scholarly journals Particularities in Cardiovascular Recovery by Physical Training in a Patient with Prosthetic Valve, Permanent Electrical Cardiac Stimulation and Aortocoronary Bypass

2019 ◽  
Vol 16 (5) ◽  
pp. 85-95
Author(s):  
Cristina Adam ◽  
Magda Mitu ◽  
Dana Mîndru ◽  
Ana-Karina Gîlcă ◽  
Radu Sebastian Gavril ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Cardiac Pacemaker ◽  
Mechanical Valve ◽  
Rehabilitation Program ◽  
Exercise Heart Rate ◽  
Second Phase ◽  
Aortocoronary Bypass ◽  
Adaptation To Exercise

AbstractIntroduction: Going through a complete cardiac rehabilitation is essential for all cardiac patients undergoing complex surgery, including those who wear intracardiac devices. Determining the effort capacity after the surgical intervention might provide satisfactory results with the improvement of the quality of life.Case presentation: We present the case of a male patient, 44 years old, known with aortic bicuspid valve, aortic mechanical valve evolved with prosthesis mismatch and aortocoronary bypass (right coronary artery), followed by total atrioventricular block which required cardiac pacemaker VVI, who is admitted in the Cardiovascular Rehabilitation Clinic to continue the second phase of the rehabilitation program. The ergospirometry test (which was performed in order to evaluate the impairment of the effort capacity) showed a moderate-severe decrease of effort capacity (42% of maximal oxygen consumption, class C Weber), effort hypotension and chronotropic incompetence which led to pausing cardiopulmonary test before anaerobic threshold. Stepper exercise or climbing stairs did not cause the lowering of blood pressure and heart rate, which led to the idea of controlling and adjusting the stimulation parameters. Within cardiopulmonary testing in patients with pacemaker special regards should be paid towards: parameters assessment during effort (heart rate during the test in pacemakers without adaptation to exercise, heart rate during the test in pacemakers with adaptation to exercise, evaluation of the effort response in patients undergoing resynchronization therapy) and diagnosis of exercise-induced arrhythmia (atrial fibrillation, ventricular extrasystoles, ventricular tachycardia, as well as identification of arrhythmias in patients with implantable cardioverter defibrillator).Conclusion: The cardiopulmonary stress test in patients with cardiostimulation should respect certain conditions in conducting the test in order to obtain realistic results of functional capacity. Due to the position of the piezoelectric crystal and the immobilization of the limbs during the cycle ergometer test it is recommended testing using the treadmill.

scholarly journals Decreased maximal heart rate with aging is related to reduced β-adrenergic responsiveness but is largely explained by a reduction in intrinsic heart rate

2008 ◽  
Vol 105 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Demetra D. Christou ◽  
Douglas R. Seals
Keyword(s):  
Heart Rate ◽  
Maximal Oxygen Consumption ◽  
Older Men ◽  
Exercise Heart Rate ◽  
Maximal Heart Rate ◽  
Adrenergic Stimulation ◽  
Ganglionic Blockade ◽  
Intrinsic Heart Rate ◽  
Age Related ◽  
Aerobic Exercise Capacity

A decrease in maximal exercise heart rate (HRmax) is a key contributor to reductions in aerobic exercise capacity with aging. However, the mechanisms involved are incompletely understood. We sought to gain insight into the respective roles of intrinsic heart rate (HRint) and chronotropic β-adrenergic responsiveness in the reductions in HRmax with aging in healthy adults. HRmax (Balke treadmill protocol to exhaustion), HRint (HR during acute ganglionic blockade with intravenous trimethaphan), and chronotropic β-adrenergic responsiveness (increase in HR with incremental intravenous infusion of isoproterenol during ganglionic blockade) were determined in 15 older (65 ± 5 yr) and 15 young (25 ± 4 yr) healthy men. In the older men, HRmax was lower (162 ± 9 vs. 191 ± 11 beats/min, P < 0.0001) and was associated with a lower HRint (58 ± 7 vs. 83 ± 9 beats/min, P < 0.0001) and chronotropic β-adrenergic responsiveness (0.094 ± 0.036 vs. 0.154 ± 0.045 ΔHR/[isoproterenol]: P < 0.0001). Both HRint ( r = 0.87, P < 0.0001) and chronotropic β-adrenergic responsiveness ( r = 0.61, P < 0.0001) were positively related to HRmax. Accounting for the effects of HRint and chronotropic β-adrenergic responsiveness reduced the age-related difference in HRmax by 83%, rendering it statistically nonsignificant ( P = 0.2). Maximal oxygen consumption was lower in the older men (34.9 ± 8.1 vs. 48.6 ± 6.7 ml·kg−1·min−1, P < 0.0001) and was positively related to HRmax ( r = 0.62, P < 0.0001), HRint ( r = 0.51, P = 0.002), and chronotropic β-adrenergic responsiveness ( r = 0.47, P = 0.005). Our findings indicate that, together, reductions in HRint and chronotropic responsiveness to β-adrenergic stimulation largely explain decreases in HRmax with aging, with the reduction in HRint playing by far the greatest role.

Post-exercise heart rate recovery and its speed are associated with cardiac autonomic responsiveness following orthostatic stress test in men

2021 ◽  
pp. 1-13
Author(s):  
Guilherme E. Molina ◽  
Carlos J. G. da Cruz ◽  
Keila E. Fontana ◽  
Edgard M. K. V. K. Soares ◽  
Luiz Guilherme G. Porto ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Exercise Heart Rate ◽  
Orthostatic Stress ◽  
Post Exercise ◽  
Orthostatic Stress Test

scholarly journals An investigation into a contactless photoplethysmographic mobile application to record heart rate post-exercise: Implications for field testing

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Daniel J. Peart ◽  
Matthew P. Shaw ◽  
Chris G. Rowley
Keyword(s):  
Heart Rate ◽  
Mobile Application ◽  
Maximal Oxygen Consumption ◽  
Cost Effective ◽  
Step Test ◽  
Exercise Heart Rate ◽  
Measurement Tool ◽  
Maximal Aerobic Capacity ◽  
Laboratory Equipment ◽  
Post Exercise

Summary Study aim: the aim of this study was to compare the accuracy of a contactless photoplethysmographic mobile application (CPA) to record post-exercise heart rate and estimate maximal aerobic capacity after the Queen’s College Step Test. It was hypothesised that the CPA may present a cost effective heart rate measurement tool for educators and practitioners with limited access to specialised laboratory equipment. Materials and Methods: seventeen participants (eleven males and six females, 28 ± 9 years, 75.5 ± 15.5 kg, 173.6 ± 9.8 cm) had their heart rate measured immediately after the 3-min test simultaneously using the CPA, a wireless heart rate monitor (HRM) and manually via palpation of the radial artery (MAN). Results: both the CPA and MAN measurements had high variance compared to the HRM (CV = 31 and 11% respectively, ES = 1.79 and 0.65 respectively), and there were no significant correlations between the methods. Maximal oxygen consumption was estimated 17% higher in CPA compared to HRM (p < 0.001). Conclusions: in conclusion it is recommended that field practitioners should exercise caution and assess the accuracy of new freely available technologies if they are to be used in practice.

scholarly journals Renal Functional Reserve Is Related to the Nondipping Phenotype and to the Exercise Heart Rate Response in Patients with Essential Hypertension and Preserved Renal Function

2020 ◽  
Vol 45 (5) ◽  
pp. 737-747
Author(s):  
Katerina Damianaki ◽  
Michel Burnier ◽  
Kyriakos Dimitriadis ◽  
Costas Tsioufis ◽  
Dimitrios Petras
Keyword(s):  
Heart Rate ◽  
Renal Function ◽  
Essential Hypertension ◽  
Vascular Reactivity ◽  
Stress Test ◽  
Kidney Injury ◽  
Exercise Heart Rate ◽  
Functional Reserve ◽  
Hypertensive Patients ◽  
Renal Functional Reserve

Background: Renal functional reserve (RFR), defined as the difference between stress and resting glomerular filtration rate (GFR), may constitute a diagnostic tool to identify patients at higher risk of developing acute kidney injury or chronic kidney disease. Blunted RFR has been demonstrated in early stages of hypertension and has been attributed to impaired vascular reactivity due to an overactive sympathetic nervous system (SNS). Objective: The purpose of this study was to investigate whether RFR correlates with other phenotypes expressing overactivity of the SNS in patients with essential hypertension and preserved renal function. Methods: Thirty-six patients with untreated essential hypertension and a GFR >60 mL/min/1.73 m2 were enrolled. The following parameters were measured: RFR, 24-h ambulatory blood pressure (BP) profile, a treadmill stress test, and an echocardiographic examination. Urine and venous samples were obtained at specific time points for the determination of clinical parameters, and both resting and stress GFR were calculated by using endogenous creatinine clearance for the measurement of RFR after an acute oral protein load (1 g/kg). Results: Twenty-one patients had a RFR <30 mL/min/1.73 m2 and 15 had a RFR above this cutoff. A nondipping pattern of 24-h BP was significantly more frequent in patients with low RFR (57.1 vs. 25.0%, p < 0.05 for systolic BP and 52.3 vs. 10.0%, p < 0.02 for diastolic BP). Moreover, patients with lower RFR values showed a blunted heart rate (HR) response to exercise during treadmill test (r = 0.439, p < 0.05). None of the echocardiographic parameters differed between the two groups of patients. Conclusions: In hypertensive patients with preserved GFR, reduced RFR is related to nondipping BP phenotype as well as to attenuated exercise HR response. Overactivity of the SNS may be a common pathway. Since loss of RFR may represent a risk factor for acute or chronic kidney injury, hypertensive patients with blunted RFR might need a more careful renal follow-up.

Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals

Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 242-248
Author(s):  
Ehimen C. Aneni ◽  
Ebenezer T. Oni ◽  
Chukwuemeka U. Osondu ◽  
Seth S. Martin ◽  
Michael J. Blaha ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stress Test ◽  
Statistical Significance ◽  
Normal Weight ◽  
Exercise Stress ◽  
Peak Exercise ◽  
Exercise Heart Rate ◽  
Cross Sectional ◽  
Metabolic Equivalents ◽  
The Impact

Objective: To assess the impact of aerobic fitness on exercise heart rate (HR) indices in an asymptomatic cohort across different body mass index (BMI) categories. Methods: We performed a cross-sectional analysis of 506 working-class Brazilian subjects, free of known clinical cardiovascular disease (e.g. ischemic heart disease and stroke) who underwent an exercise stress test. Results: There was a significant trend towards decreased HR at peak exercise, HR recovery and chronotropic index (CI) measures as BMI increased, but resting HR increased significantly across BMI categories. In multivariate analysis, the change in CI per unit change in metabolic equivalents of task was greater among the obese subjects than the normal-weight (2.7 vs. -0.07; p interaction = 0.029) and overweight (2.7 vs. 0.7; p interaction = 0.044) subjects. A similar pattern was seen with peak HR and HR recovery, although the formal tests of interaction did not achieve statistical significance. Conclusion: Our findings strongly suggest that fitness is associated with a favorable HR profile and is modified by BMI. Intervention programs should place emphasis on fitness and not only on weight loss.

scholarly journals Usability of and Adherence to a Novel, Home-based Cardiac Telerehabilitation Program for Heart Attack Survivors: The MI-PACE Cohort Study (Preprint)

2020 ◽  
Author(s):  
Eric Y Ding ◽  
Nathaniel Erskine ◽  
Wim Stut ◽  
Emily Ensom ◽  
Amy Peterson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Pilot Study ◽  
Stress Test ◽  
Academic Medical Center ◽  
Exercise Stress ◽  
Exercise Heart Rate ◽  
Management Interventions ◽  
System Usability Scale ◽  
At Home

BACKGROUND Cardiac rehabilitation (CR) programs, consisting of exercise training and disease management interventions, reduce morbidity and mortality after an acute myocardial infarction (AMI). OBJECTIVE In this pilot study, we developed and assessed the feasibility of delivering a novel health watch-informed 12-week tele-CR program to AMI survivors who declined participation in center-based CR. METHODS We enrolled hospitalized AMI survivors at an academic medical center who were eligible for, but declined, center-based CR. All participants underwent a baseline exercise stress test. Participants received a health watch that monitored heart rate (HR) and activity, and a tablet computer with an application that displayed progress towards accomplishing weekly walking and exercise goals. Results were transmitted to a CR nurse via a secure connection. For 12 weeks, participants exercised at home using HR and walking targets, and also participated in weekly phone counseling sessions with the CR nurse, who provided personalized CR problem solving and standard CR education. We assessed usability of the system, adherence to weekly exercise and walking goals, counseling session attendance, and disease-specific quality of life. RESULTS Eighteen participants completed the 12-week telerehabilitation program. Their mean age was 59 (SD 7) years, 33% were women, and 33% had an ST-elevation myocardial infarction. Participants wore the health watch for a median of 12.7 hours (Q1, Q3: 11.1, 13.8) per day and completed a median of 86% of exercise goals. Participants on average walked 121 minutes per week (SD 175) and spent 189 minutes per week (SD 210) in their targeted exercise heart rate zone. Overall, participants found the system to be highly usable (median System Usability Scale score of 83 (Q1, Q3: 65, 100). CONCLUSIONS This pilot study established the feasibility of delivering tele-CR at home to AMI survivors via a health watch-based program and telephone counseling sessions. Usability and adherence to health watch use, exercise recommendations, and counseling sessions were high. Additional studies with larger patient samples are warranted to compare center-based rehabilitation and telerehabilitation on patient outcomes and healthcare resource utilization.

scholarly journals Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research

2021 ◽  
Vol 10 (11) ◽  
pp. 2253
Author(s):  
Agnieszka Grochulska ◽  
Sebastian Glowinski ◽  
Aleksandra Bryndal
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Exercise Stress Test ◽  
Health Condition ◽  
Exercise Stress ◽  
Test Time ◽  
Before And After

(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.

scholarly journals Cardiac rehabilitation via telerehabilitation in COVID-19 pandemic situation

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Dian M. Sari ◽  
Laurentia C. G. Wijaya
Keyword(s):  
Cardiac Rehabilitation ◽  
Health Care Providers ◽  
Rehabilitation Program ◽  
Lifestyle Changes ◽  
Second Phase ◽  
Main Body ◽  
Cardiac Rehabilitation Program ◽  
Care Providers ◽  
Adherence To Medication ◽  
Home Based

Abstract Background Adherence to medication and lifestyle changes are very important in the secondary prevention of cardiovascular disease. One of the ways is by doing a cardiac rehabilitation program. Main body of the abstract Cardiac rehabilitation program is divided into three phases. The cardiac rehabilitation program’s implementation, especially the second phase, center-based cardiac rehabilitation (CBCR), has many barriers not to participate optimally. Therefore, the third phase, known as home-based cardiac rehabilitation (HBCR), can become a substitute or addition to CBCR. On the other hand, this phase is also an essential part of the patients’ functional capacity. During the coronavirus disease-2019 pandemic, HBCR has become the leading solution in the cardiac rehabilitation program’s sustainability. Innovation is needed in its implementation, such as telerehabilitation. So, the cardiac rehabilitation program can be implemented by patients and monitored by health care providers continuously. Short conclusion Physicians play an essential role in motivating patients and encouraging their family members to commit to a sustainable CR program with telerehabilitation to facilitate its implementation.

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