Moderate-intensity exercise with blood flow restriction on cardiopulmonary kinetics and efficiency during a subsequent high-intensity exercise in young women A cross-sectional study

Blood flow restriction (BFR) training applied prior to a subsequent exercise has been used as a method to induce changes in oxygen uptake pulmonary kinetics ([Formula: see text] O(2P)) and exercise performance. However, the effects of a moderate-intensity training associated with BFR on a subsequent high-intensity exercise on [Formula: see text] O(2P) and cardiac output (Q(T)) kinetics, exercise tolerance, and efficiency remain unknown. This prospective physiologic study was performed at the Exercise Physiology Lab, University of Brasilia. Ten healthy females (mean ± SD values: age = 21.3 ± 2.2 years; height = 1.6 ± 0.07 m, and weight = 55.6 ± 8.8 kg) underwent moderate-intensity training associated with or without BFR for 6 minutes prior to a maximal high-intensity exercise bout. [Formula: see text] O(2P), heart rate, and Q(T) kinetics and gross efficiency were obtained during the high-intensity constant workload exercise test. No differences were observed in [Formula: see text] O(2P), heart rate, and Q(T) kinetics in the subsequent high-intensity exercise following BFR training. However, exercise tolerance and gross efficiency were significantly greater after BFR (220 ± 45 vs 136 ± 30 seconds; P < .05, and 32.8 ± 6.3 vs 27.1 ± 5.4%; P < .05, respectively), which also resulted in lower oxygen cost (1382 ± 227 vs 1695 ± 305 mL min(–1)). We concluded that moderate-intensity BFR training implemented prior to a high-intensity protocol did not accelerate subsequent [Formula: see text] O(2P) and Q(T) kinetics, but it has the potential to improve both exercise tolerance and work efficiency at high workloads

Acute and Time-Course Effects of Osteopathic Manipulative Treatment on Vascular and Autonomic Function in Patients With Heart Failure: A Randomized Trial

The purposed of this study was to valuate the effect of osteopathic manipulative treatment (OMT) on flow-mediated dilation and heart rate variability of patients with heart failure. Osteopathic manipulative treatment modulates both the vascular and autonomic nervous system (ANS) in healthy volunteers. However, the acute and time-course effects of the OMT on patients with an overactive ANS remain unclear. This randomized controlled trial study included 20 patients with heart failure aged 50 to 60 years, allocated to a single session of OMT (base of the skull, retromaxillary region, heart, and thoracic duct) or sham. Flow-mediated dilation (FMD) at the brachial artery, hemodynamic measures, and heart rate variability were assessed in 3 periods (baseline, immediately after the intervention, and after 15 minutes). Multivariate analysis of variance procedure was used to compare intervention and periods. The OMT group had a greater FMD modulation compared with the sham (FMD,% =  9.5 vs. –5.6, 95% confidence interval (CI): [6.6, –12.35] vs. [–14.25, 2.8]; p = 0.001) and grater peak diameter (PD, mm =  0.77 vs –0.16 mm, 95% CI: [0.31,-1.24] vs [–0.63, 0.29]; P =  0.001), suggesting an important acute and time-course vascular effect from OMT. We also found some relevant heart rate variability modulation after 15 minutes from OMT: high frequency (HF, ms2 = 295 vs –354, 95% CI: [144.2, -769]; P = .001) and low frequency (LF, ms2) = 670 vs 775, 95% CI: [–98, 3591]; P = .001), suggesting a time-course ANS modulation after OMT. Osteopathic manipulative treatment was effective at increasing brachial blood flow and stimulating the vagal system in patients with heart failure. Moreover, vascular changes seem to precede the autonomic modulation

Relationship of Lung Function and Inspiratory Strength with Exercise Capacity and Prognosis in Heart Failure

Spirometry is underused in heart failure (HF) and the extent to which each defect associates with exercise capacity and prognosis is unclear. To determine the distinct relationship of continuous %predicted FVC (ppFVC) and FEV1/FVC with: 1) maximal inspiratory pressure (MIP), left ventricular ejection fraction (LVEF), exercise performance; and 2) prognosis for the composite of cardiovascular death, heart transplantation or left ventricular assist device implant. A cohort of 111 HF participants (AHA stages C/D) without diagnosed pneumopathy, spirometry, manovacuometry and maximum cardiopulmonary test. The association magnitudes were verified by linear and Cox (HR; 95% CI) regressions, age/sex adjusted. A p<0.05 was considered significant. Age was 57±12 years, 60% men, 64% in NYHA III. Every 10%-point increase in FEV1/FVC [β 7% (95% CI: 3-10)] and ppFVC [4% (2-6)] associated with ventilatory reserve (VRes), however only ppFVC associated with MIP [3.8 cmH2O (0.3-7.3)], LVEF [2.1% (0.5-3.8)] and VO2peak [0.5 mL/kg/min (0.1-1.0)], accounting for age/sex. In 2.2 years (mean), 22 events occurred, and neither FEV1/FVC (HR 1.44; 95% CI: 0.97-2.13) nor ppFVC (HR 1.13; 0.89-1.43) was significantly associated with the outcome. Only in the LVEF ≤50% subgroup (n=87, 20 events), FEV1/FVC (HR 1.50; 1.01-2.23), but not ppFVC, was associated with greater risk. In chronic HF, reduced ppFVC associated with lower MIP, LVEF, VRes and VO2peak, but no distinct poorer prognosis over 2.2 years of follow-up. Distinctively, FEV1/FVC was associated only with VRes, and, in participants with LVEF ≤50%, FEV1/FVC reduction proportionally worsened prognosis. Therefore, FEV1/FVC and ppFVC add supplementary information regarding HF phenotyping

Resistance exercise enhances oxygen uptake without worsening cardiac function in patients with systolic heart failure: a systematic review and meta-analysis

Recent literature suggests that resistance training (RT) improves peak oxygen uptake ([Formula: see text] peak), similarly to aerobic exercise (AE) in patients with heart failure (HF), but its effect on cardiac remodeling is controversial. Thus, we examined the effects of RT and AE on [Formula: see text] peak and cardiac remodeling in patients with heart failure (HF) via a systematic review and meta-analysis. MEDLINE, EMBASE, Cochrane Library and CINAHL, AMEDEO and PEDro databases search were extracted study characteristics, exercise type, and ventricular outcomes. The main outcomes were [Formula: see text] peak (ml kg  min ), LVEF (%) and LVEDV (mL). Fifty-nine RCTs were included. RT produced a greater increase in [Formula: see text] peak (3.57 ml kg  min , P < 0.00001, I  = 0%) compared to AE (2.63 ml kg  min , P < 0.00001, I  = 58%) while combined RT and AE produced a 2.48 ml kg  min increase in [Formula: see text]; I  = 69%) compared to control group. Comparison among the three forms of exercise revealed similar effects on [Formula: see text] peak (P = 0.84 and 1.00, respectively; I  = 0%). AE was associated with a greater gain in LVEF (3.15%; P < 0.00001, I  = 17%) compared to RT alone or combined exercise which produced similar gains compared to control groups. Subgroup analysis revealed that AE reduced LVEDV (- 10.21 ml; P = 0.007, I  = 0%), while RT and combined RT and AE had no effect on LVEDV compared with control participants. RT results in a greater gain in [Formula: see text] peak, and induces no deleterious effects on cardiac function in HF patients