Arterial Ventricular Uncoupling With Age and Disease and Recoupling With Exercise

Chantler, Paul D.

doi:10.1249/jes.0000000000000100

Cited by 17 publications

(12 citation statements)

References 52 publications

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“…Vascular modulation associated with physical exercise induced changes in the interaction of LV with the aorta, as measured by VAC, as previously demonstrated [39]. The significant improvement of this parameter observed in Group 2 indicates a better coupling of the LV with the aorta, contributing to an optimization of the performance of the LV, thus improving the SW, decreasing the energy expenditure, and translating into an overall better energy efficiency in LV mechanics [14][15][16]34,39]. The changes in the LVwe parameter is also in line with this positive modulation of cardiac efficiency provided by physical training in the elderly, emphasizing the improvement in cardiac performance.…”

Section: Discussionsupporting

confidence: 72%

Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study

Pereira¹,

Cipriano²,

Castanheira³

2020

Artery Res

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Introduction:This study was aimed at evaluating the changes in the Ventricular-Arterial Coupling (VAC) of old adults after the implementation of a multidisciplinary intervention program comprising a tailored physical exercise component. Methods:A non-randomized pilot study, enrolling 21 old adults with age above 65 years of age (mean 81.08 years). The participants were divided into two groups (Group 1 and 2), both subject to a baseline thorough and multidisciplinary diagnostic evaluation. A tailored intervention program was implemented for a period of 3 months, after which the participants were re-evaluated. The Group 2 included a component of tailored exercise training and physiotherapy intervention. Central and peripheral Blood Pressure (BP) and hemodynamic parameters related to cardiovascular efficiency were evaluated by transthoracic echocardiography and pulse wave analysis. Self-efficacy for exercise scales as well as handgrip strength and nutritional status were also evaluated at baseline and after intervention.Results: Baseline diagnostic information was similar in both groups. After the intervention, significant changes were observed in Group 2, mainly a reduction in BP, in arterial stiffness and a better cardiovascular efficiency was also depicted, with a decrease in the stroke work and an increase in the VAC, as well as in the left ventricle efficiency parameter. Regarding the indicators of frailty, there was an improvement in handgrip strength and self-efficacy for exercise in Group 2. No significant changes were observed in Group 1. Conclusion:The results of this pilot study highlight the positive modulation provided by a tailored physical exercise approach of the old adult, increasing cardiac efficiency and thus constituting a factor for improving overall well-being. Large randomized trials are needed to further validate these findings.

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Section: Discussionsupporting

confidence: 72%

Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study

Pereira¹,

Cipriano²,

Castanheira³

2020

Artery Res

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“…Maintenance of ventricular-vascular coupling is paramount to cardiovascular efficiency. Instances of altered ventricularvascular coupling have been observed in a myriad of condi- tions in which cardiovascular performance is altered or reduced (17,18,31,32,56,68,73). During exercise in healthy subjects, exercise performance is highly dependent on the efficiency of the cardiovascular system to maintain adequate perfusion of active tissues.…”

Section: Discussionmentioning

confidence: 99%

Muscle metaboreflex-induced increases in effective arterial elastance: effect of heart failure

Mannozzi

Kaur

Spranger

et al. 2020

American Journal of Physiology-Regulatory, Integrative and Comp

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Dynamic exercise elicits robust changes in sympathetic activity in part due to accumulation of metabolites within the active skeletal muscle which activates group III and IV afferents triggering the muscle metaboreflex. This reflex raises cardiac output via tachycardia, increased ventricular contractility, and central blood volume mobilization which improves perfusion to the active skeletal muscle. An important component of maintaining exercise performance is optimal ventricular ‐ vascular coupling which can change with exercise, aging, as well as pathophysiological conditions. The effect of muscle metaboreflex activation (MMA) on ventricular ‐ vascular interactions is unknown. We hypothesized that MMA increases Effective Arterial Elastance (Ea). We utilized two previously published methods of evaluating Ea (End Systolic Pressure / Stroke Volume (M1) and Heart Rate x Vascular Resistance (M2)) at rest, during mild treadmill exercise, and during MMA induced via partial reductions in hindlimb blood flow imposed during exercise. At rest Ea averaged 3.0 ± 0.1 and 3.0 ± 0.2 mmHg/mL for M1 and M2, respectively. With the transition from rest to mild exercise little change in Ea occurred, whereas with subsequent MMA, Ea increased significantly by 33.6% ± 2.7 and 20.5% ± 2.3 for M1 and M2. We conclude that MMA elicits robust increases in Ea which parallel the substantial increases in ventricular performance thereby optimizing ventricular ‐ vascular coupling. Support or Funding Information Supported by HL‐55473, HL‐126706, HL120822 and R25 GM058905 This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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“…Our ventricular-vascular coupling changes appear to be driven by increases in arterial elastance without a concomitant change in ventricular elastance post firefighting. Arterial elastance is not a specific arterial property; instead it reflects the total arterial load imposed on the heart (Chantler 2017). Arterial load is broadly categorized as arterial resistance, compliance and impedance.…”

Section: Discussionmentioning

confidence: 99%

Effect of live-fire training on ventricular-vascular coupling

et al. 2021

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Introduction Cardiovascular events are a leading cause of firefighter duty-related death, with the greatest risk occurring during or shortly after fire suppression activity. Increased cardiovascular risk potentially manifests from detrimental changes in ventricular function, vascular load, and their interaction, described as ventricular-vascular coupling. Purpose To determine the effect of live-fire training on ventricular-vascular coupling. Methods Sixty-eight male (28 ± 7 years, 26.9 ± 3.9 kg/m 2 ) and fifteen female (36 ± 8 years, 24.3 ± 3.9 kg/m 2 ) firefighters completed hemodynamic and cardiac measures before and after 3 h of intermittent live-fire training. Left ventricular function was assessed as ejection fraction (EF) and ventricular elastance (E LV : end systolic pressure [ESP]/end systolic volume) via echocardiography and applanation tonometry-estimated ESP. Vascular load was assessed as arterial elastance (E A : ESP/ stroke volume [SV]). Ventricular-vascular coupling (VVC) was quantified as the ratio of E A to E LV and indexed to body surface area (E A I, E LV I). Results Following firefighting EF decreased (p < 0.01) with no change in E LV I (p = 0.34). SV decreased (p < 0.01) with no change in ESP (p = 0.09), driving a significant increase in E A I (p < 0.01). These changes resulted in a significant increase in the VVC ratio (p < 0.01). ConclusionThe findings suggest that firefighting does not alter ventricular elastance but increases arterial elastance in healthy firefighters, resulting in a mismatch between ventricular and vascular systems. This increase in ventricular-vascular coupling ratio and concomitant reduction in ventricular systolic function may contribute to increased cardiovascular risk following live firefighting.

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Arterial Ventricular Uncoupling With Age and Disease and Recoupling With Exercise

Cited by 17 publications

References 52 publications

Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study

Effects of a Personalized Physical Exercise Program in the Ventricular-arterial Coupling of Older Adults. A Pilot Study

Muscle metaboreflex-induced increases in effective arterial elastance: effect of heart failure

Effect of live-fire training on ventricular-vascular coupling

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