EXPLORING ASSOCIATIONS BETWEEN HEART RATE VARIABILITY AND EXERCISE TOLERANCE IN INDIVIDUALS WITH PERIPHERAL ARTERY DISEASE

Patients with peripheral artery disease (PAD), consistent with others with atherosclerotic occlusive disorders, have autonomic dysfunction (as measured by low heart rate variability [HRV]) that predisposes them to sympathetically mediated cardiac arrhythmias and sudden death. Exercise therapy has been shown to increase HRV in patients with coronary artery disease by increasing parasympathetic modulation of heart rate. This study quantified the circulatory and autonomic effects of a progressive, 12-week home-based, low-intensity (pain-free walking) exercise program in PAD and intermittent claudication. Participants ( N = 33, mean age 67.8 8.1 years) were randomly assigned to either a walking group ( n = 18), whose members performed a structured, 12-week, progressive walking program 5 days/week for 12 weeks, or a comparison group ( n = 15), whose members performed usual activities. Circulatory measures (heart rate, blood pressure, and rate pressure product) and autonomic measures (HRV) were obtained at the beginning (Week 1) and end (Week 12) of the study. Minimal change in circulatory measures occurred. However, spectral analysis of HRV revealed that autonomic function improved significantly in members of the walking group; specifically, there was an increase in parasympathetic and a decrease in sympathetic modulation. Members of the walking group also significantly increased maximal walking distance. These findings suggest that a structured, low-intensity, high-frequency walking program improves autonomic function by increasing HRV in patients with PAD.

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Impacts of Aqua Aerobic Exercise on Vascular Health and Exercise Tolerance in Patients With Peripheral Artery Disease

Case Medical Research ◽

10.31525/ct1-nct03849300 ◽

2019 ◽

Author(s):

Keyword(s):

Aerobic Exercise ◽

Peripheral Artery Disease ◽

Exercise Tolerance ◽

Vascular Health ◽

Peripheral Artery ◽

Artery Disease

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Supervised exercise therapy, blood pressure and heart rate during exercise, and functional impairment in Peripheral Artery Disease: results of a randomized clinical trial

Journal of Vascular Surgery ◽

10.1016/j.jvs.2021.05.033 ◽

2021 ◽

Author(s):

Joshua T. Slysz ◽

Lu Tian ◽

Lihui Zhao ◽

Dongxue Zhang ◽

Mary M. McDermott

Keyword(s):

Blood Pressure ◽

Clinical Trial ◽

Heart Rate ◽

Randomized Clinical Trial ◽

Peripheral Artery Disease ◽

Exercise Therapy ◽

Functional Impairment ◽

Peripheral Artery ◽

Supervised Exercise ◽

Artery Disease

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Greater Exercise Pressor Response Is Associated With Impaired Claudication Outcomes in Symptomatic Peripheral Artery Disease

Angiology ◽

10.1177/0003319718790876 ◽

2018 ◽

Vol 70 (3) ◽

pp. 220-228 ◽

Cited By ~ 4

Author(s):

Andrew W. Gardner ◽

Polly S. Montgomery ◽

Ming Wang ◽

Chixiang Chen ◽

Marcos Kuroki ◽

...

Keyword(s):

Heart Rate ◽

Peripheral Artery Disease ◽

Pressor Response ◽

Constant Load ◽

Rate Pressure Product ◽

Treadmill Test ◽

Peripheral Artery ◽

Negatively Associated ◽

Artery Disease ◽

Constant Load Exercise

We determined whether a greater exercise pressor response during a constant-load treadmill test was associated with lower peak walking time (PWT) and claudication onset time (COT) measured during a graded maximal treadmill test in 304 patients with symptomatic peripheral artery disease (PAD). The exercise pressor response was assessed by measuring heart rate and blood pressure (BP) at rest and during a constant-load treadmill test (speed = 2 mph, grade = 0%). After only 2 minutes of walking, mean heart rate increased by 26 beats/min from rest and mean systolic BP increased by 16 mm Hg. In adjusted analyses, increases in systolic BP ( P = .021), heart rate ( P = .002), mean arterial pressure ( P = .034), and rate–pressure product ( P < .001) from rest to 2 minutes of constant-load exercise were negatively associated with COT. Similarly, increases in heart rate ( P = .012) and rate–pressure product ( P = .018) from rest to 2 minutes of constant-load exercise were negatively associated with PWT. A greater exercise pressor response observed after only 2 minutes of walking at no incline was independently associated with impaired claudication outcomes in patients with symptomatic PAD. The implication is that the exercise pressor response is an important and easily obtained clinical measurement that partially explains differences in PWT and COT.

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Abstract 15209: Effects of Coffee Consumption on Exercise Tolerance, Blood Pressure, Heart Rate, Heart Rate Variability and Premature Beats in Volunteers with Coronary Artery Disease

Circulation ◽

10.1161/circ.130.suppl_2.15209 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Bruno M Mioto ◽

Miguel A Moretti ◽

Daniela Tarasoutchi ◽

Reynaldo V Amato ◽

Dante M Giorgi ◽

...

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Exercise Tolerance ◽

Treadmill Test ◽

Holter Ecg ◽

Artery Disease ◽

Premature Beats ◽

Filtered Coffee

Introduction: Coffee is supposed to increase blood pressure (BP) and heart rate (HR), which may be deleterious for patients with coronary artery disease (CAD). However a review of the literature reveals few studies evaluating these effects in patients with CAD. Objective: The aim of this study was to compare the effects of dark roast (DR) and medium dark roast (MDR) paper-filtered coffee on BP, exercise tolerance, HR, heart rate variability (HRV) and extrasystoles in volunteers with CAD. Methods: This randomized crossed-over trial compared the effects of consuming three or four cups (150 mL) of DR and MDR coffee per day for 4 weeks in 40 volunteers with CAD. In the baseline and after each 4 weeks period of drinking they were submitted to treadmill test, ambulatory blood pressure monitoring (24-h ABPM) and 24-h Holter ECG. We analyzed average systolic BP (SBP) and diastolic BP (DBP) at 24-h ABPM, total exercise time ([[Unable to Display Character: ∆]]T Exercise) and double product (DP) at treadmill test, and average HR, SDNN, ventricular (VPB) and supraventricular premature beats (SPB) at 24-h Holter ECG. Variables were evaluated by ANOVA for repeated measures and Friedman test when indicated. Results: We evaluated 40 subjects with CAD, 64.7 ± 6.7 years old, 32 men. All volunteers received adequate treatment for CAD according to the guidelines. Compared with baseline, subjects had an increase of 6.4% and 5.7% in [[Unable to Display Character: ∆]]T exercise at treadmill test after MDR and DR consumption respectively [565.8 ± 194.8 vs 601.8 ± 212.9 vs 597.8 ± 208.0 s (p=0.001)] without an increase in DP (p=0.91). In the 24-h Holter ECG at baseline, DR and MDR the following values were obtained, respectively: HR [67.1 ± 8.6 vs 66.5 ± 8.2 vs 67.2 ± 8.5 (p=0.71)], SDNN [130.6 ± 32.7 vs 134.2 ± 30.6 vs 129.7 ± 28.5 (p=0.428)], VPB [8.0 (2.0-395.5) vs 9.5 (0.2-54.7) vs 11.5 (3.0-51.7) (p=0.16)] and SPB [18.0 (5.2-73.0) vs 20.0 (5.5-75.5) vs 16.5 (6.2-72.5) (p=0.52)]. In the 24-h ABPM at baseline, DR and MDR the following values were obtained, respectively: SBP [110.8 ± 9.1 vs 109.2 ± 19.9 vs 114.7 ± 11.8 mmHg (p=0.10)] and DBP [64.1 ± 9.1 vs 64.6 ± 9.3 vs 66.4 ± 9.7 mmHg (p=0.14)]. Conclusions: Paper-filtered coffee increased exercise tolerance and had no considerable effect on BP, HR, HRV and premature beats in volunteers with CAD.

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Prognostic impact of resting heart rate in patients with peripheral artery disease

Vascular ◽

10.1177/17085381211013971 ◽

2021 ◽

pp. 170853812110139

Author(s):

Simona Patcheva ◽

Eva K Merzel ◽

Aljosa Milanovicc ◽

Mojca Bozicc ◽

Borut Jug

Keyword(s):

Heart Rate ◽

Confidence Interval ◽

Peripheral Artery Disease ◽

Independent Predictor ◽

Prognostic Impact ◽

Resting Heart Rate ◽

Peripheral Artery ◽

Disease Manifestation ◽

Pulse Palpation ◽

Artery Disease

Objectives Resting heart rate has been increasingly identified as a marker of cardiovascular risk and has been extensively studied as a predictor of coronary artery disease progression. In peripheral artery disease, the prognostic impact of resting heart rate remains elusive. Methods Consecutive patients undergoing invasive peripheral procedures were included. Data included resting heart rate determination by averaging manual radial pulse palpation measurements taken 24 h before and after an invasive peripheral procedure. Results A total of 1720 patients were included (mean age 70±11 years, 38% were female, 39% had critical limb ischemia). During a median follow-up of 729 days, 364 (21.2%) patients died. Resting heart rate emerged as an independent predictor of mortality, even after adjusting for clinical characteristics, peripheral artery disease manifestation and anatomic extent, traditional risk factors, co-morbidities, and disease-modifying therapies: hazard ratio for heart rate >75 bpm was 1.010 (95% confidence interval 1.001–1.109), with each bpm increase in resting heart rate conferring a 1.1% increase in the risk of all-cause mortality (95% confidence interval 0.1–10.9%, adjusted p = 0.030). Conclusions Resting heart rate is an independent predictor of mortality in patients with peripheral artery disease; our findings extend heart rate as a possible marker of prognosis to non-coronary atherosclerotic vascular disease.

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Mitochondrial Targeted Antioxidant Intake Improves Vascular Function And Exercise Tolerance In Peripheral Artery Disease Patients

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000685352.94627.34 ◽

2020 ◽

Vol 52 (7S) ◽

pp. 902-902

Author(s):

Elizabeth J. Pekas ◽

Won-Mok Son ◽

Ronald J. Headid ◽

TeSean K. Wooden ◽

Song-Young Park

Keyword(s):

Peripheral Artery Disease ◽

Vascular Function ◽

Exercise Tolerance ◽

Peripheral Artery ◽

Antioxidant Intake ◽

Artery Disease

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Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

Journal of Applied Physiology ◽

10.1152/japplphysiol.00209.2019 ◽

2019 ◽

Vol 127 (4) ◽

pp. 940-949 ◽

Cited By ~ 4

Author(s):

Song-Young Park ◽

Yi-Sub Kwak ◽

Elizabeth J. Pekas

Keyword(s):

Body Composition ◽

Exercise Training ◽

Arterial Stiffness ◽

Physical Function ◽

Peripheral Artery Disease ◽

Exercise Tolerance ◽

Muscular Strength ◽

Peripheral Artery ◽

Walking Exercise ◽

Artery Disease

Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD ( n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions ( P < 0.05) after 12 wk for legPWV and HR, which significantly decreased ( P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased ( P < 0.05) in AQ, compared with no changes in CON. There were no significant differences ( P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.

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