physical fitness – ABC CARDIOL

IJCS

Original Article

High Cardiorespiratory Optimal Point Values Are Related to Cardiovascular Mortality in Men Aged 46 to 70 Years: a Prospective Cohort Study

Claudio Gil Araújo et al. Plínio Santos Ramos Jari A. Laukkanen Jonathan Myers … Setor K. Kunutsor Matthew P. Harber Thijs M. H. Eijsvogels Beatriz D. Marinho Christina Grüne de Souza e Silva

Abstract

Background:

Several hemodynamic and respiratory variables measured during cardiopulmonary exercise testing (CPX) have been shown to predict survival. One such measure is the cardiorespiratory optimal point (COP) that reflects the best possible circulation-respiration interaction, but there are still limited data on its relationship with adverse outcomes.

Objective:

To assess the association between COP and cardiovascular mortality in men aged 46 to 70 years.

Methods:

A sample of 2201 men who had anthropometric, clinical, and COP data obtained during cycling CPX between 1995 and 2022 was extracted from the CLINIMEX Exercise cohort. COP was identified as the minimal minute-to-minute VE/VO₂ during CPX. Vital data were censored on October 31, 2022 for ICD-10-identified cardiovascular deaths. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs).

Results:

The mean ± standard deviation age was 57 ± 6 years and the median COP value was 24 (interquartile range = 21.2 to 27.4). During a mean follow-up of 4688 ± 2416 days, 129 (5.6%) patients died from cardiovascular causes. The death rates for low ( 30) categories of COP were 3.2%, 9.6%, and 18.7%, respectively. Following adjustment for age, history of myocardial infarction, diagnosis of coronary artery disease, and diabetes mellitus, the HR (95% CI) for cardiovascular mortality comparing very high versus low COP was 2.76 (1.87 to 4.07; p < 0.001).

Conclusions:

Our data indicate that, for a general population-based sample of men, COP > 30 represents a considerably higher risk for cardiovascular death. Information on COP could assist cardiovascular risk assessment in men.

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IJCS

Original Article

Comparative Analysis of Direct and Indirect Methods for the Determination of Maximal Oxygen Uptake in Sedentary Young Adults

Alfredo Moreira da Rocha Neto et al. Artur Haddad Herdy Pablo de Souza

Abstract

Background:

Maximal oxygen uptake is a powerful prognostic indicator and a reliable measure of physical conditioning. It can be measured directly by cardiopulmonary exercise testing (CPET) or indirectly by formulas derived from conventional protocols.

Objective:

We compared the VO₂ max obtained by formula using exercise testing with Bruce protocol (BP) with the VO₂ max obtained by CPET on the treadmill.

Methods:

We selected 41 healthy, non-obese, physically inactive young volunteers, aged between 21 and 50 years, residents of Florianópolis, Brazil.

Results:

Twenty-one women (52%) with mean age of 35.62 ± 8.83 years, and 20 males, with mean age of 32.5 ± 7.18 years participated in the study. Statistically significant differences were found for VO₂ max between the two methods (BP – 42.31 ± 5.21 ml/kg.min vs. CPET – 30.46 ± 5.50 ml/kg.min., p < 0.0001). The Bruce formula overestimated the result by 34.1% (BP – 45.95 ± 3.94 ml/kg.min vs. CPX – 34.27 ± 4.20 ml/kg.min, p < 0.0001) for men, and by 44.8% (BP – 38.84 ± 3.72 ml/kg.min vs. CPX – 26.83 ± 3.90, p < 0.0001) for women. A moderate correlation was observed between the methods (r = 0.65). When classifying the results according to the table of aerobic capacity of the American Heart Association, the agreement was null (kappa = 0.0034; Pearson chi2 = 0.001).

Conclusion:

VO₂ estimated by BP is not capable of demonstrating the true aerobic capacity in these individuals, while CPET is an important tool for early detection of diminished functional capacity in sedentary young men and women.

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IJCS

Viewpoint

Invasive Coronary Physiological Assessment in Symptomatic Middle-Aged Endurance Athletes

Omar M. Issa et al. J. Sawalla Guseh Ignacio Inglessis Aaron L. Baggish

Abstract

Despite the health benefits of routine exercise, coronary artery disease (CAD) is common among older competitive athletes and is an important cause of sudden cardiac death. Athletes with suspected or confirmed CAD routinely undergo conventional coronary angiography involving the performance of invasive coronary physiological assessment using the fractional flow reserve (FFR) or the instantaneous-wave free ratio (iFR). Data defining the role of invasive coronary physiological assessment, while robust in general clinical populations, are untested among older competitive athletes with CAD. The paper discusses the challenges and uncertainties surrounding the use of the FFR and iFR in this unique population with an emphasis on the need for future work to better define this approach.

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IJCS

Review Article

Effects of Exercise Training on Cardiovascular and Autonomic Parameters in Stroke Survivors: A Systematic Review

Bruno Bavaresco Gambassi et al. Fabiano de Jesus Furtado Almeida Ana Eugênia Araújo Furtado Almeida João Alberto Ribeiro … Tânia Maria Gaspar Novais Paulo Adriano Schwingel Ciro Oliveira Queiroz Clarcson Plácido Conceição dos Santos Bruno Rodrigues

Abstract

Negative changes in cardiovascular and autonomic variables in stroke survivors have encouraged the global scientific community to focus on investigating therapeutic strategies to mitigate stroke damage. The objective of the present study was to describe the effects of exercise training on cardiovascular and autonomic variables in stroke survivors. We used the PICO (population, intervention, control/comparison, and outcome variables) model for the search of articles in PubMed and Physiotherapy Evidence Databases from 2009 to December 2018. The following data were also recorded: type of study, author, year of publication, participants (time after stroke, sample size, and age) and benefits of exercise training. A total of 544 articles were initially selected, of which nine peer-reviewed articles met the search criteria. These nine studies enrolled 611 participants (middle-aged or elderly), and pointed to positive effects of training on maximal oxygen uptake, peak aerobic capacity, 6-minute walk test and resting heart rate. However, more well-controlled studies are needed to confirm the benefits of exercise training on cardiovascular and autonomic variables in this population.

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IJCS

Original Article

Talk the talk and walk the walk! Association between Weekly Exercise Load and Knowledge about Recommendations for Fighting Innactivity

Diogo Thadeu Meira et al. Leonardo Giglio Gonçalves Luiz Henrique Araújo Matheus Gasparini … Bernardo Souza Cunha Amanda Monteiro Michele Heringer Christiane Prado Andre Volschan Fabrício Braga da Silva

Abstract

Background:

The World Health Organization (WHO) recommends as a weekly “target dose” of exercise 150 minutes of moderate exercise or 75 minutes of intense exercise. Public health policies have prioritized the practice of exercise as a strategy for disease prevention and health promotion, with health professionals as their main promoters.

Objective:

To assess the interaction between the amount of exercise per week and the knowledge about recommendations for fighting a sedentary lifestyle among health care professionals attending a congress of cardiology.

Methods:

Participants of the 2017 Rio de Janeiro Society of Cardiology Congress were interviewed. Knowledge about the World Health Organization (WHO) recommendations for fighting a sedentary lifestyle was assessed by asking participants the question: “How much weekly exercise is recommended by the WHO?” Responders were stratified by the weekly exercise load reported. A multivariate logistic model was created to determine independent predictors of knowledge.

Results:

A total of 426 participants were interviewed (45.5% men, median age 31 years, 37.8% physicians, 65.8% of the physicians were cardiologists). The overall knowledge level was 44.6%; 38.1%, 52.7% and 56.6% among non-physicians, non-cardiologists and cardiologists, respectively (p = 0.002). Of all participants, 21.8% were inactive, 15% were lightly active, 34.7% moderately active and 28.4% highly active, and the percentage of individuals who gave a correct answer to the question on exercise recommendations was 30.1%, 42%, 48% and 52.9% respectively (p < 0.0001). In the multivariate analysis, being highly active (OR = 2.25, IC95%, 1.238 – 4.089), moderately active (OR = 1.93, IC 95% 1.105 – 3.39) and being a cardiologist (OR = 2.01, IC 95% 1.243 – 3,267) were predictors of knowledge.

Conclusions:

There was a linear association between exercise level and knowledge about the WHO recommendations on exercise. Policies to stimulate the practice of exercise among health professionals can positively impact campaigns for reducing sedentary lifestyle in the general population.

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