AIM To study exercise capacity and determinants of early peak oxygen consumption(VO_(2peak)) in a cohort of de novo heart transplant(HTx) recipients. METHODS To determine possible central(chronotropic responses, cardi...AIM To study exercise capacity and determinants of early peak oxygen consumption(VO_(2peak)) in a cohort of de novo heart transplant(HTx) recipients. METHODS To determine possible central(chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors(muscular exercise capacity and body composition) predictive of VO_(2peak), a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing(CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer. Metabolic/respiratory measures include VO_(2peak) and VE/VCO2 slope. Additional measures included muscle strength testing, bioelectrical impedance analysis, echocardiography, blood sampling and health-related quality of life. Based on the VO_(2peak)(mL/kg per minute) median value, the study population was divided into two groups defined as a low-capacity group and a high-capacity group. Potential predictors were analyzed using multiple regression analysis with VO_(2peak)(L/min) as the dependent variable.RESULTS The mean ± standard deviation(SD) age of the total study population was 49 ± 13 years, and 73% were men. This de novo HTx cohort demonstrated a median VO_(2peak) level of 19.4 mL/kg per min at 11 ± 1.8 wk postHTx. As compared with the high-capacity group, the low-capacity group exercised for a shorter time, had lower maximal ventilation, O_2 pulse, peak heart rate and heart rate reserve, while the VE/VCO_2 slope was higher. The low-capacity group had less muscle strength and muscular exercise capacity in comparison with the highcapacity group. In order of importance, O_2 pulse, heart rate reserve, muscular exercise capacity, body mass index, gender and age accounted for 84% of the variance in VO_(2peak)(L/min). There were no minor or major serious adverse events during the CPET. CONCLUSION Although there is great individual variance among de novo HTx recipients, early VO_(2peak) measures appear to be influenced by both central and peripheral factors.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolera...BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.展开更多
基金Supported by the Norwegian Health Association,No.12906Scandiatransplantthe South-Eastern Norway Regional Authority,No.2013111
文摘AIM To study exercise capacity and determinants of early peak oxygen consumption(VO_(2peak)) in a cohort of de novo heart transplant(HTx) recipients. METHODS To determine possible central(chronotropic responses, cardiopulmonary and hemodynamic function) and peripheral factors(muscular exercise capacity and body composition) predictive of VO_(2peak), a number of different measurements and tests were performed, as follows: Cardiopulmonary exercise testing(CPET) was performed mean 11 wk after surgery in 81 HTx recipients > 18 years and was measured with breath by breath gas exchange on a treadmill or bicycle ergometer. Metabolic/respiratory measures include VO_(2peak) and VE/VCO2 slope. Additional measures included muscle strength testing, bioelectrical impedance analysis, echocardiography, blood sampling and health-related quality of life. Based on the VO_(2peak)(mL/kg per minute) median value, the study population was divided into two groups defined as a low-capacity group and a high-capacity group. Potential predictors were analyzed using multiple regression analysis with VO_(2peak)(L/min) as the dependent variable.RESULTS The mean ± standard deviation(SD) age of the total study population was 49 ± 13 years, and 73% were men. This de novo HTx cohort demonstrated a median VO_(2peak) level of 19.4 mL/kg per min at 11 ± 1.8 wk postHTx. As compared with the high-capacity group, the low-capacity group exercised for a shorter time, had lower maximal ventilation, O_2 pulse, peak heart rate and heart rate reserve, while the VE/VCO_2 slope was higher. The low-capacity group had less muscle strength and muscular exercise capacity in comparison with the highcapacity group. In order of importance, O_2 pulse, heart rate reserve, muscular exercise capacity, body mass index, gender and age accounted for 84% of the variance in VO_(2peak)(L/min). There were no minor or major serious adverse events during the CPET. CONCLUSION Although there is great individual variance among de novo HTx recipients, early VO_(2peak) measures appear to be influenced by both central and peripheral factors.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.
