According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds;many of which wer...According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds;many of which were under the age of 65 years old [1]. In 2009, 386,324 people, 1 in 6 Americans, died as a result of coronary artery disease (CAD) alone [1]. They also estimate 150,000 people have “silent” heart attacks each year [1]. Even though the number of cardiovascular disease deaths has declined in the last 10 years, they still accounted for 32.3% of American deaths [1]. As a result, the AHA updated their 2020 goals to improve the nation’s cardiovascular health by 20% [1]. One of these methods is through the use of cardiac rehabilitation. Cardiac rehabilitation (CR) is a health promotion strategy to help return cardiac patients to their previous level of functioning, increase health, decrease comorbidities and promote education and lifestyle change. For select patients, another alternative exercise plan may exist to gain even better results. High intensity interval training (HIIT) has shown positive training results for athletes and many studies show that it may also be an effective exercise modality for many cardiac patients instead of the traditional circuit training method. This article will review current literature on the effects of HIIT on CR patients as well as a sample HIIT protocol for instituting this treatment with appropriate patients.展开更多
This study aimed to investigate the potential cardioprotective effects of moderate and high-intensity aerobic interval training(MIIT and HIIT)preconditioning.The focus was on histological changes,pro-oxidant-antioxida...This study aimed to investigate the potential cardioprotective effects of moderate and high-intensity aerobic interval training(MIIT and HIIT)preconditioning.The focus was on histological changes,pro-oxidant-antioxidant balance,autophagy initiation,and apoptosis in myocardial tissue incited by isoproterenol-induced pathological cardiac remodeling(ISO-induced PCR).Male Wistar rats were randomly divided into control(n=6),ISO(n=8),MIIT(n=4),HIIT(n=4),MIIT+ISO(n=8),and HIIT+ISO(n=8)groups.The MIIT and HIIT protocols were administered for 10 weeks,followed by the induction of cardiac remodeling using subcutaneous injection of ISO(100 mg/kg for two consecutive days).Alterations in heart rate(HR),mean arterial pressure(MAP),rate pressure product(RPP),myocardial oxygen consumption(MVO_(2)),cardiac hypertrophy,histopathological changes,prooxidant-antioxidant balance,autophagy biomarkers(Beclin-1,Atg7,p62,LC3Ⅰ/Ⅱ),and apoptotic cell distribution were measured.The findings revealed that the MIIT+ISO and HIIT+ISO groups demonstrated diminished myocardial damage,hemorrhage,immune cell infiltration,edema,necrosis,and apoptosis compared to ISO induced rats.MIIT and HIIT preconditioning mitigated HR,enhanced MAP,and preserved MVO_(2)and RPP.The pro-oxidant-antioxidant balance was sustained in both MIIT+ISO and HIIT+ISO groups,with MIIT primarily inhibiting pro-apoptotic autophagy progression through maintaining pro-oxidant-antioxidant balance,and HIIT promoting pro-survival autophagy.The results demonstrated the beneficial effects of both MIIT and HIIT as AITs preconditioning in ameliorating ISO-induced PCR by improving exercise capacity,hemodynamic parameters,and histopathological changes.Some of these protective effects can be attributed to the modulation of cardiac apoptosis,autophagy,and oxidative stress.展开更多
Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations lead...Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.展开更多
Cardiac rehabilitation is recommended for patients with chronic heart failure (CHF) with preserved, or reduced left ventricular ejection fraction (LVEF). A cardiac rehabilitation program generally includes physical ex...Cardiac rehabilitation is recommended for patients with chronic heart failure (CHF) with preserved, or reduced left ventricular ejection fraction (LVEF). A cardiac rehabilitation program generally includes physical exercise, diet counseling, educational classes on lifestyle changes, and disease management as well as psychosocial support for patients and their families. Exercise training is a core component of the comprehensive cardiac rehabilitation program and is strongly recommended in combination with pharmacological treatment to patients with CHF, due to cardiorespiratory, metabolic, and autonomic cardiac response. Exercise-based cardiac rehabilitation affects positively functional capacity, exercise tolerance, and quality of life in CHF patients. The physical inactivity rate in Arabian Peninsula countries is extremely high, and exercise training of habitually physically inactive individuals should result in marked improvements of physical capacity. We present a case that demonstrates such a significant improvement in the physical capacity of a patient with CHF and a review of literature.展开更多
Heart transplantation(HT),the treatment choice of advanced heart failure pa-tients,is proven effective in increasing the survival and functional status of the recipients.However,compared to normal controls,functional ...Heart transplantation(HT),the treatment choice of advanced heart failure pa-tients,is proven effective in increasing the survival and functional status of the recipients.However,compared to normal controls,functional status is lower in HT recipients.Exercise given in cardiac rehabilitation has been shown to improve exercise capacity as measured with peak oxygen uptake(VO2 peak)and muscle strength after completion of the program and cessation of exercise results in loss of exercise benefits.Several factors related to cardiac denervation and the use of immunosuppressive agents in HT recipients result in functional impairments including cardiovascular,pulmonary,exercise capacity,psychological,and qua-lity of life(QoL)problems.High-intensity interval training(HIIT)is the most common type of exercise used in HT recipients and given as a hospital-based program.Improvement of functional impairments was found to have occurred due to primarily musculoskeletal adaptations through improvement of muscle structure and aerobic capacity and cardiovascular adaptations.In general,exercise given after transplantation improved VO2 peak significantly and improvement was better in the HIIT group compared to moderate intensity continuous training or no-exercise groups.Improvement of QoL was ascribed to improve-ment of exercise capacity,symptoms,pulmonary function,physical capacity improve-ment,anxiety,and depression.展开更多
文摘According to the American Heart Association’s (AHA) recent statistical update, over 2150 Americans die each day from cardiovascular disease (CVD), which equals approximately 1 death every 40 seconds;many of which were under the age of 65 years old [1]. In 2009, 386,324 people, 1 in 6 Americans, died as a result of coronary artery disease (CAD) alone [1]. They also estimate 150,000 people have “silent” heart attacks each year [1]. Even though the number of cardiovascular disease deaths has declined in the last 10 years, they still accounted for 32.3% of American deaths [1]. As a result, the AHA updated their 2020 goals to improve the nation’s cardiovascular health by 20% [1]. One of these methods is through the use of cardiac rehabilitation. Cardiac rehabilitation (CR) is a health promotion strategy to help return cardiac patients to their previous level of functioning, increase health, decrease comorbidities and promote education and lifestyle change. For select patients, another alternative exercise plan may exist to gain even better results. High intensity interval training (HIIT) has shown positive training results for athletes and many studies show that it may also be an effective exercise modality for many cardiac patients instead of the traditional circuit training method. This article will review current literature on the effects of HIIT on CR patients as well as a sample HIIT protocol for instituting this treatment with appropriate patients.
文摘This study aimed to investigate the potential cardioprotective effects of moderate and high-intensity aerobic interval training(MIIT and HIIT)preconditioning.The focus was on histological changes,pro-oxidant-antioxidant balance,autophagy initiation,and apoptosis in myocardial tissue incited by isoproterenol-induced pathological cardiac remodeling(ISO-induced PCR).Male Wistar rats were randomly divided into control(n=6),ISO(n=8),MIIT(n=4),HIIT(n=4),MIIT+ISO(n=8),and HIIT+ISO(n=8)groups.The MIIT and HIIT protocols were administered for 10 weeks,followed by the induction of cardiac remodeling using subcutaneous injection of ISO(100 mg/kg for two consecutive days).Alterations in heart rate(HR),mean arterial pressure(MAP),rate pressure product(RPP),myocardial oxygen consumption(MVO_(2)),cardiac hypertrophy,histopathological changes,prooxidant-antioxidant balance,autophagy biomarkers(Beclin-1,Atg7,p62,LC3Ⅰ/Ⅱ),and apoptotic cell distribution were measured.The findings revealed that the MIIT+ISO and HIIT+ISO groups demonstrated diminished myocardial damage,hemorrhage,immune cell infiltration,edema,necrosis,and apoptosis compared to ISO induced rats.MIIT and HIIT preconditioning mitigated HR,enhanced MAP,and preserved MVO_(2)and RPP.The pro-oxidant-antioxidant balance was sustained in both MIIT+ISO and HIIT+ISO groups,with MIIT primarily inhibiting pro-apoptotic autophagy progression through maintaining pro-oxidant-antioxidant balance,and HIIT promoting pro-survival autophagy.The results demonstrated the beneficial effects of both MIIT and HIIT as AITs preconditioning in ameliorating ISO-induced PCR by improving exercise capacity,hemodynamic parameters,and histopathological changes.Some of these protective effects can be attributed to the modulation of cardiac apoptosis,autophagy,and oxidative stress.
文摘Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.
文摘Cardiac rehabilitation is recommended for patients with chronic heart failure (CHF) with preserved, or reduced left ventricular ejection fraction (LVEF). A cardiac rehabilitation program generally includes physical exercise, diet counseling, educational classes on lifestyle changes, and disease management as well as psychosocial support for patients and their families. Exercise training is a core component of the comprehensive cardiac rehabilitation program and is strongly recommended in combination with pharmacological treatment to patients with CHF, due to cardiorespiratory, metabolic, and autonomic cardiac response. Exercise-based cardiac rehabilitation affects positively functional capacity, exercise tolerance, and quality of life in CHF patients. The physical inactivity rate in Arabian Peninsula countries is extremely high, and exercise training of habitually physically inactive individuals should result in marked improvements of physical capacity. We present a case that demonstrates such a significant improvement in the physical capacity of a patient with CHF and a review of literature.
文摘Heart transplantation(HT),the treatment choice of advanced heart failure pa-tients,is proven effective in increasing the survival and functional status of the recipients.However,compared to normal controls,functional status is lower in HT recipients.Exercise given in cardiac rehabilitation has been shown to improve exercise capacity as measured with peak oxygen uptake(VO2 peak)and muscle strength after completion of the program and cessation of exercise results in loss of exercise benefits.Several factors related to cardiac denervation and the use of immunosuppressive agents in HT recipients result in functional impairments including cardiovascular,pulmonary,exercise capacity,psychological,and qua-lity of life(QoL)problems.High-intensity interval training(HIIT)is the most common type of exercise used in HT recipients and given as a hospital-based program.Improvement of functional impairments was found to have occurred due to primarily musculoskeletal adaptations through improvement of muscle structure and aerobic capacity and cardiovascular adaptations.In general,exercise given after transplantation improved VO2 peak significantly and improvement was better in the HIIT group compared to moderate intensity continuous training or no-exercise groups.Improvement of QoL was ascribed to improve-ment of exercise capacity,symptoms,pulmonary function,physical capacity improve-ment,anxiety,and depression.
