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Cardiovascular Effects and Benefits of Exercise

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Epidemiology, Lifestyle, and Cardiovascular Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 32564

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Special Issue Editors

Dr. Giuseppe Caminiti

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1. Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, Italy
2. Cardiovascular Unit, San Raffaele IRCCS, 00163 Rome, Italy
Interests: hypertension; chronic heart failure; atrial fibrillation; exercise training; sport medicine
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ferdinando Iellamo

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Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Interests: exercise physiology; cardiac rehabilitation; autonomic nervous system; hypertension; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Regular physical activity is an effective measure for maintaining cardiovascular health and for preventing and treating cardiovascular diseases. In primary prevention, several studies have shown that exercise training is effective in containing cardiovascular risk factors and delaying the occurrence of organ damage. At the same time, exercise training is a well-established core component of the secondary prevention and treatment of cardiovascular diseases according to both European and American guidelines. Despite significant progress in the knowledge of cardiovascular effects produced by exercise training, there are still several aspects that remain to be clarified. For example, the best format (including exercise duration, intensity, and modality) of exercise training in the setting of cardiovascular diseases is still to be defined and is a matter of active investigations and debates. There is also room for new studies comparing different exercise protocols and modalities in particular subgroups of patients with cardiovascular diseases (post-menopausal women, very elderly/frail subjects, very advanced heart failure, oncology patients undergoing cardiotoxic chemotherapy, etc.). Studies exploring potential synergic or antagonistic effects produced by combining exercise training with drugs recently introduced in the treatment of cardiovascular diseases and in particular heart failure are lacking. Finally, further research exploring molecular mechanisms underlying the adaptative changes produced by exercise training on cardiovascular system, both in healthy subjects and patients with cardiovascular diseases, is needed. This Special Issue of the Journal of Cardiovascular Development and Disease aims to collect papers reporting the latest findings on topics that include exploring acute and chronic cardiovascular adaptations to exercise training programs, from the molecular and cellular level to the assessment of integrated systemic responses (autonomic nervous system, hormonal, immunological, etc.); assessing the effects of different exercise modalities in subgroups less represented in previous trials; using advanced research methodologies to record physiological adaptations in healthy subjects and cardiac patients; and evaluating the effects of acute and chronic exercise on new potential therapeutic targets in cardiovascular patients (atrial and ventricular longitudinal strain, blood pressure variability, myocardial work, etc.).

Dr. Giuseppe Caminiti
Prof. Dr. Ferdinando Iellamo
Guest Editors

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Keywords

exercise training
physiological adaptations
cardiovascular risks factors
cardiovascular disease

Published Papers (11 papers)

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Editorial

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5 pages, 221 KiB

Open AccessEditorial

Towards a More Individually Tailored Exercise Prescription for Promoting Cardiovascular Health

by Giuseppe Caminiti and Ferdinando Iellamo

J. Cardiovasc. Dev. Dis. 2022, 9(11), 401; https://doi.org/10.3390/jcdd9110401 - 18 Nov 2022

Cited by 1 | Viewed by 1269

Abstract

The beneficial effects of exercise training (ET) in promoting cardiovascular health have been well established [...] Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

Research

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10 pages, 474 KiB

Open AccessArticle

Efficacy and Safety of a Combined Aerobic, Strength and Flexibility Exercise Training Program in Patients with Implantable Cardiac Devices

by Maria Rosaria Squeo, Barbara Di Giacinto, Marco Alfonso Perrone, Massimo Santini, Maria Luisa Sette, Emanuele Fabrizi, Antonia Vaquer, Attilio Parisi, Antonio Spataro and Alessandro Biffi

J. Cardiovasc. Dev. Dis. 2022, 9(6), 182; https://doi.org/10.3390/jcdd9060182 - 06 Jun 2022

Cited by 1 | Viewed by 2363

Abstract

Purpose: The “FIDE Project” (Fitness Implantable DEvice) was organized by the Institute of Sports Medicine and Science and the World Society of Arrhythmias with the aim of demonstrating the usefulness of exercise training in improving functional capacity in patients with implantable cardiac devices. Materials and Methods: Thirty sedentary patients were selected for the project (25 males and 5 females), with a mean age of 73 ± 5 years (range 44–94 years). Twenty-five were implanted with a Pacemaker (PM) and five with an Implantable Cardioverter Defibrillator (ICD). Atrial fibrillation/atrial flutter was present in ten (34%) patients, post-ischemic dilated cardiomyopathy in five (17.2%), sick sinus syndrome in six (20,7%), complete atrium-ventricular block in six (20.7%), hypertrophic cardiomyopathy in one (3.4%) and recurrent syncope in one (3.4%). The baseline assessment comprised cardiovascular examination, resting and stress ECG, cardiopulmonary exercise testing (V ̇O2peak), strength assessment of different muscle groups, and a flexibility test. The same measurements were repeated after 15–20 consecutive training sessions, over a 2-month period. The exercise prescription was set to 70–80% of HRR (Heart rate reserve) and to 50–70% of 1RM (1-repetition maximum, muscular force). The training protocol consisted of two training sessions per week performed in our institute, 90 min for each (warm-up, aerobic phase, strength phase and stretching) and one or more at home autonomously. Results: The cardiopulmonary testing after the training period documents a significant improvement in V ̇O2peak (15 ± 4 mL/kg/min vs. 17 ± 4; p = 0.001) and in work load (87 ± 30 watts vs. 108 ± 37; p = 0.001). Additionally, strength capacity significantly increased after the cardiac rehabilitation program, (quadriceps: 21 ± 18 kg vs. 29 ± 16 kg, p = 0.00003). Flexibility tests show a positive trend, but without statistical significance (sit-and-reach test: −19 ± 11 cm vs. −15 ± 11.7 cm; back-scratch test: −19 ± 11.6 cm vs. −15 ± 10 cm; lateral flexibility right −44 ± 1.4 cm vs. −43 ± 9.5 cm; left −43 ± 5 vs. −45 ± 8.7 cm). Conclusion: A brief period of combined aerobic, strength and flexibility exercise training (FIDE project) proved to be effective and safe in improving functional capacity in patients with cardiac implantable devices. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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9 pages, 267 KiB

Open AccessEditor’s ChoiceArticle

Effects of Concurrent Aerobic Plus Resistance Training on Blood Pressure Variability and Blood Pressure Values in Patients with Hypertension and Coronary Artery Disease: Gender-Related Differences

by Giuseppe Caminiti, Marco Alfonso Perrone, Maurizio Volterrani, Ferdinando Iellamo, Giuseppe Marazzi, Serena Selli, Alessio Franchini and Elvira Padua

J. Cardiovasc. Dev. Dis. 2022, 9(6), 172; https://doi.org/10.3390/jcdd9060172 - 27 May 2022

Cited by 3 | Viewed by 2127

Abstract

The purpose of this study was to compare changes in blood pressure variability (BPV) and blood pressure (BP) values occurring in response to concurrent training (CT) between the two genders. A total of 35 males and 20 women aged 55–80 years, with hypertension and coronary artery disease, were included. They underwent a 12-week CT program. The aerobic component of CT was performed according to the rate of perceived exertion while the intensity of the resistance component was set at 60% of 1 repetition maximum for the first 4 weeks and then increased to 80%. BP and BPV were evaluated at baseline and at the end of the CT program through 24 h ambulatory blood pressure monitoring. After 12-weeks, 24 h and daytime systolic BPV decreased in both men and women without significant between-groups differences. Twenty-four-hour daytime and nighttime diastolic BPV decreased in both genders with a significantly greater decrease in women compared to men. Twenty-four-hour daytime systolic and 24 h diastolic BP decreased in men while they were unchanged in women. In conclusion, CT induced similar reductions of systolic BPV in men and women and a greater decrease in diastolic BPV in women. Conversely, CT decreased BP values in males but not in females. CT appears to be an effective intervention for reducing BPV in both genders. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

8 pages, 280 KiB

Open AccessArticle

The Effects of Exercise Training on Cardiopulmonary Exercise Testing and Cardiac Biomarkers in Adult Patients with Hypoplastic Left Heart Syndrome and Fontan Circulation

by Marco Alfonso Perrone, Elettra Pomiato, Rosalinda Palmieri, Giulia Di Già, Fiorella Piemonte, Ottavia Porzio and Maria Giulia Gagliardi

J. Cardiovasc. Dev. Dis. 2022, 9(6), 171; https://doi.org/10.3390/jcdd9060171 - 27 May 2022

Cited by 10 | Viewed by 2082

Abstract

Background: Several studies have shown that adult patients with Hypoplastic Left Heart Syndrome (HLHS) and Fontan circulation have a reduced exercise tolerance that affects daily life. Recent studies have investigated the effects of aerobic exercise training in patients with univentricular heart; however, this research topic is still poorly studied. The aim of this study was to evaluate the effects of an aerobic exercise training program on cardiopulmonary exercise testing parameters and cardiac biomarkers in patients with HLHS. Methods: We enrolled 12 patients with a mean age of 24 ± 2.5 years (range 22–27 years), 50% male, with HLHS at Bambino Gesù Children’s Hospital IRCCS. All patients underwent a cardiopulmonary test and blood sampling before (T0) and after (T1) a 4-week aerobic exercise program. Cardiac biomarkers hs-cTnT, NT-proBNP, ST2, GDF-15 were studied. Results: Data analysis demonstrated an increase in cardiorespiratory performance after 4 weeks of aerobic exercise training activity. In particular, the data showed a significant improvement in test duration (p < 0.05), heart rate at rest (p < 0.05), heart rate recovery 1 min (p < 0.05), VO2 max (p < 0.01) and oxygen uptake efficiency slope (p < 0.05). At the same time, the data showed a significant reduction in NT-proBNP and ST2 values (p < 0.01 and p < 0.05, respectively) and a significant increase in GDF-15 (p < 0.01). No significant changes were found between the hs-cTnT values. Conclusions: Our study demonstrated the 4-week efficacy of an aerobic training program in improving cardiorespiratory performance and cardiac biomarker values in adult patients with HLHS and Fontan circulation. More studies with larger numbers of patients will be needed to confirm these data. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

11 pages, 669 KiB

Open AccessArticle

The Effect of a Single Bout of Resistance Exercise with Blood Flow Restriction on Arterial Stiffness in Older People with Slow Gait Speed: A Pilot Randomized Study

by Samuel Amorim, Alexandra Passos Gaspar, Hans Degens, Maysa Seabra Cendoroglo, Fábio Gazelato de Mello Franco, Raphael Mendes Ritti-Dias, Gabriel Grizzo Cucato, Nicholas Rolnick and Luciana Diniz Nagem Janot de Matos

J. Cardiovasc. Dev. Dis. 2022, 9(3), 85; https://doi.org/10.3390/jcdd9030085 - 16 Mar 2022

Cited by 5 | Viewed by 2856

Abstract

Purpose: Low-intensity resistance exercise with moderate blood-flow restriction (LIRE-BFR) is a new trending form of exercises worldwide. The purpose of this study was to compare the acute effect of a single bout of traditional resistance exercise (TRE) and LIRE-BFR on arterial stiffness in older people with slow gait speeds. Methods: This was a randomized, controlled clinical study. Seventeen older adults (3 men; 14 women; 82 ± 5 years old) completed a session of TRE (n = 7) or LIRE-BFR (n = 10). At baseline and after 60 min post-exercise, participants were subject to blood pressure measurement, heart rate measurements and a determination of arterial stiffness parameters. Results: There was no significant difference between the TRE and LIRE-BFR group at baseline. Pulse-wave velocity increased in both groups (p < 0.05) post-exercise with no between-group differences. Both exercise modalities did not produce any adverse events. The increase in systolic blood pressure, pulse pressure, augmentation pressure and pulse wave velocity (all p > 0.05) were similar after both TRE and LIRE-BFR. Conclusion: TRE and LIRE-BFR had similar responses regarding hemodynamic parameters and pulse-wave velocity in older people with slow gait speed. Long-term studies should assess the cardiovascular risk and safety of LIRE-BFR training in this population. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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9 pages, 764 KiB

Open AccessArticle

Return to Play after SARS-CoV-2 Infection in Competitive Athletes of Distinct Sport Disciplines in Italy: A FMSI (Italian Federation of Sports Medicine) Study

by Maurizio Casasco, Ferdinando Iellamo, Marco Scorcu, Attilio Parisi, Irena Tavcar, Erica Brugin, Barbara Martini, Chiara Fossati and Fabio Pigozzi

J. Cardiovasc. Dev. Dis. 2022, 9(2), 59; https://doi.org/10.3390/jcdd9020059 - 15 Feb 2022

Cited by 16 | Viewed by 3545

Abstract

Background: SARS-CoV-2 can lead to several systemic complications, including myocardial injuries; these might be worsened by heavy physical activity. The optimal approach to cardiac risk stratification following SARS-CoV-2 infection in athletes for a safe return to play (RTP) still needs defining. The aim of this study was to assess the prevalence of abnormal RTP test results, according to the protocol of Italian Federation of Sport Medicine (FMSI), which was endorsed by the Italian Ministry of Health, potentially representing COVID-19-associated cardiac injuries. Methods: This was a prospective, multicenter, observational study. All consecutive competitive athletes who underwent COVID-19 RTP testing protocol from 1 May to 31 July 2021, across 60 Italian Centers of Sports Medicine, were enrolled in the study. Athletes were tested at least 30 days after negativization of the nasopharyngeal swab (or immediately after negativization in professional athletes or Probable Olympians). A 12-lead electrocardiography at rest and during maximal incremental exercise test with continuous O₂ saturation monitoring and an echocardiographic examination were part of the protocol. In athletes with “moderate” disease (NHI classification), 24 h ECG monitoring (to be performed on a training day) and Magnetic Resonance Imaging (MRI) were also performed. Results: A total of 4143 athletes (67.8% males and 32.2% females) (53% > 18 years, 20% 18–35 years and 16% > 35 years), from more than 40 different sport disciplines, were included in the study. The mean age was 22.5 ± 13.3 years, with ages ranging from 8 to 80 years. Of these athletes, 52.3% were asymptomatic, 46.4% manifested mild symptoms, 1.1% and 0.14% had moderate or severe symptoms, respectively, while critical illness was evident in one athlete. Abnormal echocardiographic findings were detected in 80 cases (1.9%), and pericarditis in 7 cases (0.2%); all were from mildly symptomatic athletes. Arrhythmic events were recorded in 239 athletes, with 224 (5.4%) in the exercise test and 15 (0.4%) during 24 h ECG monitoring. Ventricular arrhythmias were observed in 101 (2.4%) athletes from the total population (mostly isolated or couples of premature ventricular beats): 91 in the exercise test and 10 during 24 h ECG monitoring. Cardiac magnetic resonance was performed in 34 athletes; the presence of myocarditis was confirmed in 5 athletes (0.12% of the total population, 14.7% of athletes in which MRI was performed). Conclusions: According to our results, cardiac complications from SARS-CoV-2 in asymptomatic or mildly symptomatic competitive athletes are rare, and an RTP assessment based on symptoms and ECG-monitored exercise test would ensure a safe RTP in these athletes. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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14 pages, 1466 KiB

Open AccessEditor’s ChoiceArticle

Cardiopulmonary Exercise Testing in Repaired Tetralogy of Fallot: Multiparametric Overview and Correlation with Cardiac Magnetic Resonance and Physical Activity Level

by Benedetta Leonardi, Federica Gentili, Marco Alfonso Perrone, Fabrizio Sollazzo, Lucia Cocomello, Stefani Silva Kikina, Rachel M. Wald, Vincenzo Palmieri, Aurelio Secinaro, Maria Giulia Gagliardi, Attilio Parisi, Attilio Turchetta, Lorenzo Galletti, Massimiliano Bianco and Fabrizio Drago

J. Cardiovasc. Dev. Dis. 2022, 9(1), 26; https://doi.org/10.3390/jcdd9010026 - 13 Jan 2022

Cited by 11 | Viewed by 3225

Abstract

Patients with repaired Tetralogy of Fallot (rToF) typically report having preserved subjective exercise tolerance. Chronic pulmonary regurgitation (PR) with varying degrees of right ventricular (RV) dilation as assessed by cardiac magnetic resonance imaging (MRI) is prevalent in rToF and may contribute to clinical compromise. Cardiopulmonary exercise testing (CPET) provides an objective assessment of functional capacity, and the International Physical Activity Questionnaire (IPAQ) can provide additional data on physical activity (PA) achieved. Our aim was to assess the association between CPET values, IPAQ measures, and MRI parameters. All rToF patients who had both an MRI and CPET performed within one year between March 2019 and June 2021 were selected. Clinical data were extracted from electronic records (including demographic, surgical history, New York Heart Association (NYHA) functional class, QRS duration, arrhythmia, MRI parameters, and CPET data). PA level, based on the IPAQ, was assessed at the time of CPET. Eighty-four patients (22.8 ± 8.4 years) showed a reduction in exercise capacity (median peak VO₂ 30 mL/kg/min (range 25–33); median percent predicted peak VO₂ 68% (range 61–78)). Peak VO₂, correlated with biventricular stroke volumes (RVSV: β = 6.11 (95%CI, 2.38 to 9.85), p = 0.002; LVSV: β = 15.69 (95% CI 10.16 to 21.21), p < 0.0001) and LVEDVi (β = 8.74 (95%CI, 0.66 to 16.83), p = 0.04) on multivariate analysis adjusted for age, gender, and PA level. Other parameters which correlated with stroke volumes included oxygen uptake efficiency slope (OUES) (RVSV: β = 6.88 (95%CI, 1.93 to 11.84), p = 0.008; LVSV: β = 17.86 (95% CI 10.31 to 25.42), p < 0.0001) and peak O₂ pulse (RVSV: β = 0.03 (95%CI, 0.01 to 0.05), p = 0.007; LVSV: β = 0.08 (95% CI 0.05 to 0.11), p < 0.0001). On multivariate analysis adjusted for age and gender, PA level correlated significantly with peak VO₂/kg (β = 0.02, 95% CI 0.003 to 0.04; p = 0.019). We observed a reduction in objective exercise tolerance in rToF patients. Biventricular stroke volumes and LVEDVi were associated with peak VO₂ irrespective of RV size. OUES and peak O₂ pulse were also associated with biventricular stroke volumes. While PA level was associated with peak VO₂, the incremental value of this parameter should be the focus of future studies. Full article

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9 pages, 275 KiB

Open AccessEditor’s ChoiceArticle

Acute Cardiorespiratory Responses to Different Exercise Modalities in Chronic Heart Failure Patients—A Pilot Study

by Eleftherios Karatzanos, Panagiotis Ferentinos, Georgios Mitsiou, Stavros Dimopoulos, Argyrios Ntalianis and Serafeim Nanas

J. Cardiovasc. Dev. Dis. 2021, 8(12), 164; https://doi.org/10.3390/jcdd8120164 - 26 Nov 2021

Cited by 2 | Viewed by 2748

Abstract

The purpose of this study was to compare the acute cardiorespiratory responses and time spent above different %VO_2peak intensities between three “iso-work” protocols: (a) a high intensity interval training protocol (HIIT), (b) a higher intensity continuous protocol (CON₇₀) and (c) a lower intensity continuous protocol (CON₅₀) in patients with chronic heart failure (CHF). Ten male CHF patients (aged 55.1 ± 16.2 years) performed in separate days a single session of a HIIT protocol consisted of 4 sets × 4 min cycling at 80% VO_2peak with 3 min of recovery at 50% VO_2peak, a CON₇₀ protocol corresponding to 70% VO_2peak and a CON₅₀ protocol corresponding to 50% VO_2peak. Cardiopulmonary data were collected by an online gas analysis system. The HIIT and CON₇₀ elicited higher cardiorespiratory responses compared to CON₅₀ with no differences between them (p > 0.05). In HIIT and CON₇₀, patients exercised longer at >80% and >90% VO_2peak. The completion rate was 100% for the three protocols. Not any adverse events were observed in either protocol. Both HIIT and CON₇₀ elicited a stronger physiological stimulus and required shorter time than CON₅₀. Both HIIT and CON₇₀ also induced comparable hemodynamic responses and ventilatory demand. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

Review

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19 pages, 1053 KiB

Open AccessEditor’s ChoiceReview

Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature

by Giulia Crisci, Mariarosaria De Luca, Roberta D’Assante, Brigida Ranieri, Anna D’Agostino, Valeria Valente, Federica Giardino, Valentina Capone, Salvatore Chianese, Salvatore Rega, Rosangela Cocchia, Muhammad Zubair Israr, Radek Debiek, Liam M. Heaney and Andrea Salzano

J. Cardiovasc. Dev. Dis. 2022, 9(8), 241; https://doi.org/10.3390/jcdd9080241 - 28 Jul 2022

Cited by 14 | Viewed by 5692

Abstract

Heart failure with preserved ejection fraction (HFpEF) represents the most common HF phenotype of patients aged > 65 years, with an incidence and a prevalence that are constantly growing. The HFpEF cardinal symptom is exercise intolerance (EI), defined as the impaired ability to perform physical activity and to reach the predicted age-related level of exercise duration in the absence of symptoms—such as fatigue or dyspnea—and is associated with a poor quality of life, a higher number of hospitalizations, and poor outcomes. The evidence of the protective effect between exercise and adverse cardiovascular outcomes is numerous and long-established. Regular exercise is known to reduce cardiovascular events and overall mortality both in apparently healthy individuals and in patients with established cardiovascular disease, representing a cornerstone in the prevention and treatment of many cardio-metabolic conditions. Several studies have investigated the role of exercise in HFpEF patients. The present review aims to dwell upon the effects of exercise on HFpEF. For this purpose, the relevant data from a literature search (PubMed, EMBASE, and Medline) were reviewed. The analysis of these studies underlines the fact that exercise training programs improve the cardiorespiratory performance of HFpEF patients in terms of the increase in peak oxygen uptake, the 6 min walk test distance, and the ventilatory threshold; on the other hand, diastolic or systolic functions are generally unchanged or only partially modified by exercise, suggesting that multiple mechanisms contribute to the improvement of exercise tolerance in HFpEF patients. In conclusion, considering that exercise training programs are able to improve the cardiorespiratory performance of HFpEF patients, the prescription of exercise training programs should be encouraged in stable HFpEF patients, and further research is needed to better elucidate the pathophysiological mechanisms underpinning the beneficial effects described. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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11 pages, 1110 KiB

Open AccessReview

Complementary Role of Combined Indirect and Direct Cardiac Sympathetic (Hyper)Activity Assessment in Patients with Heart Failure by Spectral Analysis of Heart Rate Variability and Nuclear Imaging: Possible Application in the Evaluation of Exercise Training Effects

by Ferdinando Iellamo, Marco Alfonso Perrone, Andrea Cimini, Giuseppe Caminiti, Agostino Chiaravalloti, Attilio Parisi and Orazio Schillaci

J. Cardiovasc. Dev. Dis. 2022, 9(6), 181; https://doi.org/10.3390/jcdd9060181 - 05 Jun 2022

Cited by 8 | Viewed by 2136

Abstract

In chronic heart failure (CHF), abnormalities in cardiac autonomic control, characterized by sympathetic overactivity, contribute to the progression of the disease and are associated with an unfavorable prognosis. Assessing cardiac autonomic status is clinically important in the management of patients with CHF. To this aim, heart rate variability (HRV) analysis has been extensively used as a non-invasive tool for assessing cardiac autonomic regulation, and has been shown to predict the clinical outcome in patients with CHF. Adrenergic nerve activity has also been estimated using iodine-123 (I-123) metaiodobenzylguanidine (MIBG), a noradrenaline analogue. MIBG is an analogue of norepinephrine sharing the same cellular mechanism of uptake, storage, and release in presynaptic sympathetic neurons. As an innervation tracer, 123I-MIBG allows for the evaluation of cardiac sympathetic neuronal function. Cardiac MIBG imaging has also been reported to predict a poor clinical outcome in CHF. MIBG provides direct information on the function of the presynaptic sympathetic nerve endings, whereas HRV, which depends on postsynaptic signal transduction, reflects the end-organ response of the sinus node. The aim of this brief review is to provide the reader with some basic concepts regarding the spectral analysis of HRV and MIBG, highlighting what is known about their respective roles in detecting cardiac sympathetic hyperactivity in CHF and, in perspective, their possible combined use in assessing non-pharmacological treatments in patients with CHF and reduced ejection fraction, with a particular focus on the effects of exercise training. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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16 pages, 441 KiB

Open AccessReview

Can Acute Exercise Lower Cardiovascular Stress Reactivity? Findings from a Scoping Review

by Wei Joo Chen, Arimi Fitri Mat Ludin and Nor M. F. Farah

J. Cardiovasc. Dev. Dis. 2022, 9(4), 106; https://doi.org/10.3390/jcdd9040106 - 31 Mar 2022

Cited by 8 | Viewed by 2948

Abstract

Exaggerated cardiovascular reactivity to and delayed recovery from stress increase the risk of cardiovascular diseases in the future. While exercise training has been shown to attenuate stress-induced cardiovascular reactivity and enhance recovery from stress, the effects with acute exercise are less characterized. The aim of this scoping review was to explore the range and characteristics of published evidence regarding acute exercise on cardiovascular reactivity and stress recovery. The secondary objective was to highlight research gaps and implications for future research. A total of 36 articles met the review inclusion/exclusion criteria, involving 1200 participants from various age groups, fitness and health status. Blood pressure (BP) reactivity was the most measured outcome, followed by heart rate (HR) reactivity, and to some extent, heart rate variability. Overall, acute exercise particularly of the moderate-intensity aerobic type effectively reduced stress-induced BP reactivity in the general population. The effects on HR reactivity and cardiovascular recovery were inconclusive. Further research would be recommended to establish if other forms of exercise intensity or type are equally beneficial to lower exaggerated cardiovascular responses to stress. Despite methodological differences and limitations, the available evidence supports the therapeutic potential of acute exercise in addressing the ill effects of stress on cardiovascular health. Full article

(This article belongs to the Special Issue Cardiovascular Effects and Benefits of Exercise)

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