Статті в журналах: "Peripheral artery disease, combined training, strength"

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Cook, Jill N., Allison E. DeVan, Jessica L. Schleifer, Maria M. Anton, Miriam Y. Cortez-Cooper, and Hirofumi Tanaka. "Arterial compliance of rowers: implications for combined aerobic and strength training on arterial elasticity." American Journal of Physiology-Heart and Circulatory Physiology 290, no. 4 (April 2006): H1596—H1600. http://dx.doi.org/10.1152/ajpheart.01054.2005.

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Regular endurance exercise increases central arterial compliance, whereas resistance training decreases it. It is not known how the vasculature adapts to a combination of endurance and resistance training. Rowing is unique, because its training encompasses endurance- and strength-training components. We used a cross-sectional study design to determine arterial compliance of 15 healthy, habitual rowers [50 ± 9 (SD) yr, 11 men and 4 women] and 15 sedentary controls (52 ± 8 yr, 10 men and 5 women). Rowers had been training 5.4 ± 1.2 days/wk for 5.7 ± 4.0 yr. The two groups were matched for age, body composition, blood pressure, and metabolic risk factors. Central arterial compliance (simultaneous ultrasound and applanation tonometry on the common carotid artery) was higher ( P < 0.001) and carotid β-stiffness index was lower ( P < 0.001) in rowers than in sedentary controls. There were no group differences for measures of peripheral (femoral) arterial stiffness. The higher central arterial compliance in rowers was associated with a greater cardiovagal baroreflex sensitivity, as estimated during a Valsalva maneuver ( r = 0.54, P < 0.005). In conclusion, regular rowing exercise in middle-aged and older adults is associated with a favorable effect on the elastic properties of the central arteries. Our results suggest that simultaneously performed endurance training may negate the stiffening effects of strength training.

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Tomíčková, Jitka, Jiří Jančík, Petr Dobšák, Jarmila Siegelová, and Roman Panovský. "Vliv kombinovaného vytrvalostního/silového tréninku na variabilitu srdeční frekvence u mužů s chronickou ischemickou chorobou srdeční." Studia sportiva 4, no. 1 (July 7, 2010): 5–11. http://dx.doi.org/10.5817/sts2010-1-1.

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31 men with chronic coronary artery disease (mean age 64 ± 11 years, mean body weight 83 ± 10 kg, mean height 177 ± 6 cm, mean ejection fraction of left heart ventricle 47 ± 11%), were examined before and aft er three months lasting aerobic training combined (from 3rd week) with strength training. Symptom-limited spiroergometry was provided before and aft er the training period. Th e training (exercise unit) was performed three times a week. Before exercise testing, short-term heart rate variability (HRV) analyses of all subjects were obtained. Frequency domain HRV indexes were determined in the morning during quiet periods under metronome controlled breathing. Total power (TP), low-frequency spectral component HRV (LF, 0,05–0,15 Hz), high-frequency spectral component HRV (HF, 0,15–0,5 Hz) and lowfrequency-to-high frequency (LF/HF) ratio were measured for 5 minutes in the monitoring. Twelve weeks lasting combined endurance/strength training increased HRV (HF, LF and TP) in men with stable chronic coronary disease .

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Walsh, Jennifer H., William Bilsborough, Andrew Maiorana, Matthew Best, Gerard J. O'Driscoll, Roger R. Taylor, and Daniel J. Green. "Exercise training improves conduit vessel function in patients with coronary artery disease." Journal of Applied Physiology 95, no. 1 (July 2003): 20–25. http://dx.doi.org/10.1152/japplphysiol.00012.2003.

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It is well established that endothelial dysfunction is present in coronary artery disease (CAD), although few studies have determined the effect of training on peripheral conduit vessel function in patients with CAD. A randomized, crossover design determined the effect of 8 wk of predominantly lower limb, combined aerobic and resistance training, in 10 patients with treated CAD. Endothelium-dependent dilation of the brachial artery was determined, by using high-resolution vascular ultrasonography, from flow-mediated vasodilation (FMD) after ischemia. Endothelium-independent vasodilation was measured after administration of glyceryl trinitrate (GTN). Baseline function was compared with that of 10 control subjects. Compared with matched healthy control subjects, FMD and GTN responses were significantly impaired in the untrained CAD patients [3.0 ± 0.8 (SE) vs. 5.8 ± 0.8% and 14.5 ± 1.9 vs. 20.4 ± 1.5%, respectively; both P < 0.05]. Training significantly improved FMD in the CAD patients (from 3.0 ± 0.8 to 5.7 ± 1.1%; P < 0.05) but not responsiveness to GTN (14.5 ± 1.9 vs. 12.1 ± 1.4%; P = not significant). Exercise training improves endothelium-dependent conduit vessel dilation in subjects with CAD, and the effect, evident in the brachial artery, appears to be generalized rather than limited to vessels of exercising muscle beds. These results provide evidence for the benefit of exercise training, as an adjunct to routine therapy, in patients with a history of CAD.

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Olteanu, Gabriel, Cosmina Jercalau, Maria Pana, Andreea Lacraru, Liviu Serbanoiu, Raluca S. Costache, and Silviu M. Stanciu. "The most efficient types of training in cardiopulmonary rehabilitation programs: A narrative review." Romanian Journal of Military Medicine 125, no. 2 (May 1, 2022): 338–42. http://dx.doi.org/10.55453/rjmm.2022.125.2.25.

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"Objective. This narrative review sought to identify the most frequently used types of exercises in cardiopulmonary rehabilitation programs and to verify the level of efficiency and feasibility of this treatment method in cardiovascular diseased patients. Methods. We conducted research via Pubmed over two months using specific keywords related to cardiorespiratory rehabilitation, cardiovascular rehabilitation, endurance exercises, and respiratory exercises. In addition, we included studies that involved physical training for patients diagnosed with coronary artery disease, chronic heart failure, valvular disease or valvular surgery, asthma, and chronic obstructive pulmonary disease. Results. A total of fifteen articles were included in this narrative review. Eight studies investigated the effect of aerobic training, alone or combined, in the rehabilitation process for patients with cardiovascular disease and/or pulmonary disease. It showed that this type of training is the most recommended and used for these specific pathologies. Seven studies showed the effects of the resistance training and progressive resistance training, alone or combined, and proved the importance of their integration in patients with skeletal muscle weakness and altered functional capacity. High-intensity interval training was not superior to moderate-intensity continuous training in improving aerobic capacity and changing ventricular remodeling in patients with chronic heart failure. However, the results were promising in patients with coronary artery disease. Combined training had the best results in improving the aerobic capacity, muscle strength, functional capacity, ventilatory responses, and enhancing the quality of life for cardiovascular patients. Conclusions. Combined training was found superior to aerobic training, resistance training, respiratory training, or inspiratory muscles training applied alone as a treatment in cardiopulmonary rehabilitation programs. Thus, every rehabilitation program should be individualized for every patient to increase the effort capacity using aerobic training and functional capacity of the skeletal muscles by increasing the muscle mass (hypertrophy) as an effect of resistance training or progressive resistance training "

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Park, Song-Young, Yi-Sub Kwak, and Elizabeth J. Pekas. "Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial." Journal of Applied Physiology 127, no. 4 (October 1, 2019): 940–49. http://dx.doi.org/10.1152/japplphysiol.00209.2019.

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Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD ( n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions ( P < 0.05) after 12 wk for legPWV and HR, which significantly decreased ( P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased ( P < 0.05) in AQ, compared with no changes in CON. There were no significant differences ( P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.

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Mauer, Karin, J. Emilio Exaire, Julie A. Stoner, Jorge F. Saucedo, Polly S. Montgomery, and Andrew W. Gardner. "Effect of exercise training on clot strength in patients with peripheral artery disease and intermittent claudication: An ancillary study." SAGE Open Medicine 3 (March 19, 2015): 205031211557593. http://dx.doi.org/10.1177/2050312115575938.

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Blears, Elizabeth E., Jessica K. Elias, Christian Tapking, Craig Porter, and Victoria G. Rontoyanni. "Supervised Resistance Training on Functional Capacity, Muscle Strength and Vascular Function in Peripheral Artery Disease: An Updated Systematic Review and Meta-Analysis." Journal of Clinical Medicine 10, no. 10 (May 19, 2021): 2193. http://dx.doi.org/10.3390/jcm10102193.

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Supervised resistance training appears to be a promising alternative exercise modality to supervised walking in patients with peripheral artery disease (PAD). This meta-analysis examined the efficacy of supervised RT for improving walking capacity, and whether adaptations occur at the vascular and/or skeletal muscle level in PAD patients. We searched Medline, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials databases for randomized controlled trials (RCTs) in PAD patients testing the effects of supervised RT for ≥4 wk. on walking capacity, vascular function, and muscle strength. Pooled effect estimates were calculated and evaluated using conventional meta-analytic procedures. Six RCTs compared supervised RT to standard care. Overall, supervised RT prolonged claudication onset distance during a 6-min walk test (6-MWT) (101.7 m (59.6, 143.8), p < 0.001) and improved total walking distance during graded treadmill walking (SMD: 0.67 (0.33, 1.01), p < 0.001) and the 6-MWT (49.4 m (3.1, 95.6), p = 0.04). Five RCTS compared supervised RT and supervised intermittent walking, where the differences in functional capacity between the two exercise modalities appear to depend on the intensity of the exercise program. The insufficient evidence on the effects of RT on vascular function and muscle strength permitted only limited exploration. We conclude that RT is effective in prolonging walking performance in PAD patients. Whether RT exerts its influence on functional capacity by promoting blood flow and/or enhancing skeletal muscle strength remains unclear.

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Kropielnicka, Katarzyna, Wioletta Dziubek, Katarzyna Bulińska, Małgorzata Stefańska, Joanna Wojcieszczyk-Latos, Ryszard Jasiński, Urszula Pilch, et al. "Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly." BioMed Research International 2018 (September 23, 2018): 1–16. http://dx.doi.org/10.1155/2018/1937527.

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Introduction. A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim. The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods. Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results. Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions. Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

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Theodorou, Anastasios A., George Panayiotou, Konstantinos A. Volaklis, Helen T. Douda, Vassilis Paschalis, Michalis G. Nikolaidis, Ilias Smilios, et al. "Aerobic, resistance and combined training and detraining on body composition, muscle strength, lipid profile and inflammation in coronary artery disease patients." Research in Sports Medicine 24, no. 3 (June 3, 2016): 171–84. http://dx.doi.org/10.1080/15438627.2016.1191488.

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Tokmakidis, Savvas P., and Konstantinos A. Volaklis. "Training and Detraining Effects of a Combined-strength and Aerobic Exercise Program on Blood Lipids in Patients With Coronary Artery Disease." Journal of Cardiopulmonary Rehabilitation 23, no. 3 (May 2003): 193–200. http://dx.doi.org/10.1097/00008483-200305000-00006.

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Park, Song-Young, Alexei Wong, Won-Mok Son, and Elizabeth J. Pekas. "Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease." Journal of Applied Physiology 128, no. 3 (March 1, 2020): 565–75. http://dx.doi.org/10.1152/japplphysiol.00744.2019.

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Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with poor vascular function, walking impairment, and reduced quality of life. Land-based exercise therapy (LBET) is frequently recommended to improve walking and reduce symptoms. Recently, evidence has suggested that heated-water exercise therapy (HWET) is an effective intervention for PAD. However, the efficacy of LBET versus HWET in PAD patients had not been elucidated. Therefore, we sought to compare effects of LBET with HWET on cardiovascular function, exercise tolerance, physical function, and body composition in PAD patients. PAD patients ( n = 53) were recruited and randomly assigned to a LBET group ( n = 25) or HWET group ( n = 28). The LBET group performed treadmill walking, whereas the HWET group performed walking in heated water for 12 wk. Leg (legPWV) and brachial-to-ankle arterial stiffness (baPWV), blood pressure (BP), ankle-brachial index (ABI), 6-min walking distance (6MWD), claudication onset time (COT), physical function, and body composition were assessed before and after 12 wk. There were significant group-by-time interactions ( P < 0.05) for legPWV, BP, 6MWD, COT, body composition, and resting metabolic rate (RMR). Both groups significantly reduced ( P < 0.05) legPWV, BP, and body fat percentage, and HWET measures were significantly lower than LBET measures. Both groups significantly increased 6MWD, COT, and RMR, and HWET group measures were significantly greater than LBET measures. A time effect was noted for baPWV reduction in both groups ( P < 0.05). These results suggest that both LBET and HWET improve cardiovascular function, exercise tolerance, and body composition, and HWET showed considerably greater improvements compared with LBET in patients with PAD. NEW & NOTEWORTHY The results of this study reveal for the first time that although land-based exercise therapy is effective for reducing arterial stiffness and blood pressure in patients with peripheral artery disease (PAD), heated-water exercise therapy demonstrates greater benefits on vascular function. The greater improvements in muscular strength, time to onset of claudication, and exercise tolerance after heated-water exercise therapy may have clinical implications for improving quality of life in patients with PAD. The heated-water exercise therapy intervention demonstrated relatively higher exercise training adherence (∼88%) compared with the land-based exercise intervention (∼81%).

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Marin, Luca, Nicola Lovecchio, Adam Kawczynski, Massimiliano Febbi, Dario Silvestri, Vittoria Carnevale Pellino, Raffaele Gibellini, and Matteo Vandoni. "Intensive Rehabilitation Program in Arterial Occlusive Disease Patients." Applied Sciences 11, no. 3 (January 28, 2021): 1184. http://dx.doi.org/10.3390/app11031184.

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Peripheral arterial occlusive disease (PAOD) limits walking efficiency and distance. The main disabling symptom is vasculopathy that leads to claudicatio intermittens and limits walking efficiency. Stretching techniques are effective in treatments for retractions and are used to improve flexibility of triceps surae and range of motion of the ankle. The aim of this study is to evaluate the effects of a combined walking and stretching program on walking efficiency in elderly PAOD patients. Seventy patients with PAOD stage II of the Leriche–Fontaine classification were randomly assigned into a stretching group (SG) or conditioning group (CG). Both groups participated in an eleven-day intensive rehabilitation program based on walking and strength training, while the SG performed five extra sessions of stretching. Walking autonomy was assessed through treadmill and overground tests with the recording of initial and absolute pain. A univariate ANOVA analysis was applied for the differences between the initial and final outcomes. Walking autonomy improved in both groups (p < 0.01), while only the SG improved flexibility (from −14.0 ± 8.1 to −10.3 ± 8.3 cm; p < 0.01). An intensive eleven-day rehabilitation program based on walking, strength, and stretching exercises is effective to improve the onset and the delay of pain during walking in patients with PAOD.

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Lee, Junghoon, Ruda Lee, and Audrey J. Stone. "Combined Aerobic and Resistance Training for Peak Oxygen Uptake, Muscle Strength, and Hypertrophy After Coronary Artery Disease: a Systematic Review and Meta-Analysis." Journal of Cardiovascular Translational Research 13, no. 4 (October 27, 2019): 601–11. http://dx.doi.org/10.1007/s12265-019-09922-0.

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Kambic, Tim, Nejc Šarabon, Vedran Hadžić, and Mitja Lainscak. "Effects of high-load and low-load resistance training in patients with coronary artery disease: rationale and design of a randomised controlled clinical trial." BMJ Open 11, no. 7 (July 2021): e051325. http://dx.doi.org/10.1136/bmjopen-2021-051325.

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IntroductionResistance training (RT) combined with aerobic training (AT) enhances the effects of cardiac rehabilitation (CR) in patients with coronary artery disease (CAD). However, it remains to be investigated which type of RT (high loads (HLs) vs low loads (LLs)) is more efficacious in improving exercise performance, cardio-metabolic health and quality of life.Methods and analysisA randomised, controlled, clinical trial will enrol 20 patients with CAD into each of three study arms (total 60 patients): HL-RT (70%–80% of one repetition maximum (1-RM)) combined with AT; LL-RT (30%–40% of 1-RM) combined with AT and AT alone as standard care. Primary outcomes (maximal aerobic capacity, maximal leg isometric strength) will be assessed at baseline and after 36 training sessions. Other outcomes will include acute haemodynamic responses to LL-RT and HL-RT, body composition, physical performance, blood biomarkers (lipids, glucose metabolism, inflammation, growth factors), physical activity and quality of life. The intention-to-treat principle will be used to analyse the data.Ethics and disseminationThe study design and protocol have been approved by the National Medical Ethics Committee of Slovenia (registration number: 0120-573/2019/15). The study will be conducted in accordance with the Declaration of Helsinki. The results of the study will be published as peer-reviewed manuscripts and congress presentations, communicated with patients and the clinical community, and shared through posts on social media. The findings of the study will be disseminated among the national CR clinical community (CR centres, Slovenian association of coronary clubs) with active participation of the patients enrolled in the study. This study will expand our knowledge of RT in combination with AT in CR. We expect to find different effects of HL-RT versus LL-RT, with implications for RT strategies in rehabilitation of patients with CAD.Trial registration numberNCT04638764.

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Tofas, Tryfonas, Ioannis G. Fatouros, Dimitrios Draganidis, Chariklia K. Deli, Athanasios Chatzinikolaou, Charalambos Tziortzis, George Panayiotou, Yiannis Koutedakis, and Athanasios Z. Jamurtas. "Effects of Cardiovascular, Resistance and Combined Exercise Training on Cardiovascular, Performance and Blood Redox Parameters in Coronary Artery Disease Patients: An 8-Month Training-Detraining Randomized Intervention." Antioxidants 10, no. 3 (March 9, 2021): 409. http://dx.doi.org/10.3390/antiox10030409.

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It is well-documented that chronic/regular exercise improves the cardiovascular function, decreases oxidative stress and enhances the antioxidant capacity in coronary artery disease (CAD) patients. However, there is insufficient evidence regarding the chronic effects of different types of training and detraining on cardiovascular function and the levels of oxidative stress and antioxidant status in these patients. Therefore, the present study aimed at investigating the effects of cardiovascular, resistance and combined exercise training followed by a three-month detraining period, on cardiovascular function, physical performance and blood redox status parameters in CAD patients. Sixty coronary artery disease patients were randomly assigned to either a cardiovascular training (CVT, N = 15), resistance training (RT, N = 11), combined cardiovascular and resistance training (CT, N = 16) or a control (C, N = 15) group. The training groups participated in an 8-month supervised training program (training three days/week) followed by a 3-month detraining period, while the control group participated only in measurements. Body composition, blood pressure, performance-related variables (aerobic capacity (VO2max), muscle strength, flexibility) and blood redox status-related parameters (thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), reduced glutathione (GSH), oxidized glutathione (GSSG), catalase activity (CAT), protein carbonyls (PC)) were assessed at the beginning of the study, after 4 and 8 months of training as well as following 1, 2 and 3 months of detraining (DT). CVT induced the most remarkable and pronounced alterations in blood pressure (~9% reduction in systolic blood pressure and ~5% in diastolic blood pressure) and redox status since it had a positive effect on all redox-related variables (ranging from 16 to 137%). RT and CT training affected positively some of the assessed (TAC, CAT and PC) redox-related variables. Performance-related variables retained the positive response of the training, whereas most of the redox status parameters, for all training groups, restored near to the pre-exercise values at the end of the DT period. These results indicate that exercise training has a significant effect on redox status of CAD. Three months of detraining is enough to abolish the exercise-induced beneficial effects on redox status, indicating that for a better antioxidant status, exercise must be a lifetime commitment.

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Harwood, Amy E., Sean Pymer, Lee Ingle, Patrick Doherty, Ian C. Chetter, Belinda Parmenter, Christopher D. Askew, and Gary A. Tew. "Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners." BMJ Open Sport & Exercise Medicine 6, no. 1 (November 2020): e000897. http://dx.doi.org/10.1136/bmjsem-2020-000897.

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Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with the strongest evidence and is recommended in several national and international guidelines. Alternate forms of exercise such as upper- or lower-body cycling may be used, if required by certain patients, although there is less evidence for these types of programmes. The evidence for progressive resistance training is growing and patients can also engage in strength-based training alongside a walking programme. For those unable to attend a supervised class (strongest evidence), home-based or ‘self-facilitated’ exercise programmes are known to improve walking distance when compared to simple advice. All exercise programmes, independent of the mode of delivery, should be progressive and individually prescribed where possible, considering disease severity, comorbidities and initial exercise capacity. All patients should aim to accumulate at least 30 min of aerobic activity, at least three times a week, for at least 3 months, ideally in the form of walking exercise to near-maximal claudication pain.

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Deckx, Nathalie, Inez Wens, Amber H. Nuyts, Niel Hens, Benedicte Y. De Winter, Gudrun Koppen, Herman Goossens, et al. "12 Weeks of Combined Endurance and Resistance Training Reduces Innate Markers of Inflammation in a Randomized Controlled Clinical Trial in Patients with Multiple Sclerosis." Mediators of Inflammation 2016 (2016): 1–13. http://dx.doi.org/10.1155/2016/6789276.

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Previously, we reported that patients with multiple sclerosis (MS) demonstrate improved muscle strength, exercise tolerance, and lean tissue mass following a combined endurance and resistance exercise program. However, the effect of exercise on the underlying disease pathogenesis remains elusive. Since recent evidence supports a crucial role of dendritic cells (DC) in the pathogenesis of MS, we investigated the effect of a 12-week combined exercise program in MS patients on the number and function of DC. We demonstrate an increased number of plasmacytoid DC (pDC) following the exercise program. These pDC display an activated phenotype, as evidenced by increased numbers of circulating CD62L+and CD80+pDC. Interestingly, the number of CD80+pDC positively correlates with the presence of IL-10-producing regulatory type 1 cells (Tr1), an important cell type for maintaining peripheral tolerance to self-antigens. In addition, decreased production of the inflammatory mediators, TNF-αand MMP-9, upon Toll-like receptor (TLR) stimulation was found at the end of the exercise program. Overall, our findings suggest that the 12-week exercise program reduces the secretion of inflammatory mediators upon TLR stimulation and promotes the immunoregulatory function of circulating pDC, suggestive for a favorable impact of exercise on the underlying immunopathogenesis of MS.

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Vonk, Thijs, Esmee A. Bakker, Erwin S. Zegers, Maria T. E. Hopman, and Thijs M. H. Eijsvogels. "Effect of a personalised mHealth home-based training application on physical activity levels during and after centre-based cardiac rehabilitation: rationale and design of the Cardiac RehApp randomised control trial." BMJ Open Sport & Exercise Medicine 7, no. 3 (September 2021): e001159. http://dx.doi.org/10.1136/bmjsem-2021-001159.

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Many patients lapse into a physically inactive lifestyle within months after cardiac rehabilitation (CR) programme completion. A mobile-health (mHealth) home-based training application can be used to intensify and/or prolong the CR programme to induce long-lasting improvements of habitual physical activity levels. This study will assess the effect of an additional home-based training module during CR and post-CR on habitual physical activity levels among coronary artery disease patients. A total of 132 patients (>18 years old) will be recruited in an 18-week randomised controlled trial with four arms: (1) 6 weeks centre-based CR (ie, standard care), (2) 6 weeks combined centre-based+mHealth home-based CR, (3) 6 weeks centre-based CR followed by 12 weeks mHealth home-based CR, (4) 6 weeks combined centre-based+mHealth home-based CR followed by 12 weeks mHealth home-based CR. The intervention groups will receive a daily and personalised exercise training using a smartphone application (Virtual Training) in addition to and/or as extension of the centre-based CR programme. The participants will be assessed prior to the centre-based CR programme, after completion of the 6-week CR programme and after the 12 weeks extension. Primary outcome will be objectively measured habitual physical activity levels expressed as moderate to vigorous intensity activities (min/week). Secondary outcome parameters include sedentary behaviour, physical fitness (estimated VO2max), handgrip strength, cardiovascular risk profile, quality of life and cardiac anxiety scores. The findings of the Cardiac RehApp study will provide insight into the added value of a personalised mHealth home-based training application on physical activity levels during and after centre-based CR. Trial registration number: NL72182.091.019.

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Spranger, Marty D., Abhinav C. Krishnan, Phillip D. Levy, Donal S. O'Leary, and Scott A. Smith. "Blood flow restriction training and the exercise pressor reflex: a call for concern." American Journal of Physiology-Heart and Circulatory Physiology 309, no. 9 (November 2015): H1440—H1452. http://dx.doi.org/10.1152/ajpheart.00208.2015.

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Blood flow restriction (BFR) training (also known as Kaatsu training) is an increasingly common practice employed during resistance exercise by athletes attempting to enhance skeletal muscle mass and strength. During BFR training, blood flow to the exercising muscle is mechanically restricted by placing flexible pressurizing cuffs around the active limb proximal to the working muscle. This maneuver results in the accumulation of metabolites (e.g., protons and lactic acid) in the muscle interstitium that increase muscle force and promote muscle growth. Therefore, the premise of BFR training is to simulate and receive the benefits of high-intensity resistance exercise while merely performing low-intensity resistance exercise. This technique has also been purported to provide health benefits to the elderly, individuals recovering from joint injuries, and patients undergoing cardiac rehabilitation. Since the seminal work of Alam and Smirk in the 1930s, it has been well established that reductions in blood flow to exercising muscle engage the exercise pressor reflex (EPR), a reflex that significantly contributes to the autonomic cardiovascular response to exercise. However, the EPR and its likely contribution to the BFR-mediated cardiovascular response to exercise is glaringly missing from the scientific literature. Inasmuch as the EPR has been shown to generate exaggerated increases in sympathetic nerve activity in disease states such as hypertension (HTN), heart failure (HF), and peripheral artery disease (PAD), concerns are raised that BFR training can be used safely for the rehabilitation of patients with cardiovascular disease, as has been suggested. Abnormal BFR-induced and EPR-mediated cardiovascular complications generated during exercise could precipitate adverse cardiovascular or cerebrovascular events (e.g., cardiac arrhythmia, myocardial infarction, stroke and sudden cardiac death). Moreover, although altered EPR function in HTN, HF, and PAD underlies our concern for the widespread implementation of BFR, use of this training mechanism may also have negative consequences in the absence of disease. That is, even normal, healthy individuals performing resistance training exercise with BFR are potentially at increased risk for deleterious cardiovascular events. This review provides a brief yet detailed overview of the mechanisms underlying the autonomic cardiovascular response to exercise with BFR. A more complete understanding of the consequences of BFR training is needed before this technique is passively explored by the layman athlete or prescribed by a health care professional.

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Decramer, Marc. "Response of the respiratory muscles to rehabilitation in COPD." Journal of Applied Physiology 107, no. 3 (September 2009): 971–76. http://dx.doi.org/10.1152/japplphysiol.91459.2008.

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Respiratory rehabilitation is known to improve outcomes in patients with chronic obstructive pulmonary disease (COPD). The question addressed in the present review is whether these beneficial effects are related to improvements in inspiratory muscle function. Respiratory muscle fatigue often did not occur during exercise in patients with COPD, since exercise limitation usually occurred when significant force reserve in the inspiratory muscles was still present. Notwithstanding, a number of observations may provide indirect evidence that respiratory muscle fatigue may occur during exercise. Some evidence is present that, in normal humans, whole body exercise training improved inspiratory muscle endurance, but no studies are available in patients with COPD. Animal studies invariably demonstrated that exercise training increased the number of oxidative fibers and oxidative enzyme activity in inspiratory muscles. These effects, however, were considerably smaller than the effects found on peripheral muscles with similar fiber composition. Clear evidence indicated that inspiratory muscle training (IMT) improved inspiratory muscle function. Two large meta-analyses indicated that, if the training load was properly controlled, IMT alone or combined with general exercise reconditioning improved inspiratory muscle strength and endurance and dyspnea. The combination did not result in greater improvements in functional exercise capacity. Animal studies and one patient study confirmed the occurrence of structural remodeling of the inspiratory muscles in response to IMT. The final question is whether improvements in inspiratory muscle function produced by IMT lead to improved outcomes in COPD. In all five studies in which training load was adequately controlled, a significant reduction of dyspnea during activities of daily living was found. Eight randomized studies examined the effects of the combination. Greater improvements in exercise capacity were only found in three studies, and none showed a greater reduction in dyspnea.

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Schwaab, Bernhard, Birna Bjarnason-Wehrens, Karin Meng, Christian Albus, Annett Salzwedel, Jean-Paul Schmid, Werner Benzer, et al. "Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 2." Journal of Clinical Medicine 10, no. 14 (July 12, 2021): 3071. http://dx.doi.org/10.3390/jcm10143071.

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Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients’ groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.

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Omarjee, Loukman, Olivier Stivalet, Clément Hoffmann, Robert Scissons, Luc Bressollette, Guillaume Mahé, and Vincent Jaquinandi. "Heterogeneity of Doppler waveform description is decreased with the use of a dedicated classification." Vasa 47, no. 6 (October 1, 2018): 471–74. http://dx.doi.org/10.1024/0301-1526/a000724.

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Abstract. Background: The analysis of Doppler ultrasound waveforms (DW) provides a method for detecting and evaluating arterial stenosis in the lower limb arteries but no recommendation exists on how to describe the DWs. Aims of this study were to assess the heterogeneity of the description of DWs among vascular residents and the impact of the use of a 4-item classification. Methods: Thirty different DWs were presented to residents using Microsoft PowerPoint® slides. They were invited to describe the 30 DWs before and after the presentation of a 4-item classification (triphasic, biphasic, monophasic, and others). The heterogeneity was assessed by the number of different answers used by the residents. Nineteen residents with six to eighteen months of vascular medicine training and ultrasound experience were included. Results: The average of different answers was 9 ± 4 for the whole analysis of the 30 DWs without the use of a specific classification, whereas the average was 2 ± 1 using the 4-item classification (p < 0.005). There was a significant difference in correct answers, i. e. in combined continuous waveforms and pulsed waveforms between experienced residents and younger residents (p < 0.05). Conclusions: Using a 4-item classification for DWs reduced the heterogeneity of the DW description. There is an urgent need to standardize the DW description in order to improve the patients care with peripheral artery disease.

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Craciunescu, I., N. Ngiam, BJ Sun, S. Prado Diaz, AE Vijiiac, M. Tomaszewski, JE Yi, et al. "P235Relation between myocardial deformation by three-dimensional speckle tracking analysis , control of the hypertension and functional capacity in patients with systemic hypertensionP236Obstructive sleep apnoea is often under-recognised in patients with acute myocardial infarction, but commonly contributes to left ventricular diastolic dysfunctionP237Intrinsic left ventricular dysfunction in Behcet disease in comparison with systemic disease activity: insights from speckle tracking echocardiographyP238Echocardiography changes during singleton and twin pregnancyP239Proposal of two new echocardiographic parameters for the differentiation of pre-capillary from post-capillary pulmonary hypertensionP240The coincidence of implanted device and number of electrodes with the presence of residual fibrotic tissue after transvenous leads extraction assessed in echocardiographic examP241Hemoglobin is an independent predictor of left ventricular hypertrophy in postmenopausal women but not in premenopausal womenP242Left ventricular longitudinal deformation impairment in patients with psoriasis is linked with immunologic activationP243Impaired diastolic functions and left atrial mechanical functions in patients with vitamin-D deficiencyP244Modification of cardiac and vascular function secondary to insulin resistanceP245Impaired right ventricular function is not related to serum galectin-3 concentration in patients with repaired tetralogy of fallotP246Age-adjusted indices of right ventricular (RV) longitudinal function do not adequately reflect the global RV contraction in children with repaired congenital heart defects and RV volume overloadP247Relationship between fractional flow reserve and dobutamine stress echocardiography in coronary artery diseaseP248A retrospective observational comparative study on the negative predictive value of nuclear testing vs. stress echo in pre-operative assessment for patients undergoing solid organ transplantionP249The detection of viable myocardium by dobutamine stress speckle tracking echocardiography in patients with coronary artery diseaseP250VO2 flattening during exercise in heart failure: evidence for a combined low cardiac output and inefficient O2 extractionP251 The dynamic assessment of alveolar-capillary barrier during exercise-echocardiography in heart failure patients with reduced ejection fractionP252The effect of exercise training on cardiac function during exercise stress echo in patients with type 2 diabetes and diastolic dysfunctionP253Age-related maximal exercise O2 extraction differences in a population of apparently healthy subjects at cardiovascular riskP254Difference in the changes of functional mitral regurgitation between semisupine ergometer and handgrip exerciseP255Correlation of annulus size assessed by echo 2d, 3d and multidetector computed tomography in patients undergoing transcatheter aortic valve implantationP256Mitral annulus dynamics: from normal to extensive mixomatous disease-a three-dimensional transoesophageal studyP257Left atrial appendage closure: an echo point of view of 55 casesP258Effect of catheter-based renal denervation on left ventricular function, mass and (un)twist with two-dimensional speckle tracking echocardiographyP259Associations of microRNAs gene expression in peripheral blood mononuclear cells and left ventricular global longitudinal peak strain in patients with essential hypertension." European Heart Journal – Cardiovascular Imaging 17, suppl 2 (December 2016): ii37—ii45. http://dx.doi.org/10.1093/ehjci/jew236.002.

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Gowran, A., T. Kulikova, FC Lewis, G. Foldes, L. Fuentes, LE Viiri, V. Spinelli, et al. "Poster session 3Cell growth, differentiation and stem cells - Heart511The role of the endocannabinoid system in modelling muscular dystrophy cardiac disease with induced pluripotent stem cells.512An emerging role of T lymphocytes in cardiac regenerative processes in heart failure due to dilated cardiomyopathy513Canonical wnt signaling reverses the ‘aged/senescent’ human endogenous cardiac stem cell phenotype514Hippo signalling modulates survival of human induced pluripotent stem cell-derived cardiomyocytes515Biocompatibility of mesenchymal stem cells with a spider silk matrix and its potential use as scaffold for cardiac tissue regeneration516A snapshot of genome-wide transcription in human induced pluripotent stem cell-derived hepatocyte-like cells (iPSC-HLCs)517Can NOS/sGC/cGK1 pathway trigger the differentiation and maturation of mouse embryonic stem cells (ESCs)?518Introduction of external Ik1 to human-induced pluripotent stem cell-derived cardiomyocytes via Ik1-expressing HEK293519Cell therapy of the heart studied using adult myocardial slices in vitro520Enhancement of the paracrine potential of human adipose derived stem cells when cultured as spheroid bodies521Mechanosensitivity of cardiomyocyte progenitor cells: the strain response in 2D and 3D environments522The effect of the vascular-like network on the maturation of the human induced pluripotent stem cell derived cardiomyocytes.Transcriptional control and RNA species - Heart525Gene expression regulation in heart failure: from pathobiology to bioinformatics526Human transcriptome in idiopathic dilated cardiomyopathy - a novel high throughput screening527A high-throghput approach unveils putative miRNA-mediated mitochondria-targeted cardioprotective circuits activated by T3 in the post ischemia reperfusion setting528The effect of uraemia on the expression of miR-212/132 and the calcineurin pathway in the rat heartCytokines and cellular inflammation - Heart531Lack of growth differentiation factor 15 aggravates adverse cardiac remodeling upon pressure-overload in mice532Blocking heteromerization of platelet chemokines ccl5 and cxcl4 reduces inflammation and preserves heart function after myocardial infarction533Is there an association between low-dose aspirin use and clinical outcome in HFPEF? Implications of modulating monocyte function and inflammatory mediator release534N-terminal truncated intracellular matrix metalloproteinase-2 expression in diabetic heart.535Expression of CD39 and CD73 on peripheral T-cell subsets in calcific aortic stenosis536Mast cells in the atrial myocardium of patients with atrial fibrillation: a comparison with patients in sinus rhythm539Characteristics of the inflammatory response in patients with coronary artery disease and arterial hypertension540Pro-inflammatory cytokines as cardiovascular events predictors in rheumatoid arthritis and asymptomatic atherosclerosis541Characterization of FVB/N murinic bone marrow-derived macrophage polarization into M1 and M2 phenotypes542The biological expression and thoracic anterior pain syndromeSignal transduction - Heart545The association of heat shock protein 90 and TGFbeta receptor I is involved in collagen production during cardiac remodelling in aortic-banded mice546Loss of the inhibitory GalphaO protein in the rostral ventrolateral medulla of the brainstem leads to abnormalities in cardiovascular reflexes and altered ventricular excitablitiy547Selenoprotein P regulates pressure overload-induced cardiac remodeling548Study of adenylyl cyclase activity in erythrocyte membranes in patients with chronic heart failure549Direct thrombin inhibitors inhibit atrial myocardium hypertrophy in a rat model of heart failure and atrial remodeling550Tissue factor / FVIIa transactivates the IGF-1R by a Src-dependent phosphorylation of caveolin-1551Notch signaling is differently altered in endothelial and smooth muscle cells of ascending aortic aneurysm patients552Frizzled 5 expression is essential for endothelial proliferation and migration553Modulation of vascular function and ROS production by novel synthetic benzopyran analogues in diabetes mellitusExtracellular matrix and fibrosis - Heart556Cardiac fibroblasts as inflammatory supporter cells trigger cardiac inflammation in heart failure557A role for galectin-3 in calcific aortic valve stenosis558Omega-3 polyunsaturated fatty acids- can they decrease risk for ventricular fibrillation?559Serum levels of elastin derived peptides and circulating elastin-antielastin immune complexes in sera of patients with coronary artery disease560Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick model of hypoplastic left heart syndrome561Dynamics of serum levels of matrix metalloproteinases in primary anterior STEMI patients564Deletion of the alpha-7 nicotinic acetylcholine receptor changes the vascular remodeling induced by transverse aortic constriction in mice.565Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veinsIon channels, ion exchangers and cellular electrophysiology - Heart568Microtubule-associated protein RP/EB family member 1 modulates sodium channel trafficking and cardiac conduction569Investigation of electrophysiological abnormalities in a rabbit athlete's heart model570Upregulation of expression of multiple genes in the atrioventricular node of streptozotocin-induced diabetic rat571miR-1 as a regulator of sinoatrial rhythm in endurance training adaptation572Selective sodium-calcium exchanger inhibition reduces myocardial dysfunction associated with hypokalaemia and ventricular fibrillation573Effect of racemic and levo-methadone on action potential of human ventricular cardiomyocytes574Acute temperature effects on the chick embryonic heart functionVasculogenesis, angiogenesis and arteriogenesis577Clinical improvement and enhanced collateral vessel growth after monocyte transplantation in mice578The role of HIF-1 alpha, VEGF and obstructive sleep apnoea in the development of coronary collateral circulation579Initiating cardiac repair with a trans-coronary sinus catheter intervention in an ischemia/reperfusion porcine animal model580Early adaptation of pre-existing collaterals after acute arteriolar and venular microocclusion: an in vivo study in chick chorioallantoic membraneEndothelium583EDH-type responses to the activator of potassium KCa2.3 and KCa3.1 channels SKA-31 in the small mesenteric artery from spontaneously hypertensive rats584The peculiarities of endothelial dysfunction in patients with chronic renocardial syndrome585Endothelial dysfunction, atherosclerosis of the carotid arteries and level of leptin in patient with coronary heart disease in combination with hepatic steatosis depend from body mass index.586Role of non-coding RNAs in thoracic aortic aneurysm associated with bicuspid aortic valve587Cigarette smoke extract abrogates atheroprotective effects of high laminar flow on endothelial function588The prognostic value of anti-connective tissue antibodies in coronary heart disease and asymptomatic atherosclerosis589Novel potential properties of bioactive peptides from spanish dry-cured ham on the endothelium.Lipids592Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis593The characteristics of dyslipidemia in rheumatoid arthritisAtherosclerosis596Macrophages differentiated in vitro are heterogeneous: morphological and functional profile in patients with coronary artery disease597Palmitoylethanolamide promotes anti-inflammatory phenotype of macrophages and attenuates plaque formation in ApoE-/- mice598Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts599BMPRII signaling of fibrocytes, a mesenchymal progenitor cell population, is increased in STEMI and dyslipidemia600The characteristics of atherogenesis and systemic inflammation in rheumatoid arthritis601Role of adenosine-to-inosine RNA editing in human atherosclerosis602Presence of bacterial DNA in thrombus aspirates of patients with myocardial infarction603Novel E-selectin binding polymers reduce atherosclerotic lesions in ApoE(-/-) mice604Differential expression of the plasminogen receptor Plg-RKT in monocyte and macrophage subsets - possible functional consequences in atherogenesis605Apelin-13 treatment enhances the stability of atherosclerotic plaques606Mast cells are increased in the media of coronary lesions in patients with myocardial infarction and favor atherosclerotic plaque instability607Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasiaCalcium fluxes and excitation-contraction coupling610The coxsackie- and adenovirus receptor (CAR) regulates calcium homeostasis in the developing heart611HMW-AGEs application acutely reduces ICaL in adult cardiomyocytes612Measuring electrical conductibility of cardiac T-tubular systems613Postnatal development of cardiac excitation-contraction coupling in rats614Role of altered Ca2+ homeostasis during adverse cardiac remodeling after ischemia/reperfusion615Experimental study of sarcoplasmic reticulum dysfunction and energetic metabolism in failing myocardium associated with diabetes mellitusHibernation, stunning and preconditioning618Volatile anesthetic preconditioning attenuates ischemic-reperfusion injury in type II diabetic patients undergoing on-pump heart surgery619The effect of early and delayed phase of remote ischemic preconditioning on ischemia-reperfusion injury in the isolated hearts of healthy and diabetic rats620Post-conditioning with 1668-thioate leads to attenuation of the inflammatory response and remodeling with less fibrosis and better left ventricular function in a murine model of myocardial infarction621Maturation-related changes in response to ischemia-reperfusion injury and in effects of classical ischemic preconditioning and remote preconditioningMitochondria and energetics624Phase changes in myocardial mitochondrial respiration caused by hypoxic preconditioning or periodic hypoxic training625Desmin mutations depress mitochondrial metabolism626Methylene blue modulates mitochondrial function and monoamine oxidases-related ROS production in diabetic rat hearts627Doxorubicin modulates the real-time oxygen consumption rate of freshly isolated adult rat and human ventricular cardiomyocytesCardiomyopathies and fibrosis630Effects of genetic or pharmacologic inhibition of the ubiquitin/proteasome system on myocardial proteostasis and cardiac function631Suppression of Wnt signalling in a desmoglein-2 transgenic mouse model for arrhythmogenic cardiomyopathy632Cold-induced cardiac hypertrophy is reversed after thermo-neutral deacclimatization633CD45 is a sensitive marker to diagnose lymphocytic myocarditis in endomyocardial biopsies of living patients and in autopsies634Atrial epicardial adipose tissue derives from epicardial progenitors635Caloric restriction ameliorates cardiac function, sympathetic cardiac innervation and beta-adrenergic receptor signaling in an experimental model of post-ischemic heart failure636High fat diet improves cardiac remodelling and function after extensive myocardial infarction in mice637Epigenetic therapy reduces cardiac hypertrophy in murine models of heart failure638Imbalance of the VHL/HIF signaling in WT1+ Epicardial Progenitors results in coronary vascular defects, fibrosis and cardiac hypertrophy639Diastolic dysfunction is the first stage of the developing heart failure640Colchicine aggravates coxsackievirus B3 infection in miceArterial and pulmonary hypertension642Osteopontin as a marker of pulmonary hypertension in patients with coronary heart disease combined with chronic obstructive pulmonary disease643Myocardial dynamic stiffness is increased in experimental pulmonary hypertension partly due to incomplete relaxation644Hypotensive effect of quercetin is possibly mediated by down-regulation of immunotroteasome subunits in aorta of spontaneously hypertensive rats645Urocortin-2 improves right ventricular function and attenuates experimental pulmonary arterial hypertension646A preclinical evaluation of the anti-hypertensive properties of an aqueous extract of Agathosma (Buchu)Biomarkers648The adiponectin level in hypertensive females with rheumatoid arthritis and its relationship with subclinical atherosclerosis649Markers for identification of renal dysfunction in the patients with chronic heart failure650cardio-hepatic syndromes in chronic heart failure: North Africa profile651To study other biomarkers that assess during myocardial infarction652Interconnections of apelin levels with parameters of lipid metabolism in hypertension patients653Plasma proteomics in hypertension: prediction and follow-up of albuminuria during chronic renin-angiotensin system suppression654Soluble RAGE levels in plasma of patients with cerebrovascular events." Cardiovascular Research 111, suppl 1 (July 1, 2016): S92—S116. http://dx.doi.org/10.1093/cvr/cvw150.

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P, Clavario, Barbara C, Porcile A, Russo C, Zappulla T, apurroa E, Cornero T, Ferrari Aggradi C, Mäkikallio T, and Hautala AJ. "The Effects of Combined Same Session Aerobic and Resistance Training on Physical Performance in Coronary Artery Disease Patients: Protocol Comparison." Austin Journal of Clinical Cardiology 7, no. 2 (June 19, 2021). http://dx.doi.org/10.26420/austinjclincardiolog.2021.1077.

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Aerobic training is included to cardiac rehabilitation programs together with resistance training. The effects of combined aerobic and resistance training performed in a same session with different protocols on peak aerobic capacity (VO2peak) and maximal dynamic strength (1RM: one repetition maximum) are not well known. We compared the effectiveness of two different combined aerobic and resistance training programs for 12 weeks performed three times in a week in stable Coronary Artery Disease (CAD) patients (n=30) who had previously performed aerobic training only. The patients were randomized to High Volume- Low Intensity Group (HLG) or Low Volume-High Intensity Group (LHG). Both groups performed laboratory controlled aerobic exercise first (60min, 80% of lactate threshold) followed by six major muscle group resistance exercises (HLG: 30-35% of 1RM, 3 sets, 12 repetitions) or (LHG: 60-70% of 1RM, 3 sets, 6 repetitions). VO2peak remained at the baseline level for whole study group (23 ± 6 vs. 24 ± 7 ml·kg-1·min-1, p=0.380) and the responses did not differ between the HLG and LHG (p=0.891). Muscle strength increased when analyzed as one group for both upper (Push Up; 24 ± 8 vs. 30 ± 7 kg, p <0.0001) and lower body (Leg Extension; 20 ± 6 vs. 27 ± 6 kg, p <0.0001) with no difference between subgroups (p=0.240 and p=0.504, respectively). As conclusion, combined aerobic and resistance training in the same training session for 12 weeks improved maximal strength independently of the intensity of resistance training. These results highlight the importance of regular resistance training, even at moderate intensity, for CAD patients in terms of physical performance and independent living.

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Li, Peijun, Jian Li, Yingqi Wang, Jun Xia, and Xiaodan Liu. "Effects of Exercise Intervention on Peripheral Skeletal Muscle in Stable Patients With COPD: A Systematic Review and Meta-Analysis." Frontiers in Medicine 8 (November 18, 2021). http://dx.doi.org/10.3389/fmed.2021.766841.

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Objectives: Peripheral skeletal muscle dysfunction is an important extrapulmonary manifestation of chronic obstructive pulmonary disease (COPD) that can be counteracted by exercise training. This study aimed to review the effect of three major exercise training modalities, which are used in pulmonary rehabilitation to improve on skeletal muscle mass, function, and exercise capacity in COPD.Methods: PubMed, Embase, EBSCO, Web of Science, and the PEDro database were searched on April 25, 2020. Only randomized controlled studies published in English evaluating the effects of exercise interventions on peripheral skeletal muscle mass, strength, and exercise capacity in stable COPD patients were included. The quality of included studies was evaluated using the PEDro scale. The mean difference (MD) or the standardized mean difference (SMD) with 95% CI was calculated to summarize the results. Subgroup meta-analysis was used to investigate the effects of different exercise training modalities and different outcome measures. The Grading of Recommendations Assessment, Development, and Evaluation guidelines were used to rate evidence quality.Results: A total of 30 randomized controlled trials involving 1,317 participants were included. Data from trials investigating endurance exercise (EE), resistance exercise (RE), and combined aerobic and resistance exercise (CE) were pooled into a meta-analysis, and the differences compared with the non-exercising COPD control were improvement in the muscle strength and exercise capacity in stable COPD patients. Subgroup meta-analysis for different exercise training modalities showed that RE significantly improved muscle strength (SMD = 0.6, 95% CI 0.35–0.84, I2 = 61%), EE and CE significantly increased VO2peak (EE: MD = 3.5, 95% CI 1.1–5.91, I2 = 92%; CE: MD = 1.66, 95% CI 0.22–3.1, I2 = 1%). Subgroup meta-analysis for different outcome measures showed that only isotonic strength was improved after exercise interventions (SMD = 0.89, 95% CI 0.51–1.26, I2 = 71%).Conclusion: Moderate evidence supports that exercise training in stable COPD patients has meaningful and beneficial effects on peripheral skeletal muscle strength and exercise capacity. Peripheral skeletal muscle shows a higher response to RE, and the isotonic test is relatively sensitive in reflecting muscle strength changes. The proportion of aerobic and resistance exercise components in a combined exercise program still needs exploration.Systematic Review Registration: The review was registered with the PROSPERO: (The website is https://www.crd.york.ac.uk/PROSPERO/, and the ID is CRD42020164868).

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Waddell, A., F. Denton, R. Powell, S. Birkett, D. Broom, C. Imray, G. McGregor, and AE Harwood. "Community WALKing and home-baSed circuiT tRaining in peOple liviNG with intermittent claudication (WALK-STRONG): protocol for a randomised controlled feasibility trial." journal of Vascular Societies Great Britain and Ireland 1 (2022). http://dx.doi.org/10.54522/jvsgbi.2022.24.

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Plain English Summary Why we are undertaking the research: Peripheral artery disease is a common problem where the blood vessels in the legs are narrowed by fatty deposits. Supervised exercise programmes are recommended to help treat this condition, as they can reduce leg pain and improve fitness. However, not many people are able to access these programmes typically because of barriers including travel burdens, time constraints or other commitments. As an alternative, researchers are developing home-based programmes which do not require people to travel to centres for their sessions. In the UK and to the author’s knowledge, there are not many well researched home-based programmes available for people living with peripheral artery disease. What we aim to do: We plan to undertake a study to see how feasible our home-based programme is. People with peripheral artery disease will either be asked to continue with their normal routine or will be prescribed an exercise programme, with an activity watch to monitor physical activity. This programme will include increasing the number of steps walked each day, an exercise circuit (twice a week) and a telephone support call with a member of the research team to discuss their progress or lack of progress. Questionnaire responses, blood samples, walking ability, muscle strength and the amount of daily exercise will be compared between the two groups at the start of the 12-week programme, at the end, and 12 weeks after the programme has finished. By doing this study, we will be able to refine our home-based exercise programme so that it can be tested on a larger scale to see if it is a good option for people with peripheral artery disease who may not be able to attend a supervised exercise programme.

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Resnik, M., M. Corsi, G. Moreno, S. Taurozzi, L. Puga, L. Esker, L. Peralta, M. Bianconi, and D. Zivano. "The effect of high intensity combined training on functional capacity, muscle strength, body composition, agility and dynamic balance in patients with coronary artery disease." European Journal of Preventive Cardiology 29, Supplement_1 (May 1, 2022). http://dx.doi.org/10.1093/eurjpc/zwac056.232.

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Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is still controversy regarding the exercise characteristics that are more effective for improving peak oxygen uptake (VO2 peak), cardiac and metabolic function. High- intensity interval exercise training (HIIT) has been shown to elicit comparable and/or superior performance on endurance capacity (EC), ventricular function (VF) and quality of life. By other side, there is robust evidence that combined endurance and strength training is significantly more effective than endurance training only for improving EC, muscle mass and muscle strength. There is no enough information if the combination of HIIT with high strength training (HST) could enhance the physical conditions of these patients. Purpose The purpose of our study was to analyze the combination of HIIT + HST and its effect on physical performance compared to different types of combined training: HIIT and MCT with low load resistance training (RT) and HIIT or MCT only. Methods We evaluated 140 male patients (p) with CAD documented by angiographic studies, clinically stables with medical treatment and sinus rhythm. All of them performed a stress testing in treadmill without handrail support using a ramp protocol until maximal effort. VO2 peak (ml/kg/min) was measured indirectly through ACSM formula. We used YMCA´s method of estimating body fat with measurement of skinfolds in four sites (BF %), 30-second chair stand test (CST), 8-foot up and go test (FUGT), six-minute walk test (T6min) and one maximum repetition for quadriceps extension (1RMq) .Training intervention: p were randomly allocated to HIIT + RT (n=30), MCT + RT (n=30), HIIT (n=30), MCT (n=30) and HIIT + HST (n=20) during 3 month period of training. HIIT: 4 x 4 (85-95% peak heart rate) and 60-70% during active breaks. (36 min) MCT: 70-75% peak heart rate.(36 min) RT: 40-50% 1RM for lower body with 12-15 repetitions in 2 sets HST: ≥ 70% 1RM for lower body with low number of repetitions. Statistical analysis: all data were analyzed using IBM SPSS V.24. Comparisons were performed by following one-way ANOVA(parametric distribution) with post-hoc Tuckey or Kruskal-Wallis(non parametric distribution). The level of statistical significance was P< 0.05. Results Analyzing values pretraining (PRE) vs. postraining (POST), VO2 peak increased significantly by 27,52% for HIIT + HST P< 0,03 vs. HIIT + RT- MCT + RT and MCT. A positive effect in HIIT + HST with FUGT P< 0,001 and CST P< 0,005 between group changes and favourable observations in relation to 1RMq (PRE 60,00 ± 9,07 vs. POST 73,00 ± 9,86) and %BF(PRE 26,60 ± 3,21 vs. POST 24,80 ± 3,72) compared to MCT and HIIT P < 0,05. We didn´t find statistical significant differences with both modalities of combined training (low workloads) and HIIT for T6min. Conclusions High intensity combined training (HIIT + HST) had an additional effect related to others aerobic and resistance exercises attributed to neuromuscular adaptations, increased power and muscle strength.

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Kohlbrenner, Dario, Céline Aregger, Martin Osswald, Noriane A. Sievi, and Christian F. Clarenbach. "Blood-Flow–Restricted Strength Training Combined With High-Load Strength and Endurance Training in Pulmonary Rehabilitation for COPD: A Case Report." Physical Therapy 101, no. 6 (February 14, 2021). http://dx.doi.org/10.1093/ptj/pzab063.

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Abstract Objective The purpose of this report is to describe the case of a patient with chronic obstructive pulmonary disease (COPD) who was load compromised and being referred for outpatient pulmonary rehabilitation. Low-load blood flow restriction strength training (LL-BFRT) was applied to prepare for and increase tolerability of subsequently applied high-load strength training. Methods (Case Description) A 62-year-old woman with COPD GOLD 2 B presented with severe breathlessness. Lower limb strength was severely reduced while functional exercise capacity was preserved. The patient was severely load compromised and had high risk to be intolerant of the high training loads required to trigger the desired adaptations. LL-BFRT was applied during the first 12 training sessions and high-load strength training in the subsequent 12 training sessions of the rehabilitation program. Endurance training on a cycle ergometer was performed throughout the program. Results Symptom burden in the COPD assessment test was reduced by 6 points (40%). Lower limb strength improved by 95.3 Nm (521%) and 88.4 Nm (433%) for the knee extensors and by 33.8 Nm (95%) and 56 Nm (184%) for the knee flexors, respectively. Functional exercise capacity improved by 44 m (11%) in the 6-minute walk test and 14 repetitions (108%) in the 1-minute sit-to stand test. The patient did not experience any adverse events related to the exercise training. Conclusion Clinically relevant changes were observed in both strength-related functional and self-reported outcomes. The achievements translated well into daily living and enabled functioning according to the patients’ desires. LL-BFRT was reported to be well tolerated and implementable into an outpatient pulmonary rehabilitation program. Impact The description of this case encourages the systematic investigation of LL-BFRT in COPD. LL-BFRT has the potential to increase benefits as well as tolerability of strength training in pulmonary rehabilitation. Consideration of the physiological changes achieved through LL-BFRT highlights potential in targeting peripheral muscle dysfunction in COPD.

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El-Sobkey, Salwa B. "Resistance training is an effective exercise therapy in cardiac rehabilitation program for patients with coronary artery disease: a systematic review." Beni-Suef University Journal of Basic and Applied Sciences 11, no. 1 (February 10, 2022). http://dx.doi.org/10.1186/s43088-022-00206-2.

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Abstract Background Exercise-based cardiac rehabilitation program is a comprehensive intervention for the rehabilitation of coronary artery disease patients. Exercise therapy is a valuable, effective, and integral intervention of cardiac rehabilitation. Aerobic training is the gold standard exercise therapy in cardiac rehabilitation programs. In addition, combined training with added resistant training is also used. This systematic review aimed to provide the physical therapy clinicians with a consensus regarding the effect of resistant training by answering the question of what is the cardiovascular and non-cardiovascular effect (s) of resistant training in the cardiac rehabilitation program for patients with coronary artery disease? Main body The Physiotherapy evidence database (PEDro) was used as a search engine to select articles through study eligibility criteria. Adult or adult and old stable coronary artery disease patients engaged in a site-based (Phase II) exercise-based cardiac rehabilitation program that includes aerobic and resistant training. Selected articles applied cardiovascular and non-cardiovascular outcome measures to measure the effectiveness of resistant training. The author reviewed the selected articles and applied quantitative non-statistical analysis and appraisal for these articles. The systematic selection process resulted in 10 studies with a total participants number of 3877. Analyzing the articles revealed that adding resistant training to aerobic training resulted in a favorable improvement in outcome measures for coronary artery disease patients. Resistant training produced improvement in the exercise capacity (VO2 peak), blood pressure, skeletal muscle strength, endurance, body composition, sleep quality, depression, and health-related quality of life. Short conclusions The addition of resistant training to aerobic training in cardiac rehabilitation induces more positive cardiovascular and non-cardiovascular effects for stable coronary artery disease patients.

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Ranjbar, Najmeh, Sayed Mohammad Marandi, Mahdieh Namayandeh, Sayed Jalil Mirhosseini, and Mahdieh Ghanbery. "The effect of eight weeks of combined training on the serum macrophages phenotype of cardiac patients after coronary bypass surgery." Journal of Shahid Sadoughi University of Medical Sciences, September 28, 2019. http://dx.doi.org/10.18502/ssu.v27i5.1521.

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Introduction: Cardiovascular disease, including atherosclerosis, has an inflammatory background on a molecular scale. In the immune system, various factors activate macrophages, which ultimately lead to various macrophage activities in inflammatory and non-inflammatory conditions. The aim of the present study was to investigate the effect of eight weeks of combined training on serum macrophage phenotype after cardiac arrhythmias and coronary artery bypass graft surgery. Methods: The present study was a quasi-experimentalstudy performed in the Heart Rehabilitation Center of Afshar Hospital in Yazd. 20 male patients after coronary artery bypass graft surgery were divided into the control and combined exercise groups. Functional capacity, body mass index, muscle strength, and waist-to-hip ratio were estimated before training.The combined program was included aerobic and resistance training for eight weeks, three sessions per week. Aerobic training was performed for 15-20 minutes with maximum intensity of 50-80% of maximum heart rate and resistance training program included three upper limb and two lower limb movements with three sets and 10 repetitions. Blood samples were taken before and after eight weeks and macrophage phenotypes were measured by the ELISA method. Data were analyzed through independent t-test and paired t-test using SPSS Inc., Chicago, IL; version 16 software. Results: The combined exercise resulted in a significant decrease in the M1 macrophage (P<0.05) and a significant increase in the M2 macrophage (P<0.05). Conclusion: The results of this study emphasize the usefulness of this training protocol as a means to reduce inflammation and decreasing the mortality and morbidity rates.

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Kambic, Tim, Nejc Šarabon, Mitja Lainscak, and Vedran Hadžić. "Combined resistance training with aerobic training improves physical performance in patients with coronary artery disease: A secondary analysis of a randomized controlled clinical trial." Frontiers in Cardiovascular Medicine 9 (August 24, 2022). http://dx.doi.org/10.3389/fcvm.2022.909385.

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BackgroundThe efficacy of combined resistance training (RT) and aerobic training (AT) compared with AT alone is well established in cardiac rehabilitation (CR); however, it remains to be elucidated whether RT load (high load [HL] vs. low load [LL]) modifies the outcomes. The aim of our study was to investigate the effects of HL-RT and LL-RT combined with AT in comparison to AT alone on body composition and physical performance in patients with coronary artery disease (CAD) enrolled in phase II CR.MethodsWe randomized 79 patients with a stable CAD to 12 weeks of lower limb LL-RT + AT (35–40% of one repetition maximum [1-RM]; n = 28), HL-RT + AT (70–80% of 1-RM; n = 26), or AT (n = 25). Fifty-nine patients (75% men) with mean (standard deviation) age 61 (8) years and left ventricular ejection fraction 53 (9)% completed LL-RT (n = 19), HL-RT (n = 21) and AT (n = 19). Body composition and physical performance (upper and lower submaximal muscle strength, flexibility, balance, and mobility) were measured at baseline and post-training.ResultsTraining intervention had no significant impact on time × group interaction in the body composition measures. There was a significant time × group interaction for the gait speed test, chair sit-and-reach test, arm curl test, Stork balance test, up and go test, STS-5, and 6-min walk distance (p-values ≤ 0.001–0.04) following the training intervention. After the training intervention, HL-RT improved gait speed (+12%, p = 0.044), arm curl (+13%, p = 0.037), and time of Up and Go test (+9%, p < 0.001) to a greater extent compared with AT group, while there was a greater improvement in time of Up and Go test (+18%, p < 0.001) and time of five sit-to-stand tests (+14%, p = 0.016) following LL-RT when compared with AT. There were no differences between HL-RT and LL-RT in post-training improvement in any of the physical performance measures.ConclusionThe combination of AT with HL-RT or LL-RT promoted similar improvements in physical performance, which were superior to AT. Therefore, both types of combined AT and RT can be applied to patients with CAD.Clinical trial registration[https://clinicaltrials.gov/ct2/show/NCT04638764] Identifier [NCT04638764].

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Machline Carrion, M. Julia, Rafael M. Soares, Helio P. Penna Guimaraes, Renato H. Nakagawa, Lucas P. Damiani, Francisco A. Fonseca, Maria C. Izar, et al. "Abstract 16954: Effect of a Multifaceted Quality Improvement Intervention on the Prescription of Cardiovascular Prevention Treatments in Patients With Coronary Artery Disease Insights From the Bridge Cardiovascular Prevention Cluster Randomized Trial." Circulation 142, Suppl_3 (November 17, 2020). http://dx.doi.org/10.1161/circ.142.suppl_3.16954.

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Introduction: Moving toward evidence-based care protocols is key to reduce the burden of cardiovascular diseases. Hypothesis: We assessed the hypothesis that a multifaceted intervention could improve the adherence to evidence-based therapies for coronary artery disease patients. Methods: The BRIDGE Cardiovascular Prevention study was a cluster randomized trial including 1,619 patients with ischemic stroke, coronary artery disease or peripheral artery disease from 40 outpatient clinics in Brazil. Clusters were randomized to receive a multifaceted quality improvement intervention or to routine practice. The intervention included reminders, care algorithms, training of a case manager, audit and feedback reports, and distribution of educational materials to health care providers. The primary endpoint was the adherence to combined use of statins, antiplatelets and ACEi or ARBs, using an “all or none” approach at 12 months in patients without contra-indications. Results: Among the 1619 patients enrolled in the original sample, 1327 (81.9%) were coronary artery disease patients. The mean age was 65.7 (SD=10.4) and 880 (66.3 %) were men. There was a significant difference in the combined prescription of evidence-based therapies between the intervention and the control groups (75.4% versus 61.8 % respectively, Odds Ratio, 2.33 [95% CI, 1.29 - 4.21], p<0.01). Patients in the intervention group were more likely to receive statins (94.4% vs. 84.7%; Odds Ratio 4.15 [95% CI, 1.62 - 10.61], p<0.01) and antiplatelet (95.3% vs. 89.0%; Odds Ratio 3.32 [95% CI, 1.45 - 7.58], p<0.01). There was no significant difference in the occurrence of major cardiovascular events (non-fatal myocardial infarction, non-fatal stroke and mortality) between groups (2.34 % vs. 3.08%; Hazard Ratio 0.76 [95%CI, 0.39-1.49, p=0.42]. For patients with myocardial infarction the combined prescription of evidence-based therapies was increased in the intervention group as compared to the control group (75.6% versus 62.3 % respectively, Odds Ratio, 2.12 [95% CI, 0.99 - 4.54], p=0.02). Conclusions: Among coronary artery disease patients treated in Brazil, a quality improvement intervention resulted in improved prescription of evidence-based therapies for cardiovascular prevention.

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Nagy, Ebtesam, Doaa Elimy, Ahmed Ali, Hieba Ezzelregal, and Marwa Elsayed. "Influence of Manual Diaphragm Release Technique Combined with Inspiratory Muscle Training on Selected Persistent Symptoms in Men with Post-Covid-19 Syndrome: A Randomized Controlled Trial." Journal of Rehabilitation Medicine, September 19, 2022, jrm00330. http://dx.doi.org/10.2340/jrm.v54.3972.

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Objective: To determine whether the addition of manual diaphragm release to an inspiratory muscle training programme is more effective than inspiratory muscle training alone in reducing blood pressure, dyspnoea, fatigue, and aerobic performance capacity in men with post-COVID-19 syndrome.Design: A prospective, randomized-controlled trial.Setting: Chest Disease Department, Outpatient Clinic, Cairo University, Egypt.Participants: Fifty-two men with post-COVID-19 syndrome were allocated randomly to the study and control groups.Intervention: The study group underwent diaphragm release plus inspiratory muscle training, whereas the control group received inspiratory muscle training only.Outcome measures: All patients were assessed with the following measures at baseline and 6 weeks postintervention: maximum static inspiratory pressure for inspiratory muscle strength, peripheral arterial blood pressure, Modified Medical Research Council scale for dyspnoea, Fatigue Severity Scale, serum lactate level, and 6-min walk test distance for aerobic performance.Results: All outcome measures showed a significant improvement in favour of the study group (p < 0.001) over the control group. However, maximum static inspiratory pressure increased significantly, by 48.17% (p < 0.001) in the study group with no significant change in the control group.Conclusion: Addition of manual diaphragm release to an inspiratory muscle training programme potentiates the role of inspiratory muscle training in the management of men with symptomatic post-COVID-19 syndrome.

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Cornelis, N., P. Chatzinikolaou, R. Buys, I. Fourneau, J. Claes, and V. Cornelissen. "The use of Near-Infrared Spectroscopy to evaluate the effect of exercise on peripheral muscle oxygenation in patients with lower-extremity artery disease: a systematic review." European Journal of Preventive Cardiology 28, Supplement_1 (May 1, 2021). http://dx.doi.org/10.1093/eurjpc/zwab061.128.

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Abstract Funding Acknowledgements Type of funding sources: None. Background Near-Infrared Spectroscopy (NIRS) has been suggested as a new diagnostic tool in patients with lower-extremity artery disease (LEAD). The aim of this systematic review was i) to summarize the impact of exercise therapy on lower-limb muscle oxygenation, evaluated by means of NIRS, in patients with LEAD and ii) to give an overview on NIRS instruments and methodology. Methods A systematic search was conducted in MEDLINE and Embase, from the earliest date available until 16th of March 2020, to identify peer-reviewed studies involving the use of NIRS in the evaluation of exercise training on muscle oxygenation in patients with LEAD. Primary outcomes were NIRS-derived variables. Effect sizes were calculated as standardized mean differences. Assessment of methodological quality was done using a combined checklist from the Cochrane bias and the quality assessment tool for before-after studies without control group. Results Eleven original trials were included involving 16 exercise groups and 4 control groups. Tissue saturation index (TSI) at rest remained unchanged following the exercise interventions. Yet, exercise training increased time-to-minimum TSI during exercise (range effect sizes: +0.172 to +0.927). In addition, exercise training led to a faster recovery to half and full TSI rest values in most intervention groups (range effect sizes: -0.046 to -0.558 and -0.269 to -0.665 respectively). Finally, NIRS data reproducibility and analytic methods were underreported in the included studies. To illustrate, only four studies reported appropriate measures to ensure repeated reproducible probe positioning. The use of raw or filtered data for analysis was reported in none of the included articles. Conclusion The available NIRS data suggest that exercise training improves deoxygenation and reoxygenation patterns in patients with LEAD. Whereas NIRS is a promising tool in the evaluation of LEAD, the low number of RCT’s as well as large heterogeneity in NIRS assessment methods, outcome measures and instrumentation, warrants more research to better understand the role of muscle oxygenation associated with exercise-induced improvements in walking capacity. In particular the role of NIRS to study underlying mechanisms and determinants related to exercise progression in LEAD patients is appealing. Abstract Figure. NIRS during treadmill test

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Kambic, T., V. Hadzic, N. Sarabon, and M. Lainscak. "The efficacy of high-load resistance training in combination with aerobic training in patients with coronary artery disease: a dose-dependent randomised, controlled clinical trial." European Journal of Preventive Cardiology 29, Supplement_1 (May 1, 2022). http://dx.doi.org/10.1093/eurjpc/zwac056.240.

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Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency Background The combination of resistance training (RT) and aerobic training (AT) was shown to be superior compared to AT, although most studies applied only low-loads (LL) to moderate-loads in RT. Therefore, it remains to be elucidated whether high-load (HL) RT elicits greater improvement in maximal aerobic capacity and maximal muscle strength compared to low-load (LL) RT in combination to AT in patients with coronary artery disease (CAD). Purpose The aim of our study was to investigate the effects of HL-RT and LL-RT combined with AT in comparison to AT on maximal aerobic capacity, muscle strength and health-related quality of life. Methods We randomised 79 patients with CAD to HL-RT+AT (70 %-80% of one repetition maximum [1-RM]), LL-RT+AT (35%-40% of 1-RM) or AT group and 59 patients with mean (SD) age 61 (8) years and left ventricular ejection fraction 53 (9) % completed 12 weeks (36 training sessions) of the study. After the initial ambulatory screening by cardiologist and cardiopulmonary exercise test, patients were familiarised with proper lifting and breathing technique, and performed 1-RM test on leg press machine. During the training, the RT load progressively increased from 70% of 1-RM (6–11 repetitions per set) to 80% of 1-RM (6–8 reps per set) in HL-RT group and from 35% of 1-RM (12–22 reps per set) to 40% of 1-RM (12–16 reps per set) in LL-RT group in the first seven weeks of the intervention. Following re-evaluation of 1-RM, the training load in HL-RT group was progressed from 70% 1-RM (11 reps per set) to 80% 1-RM (6–8 reps per set), and the load in LL-RT group was progressed from 35% 1-RM (22 reps per set) to 40% 1-RM (12–16 reps per set). All patients performed AT consisted of 3-5 min of work-load interval cycling separated by 2 min of unloaded cycling progressing from 50% to 80% maximal workload achieved at baseline cardiopulmonary exercise test. We measured maximal aerobic capacity (VO2 max), maximal voluntary contraction (MVC) and quality of life at baseline and post-training. Results Exercise training was safe and associated with improvement in VO2 max (p < 0.01) in all training groups, whereas only LL-RT and HL-RT group improved MVC (both p < 0.001). Following training, VO2 max increased more in HL-RT group compared to AT group (+18 %, p = 0.032), and MVC increased more in HL-RT group compared to LL-RT group (+7 %, p = 0.018) and AT group (+16 %, p < 0.001). HL-RT group improved mental functioning component of short form 12-item quality of life questionnaire (+6 points, p = 0.003), with no significant difference compared to other training modalities. Conclusions RT on top of routine CR management, is safe and efficacious training modality for patients with CAD enrolled in cardiac rehabilitation.

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Zaidi, Hani, Rune Byrkjeland, Ida U. Njerve, Sissel Åkra, Svein Solheim, Harald Arnesen, Ingebjørg Seljeflot, and Trine B. Opstad. "Effects of exercise training on markers of adipose tissue remodeling in patients with coronary artery disease and type 2 diabetes mellitus: sub study of the randomized controlled EXCADI trial." Diabetology & Metabolic Syndrome 11, no. 1 (December 2019). http://dx.doi.org/10.1186/s13098-019-0508-9.

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Abstract Background Investigate effects of long-term exercise on the remodeling markers MMP-9, TIMP-1, EMMPRIN and Galectin-3 in combined type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) patients. Any associations between these biomarkers and glucometabolic variables were further assessed at baseline. Methods 137 patients (age 41–81 years, 17.2% females) were included and randomized to a 12-months exercise program or to a control group. Fasting blood samples and subcutaneous adipose tissue (AT) samples were taken at inclusion and after 12-months. The intervention was a combination of aerobic and strength training for a minimum of 150 min per week. Circulating protein levels were measured by ELISA methods and RNA was extracted from AT and circulating leukocytes. Expression levels were relatively quantified by PCR. Results After 12 months of intervention, both AT-expression and circulating levels of EMMPRIN were increased in the exercise group (p < 0.05, both) with significant difference in change between the two groups (p < 0.05 both). No significant effect was observed on MMP-9, TIMP-1 and Galectin-3. Levels of TIMP-1 (AT-expression and circulating) were significantly correlated to insulin, and HOMA2- after Bonferroni correction (p = 0.001, by 48 performed correlations). Conclusion The increase in levels of EMMPRIN after long-term exercise training, might indicate some degree of AT remodeling in these patients after 12-months of exercise, whether beneficial or not. The remodeling markers were to some extent associated with glucometabolic variables in our population with the combined disease. Trial registration clinicaltrials.gov, NCT01232608. Registered 2 November 2010

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Teran-Wodzinski, Patricia, Douglas Haladay, Tuan Vu, Ming Ji, Jillian Coury, Alana Adams, Lauren Schwab, and Constance Visovsky. "Assessing gait, balance, and muscle strength among breast cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): study protocol for a randomized controlled clinical trial." Trials 23, no. 1 (April 27, 2022). http://dx.doi.org/10.1186/s13063-022-06294-w.

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Abstract Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common and understudied consequence of taxane chemotherapy for breast cancer treatment. CIPN symptoms include numbness combined with tingling sensations, persistent shooting, stabbing, or burning pain even in the absence of painful stimuli, lower extremity muscle weakness, and impaired balance. CIPN symptoms often persist for a long time after completion of chemotherapy, causing significant loss of functional abilities and increased risk of falls. Persistent CIPN caused by taxanes represents a therapeutic challenge due to the limited treatment options. Resistance exercise has shown promising results; however, the effect of exercise on CIPN remains understudied. This study aims to assess the effects of exercise on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to an educational attention control condition. Methods A sample of 312 women who completed taxane-based chemotherapy for breast cancer and have symptomatic neuropathy is recruited from a community-dwelling sample. Participants are randomized to either a 16-week Home-Based Physical Activity Intervention or an Educational Attention control group. The home-based intervention protocol consists of targeted lower extremity stretches, followed by 10 min each of gait/balance and 10 min of resistive training accessed by hyperlink or DVD. An Exercise Diary records quantitative exercise data. The gait assessment includes temporospatial parameters and lower extremity joint angles using APDM motion sensors. Participants’ balance is assessed using the Sensory Organization Test (SOT) performed using a NeuroCom Balance Master. Isometric strength of hip, knee, and ankle flexor and extensor muscles is assessed using an isokinetic dynamometer, Biodex BX Advantage. In addition, we assess neuropathy symptoms using the FACT-Taxane Additional Concerns Subscale and nerve conduction velocity of the sural and peroneal nerve action potentials. Outcomes are assessed at baseline (prior to randomization) and 16 weeks. Discussion There are currently no evidence-based interventions that address the functional declines associated with CIPN. If successful, this program is simple and easy to implement in the standard of care for individuals with CIPN. Gait and balance training have the potential to reduce physical dysfunction associated with CIPN and reduce the burden of disease in cancer survivors. Trial registration ClinicalTrials.gov NCT04621721. Registered on August 3, 2020. ClincialTrials.gov is a primary registry of the World Health Organization International Clinical Trials Registry Platform (WHO ICTEP) network and includes all items from the WHO Trial Registration data set in Trial registration.

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