Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming; Teisner, Ane Søgaard; Nielsen, Henrik

doi:10.1080/14017430802593427

Cited by 11 publications

(7 citation statements)

References 26 publications

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“…However, the responses of specific APPs—such as AGP and haptoglobin—to exercise training and/or diet have been studied. Prescott and colleagues showed no change in AGP following 8 weeks of exercise in elderly heart failure patients [56]. However, they also reported no change in body composition or aerobic fitness, supporting the premise that changes in body composition, particularly visceral adiposity, mediate the observed exercise-induced changes in APPs.…”

Section: Discussionmentioning

confidence: 92%

Association of the Composite Inflammatory Biomarker GlycA, with Exercise‐Induced Changes in Body Habitus in Men and Women with Prediabetes

Bartlett

Slentz

Connelly

et al. 2017

Oxidative Medicine and Cellular Longevity

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GlycA is a new composite measure of systemic inflammation and a predictor of many inflammatory diseases. GlycA is the nuclear magnetic resonance spectroscopy-derived signal arising from glucosamine residues on acute-phase proteins. This study aimed to evaluate how exercise-based lifestyle interventions modulate GlycA in persons at risk for type 2 diabetes. GlycA, fitness, and body habitus were measured in 169 sedentary adults (45–75 years) with prediabetes randomly assigned to one of four six-month exercise-based lifestyle interventions. Interventions included exercise prescription based on the amount (energy expenditure (kcal/kg weight/week (KKW)) and intensity (%VO2peak). The groups were (1) low-amount/moderate-intensity (10KKW/50%) exercise; (2) high-amount/moderate-intensity (16KKW/50%) exercise; (3) high-amount/vigorous-intensity (16KKW/75%) exercise; and (4) a Clinical Lifestyle (combined diet plus low-amount/moderate-intensity exercise) intervention. Six months of exercise training and/or diet-reduced GlycA (mean Δ: −6.8 ± 29.2 μmol/L; p = 0.006) and increased VO2peak (mean Δ: 1.98 ± 2.6 mL/kg/min; p < 0.001). Further, visceral (mean Δ: −21.1 ± 36.6 cm2) and subcutaneous fat (mean Δ: −24.3 ± 41.0 cm2) were reduced, while liver density (mean Δ: +2.3 ± 6.5HU) increased, all p < 0.001. When including individuals in all four interventions, GlycA reductions were associated with reductions in visceral adiposity (p < 0.03). Exercise-based lifestyle interventions reduced GlycA concentrations through mechanisms related to exercise-induced modulations of visceral adiposity. This trial is registered with Clinical Trial Registration Number NCT00962962.

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Section: Discussionmentioning

confidence: 92%

Association of the Composite Inflammatory Biomarker GlycA, with Exercise‐Induced Changes in Body Habitus in Men and Women with Prediabetes

Bartlett

Slentz

Connelly

et al. 2017

Oxidative Medicine and Cellular Longevity

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“…10 The greatest training effects were found in 2 studies by Kemppainen et al, 11 , 12 using the euglycemic hyperinsulinemic clamp technique to assess insulin resistance, but these studies were not randomized and their results could not be confirmed by Sabelis et al 13 Furthermore, training studies reporting fasting venous blood samples are inconsistent, with predominantly nonsignificant effects. [11][12][13][14][15][16][17][18][19][20] To our knowledge, there are no studies investigating the effect of exercise training on glucose tolerance in CHF, using a 2-hour oral glucose tolerance test (OGTT) in combination with glycated hemoglobin (HbA1c), which are the recommended screening tools for (pre)diabetes in a clinical setting. 4 In addition, it is not known whether exercise-induced improvements in glucose regulation are necessarily related to changes in peak oxygen uptake, muscular fitness, fat mass, and/or lean tissue mass in this population.…”

mentioning

confidence: 99%

Exercise Training Improves Insulin Release During Glucose Tolerance Testing in Stable Chronic Heart Failure Patients

Stevens

Hansen

Herbots

et al. 2015

Journal of Cardiopulmonary Rehabilitation and Prevention

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“…In an older group (mean age was 68.2 (± SD 11.3) years), a similar study also showed no significant changes in serological markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and urine albumin/creatinine), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1). Despite the absence of such changes, marked improvements in physical fitness/functional capacity (workload, 6-min walk test, incremental shuttle walk test and sit-to-stand test) were documented [72]. Such changes could be attributed to improvements in muscle strength and coordination and an enhanced sense of well-being derived from the psychological support provided by formal training programs.…”

Section: Effect Of Training On Neurohumoral Changesmentioning

confidence: 95%

Exercise and heart failure in the elderly

Kappagoda

Amsterdam

2012

Heart Fail Rev

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In this review, we will examine the physiological responses to exercise in elderly populations (age > 65 years) with and without evidence of heart failure. Aging per se in both men and women is associated with a ~40% lower maximum oxygen consumption in sedentary subjects. In trained individuals, this value is 25-32% lower. A smaller SV accounts for nearly 50% of these age-related differences, and the remainder is explained by a lower maximal HR and reduced oxygen extraction. Exercise training is also associated with an increase in the arteriovenous O(2) difference in previously sedentary elderly men and women, which probably contributes to the overall beneficial effect of training in the elderly. However, during vigorous exercise (125 W), the cardiac output in the elderly is dependent upon an age-related increase in end-diastolic volume and stroke volume, which "compensates" partially for the age-related decrease in heart rate. Hence, in elderly individuals, the stroke volume during exercise depends upon diastolic filling. The changes that occur in the heart are also associated with an overall reduction in efferent sympathetic nerve activity. Despite this decline, the metaboreflex initiated by receptors in exercising muscles remains the main determinant of sympathetic activation (to maintain blood pressure) during exercise in the elderly. It is recognized that aging is associated with the development of heart failure, particularly in women in whom its prevalence increases >twofold from age 65-69 (6.6%) to age 85 years (14%). Almost half the people presenting with heart failure appear to have normal left ventricular systolic function, a phenomenon that is more common in women. Exercise training in elderly people with and without heart failure appears to have a beneficial effect in terms of enhancing the quality of life and functional capacity. Mortality benefit in the latter has not been established with certainty.

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Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

Abstract: The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF-patients are needed.

Cited by 11 publications

References 26 publications

Association of the Composite Inflammatory Biomarker GlycA, with Exercise‐Induced Changes in Body Habitus in Men and Women with Prediabetes

Association of the Composite Inflammatory Biomarker GlycA, with Exercise‐Induced Changes in Body Habitus in Men and Women with Prediabetes

Exercise Training Improves Insulin Release During Glucose Tolerance Testing in Stable Chronic Heart Failure Patients

Exercise and heart failure in the elderly

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