The Influence of Exercise on Cardiovascular Health in Sedentary Adults With Human Immunodeficiency Virus

Webel, Allison R.; Perazzo, Joseph; Longenecker, Christopher T.; Jenkins, Trevor; Sattar, Abdus; Rodriguez, Margaret; Schreiner, Nate

doi:10.1097/jcn.0000000000000450

Cited by 18 publications

(12 citation statements)

References 44 publications

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“…We initially identified substantially impaired maximal exercise capacity (VO 2 peak and VCO 2 ) in this HIV patient population with mild subjective dyspnea. This is well described and has been noted by us and others [ 21 , 22 ]. Given the impairment of peak VO 2 capacity, we systemically interrogated for cardiac causes of dyspnea.…”

Section: Discussionsupporting

confidence: 86%

Evaluation of dyspnea of unknown etiology in HIV patients with cardiopulmonary exercise testing and cardiovascular magnetic resonance imaging

Patterson

Sarode

Al‐Kindi

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Aim Human Immunodeficiency Virus (HIV) patients commonly experience dyspnea for which an immediate cause may not be always apparent. In this prospective cohort study of HIV patients with exercise limitation, we use cardiopulmonary exercise testing (CPET) coupled with exercise cardiovascular magnetic resonance (CMR) to elucidate etiologies of dyspnea. Methods and results Thirty-four HIV patients on antiretroviral therapy with dyspnea and exercise limitation (49.7 years, 65% male, mean absolute CD4 count 700) underwent comprehensive evaluation with combined rest and maximal exercise treadmill CMR and CPET. The overall mean oxygen consumption (VO2) peak was reduced at 23.2 ± 6.9 ml/kg/min with 20 patients (58.8% of overall cohort) achieving a respiratory exchange ratio > 1. The ventilatory efficiency (VE)/VCO2 slope was elevated at 36 ± 7.92, while ventilatory reserve (VE: maximal voluntary ventilation (MVV)) was within normal limits. The mean absolute right ventricular (RV) and left ventricular (LV) contractile reserves were preserved at 9.0% ± 11.2 and 9.4% ± 9.4, respectively. The average resting and post-exercise mean average pulmonary artery velocities were 12.2 ± 3.9 cm/s and 18.9 ± 8.3 respectively, which suggested lack of exercise induced pulmonary artery hypertension (PAH). LV but not RV delayed enhancement were identified in five patients. Correlation analysis found no relationship between peak VO2 measures of contractile RV or LV reserve, but LV and RV stroke volume correlated with PET CO2 (p = 0.02, p = 0.03). Conclusion Well treated patients with HIV appear to have conserved RV and LV function, contractile reserve and no evidence of exercise induced PAH. However, we found evidence of impaired ventilation suggesting a non-cardiopulmonary etiology for dyspnea.

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Section: Discussionsupporting

confidence: 86%

Evaluation of dyspnea of unknown etiology in HIV patients with cardiopulmonary exercise testing and cardiovascular magnetic resonance imaging

Patterson

Sarode

Al‐Kindi

et al. 2020

Journal of Cardiovascular Magnetic Resonance

Self Cite

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“…Physical activity was assessed using Actigraph GT3X+ accelerometers (Actigraph LLC, Pensacola, FL), which have been used in multiple studies of physical activity in patients with medical illness (Kelly et al, 2013; Webel et al, 2017). Participants wore the accelerometer for one week at the start of the intervention (baseline) and again following completion of the intervention (10 weeks).…”

Section: Data Collection and Outcomesmentioning

confidence: 99%

A Positive Psychology Intervention to Promote Health Behaviors in Heart Failure

Celano¹,

Freedman

Beale

et al. 2018

J Nerv Ment Dis

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Patients with heart failure (HF) frequently struggle to adhere to health behaviors, and psychological factors may contribute to nonadherence. We examined the feasibility and acceptability of a 10-week, positive psychology-(PP-) based intervention to promote health behavior adherence in patients (N=10) with mild to moderate HF and suboptimal health behavior adherence. Participants engaged in weekly phone sessions, completed PP exercises (e.g., writing a gratitude letter, using a personal strength), and set goals related to diet, medication adherence, and physical activity. Feasibility was assessed by the number of sessions completed, and acceptability by participant ratings of ease and utility. Preliminary efficacy was measured by changes in psychological and adherence outcomes. The intervention was feasible (87% of exercises completed) and acceptable. Furthermore, in exploratory analyses, the intervention was associated with improvements in psychological and health behavior adherence outcomes. Larger, randomized trials are needed to further investigate the utility of this intervention.

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“…This improvement caused the life expectancy of HIV patients and transformed HIV infection from an acute to a chronic disease [ 3 ]. However, the toxic side-effects of ART, long-term infection with HIV, the increased predisposition to obesity, and visceral adiposity have made PLWH more vulnerable to develop comorbidities, such as cardiovascular disease [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Physical activity level and associated factors among adult HIV patients in Ethiopia

et al. 2022

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Background People living with HIV, who take antiretroviral therapy (ART), often enjoy long and healthy lives, but this therapy has well known metabolic adverse effects. Physical activity is found to be an important factor in improving these physiological parameters. This study aimed to determine physical activity level and associated factors among HIV patients in Ethiopia. Methods An institutional based cross sectional study was conducted from May to June 2019. We selected a total of 422 adult HIV patients, attending antiretroviral therapy clinics in three selected hospitals in Southern Ethiopia. Data were collected at routine care consultations by nine trained nurses using a pre-tested structured questionnaire. The level of physical activity was measured by the international physical activity questionnaire (IPAQ). Result The mean age of participants was 38.7 ± 9.13 years. Of the participants, 68% were physically inactive, with a higher proportion of inactive women (74%) than men (61%) [(AOR = 1.64, 95% CI (1.07, 2.53)]. In addition, urban vs. rural residents [(AOR = 2.57, 95% CI (1.16, 5.72)] and patients who were on ART for ≥ 24 months [(AOR = 1.88, 95% CI (1.15, 3.08)] had higher odds of having a low physical activity level. Conclusion Most people living with HIV and receiving ART have low physical activity levels. Especially female and urban living patients and those with longer treatment duration have low levels of physical activity. More insight is needed on the reasons for physical inactivity among HIV patients and physical activity programs for HIV patients in low-income countries need to be developed.

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The Influence of Exercise on Cardiovascular Health in Sedentary Adults With Human Immunodeficiency Virus

Abstract: Human immunodeficiency virus-positive adults have poor physical activity patterns and diminished cardiovascular health. Future longitudinal studies should examine whether HIV infection blunts the beneficial effects of physical activity on cardiovascular health.

Cited by 18 publications

References 44 publications

Evaluation of dyspnea of unknown etiology in HIV patients with cardiopulmonary exercise testing and cardiovascular magnetic resonance imaging

Evaluation of dyspnea of unknown etiology in HIV patients with cardiopulmonary exercise testing and cardiovascular magnetic resonance imaging

A Positive Psychology Intervention to Promote Health Behaviors in Heart Failure

Physical activity level and associated factors among adult HIV patients in Ethiopia

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