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ABSTRACT: The aim of this study was to examine the effects of 12 weeks of supervised aerobic and strength training (SET) versus no-training (NT) on peak aerobic power (VO2peak), submaximal exercise left ventricular (LV) systolic function, peripheral vascular function, lean tissue mass and maximal strength in clinically stable heart transplant recipients (HTR). Forty-three HTR were randomly assigned to 12 weeks of SET (n = 22; age: 57 +/- 10 years; time posttransplant: 5.4 +/- 4.9 years) or NT (n = 21; age: 59 +/- 11 years; time posttransplant: 4.4 +/- 3.3 years). The change in VO2peak (3.11 mL/kg/min, 95% CI: 1.2-5.0 mL/kg/min), leg and total lean tissue mass (0.78 kg, 95% CI: 0.31-1.3 kg and 1.34 kg, 95% CI: 0.34-2.3 kg, respectively), chest-press (10.4 kg, 95% CI: 5.2-15.5 kg) and leg-press strength (34.7 kg, 95% CI: 3.7-65.6 kg) were significantly higher after SET versus NT. No significant change was found for submaximal exercise LV systolic function or brachial artery endothelial-dependent or -independent vasodilation. Supervised exercise training is an effective intervention to improve VO2peak, lean tissue mass and muscle strength in HTR. This training regimen did not improve exercise LV systolic function or brachial artery endothelial function.
American Journal of Transplantation 05/2009; 9(4):734-9. · 6.39 Impact Factor
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ABSTRACT: To assess the effects of prolonged strenuous exercise in the form of a half-ironman (HI) race (2 km swim, 90 km bike ride and a 21 km run) on left ventricular systolic function.
The study participants consisted of nine male triathletes (mean age +/- SD 32+/-5 years) who competed in the Great White North HI race. Two-dimensional transthoracic echocardiograms were obtained two to three days before the HI (prerace), immediately after completion of the HI (postrace) and 24 h after cessation of exercise. Compared with before the race, performing an HI was associated with a decline in systolic blood pressure (prerace 127.2+/-15.0 mmHg compared with after the race 116.1+/-10.2 mmHg, P<0.05), the systolic blood pressure to end-systolic cavity area ratio (a surrogate for left ventricular contractility - prerace 14.3+/-3.0 mmHg/cm(2) compared with postrace 11.0+/-2.2 mmHg/cm(2), P<0.05) and the fractional area change (prerace 54.1+/-3.8% compared with postrace 47.4+/-5.5%, P<0.05). There was also a concomitant increase in heart rate (prerace 56.3+/-9.4 beats/min compared with postrace 74.1+/-10.7 beats/min, P<0.05), the end-systolic cavity area (prerace 9.2+/-2.2 cm(2) compared with postrace 10.8+/-1.9 cm(2), P<0.05) and the end-systolic cavity area to end-systolic myocardial area ratio (prerace 0.39+/-0.08 compared with postrace 0.51+/-0.1, P<0.05), which returned toward baseline values 24 h after cessation of the HI.
Performing an HI appears to be associated with a transient impairment in left ventricular contractility and a subsequent decline in left ventricular systolic function that tends to return toward normal values within 24 h after cessation of exercise.
The Canadian journal of cardiology 07/2001; 17(6):687-90. · 3.36 Impact Factor
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ABSTRACT: To assess the effects of leg-press (LP) exercise performed with a brief (2 to 3 s) Valsalva maneuver on left ventricular (LV) systolic function and LV wall stress in five healthy men (mean +/- SD age, 27.6 +/- 2.9 years).
Subjects performed submaximal (80% one repetition maximum [1RM], 337.9 +/- 109.1 kg; 95% 1RM, 400.6 +/- 129.8 kg) and maximal LP exercise (420 +/- 118.6 kg) during which central arterial pressure, intrathoracic pressure, and two-dimensional echocardiographic analysis of LV systolic function and LV wall stress were measured.
Compared with baseline, LP exercise resulted in an increase in intrathoracic pressure (baseline, 1.7 +/- 2.9 mm Hg; 80% 1RM, 111.7 +/- 20.2 mm Hg; 95% 1RM, 112.2 +/- 21.1 mm Hg; 100% 1RM, 111.0 +/- 21.3 mm Hg; p < 0.05) and LV end-systolic pressure (baseline, 120.0 +/- 13.2 mm Hg; 80% 1RM, 251.6 +/- 15.3 mm Hg; 95% 1RM, 255.3 +/- 12.2 mm Hg; 100% 1RM, 242.8 +/- 16.5 mm Hg; p < 0.05) with no changes in LV end-systolic transmural pressure (baseline, 118.3 +/- 12.6 mm Hg; 80% 1RM, 140.0 +/- 6.1 mm Hg; 95% 1RM, 143.1 +/- 16.1 mm Hg; 100% 1RM, 131.8 +/- 29.7 mm Hg; p > 0.05), LV end-systolic wall stress (baseline, 91.7 +/- 20.2 kilodyne/cm(2); 80% 1RM, 78.0 +/- 24.4 kilodyne/cm(2); 95% 1RM, 81.4 +/- 25.3 kilodyne/cm(2); 100% 1RM, 85.9 +/- 20.1 kilodyne/cm(2); p > 0.05), or LV fractional area change (baseline, 0.48 +/- 0.03; 80% 1RM, 0.52 +/- 0.11; 95% 1RM, 0.53 +/- 0.06; 100% 1RM, 0.52 +/- 0.05; p > 0.05).
LP exercise performed with a brief Valsalva maneuver is not associated with an alteration in LV wall stress or LV systolic function in healthy young men.
Chest 01/2001; 119(1):150-4. · 5.25 Impact Factor
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ABSTRACT: This long-term, multicenter, randomized, double-blind, placebo-controlled, 2 x 2 factorial, angiographic trial evaluated the effects of cholesterol lowering and angiotensin-converting enzyme inhibition on coronary atherosclerosis in normocholesterolemic patients.
There were a total of 460 patients: 230 received simvastatin and 230, a simvastatin placebo, and 229 received enalapril and 231, an enalapril placebo (some subjects received both drugs and some received a double placebo). Mean baseline measurements were as follows: cholesterol level, 5.20 mmol/L; triglyceride level, 1.82 mmol/L; HDL, 0.99 mmol/L; and LDL, 3.36 mmol/L. Average follow-up was 47.8 months. Changes in quantitative coronary angiographic measures between simvastatin and placebo, respectively, were as follows: mean diameters, -0.07 versus -0.14 mm (P:=0.004); minimum diameters, -0.09 versus -0.16 mm (P:=0. 0001); and percent diameter stenosis, 1.67% versus 3.83% (P:=0.0003). These benefits were not observed in patients on enalapril when compared with placebo. No additional benefits were seen in the group receiving both drugs. Simvastatin patients had less need for percutaneous transluminal coronary angioplasty (8 versus 21 events; P:=0.020), and fewer enalapril patients experienced the combined end point of death/myocardial infarction/stroke (16 versus 30; P:=0.043) than their respective placebo patients.
This trial extends the observation of the beneficial angiographic effects of lipid-lowering therapy to normocholesterolemic patients. The implications of the neutral angiographic effects of angiotensin-converting enzyme inhibition are uncertain, but they deserve further investigation in light of the positive clinical benefits suggested here and seen elsewhere.
Circulation 11/2000; 102(15):1748-54. · 14.74 Impact Factor
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ABSTRACT: Resistance training (RT) has gained popularity as an effective form of exercise for older adults. However, the effects of RT on left ventricular (LV) morphology and systolic function in older persons is not well known. The purpose of this study was to assess the effects of 16 weeks of RT on LV morphology and systolic function in healthy older men. Subjects were randomly assigned into a RT group (n = 10; mean+/- SD age, 68 +/- 3 years) or a nonexercise control group (n = 10; age 68 +/- 4 years). RT was performed 3 times per week for 16 weeks at a mean intensity between 60% and 80% of 1 repetition maximum. Leg and bench press 1 repetition maximum and 2-dimensional echocardiography were performed at baseline and after 4, 8, 12, and 16 weeks of training in the RT group. Sixteen weeks of RT was associated with an increase in leg press maximal strength (baseline, 285 +/- 48 kg; after 16 weeks, 367 +/- 47 kg; p <0.05) and bench press maximal strength (baseline, 59 +/- 11 kg; after 16 weeks, 69 +/- 11 kg; p <0.05). No change in leg press maximal strength (baseline, 291 +/- 59 kg; after 16 weeks, 290 +/- 53 kg; p >0.05) or bench press maximal strength (baseline, 60 +/- 9 kg; after 16 weeks, 61 +/- 13 kg; p > .05) was found in control subjects during the same time. RT was not associated with changes in LV cavity size, wall thickness, mass, or systolic function after 4, 8, 12, and 16 weeks of exercise. Thus, 16 weeks of RT was sufficient to increase leg press and bench press maximal strength but did not alter the size or systolic function of the senescent left ventricle.
The American Journal of Cardiology 04/2000; 85(8):1002-6. · 3.37 Impact Factor
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ABSTRACT: Methods: Medline and Sports Discus databases were searched for relevant articles. Additional articles were found using cross referencing and the authors' knowledge of the subject area.
