Pilot Study Assessing the Hemodynamic Impact and Post-Exercise Hypotension Induced by High- Versus Low-Intensity Isometric Handgrip in Patients with Ischemic Heart Disease
Abstract
1. Introduction
2. Materials and Methods
2.1. Population
2.2. Study Design
2.3. Experimental Sessions
2.4. Echocardiography
2.5. Statistical Analysis
3. Results
4. Discussion
4.1. Hemodynamic Tolerability
4.2. Post-Exercise Hypotension
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
IHG | Isometric handgrip |
BP | Blood pressure |
IHD | Ischemic heart disease |
MVC | Maximal voluntary contraction |
IE | Isometric exercise |
LV | Left ventricle |
PCI | Percutaneous coronary intervention |
CABG | Coronary artery bypass grafting |
LA | Left atrial |
LAVI | LA volume index |
LVEDV | LV end-diastolic volume |
LVESV | LV end-systolic volume |
LVEF | LV ejection fraction |
SV | Stroke volume |
CO | Cardiac output |
GLS | Global longitudinal strain |
PACS | Peak atrial contraction strain |
PALS | Peak atrial longitudinal strain |
GWI | Global work index |
GCW | Global constructive work |
GWW | Global wasted work |
GWE | Global work efficiency |
SD | Standard deviation |
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IHG-70 (n = 14) | IHG-30 (n = 14) | Control (n = 14) | ANOVA p | |
---|---|---|---|---|
Age, y | 66.4 ± 11.2 | 65.9 ± 12.7 | 66.1 ± 12.0 | 0.571 |
BMI, kg/m2 | 28.4 ± 7.3 | 28.3 ± 9.1 | 27.9 ± 6.6 | 0.796 |
Males, n (%) | 11 (78.6) | 11 (78.6) | 11 (78.6) | 0.457 |
Previous STEMI/NSTEMI-UA, n (%) | 12 (85.0)/2 (14.0) | 12 (85)/2 (14.0) | 10 (71.4)/4 (28.6) | 0.642 |
Previous CABG/PCI, n (%) | 7 (50.0)/11 (78.5) | 9 (64.2)/10 (71.4) | 10 (71.4)/11 (78.6) | 0.966 |
Multivessel disease, n (%) | 12 (85.7) | 12 (85.7) | 10 (71.4) | 0.851 |
Carotid artery disease, n (%) | 7 (50.0) | 6 (42.8) | 6 (42.8) | 0.598 |
Diabetes, n (%) | 4 (28.6) | 6 (43.0) | 5 (20.0) | 0.883 |
Hypercholesterolemia, n (%) | 15 (100.0) | 14 (93.3) | 15 (100.0) | 0.248 |
eGFR, mL/min per 1.73 m2 | 78.3 ± 11.6 | 67.4 ± 12.1 | 75.7 ± 13.8 | 0.089 |
SBP, mmHg | 126.6 ± 34.0 | 125.8 ± 27.4 | 126.1 ± 30.9 | 0.144 |
DBP, mmHg | 82.2 ± 14.7 | 83.6 ± 14.4 | 82.8 ± 15.3 | 0.132 |
HR, b/min | 62.1 ± 9.5 | 60.8 ± 11.0 | 63.5 ± 8.9 | 0.091 |
NT-proBNP, pg/mL | 71.4 ± 10.8 | 68.3 ± 12.4 | 66.2 ± 9.2 | |
Echocardiography | 0.527 | |||
LVEDV, mm3/m2 | 64.2 ± 22.3 | 65.0.9 ± 15.4 | 68.7 ± 18.8 | 0.232 |
LVESD, mm3/m2 | 36.7 ± 12.3 | 37.1 ± 14.6 | 37.6 ± 13.7 | 0.522 |
LVEF, % | 55.1 ± 8.1 | 53.9 ± 8.2 | 54.5 ± 10.7 | 0.385 |
LV GLS, % | −16.9 ± 4.3 | −17.3 ± 4.8 | −17.0 ± 5.3 | 0.077 |
E/E’ | 8.6 ± 2.3 | 8.2 ± 2.9 | 8.4 ± 2.5 | 0.491 |
LAVI, mm3/m2 | 29.3 ± 7.1 | 28.6 ± 6.9 | 28.8 ± 7.7 | 0.287 |
MR mild/moderate, n (%) | 9 (64.3)/5 (35.7) | 10 (71.5)/4 (28.5) | 11 (78.6)/3 (21.4) | 0.182 |
PALS. % | 15.7 ± 3.6 | 16.2 ± 3.3 | 16. ± 3.1 | 0.362 |
PACS, % | 13.2 ± 2.9 | 12.9 ± 3.0 | 13.2 ± 3.7 | 0.371 |
Treatment | ||||
ACE-i/ARBs, n (%) | 14 (100.0) | 15 (100.0) | 13 (93.5) | 0.441 |
Betablockers, n (%) | 14 (100.0) | 13 (93.5) | 14 (100.0) | 0.642 |
MRAs, n (%) | 4 (28.5) | 4 (28.5) | 3 (21.4) | 0.238 |
Thiazide diuretic, n (%) | 6 (42.8) | 7 (50.0) | 7 (50.0) | 0.692 |
Ivabradine, n (%) | 2 (14.3) | - | 1 (7.1) | 0.383 |
Statins, n (%) | 14 (100.0) | 14 (100.0) | 13 (92.8) | 0.754 |
CCAs, n (%) | 8 (57.1) | 9 (64.3) | 7 (50.0) | 0.648 |
Acetylsalicylic acid | 13 (92.8) | 14 (100.0) | 14 (100.0) | 0.132 |
Clopidogrel | 3 (21.4) | 2 (14.3) | - | 0.167 |
Δ Systolic BP | |||
---|---|---|---|
Timing | IHG-70 vs. IHG-30 | IHG-70 vs. Control | IHG-30 vs. Control |
Rest | 0.6 ± (0.4) | −0.4 ± (0.6) | 1.0 ± (1.1) |
Peak | 3.8 ± (1.8) | 7.0 ± (2.1) | 3.2 ± (1.6) |
15 | −2.5± (0.9) | −3.6 ± (1.4) | −1.1 ± (0.6) |
30 | −4.5 ± (2.9) | −7.7 ± (1.9) * | −3.2 ± (1.9) |
45 | −4.0 ± (2.6) | −8.1 ± (2.3) * | −4.1 ± (2.2) |
60 | −2.2 ± (1.3) | −4.1 ± (1.7) | −1.9 ± (1.3) |
Δ Diastolic BP | |||
Timing | IHG-70 vs. IHG-30 | IHG-70 vs. control | IHG-30 vs. control |
Rest | −0.3 ± (0.6) | −0.1 ± (0.3) | −0.4 ± (0.7) |
Peak | 1.8 ± (1.1) | 4.9 ± (2.8) | 3.1 ± (0.9) |
15 | −1.6 ± (0.4) | −4.5 ± (3.1) | −2.9 ± (1.1) |
30 | −1.5 ± (1.2) | −4.5 ± (2.7) | −3.0 ± (1.4) |
45 | 1.4 ± (0.7) | −3.5 ± (1.8) | −4.9 ± (2.6) |
60 | 0.1 ± (0.5) | −3.2 ± (1.1) | −3.3 ± (1.5) |
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Caminiti, G.; Vitarelli, M.; Volterrani, M.; Marazzi, G.; Manzi, V.; D’Antoni, V.; Fecondo, S.; Vadalà, S.; Sposato, B.; Giamundo, D.M.; et al. Pilot Study Assessing the Hemodynamic Impact and Post-Exercise Hypotension Induced by High- Versus Low-Intensity Isometric Handgrip in Patients with Ischemic Heart Disease. J. Cardiovasc. Dev. Dis. 2025, 12, 405. https://doi.org/10.3390/jcdd12100405
Caminiti G, Vitarelli M, Volterrani M, Marazzi G, Manzi V, D’Antoni V, Fecondo S, Vadalà S, Sposato B, Giamundo DM, et al. Pilot Study Assessing the Hemodynamic Impact and Post-Exercise Hypotension Induced by High- Versus Low-Intensity Isometric Handgrip in Patients with Ischemic Heart Disease. Journal of Cardiovascular Development and Disease. 2025; 12(10):405. https://doi.org/10.3390/jcdd12100405
Chicago/Turabian StyleCaminiti, Giuseppe, Matteo Vitarelli, Maurizio Volterrani, Giuseppe Marazzi, Vincenzo Manzi, Valentino D’Antoni, Simona Fecondo, Sara Vadalà, Barbara Sposato, Domenico Mario Giamundo, and et al. 2025. "Pilot Study Assessing the Hemodynamic Impact and Post-Exercise Hypotension Induced by High- Versus Low-Intensity Isometric Handgrip in Patients with Ischemic Heart Disease" Journal of Cardiovascular Development and Disease 12, no. 10: 405. https://doi.org/10.3390/jcdd12100405
APA StyleCaminiti, G., Vitarelli, M., Volterrani, M., Marazzi, G., Manzi, V., D’Antoni, V., Fecondo, S., Vadalà, S., Sposato, B., Giamundo, D. M., Grossi, A., Morsella, V., Iellamo, F., & Perrone, M. A. (2025). Pilot Study Assessing the Hemodynamic Impact and Post-Exercise Hypotension Induced by High- Versus Low-Intensity Isometric Handgrip in Patients with Ischemic Heart Disease. Journal of Cardiovascular Development and Disease, 12(10), 405. https://doi.org/10.3390/jcdd12100405