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Exercise physiology heart failure

Akiomi Yoshihisa, Satoshi Abe, Takatoyo Kiko, Yusuke Kimishima, Yu Sato, Shunsuke Watanabe, Yuki Kanno, Makiko Miyata-Tatsumi, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, Yasuchika Takeishi
BACKGROUND: Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF). METHODS AND RESULTS: We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into three groups based on serum zinc levels (µg/dl): 1st (zinc≥75, n=323), 2nd (62≤zinc<75, n=322) and 3rd (zinc<62, n=323) tertiles...
March 1, 2018: Journal of Cardiac Failure
Antonio Berruezo, Markus Linhart, Angelo Auricchio, José Luis Zamorano, Pilar Santamaria, Roger Borràs, Felip Burgos, Josep Brugada
PURPOSE: Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy Patients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
G L Ackland, T E F Abbott, R M Pearse, S N Karmali, J Whittle, G Minto
BACKGROUND: Systemic arterial pulse pressure (systolic minus diastolic pressure) ≤53 mm Hg in patients with cardiac failure is correlated with reduced stroke volume and is independently associated with accelerated morbidity and mortality. Given that deconditioned surgical and heart failure patients share similar cardiopulmonary physiology, we examined whether lower pulse pressure is associated with excess morbidity after major surgery. METHODS: This was a prospective observational cohort study of patients deemed by their preoperative assessors to be at higher risk of postoperative morbidity...
January 2018: British Journal of Anaesthesia
Lorenz H Lehmann, Zegeye H Jebessa, Michael M Kreusser, Axel Horsch, Tao He, Mariya Kronlage, Matthias Dewenter, Viviana Sramek, Ulrike Oehl, Jutta Krebs-Haupenthal, Albert H von der Lieth, Andrea Schmidt, Qiang Sun, Julia Ritterhoff, Daniel Finke, Mirko Völkers, Andreas Jungmann, Sven W Sauer, Christian Thiel, Alexander Nickel, Michael Kohlhaas, Michaela Schäfer, Carsten Sticht, Christoph Maack, Norbert Gretz, Michael Wagner, Ali El-Armouche, Lars S Maier, Juan E Camacho Londoño, Benjamin Meder, Marc Freichel, Hermann-Josef Gröne, Patrick Most, Oliver J Müller, Stephan Herzig, Eileen E M Furlong, Hugo A Katus, Johannes Backs
The stress-responsive epigenetic repressor histone deacetylase 4 (HDAC4) regulates cardiac gene expression. Here we show that the levels of an N-terminal proteolytically derived fragment of HDAC4, termed HDAC4-NT, are lower in failing mouse hearts than in healthy control hearts. Virus-mediated transfer of the portion of the Hdac4 gene encoding HDAC4-NT into the mouse myocardium protected the heart from remodeling and failure; this was associated with decreased expression of Nr4a1, which encodes a nuclear orphan receptor, and decreased NR4A1-dependent activation of the hexosamine biosynthetic pathway (HBP)...
January 2018: Nature Medicine
Attila Vágvölgyi, Zsolt Rozgonyi, Pál Vadász, János Tamás Varga
INTRODUCTION: Besides the oncology and operative surgical technics, functional aspects influence the operability of lung cancer. Preoperative risk stratification, evaluation of postoperative complications needs to be considered. AIM: To review international literature and experiences of our institute. METHOD: We focused the literature of risk stratification of thoracic surgery. Lung function, lung mechanics, chest kinematics, exercise physiology were considered...
December 2017: Orvosi Hetilap
Michael Scharf, Derya Oezdemir, Axel Schmid, Wolfgang Kemmler, Simon von Stengel, Matthias S May, Michael Uder, Michael M Lell
OBJECTIVE: Although musculoskeletal effects in resistance training are well described, little is known about structural and functional cardiac adaption in formerly untrained subjects. We prospectively evaluated whether short term high intensity (resistance) training (HI(R)T) induces detectable morphologic cardiac changes in previously untrained men in a randomized controlled magnetic resonance imaging (MRI) study. MATERIALS AND METHODS: 80 untrained middle-aged men were randomly assigned to a HI(R)T-group (n = 40; 43...
2017: PloS One
Marco Morosin, Stefania Farina, Carlo Vignati, Emanuele Spadafora, Susanna Sciomer, Elisabetta Salvioni, Gianfranco Sinagra, Piergiuseppe Agostoni
AIMS: The two main symptoms referred by chronic heart failure (HF) patients as the causes of exercise termination during maximal cardiopulmonary exercise testing (CPET) are muscular fatigue and dyspnoea. So far, a physiological explanation why some HF patients end exercise because of dyspnoea and others because of fatigue is not available. We assessed whether patients referring dyspnoea or muscular fatigue may be distinguished by different ventilator or haemodynamic behaviours during exercise...
February 2018: ESC Heart Failure
David Cristobal Andrade, Alexis Arce-Alvarez, Camilo Toledo, Hugo S Diaz, Claudia Lucero, Rodrigo Quintanilla, Harold D Schultz, Noah J Marcus, Markus Amman, Rodrigo Del Rio
Heart failure (HF) is a global public health problem that, independent of its etiology (reduced (HFrEF) or preserved ejection fraction (HFpEF)), is characterized by functional impairments of cardiac function, chemoreflex hypersensitivity, baroreflex sensitivity (BRS) impairment, and abnormal autonomic regulation, all of which contribute to increased morbidity and mortality. Exercise training (ExT) has been identified as a nonpharmacological therapy capable of restoring normal autonomic function and improving survival in patients with HFrEF...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
Ethan J Rowin, Barry J Maron, Iacopo Olivotto, Martin S Maron
Over the last 25 years, patients with hypertrophic cardiomyopathy (HCM) have been studied with a variety of methods employing physiological exercise that have made major contributions to disease management and are performed without increased risk. Previously under-utilized in HCM, exercise (stress) echocardiography has become incorporated into the standard clinical assessment and diagnostic armamentarium of HCM using upright or supine symptom-limited treadmill or bicycle modalities. In patients without outflow gradients at rest, exercise echocardiography is the most appropriate method for provoking obstruction, with the capability of predicting future development of progressive heart failure symptoms, and differentiating patients with provocable obstruction from those without obstruction, with major implications for dictating treatment options, that is, surgical myectomy (alternatively, alcohol septal ablation) versus heart transplant...
November 2017: JACC. Cardiovascular Imaging
Jubert Marquez, Jin Han
Mitochondria are complex organelles essential for the production of energy. These dynamic, complex organelles found in every cell and tissues of the body have been well-studied in various physiological models, stressing that mitochondrial dysfunction is characteristic of pathological states, especially in cardiovascular diseases and heart failure. Since heart failure progresses due to energy deficits brought about by altered mitochondrial bioenergetics and functioning, novel ways of ameliorating mitochondrial dysfunction are being studied...
2017: Advances in Experimental Medicine and Biology
Yihua Bei, Lichan Tao, Dragos Cretoiu, Sanda Maria Cretoiu, Junjie Xiao
MicroRNAs (miRNAs, miRs), a group of small non-coding RNAs, repress gene expressions at posttranscriptional level in most cases and are involved in cardiovascular physiology and disease pathogenesis. Increasing evidence has proved that miRNAs are potential regulators of exercise induced cardiac growth and mediate the benefits of exercise in a variety of cardiovascular diseases. In this chapter, we will review the regulatory effects of miRNAs in cardiac adaptations to exercise, and summarize their cardioprotective effects against myocardial infarction, ischemia/reperfusion injury, heart failure, diabetic cardiomyopathy, atherosclerosis, hypertension, and pulmonary hypertension...
2017: Advances in Experimental Medicine and Biology
Kate L Weeks, Bianca C Bernardo, Jenny Y Y Ooi, Natalie L Patterson, Julie R McMullen
Regular physical activity or exercise training can lead to heart enlargement known as cardiac hypertrophy. Cardiac hypertrophy is broadly defined as an increase in heart mass. In adults, cardiac hypertrophy is often considered a poor prognostic sign because it often progresses to heart failure. Heart enlargement in a setting of cardiac disease is referred to as pathological cardiac hypertrophy and is typically characterized by cell death and depressed cardiac function. By contrast, physiological cardiac hypertrophy, as occurs in response to chronic exercise training (i...
2017: Advances in Experimental Medicine and Biology
Danilo Marcelo Leite do Prado, Enéas Antônio Rocco
Heart failure with preserved ejection fraction (HFpEF) is defined as an inability of the ventricles to optimally accept blood from atria with blunted end- diastolic volume response by limiting the stroke volume and cardiac output. The HEpEF prevalence is higher in elderly and women and may be associated to hypertension, diabetes mellitus and atrial fibrillation. Severe exercise intolerance, manifested by dyspnea and fatigue during physical effort is the important chronic symptom in HFpEF patients, in which is the major determinant of their reduced quality of life...
2017: Advances in Experimental Medicine and Biology
Amy M Pastva, Pamela W Duncan, Gordon R Reeves, M Benjamin Nelson, David J Whellan, Christopher M O'Connor, Joel D Eggebeen, Leigh Ann Hewston, Karen M Taylor, Robert J Mentz, Paul B Rosenberg, Dalane W Kitzman
INTRODUCTION: Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in older adults. Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial is a multi-site clinical trial to determine if physical rehabilitation intervention in older patients with ADHF improves physical function and reduces rehospitalizations. The REHAB-HF intervention aims to improve functional performance utilizing reproducible and progressive exercises that are individually tailored to the patient's physiological and physical capabilities...
October 25, 2017: Contemporary Clinical Trials
Erik H Van Iterson, Thomas P Olson
BACKGROUND: Arterial CO2 tension (PaCO2 ) and physiological dead space (VD ) are not routinely measured during clinical cardiopulmonary exercise testing (CPET). Abnormal changes in PaCO2 accompanied by increased VD directly contribute to impaired exercise ventilatory function in heart failure (HF). Because arterial catheterization is not standard practice during CPET, this study tested the construct validity of PaCO2 and VD prediction models using 'ideal' alveolar air equations and basic ventilation and gas-exchangegas exchange measurements during CPET in HF...
January 1, 2018: International Journal of Cardiology
Khaled M Musallam, Ali T Taher
OBJECTIVE: To consider the key implications of iron deficiency for biochemical and physiological functions beyond erythropoiesis. METHODS: PubMed was searched for relevant journal articles published up to August 2017. RESULTS: Anemia is the most well-recognized consequence of persisting iron deficiency, but various other unfavorable consequences can develop either before or concurrently with anemia. Mitochondrial function can be profoundly disturbed since iron is a cofactor for heme-containing enzymes and non-heme iron-containing enzymes in the mitochondrial electron transport chain...
October 20, 2017: Current Medical Research and Opinion
Marcelo C Freitas, Jason M Cholewa, Jose Gerosa-Neto, Daniela C Gonçalves, Erico C Caperuto, Fábio S Lira, Fabrício E Rossi
The aim of this study was to investigate the acute effect of ATP supplementation on performance and physiological responses during resistance exercise in recreationally resistance trained males. Eleven men (age= 27.5±5.5 yrs, weight= 83.4±9.8 kg, height= 182±0.04 cm) completed two randomized, double-blind trials: ATP supplement condition (ATP=400mg) or a placebo condition. Thirty minutes after supplement consumption, subjects performed four sets of half-squats until momentary muscular failure at 80% of the 1RM with two minutes of recovery between sets...
October 16, 2017: Journal of Strength and Conditioning Research
Bryce N Balmain, Ollie Jay, Norman R Morris, Kenji Shiino, Glenn M Stewart, Rohan Jayasinghe, Jonathan Chan, Surendran Sabapathy
PURPOSE: Heart failure (HF) patients appear to exhibit altered thermoregulatory responses during exercise in the heat. However, the extent to which these responses are altered due to physiological impairments independently of biophysical factors associated with differences in metabolic heat production (Hprod), evaporative heat balance requirements (Ereq) and/or body size, is presently unclear. Therefore, we examined thermoregulatory responses in 10 HF and 10 age-matched controls (CON) similar in body size during exercise at a fixed rate of Hprod, and therefore Ereq in a 30°C environment...
October 16, 2017: Medicine and Science in Sports and Exercise
A Arrieta, E A Blackwood, C C Glembotski
Cardiac myocytes are the cells responsible for the robust ability of the heart to pump blood throughout the circulatory system. Cardiac myocytes grow in response to a variety of physiological and pathological conditions; this growth challenges endoplasmic reticulum-protein quality control (ER-PQC), a major feature of which includes the unfolded protein response (UPR). ER-PQC and the UPR in cardiac myocytes growing under physiological conditions, including normal development, exercise, and pregnancy, are sufficient to support hypertrophic growth of each cardiac myocyte...
October 13, 2017: Current Topics in Microbiology and Immunology
Simon Malenfant, Patrice Brassard, Myriam Paquette, Olivier Le Blanc, Audrey Chouinard, Valérie Nadeau, Philip D Allan, Yu-Chieh Tzeng, Sébastien Simard, Sébastien Bonnet, Steeve Provencher
BACKGROUND: Functional cerebrovascular regulatory mechanisms are important for maintaining constant cerebral blood flow and oxygen supply in heathy individuals and are altered in heart failure. We aim to examine whether pulmonary arterial hypertension (PAH) is associated with abnormal cerebrovascular regulation and lower cerebral oxygenation and their physiological and clinical consequences. METHODS AND RESULTS: Resting mean flow velocity in the middle cerebral artery mean flow velocity in the middle cerebral artery (MCAvmean); transcranial Doppler), cerebral pressure-flow relationship (assessed at rest and during squat-stand maneuvers; analyzed using transfer function analysis), cerebrovascular reactivity to CO2, and central chemoreflex were assessed in 11 patients with PAH and 11 matched healthy controls...
October 12, 2017: Journal of the American Heart Association
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