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Unexpected effects of exercise-based cardiac rehabilitation on changes in metabolic, mechanical and neuromuscular responses observed during cardiopulmonary exercise testing
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Archives of Cardiovascular Diseases Supplements (2017) 9,100-105
week in each session, the patient will bike 30 min, 10 min treadmill, 10 min of rowing machine and muscle building a group activity session weekly. An evaluation will be done by ergospirometry at the beginning and at the end of the program to assess the improvement in the ability of patients to the effort.
066 Left atrial function assessment in athletes C. Hedon* (1), S. Cade (1), D. Matelot (2), F. Cransac (1), E. Donal (2), F. Schnell (2), F. Carre (2) (1) CHU Montpellier, Arnaud de Villeneuve, Cardiologie, Montpellier, France – (2) CHU Pontchaillou, Cardiologie et médecine du sport, Rennes, France *Corresponding author: [email protected]
The authors hereby declare no conflict of interest
228 Unexpected effects of exercise-based cardiac rehabilitation on changes in metabolic, mechanical and neuromuscular responses observed during cardiopulmonary exercise testing P. Leprêtre* (2), A. Barnabé (1), L. Gaillard (1)- (4), S. Delanaud (1)- (3), N. Jaunet (4), M. Ghannem (4), T. Porcher (4) (1) Institut d'Ingénierie de la Santé (2IS), UFR de médecine, Amiens, France – (2) Université Jules Verne, EA-3300-UFR STAPS, Laboratoire adaptations physiologiques à l’exercice et réadaptation à l’effort, Amiens, France – (3) CHU Salouël, Laboratoire périnatalité & risques toxiques PERITOX – UMI_01, Amiens, France – (4) Centre de Réadaptation Cardiaque, château d’Ollencourt, Fondation Léopold Bellan, Tracy Le Mont, France *Corresponding author: [email protected] The significant improvement in survival was reported when the changes in maximal tolerated power output (MTP) induced a 3.5 mlO2.min-1.kg-1 increase in peak of oxygen uptake value (VO2peak), which represented a 24 watts increase in cycling power output. Previous studies have also shown that real changes in VO2peak were poorly related to changes in MTP among patients with cardiovascular disease. This result could be due to a difference between cardiopulmonary adaptation to training and the skeletal muscle conditioning, visible through the electromyographic activities of vastus lateralis (EMG). The aim of the study was to compare the responses to exercise training of rmsEMG and respiratory parameters. 9 cardiac patients (64.0±3.1y, 172.9±4.8cm, 83.4±16.3kg, IMC: 27.8±4.5) performed an incremental cycling exercise test until exhaustion to determine MTP, VO2peak and peak values of heart rate (HRpeak), before and after an aerobic training. Ventilatory thresholds were respectively determined as the breakpoint in the curve of carbon dioxide output against oxygen uptake plot (VT1) and the point at which the ratio of minute ventilation to carbon dioxide output starts to increase (VT2). EMGth1 and EMGth2 were defined as the first and the second breakpoints in the rmsEMG – power output relationship. Short-term exercise training (23.7±8.8 days) induced a significant increase in VO2peak (P=0.004) MTP (P=0.015), VT1 (P=0.001) and VT2 (P=0.001). No significant differences (p > 0.05) existed between mean power values of VT1 and EMGth1 (60.5±4.1 vs. 59.2±9.6% of MTP, respectively), or between VT2 and EMGth2 (78.3±5.7 vs. 80.2±5.2% of MTP). Changes in VO2peak only attained the survival criteria (3.5±2.9mL. min-1.kg-1 vs. 23.3±18.7w for MTP). After training, EMGth1 occurred significantly before VT1 (60.5±6.2 vs. 64.8±4.8% of MTP, P=0.049, medium effect size). This might be taken into account for prescribing exercise rehabilitation according initial clinical limitations of patients. The authors hereby declare no conflict of interest
Introduction Athlete’s heart is characterized by a geometrical remodeling of the left atrium (LA). Purpose To evaluate atrial functional remodeling due to training. Methods 61 men aged 18 to 35 years old were included in this bicentric prospective study. 36 athletes (group trained T) training at least 6 hours per week were compared to 25 healthy sedentary subjects (group S). Transthoracic echocardiogram was performed at rest and during a submaximal exercise (110 beats per minute). Results Group T presented a higher LA end-systolic volume (27.5±8.0 vs 18.7±4.7ml/m2, p<0,0001) compared to group S. At rest, LA longitudinal strain analysis showed a lower peak in reservoir phase (39±6 vs 44±6%, p=0.01) and in contraction phase (-12±2 vs -16±4%, p<0.0001) in group T. During exercise, there was no difference between groups for contraction strain but reservoir strain (Figure, A) remained decreased for group T (50±7 vs 57±9%, p=0.022, Figure, B). Conclusion Functional remodeling of LA in athletes was marked by a lower contribution of the contraction phase for left ventricle filling at rest, and a contractile reserve of the same phase during a sub maximal exercise. The lower distensibility observed in athletes during LA reservoir phase is unclear. A compliance reserve for maximal intensity exercise, or a marker of LA wall stiffness can be hypothesized. The authors hereby declare no conflict of interest
381 Arrhythmogenic right ventricular cardiomyopathy or athlete's heart adaptations? A. Zaroui* (1), Z. Rezine (2), R. Mechmeche (3) (1) Institut Pasteur, Tunis, Tunisie – (2) Clinique Pasteur, Tunis, Tunisie – (3) Faculté de Médecine, Cardiologie, Tunis, Tunisie *Corresponding author: [email protected] Background Intensive physical activity is associated with physiologic changes in cardiac morphology. This transformation is more problematic on the right ventricular and the difference with arrhythmogenic right ventricular cardiomyopathy (ARVC) constitutes a recurrent problem.
Abstract 066 – Figure
© Elsevier Masson SAS. All rights reserved.
Archives of Cardiovascular Diseases Supplements (2017) 9,100-105
week in each session, the patient will bike 30 min, 10 min treadmill, 10 min of rowing machine and muscle building a group activity session weekly. An evaluation will be done by ergospirometry at the beginning and at the end of the program to assess the improvement in the ability of patients to the effort.
066 Left atrial function assessment in athletes C. Hedon* (1), S. Cade (1), D. Matelot (2), F. Cransac (1), E. Donal (2), F. Schnell (2), F. Carre (2) (1) CHU Montpellier, Arnaud de Villeneuve, Cardiologie, Montpellier, France – (2) CHU Pontchaillou, Cardiologie et médecine du sport, Rennes, France *Corresponding author: [email protected]
The authors hereby declare no conflict of interest
228 Unexpected effects of exercise-based cardiac rehabilitation on changes in metabolic, mechanical and neuromuscular responses observed during cardiopulmonary exercise testing P. Leprêtre* (2), A. Barnabé (1), L. Gaillard (1)- (4), S. Delanaud (1)- (3), N. Jaunet (4), M. Ghannem (4), T. Porcher (4) (1) Institut d'Ingénierie de la Santé (2IS), UFR de médecine, Amiens, France – (2) Université Jules Verne, EA-3300-UFR STAPS, Laboratoire adaptations physiologiques à l’exercice et réadaptation à l’effort, Amiens, France – (3) CHU Salouël, Laboratoire périnatalité & risques toxiques PERITOX – UMI_01, Amiens, France – (4) Centre de Réadaptation Cardiaque, château d’Ollencourt, Fondation Léopold Bellan, Tracy Le Mont, France *Corresponding author: [email protected] The significant improvement in survival was reported when the changes in maximal tolerated power output (MTP) induced a 3.5 mlO2.min-1.kg-1 increase in peak of oxygen uptake value (VO2peak), which represented a 24 watts increase in cycling power output. Previous studies have also shown that real changes in VO2peak were poorly related to changes in MTP among patients with cardiovascular disease. This result could be due to a difference between cardiopulmonary adaptation to training and the skeletal muscle conditioning, visible through the electromyographic activities of vastus lateralis (EMG). The aim of the study was to compare the responses to exercise training of rmsEMG and respiratory parameters. 9 cardiac patients (64.0±3.1y, 172.9±4.8cm, 83.4±16.3kg, IMC: 27.8±4.5) performed an incremental cycling exercise test until exhaustion to determine MTP, VO2peak and peak values of heart rate (HRpeak), before and after an aerobic training. Ventilatory thresholds were respectively determined as the breakpoint in the curve of carbon dioxide output against oxygen uptake plot (VT1) and the point at which the ratio of minute ventilation to carbon dioxide output starts to increase (VT2). EMGth1 and EMGth2 were defined as the first and the second breakpoints in the rmsEMG – power output relationship. Short-term exercise training (23.7±8.8 days) induced a significant increase in VO2peak (P=0.004) MTP (P=0.015), VT1 (P=0.001) and VT2 (P=0.001). No significant differences (p > 0.05) existed between mean power values of VT1 and EMGth1 (60.5±4.1 vs. 59.2±9.6% of MTP, respectively), or between VT2 and EMGth2 (78.3±5.7 vs. 80.2±5.2% of MTP). Changes in VO2peak only attained the survival criteria (3.5±2.9mL. min-1.kg-1 vs. 23.3±18.7w for MTP). After training, EMGth1 occurred significantly before VT1 (60.5±6.2 vs. 64.8±4.8% of MTP, P=0.049, medium effect size). This might be taken into account for prescribing exercise rehabilitation according initial clinical limitations of patients. The authors hereby declare no conflict of interest
Introduction Athlete’s heart is characterized by a geometrical remodeling of the left atrium (LA). Purpose To evaluate atrial functional remodeling due to training. Methods 61 men aged 18 to 35 years old were included in this bicentric prospective study. 36 athletes (group trained T) training at least 6 hours per week were compared to 25 healthy sedentary subjects (group S). Transthoracic echocardiogram was performed at rest and during a submaximal exercise (110 beats per minute). Results Group T presented a higher LA end-systolic volume (27.5±8.0 vs 18.7±4.7ml/m2, p<0,0001) compared to group S. At rest, LA longitudinal strain analysis showed a lower peak in reservoir phase (39±6 vs 44±6%, p=0.01) and in contraction phase (-12±2 vs -16±4%, p<0.0001) in group T. During exercise, there was no difference between groups for contraction strain but reservoir strain (Figure, A) remained decreased for group T (50±7 vs 57±9%, p=0.022, Figure, B). Conclusion Functional remodeling of LA in athletes was marked by a lower contribution of the contraction phase for left ventricle filling at rest, and a contractile reserve of the same phase during a sub maximal exercise. The lower distensibility observed in athletes during LA reservoir phase is unclear. A compliance reserve for maximal intensity exercise, or a marker of LA wall stiffness can be hypothesized. The authors hereby declare no conflict of interest
381 Arrhythmogenic right ventricular cardiomyopathy or athlete's heart adaptations? A. Zaroui* (1), Z. Rezine (2), R. Mechmeche (3) (1) Institut Pasteur, Tunis, Tunisie – (2) Clinique Pasteur, Tunis, Tunisie – (3) Faculté de Médecine, Cardiologie, Tunis, Tunisie *Corresponding author: [email protected] Background Intensive physical activity is associated with physiologic changes in cardiac morphology. This transformation is more problematic on the right ventricular and the difference with arrhythmogenic right ventricular cardiomyopathy (ARVC) constitutes a recurrent problem.
Abstract 066 – Figure
© Elsevier Masson SAS. All rights reserved.