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. 2024 Oct 7;13(19):5955.
doi: 10.3390/jcm13195955.

Acute Changes in Myocardial Work during Isometric Exercise in Hypertensive Patients with Ischemic Heart Disease: A Case-Control Study

Giuseppe Caminiti  1   2 , Maurizio Volterrani  1   2 , Ferdinando Iellamo  3 , Giuseppe Marazzi  2 , Valentino D'Antoni  2 , Camilla Calandri  3 , Sara Vadalà  2 , Matteo Catena  2 , Deborah Di Biasio  2 , Vincenzo Manzi  4 , Valentina Morsella  2 , Marco Alfonso Perrone  3
Affiliations

Acute Changes in Myocardial Work during Isometric Exercise in Hypertensive Patients with Ischemic Heart Disease: A Case-Control Study

Giuseppe Caminiti et al. J Clin Med. .

Abstract

Background: The acute hemodynamic response to isometric exercise in hypertensive patients' ischemic heart disease (IHD) has been poorly investigated. The aim of this study was to assess acute changes in left ventricular myocardial work (MW) during isometric bilateral knee extension in patients with IHD. Methods: Twenty stable hypertensive patients with IHD and ten healthy, age-matched controls (HC) were enrolled. All subjects performed an isometric knee extension exercise at 30% of their maximal voluntary contraction. The effort was maintained for three minutes or until exhaustion. At baseline, at peak exercise, and after 10 min of recovery, echocardiography evaluation was performed and blood pressure (BP) and heart rate (HR) were measured. Results: The exercise was well tolerated by all subjects. At peak exercise, systolic BP in the IHD was significantly higher than HC (37.6 ± 7.2 vs. 8.4 ± 2.3 mmHg; p 0.002). The HC group had a greater increase in HR than IHD (19.7 ± 6.2 vs. 8.4 ± 2.2 bpm; p 0.009). The E/E' ratio increased in IHD and was unchanged in the control group. The global work index increased significantly in IHD compared to HC (+15% vs. +3%; p 0.026). Global constructive work increased significantly in IHD compared to HC (+29.8% vs. +7.4 respectively, p 0.031). Global wasted work increased by 92.3% in IHD and was unchanged in HC. The global work efficiency decreased in IHD (-18%), but was unchanged in HC (between-groups p 0.019). Stroke volume decreased in IHD and was unchanged in HC. Cardiac output was unchanged in IHD, while it increased in HC. Conclusion: In patients with hypertension and underlying IHD, an acute isometric load causes a great increase in systolic BP and LV filling pressure. It follows a mostly ineffective increase in MW that fails to maintain stroke volume.

Keywords: ischemic heart disease; isometric exercise; myocardial work.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study flowchart. IHD: Ischemic Heart Disease; HC: Healthy Controls; MVC: Maximal Voluntary Contraction.
Figure 2
Figure 2
Percentage changes in GWI, GWC, GWW (2.A), and GWE (2.B) during isometric knee extension (peak exercise vs. rest) in the IHD (black bars) and HC (gray bars) groups. IHD = ischemic heart disease; HC = healthy controls; GWI = global work index; GCW = global constructive work; GWW = global wasted work; GWE = global work efficiency.
Figure 3
Figure 3
Changes in stroke volume (3.A) and cardiac output (3.B) during isometric exercise in the IHD (black line) and HC (gray line) groups.
See this image and copyright information in PMC

References

    1. Pelliccia A., Sharma S., Gati S., Bäck M., Börjesson M., Caselli S., Collet J.P., Corrado D., Drezner J.A., Halle M., et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021;42:17–96. doi: 10.1093/eurheartj/ehaa605. Erratum in Eur. Heart J. 2021, 42, 548–549. - DOI - PubMed
    1. Mancia G., Kreutz R., Brunström M., Burnier M., Grassi G., Januszewicz A., Muiesan M.L., Tsioufis K., Agabiti-Rosei E., Algharably E.A.E., et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA) J. Hypertens. 2023;41:1874–2071. doi: 10.1097/HJH.0000000000003480. - DOI - PubMed
    1. Whelton S.P., Chin A., Xin X., He J. Effect of aerobic exercise on blood pressure: A meta-analysis of randomized, controlled trials. Ann. Intern. Med. 2002;136:493–503. doi: 10.7326/0003-4819-136-7-200204020-00006. - DOI - PubMed
    1. Cornelissen V.A., Fagard R.H., Coeckelberghs E., Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: A meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–958. doi: 10.1161/HYPERTENSIONAHA.111.177071. - DOI - PubMed
    1. López-Valenciano A., Ruiz-Pérez I., Ayala F., Sánchez-Meca J., Vera-Garcia F.J. Updated systematic review and meta-analysis on the role of isometric resistance training for resting blood pressure management in adults. J. Hypertens. 2019;37:1320–1333. doi: 10.1097/HJH.0000000000002022. - DOI - PubMed

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