Effects of physical exercise on the autonomic nervous system in patients with coronary artery disease: a systematic review

2020 ◽  
Vol 18 (11) ◽  
pp. 749-759
Author(s):  
Thainá de Gomes Figueiredo ◽  
Helga Cecília Muniz de Souza ◽  
Victor Ribeiro Neves ◽  
Ana Eugênia Vasconcelos do Rêgo Barros ◽  
Armèle de Fátima Dornelas de Andrade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Coronary Artery ◽  
Physical Exercise ◽  
Autonomic Nervous ◽  
Artery Disease

A Psychophysiological Case Study of Orchestra Conductors

2015 ◽  
Vol 30 (4) ◽  
pp. 189-196 ◽  
Author(s):  
S Victoria Jaque ◽  
Isabel H Karamanukyan ◽  
Paula Thomson
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Coronary Artery ◽  
Self Report ◽  
Stair Climbing ◽  
Public Performance ◽  
Autonomic Nervous ◽  
Artery Disease

The psychological and physiological effects of performance were investigated in two professional orchestral conductors, with data collected prior to, during, and after a rehearsal and a public performance. The participants were given a battery of psychological self-report tests (anxiety, dissociation, health inventory, fantasy proneness, shame, and flow). Ambulatory physiological monitoring (Vivometric LifeShirt® system) was conducted during both a rehearsal and public performance to gather information about the autonomic nervous system and heart rate variability (HRV). One conductor had a history of asthma and anxiety, and the second conductor had coronary artery disease. The results revealed within-subject and between-subject differences in autonomic nervous system responses and HRV during several conditions (pre-performance rest, stair-climbing, rehearsal, and performance). Based on heart rate, the physiological demands of professional conducting are reflective of work intensities considered “hard.” Both conductors experienced high flow states. Anxiety and coronary artery disease may have attenuated HRV resilience in this study. It is recommended that noninvasive methods be implemented to assess cardiac autonomic activity in professional conductors, particularly during engagement in their professional activities. The findings suggest a need to further study anxiety, respiratory conditions, and cardiovascular risks for conductors.

Coronary Artery Disease Screening Using CT Coronary Angiography

2020 ◽  
Vol 91 (10) ◽  
pp. 812-817
Author(s):  
Randy Wang Long Cheong ◽  
Brian See ◽  
Benjamin Boon Chuan Tan ◽  
Choong Hou Koh
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiac Risk ◽  
Disease Screening ◽  
Ct Coronary Angiography ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Events ◽  
Artery Disease

BACKGROUND: The increased utility of CT coronary angiography (CTCA) in cardiovascular screenings of aircrew has led to the increased detection of asymptomatic coronary artery disease (CAD). A systematic review of studies relevant to the interpretation of CTCA for the occupational fitness assessment of high-risk vocations was performed, with findings used to describe the development of a pathway for the aeromedical disposition of military aviators with asymptomatic CAD.METHODS: Medline was searched using the terms CT coronary angiogram and screening and prognosis. The inclusion criteria were restricted to study populations ages > 18 yr, were asymptomatic, were not known to have CAD, had undergone CTCA, and with their associations with major adverse cardiovascular events (MACE) and other relevant cardiac outcomes reported.RESULTS: Included in this systematic review were 10 studies. When compared to subjects with no or nonobstructive CAD, those with obstructive CAD on CTCA had hazard ratios (HR) for cardiac events ranging from 1.42 to 105.48. Comparing subjects with nonobstructive CAD and those without CAD on CTCA, a lower HR of 1.19 for cardiac events was found. The annual event rates of subjects with no CAD on CTCA were extremely low, ranging from 0 to 0.5%.CONCLUSIONS: Based on the findings, we suggest that CTCA should only be performed in aircrew with higher cardiac risk profiles. Those found to have no CAD or minimal CAD (i.e., 25% stenosis) in a non-left main coronary artery on CTCA can be returned to flying duties. All other results should be further evaluated with an invasive angiogram.Cheong RWL, See B, Tan BBC, Koh CH. Coronary artery disease screening using CT coronary angiography. Aerosp Med Hum Perform. 2020; 91(10):812817.

scholarly journals Discrimination capability of pretest probability of stable coronary artery disease: a systematic review and meta-analysis suggesting how to improve validation procedures

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047677
Author(s):  
Pierpaolo Mincarone ◽  
Antonella Bodini ◽  
Maria Rosaria Tumolo ◽  
Federico Vozzi ◽  
Silvia Rocchiccioli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Stable Coronary Artery Disease ◽  
First Line ◽  
Discrimination Capability ◽  
Artery Disease

ObjectiveExternally validated pretest probability models for risk stratification of subjects with chest pain and suspected stable coronary artery disease (CAD), determined through invasive coronary angiography or coronary CT angiography, are analysed to characterise the best validation procedures in terms of discriminatory ability, predictive variables and method completeness.DesignSystematic review and meta-analysis.Data sourcesGlobal Health (Ovid), Healthstar (Ovid) and MEDLINE (Ovid) searched on 22 April 2020.Eligibility criteriaWe included studies validating pretest models for the first-line assessment of patients with chest pain and suspected stable CAD. Reasons for exclusion: acute coronary syndrome, unstable chest pain, a history of myocardial infarction or previous revascularisation; models referring to diagnostic procedures different from the usual practices of the first-line assessment; univariable models; lack of quantitative discrimination capability.MethodsEligibility screening and review were performed independently by all the authors. Disagreements were resolved by consensus among all the authors. The quality assessment of studies conforms to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A random effects meta-analysis of area under the receiver operating characteristic curve (AUC) values for each validated model was performed.Results27 studies were included for a total of 15 models. Besides age, sex and symptom typicality, other risk factors are smoking, hypertension, diabetes mellitus and dyslipidaemia. Only one model considers genetic profile. AUC values range from 0.51 to 0.81. Significant heterogeneity (p<0.003) was found in all but two cases (p>0.12). Values of I2 >90% for most analyses and not significant meta-regression results undermined relevant interpretations. A detailed discussion of individual results was then carried out.ConclusionsWe recommend a clearer statement of endpoints, their consistent measurement both in the derivation and validation phases, more comprehensive validation analyses and the enhancement of threshold validations to assess the effects of pretest models on clinical management.PROSPERO registration numberCRD42019139388.

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