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- Title
Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients.
- Authors
Kirsch, Marine; Vitiello, Damien; Trachsel, Lukas‐Daniel; Boidin, Maxime; Lalongé, Julie; Juneau, Martin; Bherer, Louis; Nigam, Anil; Gayda, Mathieu
- Abstract
Background: In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake (V̇$$ \dot{\mathrm{V}} $$O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non‐responder (NR) CHD patients. Methods: A total of 72 CHD patients completed a 3‐month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: V̇$$ \dot{\mathrm{V}} $$O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in V̇$$ \dot{\mathrm{V}} $$O2peak (>the median for R and ≤the median for NR). Results: In the R group, V̇$$ \dot{\mathrm{V}} $$O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, V̇$$ \dot{\mathrm{V}} $$O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (−19% in R and −11% in NR, p < 0.001). Conclusion: Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.
- Subjects
CORONARY disease; RESEARCH funding; VENTRICULAR remodeling; EXERCISE therapy; HEMODYNAMICS; ERGOMETRY; DESCRIPTIVE statistics; PATIENT-centered care; CARDIOPULMONARY system; CARDIOGRAPHY; HEART beat; PHYSICAL fitness; OXYGEN consumption; EXERCISE tests; PHENOTYPES; CARDIAC rehabilitation
- Publication
Scandinavian Journal of Medicine & Science in Sports, 2024, Vol 34, Issue 4, p1
- ISSN
0905-7188
- Publication type
Article
- DOI
10.1111/sms.14633