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Exercise physiology heart failure

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https://www.readbyqxmd.com/read/28210939/deep-phenotyping-of-systemic-arterial-hemodynamics-in-hfpef-part-1-physiologic-and-technical-considerations
#1
REVIEW
Julio A Chirinos
A better understanding of the pathophysiology of heart failure with a preserved left ventricular ejection fraction (HFpEF) is important. Detailed phenotyping of pulsatile hemodynamics has provided important insights into the pathophysiology of left ventricular remodeling and fibrosis, diastolic dysfunction, microvascular disease, and impaired oxygen delivery to peripheral skeletal muscle, all of which contribute to exercise intolerance, the cardinal feature of HFpEF. Furthermore, arterial pulsatile hemodynamic mechanisms likely contribute to the frequent presence of comorbidities, such as renal failure and dementia, in this population...
February 16, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28151429/the-influence-of-adipose-tissue-on-spatially-resolved-near-infrared-spectroscopy-derived-skeletal-muscle-oxygenation-the-extent-of-the-problem
#2
Victor M Niemeijer, Jasper P Jansen, Thomas van Dijk, Ruud F Spee, Eduard J Meijer, Hareld M C Kemps, Pieter F F Wijn
OBJECTIVE: Near-infrared spectroscopy (NIRS) measurements of tissue oxygen saturation (StO2) are useful for the assessment of skeletal muscle perfusion and function during exercise, however, they are influenced by overlying skin and adipose tissue. This study explored the extent and nature of the influence of adipose tissue thickness (ATT) on StO2. APPROACH: NIR spatially resolved spectroscopy (SRS) derived oxygenation was measured on vastus lateralis in 56 patients with chronic heart failure (CHF) and 20 healthy control (HC) subjects during rest and moderate intensity exercise with simultaneous assessment of oxygen uptake kinetics (τ [Formula: see text])...
February 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28118062/taurine-supplementation-improves-functional-capacity-myocardial-oxygen-consumption-and-electrical-activity-in-heart-failure
#3
Mehdi Ahmadian, Valiollah Dabidi Roshan, Eadeh Ashourpore
BACKGROUND: Taurine is an amino acid found abundantly in the heart in very high concentrations. It is assumed that taurine contributes to several physiological functions of mammalian cells, such as osmoregulation, anti-inflammation, membrane stabilization, ion transport modulation, and regulation of oxidative stress and mitochondrial protein synthesis. The objective of the current study was to evaluate the effectiveness of taurine supplementation on functional capacity, myocardial oxygen consumption, and electrical activity in patients with heart failure...
July 4, 2017: Journal of Dietary Supplements
https://www.readbyqxmd.com/read/28111407/determinants-of-aortic-size-and-stiffness-and-the-impact-on-exercise-physiology-in-patients-after-the-fontan-operation
#4
Hideo Ohuchi, Yosuke Hayama, Jun Negishi, Kanae Noritake, Aya Miyazaki, Osamu Yamada, Isao Shiraishi
The pathophysiology of congenital heart disease includes aortic dilation and increased stiffness. However, the clinical determinants and significance remain unclear in patients after the Fontan operation.Size and stiffness index (SI) of the ascending and descending aorta (aAO and dAO, respectively) were assessed using angiography in 130 consecutive Fontan patients and 30 age-matched controls. Compared with controls, Fontan patients showed a dilated aAO and smaller dAO (P < 0.0001) with greater SI (3.2 ± 0...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28105791/the-future-of-pleiotropic-therapy-in-heart-failure-lessons-from-the-benefits-of-exercise-training-on-endothelial-function
#5
REVIEW
Gilles W De Keulenaer, Vincent F M Segers, Faiez Zannad, Dirk L Brutsaert
A novel generation of drugs is introduced in the treatment of heart failure (HF). These drugs, including phosphodiesterase-5 inhibitors, guanylate cyclase stimulators and activators, share the feature that their action is either endothelial-mediated or substitutes for endothelial pathways, in particular the nitric oxide-cyclic guanosine monophosphate pathway, thereby influencing homeostatic balances in virtually each organ system in a pleiotropic fashion. Unfortunately, recent clinical trials with some of these drugs have shown disappointing results, at least in the setting of HF with a preserved ejection fraction...
January 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28091823/skeletal-muscle-inflammation-and-atrophy-in-heart-failure
#6
Kory J Lavine, Oscar L Sierra
Heart failure represents a systemic disease with profound effects on multiple peripheral tissues including skeletal muscle. Within the context of heart failure, perturbations in skeletal muscle physiology, structure, and function strongly contribute to exercise intolerance and the morbidity of this devastating disease. There is growing evidence that chronic heart failure imparts specific pathological changes within skeletal muscle beds resulting in muscle dysfunction and tissue atrophy. Mechanistically, systemic and local inflammatory responses drive critical aspects of this pathology...
January 14, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28069473/high-intensity-training-improves-global-and-segmental-strains-in-severe-congestive-heart-failure
#7
Yair Blumberg, Offir Ertracht, Itai Gershon, Noa Bachner-Hinenzon, Tali Reuveni, Shaul Atar
BACKGROUND: High intensity training (HIT) is superior to moderate aerobic training (MAT) for improving quality of life in congestive heart failure (CHF) patients. Speckle tracking echocardiography (STE) has recently been suggested for estimation of left ventricle global and regional function. AIMS: We evaluated the utility of STE for characterizing differences in cardiac function following MAT or HIT in a CHF rat model. METHODS AND RESULTS: Following baseline physiological assessment, CHF was induced by coronary artery ligation in Sprague-Dawley rats...
January 6, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27940954/frailty-and-cardiac-rehabilitation-a-call-to-action-from-the-eapc-cardiac-rehabilitation-section
#8
Carlo Vigorito, Ana Abreu, Marco Ambrosetti, Romualdo Belardinelli, Ugo Corrà, Margaret Cupples, Constantinos H Davos, Stefan Hoefer, Marie-Christine Iliou, Jean-Paul Schmid, Heinz Voeller, Patrick Doherty
Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation...
January 1, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27881506/development-and-evolution-of-a-hierarchical-clinical-composite-end-point-for-the-evaluation-of-drugs-and-devices-for-acute-and-chronic-heart-failure-a-20-year-perspective
#9
Milton Packer
Traditional approaches to the assessment of new treatments for heart failure have generally evaluated individual components of the syndrome at fixed points in time or have relied on surrogate physiological measures that are poorly correlated with the clinical status of patients. Conventional time-to-event trials that focus on morbidity and mortality represent an important methodological advance, but they generally assign undue weight to clinical events of less importance and are insensitive to difference in functional capacity among individuals who do not experience a clinical event during follow-up...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27864509/loss-of-%C3%AE-adrenergic-stimulated-phosphorylation-of-cav1-2-channels-on-ser1700-leads-to-heart-failure
#10
Linghai Yang, Dao-Fu Dai, Can Yuan, Ruth E Westenbroek, Haijie Yu, Nastassya West, Horacio O de la Iglesia, William A Catterall
L-type Ca(2+) currents conducted by voltage-gated calcium channel 1.2 (CaV1.2) initiate excitation-contraction coupling in the heart, and altered expression of CaV1.2 causes heart failure in mice. Here we show unexpectedly that reducing β-adrenergic regulation of CaV1.2 channels by mutation of a single PKA site, Ser1700, in the proximal C-terminal domain causes reduced contractile function, cardiac hypertrophy, and heart failure without changes in expression, localization, or function of the CaV1.2 protein in the mutant mice (SA mice)...
December 6, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27855113/comparison-of-novel-physiological-load-adaptive-control-strategies-for-ventricular-assist-devices
#11
Moriz Habigt, Maike Ketelhut, Jonas Gesenhues, Frank Schrödel, Marc Hein, Mare Mechelinck, Thomas Schmitz-Rode, Dirk Abel, Rolf Rossaint
Terminal heart failure (HF) is the most prevalent cause of death in the Western world and the implantation of a left ventricular assist device (LVAD) has become the gold standard therapy today. Most of the actually implanted devices are driven at a constant speed (CS) regardless of the patient's physiological demand. A new physiological controller [power ratio (PR) controller], which keeps a constant ratio between LVAD power and left ventricular power, a previous concept [preload responsive speed (PRS) controller], which adds a variable LVAD power to reach a defined stroke work, and a CS controller were compared with an unimpaired ventricle in a full heart computer simulation model...
November 17, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27818024/exertional-dyspnoea-in-chronic-respiratory-diseases-from-physiology-to-clinical-application
#12
Bruno-Pierre Dubé, François Vermeulen, Pierantonio Laveneziana
Dyspnoea is a complex, highly personalized and multidimensional sensory experience, and its underlying cause and mechanisms are still being investigated. Exertional dyspnoea is one of the most frequently encountered symptoms of patients with cardiopulmonary diseases, and is a common reason for seeking medical help. As the symptom usually progresses with the underlying disease, it can lead to an avoidance of physical activity, peripheral muscle deconditioning and decreased quality of life. Dyspnoea is closely associated with quality of life, exercise (in)tolerance and prognosis in various conditions, including chronic obstructive pulmonary disease, heart failure, interstitial lung disease and pulmonary hypertension, and is therefore an important therapeutic target...
February 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/27783854/neurocardiology-structure-based-function
#13
Jeffrey L Ardell, John Andrew Armour
Cardiac control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis...
September 15, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#14
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27765748/limitations-of-skeletal-muscle-oxygen-delivery-and-utilization-during-moderate-intensity-exercise-in-moderately-impaired-patients-with-chronic-heart-failure
#15
Victor M Niemeijer, Ruud F Spee, Thijs Schoots, Pieter F F Wijn, Hareld M C Kemps
The extent and speed of transient skeletal muscle deoxygenation during exercise onset in patients with chronic heart failure (CHF) are related to impairments of local O2 delivery and utilization. This study examined the physiological background of submaximal exercise performance in 19 moderately impaired patients with CHF (Weber class A, B, and C) compared with 19 matched healthy control (HC) subjects by measuring skeletal muscle oxygenation (SmO2) changes during cycling exercise. All subjects performed two subsequent moderate-intensity 6-min exercise tests (bouts 1 and 2) with measurements of pulmonary oxygen uptake kinetics and SmO2 using near-infrared spatially resolved spectroscopy at the vastus lateralis for determination of absolute oxygenation values, amplitudes, kinetics (mean response time for onset), and deoxygenation overshoot characteristics...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27746287/nonobstructive-hypertrophic-cardiomyopathy-out-of-the-shadows-known-from-the-beginning-but-largely-ignored-%C3%A2-until-now
#16
REVIEW
Barry J Maron, Ethan J Rowin, Martin S Maron, Eugene Braunwald
Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence, its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the National Institutes of Health >50 years ago in the preimaging era, and is now recognized as comprising about one-third of hypertrophic cardiomyopathy patients...
February 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27701063/physiological-and-sensory-consequences-of-exercise-oscillatory-ventilation-in-heart-failure-copd
#17
Alcides Rocha, Flavio F Arbex, Maria Clara N Alencar, Priscila A Sperandio, Daniel M Hirai, Danilo C Berton, Denis E O'Donnell, J Alberto Neder
BACKGROUND: Exercise oscillatory ventilation (EOV) is associated with poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalities may be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. METHODS: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria...
December 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27672504/muscle-size-explains-low-passive-skeletal-muscle-force-in-heart-failure-patients
#18
Fausto Antonio Panizzolo, Andrew J Maiorana, Louise H Naylor, Lawrence G Dembo, David G Lloyd, Daniel J Green, Jonas Rubenson
BACKGROUND: Alterations in skeletal muscle function and architecture have been linked to the compromised exercise capacity characterizing chronic heart failure (CHF). However, how passive skeletal muscle force is affected in CHF is not clear. Understanding passive force characteristics in CHF can help further elucidate the extent to which altered contractile properties and/or architecture might affect muscle and locomotor function. Therefore, the aim of this study was to investigate passive force in a single muscle for which non-invasive measures of muscle size and estimates of fiber force are possible, the soleus (SOL), both in CHF patients and age- and physical activity-matched control participants...
2016: PeerJ
https://www.readbyqxmd.com/read/27664189/exercise-training-increases-protein-o-glcnacylation-in-rat-skeletal-muscle
#19
Kristin Halvorsen Hortemo, Per Kristian Lunde, Jan Haug Anonsen, Heidi Kvaløy, Morten Munkvik, Tommy Aune Rehn, Ivar Sjaastad, Ida Gjervold Lunde, Jan Magnus Aronsen, Ole M Sejersted
Protein O-GlcNAcylation has emerged as an important intracellular signaling system with both physiological and pathophysiological functions, but the role of protein O-GlcNAcylation in skeletal muscle remains elusive. In this study, we tested the hypothesis that protein O-GlcNAcylation is a dynamic signaling system in skeletal muscle in exercise and disease. Immunoblotting showed different protein O-GlcNAcylation pattern in the prototypical slow twitch soleus muscle compared to fast twitch EDL from rats, with greater O-GlcNAcylation level in soleus associated with higher expression of the modulating enzymes O-GlcNAc transferase (OGT), O-GlcNAcase (OGA), and glutamine fructose-6-phosphate amidotransferase isoforms 1 and 2 (GFAT1, GFAT2)...
September 2016: Physiological Reports
https://www.readbyqxmd.com/read/27581831/exertional-dyspnoea-in-chronic-heart-failure-the-role-of-the-lung-and-respiratory-mechanical-factors
#20
Bruno-Pierre Dubé, Piergiuseppe Agostoni, Pierantonio Laveneziana
Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology.Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators or inotropes that improve central haemodynamics, patients with heart failure still complain of exertional dyspnoea...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
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