Document Detail

Effects of physical training on cardiovascular control after heart transplantation.
MedLine Citation:
PMID:  17050012     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise performance in heart-transplanted patients increases with respect to pre-transplantation but remains subnormal, and it does not improve with time after surgery. Possible causes include persisting denervation, and sympathetic vasoconstriction inducing functional vascular abnormalities that prevent adequate increase in blood flow to the exercising limbs. We tested the effects of physical training on baroreceptors-mediated control of heart rate and blood pressure in recently heart-transplanted subjects. METHODS: Patients were randomly allocated to physical training (n=13, 30 min cycling at 60-70% of peak oxygen consumption for 5 days/week for 6 months) or to control (n=11). Upright exercise test to exhaustion was performed at the beginning of the study after 3 and 6 months. Reflex changes in RR interval and blood pressure in response to sinusoidal neck suction (6 and 12 cycles/min 0 to -30 mm Hg swing) were considered as evidence of reinnervation and baroreflex control of blood pressure, respectively. RESULTS: After 6 months peak oxygen consumption (p<0.001), exercise time (p<0.01) and workload (p<0.01) increased in trained patients. Before training RR interval and blood pressure were not modified by neck suction. After physical training systolic (p<0.01) and diastolic blood pressure decreased, RR interval and blood pressure could be modulated (p<0.05) by slow (6 cycles/min) neck suction, indicating initial cardiac sympathetic reinnervation and restored sensitivity to autonomic modulation on the arteries. No changes were observed in controls. CONCLUSIONS: Physical training improved exercise performance and the control exerted by the autonomic nervous system through the sympathetic nerves at both cardiac and vascular level.
Luciano Bernardi; Alberto Radaelli; Claudio Passino; Colomba Falcone; Carla Auguadro; Luigi Martinelli; Mauro Rinaldi; Mario Viganò; Giorgio Finardi
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-10-16
Journal Detail:
Title:  International journal of cardiology     Volume:  118     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-08     Completed Date:  2007-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  356-62     Citation Subset:  IM    
Department of Internal Medicine, IRCCS Policlinico S Matteo, University of Pavia, Italy. <>
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MeSH Terms
Blood Pressure Determination
Exercise / physiology*
Exercise Tolerance / physiology
Follow-Up Studies
Heart Rate / physiology
Heart Transplantation / methods*,  rehabilitation*
Middle Aged
Oxygen Consumption / physiology
Physical Endurance / physiology*
Postoperative Care
Pressoreceptors / physiology
Pulmonary Gas Exchange
Reference Values
Risk Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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