Relationship between Daily Physical Activity and ANS Activity in Patients with CHF (original) (raw)
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A questionnaire-based assessment of daily physical activity in heart failure
European Journal of Heart Failure, 2004
Type and dose of daily energy expenditure (DEE) play a major role in modulations of health status and an increased knowledge of these dimensions of physical activity in congestive heart failure (CHF) patients would be valuable for clinical and epidemiological aims. We propose a new self-administered DEE questionnaire adapted to CHF patients and tested its validity. One hundred and five stable CHF participants, NYHA class I-IV, LVEF = 33.2F6.1% performed an incremental symptom-limited VO 2 (peak) test and filled in the questionnaire for DEE calculation. Reproducibility (n = 24), sensitivity (n = 21) of the questionnaire and inter-observer variability (n = 105) were tested. Intensity levels were identified from DEE and their relationships to VO 2 (peak), ventilatory and anthropometric characteristics were assessed by simple and multiple regression models. Reproducibility and sensitivity were high (r = 0.98 and 0.88, respectively, P < 0.0001) and inter-observer error reached 1.37%. DEE was highly correlated to physical activity energy expenditure (r = 0.96, P < 0.0001). Relationships between DEE, VO 2 (peak), V E /VO 2 and anthropometric characteristics were significant. An activity level above 3 MET was the best intensity criteria related to VO 2 (peak) (r = 0.62, P < 0.0001) and DEE (r = 0.80, P < 0.0001). The questionnaire seems reproducible, sensible and valid for DEE estimation. VO 2 (peak) appears related to DEE and especially to activities above 3 MET in CHF.
Impact of Physical Activity on Cardiovascular Events in Patients With Chronic Heart Failure
Circulation Journal, 2013
he prevalence of lifestyle diseases, such as diabetes mellitus, dyslipidemia, hypertension, and their combination in metabolic syndrome (MetS), has been rapidly increasing in Japan over the past decades, because of westernization of lifestyle. 1 Recently, we performed a prospective, nationwide large-scale multicenter study supported by the Japanese government on the current status of chronic heart failure (CHF) patients in Japan, with a special reference to lifestyle diseases, and demonstrated that the prevalence of MetS in CHF patients is more than double compared with the general population in Japan. 2 This suggests that lifestyle diseases have a substantial impact on the development of both ischemic and non-ischemic CHF. 2,3 CHF is a complex clinical syndrome in which both HF with preserved ejection fraction (HFpEF) and HF with reduced EF (HFrEF) are substantially involved. 3-7 We have also demonstrated that the prevalence of the metabolic components is comparable between HFpEF and HFrEF. 2 In Japan, CHF has become a growing social issue as the number of CHF patients has been rapidly increasing because of the aging of the popu-T
Volume and Patterns of Physical Activity Across the Health and Heart Failure Continuum
Canadian Journal of Cardiology, 2017
This study objectively assessed the PA and sedentary behavior of both HF phenotypes, those at risk of developing HF and healthy subjects. The results showed patients with HFPEF having a lower volume of continuous MVPA than patients with HFREF. Also, steps/day seems to be the most robust outcome for evaluating and promoting PA in this population. Moreover, those at risk are performing substantially below recommended level of PA which should be addressed in their treatment plan. "
2020
Background: By 2030, approximately 20% of the population worldwide will be 65 years of age or older. In this age group, cardiovascular diseases (CVD) will result in 40% of all deaths. Heart rate variability (HRV) appears to be reduced under stress conditions and in many chronic diseases as cardiovascular diseases that appear to be associated with autonomic changes that usually include decreased parasympathetic activation and/or increased sympathetic modulation. Thus, aging is very important for altering neurohumoral mechanisms that control the cardiovascular system. Objective: To analyze the influence of level of physical activity in the HRV in elderly people. Methods: Cross-sectional analytical study which included 49 subjects (60 – 86 years), which answered the Baecke questionnaire. Results: The less physically active group had lower levels of plasma HDL (42±2.43mg/dL vs 52±3.8mg/dL) and higher systolic BP (131±117mmHg vs 117±4.07mmHg) when compared to the most active group. The m...
International journal of cardiology, 2013
Background: Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods: We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n=489; reference), low (1-499; n=1458), medium (500-999; n=1086) and high (≥1000; n=2470). Results: Participants had a mean (±SD) age of 73 (±6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend pb 0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p =0.170), 0.68 (0.54-0.85; p =0.001) and 0.60 (0.49-0.74; p b 0.001), respectively (trend pb 0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64-0.97; p =0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion: In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.
International Journal of Cardiology, 2018
Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity Troponin T (hsTnT) are markers of cardiac injury used in diagnosis of heart failure and myocardial infarction respectively, and associated with increased risk of cardiovascular disease. Since physical activity is protective against cardiovascular disease and heart failure, we investigated whether higher levels of physical activity, and less sedentary behaviour were associated with lower NT-proBNP and hsTnT. Methods and results: Cross sectional study of 1130 men, age 70-91 years, from the British Regional Heart Study, measured in 2010-2012. Fasting blood samples were analysed for NT-proBNP and hsTnT. Physical activity and sedentary behaviour were measured using ActiGraph GT3X accelerometers. Relationships between activity and NT-proBNP or hsTnT were non-linear; biomarker levels were lower with higher total activity, steps, moderate/vigorous activity and light activity only at low to moderate levels of activity. For example, for each additional 10 min of moderate/vigorous activity, NT-proBNP was lower by 35.7% (95% CI −47.9, −23.6) and hsTnT by 8.4% (95% CI-11.1, −5.6), in men who undertook b 25 or 50 min of moderate/vigorous activity per day respectively. Biomarker levels increased linearly with increasing sedentary behaviour, but not independently of moderate/ vigorous activity. Conclusion: Associations between biomarkers and moderate/vigorous activity (and between hsTnT and light activity) were independent of sedentary behaviour, suggesting activity is driving the relationships. In these older men with concomitantly low levels of physical activity, activity may be more important in protecting against cardiac health deterioration in less active individuals, although reverse causality might be operating.
QJM: An International Journal of Medicine, 2013
Background: The aim of this study was to evaluate the effect of high intensity, interval exercise on quality of life (QoL) and depression status, in chronic heart failure (CHF) patients. Methods: A randomized controlled trial (phase III). Of the 100 consecutive CHF patients (NYHA classes II-IV, ejection fraction 4 50%) that were randomly allocated to exercise intervention (n = 50, highintensity intermittent endurance training 30 s at 100% of max workload, 30 s at rest, for 45 min/ day-by-12 weeks) or no exercise advice (n = 50), 72 (exercise group, n = 33, 63 AE 9 years, 88% men, 70% ischemic CHF and control group, n = 39, 56 AE 11 years, 82% men, 70% ischemic CHF) completed the study. QoL was assessed using the validated and translated Minnesota Living with Heart Failure questionnaire. Depressive symptomatology was evaluated using the validated and translated Zung Depression Rating Scale (ZDRS). Maximal oxygen uptake (_ V O 2max) and carbon dioxide production (_ V CO 2max) were also measured breath-bybreath. Results: Data analysis demonstrated that in the intervention group MLHFQ score was reduced by 66% (P = 0.003); 6-min-walk distance increased by 13% (P < 0.05), _ V O 2max level increased by 31% (P = 0.001), _ V CO 2max level increased by 28% (P = 0.001) and peak power output increased by 25% (P = 0.001), as compared with the control group. Conclusion: High intensity, systematic aerobic training, could be strongly encouraged in CHF patients, since it improves QoL, by favorably modifying their fitness level.
Accelerometer-Measured Daily Activity Levels and Related Factors in Patients With Heart Failure
The Journal of cardiovascular nursing, 2018
Few studies report objective accelerometer-measured daily physical activity levels in patients with heart failure (HF). We examined baseline accelerometer-measured physical activity from the Heart Failure Exercise and Resistance Training Camp trial, a federally funded (R01-HL112979) 18-month intervention study to promote adherence to exercise in patients with HF. Factors associated with physical activity levels were also explored. Patients with diagnosed HF (stage C chronic HF confirmed by echocardiography and clinical evaluation) were recruited from 2 urban medical centers. Physical activity energy expenditure and the number of minutes of moderate or vigorous physical activity (MVPA) were obtained from 7 full days of measurement with the accelerometer (Actigraph Model GT3X, Pensacola, Florida) for 182 subjects who met minimum valid wear time parameters. Additional measures of health-related factors were included to explore the association with physical activity levels. Subjects had...
Frontiers in Physiology, 2013
Quantification of cardiac autonomic activity and control via heart rate (HR) and heart rate variability (HRV) is known to provide prognostic information in clinical populations. Issues with regard to standardization and interpretation of HRV data make the use of the more easily accessible HR on its own as an indicator of autonomic cardiac control very appealing. The aim of this study was to investigate the strength of associations between an important cardio vascular health metric such as VO 2 max and the following: HR, HRV indicators, and HR normalized HRV indicators. A cross sectional descriptive study was done including 145 healthy volunteers aged between 18 and 22 years. HRV was quantified by time domain, frequency domain and Poincaré plot analysis. Indirect VO 2 max was determined using the Multistage Coopers test. The Pearson correlation coefficient was calculated to quantify the strength of the associations. Both simple linear and multiple stepwise regressions were performed to be able to discriminate between the role of the individual indicators as well as their combined association with VO 2 max. Only HR, RR interval, and pNN50 showed significant (p < 0.01, p < 0.01, and p = 0.03) correlations with VO 2 max. Stepwise multiple regression indicated that, when combining all HRV indicators the most important predictor of cardio vascular fitness as represented by VO 2 max, is HR. HR explains 17% of the variation, while the inclusion of HF (high frequency HRV indicator) added only an additional 3.1% to the coefficient of determination. Results also showed when testing the normalized indicators, HR explained of the largest percentage of the changes in VO 2 max (16.5%). Thus, HR on its own is the most important predictor of changes in an important cardiac health metric such as VO 2 max. These results may indicate that during investigation of exercise ability (VO 2 max) phenomena, quantification of HRV may not add significant value.
138 - Exercise and Heart Failure: A Review of Current Evidence
2013
Heart failure (HF) is now considered a serious and growing public health problem. It has a high prevalence, high cost, is often disabling and has a high mortality. Early diagnosis and effective treatment reduce morbidity/mortality and costs, so it is important to set up guidelines for its approach in primary (SOCIEDADE BRASILEIRA DE CARDIOLOGIA, 2006). According Carvalho et al. (2011) the HF is one of the cardiovascular diseases where lifestyle habits have great influence in its appearance. It is a complex clinical syndrome characterized by the inability of the heart to generate cardiac output at levels able to meet the metabolic needs of the body, associated with metabolic and inflammatory disorders, and neurohormonal activation. Life habits interfere not only in the prevention of this important clinical condition but also determine the success of its rehabilitation. Within this context Dalal (2012) et al. explains that the current guidelines from the National Institute for Health and Clinical Excellence (NICE) and the European Society of Cardiology recommend that the Cardiac Rehabilitation (CR) through physical exercise is effective and safe as a form of complementary treatment of HF. Although there has been progress in the treatment, Domingues (2011) et al. reports that the HF remains as one of the leading causes of hospitalization in several countries and it is associated with high morbidity and mortality, high cost to health and, particularly, poor quality of life (QoL). Some studies of meta-analysis show that the Cardiac Rehabilitation improves QoL, reduces the incidence of symptoms, re-hospitalization and may improve survival in patients with HF (BOCCHI, 2012). In order to determine how best to care, we must evaluates the phase of heart failure according to the rating system functional New York Heart Association (NYHA) (SOCIEDADE BRASILEIRA DE CARDIOLOGIA, 2006). This system relates symptoms to everyday activities and quality of life (Table 1). Table 1. Classification of Heart Failure. Fonte: Sociedade Brasileira de Cardiologia. Diretriz de reabilitação cardiopulmonar e metabólica: aspectos práticos e responsabilidades. Arquivos Brasileiros de Cardiologia, 2006. Physical exercise as a form of complementary treatment of HF is an issue addressed in several studies, like those performed by Bocchi et al. (2012), Nishi et al. (2011) and Gielen et al. (2012), being all paramount. Trivi et al. (2011) in their study show that physical exercise has become an important therapeutic strategy nonpharmacologic in patients with cardiovascular diseases, which being performed regularly, even when done at moderate levels, reduces the rates of morbidity caused by the disease (CIAMPI, 2012; IZAWA, 2012). Based on these assumptions, this article aims to review the literature through eletronic databases about the effects of different types and methods of achieving physical exercise in patients with heart failure. 2 METHODS This study based on literature review about the effects of physical activity in HF patients. Was searched in the electronic databases Medline, PubMed, Lilacs, SciELO, studies published between 2009 and 2012 in English and Portuguese, using the following terms simple or crossed: Heart Failure, Physical Exercise, Cardiac Rehabilitation, Cardiovascular Disease, HF and Quality of Life, HF and Morbidity, HF and Functional Capacity. There were selected studies that had as main outcome measures, the effects of exercise on: functional capacity, quality of life and or morbidity / mortality in patients with Cardiac Failure. There were selected studies that had as main outcome measures, the effects of exercise on: functional capacity, quality of life and or morbidity / mortality in patients with Cardiac Failure. We evaluated and classified as eligible to submit relevant studies and that results have come from studies designed as randomized, blinded clinical trial. Of the total 185 articles found on the topic, 10 papers were included in this study. In Table 2 it can be observed the characteristics of papers. 3 RESULTS We evaluated ten articles and for better visualization and understanding, studies are presented in the table below, according to exposed: author / year, periodic, objective of the study population, assessments used, instruments used for implementation of physical exercise, and effects of physical exercise on individuals with heart failure.