CARDIOVASCULAR CHANGE IN ATHLETES AT DIFFERENT TRAINING STATUS LEVELS

ABSTRACT Introduction: Heart rate and blood pressure are important physiological indicators that reflect cardiovascular function, and they are widely used because they are convenient and practical to measure. Objective: To study the characteristics of cardiovascular changes in athletes under different training conditions. Methods: Thirty-four male students majoring in physical education in universities (group A) and 22 male non-sports majors (group B) with no formal training history were randomly selected. Heart rate before and after exercise and heart rate recovery rate at different stages of the recovery period were compared. Results: As regards heart rate changes in the recovery phase after loading, both groups showed a continuous decline, although the drop in heart rate of group A was slightly lower than that of group B (153.03± 15.88 beats/min, dropped to 110.69± 15.78 beats/minute, 171.00± 14.67 beats/minute dropped to 122. 82± 13.77 beats/min, respectively). However, the heart rate recovery rate of group A (59.40%) was significantly higher than that of group B (49.42%) (P<0.05). Conclusions: Physical exercise plays a significant role in promoting physical fitness and its effect on improving cardiovascular function is especially evident. Level of evidence II; Therapeutic studies - investigation of treatment results.

Heart Rate Recovery at 1 Min after Exercise Is a Marker of Disease Severity and Prognosis in Chronic Thromboembolic Pulmonary Hypertension

<b><i>Background:</i></b> Attenuated heart rate recovery at 1 min (HRR1) was demonstrated to correlate with poor prognosis in patients with pulmonary arterial hypertension, whereas its role in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. <b><i>Objectives:</i></b> The aim of this study was to investigate the correlations between HRR1 and functional status, echocardiography, hemodynamics, and prognosis of CTEPH. <b><i>Methods:</i></b> We retrospectively enrolled patients with CTEPH who underwent right heart catheterization and cardiopulmonary exercise test between June 2014 to October 2020 in Fuwai hospital. The primary outcome was clinical worsening. Linear regression was performed to assess the association between HRR1 and established markers of CTEPH severity. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff of HRR1. Cox regression models were used to assess the association between HRR1 and clinical worsening. <b><i>Results:</i></b> A total of 211 patients with CTEPH were included in the study. After adjusting for confounders, HRR1 positively correlated with 6-min walk distance, mixed venous oxygen saturation, and peak oxygen consumption, and negatively correlated with NT-proBNP, pulmonary vascular resistance, and ventilatory equivalent of carbon dioxide. Compared with patients with HRR1 ≥16 beats, patients with HRR1 &#x3c;16 beats had approximately a 3-fold risk of experiencing clinical worsening and the risk escalated with time. <b><i>Conclusion:</i></b> HRR1 could reflect disease severity and was independently associated with prognosis in patients with CTEPH.

Biochemical and Hematological Relationship with the Evaluation of Autonomic Dysfunction by Heart Rate Recovery in Patients with Asthma and Type 2 Diabetes

There are several methods to assess the function of the autonomic nervous system. Among them, heart rate recovery (HRR) is an accepted, easy, low-cost technique. Different pathological conditions have been related to the development of autonomic dysfunction. Our study aimed to evaluate the relationship between HRR and HRR-derived parameters in ambulatory patients with asthma or type 2 diabetes followed at the National Institutes of Health in Mexico City. A total of 78 participants, 50 women and, 28 men were enrolled; anthropometric, respiratory evaluations, and fasting blood samples were taken before participants performed a 6-min walking test (6MWT). Abnormal HRR was defined as a drop of ≤8 and ≤11 beats/min at 1 or 2 min and correlated negatively with basal oxygen saturation at 1 min. Heart rate at 1 min, correlated negatively with final oxygen saturation (p < 0.01). Statistically significant negative correlations were also observed between red cell count and white blood cell count and HOMA-IR with a p < 0.01. Since discrete hematological but significant changes correlated with HRR and HRR-derived parameters, we consider that these measures are helpful in clinical settings to identify subclinical autonomic dysfunction that permits us to prevent or anticipate chronic and fatal clinical outcomes.

The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy

Background Cardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients. Methods One hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1–4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal). Results Patients with reduced HRR (< 23 bpm) had significantly more end point events (22/62 patients vs. 9/53 patients, p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012). Conclusion Our results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.

Impaired heart rate recovery may predict radial artery spasm in patients undergoing coronary angiography via radial access

Objectives: Radial artery spasm (RAS) is associated with several pathophysiological pathways, including endothelial and autonomic dysfunction, and causes failed coronary interventions. Heart rate recovery (HRR) is a simple measurement of autonomic nervous system dysfunction. We aimed to investigate the relationship between HRR and RAS during coronary angiography (CA) in the present study. Patients and Methods: This study included 167 patients (mean age 54.6 ± 8.2, 131 males) who underwent a treadmill stress test (TST) according to the Bruce protocol before trans-radial CA. HRR in the first minute (HRR1) was calculated as the difference between peak heart rate and heart rate one minute after the TST. Patients were divided into two groups according to the presence of RAS. Results: Among the study population, RAS developed in 26 patients (15.5%). HRR1 and HRR in the third minute (HRR3) were lower in the RAS group. Also, the abnormal HRR1 rate was higher in the RAS group (35.5% vs. 76.9%, p < 0.001). Total procedural time, more than one puncture attempt, more than one catheter use, fluoroscopy time, radiation exposure, contrast volume was higher in the RAS group. Female gender, total procedural time, more than one catheter use, and abnormal HRR1 were independent predictors of RAS. Conclusion: The current data suggest that a significant relationship was found between abnormal HRR1 and RAS. HRR, a simple autonomic dysfunction parameter, can provide additional information regarding the success of radial procedures.

Relationship Between Autonomic Nervous System Activity and Recurrence after Cryoballoon Ablation in Patients with Paroxysmal Atrial Fibrillation.

Objectives: In this study, we aimed to investigate the relationship between autonomic dysfunction (AD) determined according to the blood pressure (BP) and heart rate (HR) response in exercise treadmill test (ETT) prior to cryoballoon ablation (CBA), and the recurrence of atrial fibrillation (AF) after CBA in patients with paroxysmal AF. Patients and Methods: Seventy-six patients (mean age 53±11 years, 61.8% male) with paroxysmal AF who underwent CBA were enrolled. Before CBA the ETT was performed by all patients. BP and HR response in ETT were compared between patients with and without AF recurrence. Results: AD rate was significantly higher in the group with recurrence compared to the non- recurrent group (p<0.001). In addition to AD, age, female gender and lower exercise capacity were also associated with post-CBA AF recurrence ( p>0.05 for all ). Examining AD parameters, systolic blood pressure at peak exercise (SBPpeak) (p<0.001) and diastolic blood pressure at peak exercise (DBPpeak) (p<0.001), slow heart rate recovery (HRR) (p<0.001) were significantly higher in the recurrent group. Conclusion: AD may associated with AF recurrence after CBA in patients with paroxysmal AF. SBPpeak, DBPpeak and slow HRR appear to be predictors of AF recurrence after ablation.