Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals

Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 242-248
Author(s):  
Ehimen C. Aneni ◽  
Ebenezer T. Oni ◽  
Chukwuemeka U. Osondu ◽  
Seth S. Martin ◽  
Michael J. Blaha ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stress Test ◽  
Statistical Significance ◽  
Normal Weight ◽  
Exercise Stress ◽  
Peak Exercise ◽  
Exercise Heart Rate ◽  
Cross Sectional ◽  
Metabolic Equivalents ◽  
The Impact

Objective: To assess the impact of aerobic fitness on exercise heart rate (HR) indices in an asymptomatic cohort across different body mass index (BMI) categories. Methods: We performed a cross-sectional analysis of 506 working-class Brazilian subjects, free of known clinical cardiovascular disease (e.g. ischemic heart disease and stroke) who underwent an exercise stress test. Results: There was a significant trend towards decreased HR at peak exercise, HR recovery and chronotropic index (CI) measures as BMI increased, but resting HR increased significantly across BMI categories. In multivariate analysis, the change in CI per unit change in metabolic equivalents of task was greater among the obese subjects than the normal-weight (2.7 vs. -0.07; p interaction = 0.029) and overweight (2.7 vs. 0.7; p interaction = 0.044) subjects. A similar pattern was seen with peak HR and HR recovery, although the formal tests of interaction did not achieve statistical significance. Conclusion: Our findings strongly suggest that fitness is associated with a favorable HR profile and is modified by BMI. Intervention programs should place emphasis on fitness and not only on weight loss.

Abstract MP80: Increased Physical Fitness Is Associated With Greater Improvement In Cardiac Parasympathetic Function Among The Obese Than Overweight Or Normal Weight Individuals

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ehimen Aneni ◽  
Ebenezer Oni ◽  
Lara Roberson ◽  
Romeu Meneghelo ◽  
Michael Blaha ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Maximal Exercise ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Exercise Stress ◽  
Metabolic Equivalents ◽  
The Impact ◽  
Weight Groups

Introduction: The impact of physical fitness on heart rate recovery (HRR), a marker of cardiac parasympathetic activity, has rarely been studied across weight categories. We examined the effect of physical fitness across different weight categories on HRR at 2 minutes after exercise stress test in an asymptomatic cohort. Methods: This is a cross-sectional analysis of 525 Brazilian subjects, free of known cardiovascular disease that underwent exercise stress test. Metabolic equivalents at maximal exercise (METS) were calculated from the volume of oxygen consumed during maximal exercise (VO2max). HRR was defined as peak exercise HR minus HR after 2minutes rest. Weight was classified into obese (BMI ≥ 30), overweight (BMI 25 -29) and normal weight (BMI <25). Results: The prevalence of overweight and obesity was 51% and 19% respectively. There was a positive significant correlation between METS and HRR (r= 0.34 p<0.001). The mean HRR was higher among the normal weight than the overweight or obese (92 vs. 89 vs.76 beats; p<0.001) while the average (mean) METS decreased across increasing weight categories (10.6 vs. 10.4 vs. 9.1 METS; p <0.001). In a fully adjusted linear regression model, for every unit increase in METS the HRR increased by 2.0 beats among the obese (p<0.005), 1.1 beats among the overweight (p<0.001) and 0.8 beats among the normal weight (p=0.143). These increases were significantly different among the 3 groups (p<0.001). Line fitted plots (figure below) showed that the increase in HRR associated with increasing METS was greater among the obese than the other weight groups and at high METS value (about 13 METS) the HRR are similar regardless of BMI. Conclusion: Our findings suggest that increasing fitness increases HRR, with greater benefit in the obese than other weight groups. Physical fitness, not simply weight loss, should be advocated in the obese. More studies are required to fully understand the temporal relationship between BMI, physical fitness and HRR.

scholarly journals Deterioration of heart rate recovery index in patients after carotid artery stenting

2017 ◽  
Vol 23 (6) ◽  
pp. 578-582
Author(s):  
Emrah Aytac ◽  
Murat Gonen ◽  
Orhan Dogdu ◽  
Mehmet Balin
Keyword(s):  
Heart Rate ◽  
Carotid Artery ◽  
Exercise Testing ◽  
Carotid Artery Stenting ◽  
Heart Rate Recovery ◽  
Recovery Period ◽  
Exercise Stress ◽  
Peak Exercise ◽  
Maximal Heart Rate ◽  
Metabolic Equivalents

Objective Although carotid artery stenting (CAS) is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions long term after the procedure. Patients with CAS have been reported to have autonomic nervous system (ANS) dysfunction. This study aimed to evaluate heart rate recovery (HRR) indices and exercise test parameters after CAS. Methods Patients (10 male, 11 female) suitable for CAS, without a history of hypertension, diabetes mellitus, severe coronary artery or valvular heart disease, were enrolled in our study. Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients pre- and post-procedure. The HRR index was defined as the reduction in the heart rate from the rate at peak exercise to the rate first minute (HRR1), second minute (HRR2), third minute (HRR3) and fifth minute (HRR5) after the cessation of exercise stress testing. Results The exercise time, maximal heart rate, maximal blood pressure and maximal metabolic equivalents values were significantly decreased after the procedure. The first- and second-minute HRR indices of patients before procedure were significantly lower than after procedure (23.5 ± 6.6 vs 25.8 ± 8.3; p < 0.001 and 41.8 ± 12.3 vs 50.2 ± 16.3; p < 0.001, respectively). Similarly, HRR indices after the third and fifth minutes of the recovery period were significantly lower in patients before procedure, when compared with those indices after procedure (52.9 ± 13.1 vs 60.7 ± 14.4; p < 0.001 and 62.4 ± 12.8 vs 71.9 ± 14.1; p < 0.001). Conclusion We have demonstrated that HRR indices increased in the first, second, third and fifth minutes of the recovery period after maximal exercise testing in patients after the CAS procedure, which may be a reflection of parasympathetic dominance after CAS.

scholarly journals Usability of and Adherence to a Novel, Home-based Cardiac Telerehabilitation Program for Heart Attack Survivors: The MI-PACE Cohort Study (Preprint)

2020 ◽  
Author(s):  
Eric Y Ding ◽  
Nathaniel Erskine ◽  
Wim Stut ◽  
Emily Ensom ◽  
Amy Peterson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Pilot Study ◽  
Stress Test ◽  
Academic Medical Center ◽  
Exercise Stress ◽  
Exercise Heart Rate ◽  
Management Interventions ◽  
System Usability Scale ◽  
At Home

BACKGROUND Cardiac rehabilitation (CR) programs, consisting of exercise training and disease management interventions, reduce morbidity and mortality after an acute myocardial infarction (AMI). OBJECTIVE In this pilot study, we developed and assessed the feasibility of delivering a novel health watch-informed 12-week tele-CR program to AMI survivors who declined participation in center-based CR. METHODS We enrolled hospitalized AMI survivors at an academic medical center who were eligible for, but declined, center-based CR. All participants underwent a baseline exercise stress test. Participants received a health watch that monitored heart rate (HR) and activity, and a tablet computer with an application that displayed progress towards accomplishing weekly walking and exercise goals. Results were transmitted to a CR nurse via a secure connection. For 12 weeks, participants exercised at home using HR and walking targets, and also participated in weekly phone counseling sessions with the CR nurse, who provided personalized CR problem solving and standard CR education. We assessed usability of the system, adherence to weekly exercise and walking goals, counseling session attendance, and disease-specific quality of life. RESULTS Eighteen participants completed the 12-week telerehabilitation program. Their mean age was 59 (SD 7) years, 33% were women, and 33% had an ST-elevation myocardial infarction. Participants wore the health watch for a median of 12.7 hours (Q1, Q3: 11.1, 13.8) per day and completed a median of 86% of exercise goals. Participants on average walked 121 minutes per week (SD 175) and spent 189 minutes per week (SD 210) in their targeted exercise heart rate zone. Overall, participants found the system to be highly usable (median System Usability Scale score of 83 (Q1, Q3: 65, 100). CONCLUSIONS This pilot study established the feasibility of delivering tele-CR at home to AMI survivors via a health watch-based program and telephone counseling sessions. Usability and adherence to health watch use, exercise recommendations, and counseling sessions were high. Additional studies with larger patient samples are warranted to compare center-based rehabilitation and telerehabilitation on patient outcomes and healthcare resource utilization.

scholarly journals Protective effect of BNT162b2 vaccination on aerobic capacity following mild to moderate SARS-CoV-2 infection: a cross sectional study, Israel, March-December 2021

2022 ◽  
Author(s):  
Yair Blumberg ◽  
Michael Edelstein ◽  
Kamal Abu Jabal ◽  
Ron Golan ◽  
Yuval Perets ◽  
...  
Keyword(s):  
Heart Rate ◽  
Aerobic Capacity ◽  
Acute Infection ◽  
Cross Sectional Study ◽  
Peak Exercise ◽  
Exercise Heart Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adverse Health Outcomes ◽  
Significant Difference

There is increasing evidence that patients who were infected with SARS-CoV-2 may experience adverse health outcomes months after the acute infection has resolved including reduction in aerobic capacity and fatigue. In this study, we compared aerobic capacity and exercise performance of 28 unvaccinated participants to 15 vaccinated ones who performed a symptom limited cardio-pulmonary exercise test (CPET) after acute COVID-19. We identified a significant difference in aerobic capacity between vaccinated and unvaccinated individuals, with a lower V'O2 peak percentage of predicted in the unvaccinated group. In addition, the unvaccinated group had a reduction in the peak-exercise heart rate and lower ventilation values. Our results suggest objective limitations to exercise capacity in the months following acute COVID19 illness, mitigated by vaccination

scholarly journals COMPARATIVE STUDY OF EXERCISE STRESS TEST ON CARDIOVASCULAR AUTONOMIC FUNCTIONS BETWEEN MALES AND FEMALES - A CROSS SECTIONAL STUDY

2021 ◽  
pp. 14-16
Author(s):  
Tamil Sudar S ◽  
S. Kannan
Keyword(s):  
Stress Test ◽  
Exercise Stress Test ◽  
Cross Sectional Study ◽  
Exercise Stress ◽  
South Indian Population ◽  
Sectional Study ◽  
Autonomic Functions ◽  
Cross Sectional ◽  
Males And Females ◽  
The Impact

Background: Exercise stress test is a simple, reliable and noninvasive test which detects the coronary artery disease even before the symptoms arise among both males and females.Hence this test was used to assess the impact of exercise stress test on cardiac autonomic function among males and females. Objectives: To compare the cardiac autonomic functions between the males and females among normal, overweight and obese individuals in South Indian population. Methods:A cross sectional study in department of Cardiology and Master Health Checkup in Chennai medical College and hospital, Trichy, a tertiary care teaching hospital during December 2015 to December 2016. Study population includes healthy participants aged between 18-70 years of age from both genders with BMI more than 20 kg/m2. Participants who gave history of alcohol consumption,smoking,hypertension,diabetes mellitus,pregnant and lactating mothers and cases with psychiatric disorders were excluded from the study.Total participants included were 135.Data was entered and analyzed using Statistical Package for Social Sciences version 18.Descriptive statistics and analysis of variance tests were used,appropriately to test the statistical significance. Results: Overweight females had significantly low duration of exercise and MET and obese females had significantly low hear rate at peak of the exercise, duration of exercise, MET and HRR at one and three minutes compared to the individuals with similar BMI categories.Females with normal BMI were found to show no significant difference in any of the observed parameters. Conclusion: Overweight and obese females were comparative at higher risk of developing cardiac disorders compared to overweight and obese males.To reduce the burden of cardiovascular disease in the population,these high risk populations should be targeted first by health education and promoting weight reduction

scholarly journals Comparison of Preoperative Assessment of Patient’s Metabolic Equivalents (METs) Estimated from History versus Measured by Exercise Cardiac Stress Testing

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Adam S. Weinstein ◽  
Martin I. Sigurdsson ◽  
Angela M. Bader
Keyword(s):  
Cardiac Failure ◽  
Stress Testing ◽  
Stress Test ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
Exercise Stress ◽  
Cardiac Stress ◽  
Metabolic Equivalents ◽  
Cardiac Stress Testing ◽  
Cardiac Stress Test

Background. Preoperative anesthetic evaluations of patients before surgery traditionally involves assessment of a patient’s functional capacity to estimate perioperative risk of cardiovascular complications and need for further workup. This is typically done by inquiring about the patient’s physical activity, with the goal of providing an estimate of the metabolic equivalents (METs) that the patient can perform without signs of myocardial ischemia or cardiac failure. We sought to compare estimates of patients’ METs between preoperative assessment by medical history with quantified assessment of METs via the exercise cardiac stress test. Methods. A single-center retrospective chart review from 12/1/2005 to 5/31/2015 was performed on 492 patients who had preoperative evaluations with a cardiac stress test ordered by a perioperative anesthesiologist. Of those, a total of 170 charts were identified as having a preoperative evaluation note and an exercise cardiac stress test. The METs of the patient estimated by history and the METs quantified by the exercise cardiac stress test were compared using a Bland–Altman plot and Cohen’s kappa. Results. Exercise cardiac stress test quantified METs were on average 3.3 METS higher than the METs estimated by the preoperative evaluation history. Only 9% of patients had lower METs quantified by the cardiac stress test than by history. Conclusions. The METs of a patient estimated by preoperative history often underestimates the METs measured by exercise stress testing. This demonstrates that the preoperative assessments of patients’ METs are often conservative which errs on the side of patient safety as it lowers the threshold for deciding to order further cardiac stress testing for screening for ischemia or cardiac failure.

scholarly journals Asthma prevalence and the impact of nutritional status on prescribed asthma medications in children

2020 ◽  
Vol 73 (9-10) ◽  
pp. 265-270
Author(s):  
Vesna Petrovic ◽  
Vesna Vujic-Aleksic ◽  
Tanja Rozek-Mitrovic ◽  
Aleksandra Hristov
Keyword(s):  
Nutritional Status ◽  
Normal Weight ◽  
Asthma Prevalence ◽  
Obese Children ◽  
Primary Health Center ◽  
Cross Sectional ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
Nutritional Status Of Children ◽  
The Impact

Introduction. Asthma and obesity are the most common chronic health disorders in children. Although heredity plays a significant role in their development, environmental factors and early exposure have contributed to the increasing incidence of both disorders in recent decades. The aim of the study was to estimate asthma prevalence in schoolchildren in Indjija, Srem District, Serbia, and to investigate differences in nutritional status of children with asthma as well as differences between their nutritional status and prescribed asthma medications. Material and Methods. A cross-sectional retrospective cohort study was conducted at the Primary Health Center in Indjija. Of all the medical records of children aged 6 - 14 years, a cohort of children with asthma was formed. The retrospective study evaluated their nutritional status and the prescribed asthma medications. Results. The prevalence of asthma in children aged 6 - 14 was 6.9%. Children with asthma were significantly more overweight and obese (40.5%) than children without asthma. Boys accounted for 63.7% of children with asthma, with a statistically significant gender difference. Abnormal nutritional status was found in 44.3% of children with asthma and boys with asthma were significantly more obese (23%) compared to girls (7.8%). Overweight and obese children with asthma were not prescribed significantly more medications to relieve asthma symptoms than normal-weight children. Conclusion. The prevalence of asthma among schoolchildren in Indjija was 6.9%. Children with asthma were more likely to be overweight and obese than children without asthma, whereas boys with asthma were significantly more obese than girls. No significant differences were found between their nutritional status and prescribed asthma medications.

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