Exercise reveals impairments in left ventricular systolic function in patients with metabolic syndrome

Abstract

MetS is the manifestation of a cluster of cardiovascular (CV) risk factors and is associated with a three-fold increase risk of CV morbidity and mortality, which is suggested to be mediated, in part, by resting left ventricular (LV) systolic dysfunction. However, to what extent resting LV systolic function is impaired in MetS is controversial, and there are no data indicating whether LV systolic function is impaired during exercise. Accordingly, the objective of this study was to comprehensively examine LV and arterial responses to exercise in MetS individuals without diabetes and/or overt CVD compared to a healthy control population. CV function was characterized using Doppler echocardiography and gas exchange in MetS (n=27) vs. healthy controls (n=20) at rest and during peak exercise. At rest, MetS individuals displayed normal LV systolic function but reduced LV diastolic function vs. healthy controls. During peak exercise, individuals with MetS had impaired contractility; pump performance, and vasodilator reserve capacity vs. controls. A blunted contractile reserve response resulted in diminished arterial-ventricular coupling reserve and limited aerobic capacity in MetS vs. controls. These findings possess clinical importance as they provide insight to the pathophysiological changes in MetS that may predispose this population of individuals to an increased risk of CV morbidity and mortality.

Ventricular-Arterial Coupling in Breast Cancer Patients After Treatment With Anthracycline-Containing Adjuvant Chemotherapy

“…In the present study, Ees was normal at rest; however, the typical exercise-induced increase was attenuated at moderate intensities (i.e., 50% and 75% In the present study, as exercise intensity increased from rest to 75% W max , control subjects reduced Ea/Ees by 42%, similar to the findings from previous studies of healthy individuals (aged 40-70 years) [24,25]. However, the reduction in Ea/Ees in survivors was only 28% and was considerably attenuated compared with that observed in healthy aging [24,25]. This inability to appropriately reduce Ea/Ees in response to exercise stress occurred in the presence of a preserved stroke volume.…”

“…It is well-established that Anth-C directly injures the myocardium [22], which induces structural changes that can perturb myocardial contractile function beyond that commonly seen with aging [23]. In the present study, Ees was normal at rest; however, the typical exercise-induced increase was attenuated at moderate intensities (i.e., 50% and 75% In the present study, as exercise intensity increased from rest to 75% W max , control subjects reduced Ea/Ees by 42%, similar to the findings from previous studies of healthy individuals (aged 40-70 years) [24,25]. However, the reduction in Ea/Ees in survivors was only 28% and was considerably attenuated compared with that observed in healthy aging [24,25].…”

“…Pressure and flow were not measured directly in the present study, instead, these were estimated using noninvasive surrogates. These measures, however, have been validated at rest [18] and have been used in multiple disease populations during exercise [24,25], yielding similar results to those shown in the present study.…”

Effects of Shallow Water Aerobic Exercise Training on Arterial Stiffness and Pulse Wave Analysis in Older Individuals

“…Structural changes to the large elastic arteries such as increased fibrosis, collagen deposition along with collagen crosslinking, and a reduction in elastin content and integrity, increase the stiffness of the arteries (Dao, Essalihi, Bouvet, & Moreau, 2005;Zieman, Melenovsky, & Kass, 2005). Such changes are evident with aging even in the absence of cardiovascular disease (CVD) (AlGhatrif et al, 2013;Vaitkevicius et al, 1993); however, the degree of arterial stiffening with aging is exacerbated in the presence of CVD (Fournier et al, 2014;Scuteri et al, 2014). Arterial stiffness (AS) can be measured noninvasively as pulse wave velocity and used to characterize the cardiovascular risk for a given individual.…”

“…Land-based aerobic exercise training has been shown to effectively improve AS in healthy individuals and in patients with CVD (Currie, Thomas, & Goodman, 2009;Donley et al, 2014;Moreau, Donato, Seals, DeSouza, & Tanaka, 2003;Hirofumi Tanaka, DeSouza, & Seals, 1998;Tanaka et al, 2000). Further, aquatic-based exercise training (swimming) has been shown to improve arterial compliance and blood pressure (Nualnim et al, 2012).…”