scholarly journals Gut leakage markers in response to strenuous exercise in patients with suspected coronary artery disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S K Aune ◽  
J Cwikiel ◽  
A Flaa ◽  
H Arnesen ◽  
S Solheim ◽  
...  
Keyword(s):  
Gene Expression ◽  
Physical Activity ◽  
Coronary Angiography ◽  
Stress Test ◽  
Exercise Stress ◽  
Strenuous Exercise ◽  
Vigorous Exercise ◽  
Gut Leakage ◽  
Coronary Events ◽  
Exercise Induced

Abstract Introduction Although regular physical activity is associated with reduced risk of cardiovascular disease (CVD), acute vigorous exercise seems to transiently increase the risk of acute coronary events in patients with underlying CVD. Some studies have reported regular physical activity to associate with microbial diversity, whereas elevated levels of gut leakage markers have been shown after strenuous exercise in healthy individuals. Any predictive value of a temporary increase in gut leakage markers on the risk of coronary events in susceptible individuals is unknown. Purpose We aimed to explore gut leakage markers in response to a bout of strenuous exercise in patients with symptoms of chronic coronary syndrome (CCS). We hypothesized that gut leakage markers would increase after acute strenuous exercise, and that the increase would be higher in patients with angiographically verified CAD. Methods Patients referred to exercise stress testing or coronary angiography due to symptoms suggestive of CCS were included (n=327). A maximal exercise ECG stress test was performed using a bicycle ergometer. Venous blood samples were drawn at rest prior to the test and within 5 min after the test ended, for analysis of soluble cluster of differentiation 14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty-acid binding protein (I-FABP) by ELISAs. Quantification of lipopolysaccharide (LPS) and relative quantification of gene expression of the toll-like receptor 4 (TLR4) in circulating leukocytes was performed in a subset of patients (n=101). Patients then underwent coronary angiography, and were grouped according to the degree of CAD. Results Of the 287 patients who completed the exercise stress test and coronary angiography, 69 (24%) had no CAD, 88 (31%) had non-significant CAD and 130 (45%) had significant CAD. Mean exercise duration was 10:05±4:46 min and the duration did not differ between the groups. There were no significant differences in resting levels of gut leakage markers between the groups. In the total population, sCD14, LBP and LPS increased significantly after exercise (p<0.0001, all), whereas I-FABP did not. The gene expression of TLR4 decreased significantly after exercise (p<0.0001). There were no differences in exercise-induced changes in any of the measured markers between groups with no CAD, non-significant CAD and significant CAD. Conclusion In patients with symptoms suggestive of CCS, LPS, LBP and sCD14 increased significantly after strenuous exercise, suggesting that even short bouts of vigorous exercise are associated with gut leakage. The decrease in gene expression of TLR4 may be discussed to be compensatory to the increase in LPS or possibly reflecting an increase in TLR4 translation in response to LPS. The presence of CAD or not did not seem to impact exercise-induced increase in gut leakage markers. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Stein Erik Hagen Foundation for Clinical Heart Research, Olso, Norway

scholarly journals Gut Leakage Markers in Response to Strenuous Exercise in Patients with Suspected Coronary Artery Disease

Cells ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2193
Author(s):  
Susanne Kristine Aune ◽  
Joanna Cwikiel ◽  
Arnljot Flaa ◽  
Harald Arnesen ◽  
Svein Solheim ◽  
...  
Keyword(s):  
Gene Expression ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Binding Protein ◽  
Exercise Stress ◽  
Strenuous Exercise ◽  
Temporary Increase ◽  
Fatty Acid Binding ◽  
Gut Leakage ◽  
Artery Disease

Elevated levels of gut leakage markers have been shown after strenuous exercise in healthy individuals. Any association between a temporary increase in these markers and the presence of coronary artery disease (CAD) is unknown. We therefore aimed to explore circulating gut leakage markers in response to a bout of strenuous exercise in patients with symptoms of CAD. Patients referred to exercise stress testing due to symptoms of CAD were included (n = 287). A maximal exercise ECG stress test was performed and venous blood samples were drawn at rest and within five minutes after, for analysis of soluble cluster of differentiation 14 (sCD14), lipopolysaccharide-binding protein (LBP), intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide (LPS) and gene expression of toll-like receptor 4 (TLR4) in circulating leukocytes. Patients then underwent coronary angiography. LPS, LBP and sCD14 increased significantly after strenuous exercise in patients with symptoms of CAD, suggesting that even short bouts of vigorous exercise are associated with gut leakage. The gene expression of TLR4 decreased significantly after exercise, possibly as a negative feedback to the increase in LPS. There were no differences in exercise-induced changes between the groups of CAD, suggesting gut leakage to be independent of the presence of CAD.

scholarly journals Exercise recommendations in patients with valvular heart disease

Heart ◽  
2018 ◽  
Vol 105 (2) ◽  
pp. 106-110 ◽  
Author(s):  
Sabiha Gati ◽  
Aneil Malhotra ◽  
Sanjay Sharma
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Ventricular Function ◽  
Functional Capacity ◽  
Valvular Heart Disease ◽  
Stress Test ◽  
Exercise Stress ◽  
Competitive Sport ◽  
Increased Risk ◽  
The Impact

Valvular heart disease affects 1%–2% of young individuals, many of whom aspire to partake in competitive sport or high intensity recreational exercise. There are limited reports on the impact of intensive physical activity on the progression of valvular heart disease; therefore, current recommendations are based on consensus opinion. The management of exercising individuals with valvular heart disease requires a structured approach that incorporates several key factors including symptomatic status, functional capacity, type and nature of the valvular lesion, impact on ventricular structure and function and effect on pulmonary artery pressure. Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia. Symptomatic athletes and those with severe valvular heart disease, impaired ventricular function, pulmonary hypertension and arrhythmias should refrain from most competitive sports. Athletes with a bicuspid aortic valve and aortic root diameter >40 mm should avoid sport with a strong isometric component even with minimal valvular dysfunction. There is an association between mitral valve prolapse and sudden cardiac death in the general population; however, there is limited evidence of increased risk with competitive sport. Athletes undergoing corrective surgery may return to exercise after 3 months if ventricular function and exercise capacity are preserved. Individuals anticoagulated for mechanical bioprosthetic valves should avoid contact or collision sport to minimise the risk of bleeding.

Exericise and the Asthmatic Child

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 392-393
Author(s):  
◽  
Keyword(s):  
Airway Obstruction ◽  
Physical Exertion ◽  
Ambient Air ◽  
Important Variable ◽  
Strenuous Exercise ◽  
Chest Tightness ◽  
Vigorous Exercise ◽  
Children With Asthma ◽  
Exercise Induced ◽  
Response To Exercise

Airway obstruction often develops in children with asthma after physical exertion. This exerciseinduced bronchoconstriction on asthma is not limited to children with asthma but also occurs in children with allergic rhinitis without clinically necognizable asthma. Typically, 5 to 8 minutes of vigorous exercise is sufficient to make the child short of breath, and symptoms of coughing, chest tightness, and wheezing begin shortly afterward. Chest pain, shortness of breath, and/on chest tightness may be the only complaints. Usually, within ½ to 1 hour, the episode subsides spontaneously. Some children appear to also have a delayed (4 to 12 hours) response to exercise, with the same symptoms that were present immediately after exercise. The severity of such an attack of exercise-induced asthma depends on many factors. Children with poorly controlled asthma may have increased airway obstruction with trivial exercise such as walking or climbing a flight of stairs. The severity of obstruction at the onset of exercise may contribute as well, because an attack that begins with partially obstructed airways may end with more obstructed airways. The cold, dry ambient air significantly increases obstruction, as do many industrial pollutants, particularly sulfur dioxide. Both reactivity and obstruction may worsen with or after a viral infection on with allergen exposure, so that an asthmatic child's response to exercise may vary dramatically from day to day. The exercise itself is an important variable but is individualized. Strenuous exercise increases the severity of the asthma and a short, intense effort may induce exercise-induced asthma as well as a longer, less intense effort.

Abstract 14500: Physical Activity in Individuals With the Long Qt Syndrome: Baseline Data From the Lifestyle and Exercise in Long Qt Study (live Lqts)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Rachel J Lampert ◽  
Sharlene Day ◽  
Bradley S Marino ◽  
Matthew Burg ◽  
Barbara Ainsworth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Beta Blockers ◽  
Demographic Data ◽  
Activity Patterns ◽  
Protective Services ◽  
Vigorous Exercise ◽  
Long Qt ◽  
Or Gene ◽  
Exercise Induced ◽  
Record Review

Introduction: The safety of vigorous exercise for individuals with appropriately-treated LQTS remains unproven, and physical activity practices in this population have not been described. Methods: LIVE-LQTS prospectively enrolled individuals age 8-60 years with overt LQTS or gene mutation carriers. Participants (or parents, for children) answered surveys describing activity patterns. Vigorous exercise was defined as > 6 METS for > 60 hours per year. Clinical and demographic data were derived from medical record review. Results: Among 1554 participants, 804 (52%) reported exercising vigorously, 473 of these competitively, 577 (37%) exercising at moderate, and 173 (11%) at low levels. Seven percent of those working describe jobs more active than walking, including 10 in protective services and 19 in sports/coaching. Over 90% are genotype positive, 57% are phenotype positive at rest and an additional 16% have exercise-induced QT prolongation. Forty four percent have had documented ventricular arrhythmias or syncope. Eighty-four percent are appropriately treated with either beta-blockers, ICD, and/or sympathectomy, although among beta-blocked patients, only 60% are on the most effective agents. Among adults, BMI was significantly lower among the vigorous exercisers. Conclusion: While the high percentage of vigorous exercisers seen in this study may not represent all patients with LQTS due to self-selection for study participation, many patients with LQTS are engaged in vigorous exercise or competitive athletics. Prospective follow up of this cohort is ongoing and will determine safety of vigorous exercise through comparison of arrhythmic outcomes in vigorous exercisers vs moderate/low level exercisers.

scholarly journals Perceptions of exercise screening among older adults

2018 ◽  
Vol 43 (6) ◽  
pp. 580-586
Author(s):  
Liza Stathokostas ◽  
Andrea F.M. Petrella ◽  
Wendy Blunt ◽  
Robert J. Petrella
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Thematic Analysis ◽  
Stress Test ◽  
Community Dwelling ◽  
Exercise Stress ◽  
Screening Process ◽  
Convenience Sample ◽  
Exercise Participation ◽  
Activity Screening

Prephysical activity screening is important for older adults’ participating in physical activity. Unfortunately, many older adults face barriers to exercise participation and thus, may not complete proper physical activity screening. The purpose of this project was to conduct a thematic analysis of perceptions and experiences of community-dwelling older adults regarding prephysical activity screening (i.e., Get Active Questionnaire (GAQ) and a standardized exercise stress test). A convenience sample of adults (male n = 58, female n = 54) aged 75 ± 7 years living in the City of London, Ontario, Canada, was used. Participants completed a treadmill stress test and the GAQ at a research laboratory for community-based referrals. One week later, participants completed the GAQ again and were asked questions by a research assistant about their perceptions of the screening process. Thematic analysis of the responses was conducted. The results indicated that older adults view physical activity screening as acceptable, but not always necessary. Also, the experiences expressed by this sample of older adults indicated that physical activity screening can contribute to continued confidence (through reassurance) and can contribute to increased motivation (through yearly fitness results) in exercise participation. In conclusion, older adults may perceive screening as supportive in exercise adoption, if screening is simple, convenient, and supports older adults’ motivation and confidence to exercise.

scholarly journals Exercise-induced bronchoconstriction and non-specific airway hyperreactivity in patients suffering from bronchial asthma

2014 ◽  
Vol 71 (2) ◽  
pp. 191-194
Author(s):  
Dobrivoje Novkovic ◽  
Vesna Skuletic ◽  
Aleksandra Vulin ◽  
Gordana Cvetkovic
Keyword(s):  
Stress Test ◽  
Provocation Test ◽  
Exercise Stress Test ◽  
Airway Hyperreactivity ◽  
Exercise Stress ◽  
Bronchial Obstruction ◽  
Bronchial Provocation Test ◽  
Exercise Induced ◽  
Bronchial Provocation ◽  
Positive Results

Background/Aim. Physical activity is a common stimulus of asthmatic symptoms manifestation. Airway hyperreactivity is a predisposing cause of exercise induced bronchial obstruction, diagnosed by histamine inhalation. The aim of this study was to determine the relation between the amounts of histamine needed to induce non-specific airway hyperreactivity and exercise-induced bronchial obstruction. Methods. This randomized cross-over study included 160 male patients (age 19-27 years) suffering from bronchial asthma who showed positive results as the reaction after the histamine bronchial provocation test. Histamine concentrations were in a range of 0.03 to 4 mg/mL. Each patient participated in the exercise stress test conducted on a conveyor belt. The results of the exercise stress test were considered positive if the FEV1 level dropped by at least 15% from its initial value, 5-10 minutes after the test. Results. All the patients showed positive results as the reaction after the histamine bronchial provocation test, while 50 of them showed positive results after the exercise-induced stress test. There was a statistically highly significant difference in administrated histamine concentrations between the group of patients that had positive results on exercise stress test and those who did not (1mg/mL vs 0.5mg/mL; U = 1678; p < 0.01). Also, there was a statistically significant difference concerning the frequency of the positive results regarding histamine concentration after induced stress test (?2 = 10.885; p = 0.001). Among the patients with positive results, there was a statistically highly significant number of patients with bronchial obstruction induced by less than 2 mg/mL of histamine (p < 0.01). A statistically significant relation between the amount of histamine needed to induce bronchial obstruction and the results of the exercise stress test (p < 0.01) was also observed after the testing. Conclusion. In the group of patients with positive results after the exercise-induced stress test, there were significantly more patients with positive results to non-specific bronchial provocation test with lower histamine concentrations. Histamine concentrations needed to induce non-specific hyperreactivity of asthmatic airway were shown to be related to the reactivity to physical effort.

scholarly journals Comparison of the Levels of Hematological Parameters at Rest and after Maximum Exercise between Physically Active People with Spinal Cord Injury and Able-Bodied People

2021 ◽  
Vol 18 (23) ◽  
pp. 12323
Author(s):  
Łukasz Szymczak ◽  
Tomasz Podgórski ◽  
Katarzyna Domaszewska
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Maximal Exercise ◽  
Stress Test ◽  
Exercise Stress ◽  
Control Group ◽  
Physically Active ◽  
Significant Difference ◽  
Cord Injury ◽  
Exercise Induced

The aim of the study was to reveal the difference in the hematological reaction to the applied exercise-induced workload between the able-bodied and physically active people with cervical spinal cord injury. The study covered 11 males with spinal cord injury and 11 able-bodied persons. An incremental stress test was carried out until the maximum individual workloads were achieved. The peak oxygen uptake was measured with the use of the ergospirometric method. Venous blood test results at rest and after finishing the maximal exercise showed hemoglobin (Hb) concentration, hematocrit (HCT) value, erythrocytes (RBC), leukocytes (WBC) and platelets (PLT) counts as well as the relative percentage of granulocytes (GRA), lymphocytes (LYM), and monocytes (MON). RBC, HCT as well as Hb and PLT among people with the injury were statistically lower (p < 0.001) large effect size, than in the control group. Statistically significant difference between the test and control group, subjected to the maximal exercise stress test, was observed in the exercise induced change of the PLT [p < 0.001, (ES: 2.631)] WBC [p < 0.05, (ES: 1.429)] and the percentage of LYM and GRA [p < 0.05, (ES: 1.447) for LYM and (ES: 1.332) for GRA] between both groups, subjected to the maximal cardiac stress test on the manual cycloergometer. The analysis of the obtained results indicates that people with spinal cord injury are much more vulnerable to the occurrence of microcytic anemia compared to able-bodied people. The after-exercise percentage shift of selected subpopulations of leukocytes in both groups indicates a delayed post-exercise recovery among people with spinal cord injury.

Exercise induced complete atrioventricular block: Utility of exercise stress test

2018 ◽  
Vol 51 (1) ◽  
pp. 153-155
Author(s):  
Srikanth Yandrapalli ◽  
Prakash Harikrishnan ◽  
Amole Ojo ◽  
Venkat Lakshmi Kishan Vuddanda ◽  
Diwakar Jain
Keyword(s):  
Atrioventricular Block ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Complete Atrioventricular Block ◽  
Exercise Induced ◽  
Complete Atrioventricular
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