Age-Related Maximum Heart Rate Among Ischemic and Nonischemic Heart Failure Patients Receiving β-Blockade Therapy

Silva, Miguel Morita Fernandes; Bacal, Fernando; Roque, Jean Marcelo; Teixeira-Neto, Iram Soares; Carvas, Nelson; Bocchi, Edimar Alcides; Guimarães, Guilherme Veiga

doi:10.1016/j.cardfail.2012.10.007

Cited by 3 publications

(2 citation statements)

References 41 publications

(25 reference statements)

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“…Nevertheless, the exercise testing would be terminated in the case of a drop in systolic blood pressure more than 10 mmHg from baseline, moderate to severe angina, symptoms (ataxia, dizziness or near-syncope) or signs of poor perfusion (cyanosis or pallor), sustained ventricular tachycardia, frequent episodes of multifocal premature ventricular contractions (PVCs) or triplets of PVCs, ST or QRS changes suggestive of ischemia according to guidelines for exercise testing from the American College of Cardiology and American Heart Association. 21 The test was performed in a controlledtemperature room (21)(22)(23) C) with continuous monitoring of 12-lead electrocardiogram (CardioSoft 6.5; GE Medical Systems IT, Milwaukee, WI, USA) as previously described. 22 After intervention, the CPET was repeated between 24 and 72 h after the last training session at the same period of the day, using the same ramp protocol as the baseline.…”

Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

“…21 The test was performed in a controlledtemperature room (21)(22)(23) C) with continuous monitoring of 12-lead electrocardiogram (CardioSoft 6.5; GE Medical Systems IT, Milwaukee, WI, USA) as previously described. 22 After intervention, the CPET was repeated between 24 and 72 h after the last training session at the same period of the day, using the same ramp protocol as the baseline. All participants were instructed to take all medications on the test day.…”

Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

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Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial

Fernandes-Silva

Guimarães

Rigaud

et al. 2017

Eur J Prev Cardiolog

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Background: In patients with heart failure, inflammation has been associated with worse functional capacity, but it is uncertain whether it could affect their response to exercise training. We evaluated whether inflammatory biomarkers are related to differential effect of exercise on the peak oxygen uptake ( _ VO 2 ) among patients with heart failure. Design: Open, parallel group, randomized controlled trial. Methods: Patients with heart failure and ejection fraction 0.4 were randomized into exercise training or control for 12 weeks. Patients were classified according to: 1) inflammatory biomarkers blood levels, defined as 'low' if both interleukin-6 and tumor necrosis factor-alpha blood levels were below median, and 'high' otherwise; and 2) galectin-3 blood levels, which also reflect pro-fibrotic processes. Results: Forty-four participants (50 AE 7 years old, 55% men, 25% ischemic) were allocated to exercise training (n ¼ 28) or control (n ¼ 16). Exercise significantly improved peak _ VO 2 among participants with 'low' inflammatory biomarkers (3.5 AE 0.9 vs. À0.7 AE 1.1 ml/kg per min, p ¼ 0.006), as compared with control, but not among those with 'high' inflammatory biomarkers (0.4 AE 0.6 vs. À0.2 AE 0.7 ml/kg per min, p ¼ 0.54, p for interaction ¼ 0.009). Similarly, exercise improved peak _ VO 2 among participants with below median (2.4 AE 0.8 vs. À0.3 AE 0.9 ml/kg per min, p ¼ 0.032), but not among those with above median galectin-3 blood levels (0.3 AE 0.7 vs. À0.7 AE 1.0 ml/kg per min, p ¼ 0.41, p for interaction ¼ 0.053). Conclusion: In patients with heart failure, levels of biomarkers that reflect pro-inflammatory and pro-fibrotic processes were associated with differential effect of exercise on functional capacity. Further studies should evaluate whether exercise training can improve clinical outcomes in patients with heart failure and low levels of these biomarkers.

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Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial

Fernandes-Silva

Guimarães

Rigaud

et al. 2017

Eur J Prev Cardiolog

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Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: Possible impact in clinical decision-making?

Ciolac

Bocchi²,

Fernandes-Silva³

et al. 2013

Cardiol J

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Alternatives to Aerobic Exercise Prescription in Patients with Chronic Heart Failure

Oliveira¹,

Zanussi²,

Sprovieri³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundExercise is essential for patients with heart failure as it leads to a reduction in morbidity and mortality as well as improved functional capacity and oxygen uptake (⩒O2). However, the need for an experienced physiologist and the cost of the exam may render the cardiopulmonary exercise test (CPET) unfeasible. Thus, the six-minute walk test (6MWT) and step test (ST) may be alternatives for exercise prescription.ObjectiveThe aim was to correlate heart rate (HR) during the 6MWT and ST with HR at the anaerobic threshold (HRAT) and peak HR (HRP) obtained on the CPET.MethodsEighty-three patients (58 ± 11 years) with heart failure (NYHA class II) were included and all subjects had optimized medication for at least 3 months. Evaluations involved CPET (⩒O2, HRAT, HRP), 6MWT (HR6MWT) and ST (HRST).ResultsThe participants exhibited severe ventricular dysfunction (ejection fraction: 31 ± 7%) and low peak ⩒O2 (15.2 ± 3.1 mL.kg-1.min-1). HRP (113 ± 19 bpm) was higher than HRAT (92 ± 14 bpm; p < 0.05) and HR6MWT (94 ± 13 bpm; p < 0.05). No significant difference was found between HRP and HRST. Moreover, a strong correlation was found between HRAT and HR6MWT (r = 0.81; p < 0.0001), and between HRP and HRST (r = 0.89; p < 0.0001).ConclusionThese findings suggest that, in the absence of CPET, exercise prescription can be performed by use of 6MWT and ST, based on HR6MWT and HRST

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Age-Related Maximum Heart Rate Among Ischemic and Nonischemic Heart Failure Patients Receiving β-Blockade Therapy

Cited by 3 publications

References 41 publications

Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial

Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial

Effects of age on aerobic capacity in heart failure patients under beta-blocker therapy: Possible impact in clinical decision-making?

Alternatives to Aerobic Exercise Prescription in Patients with Chronic Heart Failure

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