, and calcium took place routinely up to 2 days before the ECT session. To assess the impact of serum electrolyte levels on seizure quality parameters, we used mixed-effects linear regression analysis with Bonferroni correction for multiple testing. Serum sodium, potassium, and calcium levels were not associated with seizure quality markers after correcting the significance level for multiple testing. Younger age was consistently associated with higher postictal suppression, interhemispheric coherence, midictal amplitude, and peak heart rate. Lower dose was consistently associated with longer electroencephalogram and motor seizure duration. Our results suggest that there is no clinically relevant effect of serum electrolyte levels on seizure quality, at least within clinically commonly observed ranges of serum electrolyte concentrations.

High intensity interval training vs. moderate intensity continuous training on aerobic capacity and functional capacity in patients with heart failure: a systematic review and meta-analysis.

Exercise training is commonly employed as a efficacious supplementary treatment for individuals suffering from heart failure, but the optimal exercise regimen is still controversial. The objective of the review was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the exercise capacity, cardiac function, quality of life (QoL) and heart rate among patients with heart failure with reduced ejection fraction. A systematic search was performed using the following eight databases from their inception to July 5, 2023: PubMed, Web of Science, Embase, Cochrane Library, Clinical Trials, China Knowledge Network, Wan fang Data, and the China Biology Medicine databases. The meta-analysis results were presented as mean difference (MD) and 95% confidence interval (CI). The Cochrane Risk of Bias tool was used for the included studies. The Grading of Recommendations Assessment, Development, and Evaluations was used to assess the certainty of evidence. Thirteen randomized controlled trials were included in the study. The results showed that HIIT had a significant positive effect on peak oxygen uptake (MD = 1.78, 95% CI for 0.80-2.76), left ventricular ejection fraction (MD = 3.13, 95% CI for 1.25-5.02), six-minute walk test (MD = 28.13, 95% CI for 14.56-41.70), and Minnesota Living with Heart Failure Questionnaire (MD = -4.45, 95% CI for -6.25 to -2.64) compared to MICT. However, there were no statistically significant differences observed in resting heart rate and peak heart rate. HIIT significantly improves peak oxygen uptake, left ventricular ejection fraction, six-minute walk test, and Minnesota Living with Heart Failure Questionnaire in patients with heart failure with reduced ejection fraction. Additionally, HIIT exhibits greater effectiveness in improving peak oxygen uptake among patients with lower body mass index. https://www.doi.org/10.37766/inplasy2023.7.0100, identifier (INPLASY2023.7.0100).

Age-specific determinants of reduced exercise capacity in youth after heart transplant: A longitudinal cohort study

BackgroundAlthough prior studies show that children have impaired exercise capacity after heart transplant, the age-specific determinants of this phenomenon are not well understood. We examine exercise capacity and its associations in school-age and adolescent youth post-heart transplant. MethodsThis retrospective cohort study of heart transplant patients who completed a cardiopulmonary exercise test between 1999-2018 includes 332 tests on 104 patients younger than 18 years. Tests were stratified into those by school-aged children (5 to 11 years old) and adolescents (12-17). The primary outcome was peak oxygen consumption; secondary outcomes were anaerobic threshold and peak power production. Potential determinants included age at transplant, diagnosis, and laboratory and invasive hemodynamic measurements. ResultsAll exercise capacity outcomes for patients post-transplant regardless of age were significantly reduced compared to the predicted performance of age and sex-matched controls. Percent predicted median peak oxygen consumption (62.63, 95% confidence interval 59.18, 66.07), anaerobic threshold (66.52, 95%CI 62.24, 70.81), and peak power production (54.00, 95%CI 50.56, 57.44) were reduced. Younger age at transplant and a higher peak heart rate were independently associated with increased peak oxygen consumption across age groups. Elevated wedge pressure and BNP predict decreased exercise capacity in adolescents. ConclusionsYouth after heart transplant have significantly reduced exercise capacity. Younger age at transplant and higher peak heart rate predict increased exercise capacity throughout childhood. Indicators of congestion predict decreased exercise capacity in adolescents. These findings should encourage deeper attention to the relationship between exercise physiology and the social context of children after transplant.

Exercise-induced cardiac troponin release in athletes with versus without coronary atherosclerosis.

The magnitude of exercise-induced cardiac troponin (cTn) elevations is dependent on cardiovascular health status, and previous studies have shown that occult coronary atherosclerosis is highly prevalent among amateur athletes. We tested the hypothesis that middle-aged and older athletes with coronary atherosclerosis demonstrate greater cTn elevations following a controlled endurance exercise test compared with healthy peers. We included 59 male athletes from the Measuring Athletes' Risk of Cardiovascular events 2 (MARC-2) study and stratified them as controls [coronary artery calcium score (CACS) = 0, n = 20], high CACS [≥300 Agatston units or ≥75th Multi-Ethnic Study of Atherosclerosis (MESA) percentile, n = 20] or significant stenosis (≥50% in any coronary artery, n = 19). Participants performed a cycling test with incremental workload until volitional exhaustion. Serial high-sensitivity cTn (hs-cTn) T and I concentrations were measured (baseline, after 30-min warm-up, and 0, 30, 60, 120, and 180 min postexercise). There were 58 participants (61 [58-69] yr) who completed the exercise test (76 ± 14 min) with a peak heart rate of 97.7 [94.8-101.8]% of their estimated maximum. Exercise duration and workload did not differ across groups. High-sensitivity cardiac troponin T (Hs-cTnT) and high-sensitivity cardiac troponin I (hs-cTnI) concentrations significantly increased (1.55 [1.33-2.14]-fold and 2.76 [1.89-3.86]-fold, respectively) over time, but patterns of cTn changes and the incidence of concentrations >99th percentile did not differ across groups. Serial sampling of hs-cTnT and hs-cTnI concentrations during and following an exhaustive endurance exercise test did not reveal differences in exercise-induced cTn release between athletes with versus without coronary atherosclerosis. These findings suggest that a high CACS or a >50% stenosis in any coronary artery does not aggravate exercise-induced cTn release in middle-aged and older athletes.NEW & NOTEWORTHY Exercise-induced cardiac troponin (cTn) release is considered to be dependent on cardiovascular health status. We tested whether athletes with coronary atherosclerosis demonstrate greater exercise-induced cTn release compared with healthy peers. Athletes with coronary atherosclerosis did not differ in cTn release following exercise compared with healthy peers. Our findings suggest that a high CACS or a >50% stenosis in any coronary artery does not aggravate exercise-induced cTn release in middle-aged and older athletes.