Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta‑Analysis

Background Exercise-based cardiac rehabilitation (CR) is considered an effective treatment for enhancing endothelial function in patients with heart failure (HF). However, recent studies have been published and the optimal “dose” of exercise required to increase the benefits of exercise-based CR programmes on endothelial function is still unknown. Objectives (a) To estimate the effect of exercise-based CR on endothelial function, assessed by flow-mediated dilation (FMD), in patients with HF; (b) to determine whether high-intensity interval training (HIIT) is better than moderate-intensity training (MIT) for improving FMD; and (c) to investigate the influence of exercise modality (i.e. resistance exercise vs. aerobic exercise and combined exercise vs. aerobic exercise) on the improvement of endothelial function. Methods Electronic searches were carried out in PubMed, Embase, and Scopus up to February 2022. Random-effects models of between-group mean differences were estimated. Heterogeneity analyses were performed by means of the chi-square test and I2 index. Subgroup analyses and meta-regressions were used to test the influence of potential moderator variables on the effect of exercise. Results We found a FMD increase of 3.09% (95% confidence interval [CI] = 2.01, 4.17) in favour of aerobic-based CR programmes compared with control groups in patients with HF and reduced ejection fraction (HFrEF). However, the results of included studies were inconsistent (p < .001; I2 = 95.2%). Higher FMD improvement was found in studies which were randomised, reported radial FMD, or performed higher number of training sessions a week. Moreover, HIIT enhanced FMD to a greater extent than MIT (2.35% [95% CI = 0.49, 4.22]) in patients with HFrEF. Insufficient data prevented pooled analyses for the effect of exercise in patients with HF and preserved ejection fraction and the influence of exercise modality on the improvement of endothelial function. Conclusion Aerobic-based CR is a non-pharmacological treatment for enhancing endothelial function in patients with HFrEF. However, higher training frequency and HIIT induce greater adaptation of endothelial function in these patients, which should betaken into consideration when designing exercise-based CR programmes. Trial registration The protocol was prospectively registered on the PROSPERO database (CRD42022304687)

Validez del acelerómetro de un teléfono móvil para la cuantificación de la carga en saltos

El control de la carga en el entrenamiento es fundamental para la planificación deportiva. En deportes de carácter aérobico, extensivo y cíclico encontramos modelos de cuantificación que tienen en cuenta variables tanto de volumen como de intensidad, pero que no tienen buena relación con el tipo de trabajo realizado en deportes explosivos. Estas modalidades suelen incidir en dos cualidades principales: la fuerza y la velocidad. Concretamente en salto de longitud, los entrenamientos se basan en series de carrera y sesiones de fuerza, a las que se añade un alto componente en saltos. Mientras que para los dos primeros casos se consideran variables de volumen e intensidad a la hora de cuantificar la carga, en saltos únicamente se contemplan variables de volumen. Para conseguir una herramienta que tenga en cuenta otras variables como la intensidad, el objetivo de este trabajo es validar el acelerómetro de un teléfono móvil como herramienta de cuantificación de la carga en saltos. Se colocó un teléfono móvil con acelerómetro a una participante para realizar varias tareas de saltos verticales y horizontales sobre plataformas de fuerzas. La aceleración resultante del teléfono móvil y de las plataformas de fuerzas ha sido filtrada y se han extraído los picos para calcular la correlación existente entre ambas. En el total de los saltos analizados aparece una correlación alta y en el conjunto de los saltos verticales la correlación es muy alta, aunque en el conjunto de los saltos horizontales es trivial. Se sugiere que el uso del acelerómetro de un teléfono móvil como herramienta para el análisis de la intensidad de los saltos verticales es adecuado, pero no para los saltos horizontales

Is the Verification Phase a Suitable Criterion for the Determination of Maximum Oxygen Uptake in Patients with Heart Failure and Reduced Ejection Fraction? A Validation Study

The verification phase (VP) has been proposed as an alternative to the traditional criteria used for the determination of the maximum oxygen uptake (VO2 max) in several populations. Nonetheless, its validity in patients with heart failure with reduced ejection fraction (HFrEF) remains unclear. Therefore, the aim of this study was to analyse whether the VP is a safe and suitable method to determine the VO2 max in patients with HFrEF. Adult male and female patients with HFrEF performed a ramp-incremental phase (IP), followed by a submaximal constant VP (i.e., 95% of the maximal workload during the IP) on a cycle ergometer. A 5-min active recovery period (i.e., 10 W) was performed between the two exercise phases. Group (i.e., median values) and individual comparisons were performed. VO2 max was confirmed when there was a difference of ≤ 3% in peak oxygen uptake (VO2 peak) values between the two exercise phases. Twenty-one patients (13 males) were finally included. There were no adverse events during the VP. Group comparisons showed no differences in the absolute and relative VO2 peak values between both exercise phases (p = 0.557 and p = 0.400, respectively). The results did not change when only male or female patients were included. In contrast, individual comparisons showed that the VO2 max was confirmed in 11 patients (52.4%) and not confirmed in 10 (47.6%). The submaximal VP is a safe and suitable method for the determination of the VO2 max in patients with HFrEF. In addition, an individual approach should be used because group comparisons could mask individual differences

Is the Verification Phase a Suitable Criterion for the Determination of Maximum Oxygen Uptake in Patients with Heart Failure and Reduced Ejection Fraction? A Validation Study

The verification phase (VP) has been proposed as an alternative to the traditional criteria used for the determination of the maximum oxygen uptake (VO2 max) in several populations. Nonetheless, its validity in patients with heart failure with reduced ejection fraction (HFrEF) remains unclear. Therefore, the aim of this study was to analyse whether the VP is a safe and suitable method to determine the VO2 max in patients with HFrEF. Adult male and female patients with HFrEF performed a ramp-incremental phase (IP), followed by a submaximal constant VP (i.e., 95% of the maximal workload during the IP) on a cycle ergometer. A 5-min active recovery period (i.e., 10 W) was performed between the two exercise phases. Group (i.e., median values) and individual comparisons were performed. VO2 max was confirmed when there was a difference of &le; 3% in peak oxygen uptake (VO2 peak) values between the two exercise phases. Twenty-one patients (13 males) were finally included. There were no adverse events during the VP. Group comparisons showed no differences in the absolute and relative VO2 peak values between both exercise phases (p = 0.557 and p = 0.400, respectively). The results did not change when only male or female patients were included. In contrast, individual comparisons showed that the VO2 max was confirmed in 11 patients (52.4%) and not confirmed in 10 (47.6%). The submaximal VP is a safe and suitable method for the determination of the VO2 max in patients with HFrEF. In addition, an individual approach should be used because group comparisons could mask individual differences

Investigación en el aprendizaje de Biología Celular e Histología

Promovida por el Espacio Europeo de Educación Superior, la aproximación al aprendizaje centrado en el estudiante es el cambio más importante al que hemos asistido en los últimos años en el contexto educativo universitario. La Red de Investigación en el Aprendizaje de Biología Celular e Histología está constituida por un grupo de profesores y por alumnado de tercer ciclo implicados en la introducción de prácticas docentes innovadoras que permitan un aprendizaje interesante y efectivo. Basándonos en el aprendizaje por competencias perseguimos la participación activa del estudiante a través de la creación de entornos de aprendizaje colaborativos en los que adoptamos un papel de orientador y facilitador. En este contexto, con el deseo de mejorar la eficacia del aprendizaje de nuestros estudiantes nos hemos centrado principalmente en diseñar actividades que contemplen, en gran medida, la dimensión afectiva y motivación durante las clases prácticas de las asignaturas de Biología Celular y de Histología